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The rate of induction of labour has increased over the decades and numerous medications are available in the market. This study compares the efficacy and safety between dinoprostone slow-release pessary (Propess) and dinoprostone tablet (Prostin) for labour induction at term in nulliparous women. This was a prospective single-blind randomized controlled trial conducted in a tertiary medical centre in Taiwan from September 1, 2020 to February 28, 2021. We recruited nulliparous women at term with a singleton pregnancy, fetus in cephalic presentation, an unfavourable cervix, and the cervical length had been measured by transvaginal sonography three times during labour induction. The main outcomes are duration from induction of labour to vaginal delivery, vaginal delivery rate, maternal and neonatal complication rates. In both groups, Prostin and Propess, 30 pregnant women were enrolled. The Propess group had higher vaginal delivery rate but it did not meet statistically significant difference. The Prostin group had significantly higher rate of adding oxytocin for augmentation (p = 0.0002). No significant difference was observed in either labouring course, maternal or neonatal outcomes. The probability of vaginal delivery was independently related to the cervical length measured by transvaginal sonography 8 h after Prostin or Propess administration as well as neonatal birth weight. Both Prostin and Propess can be used as cervical ripening agents with similar efficacy and without significant morbidity. Propess administration was associated with higher vaginal delivery rate and less need to add oxytocin. Intrapartum measurement of cervical length is helpful in predicting successful vaginal delivery. [ABSTRACT FROM AUTHOR]

Background: Preterm premature rupture of membranes (PPROM) is one of the most common causes of preterm birth. Antibiotic treatment is recommended to prolong the pregnancy course and reduce fetal morbidity in women with PPROM. However, the guidelines for antibiotic selection are based on studies done years ago, mostly in Western countries, which may not reflect the geographic, temporal, and ethnic variation in microbial colonization and infection in other parts of the world. We aimed to understand whether the antibiotics recommended by the current guidelines were sufficient to eradicate the majority of pathogens involved.Methods: This is a single-center retrospective study at a tertiary medical center in Taiwan with patients recruited from January 1, 2017, to December 31, 2019. All patient included had a confirmed diagnosis of PPROM. In this study, we aimed to investigate which broad-spectrum antibiotic was most suitable for PPROM cases in Taiwan.Results: 133 women were included, and 121 women had positive culture results. Most of the pregnant women had one positive result (35.5%). The most common pathogen was Lactobacillus species (27.8%), followed by Streptococcus species (12.9%) and Staphylococcus species (12.09%).Conclusion: The most appropriate antibiotic therapy for PPROM was a combination of 1 g azithromycin given orally on admission plus a third-generation cephalosporin administered intravenously in the first 48 hours and followed by amoxicillin 500 mg per os for another five days. This recommended antibiotic regimen for women with PPROM needs further study under a randomized clinical trial with a larger study population to evaluate its efficacy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of adding carbetocin to regular uterotonic agents for prevention of postpartum hemorrhage (PPH) after cesarean section for twin pregnancies.Methods: This is a retrospective uncontrolled before-after study done in a tertiary center in Taiwan, 2010-2017. Women with twin pregnancies that underwent cesarean section were enrolled. The control group (n = 114) received oxytocin infusion and direct uterine injection. In addition to these, the study group (n = 127) received 100ug of intravenous carbetocin. Primary endpoint was the change in hemoglobin. Secondary endpoints included risk of PPH and undiagnosed PPH (Hb dropped more than 2 g/dL), blood loss, the need for additional uterotonic maneuvers, and blood transfusion. Hemodynamic changes were also investigated.Results: After adjusting for confounding factors, the change in Hb (0.35 g/dL, 95% CI: -0.03∼0.74) and incidence of PPH (OR 0.30, 95% CI: 0.03∼3.28) were comparable in both groups. However, women with undiagnosed PPH decreased (OR 0.43, 95% CI:0.22∼0.85). Total blood loss in 24 h after delivery also decreased (-40.33 mL, 95%CI: -80.32∼ -0.34). The use of extra uterotonic medications and the need for blood transfusion did not differ. The systolic blood pressure 4 h after childbirth was higher in the carbetocin group (6.71, 95% CI: 2.27∼11.15).Conclusion: The use of carbetocin in addition to regular uterotonic agents decreased total blood loss and undiagnosed PPH. Also, systolic blood pressure 4 h after childbirth is higher in the carbetocin group. There was no significant difference in hemoglobin change and risk of PPH. [ABSTRACT FROM AUTHOR]

The influence of differential chemical weathering intensity on the contents and spatial distribution of highly reactive iron (Fe HR) in the marginal sea sediments is not well documented. Here, we used sequential extractions to quantify various Fe pools in offshore surface sediments of the northern South China Sea (nSCS), which receives multiple fluvial sediments with distinct chemical weathering intensity, and then to unravel whether and if so, to what extent, the contents and spatial distributions of Fe HR are linked to chemical index of alternation (CIA) of the sediments. Our results show that, despite the inputs of Fe HR -rich, highly chemically weathered fluvial sediments, Fe HR contents in offshore sediments of the nSCS are almost independent of the CIA values, and Fe HR was not enriched relative to the global average of Fe HR in oxic sediments, probably due to effective trapping of Fe HR in the estuary and dilution by moderately chemically weathered Taiwan-sourced sediments. Our results indicate that the signature of Fe HR enrichment previously observed in the offshore sediments, which are discharged from a highly chemically weathered mountainous island (Hainan Island) of the nSCS, becomes lost beyond the local zone around the island. Relative to the marginal sediments of the nSCS (water depth <1000 m), the higher Fe HR contents in the deep-water sediments (water depth larger than 1000 m) can be attributed to higher smectite contents, lower inorganic carbon contents, and low dilution by Taiwan-sourced fluvial material in the deep-water area. A comparison of the subtropical nSCS and the temperate East China Sea indicates that chemical weathering intensity is not the overarching factor governing Fe HR /Fe T ratios in the two climatically different regions, though chemical weathering intensity along with depositional/diagenetic regimes is an important factor controlling the sizes and transformation of some specific Fe HR pools. • Reactive Fe (Fe HR) enriched by chemical weathering is restricted to local zone. • Chemical weathering intensity has minor effect on Fe HR content in offshore sediment. • Sediment sources, sorting, and depositional/diagenetic regimes impact Fe HR and CIA. [ABSTRACT FROM AUTHOR]

Abstract: This study documented the reproductive performance of 210 adult female Formosan sambar deer (FSD, Cervus unicolor swinhoei) from four semi-domesticated deer herds in Taiwan. An extensive analysis of 525 reproductive records from 2000 to 2008, including the conditions of estrus, gestation, and parturition was conducted. The mean±S.E.M. lengths of the estrous cycle, gestation, and fawning interval were 18.2±0.5d (n =56), 258.6±0.3d (n =160), and 369.9±2.3d (n =122), respectively. Hand breeding was performed between June and December (n =494), with the majority (93.1%) occurring between July and October (P <0.05). Fawning occurred from February to September (n =318), and most frequently (83.0%) between April and June (P <0.05). Pregnancy rate per mating in FSD hinds was 64.4%. There was a 1.3:1 male-to-female ratio at birth (P <0.05) among 320 fawns, and only two cases of twinning (0.63%). The postnatal mortality rate was 6.6% (21/320), and the mortality rate in fawns before weaning did not exceed 8% on any farm. Fecundity was enhanced by high pregnancy rates and high offspring survival rates. This study provides baseline information on reproductive performance of FSD, which should be valuable to veterinarians and deer industry personnel for management of FSD on farms in subtropical countries. [Copyright &y& Elsevier]

• An AI model was applied in the spatiotemporal wave forecast with only wind inputs. • The proposed model has an efficient structure, outperforming popular ConvLSTM model. • The AI model achieve high accuracy against buoy data, even compared with ERA5. The forecast of ocean waves relies mostly on complex dynamic-based models, which are expensive in computation and demanding in professional skills to run. Diverse deep learning methods have been proposed to tackle this problem, yet the architecture of Transformer (i.e., the self-attention) was seldom tested for such a learning problem. To bridge this gap, we apply a state-of-the-art spatiotemporal attention network, the EarthFormer, and apply it for wave forecasting in the northwestern Pacific. To train and validate the EarthFormer, the fifth-generation atmospheric reanalysis dataset (ERA5) from the European Centre for Medium-Range Weather Forecast product with hourly resolution was adopted, with the sequence of wind as the input and the three key variables (i.e., significance wave height, mean wave period, and mean wave direction) of ocean waves as the output. The prediction can generate accurate wave forecasts up to 12 h ahead, with considerably low root-mean-squared error (RMSE). Overall, the predicted waves resulted in RMSE for the significance wave height of 0.22 m, for the mean wave period of 0.68 s, and for the mean wave direction of 0.28 rad. These wave height and wave period values are ∼13 % and ∼10 % of corresponding spatiotemporal mean values. The EarthFormer outperformed a popular spatiotemporal forecast network, the ConvLSTM, in our problem. For site-wise forecasts against buoy observations near Taiwan, the EarthFormer forecast also presents considerably high accuracy comparable to the ERA5 forecasts. This method can therefore provide an accurate and prompt way to forecast the large-scale distribution of waves to better model the marine dynamic and its climate effects, which could have a high potential for disaster prevention and climate modeling. [ABSTRACT FROM AUTHOR]