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Complete Hydatidiform Mole at Menopause: A Case Report from Panzi Hospital, Bukavu, Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1010-1017页

作者： Julien Bwama De-Joseph Kakisingi Mibi Nsenga Bin Musa jeff Andrea Mbozi Déborah Kambonesa Salire Dieudonné Kakusu Christine Amisi Tina Aroni Toto Tchass Chasinga Baharanyi Denis Mukwege Mukengere Olivier Nyakio Ngeleza Department of Gynaecology-Obstetrics Faculty of Medicine and Community Health Evangelical University in Africa Bukavu Democratic Republic of Congo Gynaecology-Obstetrics Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Saint Vincent Hospital Bukavu Democratic Republic of Congo Medical Imaging Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Anatomopathology Department Panzi General Referral Hospital Bukavu Democratic Republic of Congo Panzi Foundation Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine Official University of Bukavu Bukavu Democratic Republic of Congo Department of Gynaecology-Obstetrics Faculty of Medicine University of Kindu Kindu Democratic Republic of Congo

Gestational trophoblastic disease is an abnormal proliferation of trophoblastic tissue during pregnancy. It occurs in women of childbearing age, although a few cases have also been observed in post-menopausal women, although it is extremely rare in the latter. Here we describe a rare case of complete hydatidiform mole in a 56-year-old female patient who presented with genital bleeding combined with nausea and vomiting and a gravid uterus 16 cm in height. The ultrasound findings and the increase in serum β-HCG to 182566.00 mIU/ml suggested a diagnosis of complete hydatidiform mole. Given the post-menopausal state and the future risk of post-molar gestational trophoblastic neoplasia, we opted for total hysterectomy without preservation of the adnexa via a transabdominal approach, followed by antimitotic treatment with methotrexate. The uterus measured 18.45 cm × 11.18 cm with intra cavitary vesicles. Microscopic examination showed chorionic villi of variable size and shape, most of which were dilated and oedematous, associated with trophoblastic cell proliferation and haemorrhage suggestive of complete benign hydatidiform mole. Follow-up showed a consistent decrease in serum β-HCG levels and no evidence of residual disease. A suspicion of gestational trophoblastic disease should be borne in mind when evaluating a patient with peri- or post-menopausal bleeding to avoid delay in diagnosis and treatment.

关键词： Complete Hydatidiform Mole Menopause β-HCG Panzi Bukavu DRC

Skeletal phenotypes in secreted frizzled-related protein 4 gene knockout mice mimic skeletal architectural abnormalities in subjects with Pyle's disease from SFRP4 mutations

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Bone Research 2023年第1期11卷 193-200页

作者： Robert Brommage jeff Liu David R.Powell Department of Metabolism Research Lexicon PharmaceuticalsThe WoodlandsTX77381USA

Mutations in SFRP4 cause Pyle’s bone disease with wide metaphyses and increased skeletal *** WNT signaling pathway plays important roles in determining skeletal architecture and SFRP4 is a secreted Frizzled decoy receptor that inhibits WNT *** cohorts of male and female Sfrp4 gene knockout mice,examined through 2 years of age,had a normal lifespan but showed cortical and trabecular bone *** human Erlenmeyer flask deformities,bone cross-sectional areas were elevated 2-fold in the distal femur and proximal tibia but only 30%in femur and tibia *** cortical bone thickness was observed in the vertebral body,midshaft femur and distal *** trabecular bone mass and numbers were observed in the vertebral body,distal femur metaphysis and proximal tibia *** femurs retained extensive trabecular bone through 2 years of *** bodies had increased compressive strength,but femur shafts had reduced bending ***,but not cortical,bone parameters in heterozygous Sfrp4mice were modestly *** resulted in similar declines in both cortical and trabecular bone mass in wild-type and Sfrp4 KO ***4 is critical for metaphyseal bone modeling involved in determining bone ***4 KO mice show similar skeletal architecture and bone fragility deficits observed in patients with Pyle’s disease with SFRP4 mutations.

关键词： SFRP4 skeletal elevated

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天文爱好者 2024年第5期 52-57页

作者：李海辉(摄影) 李德谦(摄影) 慕星(摄影) 鲁罡(摄影) 胡文迪(摄影) 林滇翊(摄影) jeff的星空之旅(摄影) 杨利平(摄影) 不详

星海伴花海时间:2024年3月2日地点:广西桂林市草坪回族乡器材:佳能EOS6D(天文改机),适马35mm f/1.4镜头。参数:天空f12.8,ISO1600,单张曝光90秒,赤道仪跟踪;地景f12.8,ISO1600,单张曝光90秒,关闭赤道仪。简介:烟雨季节的三月,娇艳的油... 详细信息

星海伴花海时间:2024年3月2日地点:广西桂林市草坪回族乡器材:佳能EOS6D(天文改机),适马35mm f/1.4镜头。参数:天空f12.8,ISO1600,单张曝光90秒,赤道仪跟踪;地景f12.8,ISO1600,单张曝光90秒,关闭赤道仪。简介:烟雨季节的三月,娇艳的油菜花正是盛开的季节,猎户座缓缓地从西边落下。喀斯特山峰上闪烁的点点星光呼应着农田里的朵朵油菜花,似乎都在为春来早的南方大放光彩。

关键词：油菜花广西桂林市草坪回族乡春来早单张喀斯特

Designs to Improve Capability of Neural Networks to Make Structural Predictions

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Chinese Journal of Polymer Science 2023年第9期41卷 1477-1485,I0009页

作者： Tian-Yao Wang Jian-Feng Li Hong-Dong Zhang jeff Z.Y.Chen Department of Macromolecular Science State Key Laboratory of Macromolecular Engineering of PolymersFudan UniversityShanghai200438China Department of Physics and Astronomy University of WaterlooWaterlooN2L 3G1Canada

A deep neural network model generally consists of different modules that play essential roles in performing a *** optimal design of a module for use in modeling a physical problem is directly related to the success of the *** this work,the effectiveness of a number of special modules,the self-attention mechanism for recognizing the importance of molecular sequence information in a polymer,as well as the big-stride representation and conditional random field for enhancing the network ability to produce desired local configurations,is numerically *** models containing these modules are trained by using the well documented data of the native structures of the HP model and assessed according to their capability in making structural predictions of unseen *** specific network design of self-attention mechanism adopted here is modified from a similar idea in natural language *** big-stride representation module introduced in this work is shown to drastically improve network's capability to model polymer segments of strong lattice position correlations.

关键词： Deep neural network Self-attention mechanism Big-stride representation Conditional random methods

A Rigorous Architectural Approach to Adaptive Software Engineering

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Journal of Computer Science & Technology 2009年第2期24卷 183-188页

作者： jeff Kramere jeff Magee Department of Computing Imperial College London

The engineering of distributed adaptive software is a complex task which requires a rigorous approach. Software architectural （structural） concepts and principles are highly beneficial in specifying, designing, analysing, constructing and evolving distributed software. A rigorous architectural approach dictates formalisms and techniques that are compositional, components that are context independent and systems that can be constructed and evolved incrementally. This paper overviews some of the underlying reasons for adopting an architectural approach, including a brief ＂rational history＂ of our research work, and indicates how an architectural model can potentially facilitate the provision of self-managed adaptive software system.

关键词： adaptiye systems self-managed systems autonomic systems software architecture

Variability scaling and capacity planning in Covid-19 pandemic

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Fundamental Research 2023年第4期3卷 627-639页

作者： L.jeff Hong Guangwu Liu Jun Luo Jingui Xie School of Management and School of Data Science Fudan UniversityShanghai 200433China College of Business City University of Hong KongKowloon TongHong Kong 999077China Antai College of Economics and Management Shanghai Jiao Tong UniversityShanghai 200030China School of Management Technical University of MunichHeilbronn 74076Germany Munich Data Science Institute Technical University of MunichMunich 80333Germany

Capacity planning is a very important global challenge in the face of Covid-19 *** order to hedge against the fluctuations in the random demand and to take advantage of risk pooling effect,one needs to have a good understanding of the variabilities in the demand of ***,Covid-19 predictive models that are widely used in capacity planning typically often predict the mean values of the demands(often through the predictions of the mean values of the confirmed cases and deaths)in both the temporal and spatial *** seldom provide trustworthy prediction or estimation of demand variabilities,and therefore,are insufficient for proper capacity *** by the literature on variability scaling in the areas of physics and biology,we discovered that in the Covid-19 pandemic,both the confirmed cases and deaths exhibit a common variability scaling law between the average of the demand μ and its standard deviationσ,that is,σ ∝ μ^(β),where the scaling parameterμis typically in the range of 0.65 to 1,and the scaling law exists in both the temporal and spatial *** on the mechanism of contagious diseases,we further build a stylized network model to explain the variability scaling *** finally provide simple models that may be used for capacity planning in both temporal and spatial dimensions,with only the predicted mean demand values from typical Covid-19 predictive models and the standard deviations of the demands derived from the variability scaling law.

关键词： Covid-19 Capacity planning Variability scaling Demand aggregation Network model Risk pooling effect

Pregnancy in Patients with Shone Complex: A Single-Center Case Series

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Congenital Heart Disease 2022年第2期17卷 147-160页

作者： Rachel Gardner Emily Durbak Rachael Baird Katherine Singh jeff Chapa David Majdalany Department of Cardiology Cleveland ClinicCleveland44195USA Department of Obstetrics Cleveland ClinicCleveland44195USA Department of Cardiology Mayo ClinicPhoenix85054USA

Background:There is limited literature written on the course and outcomes for pregnant mothers with Shone ***:We describe a case series of five pregnancies in four women with Shone complex within a multidisciplinary cardio-obstetrics clinic from 2016–***:Maternal age ranged from 21–39 *** patients had preserved left ventricular function while one had moderately decreased *** age at presentation ranged from 6–15 *** were three successful pregnancies(mean gestational age=37 weeks,range 35–39 weeks)with one patient accounting for two unsuccessful *** infants were delivered via Cesarean *** infant required a NICU stay,but all other infants delivered were ***:Patients with Shone complex can have successful pregnancies although complications can occur for both the mother and the *** prenatal care,coordinated and consistent management during pregnancy,and tertiary care support can promote positive maternal and fetal outcomes.

关键词： Shone complex pregnancy cardiac disease in pregnancy women’s cardiovascular health