Pulsatile gonadotropin-releasing hormone therapy induces spermatogenesis in pituitary stalk interruption syndrome:A case report and review of the literature

BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.

Pituitary stalk interruption syndrome complicated with liver cirrhosis:A case report

BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.

Game and Dynamic Communication Path-Based Pricing Strategies for Microgrids Under Communication Interruption

Nowadays,the microgrid cluster is an important application scenario for energy trading.In trading,one of the most important research directions is the issue of pricing.To determine reasonable pricing for the microgrid cluster,data communication is used to create the cyber-physical system(CPS),which can improve the observability of microgrids.Then,the following works are carried out in the CPS.In the physical layer:1)Regarding trading between microgrids and the load,based on the generalized game theory,an optimal pricing strategy is proposed,which takes into account the interactive relationships among microgrids and transforms the pricing problem into a Nikaido-Isoda function to obtain the optimal prices conveniently;2)Regarding peer-to-peer trading between two microgrids,based on evolutionary game theory and the penalty mechanism,the optimal sale price of the seller is selected with boundary rationality.In the cyber layer,regarding the communication interruption issue existing in pricing(i.e.,the game process),based on the principle of matching the performance of the path with the importance degree of the data,a dynamic regulating method of paths is proposed,i.e.,adopting a new path to re-transmit the interrupted data to the destination.Finally,the effect of the proposed strategies is verified by case studies.

A randomized controlled clinical trial: Interruption of intrauterine transmission of hepatitis B virus infection with HBIG

AIM： To evaluate the efficacy of interruption of intrauterine infection of HBV with HBIG in pregnant women with positive HBeAg and HBsAg.METHODS： A prospective randomized controlled trial was adopted. Sixty cases with positive HBeAg and HBsAg were coincident with the criteria of inclusion, and 8 cases were excluded. Fifty-two cases were analyzed （28 cases in trial group and 24 in control group）. All cases in trial group received 200 IU HBIG intravenously every 4 wk for 3 times from the 28^th wk. The cases of control group received placebo in the same way. All pregnant women were detected for HBeAg and HBV-DNA at the beginning of the trial and end of the trial （delivery）. The cord blood of all newborns were collected for detecting HBeAg and HBV-DNA simultaneously.RESULTS： For investigation of HBeAg of newborns in trial group, 6 of 28 cases of newborns had positive HBeAg, the HBeAg positive rate being 21.4%, the total rate of 95% CI being 8%-41%. In control group, 19 of 24 cases of newborns had positive HBeAg, HBeAg positive rate was 79.2%, the rate of 95%CI being 5%-93%. By statistical analysis, 2= 17.26, P 〈 0.01, RR = 0.27, 95% CI （6.3 × 10^-6, 8.6 × 10^-5）. For investigation of HBV-DNA of newborns in trial group, 7 of 28 cases of newborns had positive HBV-DNA, HBV-DNA positive rate being 25%, the total rate of 95% CI being 11%-45%. In control group, 20 of 24 cases of newborns had positive HBV-DNA, HBV-DNA positive rate was 83.3%, the total rate of 95% CI being 63%-95%. By statistical analysis, X^2 = 17.62, P 〈 0.01, RR = 0.30, 95% CI （1.5 × 10^-5, 1.7× 10^-4）. The results indicated that there was significant difference in HBeAg positive rate and HBV-DNA positive rate of newborns between the two groups. In trial group, 7 of 28 newborns had HBV-DNA positive, but the HBV-DNA load of newborns was lower than that of their mothers. In control group, 20 of 24 newborns still had HBV-DNA positive, and the HBV-DNA load of newborns was close to those of their mothers. Statistical analysis indicated that there was no significant difference in HBV- DNA load between postnatal women without HBIG intervention and their filial generations （T = 81.5, P 〉 0.1）. CONCLUSION： It is effective and safe to prevent intrauterine infection of HBV with HBIG from the 28^th wk in pregnant women with positive HBeAg and HBsAg. In clinical application, those pregnant women with negative HBeAg and positive HBV-DNA also need to be interrupted by HBIG.

MEASUREMENT OF ANODIC OVERVOLTAGE BY AMODIFIED CURRENT INTERRUPTION METHOD IN CRYOLITE-ALUMINA MELTS

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Knowledge, attitude and practice regarding nursing interruptions among Chinese nurses: A nationwide cross-sectional survey

Objectives:To explore the knowledge,attitude and practice of Chinese nurses regarding nursing interruptions and related factors.Methods:A total of 6,400 nurses from 31 hospitals in China were investigated by using the Knowledge,Attitude and Practice(KAP)Questionnaire of Nursing Interruptions.The questionnaire consists of three dimensions,knowledge,attitude and practice,containing 10,9 and 7 items,with full score of 50,45 and 28,respectively.Results:The mean overall KAP score regarding nursing interruptions of Chinese nurses was 74.05±16.65(range:26-123),with scores for the knowledge,attitude,and practice component being 21.74±9.80,34.83±6.98,and 17.49±4.97,respectively.Among the nurses,70.8%of them experienced an average level of KAP toward nursing interruptions while 15.5%were at a poor level.The knowledge,attitude,and practice of nursing interruptions were better in chief nurses,managers,nurses with a master degree or above,nurses ever received training,and nurses with a strong agreement to leadership compared to nurses in other groups(P<0.05).In addition,employment type,professional title,position,standardized training and leaders'attention were predictors of KAP in nurses.Conclusion:Chinese nurses have a moderate level of KAP regarding nursing interruptions.Leaders'attention,standardized training,position,professional title and employment type could predict nurses'KAP state of nursing interruptions.Thus,a targeted training program should be implemented for clinical nurses by nursing leaders,with a particular focus on feasibility and professionalism.

A new car-following model with consideration of the traffic interruption probability

In this paper, we present a new car-following model by taking into account the effects of the traffic interruption probability on the car-following behaviour of the following vehicle. The stability condition of the model is obtained by using the linear stability theory. The modified Korteweg-de Vries （KdV） equation is constructed and solved, and three types of traffic flows in the headway sensitivity space-stable, metastable, and unstable--are classified. Both the analytical and simulation results show that the traffic interruption probability indeed has an influence on driving behaviour, and the consideration of traffic interruption probability in the car-following model could stabilize traffic flow.

Abnormal interruption of water flow from an artesian well prior to 2008 Wenchuan earthquake

Water flow from an artesian well stopped on December 17, 2007 but recovered when the Wenchuan Ms 8.0 earthquake occurred on May 12, 2008. This well is located 90 km south of the epicenter in an extensional tectonic setting, where similar changes of water level and resistivity were observed at two other nearby sites. Our investigation suggests that this phenomenon was not caused by environmental disturbances, such as drought or borehole-drilling activity, but might be a precursor to the earthquake.

Pituitary stalk interruption syndrome and liver changes:From clinical features to mechanisms

Pituitary stalk interruption syndrome(PSIS)is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk,hypoplasia of the anterior pituitary and an ectopic posterior pituitary.Although the etiology of PSIS is still unclear,gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS.PSIS can cause multiple hormone deficiencies,such as growth hormone,which then cause a series of changes in the human body.On the one hand,hormone changes affect growth and development,and on the other hand,they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease(NAFLD).Under the synergistic effect of multiple mechanisms,the progression of NAFLD caused by PSIS is faster than that due to other causes.Therefore,in addition to early identification of PSIS,timely hormone replacement therapy and monitoring of relevant hormone levels,clinicians should routinely assess the liver function while managing PSIS.

On-line Measurement for Ohmic Resistance in Direct Methanol Fuel Cell by Current Interruption Method

Electrochemical impedance spectroscopy (EIS) is widely used in fuel cell impedance analysis. However, for ohmic resistance (R Ω), EIS has some disadvantages such as long test period and complex data analysis with equivalent circuits. Therefore, the current interruption method is explored to measure the value of RΩ in direct methanol fuel cells (DMFC) at different temperatures and current densities. It is found that RΩ decreases as temperature increase, and decreases initially and then increases as current density increases. These results are consistent with those measured by the EIS technique. In most cases, the ohmic resistances with current interruption (R iR ) are larger than those with EIS (R EIS ), but the difference is small, in the range from –0.848% to 5.337%. The errors of R iR at high current densities are less than those of R EIS . Our results show that the R iR data are reliable and easy to obtain in the measurement of ohmic resistance in DMFC.

Continuum modeling for two-lane traffic flow with consideration of the traffic interruption probability

Considering the effects that the probability of traffic interruption and the friction between two lanes have on the car-following behaviour, this paper establishes a new two-lane microscopic car-following model. Based on this microscopic model, a new macroscopic model was deduced by the relevance relation of microscopic and macroscopic scale parameters for the two-lane traffic flow. Terms related to lane change are added into the continuity equations and velocity dynamic equations to investigate the lane change rate. Numerical results verify that the proposed model can be efficiently used to reflect the effect of the probability of traffic interruption on the shock, rarefaction wave and lane change behaviour on two-lane freeways. The model has also been applied in reproducing some complex traffic phenomena caused by traffic accident interruption.

Effects of Si δ-Doping Condition and Growth Interruption on Electrical Properties of InP-Based High Electron Mobility Transistor Structures

The InGaAs/InAIAs/InP high electron mobility transistor （HEM：F） structures with lattice-matched and pseudo- morphic channels are grown by gas source molecular beam epitaxy. Effects of Si ^-doping condition and growth interruption on the electrical properties are investigated by changing the Si-cell temperature, doping time and growth process. It is found that the optimal Si ^-doping concentration （Nd） is about 5.0 x 1012 cm-2 and the use of growth interruption has a dramatic effect on the improvement of electrical properties. The material structure and crystal interface are analyzed by secondary ion mass spectroscopy and high resolution transmission elec- tron microscopy. An InGaAs/InAiAs/InP HEMT device with a gate length of lOOnm is fabricated. The device presents good pinch-off characteristics and the kink-effect of the device is trifling. In addition, the device exhibits fT = 249 GHa and fmax 〉 400 GHz.

A Novel Hybrid Approach to Estimate Customer Interruption Costs for Industry Sectors

The power system infrastructure, operations and market have gone through radical changes for the last couple of decades. The society has become more dependent to the continuous electric power supply and hence the concept of electric power reliability has become more significant. At this point, understanding the economic outcomes of power outages is vital and imperative for both utilities and the customers. There are certain methodologies to understand the costs of power interruptions. This paper suggests a novel hybrid method that comprises of customer surveys and direct analytical methods to reach customer specific, objective and reliable results for the industry sector customers. The paper also brings a statistical approach to censor the zero and extreme responses given via the surveys.

Factors Affecting Treatment Interruption among TB Patients in Lagos Nigeria: Is There Any Need for Treatment Supporters?

Background: This study assessed treatment interruption of tuberculosis (TB) patients managed by treatment supporters and health care workers and other predictors of treatment interruption. Methods: A descriptive cross-sectional study was conducted. Four hundred and seventy new smear positive TB patients above 14 years of age were consecutively recruited between October 1 and December 31 2012 from 34 (23 public and 11 private) directly observed treatment short course (DOTS) facilities that offered TB treatment and microscopy services. They were followed up till treatment was completed. Logistic regression was used to assess the predictors of treatment interruption. Results: A significantly higher proportion of smokers (58.6% vs 38.3%, p = 0.030), patients supervised by treatment supporters (44.4% vs 34.7%, p = 0.032), patients not counselled before initiation of treatment (55.6% vs 38.2%, p = 0.041), patients managed at private DOTS facilities (50% vs 36.3%, p = 0.010) and TB/HIV co-infected patients (54.2% vs 38.6%, p = 0.038) had treatment interruption. Predictors of treatment interruption were supervision by treatment supporters, smoking, lack of pre-treatment counselling and TB/HIV co-infection. Conclusion: A higher proportion of patients supervised by treatment supporters had treatment interruption than those supervised by health care workers. There may be a need to review the concept of treatment supervision by treatment supporters in Lagos state Nigeria.

Comparison of Interruption in Relatively Formal and Informal Talk Show Programs

Interruption,as a linguistic phenomenon,can be see everywhere.And talk show programs are common setting for interruptions.So in this thesis three questions are addressed as followed:What function does the interruption have in these two kinds of talk shows(relatively formal and informal) respectively;what are the similarities of relatively formal and informal talk show programs;what are the differences between relatively formal and informal talk shows.

A new car-following model with driver's anticipation effect of traffic interruption probability

Traffic interruption phenomena frequently occur with the number of vehicles increasing.To investigate the effect of the traffic interruption probability on traffic flow,a new optimal velocity model is constructed by considering the driver anticipation term in the interruption case for car-following theory.Furthermore,the effect of driver anticipation in the interruption case is investigated via linear stability analysis.Also,the MKdV equation is obtained concerning the effect of driver anticipation in the interruption case.Moreover,numerical simulation states that the driver anticipation term in the interruption case contributes to the stability of traffic flow.

Effectiveness of daily interruption of sedation in sedated patients with mechanical ventilation in ICU: A systematic review

Purpose:To evaluate the effectiveness of daily sedation interruption in patients with mechanical ventilation in intensive care unit(ICU).Methods:The randomized controlled trials(RCTs)on the application of daily interruption of sedation in sedated patients with mechanical ventilation in ICU were collected through databases including Cochrane library,MEDLINE,Web of Knowledge,Embase,CNKI,CBM and VIP Data.Two reviewers independently assessed the quality of studies and extracted the data.Meta-analysis was conducted on the included studies.Results:Eight RCTs involving 757 patients were included.The daily sedation interruptions could shorten the duration of mechanical ventilation(Z=5.36,p<0.0001),length of stay(Z=2.93,p=0.003<0.05)and reduce the rate of tracheotomy(Z=3.97,p<0.00001)in these patients.Additionally,daily sedation interruption was not associated with increased rate of unplanned extubation by the patients(Z=0.53,p=0.6<0.05).Conclusion:The application of daily interruption of sedation in patients with mechanical ventilation in ICU is safe and effective.

An Optimal Control Approach to Structured Treatment Interruptions for HIV Patients: A Personalized Medicine Perspective

Highly Active Antiretroviral Therapy (HAART) has changed the course of human immunodeficiency virus (HIV) treatments since its introduction. However, for many patients, long term continuous HAART is expensive and can include problems with drug toxicity and side effects, as well as increased drug resistance. Because of these reasons, some HIV infected patients will voluntarily terminate HAART. Some of these patients will also interrupt the continuous prescribed therapies for short or long periods. After discontinuing HAART, patients will usually experience a rapid increase in viral load coupled with an immediate decline in CD4+ counts. The canonical example of a patient undergoing unsupervised breaks in HAART is that of the “Berlin patient”. In this case, the patient was able to control viral load in the absence of treatment by cycling HAART on and off due to non-related infections. Due to this patient, interest in the use of structured treatment interruptions (STI) as a mechanism to regulate an HIV infection piqued. This paper describes an optimal control approach to determine STI regimen for HIV patients. The optimal STI was implemented in the context of the receding horizon control (RHC) using a mathematical model for the in-vivo dynamics of an HIV type 1 infection. Using available clinical data, we calibrate the model by estimating on a patient specific basis, a best estimable set of parameters using sensitivity analysis and subset selection. We demonstrate how customized STI protocols can be designed through the variation of control parameters on a patient specific basis.

Childbearing or Working?——Impact of Childbirth on Rural Women's Interruption of Off-farm Employment

To assess the work interruption information and examine the correlation between childbirth and the off-farm employment interruption of rural women,this article collected 3 820 women's childbirth and employment information over the past 18 years( 1998-2015),using multivariate regression to explore the impact of female individual,family and employment characteristics on probability of employment interruption and duration of interruption. Results indicated that overall,40% of women got interrupted after childbirth in rural areas and the average duration of interruption was about four years. Human capital factors,such as their work experience,first childbirth age and education experience,influence the probability of employment interruption,but these factors do not extend the duration of interruption for women who got interrupted.It is concluded that increasing the human capital of rural women is helpful to increasing their labor force participation rate after childbirth.

Proposed Measures to Mitigate Energy Interruptions in Residential Sector

This study investigates and analyzes the electric energy interruptions impact upon the residential sector in Riyadh city, the capital of the Kingdom of Saudi Arabia (KSA) resulting from severe power outages. The study results show that this sector which constitutes about 54% of the Saudi Electric Company in the Central Operating Area (SEC-COA) will suffer enormous tangible and intangible losses should occur in specific times, seasons and last for longer durations. The results obtained for the costs of these energy interruptions reveal a time-dependent non-linear outage cost variation. In order to reduce these energy interruptions and hence mitigate their adverse effects and consequences, the study proposes proper practical measures and solutions without compromising the consumers’ needs and convenience.