BACKGROUND Indeterminate dendritic cell tumor(IDCT)is a rare tumor of immune cells,and IDCT patients without skin lesions are rarely reported.Therefore,the clinical course in this type of patient is unclear,and furthe...BACKGROUND Indeterminate dendritic cell tumor(IDCT)is a rare tumor of immune cells,and IDCT patients without skin lesions are rarely reported.Therefore,the clinical course in this type of patient is unclear,and further research on the underlying pathological mechanisms and appropriate treatments is needed.CASE SUMMARY This study describes a female IDCT patient with bile duct lesions.The strong mimicry of IDCT lesions confused doctors,and consequently,this patient,who had no skin lesions,was first diagnosed with cholangiocarcinoma.Then,she presented with persistent abdominal distension without jaundice.Enlarged mesenteric lymph nodes along with massive ascites were observed in the subsequent imaging examination.However,no tumor cells or pathogens were found in the three subsequent ascites analyses.It took 2 years to reach the correct diagnosis,which was eventually obtained by performing surgery for biopsy of the patient’s abdominal lymph nodes.However,by then,she was already in a cachexic state.Finally,she received a cycle of cyclophosphamide therapy and was advised to visit a hospital specializing in rare diseases.CONCLUSION For IDCT patients without skin lesions,early biopsy is the key to obtaining a correct diagnosis.Moreover,the collective management of IDCT patients is important.Further histological and molecular biology studies based on human specimens are critical for understanding the pathological mechanism of dendritic cell tumors in the future.展开更多
BACKGROUND Studies with large size samples on the liver histological changes of indeterminate phase chronic hepatitis B(CHB)patients were not previously conducted.AIM To assess the liver histological changes in the in...BACKGROUND Studies with large size samples on the liver histological changes of indeterminate phase chronic hepatitis B(CHB)patients were not previously conducted.AIM To assess the liver histological changes in the indeterminate phase CHB patients using liver biopsy.METHODS The clinical and laboratory data of 1532 untreated CHB patients were collected,and all patients had least once liver biopsy from January 2015 to December 2021.The significant differences among different phases of CHB infection were compared with t-test,and the risk factors of significant liver histological changes were analyzed by the multivariate logistic regression analysis.RESULTS Among 1532 untreated CHB patients,814(53.13%)patients were in the indeterminate phase.Significant liver histological changes(defined as biopsy score≥G2 and/or≥S2)were found in 488/814(59.95%)CHB patients in the indete-rminate phase.Significant liver histological changes were significant differences among different age,platelets(PLTs),and alanine aminotransferase(ALT)subgroup in indeterminate patient.Multivariate logistic regression analysis indicated that age≥40 years old[adjust odd risk(aOR),1.44;95%confidence interval(CI):1.06-1.97;P=0.02],PLTs≤150×10^(9)/L(aOR,2.99;95%CI:1.85-4.83;P<0.0001),and ALT≥upper limits of normal(aOR,1.48;95%CI:1.08,2.05,P=0.0163)were independent risk factors for significant liver histological changes in CHB patients in the indeterminate phase.CONCLUSION Our results suggested that significant liver histological changes were not rare among the untreated CHB patients in indeterminate phase,and additional strategies are urgently required for the management of these patients.展开更多
Indeterminate biliary strictures pose a significant diagnostic dilemma for gastroenterologists.Despite advances in endoscopic techniques and instruments,it is difficult to differentiate between benign and malignant pa...Indeterminate biliary strictures pose a significant diagnostic dilemma for gastroenterologists.Despite advances in endoscopic techniques and instruments,it is difficult to differentiate between benign and malignant pathology.A positive histological diagnosis is always preferred prior to high risk hepatobiliary surgery,or to inform other types of therapy.Endoscopic retrograde cholangiopancreato-graphy with brushings has low sensitivity and despite significant improvements in instruments there is still an unacceptably high false negative rate.Other methods such as endoscopic ultrasound and cholangioscopy have improved diagnostic quality.In this review we explore the techniques available to aid accurate diagnosis of indeterminate biliary strictures and obtain accurate histology to facilitate clinical management.展开更多
Free will is difficult to classify with respect to determinism or indeterminism, and its phenomenology in consciousness often shows both aspects. Initially, it is felt as unlimited and indeterminate will power, with t...Free will is difficult to classify with respect to determinism or indeterminism, and its phenomenology in consciousness often shows both aspects. Initially, it is felt as unlimited and indeterminate will power, with the potentiality of multiple choices. Thereafter, reductive deliberation is led by determinism to the final decision, which realises only one of the potential choices. The reductive deliberation phase tries to find out the best alternative and simultaneously satisfying vague motivations, contextual conditions and personal preferences. The essential sense of free will is the introduction of personal preferences, which allows a higher diversity of reactions to vague motivations. With an oversimplified model of determinism as a chain of events, incompatibilists define "free" as "undetermined" so that determinism becomes incompatible with any free choice between alternatives. In consciousness, free will requires a more complex model of network determinism as well as the consideration of unconsciousness as a causal factor. When "free" defined as "undetermined" is applied to the context of consciousness, it should be reinterpreted as "unconscious of being determined" or not aware of underlying determinism. Lacking information on determinism generates a feeling of "free" in consciousness and, therefore, gives the impression of indeterminism. Lacking information may be induced by an uncertain future without determined events--an unconscious past with biological reactions suddenly emerging from the unconsciousness or an unknown present unable to distinguish determinism of complex events. Therefore, at the level of human consciousness, the experience of free will is associated with apparent indeterminism although it is based on unconscious determinism. The concepts of compatibilism and incompatibilism are only two different aspects of the same phenomenon and correspond to consciousness and unconsciousness. Nevertheless, they can be considered together with a free will concept based on relativity depending on two different reference frames--the first person's experience frame or the Laplace's demon frame with knowledge on every molecule of the universe. Only relativity of the free will concept avoids the contradiction between "free" and "unfree" for the same phenomenon and could be a compromise for considering compatibilism and incompatibilism equally.展开更多
By Invoking symmetry principle, we present a self-consistent interpretation of the existing quantum theory which explains why our world is fundamentally indeterministic and that why non-local quantum jumps occur. Symm...By Invoking symmetry principle, we present a self-consistent interpretation of the existing quantum theory which explains why our world is fundamentally indeterministic and that why non-local quantum jumps occur. Symmetry principle dictates that the concept of probability is more fundamental than the notion of the wave function in that the former can be derived directly from symmetries rather than have to be assumed as an additional axiom. It is argued that the notion of quantum probability and that of the wavefunction are intimately connected.展开更多
Estimating causal effects is a principal goal in epidemiology and other branches of science. Nonetheless, what constitutes an effect and which measure of effect is pre-ferred are unsettled questions. I argue that, und...Estimating causal effects is a principal goal in epidemiology and other branches of science. Nonetheless, what constitutes an effect and which measure of effect is pre-ferred are unsettled questions. I argue that, under indeterminism, an effect is a change in the tendency of the outcome variable to take each of its values, and then present a critical analysis of commonly used measures of effect and the measures of frequency from which they are calculated. I conclude that all causal effects should be quantified using a unifying measure of effect called the log likelihood ratio (which is the log probability ratio when the outcome is a discrete variable). Furthermore, I suggest that effects should be estimated for all causal contrasts of the causal variable (i.e., expo-sure), on all values of the outcome variable, and for all time intervals between the cause and the outcome. This goal should be kept in mind in practical approximations.展开更多
Irreducible indeterminism is considered by most physicists as an ontological interpretation of quantum mechanics, which attributes inherent indeterminism to elementary paJcticles. This view was extrapolated by von Neu...Irreducible indeterminism is considered by most physicists as an ontological interpretation of quantum mechanics, which attributes inherent indeterminism to elementary paJcticles. This view was extrapolated by von Neumann from the atomocosm to the entire universe. Heisenberg proposed an epistemic interpretation, postulating that indeterminism stems from ambivalent detection systems, rather than being a characteristic of elementary particles Transformative detection that inherently affects the measured phenomena is responsible for the indeterminism in the atomocosm. As the same does not generally hold true in the macrocosm, this discrepancy has led to the notion of the Heisenberg cut. As explained by Heisenberg's microscope example, high-energy light can displace electrons from their atomic shells in the atomocosm, but would not induce the same effect on objects in the macrocosm, thus rendering such detection neutral. Therefore, detection systems are ambivalent in that they can be transformative under the cut and neutral otherwise. Device variation is found under and above the cut and is the essential cause of outcome variability in the macrocosm. Thus, two completely different categories of indeterminism exist simultaneously under the Heisenberg cut, but only one is found above the cut, known as measurement variations of devices. Experimental exploration of elementary paJcticle behaviors is possible only with the help of detection systems. If these systems affect particle characteristics in any way, this would be sufficient to explain the irreducible quantum mechanical indeterminism. Consequently, the true behavior of elementary particles, whether indeterminist or determinist, would never be detectable. Above the cut, on the other hand, variations in device performance are inevitable, due to reducible perturbing factors, inducing measurement wJciation of devices Heisenberg discovered a general principle of ambivalent detection systems, which can also be found in the macrocosm. In the Wilson Cloud Chamber, vapor is an ambivalent detection system, since high-energy charged particles would produce straight tracks, whereas those of lower energy would leave an irregular trace. According to the epistemic interpretation, von Neumann's extrapolation of irreducible quantum mechanical indeterminism to the entire universe would not be necessary, thereby avoiding the uncomfortable conclusion that the entire universe is based on indeterminism展开更多
Despite advances in cross-sectional imaging and endoscopic technology,bile duct strictures remain a challenging clinical entity.It is crucial to make an early determination of benign or malignant nature of biliary str...Despite advances in cross-sectional imaging and endoscopic technology,bile duct strictures remain a challenging clinical entity.It is crucial to make an early determination of benign or malignant nature of biliary strictures.Early diagnosis not only helps with further management but also minimizes mortality and morbidity associated with delayed diagnosis.Conventional imaging and endoscopic techniques,particularly endoscopic retrograde cholangiopancreatography(ERCP)and tissue sampling techniques play a key in establishing a diagnosis.Indeterminate biliary strictures(IDBSs)have no definite mass on imaging or absolute histopathological diagnosis and often warrant utilization of multiple diagnostics to ascertain an etiology.In this review,we discuss possible etiologies,clinical presentation,diagnosis,and management of IDBSs.Based on available data and expert opinion,we depict an evidence based diagnostic algorithm for management of IDBSs.Areas of focus include use of traditional tissue sampling techniques such as ERCP with brush cytology,intraductal biopsies,fluorescence in situ hybridization and flow cytometry.We also describe the role of endoscopic ultrasound(EUS)-guided fine needle aspiration and biopsies,cholangioscopy,confocal laser endomicroscopy,and intraductal EUS in management of IDBSs.展开更多
Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatm...Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatment planning,management,prognosis,and follow-up.It also helps to identify high-risk groups who can be subjected to timely screening for early detection of malignant conditions.It is more important in pancreatic cancer as it is one of the major causes of cancer-related deaths worldwide and there are no specific early features(clinical and radiological)for diagnosis.With improvement in imaging modalities(computed tomography,magnetic resonance imaging,endoscopic ultrasound),most often clinicians were being challenged with lesions that were difficult to diagnose with human competence.AI has been used in various other branches of medicine to differentiate such indeterminate lesions including the thyroid gland,breast,lungs,liver,adrenal gland,kidney,etc.In the case of pancreatic cancer,the role of AI has been explored and is still ongoing.This review article will focus on how AI can be used to diagnose pancreatic cancer early or differentiate it from benign pancreatic lesions,therefore,management can be planned at an earlier stage.展开更多
Background: Access to safe and effective contraception is crucial for sexual and reproductive health to be at its best. This allows improved pregnancy results and the avoidance of unintended births. Teenagers’ views ...Background: Access to safe and effective contraception is crucial for sexual and reproductive health to be at its best. This allows improved pregnancy results and the avoidance of unintended births. Teenagers’ views on using contraceptives are influenced by the information available at their disposal. The study assessed the influential factors affecting the utilization of modern contraceptives among the youth in Akuse in the Eastern Region of Ghana. Methods: The data for the study were gathered from 378 consented youth aged 15 - 24 years using a quantitative cross-sectional study design and a well-structured questionnaire. Person’s Chi-Square test was adopted to measure the association between the outcome variable and selected independent variables. Logistic regression models were utilized to measure the odds of the factors influencing modern contraceptive use among the respondents. Results: The results of the study suggested a high knowledge level of contraceptives;however, the prevalence of utilization was low. The level of education and age were factors found to influence the uptake of contraceptives. A bivariate analysis to examine the association between selected socio-demographic variables revealed that educational level (p = 0.044), religious affiliation (p = 0.002), and ethnicity (p = 0.016) were statistically associated with modern contraceptive use among the respondents. All other tested demographic variables including the age groups, gender, marital status, and residential status proved otherwise at the observed p-values greater than the 0.05 threshold. Respondents who indicated staying with partners were 6.79 times more likely to use contraceptives compared to their counterparts staying with a parent, after controlling for all other covariates. Conclusions: Based on the findings of this study, it was concluded that high contraceptive knowledge influences the choice of contraceptive preferred by the youth, and contraceptive use is also influenced by the advancement in age and educational level of the youth. It is however recommended that parents, guidance, and teachers be entreated to offer relevant and timely sexual information or education as these will most likely improve the uptake of modern contraceptives among the targeted population.展开更多
Reproduction via cis-binary mechanisms appears to have evolved fairly early in the evolution of complex organisms, and a system committed to prior to evolution of humans. While the evolution of a chromosomal-specific ...Reproduction via cis-binary mechanisms appears to have evolved fairly early in the evolution of complex organisms, and a system committed to prior to evolution of humans. While the evolution of a chromosomal-specific approach has been a successful strategy for survival of a large variety of species including humans, the fidelity of sex determination leading to 100% cis-binary outcomes is not achieved in many species, with evidence for homosexual or bisexual behaviour evident in more than 1500 species. Thus, such outcomes indicates that sex determination is a multi-step process and not a single event, and as such, could lead to the appearance of variants during the process which developed much earlier than humans. Variants could arise either due to intrinsic variation in the steps of determination, or also be influenced by environmental factors of a biological or psychological nature. In contrast to homosexual variants which do not require interventions such as hormone therapy or surgery, expression of gender dysphoria, is more based in psychology, but also has biological underpinnings and can be influenced by such hormonal interventions and surgery. While the numbers of those with gender dysphoria is small (~0.6% - 1.0% of population), the attention given to this issue raises the possibility of biological and psychological environmental factors impacting the emergence of some of those expressing gender dysphoria. Furthermore, transitioning from male-to-female or female-to-male can have consequences regarding disease risks latter in life, including the appearance of autoimmune diseases. This review will attempt to review some of the evidence regarding sex determination, discuss why the system has potentially not been improved upon during evolution, how a potential role for sex chromosome function on neurodevelopment may be central to variation in humans, and how commitment to the current strategy is likely integrated into other sex-related events such as puberty, pregnancy, and menopause to ensure species survival. It will also discuss how variants in sex determination could contribute to sex differences in disease risk and how epigenetic modifications could play a role in such risk. .展开更多
Rabies, a viral zoonosis, is one of the neglected tropical diseases (NTDs) that mainly affects poor and vulnerable populations. Human rabies is endemic in Benin. Although listed among the notifiable diseases, it never...Rabies, a viral zoonosis, is one of the neglected tropical diseases (NTDs) that mainly affects poor and vulnerable populations. Human rabies is endemic in Benin. Although listed among the notifiable diseases, it nevertheless remains a neglected and under-reported disease. The objective of this study was to investigate the determinants of knowledge of rabies risk among subjects exposed to human rabies by dog bites in the Plateau department of Benin. Methods: This was a cross-sectional study with an analytical aim which involved a sample of 900 people aged at least 18 years old chosen randomly and residing in the Plateau department for at least six months. A pre-tested and validated digital questionnaire served as a data collection tool. Data analysis was done with R 3.4.1 software. The prevalence ratio was used as a measure of association. The confidence threshold was set at 5%. We carried out a multiple logistic regression using the likelihood ratio (top-down approach) in order to identify the main factors which influenced the good knowledge of human rabies in the population of Plateau. Results: In the study population, 80.89% of the subjects surveyed lived in a rural area. The sex ratio (Male/Female) was 1.11. The average age of the subjects was 40.24 ± 14.52 years. The prevalence of dog bites was 4.11% (95% CI = [3.00;5.63]) or 37 subjects bitten. After evaluation of knowledge of rabies risk in the study population, the main factors which positively influenced good knowledge of human rabies were age (p linear trend 0.01), residence of the subject in the municipality of Pobè (ORa = 8.34;95% CI = 0.83 - 1.23;p < 0.01), individual dwelling (ORa = 17.95;95% CI = 13.12 - 49.58;p < 0. 01), educational level of at least secondary (ORa = 5.53;CI 95 = 3.06 - 10.15;p = 0.01), the existence of a veterinary center (ORa = 3.66;CI 95 = 1.07 - 12.43 p = 0.01) and knowledge of a dog bites victim (ORa = 6.55;95% CI = 2.73 - 8.25;p < 0.01). Conclusion: This population study confirms that human rabies remains a public health problem with a need to raise awareness among populations on good prevention practices against human rabies after a dog bite in the Plateau department. This could help to improve strategies surveillance for the control and eradication of human rabies through the implementation of the One Health approach.展开更多
An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among p...An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P < 0.05. The prevalence rate of unintended pregnancy from the study was 16.28% (≈16%). The contraceptive awareness was very high (209, 97.21%), however, 101 (46.98%) participants had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unintended pregnancy (P = 0.042), level of education and unwanted pregnancy (P = 0.033) as well as parity and unintended pregnancy (P = 0.019). The prevalence of unintended pregnancy among women attending antenatal clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.展开更多
Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the ...Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartile (Q1) was 36 months (3 years). Independent factors associated with reduced survival were breast ulceration (aHR = 3.23;p = 0.002), bilateral tumor location (aHR = 9.2;p < 0.001) and clinical stage 3 (aHR = 1.72;p = 0.010) while patients classified ACR3 on imaging (aHR = 0.19;p = 0.005) had improved survival. Conclusion: Breast cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was highest in the first 40 months. Independent factors associated with reduced survival were breast ulceration, bilateral tumor location and clinical stage 3 while patients classified ACR3 on imaging had improved survival.展开更多
transformer is a switch gene for sex determination in many insects, which cooperates with transformer-2 that is expressed in both sexes to regulate female differentiation, particularly in dipterans. Zeugodacus cucurbi...transformer is a switch gene for sex determination in many insects, which cooperates with transformer-2 that is expressed in both sexes to regulate female differentiation, particularly in dipterans. Zeugodacus cucurbitae(Coquillett) is a very destructive pest worldwide, however, its sex determination pathway remains largely uncharacterized. Here, we show that the female sex ratio is sharply reduced with knockdown of either transformer or transformer-2 by RNA interference in early embryos of Z. cucurbitae. Most of the males grown from the embryos with transient transformer and transformer-2 suppression mated with wild-type females and produced mixed sex progeny, with one exception that produced only female progeny, and all of the few remaining males failed to mate with wild-type females and produced no progeny. The exceptional male and those males with mating failure were XX pseudomales as determined by the detection of Y chromosome-linked Maleness-on-the-Y, indicating that most XX pseudomales are not viable. The phenotypes of transformer and transformer-2 suggest that they play a key role in regulating sex determination and are required for female sexual development of Z. cucurbitae. Our results will be beneficial to the understanding of sex determination in Z. cucurbitae and can facilitate the development of genetic sexing strains for its biological control.展开更多
Background: A major cause of mortality and disability on a global scale is myocardial infarction (MI). These days, the most reliable way to detect and measure MI is via cardiovascular magnetic resonance imaging (CMR)....Background: A major cause of mortality and disability on a global scale is myocardial infarction (MI). These days, the most reliable way to detect and measure MI is via cardiovascular magnetic resonance imaging (CMR). Aims and Objectives: To evaluate the effectiveness of the Electrocardiogram DETERMINE Score in predicting the severity of coronary artery disease (CAD) in patients who have experienced an Acute Myocardial Infarction (AMI) & to assess improvements in left ventricular function at 6 months following coronary artery bypass grafting (CABG). Subjects and Methods: This Observational cohort study was done at the Cardiology and Radiology department and cardiac surgery department, Al-Azhar university hospitals and Helwan University hospital. The study involved 700 cases who patients diagnosed with Acute Myocardial Infarction and fulfilled specific criteria for selection. Result: There was highly statistically significant relation between Myocardial infarction size and ECG Marker Score as mean infarct size elevated When the number of ECG markers increased. There was a highly statistically significant relation between myocardial infarct segments, myocardial infarction size and improvement of cardiac function 6 months post-CABG. Conclusion: The study found that larger myocardial infarctions corresponded with higher DETERMINE Scores. It concluded that an ECG-based score better estimates infarct size than LVEF alone. Additionally, there was a significant statistical correlation between the size and segmentation of myocardial infarction and better cardiac function six months after CABG.展开更多
Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Sever...Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.展开更多
Angles-only relative orbit determination for space non-cooperative targets based on passive sensor is subject to weakly observable problem of the relative state between two spacecraft. Previously, the evidence for ang...Angles-only relative orbit determination for space non-cooperative targets based on passive sensor is subject to weakly observable problem of the relative state between two spacecraft. Previously, the evidence for angles-only observability was found by using cylindrical dynamics, however, the solution of orbit determination is still not provided. This study develops a relative orbit determination algorithm with the cylindrical dynamics based on differential evolution. Firstly, the relative motion dynamics and line-of-sight measurement model for nearcircular orbit are established in cylindrical coordinate system.Secondly, the observability is qualitatively analyzed by using the dynamics and measurement model where the unobservable geometry is found. Then, the angles-only relative orbit determination problem is modeled into an optimal searching frame and an improved differential evolution algorithm is introduced to solve the problem. Finally, the proposed algorithm is verified and tested by a set of numerical simulations in the context of highEarth and low-Earth cases. The results show that initial relative orbit determination(IROD) solution with an appropriate accuracy in a relative short span is achieved, which can be used to initialize the navigation filter.展开更多
This paper studied the invariance of the Cauchy mean with respect to the arithmetic mean when the denominator functions satisfy certain conditions. The partial derivatives of Cauchy’s mean on the diagonal are obtaine...This paper studied the invariance of the Cauchy mean with respect to the arithmetic mean when the denominator functions satisfy certain conditions. The partial derivatives of Cauchy’s mean on the diagonal are obtained by using the method of Wronskian determinant in the process of solving. Then the invariant equation is solved by using the obtained partial derivatives. Finally, the solutions of invariant equations when the denominator functions satisfy the same simple harmonic oscillator equation or the denominator functions are power functions that have been obtained.展开更多
文摘BACKGROUND Indeterminate dendritic cell tumor(IDCT)is a rare tumor of immune cells,and IDCT patients without skin lesions are rarely reported.Therefore,the clinical course in this type of patient is unclear,and further research on the underlying pathological mechanisms and appropriate treatments is needed.CASE SUMMARY This study describes a female IDCT patient with bile duct lesions.The strong mimicry of IDCT lesions confused doctors,and consequently,this patient,who had no skin lesions,was first diagnosed with cholangiocarcinoma.Then,she presented with persistent abdominal distension without jaundice.Enlarged mesenteric lymph nodes along with massive ascites were observed in the subsequent imaging examination.However,no tumor cells or pathogens were found in the three subsequent ascites analyses.It took 2 years to reach the correct diagnosis,which was eventually obtained by performing surgery for biopsy of the patient’s abdominal lymph nodes.However,by then,she was already in a cachexic state.Finally,she received a cycle of cyclophosphamide therapy and was advised to visit a hospital specializing in rare diseases.CONCLUSION For IDCT patients without skin lesions,early biopsy is the key to obtaining a correct diagnosis.Moreover,the collective management of IDCT patients is important.Further histological and molecular biology studies based on human specimens are critical for understanding the pathological mechanism of dendritic cell tumors in the future.
基金Supported by Construction of Key Medical Disciplines in Shenzhen,No.SZXK076.
文摘BACKGROUND Studies with large size samples on the liver histological changes of indeterminate phase chronic hepatitis B(CHB)patients were not previously conducted.AIM To assess the liver histological changes in the indeterminate phase CHB patients using liver biopsy.METHODS The clinical and laboratory data of 1532 untreated CHB patients were collected,and all patients had least once liver biopsy from January 2015 to December 2021.The significant differences among different phases of CHB infection were compared with t-test,and the risk factors of significant liver histological changes were analyzed by the multivariate logistic regression analysis.RESULTS Among 1532 untreated CHB patients,814(53.13%)patients were in the indeterminate phase.Significant liver histological changes(defined as biopsy score≥G2 and/or≥S2)were found in 488/814(59.95%)CHB patients in the indete-rminate phase.Significant liver histological changes were significant differences among different age,platelets(PLTs),and alanine aminotransferase(ALT)subgroup in indeterminate patient.Multivariate logistic regression analysis indicated that age≥40 years old[adjust odd risk(aOR),1.44;95%confidence interval(CI):1.06-1.97;P=0.02],PLTs≤150×10^(9)/L(aOR,2.99;95%CI:1.85-4.83;P<0.0001),and ALT≥upper limits of normal(aOR,1.48;95%CI:1.08,2.05,P=0.0163)were independent risk factors for significant liver histological changes in CHB patients in the indeterminate phase.CONCLUSION Our results suggested that significant liver histological changes were not rare among the untreated CHB patients in indeterminate phase,and additional strategies are urgently required for the management of these patients.
文摘Indeterminate biliary strictures pose a significant diagnostic dilemma for gastroenterologists.Despite advances in endoscopic techniques and instruments,it is difficult to differentiate between benign and malignant pathology.A positive histological diagnosis is always preferred prior to high risk hepatobiliary surgery,or to inform other types of therapy.Endoscopic retrograde cholangiopancreato-graphy with brushings has low sensitivity and despite significant improvements in instruments there is still an unacceptably high false negative rate.Other methods such as endoscopic ultrasound and cholangioscopy have improved diagnostic quality.In this review we explore the techniques available to aid accurate diagnosis of indeterminate biliary strictures and obtain accurate histology to facilitate clinical management.
文摘Free will is difficult to classify with respect to determinism or indeterminism, and its phenomenology in consciousness often shows both aspects. Initially, it is felt as unlimited and indeterminate will power, with the potentiality of multiple choices. Thereafter, reductive deliberation is led by determinism to the final decision, which realises only one of the potential choices. The reductive deliberation phase tries to find out the best alternative and simultaneously satisfying vague motivations, contextual conditions and personal preferences. The essential sense of free will is the introduction of personal preferences, which allows a higher diversity of reactions to vague motivations. With an oversimplified model of determinism as a chain of events, incompatibilists define "free" as "undetermined" so that determinism becomes incompatible with any free choice between alternatives. In consciousness, free will requires a more complex model of network determinism as well as the consideration of unconsciousness as a causal factor. When "free" defined as "undetermined" is applied to the context of consciousness, it should be reinterpreted as "unconscious of being determined" or not aware of underlying determinism. Lacking information on determinism generates a feeling of "free" in consciousness and, therefore, gives the impression of indeterminism. Lacking information may be induced by an uncertain future without determined events--an unconscious past with biological reactions suddenly emerging from the unconsciousness or an unknown present unable to distinguish determinism of complex events. Therefore, at the level of human consciousness, the experience of free will is associated with apparent indeterminism although it is based on unconscious determinism. The concepts of compatibilism and incompatibilism are only two different aspects of the same phenomenon and correspond to consciousness and unconsciousness. Nevertheless, they can be considered together with a free will concept based on relativity depending on two different reference frames--the first person's experience frame or the Laplace's demon frame with knowledge on every molecule of the universe. Only relativity of the free will concept avoids the contradiction between "free" and "unfree" for the same phenomenon and could be a compromise for considering compatibilism and incompatibilism equally.
文摘By Invoking symmetry principle, we present a self-consistent interpretation of the existing quantum theory which explains why our world is fundamentally indeterministic and that why non-local quantum jumps occur. Symmetry principle dictates that the concept of probability is more fundamental than the notion of the wave function in that the former can be derived directly from symmetries rather than have to be assumed as an additional axiom. It is argued that the notion of quantum probability and that of the wavefunction are intimately connected.
文摘Estimating causal effects is a principal goal in epidemiology and other branches of science. Nonetheless, what constitutes an effect and which measure of effect is pre-ferred are unsettled questions. I argue that, under indeterminism, an effect is a change in the tendency of the outcome variable to take each of its values, and then present a critical analysis of commonly used measures of effect and the measures of frequency from which they are calculated. I conclude that all causal effects should be quantified using a unifying measure of effect called the log likelihood ratio (which is the log probability ratio when the outcome is a discrete variable). Furthermore, I suggest that effects should be estimated for all causal contrasts of the causal variable (i.e., expo-sure), on all values of the outcome variable, and for all time intervals between the cause and the outcome. This goal should be kept in mind in practical approximations.
文摘Irreducible indeterminism is considered by most physicists as an ontological interpretation of quantum mechanics, which attributes inherent indeterminism to elementary paJcticles. This view was extrapolated by von Neumann from the atomocosm to the entire universe. Heisenberg proposed an epistemic interpretation, postulating that indeterminism stems from ambivalent detection systems, rather than being a characteristic of elementary particles Transformative detection that inherently affects the measured phenomena is responsible for the indeterminism in the atomocosm. As the same does not generally hold true in the macrocosm, this discrepancy has led to the notion of the Heisenberg cut. As explained by Heisenberg's microscope example, high-energy light can displace electrons from their atomic shells in the atomocosm, but would not induce the same effect on objects in the macrocosm, thus rendering such detection neutral. Therefore, detection systems are ambivalent in that they can be transformative under the cut and neutral otherwise. Device variation is found under and above the cut and is the essential cause of outcome variability in the macrocosm. Thus, two completely different categories of indeterminism exist simultaneously under the Heisenberg cut, but only one is found above the cut, known as measurement variations of devices. Experimental exploration of elementary paJcticle behaviors is possible only with the help of detection systems. If these systems affect particle characteristics in any way, this would be sufficient to explain the irreducible quantum mechanical indeterminism. Consequently, the true behavior of elementary particles, whether indeterminist or determinist, would never be detectable. Above the cut, on the other hand, variations in device performance are inevitable, due to reducible perturbing factors, inducing measurement wJciation of devices Heisenberg discovered a general principle of ambivalent detection systems, which can also be found in the macrocosm. In the Wilson Cloud Chamber, vapor is an ambivalent detection system, since high-energy charged particles would produce straight tracks, whereas those of lower energy would leave an irregular trace. According to the epistemic interpretation, von Neumann's extrapolation of irreducible quantum mechanical indeterminism to the entire universe would not be necessary, thereby avoiding the uncomfortable conclusion that the entire universe is based on indeterminism
文摘Despite advances in cross-sectional imaging and endoscopic technology,bile duct strictures remain a challenging clinical entity.It is crucial to make an early determination of benign or malignant nature of biliary strictures.Early diagnosis not only helps with further management but also minimizes mortality and morbidity associated with delayed diagnosis.Conventional imaging and endoscopic techniques,particularly endoscopic retrograde cholangiopancreatography(ERCP)and tissue sampling techniques play a key in establishing a diagnosis.Indeterminate biliary strictures(IDBSs)have no definite mass on imaging or absolute histopathological diagnosis and often warrant utilization of multiple diagnostics to ascertain an etiology.In this review,we discuss possible etiologies,clinical presentation,diagnosis,and management of IDBSs.Based on available data and expert opinion,we depict an evidence based diagnostic algorithm for management of IDBSs.Areas of focus include use of traditional tissue sampling techniques such as ERCP with brush cytology,intraductal biopsies,fluorescence in situ hybridization and flow cytometry.We also describe the role of endoscopic ultrasound(EUS)-guided fine needle aspiration and biopsies,cholangioscopy,confocal laser endomicroscopy,and intraductal EUS in management of IDBSs.
文摘Artificial intelligence(AI)has been used in various fields of day-to-day life and its role in medicine is immense.Understanding of oncology has been improved with the introduction of AI which helps in diagnosis,treatment planning,management,prognosis,and follow-up.It also helps to identify high-risk groups who can be subjected to timely screening for early detection of malignant conditions.It is more important in pancreatic cancer as it is one of the major causes of cancer-related deaths worldwide and there are no specific early features(clinical and radiological)for diagnosis.With improvement in imaging modalities(computed tomography,magnetic resonance imaging,endoscopic ultrasound),most often clinicians were being challenged with lesions that were difficult to diagnose with human competence.AI has been used in various other branches of medicine to differentiate such indeterminate lesions including the thyroid gland,breast,lungs,liver,adrenal gland,kidney,etc.In the case of pancreatic cancer,the role of AI has been explored and is still ongoing.This review article will focus on how AI can be used to diagnose pancreatic cancer early or differentiate it from benign pancreatic lesions,therefore,management can be planned at an earlier stage.
文摘Background: Access to safe and effective contraception is crucial for sexual and reproductive health to be at its best. This allows improved pregnancy results and the avoidance of unintended births. Teenagers’ views on using contraceptives are influenced by the information available at their disposal. The study assessed the influential factors affecting the utilization of modern contraceptives among the youth in Akuse in the Eastern Region of Ghana. Methods: The data for the study were gathered from 378 consented youth aged 15 - 24 years using a quantitative cross-sectional study design and a well-structured questionnaire. Person’s Chi-Square test was adopted to measure the association between the outcome variable and selected independent variables. Logistic regression models were utilized to measure the odds of the factors influencing modern contraceptive use among the respondents. Results: The results of the study suggested a high knowledge level of contraceptives;however, the prevalence of utilization was low. The level of education and age were factors found to influence the uptake of contraceptives. A bivariate analysis to examine the association between selected socio-demographic variables revealed that educational level (p = 0.044), religious affiliation (p = 0.002), and ethnicity (p = 0.016) were statistically associated with modern contraceptive use among the respondents. All other tested demographic variables including the age groups, gender, marital status, and residential status proved otherwise at the observed p-values greater than the 0.05 threshold. Respondents who indicated staying with partners were 6.79 times more likely to use contraceptives compared to their counterparts staying with a parent, after controlling for all other covariates. Conclusions: Based on the findings of this study, it was concluded that high contraceptive knowledge influences the choice of contraceptive preferred by the youth, and contraceptive use is also influenced by the advancement in age and educational level of the youth. It is however recommended that parents, guidance, and teachers be entreated to offer relevant and timely sexual information or education as these will most likely improve the uptake of modern contraceptives among the targeted population.
文摘Reproduction via cis-binary mechanisms appears to have evolved fairly early in the evolution of complex organisms, and a system committed to prior to evolution of humans. While the evolution of a chromosomal-specific approach has been a successful strategy for survival of a large variety of species including humans, the fidelity of sex determination leading to 100% cis-binary outcomes is not achieved in many species, with evidence for homosexual or bisexual behaviour evident in more than 1500 species. Thus, such outcomes indicates that sex determination is a multi-step process and not a single event, and as such, could lead to the appearance of variants during the process which developed much earlier than humans. Variants could arise either due to intrinsic variation in the steps of determination, or also be influenced by environmental factors of a biological or psychological nature. In contrast to homosexual variants which do not require interventions such as hormone therapy or surgery, expression of gender dysphoria, is more based in psychology, but also has biological underpinnings and can be influenced by such hormonal interventions and surgery. While the numbers of those with gender dysphoria is small (~0.6% - 1.0% of population), the attention given to this issue raises the possibility of biological and psychological environmental factors impacting the emergence of some of those expressing gender dysphoria. Furthermore, transitioning from male-to-female or female-to-male can have consequences regarding disease risks latter in life, including the appearance of autoimmune diseases. This review will attempt to review some of the evidence regarding sex determination, discuss why the system has potentially not been improved upon during evolution, how a potential role for sex chromosome function on neurodevelopment may be central to variation in humans, and how commitment to the current strategy is likely integrated into other sex-related events such as puberty, pregnancy, and menopause to ensure species survival. It will also discuss how variants in sex determination could contribute to sex differences in disease risk and how epigenetic modifications could play a role in such risk. .
文摘Rabies, a viral zoonosis, is one of the neglected tropical diseases (NTDs) that mainly affects poor and vulnerable populations. Human rabies is endemic in Benin. Although listed among the notifiable diseases, it nevertheless remains a neglected and under-reported disease. The objective of this study was to investigate the determinants of knowledge of rabies risk among subjects exposed to human rabies by dog bites in the Plateau department of Benin. Methods: This was a cross-sectional study with an analytical aim which involved a sample of 900 people aged at least 18 years old chosen randomly and residing in the Plateau department for at least six months. A pre-tested and validated digital questionnaire served as a data collection tool. Data analysis was done with R 3.4.1 software. The prevalence ratio was used as a measure of association. The confidence threshold was set at 5%. We carried out a multiple logistic regression using the likelihood ratio (top-down approach) in order to identify the main factors which influenced the good knowledge of human rabies in the population of Plateau. Results: In the study population, 80.89% of the subjects surveyed lived in a rural area. The sex ratio (Male/Female) was 1.11. The average age of the subjects was 40.24 ± 14.52 years. The prevalence of dog bites was 4.11% (95% CI = [3.00;5.63]) or 37 subjects bitten. After evaluation of knowledge of rabies risk in the study population, the main factors which positively influenced good knowledge of human rabies were age (p linear trend 0.01), residence of the subject in the municipality of Pobè (ORa = 8.34;95% CI = 0.83 - 1.23;p < 0.01), individual dwelling (ORa = 17.95;95% CI = 13.12 - 49.58;p < 0. 01), educational level of at least secondary (ORa = 5.53;CI 95 = 3.06 - 10.15;p = 0.01), the existence of a veterinary center (ORa = 3.66;CI 95 = 1.07 - 12.43 p = 0.01) and knowledge of a dog bites victim (ORa = 6.55;95% CI = 2.73 - 8.25;p < 0.01). Conclusion: This population study confirms that human rabies remains a public health problem with a need to raise awareness among populations on good prevention practices against human rabies after a dog bite in the Plateau department. This could help to improve strategies surveillance for the control and eradication of human rabies through the implementation of the One Health approach.
文摘An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P < 0.05. The prevalence rate of unintended pregnancy from the study was 16.28% (≈16%). The contraceptive awareness was very high (209, 97.21%), however, 101 (46.98%) participants had never used any form of contraceptives. Univariate analysis using Chi-square test showed a statistically significant association between age and unintended pregnancy (P = 0.042), level of education and unwanted pregnancy (P = 0.033) as well as parity and unintended pregnancy (P = 0.019). The prevalence of unintended pregnancy among women attending antenatal clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.
文摘Introduction: Breast cancer is one of the leading causes of death worldwide. We carried out this study with the aim of evaluating the determinants of early survival of women with breast cancer in two hospitals in the city of Yaoundé. Methodology: This was an analytical cross-sectional study with retrospective and prospective data collection of breast cancer patients during 6 years in two Hospitals of Yaoundé from January 2017 to December 2022. We consulted the files in search of epidemiological, clinical, paraclinical, therapeutic and survival variables. We completed the survival data directly from the patients or their relatives after their consent. We analyzed the data using SPSS version 23.0 software. Survival analysis was done using the Kaplan-Meier method and survival curves were compared using the Log Rank test. Factors influencing survival were evaluated using the Cox model. The significance threshold (P value) was set at 0.05 at 95% confidence interval. The study was approved by the ethics committees. Results: We included 500 patients whose ages varied between 22 and 83 years with a mean age of 47.19 ± 11.61 years. The most represented age group was 30 to 45 years old (45.8%). Less than half (41.6%) were postmenopausal. The most frequent reason for consultation was a breast lump (79.9%). The most common clinical stage at presentation was stage-3 (47.6%). Infiltrating ductal carcinoma was the most represented histological type (84.7%). The most represented histological grade was grade 2 (40.2%). Immunohistochemistry was performed in 34.20% of cases. The most represented molecular subtype was triple negative (41.8%) followed by Luminal A (30%). Concerning treatment, 17.2% did not receive any, 45% had surgery, 79.4% had chemotherapy, 34.2% hormone therapy, and 14.6% radiotherapy. The survival of patients with breast cancer at 1, 2, 3, 4 and 5 years was respectively 90.6%;83.1%;74.2%;69.8% and 59.2%. The median survival was not reached;however, the first quartile (Q1) was 36 months (3 years). Independent factors associated with reduced survival were breast ulceration (aHR = 3.23;p = 0.002), bilateral tumor location (aHR = 9.2;p < 0.001) and clinical stage 3 (aHR = 1.72;p = 0.010) while patients classified ACR3 on imaging (aHR = 0.19;p = 0.005) had improved survival. Conclusion: Breast cancer survival from 1 to 5 years decrease from 90 to 59%. Mortality was highest in the first 40 months. Independent factors associated with reduced survival were breast ulceration, bilateral tumor location and clinical stage 3 while patients classified ACR3 on imaging had improved survival.
基金supported by the Hainan Provincial Natural Science Foundation of China(321CXTD435)the National Natural Science Foundation of China(31860523,31660339,31702059,and 32260665)the National Key R&D Program of China(2022YFC2601400)。
文摘transformer is a switch gene for sex determination in many insects, which cooperates with transformer-2 that is expressed in both sexes to regulate female differentiation, particularly in dipterans. Zeugodacus cucurbitae(Coquillett) is a very destructive pest worldwide, however, its sex determination pathway remains largely uncharacterized. Here, we show that the female sex ratio is sharply reduced with knockdown of either transformer or transformer-2 by RNA interference in early embryos of Z. cucurbitae. Most of the males grown from the embryos with transient transformer and transformer-2 suppression mated with wild-type females and produced mixed sex progeny, with one exception that produced only female progeny, and all of the few remaining males failed to mate with wild-type females and produced no progeny. The exceptional male and those males with mating failure were XX pseudomales as determined by the detection of Y chromosome-linked Maleness-on-the-Y, indicating that most XX pseudomales are not viable. The phenotypes of transformer and transformer-2 suggest that they play a key role in regulating sex determination and are required for female sexual development of Z. cucurbitae. Our results will be beneficial to the understanding of sex determination in Z. cucurbitae and can facilitate the development of genetic sexing strains for its biological control.
文摘Background: A major cause of mortality and disability on a global scale is myocardial infarction (MI). These days, the most reliable way to detect and measure MI is via cardiovascular magnetic resonance imaging (CMR). Aims and Objectives: To evaluate the effectiveness of the Electrocardiogram DETERMINE Score in predicting the severity of coronary artery disease (CAD) in patients who have experienced an Acute Myocardial Infarction (AMI) & to assess improvements in left ventricular function at 6 months following coronary artery bypass grafting (CABG). Subjects and Methods: This Observational cohort study was done at the Cardiology and Radiology department and cardiac surgery department, Al-Azhar university hospitals and Helwan University hospital. The study involved 700 cases who patients diagnosed with Acute Myocardial Infarction and fulfilled specific criteria for selection. Result: There was highly statistically significant relation between Myocardial infarction size and ECG Marker Score as mean infarct size elevated When the number of ECG markers increased. There was a highly statistically significant relation between myocardial infarct segments, myocardial infarction size and improvement of cardiac function 6 months post-CABG. Conclusion: The study found that larger myocardial infarctions corresponded with higher DETERMINE Scores. It concluded that an ECG-based score better estimates infarct size than LVEF alone. Additionally, there was a significant statistical correlation between the size and segmentation of myocardial infarction and better cardiac function six months after CABG.
文摘Research Background: Pre-eclampsia is one of main causes of materno-foetal mortality and morbidity worldwide, with a prevalence of 3% - 7%. Although considered a primiparous condition, it can nevertheless recur. Several factors appear to be associated with risk of recurrence of pre-eclampsia, such as the term of delivery of previous pregnancy, severity of disease, the existence of co-morbidities and the inter-genital space. Purpose: The aim of our study will be to analyse and identify in a population of pregnant women with a history of preeclampsia risk factors associated with occurrence of recurrent preeclampsia at University clinics of Kinshasa (Democratic Republic of Congo) and at Victor Dupouy Hospital Center (France). Methods: In this study, pregnant women with an history of preeclampsia who will give birth between November 2018 and October 2024 at University Clinics of Kinshasa (UCK) and Victor Dupouy Hospital Center (VDHC) will be included. This will be a cross-sectional analytical study, data from previous and subsequent pregnancies will be studied. Expected Result: The prevalence of recurrent preeclampsia in the study population will be determined. And we will highlight the factors that will determine the recurrence of preeclampsia by analysing the risk factors. Conclusion: Knowledge of the factors associated with recurrent preeclampsia could be an excellent tool for predicting and preventing the disease.
基金supported by the National Natural Science Foundation of China (12272168)the Foundation of Science and Technology on Space Intelligent Control Laboratory (HTKJ2023KL502015)。
文摘Angles-only relative orbit determination for space non-cooperative targets based on passive sensor is subject to weakly observable problem of the relative state between two spacecraft. Previously, the evidence for angles-only observability was found by using cylindrical dynamics, however, the solution of orbit determination is still not provided. This study develops a relative orbit determination algorithm with the cylindrical dynamics based on differential evolution. Firstly, the relative motion dynamics and line-of-sight measurement model for nearcircular orbit are established in cylindrical coordinate system.Secondly, the observability is qualitatively analyzed by using the dynamics and measurement model where the unobservable geometry is found. Then, the angles-only relative orbit determination problem is modeled into an optimal searching frame and an improved differential evolution algorithm is introduced to solve the problem. Finally, the proposed algorithm is verified and tested by a set of numerical simulations in the context of highEarth and low-Earth cases. The results show that initial relative orbit determination(IROD) solution with an appropriate accuracy in a relative short span is achieved, which can be used to initialize the navigation filter.
文摘This paper studied the invariance of the Cauchy mean with respect to the arithmetic mean when the denominator functions satisfy certain conditions. The partial derivatives of Cauchy’s mean on the diagonal are obtained by using the method of Wronskian determinant in the process of solving. Then the invariant equation is solved by using the obtained partial derivatives. Finally, the solutions of invariant equations when the denominator functions satisfy the same simple harmonic oscillator equation or the denominator functions are power functions that have been obtained.