An extremely rare case of ovarian abscess in third trimester of pregnancy managed by successful vaginal birth and review of literature

Ovarian abscess (OA) in pregnancy is actually rare occurrence, almost unheard, which associated with poor prognosis for mother and fetus. This diagnostic dilemma is often difficult to be elucidated because of anatomical changes in pregnancy. It was established incidentally by obstetric ultrasound or during cesarean section performed for an obstetric indication. Specially, the presentation of adnexal abscess is very hard to distinguish from appendical abscess. In this report, we presented a 20-year-old woman (G0P0) at 33-34 weeks of gestation was admitted to the clinic of our hospital with a pelvic abnormal tumour accompanied by fetal growth restriction. The patient was indicated for serial laboratory examination, which showed a right abnormal adnexal mass. At hospitalization, the patient was mostly asymptomatic so she was followed by medical treatment and by an expectant management. The surveillance was strictly controlled without complications, except intrauterine growth restriction associated with pregnancy. The patient received a conservative management and gave a well-being infant at 36-37 weeks of gestation by vaginal delivery. Twelfth days after delivery, she underwent a laparoscopic operation to remove the abscess mass. Preventive treatment is also a major importance. This report describes the clinical features and results of the case with an ovarian abscess detected in the 3rd trimester without adverse sequelae and compared to the recurrent knowledge based on the literature regarding the advanced management of OA involved in pregnancy. Through this report, we aim to carry out a literature review in order to discuss these clinical manifestations of OA, optimize the importance in definitive diagnosis and underline the appropriate treatment of an individual case

Economic Uncertainty and Tourism Consumption

This study examines the influence of economic uncertainty on tourism. The key hypothesis to test is that while economic uncertainty reduces outbound tourism, it may boost domestic tourism due to the economic-stagnant effects. Utilizing the framework of the theory of reasoned action to analyze a global sample of 124 countries over the period 1996–2017, we find some initial evidence showing that an increase in economic uncertainty encourages domestic tourism while reducing outbound tourism in the global sample. Notably, while these effects are consistent in the upper-middle-income economies, an increase in uncertainty has a positive impact on both domestic and outbound tourism in lower-middle-income economies and a negative impact on both domestic and outbound tourism in higher-income economies. The key implementation of this study is that tourism development is not always associated with economic development and stability; sometimes it could be a signal of economic stagnancy and inactiveness

Hardware Architectures of Visible Light Communication Transmitter and Receiver for Beacon-based Indoor Positioning Systems

High-speed applications of Visible Light Communications have been presented recently in which response times of photodiode-based VLC receivers are critical points. Typical VLC receiver routines, such as soft-decoding of run-length limited (RLL) codes and FEC codes was purely processed on embedded firmware, and potentially cause bottleneck at the receiver. To speed up the performance of receivers, ASIC-based VLC receiver could be the solution. Unfortunately, recent works on soft-decoding of RLL and FEC have shown that they are bulky and time-consuming computations. This causes hardware implementation of VLC receivers becomes heavy and unrealistic. In this paper, we introduce a compact Polar-code-based VLC receivers. in which flicker mitigation of the system can be guaranteed even without RLL codes. In particular, we utilized the centralized bit-probability distribution of a pre-scrambler and a Polar encoder to create a non-RLL flicker mitigation solution. At the receiver, a 3-bit soft-decision filter was implemented to analyze signals received from the VLC channel to extract log-likelihood ratio (LLR) values and feed them to the Polar decoder. Therefore, the proposed receiver could exploit the soft-decoding of the Polar decoder to improve the error-correction performance of the system. Due to the non-RLL characteristic, the receiver has a preeminent code-rate and a reduced complexity compared with RLL-based receivers. We present the proposed VLC receiver along with a novel very-large-scale integration (VLSI) architecture, and a synthesis of our design using FPGA/ASIC synthesis tools

Neonatal Outcomes in the Surgical Management of Placenta Accreta Spectrum Disorders: A Retrospective Single-Center Observational Study From 468 Vietnamese Pregnancies Beyond 28 Weeks of Gestation

BACKGROUND: Placenta accreta spectrum disorders (PASDs) increase the mortality rate for mothers and newborns over a decade. Thus, the purpose of the study is to evaluate the neonatal outcomes in emergency cesarean section (CS) and planned surgery as well as in Cesarean hysterectomy and the modified one-step conservative uterine surgery (MOSCUS). The secondary aim is to reveal the factors relating to poor neonatal outcomes. METHODS: This was a single-center retrospective study conducted between 2019 and 2020 at Tu Du Hospital, in the southern region of Vietnam. A total of 497 pregnant women involved in PASDs beyond 28 weeks of gestation were enrolled. The clinical outcomes concerning gestational age, birth weight, APGAR score, neonatal intervention, neonatal intensive care unit (NICU) admission, and NICU length of stay (LOS) were compared between emergency and planned surgery, between the Cesarean hysterectomy and the MOSCUS. The univariate and multivariable logistic regression were used to assess the adverse neonatal outcomes. RESULTS: Among 468 intraoperatively diagnosed PASD cases who underwent CS under general anesthesia, neonatal outcomes in the emergency CS (n = 65) were significantly poorer than in planned delivery (n = 403). Emergency CS increased the odds ratio (OR) for earlier gestational age, lower birthweight, lower APGAR score at 5 min, higher rate of neonatal intervention, NICU admission, and longer NICU LOS ≥ 7 days with OR, 95% confidence interval (CI) were 10.743 (5.675-20.338), 3.823 (2.197-6.651), 5.215 (2.277-11.942), 2.256 (1.318-3.861), 2.177 (1.262-3.756), 3.613 (2.052-6.363), and 2.298 (1.140-4.630), respectively, p \u3c 0.05. Conversely, there was no statistically significant difference between the neonatal outcomes in Cesarean hysterectomy (n = 79) and the MOSCUS method (n = 217). Using the multivariable logistic regression, factors independently associated with the 5-min-APGAR score of less than 7 points were time duration from the skin incision to fetal delivery (min) and gestational age (week). One minute-decreased time duration from skin incision to fetal delivery contributed to reduce the risk of adverse neonatal outcome by 2.2% with adjusted OR, 95% CI: 0.978 (0.962-0.993), p = 0.006. Meanwhile, one week-decreased gestational age increased approximately two fold odds of the adverse neonatal outcome with adjusted OR, 95% CI: 1.983 (1.600-2.456), p \u3c 0.0001. CONCLUSIONS: Among pregnancies with PASDs, the neonatal outcomes are worse in the emergency group compared to planned group of cesarean section. Additionally, the neonatal comorbidities in the conservative surgery using the MOSCUS method are similar to Cesarean hysterectomy. Time duration from the skin incision to fetal delivery and gestational age may be considered in PASD surgery. Further data is required to strengthen these findings

Umbilical Cord Haematoma and Uterine Torsion: Rare Pregnancy Complications at Tu Du Hospital in Vietnam and a Review of Literature

Umbilical cord haematoma (UCH) and uterine torsion are extremely rare complications in pregnancy. These abnormalities may present in acute and spontaneous conditions, however, they should not be neglected in clinical practice when monitoring an abnormal fetal heart without other suspects. The authors hereby report a rare case of UCH and uterine torsion as well as a review of the literature. A female, aged 35 years old (gravida 1, para 0), was admitted to the Emergency Department of Tu Du Hospital, Ho Chi Minh City, Vietnam, due to term gestation without complaints. They had an uncomplicated pregnancy, except a large uterine fibroid and cervical pessary which prevented pre-term birth from 28 weeks of gestational age. A very rare complication of UCH was revealed accidentally following emergency caesarean section associated with abnormal fetal heart rate tracing. Asymptomatic uterine torsion was noticed at the same time as this dramatic event. Pre-operative diagnosis of two rare complications was missed; hence, the authors timely delivered the baby based on another modality of management, computerised cardiotocography. In conclusion, UCH along with uterine torsion is difficult to diagnosis due to its rarity; it is usually an incidental finding. Moreover, no available imaging modality could investigate UCH prior to delivery. Surveillance on fetal heart rate monitoring may be helpful in this fatal situation

TwinLiteNet: An Efficient and Lightweight Model for Driveable Area and Lane Segmentation in Self-Driving Cars

Semantic segmentation is a common task in autonomous driving to understand the surrounding environment. Driveable Area Segmentation and Lane Detection are particularly important for safe and efficient navigation on the road. However, original semantic segmentation models are computationally expensive and require high-end hardware, which is not feasible for embedded systems in autonomous vehicles. This paper proposes a lightweight model for the driveable area and lane line segmentation. TwinLiteNet is designed cheaply but achieves accurate and efficient segmentation results. We evaluate TwinLiteNet on the BDD100K dataset and compare it with modern models. Experimental results show that our TwinLiteNet performs similarly to existing approaches, requiring significantly fewer computational resources. Specifically, TwinLiteNet achieves a mIoU score of 91.3% for the Drivable Area task and 31.08% IoU for the Lane Detection task with only 0.4 million parameters and achieves 415 FPS on GPU RTX A5000. Furthermore, TwinLiteNet can run in real-time on embedded devices with limited computing power, especially since it achieves 60FPS on Jetson Xavier NX, making it an ideal solution for self-driving vehicles. Code is available: url{https://github.com/chequanghuy/TwinLiteNet}.Comment: Accepted by MAPR 202