Giant uterine artery pseudoaneurysm after a missed miscarriage termination in a cesarean scar pregnancy

BACKGROUND: Uterine artery pseudoaneurysms are dangerous and can lead to severe hemorrhage. We report an uncommon cause of a giant pseudoaneurysm in a missed miscarriage in a woman with a cesarean scar pregnancy. CASE PRESENTATION: The patient was a 25-year-old Chinese woman with a missed miscarriage in a cesarean scar pregnancy. Curettage was performed under ultrasound monitoring. A uterine artery pseudoaneurysm measuring 71 × 44 × 39 mm was detected the next day by Doppler ultrasonography. While waiting for admittance to an advanced institution to undergo embolization treatment, the pseudoaneurysm ruptured spontaneously. The subsequent severe hemorrhage necessitated hysterectomy. CONCLUSION: A delay in diagnosis of uterine artery pseudoaneurysms may result from a long period between the curettage and follow-up examination. Ultrasound and Doppler ultrasonography should be performed repeatedly at short intervals to rule out them, especially in cesarean scar pregnancies. For a giant uterine artery pseudoaneurysm, interventional embolization might be the first treatment choice. If time allows, intra-operative ligation of the feeding vessels should be attempted before any decision to perform a hysterectomy is made. However, hysterectomy remains a possibility when severe bleeding occurs

Finite-key analysis for time-energy high-dimensional quantum key distribution

Time-energy high-dimensional quantum key distribution (HD-QKD) leverages the high-dimensional nature of time-energy entangled biphotons and the loss tolerance of single-photon detection to achieve long-distance key distribution with high photon information efficiency. To date, the general-attack security of HD-QKD has only been proven in the asymptotic regime, while HD-QKD's finite-key security has only been established for a limited set of attacks. Here we fill this gap by providing a rigorous HD-QKD security proof for general attacks in the finite-key regime. Our proof relies on an entropic uncertainty relation that we derive for time and conjugate-time measurements that use dispersive optics, and our analysis includes an efficient decoy-state protocol in its parameter estimation. We present numerically evaluated secret-key rates illustrating the feasibility of secure and composable HD-QKD over metropolitan-area distances when the system is subjected to the most powerful eavesdropping attack.United States. Office of Naval Research (Grant N00014- 13-1-0774)United States. Air Force Office of Scientific Research (Grant FA9550-14-1-0052)Natural Sciences and Engineering Research Council of Canada (Postdoctoral Fellowship

Understanding health education needs of pregnant women in China during public health emergencies: a qualitative study amidst the COVID-19 pandemic

BackgroundPublic health emergencies impose unique challenges on pregnant women, affecting their physiological, psychological, and social wellbeing. This study, focusing on the context of the corona virus disease in 2019 (COVID-19) pandemic in China, aims to comprehensively explore the experiences of pregnant women amidst diverse public health crises. Herein, we investigate the health education needs of pregnant Chinese women in regard to public health emergencies to provide a scientific foundation for the development of targeted health education strategies.ObjectiveThe study described in this article aims to explore the health education needs of pregnant Chinese women in the context of public health emergencies specifying the types of emergencies of pandemics and to provide a scientific basis for targeted health education interventions.MethodsThirteen pregnant women were purposively selected, and the rationale for this sample size lies in the qualitative nature of the study, seeking in-depth insights rather than generalizability. Data collection involved semi-structured interviews, and the Colaizzi, which is a structured qualitative technique used to extract, interpret, and organize significant statements from participant descriptions into themes, providing a comprehensive understanding of their lived experiences.ResultsThe analysis yielded six prominent themes encompassing the following areas: I. Personal protection and vaccine safety; II. Knowledge of maternal health; III. Knowledge of fetal health; IV. Knowledge of childbirth; V. Knowledge of postpartum recovery; and VI. Knowledge sources of health education for pregnant women and their expectations of healthcare providers. Theme I was analyzed with two sub-themes (needs for personal protection knowledge, vaccine safety knowledge needs); Theme II was analyzed with three sub-themes (nutrition and diet, exercise and rest, sexual life); Theme III was analyzed with three sub-themes (medications and hazardous substances, pregnancy check-ups, and fetal movement monitoring); Theme IV was analyzed with three sub-themes (family accompaniment, analgesia in childbirth, and choice of mode of delivery); Theme V was analyzed with one sub-theme (knowledge of postnatal recovery); Theme VI was analyzed with one sub-theme (expectations of Healthcare providers). Sub-themes within each main theme were identified, offering a nuanced understanding of the multifaceted challenges faced by pregnant women during public health emergencies. The interrelation between sub-themes and main themes contributes to a holistic portrayal of their experiences.ConclusionThe study emphasizes the need for healthcare professionals to tailor health education for pregnant women during emergencies, highlighting the role of the Internet in improving information dissemination. It recommends actionable strategies for effective health communication, ensuring these women receive comprehensive support through digital platforms for better health outcomes during public health crises

Investigating characteristics of the long-term settlement of railway embankments in warm permafrost areas

Introduction: The embankment in the permafrost zone of the Qinghai–Tibet Railway (QTR) faces the problem of permafrost degradation, especially in the warm and ice-rich permafrost areas. The settlement deformation of the embankment is more serious in these areas.Methods: This study systematically investigates the settlement deformation characteristics during 16 operational years of three types of typical roadbed structures. The traditional embankment (TE), U-shaped crushed-rock embankment (UCRE), and crushed-rock revetment embankment (CRRE) are the roadbed structures. The long-term monitoring ground temperature and deformation data of the embankment section along the QTR in warm permafrost areas from 2005 to 2020 are utilized in analysis.Results and Discussion: This study focuses on the influence law of the roadbed structure form, shady–sunny slope effect, and temperature field change on the settlement of the roadbed. The results indicated that the two types of the crushed-rock embankment (CRE) of the long-term cumulative settlement are less than 50% of the cumulative settlement of the TE, and the impact on controlling the settlement is significant. The annual settlements of the three types of embankment structures are related to the artificial permafrost table (APT) and influenced by cyclical climate change at the regional scale. The annual growth rate of the settlement at the left and right shoulders of the UCRE as a result of the effect of the shady–sunny slope does not vary considerably as the number of operational years increases. The impact of the shady–sunny slope on the CRRE for the various settlements before 2008 was negligible. After 2008, the thermal disturbance to the embankment temperature field induced by the preconstruction and the effect of shady–sunny slopes decreased gradually as the number of operational years increased. In some years of operation, a thawed interlayer in the TE and CRRE greatly affected the embankment settlement acceleration. The settlement growth rate of the TE is related to the decline of the artificial permafrost table (APT). During the operational years, there was no thawed interlayer in the UCRE. The development of the settlement rate is unaffected by the temperature field for either the left or right embankment shoulder

Flutamide ameliorates uterine decidualization and angiogenesis in the mouse hyperandrogenemia model during mid-pregnancy.

Background/aimPatients with polycystic ovary syndrome (PCOS), characterized by anovulation, hyperandrogenemia and polycystic ovaries, are still vulnerable to undergo recurrent pregnancy loss and premature labor even though the ovulatory process is pharmacologically recovered. However, its potential mechanism remains unknown. Thus, our aim was to investigate the effect and mechanism of hyperandrogenemia and flutamide (a non-steroidal anti-androgen) on the embryo implantation and pregnancy during mid-pregnancy.MethodsWe used a mouse model in which PCOS-like hyperandrogenemia was induced by subcutaneous injection of testosterone propionate. In this model, we observed the effect of hyperandrogenemia and flutamide on the decidualization, angiogenesis and uNK cells by methods of immunohistochemistry, quantitative PCR, western blotting and Dolichos biflorus agglutinin (DBA) lectin staining.ResultsTestosterone and flutamide treatment did not significantly influence the numbers of implanted embryo compared with the control group. However, different doses of testosterone significantly increased the ratio of resorbed /implanted embryo, decreased the level of prl8a2 mRNA and cyclin D3 protein, inhibited the uterine angiogenesis and reduced the numbers of uNK cells, but combined treatment with flutamide markedly decreased the resorbed embryos, increased expressions of prl8a2 mRNA and cyclin D3 protein and angiogenesis and numbers of uNK cells.ConclusionFlutamide treatment can efficiently ameliorate the hyperandrogenemia-induced the disorders in aspects of decidualization, angiogenesis and uNK cells, which further improve the poor endometrial receptivity in PCOS patients