We report a case of a woman who was incidentally diagnosed with acromegaly after referral for prolonged post-partum amenorrhea. A 25-year-old woman, gravida 2 para 1, had a normal transvaginal ...delivery and breastfeeding had been discontinued more than a year after delivery. Thereafter, spontaneous menstruation did not restart and she underwent hormonal therapy. Subsequently, she was referred to our university hospital for prolonged amenorrhea. Hormonal examination revealed severe hypogonadotropic hypogonadism (luteinizing hormone 0.5 mIU/mL, follicle-stimulating hormone < 1.0 mIU/mL, estradiol 13 pg/mL), along with a modest increase in serum prolactin levels (43.2 ng/mL). She also complained of milk ejection on nipple stimulation. Magnetic resonance imaging of the head was performed, because an organic abnormality in the central nervous system was suspected to be causing the amenorrhea, which revealed mass lesions extending from the pituitary fossa to the suprasellar area with similar signal intensity as the gray matter. In addition, bitemporal hemianopsia was observed on campimetry. After further examination, the patient was diagnosed with acromegaly.
We studied the IW And star V507 Cyg using ASAS-SN data, ZTF data and our snapshot photometry. The star has been found to be in a long standstill in 2020 May-2022 March (and it still continues now). ...Such long-lasting standstills have been found in a few other IW And stars in the past literature. We found that this system was systematically fainter by 0.3 mag between 2018 March and 2019 January when it showed dwarf nova-type variations, including IW And-type states. This is one of the clearest pieces of evidence that the dwarf nova-type state in Z Cam stars (in a broader sense) is associated with a decrease in the mass-transfer rate (~25% for a duration of 300 d in this case). The object also showed IW And-type phenomena in 2019, when the system was as bright as in the current long standstill. This finding suggests that the condition whether the IW And-type phenomenon occurs or not is subtle under the same mass-transfer rate.
This paper aims to examine the effectiveness of the complementary indicators from conventionally well-used monetary ones to evaluate public transportation planning in rural areas. Proposed ...non-monetary indicators for public transport services consist of “Quality of Life”, “Customer Satisfaction” and “Equality of public transport services”. An empirical analysis results show that the indicators are useful to evaluate the effects of improving the levels of public transport services and can consequently contribute to planning the public transportation planning.
CR Boo is one of the brightest and most famous AM CVn stars showing dwarf nova-type outbursts. Previous studies showed different modes of outbursts in this object ranging from the one equivalent to a ...hydrogen-rich ER UMa star or WZ Sge star to a low-amplitude oscillating state. We for the first time identified a bona fide standstill in this object in 2022 and we consider that CR Boo is a helium analog of Z Cam stars in addition to its SU UMa/ER UMa-type classification. The standstill lasted for ~60 d with variations typically less than 0.2 mag and ended with fading. This standstill was not preceded by a superoutburst and was different from a post-superoutburst phenomenon. The brightness after the standstill was similar to those after superoutbursts and the standstill appears to have acted like a superoutburst in effectively accreting the disk mass. The existence of a standstill in an AM CVn star be a challenge to theories of a helium disk or a degenerate secondary to explain how such a state could be maintained.
This paper aims to develop a GIS-aid planning system for public transportation in depopulated rural areas. The proposed system consists of travel demand forecasting system that evaluates the ...profitability of transportation planning alternatives, and evaluation system for non-monetary indices (i. e., Quality of Life, Customer Satisfaction and Equality). Travel frequency is estimated by using a discrete-continuous model, which is based on a non-compensatory utility function to represent conjunctive choice strategies. QOL and CS indices are calculated using an ordered probit model. Empirical analysis indicates that the proposed system is useful to evaluate the effects of improving levels of public transportation services and can consequently contdbute to develop public transportation plans efficiently.
This paper attempts to clarify better combinations of a new local bus system (i. e., DRT: Demand Responsive Transport) and existing regional buses at a bus terminal in order to provide convenient ...transfers between them in depopulated rural areas, where local buses are more frequent than regional ones. Especially, the paper focuses on how the elderly people's preferences of bus use are influenced by terminal environments, waiting time at the terminal and other level-of-service factors. For that purpose, bus use two SP models of bus use are developed to analyze the influences of seamless transfers at the terminal on the preferences of using both local and regional bus services. Furthermore, the required facilities and services when waiting at the terminal are also investigated, using the Covariance Structure Analysis method, from the perspective of improving the convenience and amenity
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