Due to significant advances in the treatment of human immunodeficiency virus type-1(HIV-1), HIV-1 infection gradually has become a treatable chronic disease. Successfully treated HIV-positive individuals can have a no...Due to significant advances in the treatment of human immunodeficiency virus type-1(HIV-1), HIV-1 infection gradually has become a treatable chronic disease. Successfully treated HIV-positive individuals can have a normal life expectancy. Hence, more and more HIV-1 discordant couples in Taiwan and the rest of the world are seeking fertility assistance. Pre-treatment of highly active antiretroviral therapy(HAART) combined with sperm washing and RT-polymerase chain reaction examination for HIV-1 viral load has become the standard procedure to assist them to conceive. However,in order to reduce the transmission risk to the lowest level for the couple and to diminish the cost of health care for the insurance institutes or government, in vitro fertilization(IVF)-intracytoplasmic sperm injection(ICSI) therapy provides the ideal solution for HIV-1 discordant couples with infected men. Intrauterine insemination(IUI) theoretically introduces more than 107 times of sperm counts or semen volume to uninfected women vs IVF-ICSI. However, since some regimens of HAART may significantly decrease the sperm motility, compared to IVF-ICSI, IUI only produces 1/5 to 1/2 pregnancy rates per cycle. Given the risk of seroconversion of HIV infection which actually happens after successful treatment, IVF-ICSI for these HIV-1 seropositive men is more cost-effective and should be the first line treatment for these cases.展开更多
Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships...Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.展开更多
Aim: To elucidate clinical features in patients with type 2 diabetes with advanced retinopathy but without nephropathy. Methods: This study examined 1324 patients (784 males and 540 females) with type 2 diabetes melli...Aim: To elucidate clinical features in patients with type 2 diabetes with advanced retinopathy but without nephropathy. Methods: This study examined 1324 patients (784 males and 540 females) with type 2 diabetes mellitus. Diabetic reti-nopathy was graded according to the International Clinical Classification of Diabetic Retinopathy as no diabetic reti-nopathy, mild or moderate non-proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy. Diabetic nephropathy was classified into four stages of severity according to the Guideline Committee of the Japan Diabetes Society. Each patient was examined for retinopathy grade and nephropathy stage. Clinical features of patients with proliferative diabetic retinopathy were compared with regard to the four grades of diabetic nephropathy. Results: Fifty-two patients with type 2 diabetes (3.9% of the whole series of 1324 patients with type 2 diabetes and 25.7% of patients with proliferative diabetic retinopathy) had proliferative diabetic retinopathy without the presence of nephropathy. Multiple statistical analysis using a proportional odds model revealed that pa-tients with proliferative diabetic retinopathy without nephropathy had a significantly lower systolic blood pressure (p < 0.001) than those who did and were preponderantly female (p < 0.05). Conclusions: A possible susceptibility of dia-betic females to proliferative advanced retinopathy without nephropathy encourages further studies on the role of hor-mones and blood coagulation in the pathogensis of proliferative diabetic retinopathy.展开更多
BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histolog...BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for H.pylori,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and specific.Typically,the results of histology and other tests align with each other.However,on rare occasions,discrepancy between histopathology and other H.pylori diagnostic tests occurs.AIM To investigate the discordance between histology and other H.pylori tests,the underlying causes,and the impact on clinical management.METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018.Reports were included in the study only if there were other H.pylori tests within seven days of the biopsy.These additional tests include CLO test,SA,and H.pylori culture.Concordance between histopathology and other tests was determined based on the consistency of results.In instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was reviewed.RESULTS Of 1396 pathology reports were identified,each accompanied by one additional H.pylori test.The concordance rates in detecting H.pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were identified.Only 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other tests.Four cases initially stained with Warthin-Starry turned out to be positive for H.pylori with subsequent IHC staining.Among the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other tests.Most patients underwent treatment,except for two who were untreated,and two patients who were lost to follow-up.CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test.Various factors may contribute to this inconsistency.Most patients in such cases had undergone treatment.展开更多
Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate....Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate.Methods A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023.Patients were categorized based on the nadir GH(GHn)and ICF-1 levels at the last follow-up into four groups:controlled,high GH,high IGF-1,and active.Clinical and metabolic parameters were compared across these groups,and impact of different CHn and fasting growth hormone(GHf)cut-offs on discordance rate vwas evaluated.Results No statistically significant differences were observed among groups in age,duration of followup,imaging characteristics(all P>0.05).High IGF-1 group had higher fasting insulin and homeostasis model assessment forβcell function compared to controlled and high GH group(all P<0.05),while these parameters did not differ between high GH and controlled group.High ICF-1 group had higher carboxy-terminal crosslinked telopeptide of type 1 collagen,osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group,but differences were not statistically significant(all P>0.05).These parameters also did not differ between high CH and controlled group.Discordance rate was not significantly different when CHn cut-offs were 1.0μg/L or 0.4μg/L(30.3%vs 21.3%,P=0.146).Compared to 2.5μg/L,discordance rate was lower when CHf cut-off was 1.0μg/L(39.4%us 24.3%,P=0.041).Conclusion The discordance rate in treated acromegaly patients during follow-up is approximately 30%.Different CH measurement timings and cut-offs significantly impact discordance rate.Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease,and require closer followup.This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.展开更多
Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes. This study aimed to investigate the perinatal risk factors and neonatal complications of discordant tw...Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes. This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit. Methods A total of 87 sets of twins were enrolled in this retrospective study, of which 22 sets were discordant twins and 65 sets were concordant twins. Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins. The common neonatal complications of discordant twins were also investigated. Results Multivariate analysis showed that the use of assisted reproductive techniques, pregnancy-induced hypertension, and unequal placental sharing were risk factors for the occurrence of discordant twins. The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher, while the birth weight of discordant twins was significantly lower than those of concordant twins. The duration of hospitalization of discordant twins was longer than that of concordant twins. The incidence of several neonatal complications, such as neonatal respiratory distress syndrome and intracranial hemorrhage, was higher in discordant twins than that in concordant twins. The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins. Conclusions Use of assisted reproductive techniques, pregnancy-induced hypertension, and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit. These infants are also much more likely to suffer from various neonatal complications, especially respiratory and central nervous system diseases. It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant twins.展开更多
There are many practical decision problems where decision makers＇ preferences may be inconsistent and contradictory. In this paper, new methods for ordering and classifying multi-attribute objects by discordant colle...There are many practical decision problems where decision makers＇ preferences may be inconsistent and contradictory. In this paper, new methods for ordering and classifying multi-attribute objects by discordant collective preferences are suggested. These methods are based on the theory of multiset metric spaces. The proposed techniques are applied to ranking companies and a competitive selection of projects, which are estimated by several experts upon multiple qualitative criteria.展开更多
Summary What is already known about this topic?HIV transmission among serodiscordant couples remains a persistent issue in China.However,the practice of combining counseling with antiretroviral therapies(ART)to enhanc...Summary What is already known about this topic?HIV transmission among serodiscordant couples remains a persistent issue in China.However,the practice of combining counseling with antiretroviral therapies(ART)to enhance ART adherence is not widely implemented or recommended in Chinese health guidelines.What is added by this report?展开更多
The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our unde...The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our understanding of the limitations of current biopsy protocols,it raises several concerns about the generalizability of its findings,sample size,and methodology.One major limitation was the exclusion of patients with ileal strictures,ileostomies,or J-pouches,which reduced the applicability of the results to the wider CD population.Furthermore,the biopsy protocol's focus on single biopsies from specific locations may inadequately capture the patchy inflammation characteristic of CD.The study also uses histologic indices primarily developed for ulcerative colitis,which may not be suitable for assessing CD.It is recommended that multi-center studies be conducted and histologic indices specific to CD be developed to improve the relevance of future research.Additionally,researchers should consider the influence of treatment regimens on the findings.Addressing these limitations would enhance the clinical significance of the study and inform better diagnostic and therapeutic approaches for CD.展开更多
Using quantum discord(QD)and geometric quantum discord(GQD),quantum correlation dynamics is investigated for two coupled qubits within a multiqubit interacting system in the zero-temperature bosonic reservoir,under bo...Using quantum discord(QD)and geometric quantum discord(GQD),quantum correlation dynamics is investigated for two coupled qubits within a multiqubit interacting system in the zero-temperature bosonic reservoir,under both weak and strong qubit-reservoir coupling regimes.The multiqubit system is connected with either a common bosonic reservoir(CBR)or multiple independent bosonic reservoirs(IBRs).In the CBR case,our findings indicate that both QD and GQD can be strengthened by increasing the number of qubits in the multiqubit system.Furthermore,we study the steady state QD and GQD in the strong coupling regime,and find that the stable value in the long-time limit is determined exclusively by the number of qubits.The evolution period of QD and GQD gets longer as the dipole–dipole interaction(DDI)strength increases,which helps prolong the correlation time and thus preserves the quantum correlation under the weak coupling regime.Further analysis reveals notable differences between the CBR and IBRs scenarios.In the IBRs case,the decay of QD and GQD becomes slower compared to the CBR case,with both measures tending to zero at a reduced rate.Moreover,GQD consistently exhibits lower values than QD in both scenarios.These findings provide valuable insights into the selection of appropriate correlation measurement techniques for quantifying quantum correlations.展开更多
BACKGROUND Discordance between endoscopic and histologic assessments in Crohn’s disease(CD)have been observed,however the prevalence and cause are unclear.AIM To assess if a protocolized approach to biopsy collection...BACKGROUND Discordance between endoscopic and histologic assessments in Crohn’s disease(CD)have been observed,however the prevalence and cause are unclear.AIM To assess if a protocolized approach to biopsy collection facilitates understanding of this discordance in patients with ileal CD.METHODS Patients with known ileal CD underwent colonoscopy with endoscopic disease activity assessment.Three protocolized biopsies were taken respectively from an ulcer edge,7-mm,and 14-mm away from the ulcer edge in patients with discrete ileal ulcer(s).In patients with no ulcers as controls,the same 3-site biopsy protocol was applied in a randomly selected area of endoscopically-unremarkable terminal ileal mucosa.A blinded pathologist assessed mucosal inflammation in each biopsy using 3 validated histologic indices.RESULTS Twenty-four participants had visible ulcer(s)on endoscopy and 12 served as no-ulcer controls.Of biopsies taken from an ulcer edge,only 67%showed histologic evidence of active(neutrophilic)inflammation,and 33%showed histologic features of ulcer or erosion;all were from either large(n=4)or very large(n=4)ulcers.In the no-ulcer controls,no biopsies showed histologic features of ulcer or erosion,but 8%showed active inflammation.CONCLUSION A striking discordance exists between endoscopic and histologic assessments for mucosal inflammation in patients with active ileal CD,even in biopsies targeted at an ulcer edge,while a higher concordance is seen in patients with no endoscopic disease activity.It remains unclear how to incorporate histologic disease activity into the treatment paradigm.Further research is needed to optimize biopsy protocols and histologic assessments for CD.展开更多
Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Metho...Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Methods:This study included 300 patients diagnosed with invasive breast cancer who were treated with both NAC and surgery between 2012 and 2021.The hormone receptor(HR)and human epidermal growth factor receptor 2(HER2)levels were measured before and after NAC.The prognostic impact of receptor conversion was also evaluated in patients receiving NAC,by using the Kaplan-Meier method and Cox proportional hazards models as statistical methods.Results:The conversion rate of estrogen receptor–positive(ER^(+))to ER-negative(ER^(-))was similar to that of ER^(-)to ER^(+)(9.2%and10.9%,respectively).The proportion of HR^(-)to HR^(+)was remarkably higher than that of HR^(+)to HR^(-)(14.8%vs 9.2%,respectively).The change from HER2^(+)to HER2^(-)was significantly more frequently than that from HER2^(-)to HER2^(+)(20.3%vs 6%,respectively).Patients with ER and HR status changes from(-)to(+)after NAC had significantly worse recurrence-free survival(RFS)and overall survival(OS)than those in the other 3 groups(ER^(-)to ER^(+):RFS:p=0.002,OS:p<0.001;HR^(-)to HR^(+):RFS:p=0.003,OS:p<0.001).The 4 HER2 conversion subgroups were not significantly associated with RFS or OS.Conclusions:This study demonstrated a discordance in HR status after NAC and identified predictors of conversion.Patients whose HR status switched to positive after NAC had the worst 3-year RFS and OS rates.展开更多
We herein describe a new species of spiny frog,Quasipaa yunkaiensis sp.nov.from Yunkaishan National Nature Reserve,Xinyi City,Guangdong Province,China.Morphological examination combined with mitochondrial(810 bp Cyt b...We herein describe a new species of spiny frog,Quasipaa yunkaiensis sp.nov.from Yunkaishan National Nature Reserve,Xinyi City,Guangdong Province,China.Morphological examination combined with mitochondrial(810 bp Cyt b)and nuclear(1852 bp concatenated Rag2,Tyr,and Rhod)genetic data was used to test its distinctiveness within Quasipaa.Morphologically,the new species differs from other congeners by the following diagnostic characteristics:relatively large body size within Quasipaa;dorsal skin relatively smooth,having sparse tubercles;lacking spiny tubercles on the ventrolateral sides of the body;lacking keratinized spines in the ventral surface of the body,only present on prepollex,fingers I and II,in breeding males.Both mitochondrial and nuclear phylogenetic results indicate that Quasipaa yunkaiensis sp.nov.constitutes a highly supported,deeply divergent lineage,but its precise phylogenetic placement within the genus Quasipaa remains unresolved.In view of the pronounced discordance between mitochondrial and nuclear datasets within Quasipaa,we encourage future studies to use genome-wide data to improve phylogenetic resolution and to estimate species diversity more accurately.展开更多
From a compilation of geochemical data for the discrimination of the tectonic settings of mid-ocean ridge(MOR;3730 samples)and oceanic plateau(OP;3656 samples),we present two new discriminant functions and diagrams ob...From a compilation of geochemical data for the discrimination of the tectonic settings of mid-ocean ridge(MOR;3730 samples)and oceanic plateau(OP;3656 samples),we present two new discriminant functions and diagrams obtained from censored multivariate discordant outlier-free datasets.Ten different sets of data(original concentrations as well as isometric log-ratio transformed(ilr)variables;all 10 major(M)elements as well as all 10 major and 6 trace elements MT)were used to evaluate the quality of discrimination from linear discriminant analysis(LDA)and canonical analysis.Two selected multidimensional models ilrM(9 ilr transformed variables of multi-normally distributed 10 major elements)and ilrMT(15 ilr transformed variables of multi-normally distributed combined 10 major and 6 trace elements),considered as the best or most representative(total of5650 samples for ilrM and 2858 for ilrMT),provided percent success values,respectively,of 80.9%for the MOR and 81.1%for the OP(ilrM)and 88.5%for the MOR and 90.1%for the OP(ilrMT).Both processes(log-ratio transformation and multi-normality)rendered the percent success values similar for both groups(MOR and OP).The respective discriminant functions were successfully used for four tests from known tectonic settings and four application cases(two for ophiolites and two for Precambrian rocks),documenting thus the utility of the new discrimination procedure for the MOR and OP tectonic settings.Furthermore,we showed that our multidimensional procedure is robust against analytical errors or uncertainties,as well as post-emplacement compositional changes caused by element mobility from both low or high temperature alteration.The robustness against the gain or loss of a single element at a time was also documented,from which the ilrMT model was evaluated as more robust than the ilrM model.A new online computer program MOROPdisc was written in Java Framework ZK,which is freely available for use at our web portal http://tlaloc.ier.unam.mx.展开更多
BACKGROUND Follicular lymphoma(FL),a common type of indolent lymphoma,carries markers of the germinal center,and the rearrangement of the BCL-2 gene is regarded as an initiating event and a hallmark of the neoplasm.Wh...BACKGROUND Follicular lymphoma(FL),a common type of indolent lymphoma,carries markers of the germinal center,and the rearrangement of the BCL-2 gene is regarded as an initiating event and a hallmark of the neoplasm.When FL has marginal zone differentiation,some marginal zone features are carried by the neoplasm.CASE SUMMARY A 54-year-old male with lymphadenopathy,splenomegaly and hyperlymphocytosis was diagnosed with FL with marginal zone differentiation.The tumor demonstrated different features in the bone marrow(BM)compared with the follicle of the lymph node(LN).Some component of the neoplasm mimicked marginal zone lymphoma,such as infiltrating the marginal zone of the LN,displaying a monocytoid shape and lacking the expression of CD10 in the BM.The diagnosis of FL was made due to the concurrent detection of BCL-2 rearrangement in the LN and BM.CONCLUSION Discordant pathological features in LN and BM could mislead diagnosis.When clinical and pathological manifestations are confusing in diagnosis,typical genetic abnormalities are decisive.展开更多
The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Neg...The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Negative (HESN) partners to highlight background morbidities that might impact the interpretation of research findings especially in low income countries where “normal control” is based on physical appearance and self-reporting. We established a 2-year prospective cohort of HESN, and obtained, at baseline medical history, general physical examination findings and safety laboratory tests results. Among 534 participants with a mean age of 37 ± 9 years, the commonest symptoms were headache (25.5%) and fever (20%), which occurred more among females. Also, 13% reported a history of urethral/vaginal discharge and genital ulcer. High blood pressure (HBP) (i.e. blood pressure ≥ 140/90 mmhg) was a major abnormal examination finding, which occurred more among males (53.2% vs 26.2%, p < 0.01). More female participants had abnormal laboratory results with 31% having low hemoglobin concentration (<12 g/dl, p = 0.021);30% with elevated alanine transaminase level (p = 0.019) and 28% with abnormal blood urea nitrogen level (p = 0.093). HBP and abnormal safety laboratory are significant findings among so called “normal population” that could affect interpretation of research findings of HIV biomedical prevention studies in Nigeria.展开更多
This work briefly reviews and extends the author’s three previous works (2015), Journal of Modern Physics, 6, 78-87, and 1360-1370;(2016), 7, 1829-1844 that propose as an alternative to the accelerating ΛCDM univers...This work briefly reviews and extends the author’s three previous works (2015), Journal of Modern Physics, 6, 78-87, and 1360-1370;(2016), 7, 1829-1844 that propose as an alternative to the accelerating ΛCDM universe, the decelerating Einstein de Sitter (EdS) universe, in which dark energy is a different phase of dark matter located only in intergalactic space (IGS), and that instead of a negative pressure, it has an index of refraction n≈1.50, and hence a reduced speed of light c / n through it. This allows the EdS universe to expand the extra distance necessary to obtain the diminished brightness of the Type Ia supernovae. In view of the recent suggestion that the universe is not accelerating, but possibly expanding uniformly, a table is given comparing both the accelerating and uniformly expanding universes with the EdS universe supplemented by the reduced speed of light. It is shown that fitting the uniformly expanding universe leads to a smaller value of n, and hence too short an age for the EdS universe, unlike the case with fitting the accelerating universe. The main result is that the proposed reduced speed of light in the IGS predicts discordant redshifts. It is shown that the current explanation of “accidental superposition,” is most likely insufficient to explain the number of observations, and that the present proposal could make up the difference. It can be tested astronomically, as illustrated in a figure.展开更多
文摘Due to significant advances in the treatment of human immunodeficiency virus type-1(HIV-1), HIV-1 infection gradually has become a treatable chronic disease. Successfully treated HIV-positive individuals can have a normal life expectancy. Hence, more and more HIV-1 discordant couples in Taiwan and the rest of the world are seeking fertility assistance. Pre-treatment of highly active antiretroviral therapy(HAART) combined with sperm washing and RT-polymerase chain reaction examination for HIV-1 viral load has become the standard procedure to assist them to conceive. However,in order to reduce the transmission risk to the lowest level for the couple and to diminish the cost of health care for the insurance institutes or government, in vitro fertilization(IVF)-intracytoplasmic sperm injection(ICSI) therapy provides the ideal solution for HIV-1 discordant couples with infected men. Intrauterine insemination(IUI) theoretically introduces more than 107 times of sperm counts or semen volume to uninfected women vs IVF-ICSI. However, since some regimens of HAART may significantly decrease the sperm motility, compared to IVF-ICSI, IUI only produces 1/5 to 1/2 pregnancy rates per cycle. Given the risk of seroconversion of HIV infection which actually happens after successful treatment, IVF-ICSI for these HIV-1 seropositive men is more cost-effective and should be the first line treatment for these cases.
文摘Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%);although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners;all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.
文摘Aim: To elucidate clinical features in patients with type 2 diabetes with advanced retinopathy but without nephropathy. Methods: This study examined 1324 patients (784 males and 540 females) with type 2 diabetes mellitus. Diabetic reti-nopathy was graded according to the International Clinical Classification of Diabetic Retinopathy as no diabetic reti-nopathy, mild or moderate non-proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, and proliferative diabetic retinopathy. Diabetic nephropathy was classified into four stages of severity according to the Guideline Committee of the Japan Diabetes Society. Each patient was examined for retinopathy grade and nephropathy stage. Clinical features of patients with proliferative diabetic retinopathy were compared with regard to the four grades of diabetic nephropathy. Results: Fifty-two patients with type 2 diabetes (3.9% of the whole series of 1324 patients with type 2 diabetes and 25.7% of patients with proliferative diabetic retinopathy) had proliferative diabetic retinopathy without the presence of nephropathy. Multiple statistical analysis using a proportional odds model revealed that pa-tients with proliferative diabetic retinopathy without nephropathy had a significantly lower systolic blood pressure (p < 0.001) than those who did and were preponderantly female (p < 0.05). Conclusions: A possible susceptibility of dia-betic females to proliferative advanced retinopathy without nephropathy encourages further studies on the role of hor-mones and blood coagulation in the pathogensis of proliferative diabetic retinopathy.
文摘BACKGROUND A reliable test is essential for diagnosing Helicobacter pylori(H.pylori)infection,and crucial for managing H.pylori-related diseases.Serving as an excellent method for detecting H.pylori infection,histologic examination is a test that clinicians heavily rely on,especially when complemented with immunohistochemistry(IHC).Additionally,other diagnostic tests for H.pylori,such as the rapid urease test(CLO test)and stool antigen test(SA),are also highly sensitive and specific.Typically,the results of histology and other tests align with each other.However,on rare occasions,discrepancy between histopathology and other H.pylori diagnostic tests occurs.AIM To investigate the discordance between histology and other H.pylori tests,the underlying causes,and the impact on clinical management.METHODS Pathology reports of gastric biopsies were retrieved spanning August 2013 and July 2018.Reports were included in the study only if there were other H.pylori tests within seven days of the biopsy.These additional tests include CLO test,SA,and H.pylori culture.Concordance between histopathology and other tests was determined based on the consistency of results.In instances where histology results were negative while other tests were positive,the slides were retrieved for re-assessment,and the clinical chart was reviewed.RESULTS Of 1396 pathology reports were identified,each accompanied by one additional H.pylori test.The concordance rates in detecting H.pylori infection between biopsy and other tests did not exhibit significant differences based on the number of biopsy fragments.117 discrepant cases were identified.Only 20 cases(9 with CLO test and 11 with SA)had negative biopsy but positive results in other tests.Four cases initially stained with Warthin-Starry turned out to be positive for H.pylori with subsequent IHC staining.Among the remaining 16 true discrepant cases,10 patients were on proton pump inhibitors before the biopsy and/or other tests.Most patients underwent treatment,except for two who were untreated,and two patients who were lost to follow-up.CONCLUSION There are rare discrepant cases with negative biopsy but positive in SA or CLO test.Various factors may contribute to this inconsistency.Most patients in such cases had undergone treatment.
文摘Objective To analyze clinical characteristics of acromegaly patients who have discordant growth hormone(GH)or insulin-like growth factor-1(IGF-1)levels and evaluate impact of different GH cut-offs on discordance rate.Methods A retrospective analysis was conducted on data from 66 acromegaly patients treated at Nanjing Drum Tower Hospital from November 2017 to March 2023.Patients were categorized based on the nadir GH(GHn)and ICF-1 levels at the last follow-up into four groups:controlled,high GH,high IGF-1,and active.Clinical and metabolic parameters were compared across these groups,and impact of different CHn and fasting growth hormone(GHf)cut-offs on discordance rate vwas evaluated.Results No statistically significant differences were observed among groups in age,duration of followup,imaging characteristics(all P>0.05).High IGF-1 group had higher fasting insulin and homeostasis model assessment forβcell function compared to controlled and high GH group(all P<0.05),while these parameters did not differ between high GH and controlled group.High ICF-1 group had higher carboxy-terminal crosslinked telopeptide of type 1 collagen,osteocalcin and procollagen type 1 N-terminal propeptide compared to controlled and high GH group,but differences were not statistically significant(all P>0.05).These parameters also did not differ between high CH and controlled group.Discordance rate was not significantly different when CHn cut-offs were 1.0μg/L or 0.4μg/L(30.3%vs 21.3%,P=0.146).Compared to 2.5μg/L,discordance rate was lower when CHf cut-off was 1.0μg/L(39.4%us 24.3%,P=0.041).Conclusion The discordance rate in treated acromegaly patients during follow-up is approximately 30%.Different CH measurement timings and cut-offs significantly impact discordance rate.Patients with normal GH and elevated IGF-1 levels are at potential risk of active disease,and require closer followup.This study provides a valuable reference for treatment of patients with discordant GH and IGF-1 levels.
文摘Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes. This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit. Methods A total of 87 sets of twins were enrolled in this retrospective study, of which 22 sets were discordant twins and 65 sets were concordant twins. Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins. The common neonatal complications of discordant twins were also investigated. Results Multivariate analysis showed that the use of assisted reproductive techniques, pregnancy-induced hypertension, and unequal placental sharing were risk factors for the occurrence of discordant twins. The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher, while the birth weight of discordant twins was significantly lower than those of concordant twins. The duration of hospitalization of discordant twins was longer than that of concordant twins. The incidence of several neonatal complications, such as neonatal respiratory distress syndrome and intracranial hemorrhage, was higher in discordant twins than that in concordant twins. The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins. Conclusions Use of assisted reproductive techniques, pregnancy-induced hypertension, and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit. These infants are also much more likely to suffer from various neonatal complications, especially respiratory and central nervous system diseases. It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant twins.
文摘There are many practical decision problems where decision makers＇ preferences may be inconsistent and contradictory. In this paper, new methods for ordering and classifying multi-attribute objects by discordant collective preferences are suggested. These methods are based on the theory of multiset metric spaces. The proposed techniques are applied to ranking companies and a competitive selection of projects, which are estimated by several experts upon multiple qualitative criteria.
基金Funding The study was supported by the National Health Commission of the People’s Republic of China(grant number 2018ZX10721102).
文摘Summary What is already known about this topic?HIV transmission among serodiscordant couples remains a persistent issue in China.However,the practice of combining counseling with antiretroviral therapies(ART)to enhance ART adherence is not widely implemented or recommended in Chinese health guidelines.What is added by this report?
文摘The recent study published by Lee et al examined the discrepancies between endoscopic and histologic evaluations of mucosal inflammation in active ileal Crohn’s disease(CD).While this research contributes to our understanding of the limitations of current biopsy protocols,it raises several concerns about the generalizability of its findings,sample size,and methodology.One major limitation was the exclusion of patients with ileal strictures,ileostomies,or J-pouches,which reduced the applicability of the results to the wider CD population.Furthermore,the biopsy protocol's focus on single biopsies from specific locations may inadequately capture the patchy inflammation characteristic of CD.The study also uses histologic indices primarily developed for ulcerative colitis,which may not be suitable for assessing CD.It is recommended that multi-center studies be conducted and histologic indices specific to CD be developed to improve the relevance of future research.Additionally,researchers should consider the influence of treatment regimens on the findings.Addressing these limitations would enhance the clinical significance of the study and inform better diagnostic and therapeutic approaches for CD.
基金supported by the National Natural Science Foundation of China(Grant Nos.11564013 and 11964010)the Natural Science Foundation of Hunan Province(Grant No.2020JJ4495)the Scientific Research Fund of Hunan Provincial Education Department,China(Grant Nos.22A0377 and 21A0333).
文摘Using quantum discord(QD)and geometric quantum discord(GQD),quantum correlation dynamics is investigated for two coupled qubits within a multiqubit interacting system in the zero-temperature bosonic reservoir,under both weak and strong qubit-reservoir coupling regimes.The multiqubit system is connected with either a common bosonic reservoir(CBR)or multiple independent bosonic reservoirs(IBRs).In the CBR case,our findings indicate that both QD and GQD can be strengthened by increasing the number of qubits in the multiqubit system.Furthermore,we study the steady state QD and GQD in the strong coupling regime,and find that the stable value in the long-time limit is determined exclusively by the number of qubits.The evolution period of QD and GQD gets longer as the dipole–dipole interaction(DDI)strength increases,which helps prolong the correlation time and thus preserves the quantum correlation under the weak coupling regime.Further analysis reveals notable differences between the CBR and IBRs scenarios.In the IBRs case,the decay of QD and GQD becomes slower compared to the CBR case,with both measures tending to zero at a reduced rate.Moreover,GQD consistently exhibits lower values than QD in both scenarios.These findings provide valuable insights into the selection of appropriate correlation measurement techniques for quantifying quantum correlations.
文摘BACKGROUND Discordance between endoscopic and histologic assessments in Crohn’s disease(CD)have been observed,however the prevalence and cause are unclear.AIM To assess if a protocolized approach to biopsy collection facilitates understanding of this discordance in patients with ileal CD.METHODS Patients with known ileal CD underwent colonoscopy with endoscopic disease activity assessment.Three protocolized biopsies were taken respectively from an ulcer edge,7-mm,and 14-mm away from the ulcer edge in patients with discrete ileal ulcer(s).In patients with no ulcers as controls,the same 3-site biopsy protocol was applied in a randomly selected area of endoscopically-unremarkable terminal ileal mucosa.A blinded pathologist assessed mucosal inflammation in each biopsy using 3 validated histologic indices.RESULTS Twenty-four participants had visible ulcer(s)on endoscopy and 12 served as no-ulcer controls.Of biopsies taken from an ulcer edge,only 67%showed histologic evidence of active(neutrophilic)inflammation,and 33%showed histologic features of ulcer or erosion;all were from either large(n=4)or very large(n=4)ulcers.In the no-ulcer controls,no biopsies showed histologic features of ulcer or erosion,but 8%showed active inflammation.CONCLUSION A striking discordance exists between endoscopic and histologic assessments for mucosal inflammation in patients with active ileal CD,even in biopsies targeted at an ulcer edge,while a higher concordance is seen in patients with no endoscopic disease activity.It remains unclear how to incorporate histologic disease activity into the treatment paradigm.Further research is needed to optimize biopsy protocols and histologic assessments for CD.
基金supported by grants from the Basic Research Project of Shanxi Science and Technology Department(no.202303021221190)the Shanxi General Surgery“136”Healthcare Engineering Project(no.2024XYZ03)。
文摘Background:This study assessed the frequency of changes in some key receptor status of tumors after neoadjuvant chemotherapy(NAC)in patients with invasive breast cancer and the prognostic impact of these changes.Methods:This study included 300 patients diagnosed with invasive breast cancer who were treated with both NAC and surgery between 2012 and 2021.The hormone receptor(HR)and human epidermal growth factor receptor 2(HER2)levels were measured before and after NAC.The prognostic impact of receptor conversion was also evaluated in patients receiving NAC,by using the Kaplan-Meier method and Cox proportional hazards models as statistical methods.Results:The conversion rate of estrogen receptor–positive(ER^(+))to ER-negative(ER^(-))was similar to that of ER^(-)to ER^(+)(9.2%and10.9%,respectively).The proportion of HR^(-)to HR^(+)was remarkably higher than that of HR^(+)to HR^(-)(14.8%vs 9.2%,respectively).The change from HER2^(+)to HER2^(-)was significantly more frequently than that from HER2^(-)to HER2^(+)(20.3%vs 6%,respectively).Patients with ER and HR status changes from(-)to(+)after NAC had significantly worse recurrence-free survival(RFS)and overall survival(OS)than those in the other 3 groups(ER^(-)to ER^(+):RFS:p=0.002,OS:p<0.001;HR^(-)to HR^(+):RFS:p=0.003,OS:p<0.001).The 4 HER2 conversion subgroups were not significantly associated with RFS or OS.Conclusions:This study demonstrated a discordance in HR status after NAC and identified predictors of conversion.Patients whose HR status switched to positive after NAC had the worst 3-year RFS and OS rates.
基金supported by the DFGP Project of Fauna of Guangdong-202115,Science and Technology Planning Projects of Guangdong Province(2021B1212110002)the National Natural Science Foundation of China(32400361)+1 种基金Biological Resources Programme,Chinese Academy of Sciences(CAS-TAX-24-052)the project“Population Survey and Monitoring of the Shinisaurus crocodilurus and Syntopic Amphibian and Reptile Inventory”supported by the Guangdong Wildlife Rescue and Monitoring Center.
文摘We herein describe a new species of spiny frog,Quasipaa yunkaiensis sp.nov.from Yunkaishan National Nature Reserve,Xinyi City,Guangdong Province,China.Morphological examination combined with mitochondrial(810 bp Cyt b)and nuclear(1852 bp concatenated Rag2,Tyr,and Rhod)genetic data was used to test its distinctiveness within Quasipaa.Morphologically,the new species differs from other congeners by the following diagnostic characteristics:relatively large body size within Quasipaa;dorsal skin relatively smooth,having sparse tubercles;lacking spiny tubercles on the ventrolateral sides of the body;lacking keratinized spines in the ventral surface of the body,only present on prepollex,fingers I and II,in breeding males.Both mitochondrial and nuclear phylogenetic results indicate that Quasipaa yunkaiensis sp.nov.constitutes a highly supported,deeply divergent lineage,but its precise phylogenetic placement within the genus Quasipaa remains unresolved.In view of the pronounced discordance between mitochondrial and nuclear datasets within Quasipaa,we encourage future studies to use genome-wide data to improve phylogenetic resolution and to estimate species diversity more accurately.
文摘From a compilation of geochemical data for the discrimination of the tectonic settings of mid-ocean ridge(MOR;3730 samples)and oceanic plateau(OP;3656 samples),we present two new discriminant functions and diagrams obtained from censored multivariate discordant outlier-free datasets.Ten different sets of data(original concentrations as well as isometric log-ratio transformed(ilr)variables;all 10 major(M)elements as well as all 10 major and 6 trace elements MT)were used to evaluate the quality of discrimination from linear discriminant analysis(LDA)and canonical analysis.Two selected multidimensional models ilrM(9 ilr transformed variables of multi-normally distributed 10 major elements)and ilrMT(15 ilr transformed variables of multi-normally distributed combined 10 major and 6 trace elements),considered as the best or most representative(total of5650 samples for ilrM and 2858 for ilrMT),provided percent success values,respectively,of 80.9%for the MOR and 81.1%for the OP(ilrM)and 88.5%for the MOR and 90.1%for the OP(ilrMT).Both processes(log-ratio transformation and multi-normality)rendered the percent success values similar for both groups(MOR and OP).The respective discriminant functions were successfully used for four tests from known tectonic settings and four application cases(two for ophiolites and two for Precambrian rocks),documenting thus the utility of the new discrimination procedure for the MOR and OP tectonic settings.Furthermore,we showed that our multidimensional procedure is robust against analytical errors or uncertainties,as well as post-emplacement compositional changes caused by element mobility from both low or high temperature alteration.The robustness against the gain or loss of a single element at a time was also documented,from which the ilrMT model was evaluated as more robust than the ilrM model.A new online computer program MOROPdisc was written in Java Framework ZK,which is freely available for use at our web portal http://tlaloc.ier.unam.mx.
文摘BACKGROUND Follicular lymphoma(FL),a common type of indolent lymphoma,carries markers of the germinal center,and the rearrangement of the BCL-2 gene is regarded as an initiating event and a hallmark of the neoplasm.When FL has marginal zone differentiation,some marginal zone features are carried by the neoplasm.CASE SUMMARY A 54-year-old male with lymphadenopathy,splenomegaly and hyperlymphocytosis was diagnosed with FL with marginal zone differentiation.The tumor demonstrated different features in the bone marrow(BM)compared with the follicle of the lymph node(LN).Some component of the neoplasm mimicked marginal zone lymphoma,such as infiltrating the marginal zone of the LN,displaying a monocytoid shape and lacking the expression of CD10 in the BM.The diagnosis of FL was made due to the concurrent detection of BCL-2 rearrangement in the LN and BM.CONCLUSION Discordant pathological features in LN and BM could mislead diagnosis.When clinical and pathological manifestations are confusing in diagnosis,typical genetic abnormalities are decisive.
文摘The burden and viral diversity of HIV in Nigeria makes it suitable to evaluate biomedical prevention strategies including HIV vaccines. We document baseline clinical characteristics of a cohort of HIV Exposed Sero-Negative (HESN) partners to highlight background morbidities that might impact the interpretation of research findings especially in low income countries where “normal control” is based on physical appearance and self-reporting. We established a 2-year prospective cohort of HESN, and obtained, at baseline medical history, general physical examination findings and safety laboratory tests results. Among 534 participants with a mean age of 37 ± 9 years, the commonest symptoms were headache (25.5%) and fever (20%), which occurred more among females. Also, 13% reported a history of urethral/vaginal discharge and genital ulcer. High blood pressure (HBP) (i.e. blood pressure ≥ 140/90 mmhg) was a major abnormal examination finding, which occurred more among males (53.2% vs 26.2%, p < 0.01). More female participants had abnormal laboratory results with 31% having low hemoglobin concentration (<12 g/dl, p = 0.021);30% with elevated alanine transaminase level (p = 0.019) and 28% with abnormal blood urea nitrogen level (p = 0.093). HBP and abnormal safety laboratory are significant findings among so called “normal population” that could affect interpretation of research findings of HIV biomedical prevention studies in Nigeria.
文摘This work briefly reviews and extends the author’s three previous works (2015), Journal of Modern Physics, 6, 78-87, and 1360-1370;(2016), 7, 1829-1844 that propose as an alternative to the accelerating ΛCDM universe, the decelerating Einstein de Sitter (EdS) universe, in which dark energy is a different phase of dark matter located only in intergalactic space (IGS), and that instead of a negative pressure, it has an index of refraction n≈1.50, and hence a reduced speed of light c / n through it. This allows the EdS universe to expand the extra distance necessary to obtain the diminished brightness of the Type Ia supernovae. In view of the recent suggestion that the universe is not accelerating, but possibly expanding uniformly, a table is given comparing both the accelerating and uniformly expanding universes with the EdS universe supplemented by the reduced speed of light. It is shown that fitting the uniformly expanding universe leads to a smaller value of n, and hence too short an age for the EdS universe, unlike the case with fitting the accelerating universe. The main result is that the proposed reduced speed of light in the IGS predicts discordant redshifts. It is shown that the current explanation of “accidental superposition,” is most likely insufficient to explain the number of observations, and that the present proposal could make up the difference. It can be tested astronomically, as illustrated in a figure.
