Association Between Vaginal Gardnerella and Tubal Pregnancy in Women With Symptomatic Early Pregnancies in China: A Nested Case-Control Study

The early diagnosis and treatment of ectopic pregnancy (EP) remains a major challenge. Despite a known link between vaginal microbiota and female reproductive health, few studies have focused on the association between vaginal microbiota and pregnancy location. This nested case-control study aimed to characterize the vaginal microbiota in tubal pregnancy (TP) among symptomatic women in early pregnancy. Women with symptomatic early pregnancy of unknown location (PUL) were included in this study. 16S rDNA gene sequencing was performed to assess vaginal microbial diversity and relative abundance. Machine learning and multivariate logistic regression were also used to evaluate the association between Gardnerella and TP. The results indicate that the vaginal microbiome in TP was more diverse (Shannon, p < 0.05) and was different in composition to that of women with intrauterine pregnancy (IUP) (weighted Unifrac, R = 0.08, p = 0.01). The genus Gardnerella was significantly enriched in TP. The XGBoost analysis was able to classify Gardnerella-induced TP more reliably (AUC = 0.621). Moreover, after adjusting potential confounders, our results indicate a robust association between Gardnerella and TP (as a continuous variable, adjusted OR: 12.0, 95% CI: 2.1–67.4, p < 0.01; as a categorical variable (≥0.85%), and adjusted OR: 4.2, 95% CI: 2.0–8.8, p < 0.01). In conclusion, we found that higher virginal Gardnerella levels were associated with TP in women with symptomatic early pregnancy.

Indices of Loading and Propulsive Ability in the Gait of Patients With Chronic Stroke With Equinus Foot Deviation: A Correlation Study

In literature, indices of overall walking ability that are based on ground reaction forces have been proposed because of their ease of administration with patients. In this study, we analyzed the correlation between the indices of dynamic loading and propulsion ability of 40 chronic hemiparetic post-stroke patients with equinus foot deviation and a set of clinical assessments of ankle joint deviations and walking ability. Ankle passive and active range of motion (ROM) and triceps surae spasticity were considered, along with walking speed and three complementary scales of walking ability focusing respectively on the need for assistance on functional mobility, including balance and transfers, and the limitation in social participation. The correlation between the ground reaction force-based indices and both clinical and functional variables was carried out using the non-parametric Spearman correlation coefficient. Both indices were correlated to 8 of the 10 investigated variables, thus supporting their use. In particular, the dynamic propulsive ability was correlated with all functional scales (rho = 0.5, p < 0.01), and has the advantage of being a continuous variable. Among clinical assessments, limited ankle ROM affected walking ability the most, while spasticity did not. Since the acquisition of ground reaction forces does not require any patient prepping, the derived indices can be used during the rehabilitation period to quickly detect small improvements that, over time, might lead to the broad changes detectable by clinical scales, as well as to immediately highlight the lack of these improvements, thus suggesting adjustments to the ongoing rehabilitation approach.

Resilience in agroecosystems: an index based on a socioecological systems approach

This article presents an agroecosystem resilience index (ARI) relative to two types of exogenous drivers: biophysical and socioeconomic threats. The ARI is based on a theoretical framework of socioecological systems and draws upon multicriteria analysis. The multicriteria consists of variables related to natural, productive, socioeconomic, and institutional systems that are weighted and grouped through expert judgment. The index was operationalized in the Rio Grande Basin (RGB), in the Colombian Andes. The ARI was evaluated at the household level using information from 99 RGB households obtained through workshops, individual semistructured interviews, and surveys. The ARI is a continuous variable that ranges between zero and one and results in five categories of resilience: very low, low, medium, high, and very high. When faced with climate change impacts, 19% of households showed low resilience, 64% medium resilience, and 16% high resilience according to the ARI. When faced with price fluctuations, 23% of households showed low resilience, 65% medium resilience, and 11% high resilience. Key variables associated with high resilience include the diversity of vegetation cover, households that have forests on their properties, a high degree of connectivity with other patches of forest, diversification of household economic activities, profitability of economic activities, availability of water sources, and good relationship with local institutions.

Effect of Estradiol as a Continuous Variable on Breast Cancer Survival by Menopausal Status: a Cohort Study in China

High levels of circulating estradiol (E2) are associated with increased risk of breast cancer, whereas its relationship with breast cancer prognosis is still unclear. We evaluated the effect of E2 concentration on survival endpoints among 8766 breast cancer cases diagnosed between 2005 and 2017 from the Tianjin Breast Cancer Cases Cohort. Levels of serum E2 were measured in pre-menopausal and post-menopausal women. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) between quartile of E2 levels and overall survival (OS) and progression-free survival (PFS) of breast cancer. The penalized spline was then used to test for non-linear relationships between E2 (continuous variable) and survival endpoints. 612 deaths and 982 progressions occurred over follow-up through 2017. Compared to women in the quartile 3, the highest quartile of E2 was associated with reduced risk of both PFS in pre-menopausal women (HR=1.79, 95% CI: 1.17-2.75, P=0.008) and OS in post-menopausal women (HR=1.35, 95% CI: 1.04-1.74, P=0.023). OS and PFS in pre-menopausal women exhibited a nonlinear relation (“L-shaped” and “U-shaped”, respectively) with E2 levels. However, there was a linear relationship in post-menopausal women. Moreover, patients with estrogen receptor-negative (ER-negative) breast cancer showed a “U-shaped” relationship with OS and PFS in pre-menopausal women. Pre-menopausal breast cancer patients have a plateau stage of prognosis at the intermediate concentrations of E2, whereas post-menopausal patients have no apparent threshold, and ER status may have an impact on this relationship.

Security Analysis of Continuous-Variable Measurement-Device-Independent Quantum Key Distribution Systems in Complex Communication Environments

Continuous-variable measure-device-independent quantum key distribution (CV-MDI QKD) is proposed to remove all imperfections originating from detection. However, there are still some inevitable imperfections in a practical CV-MDI QKD system. For example, there is a fluctuating channel transmittance in the complex communication environments. Here we investigate the security of the system under the effects of the fluctuating channel transmittance, where the transmittance is regarded as a fixed value related to communication distance in theory. We first discuss the parameter estimation in fluctuating channel transmittance based on these establishing of channel models, which has an obvious deviation compared with the estimated parameters in the ideal case. Then, we show the evaluated results when the channel transmittance respectively obeys the two-point distribution and the uniform distribution. In particular, the two distributions can be easily realized under the manipulation of eavesdroppers. Finally, we analyze the secret key rate of the system when the channel transmittance obeys the above distributions. The simulation analysis indicates that a slight fluctuation of the channel transmittance may seriously reduce the performance of the system, especially in the extreme asymmetric case. Furthermore, the communication between Alice, Bob and Charlie may be immediately interrupted. Therefore, eavesdroppers can manipulate the channel transmittance to complete a denial-of-service attack in a practical CV-MDI QKD system. To resist this attack, the Gaussian post-selection method can be exploited to calibrate the parameter estimation to reduce the deterioration of performance of the system.

Short-wave infrared continuous-variable quantum key distribution over satellite-to-submarine channels

The trans-media transmission of quantum pulse is one of means of free-space transmission which can be applied in continuous-variable quantum key distribution (CVQKD) system. In traditional implementations for atmospheric channels, the 1500-to-1600-nm pulse is regarded as an ideal quantum pulse carrier. Whereas, the underwater transmission of this pulses tends to suffer from severe attenuation, which inevitably deteriorates the security of the whole CVQKD system. In this paper, we propose an alternative scheme for implementations of CVQKD over satellite-to-submarine channels. We estimate the parameters of the trans-media channels, involving atmosphere, sea surface and seawater and find that the short-wave infrared performs well in the above channels. The 450 nm pulse is used for generations of quantum signal carriers to accomplish quantum communications through atmosphere, sea surface and seawater channels. Numerical simulations show that the proposed scheme can achieve the transmission distance of 600 km. In addition, we demonstrate that non-Gaussian operations can further lengthen its maximal transmission distance, which contributes to the establishment of practical global quantum networks.

Plasma MCP-1 and changes on cognitive function in community-dwelling older adults

Background Monocyte Chemoattractant Protein-1 (MCP-1), a glial-derived chemokine, mediates neuroinflammation and may regulate memory outcomes among older adults. We aimed to explore the associations of plasma MCP-1 levels (alone and in combination with β-amyloid deposition—Aβ42/40) with overall and domain-specific cognitive evolution among older adults. Methods Secondary analyses including 1097 subjects (mean age = 75.3 years ± 4.4; 63.8% women) from the Multidomain Alzheimer Preventive Trial (MAPT). MCP-1 (higher is worse) and Aβ42/40 (lower is worse) were measured in plasma collected at year 1. MCP-1 in continuous and as a dichotomy (values in the highest quartile (MCP-1+)) were used, as well as a dichotomy of Aβ42/40. Outcomes were measured annually over 4 years and included the following: cognitive composite z-score (CCS), the Mini-Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) sum of boxes (overall cognitive function); composite executive function z-score, composite attention z-score, Free and Cued Selective Reminding Test (FCSRT - memory). Results Plasma MCP-1 as a continuous variable was associated with the worsening of episodic memory over 4 years of follow-up, specifically in measures of free and cued delayed recall. MCP-1+ was associated with worse evolution in the CCS (4-year between-group difference: β = −0.14, 95%CI = −0.26, −0.02) and the CDR sum of boxes (2-year: β = 0.19, 95%CI = 0.06, 0.32). In domain-specific analyses, MCP-1+ was associated with declines in the FCSRT delayed recall sub-domains. In the presence of low Aβ42/40, MCP-1+ was not associated with greater declines in cognitive functions. The interaction with continuous biomarker values Aβ42/40× MCP-1 × time was significant in models with CDR sum of boxes and FCSRT DTR as dependent variables. Conclusions Baseline plasma MCP-1 levels were associated with longitudinal declines in overall cognitive and episodic memory performance in older adults over a 4-year follow-up. How plasma MCP-1 interacts with Aβ42/40 to determine cognitive decline at different stages of cognitive decline/dementia should be clarified by further research. The MCP-1 association on cognitive decline was strongest in those with amyloid plaques, as measured by blood plasma Aβ42/40.

Building a large-scale quantum computer with continuous-variable optical technologies

Realizing a large-scale quantum computer requires hardware platforms that can simultaneously achieve universality, scalability, and fault tolerance. As a viable pathway to meeting these requirements, quantum computation based on continuous-variable optical systems has recently gained more attention due to its unique advantages and approaches. This review introduces several topics of recent experimental and theoretical progress in the optical continuous-variable quantum computation that we believe are promising. In particular, we focus on scaling-up technologies enabled by time multiplexing, bandwidth broadening, and integrated optics, as well as hardware-efficient and robust bosonic quantum error correction schemes.