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Aims Information on breastfeeding and the safety of biologics in infants is lacking due to difficulties in case collection. We evaluated a method for determining the concentration of biologics in breast milk using a dry filter method that can simplify the collection, storage, and transport of breast milk. Methods To generate dried filter paper (DFP) samples, approximately 30 L of breast milk was placed onto a Whatman 903 card and punched out. After extraction, the supernatant was measured using an enzyme-linked immunosorbent assay. Three concentrations of each drug were prepared in liquid breast milk (LBM) and DFP samples for stability testing, which confirmed that samples were stable up to 28 days after storage at 2–8 ºC or -20 ºC for LBM and at 25±5 ºC for DFP. LBM and DFP samples were provided by lactating mothers using biologics during lactation. Drug concentrations were compared. Results Breast milk was provided by 12 lactating mothers (tocilizumab, n=4; abatacept, n=2; etanercept, n=1; golimumab, n=1; sarilumab, n=1; and belimumab, n=3). The accuracy and precision of measurements for the six drugs were within acceptable limits. After 28 days, concentrations remained at more than 90% under all storage conditions. The quantitative values of the provided LBM and DFP samples were similar. The maximum relative infant dose ranged from 0.09% to 1.12%, which was an acceptable range. Conclusion A method for determining the concentration of biologics using DFP is expected to help improve pharmacotherapy for lactating women.

With the rapid development of science and technology, paper-based functional materials have become the core of the field of new materials. Recently, they have received extensive attention in the field of energy storage due to their advantages of rich and adjustable porous network structure, good flexibility. As an important energy storage device, paper-based supercapacitors have important application prospects in many fields, and have also received extensive attention from researchers in recent years. At present, researchers have modified and regulated paper-based materials by different means such as structural design and material composition to enhance their electrochemical storage capacity. The development of paper-based supercapacitors provides an important direction for the development of green and sustainable energy. Therefore, it is of great significance to summarize the relevant work of paper-based supercapacitors for their rapid development and application. In this review, the recent research progress of paper-based supercapacitors based on cellulose was summarized in terms of various cellulose-based composites, preparation skills and electrochemical performance. Finally, some opinions on the problems in the development of this field and the future development trend were proposed. It is hoped that this review can provide valuable references and ideas for the rapid development of paper-based energy storage devices.

Paper mulberry pollens are known to trigger severe allergies that can also cause asthma exacerbations. In Islamabad, the paper mulberry pollen concentrations are thought to peak between the 10th and 31st of March each year, depending on the weather in the preceding months. However, more accurate prediction of high pollen days would allow patients to take more timely precautionary measures. We developed and validated two prediction algorithms that took historical pollen data and historical weather data in Islamabad as its input. One is based on linear regression and the other is based on phenological modelling. These algorithms gave encouraging results where the mean absolute error for start day was between 2.33 and 3.67 days. On the other hand, for peak day, the mean absolute error was recorded between 3.33 and 4 days. These results could be used in a website or app to notify patients and healthcare providers to start preparing for the paper mulberry pollen season and its adverse effects.

Medicine has always reflected the behavior of its practitioners. It can look back on an impressive history with the Hippocratic Oath, which is approximately 2000 to 2500 years old. But despite this history, the question remains why there should be medical ethics or whether it is not sufficient to demand morally of a physician what is to be demanded of every citizen anyway. A paper by the “Ethics in Medicine Working Group“ of the International Association of Therapists & Medical Doctors (IAAT).

Narcolepsy with cataplexy is an often underestimated disorder in both its primary and secondary forms. As with epilepsy, narcolepsy and cataplexy pose a high risk of injury to the patient. Yet, narcoleptics have historically received poorer care than epileptics with regard to non-pharmacological aids. This “White Paper” informs both professionals and patients about protective measures that are advisable.

Scientific publication metrics provide a way to measure the impact and influence of a publication. These metrics can be used to evaluate the quality and importance of a scientific publication, as well as the research productivity and success of a scientist. While citation is key, citation metrics are closely linked to number of papers. There is anocdetal evidence that some hyperprolific authors can publish a paper within 5 days. This paper examines these authors in detail using the latest top 2% scientists database. The study reveals that some authors can publish, on average, 100-200 papers per year, including single-authored papers. A closer look reveals the flaw of the database and that these authors from medical science are journalists. Some of these journalists were even ranked higher than Nobel laureattes. Further investigation exposes some close-connected scientists who publish more than 100 papers per year in environmental sciences and gain incredible number of highly cited paper records. It is concluded that the scientific community has the need to establish ethical guidelines and practices on number of publications to ensure that publishing a paper is conducted with integrity and that the pursuit of knowledge is not compromised by personal interests.

Concerns have been raised regarding the potential negative effects on human health of water disinfectants used in swimming-pools. Among the disinfection options, the approaches using chlorine-based products have been typically preferred. Chlorine readily reacts with natural organic matter that are introduced in the water mainly through the bathers, leading to the formation of potentially harmful chlorination by-products (CBPs). The formation of CBPs is of particular concern since they have been epidemiologically associated with the development of various clinical manifestations. The higher the concentration of these volatile CBPs in the water, the higher their concentration in the air above the pool, and different routes of exposure to chemicals in swimming-pools (water ingestion, skin absorption and inhalation) contribute to the individual exposome. CBPs may affect the respiratory and skin health of those who stay indoor for long periods, such as swimming instructors, pool staff, and competitive swimmers. Whether those who use chlorinated-pools as customers, particularly children, may also be affected has been a matter of debate. In this article, the EAACI Joint Task Force of the Working Group of Allergy, Asthma & Sports and the Interest Groupf of Environmental & Occupational Allergy discusses the current evidence regarding the health effects of both acute and chronic exposures in different populations (work-related exposures, intensive sports and recreational attendance) and identify the main recommendations and unmet needs for research in this area.

Since the market launch of alprazolam (in many countries under the brand name Xanax), this highly potent benzodiazepine has had a disastrous public reputation. Even in media, entertainment and pop culture, its very powerful effects have made it emblematic of a sinister psychodrug that drags its users into an abyss of dependence and suffering. Indeed, the substance has certain specific properties (mood elevating, extremely fast acting, very short half-life, effects on adrenaline), but at its core it is a benzodiazepine like any other. How Xanax came to be demonized is therefore an important question to be discussed. On the other hand, the substance alprazolam possesses a unique property that is hardly known even among experts to this day and can be life-saving for people whose body’s own adrenaline synthesis and regulation is disturbed by certain (often hereditary, auto-immune, or toxic) rare diseases. For these patients, there is virtually no other medication available than alprazolam, which quickly, specifically and highly effectively inhibits pathological adrenaline surges, for example due to disorders of the SAM axis, effectively at the site of adrenaline (epinephrine) synthesis by up to 50%. Logically, this also gives rise to the legendary reputation that alprazolam is more effective than any other benzodiazepine, especially in patients with panic disorders. This paper, a source-supported opinion piece, is intended to remind the worldwide community of medical professionals that alprazolam is a legitimate, and often the only available, treatment option for abnormal adrenaline balance involving the adrenal gland and/or the SAM axis. Demonizing alprazolam in a clinically well regulated setting is therefore immoral and detrimental to the patients health and compliance.

Beamforming technique can effectively improve the spectrum utilization of multi-antenna systems, while the dirty-paper coding (DPC) technique can reduce inter-user interference. In this letter, we aim to maximize the weighted sum-rate under power constraint in a multiple-input-single-output (MISO) system with the DPC. However, the existing methods of beamforming optimization mainly rely on customized iterative algorithms, which have high computational complexity. To address this issue, by utilizing the deep learning technique and the uplink-downlink duality, and carefully exploring the optimal solution structure, we devise a beamforming neural network (BFNNet), which includes a deep neural network module and a signal processing module. Besides, we use the modulus of the channel coefficients as the input of deep neural network, which reduces the input size. Simulation results show that a well-trained BFNNet can achieve near-optimal solutions, while significantly reducing computational complexity

Rock-paper-scissors (RPS) dynamics have been shown to affect the evolutionary relationships within populations. These processes are analogous to the ways in which intransitive competition modifies ecological outcomes and the co-existence between species within communities. Here we explore the similarities between rock-paper-scissor dynamics and intransitive competition and how this link opens new avenues of research into eco-evolutionary processes. Intransitivity can drive the stable coexistence of phenotypes within species, as well as the diversity of species within communities. In addition, the links between these dynamics highlight possible feedback mechanisms that might operate across these evolutionary and ecological scales. Using simulations, we show that greater intraspecific intransitivity within a population can lead greater levels of intransitivity at the community-level, with direct implications for community diversity and stability. As such, RPS dynamics and intransitivity can serve as an ideal conceptual framework to understand the feedback mechanisms that drive diversity across evolutionary and ecological scales.

Gastro-oesophageal reflux (GOR) and food allergy (FA) are common conditions, especially during the first 12 months of life. When GOR leads to troublesome symptoms, that affect daily functioning of the infant and family, it is referred to GOR disease (GORD). The role of food allergens as a cause of GORD remains controversial. This European Academy of Allergy and Clinical Immunology (EAACI) position paper aims to review the evidence for FA-associated GORD in young children and translate this into clinical practice that guides healthcare professionals through the diagnosis of suspected FA-associated GORD and the medical and dietary management. The Task Force (TF) on non-IgE mediated allergy consists of EAACI experts in paediatric gastroenterology, allergy, dietetics and psychology from Europe, United Kingdom, United States, Turkey and Brazil. Six clinical questions were formulated, amended and approved by the TF to guide this publication. A systematic literature search using PubMed, Cochrane and EMBASE databases (until June 2021) using a predefined inclusion criteria based on the 6 questions was used. The TF also gained access to the database from the European Society of Paediatric Gastroenterology and Hepatology working group, who published guidelines on GORD and ensured that all publications used within that position paper were included. For each of the 6 questions, practice points were formulated, followed by a modified Delphi method consisting of anonymous web-based voting that was repated with modified practice points where required, until at least 80% consensus for each practice point was achieved. This TF position paper shares the process, the discussion and consensus on all practice points on FA-associated GORD.

1. Stable nucleic acid storage and preservation in resource limited settings is often a barrier to widespread pathogen surveillance. 2. Dried Blood Spot (DBS) filter paper has a long history of preserving nucleic acid in whole blood, we tested extending this technology to the room temperature storage of DNA extract. 3. We found that DNA extracted from whole mammalian blood can be stored at room temperature on DBS filter paper, then washed with the buffer solution Tris-HCL, and used in downstream PCR analysis with results comparable to PCR performed on DNA extracted from whole blood dried on DBS filter paper which is the gold standard. 4. The success of this method means DNA can be stored at room temperature making sharing genomic samples easier by eliminating the need for cold chain.

Coronavirus disease 2019 (COVID-19) vaccine BNT162b2 received approval and within the first few days of public vaccination several severe anaphylaxis cases occurred. An investigation is taking place to understand the cases and their triggers. The vaccine will be administered to a large number of individuals worldwide and concerns raised for severe adverse events might occur. With the current information, the European Academy of Allergy and Clinical Immunology (EAACI) states its position for the following preliminary recommendations that are to be revised as soon as more data emerges. To minimize the risk of severe allergic reactions in vaccinated individuals, it is urgently required to understand the specific nature of the reported severe allergic reactions, including the background medical history of the individuals affected and the mechanisms involved. To achieve this goal all clinical and laboratory information should be collected and reported. Mild and moderate allergic patients should not be excluded from the vaccine as the exclusion of all these patients from vaccination may have a significant impact on reaching the goal of population immunity. Health care practitioners vaccinating against COVID-19 are required to be sufficiently prepared to recognise and treat anaphylaxis properly with the ability to administer adrenaline. A mandatory observation period after vaccine administration of at least 15 minutes for all individuals should be followed. The current guidelines, which exclude patients with severe allergies from vaccination with BNT162b2, should be re-evaluated after more information and experience with the new vaccine develops.

Primary pancreatic tumors in children are rare with an overall age-adjusted incidence of 0.018 new cases per 100,000 pediatric patients. The most prevalent histologic type is the solid pseudopapillary neoplasm followed by pancreatoblastoma. This manuscript describes relevant imaging modalities and presents consensus-based recommendations for imaging at diagnosis and follow up.

The most common pediatric extragonadal pelvic cancers include germ cell tumors, sacrococcygeal teratomas, and rhabdomyosarcomas (arising from the urinary bladder, prostate, paratesticular tissues, vagina, uterus, and perineum). This manuscript describes the radiological and nuclear medicine features of these entities and provides consensus-based recommendations for the assessment at diagnosis, during and after treatment.

Objective The aim of this study is to identify and analyze the gender breakdown of first authorship contributing to the most cited papers in the field of otolaryngology, with a goal towards identifying trends in gender representation in publishing. Methods The top fifty most-cited papers were identified using Science Citation Index of the Institute for Scientific Information. Institution, journal, date of publication, research nature, and subspecialty were extracted for each article. Among the first authors, gender, h-index, percentage of first, last, and corresponding authorship positions, total publications, and citations were analyzed. Results The majority of papers were in the English language, from the United States, of clinical nature, and on otologic topics. Eighty-four percent of papers had men who were first authors although there was no difference in h-index score, authorship position, and number of publications between men and women first authors. Women first authors had significantly more citations (p = 0.02) and average citations/year (p= 0.04) compared to their colleagues. There was no difference in the number of articles with women first authors (p = 0.17) or the total percentage of women authors (p = 0.44) in papers published earlier compared to those published later. Conclusion While a promising number of women otolaryngologists are publishing high-powered articles, future initiatives to promote academic productivity and inclusivity should be considered.