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Background Various atopic dermatitis (AD) phenotypes showed an enormously heterogenic risk for subsequent asthma development. Objective We aimed to investigate the association between AD phenotypes and the risk for progression to asthma. Methods We searched PubMed, Embase, and Web of Science databases for relevant publications. Pooled relative risks (RR) with 95% CI were calculated using the CMA-3.0 software. This study has been registered with PROSPERO (CRD42019129273). Results We analyzed 39 publications with 458,810 participants. The RR for asthma in AD was 2.16 (95% CI, 1.88-2.48). The risk in persistent AD (RR, 3.36; 95% CI, 2.83-3.99) was higher than in transient AD (RR, 1.52; 95% CI, 1.34-1.73), and the risk in severe AD (RR, 2.40; 95% CI, 1.96-2.94) was higher than in mild AD (RR, 1.82; 95% CI, 1.03-3.23) or moderate AD (RR, 1.51; 95% CI, 1.30-1.75). The risk for asthma in early-onset AD was slightly higher than in late-onset AD and higher in boys than in girls. Limitations The AD and asthma definitions differed across the included studies. Conclusion Patients with persistent or severe AD were at a higher risk for developing asthma. These findings further elucidate the atopic march and identify target populations for asthma prevention.

High operation and maintenance costs, and ‘last-mile’ issues for populations not connected to municipal water infrastructure, have limited the utility of centralized reverse osmosis (RO) systems to alleviate water availability issues for rural communities. To address these challenges, a decentralized RO module which employs tubular RO membranes was designed and investigated. The system represents an appropriate technology because it requires minimal pretreatment and it fits in self-contained, low-profile suitcase. This compact desgin also incorporated innovative 3D printed static mixers to minimize salt concentration polarization and to improve performance. Since grid electricity may also be discontinuous in the target use cases, the system was tested with two direct current (DC) power solutions: a photovoltaics-battery configuration and an alternator-battery. The final prototype weighs less than 15 kg and was found to have a production capacity of ∼8 L/h, consuming ∼100 W of pumping power. Experiments of the prototype module revealed a 96% rejection rate of salt from a 1000–2000 ppm synthetic groundwater solution and a >99% rejection coefficient for bovine serum albumin protein and humic acid. From these performance metrics, it was estimated that 36 sets of this decentralized system (with a total CapEx of US$23,400) could provide drinking water for ∼600 rural households at a unit cost of water of 1 LKR/L (0.005 USD/L) in Sri Lanka. Overall, this study demonstrates how computational modeling and 3D printing can be leveraged to develop a compact and cost-effective decentralized RO package that could be rapidly deployed to water-stressed rural areas and in disaster relief applications.

In this paper, we study a wireless networked control system (WNCS) with N ⩾ 2 sub-systems sharing a common wireless channel. Each sub-system consists of a plant and a controller and the control message must be delivered from the controller to the plant through the shared wireless channel. The wireless channel is unreliable due to shadowing and fading. As a result, a packet can be successfully delivered in a slot with a certain probability. A network scheduling policy determines how to transmit those control messages generated by such N sub-systems and directly influences the transmission delay of control messages. We first consider the case that all sub-systems have the same sampling period. We characterize the stability condition of such a WNCS under the joint design of the control policy and the network scheduling policy by means of 2N linear inequalities . For scalar systems, we further simplify the stability condition into only one linear inequality for two special cases: the perfect-channel case and the symmetric-structure case. One main technical contribution of this paper is to introduce the recent results on the network scheduling policy design for delay-constrained wireless communications into the analysis of WNCSs. In addition, we have applied our theory to a practical problem of stabilizing multiple pendulum-cart sub-systems over a shared wireless channel. Simulations show that our joint design effectively achieves better performance than existing baseline.

Rationale: There are limited data on mechanical discontinuation practices in Asia. Objectives: To document self-reported mechanical discontinuation practices and determine whether there is clinical...

Objective To explore the risk factors for intrapartum fever and to develop a nomogram to predict the incidence of intrapartum fever. Methods The general demographic characteristics and perinatal factors of 696 parturients who underwent vaginal birth at the Affiliated Hospital of Xuzhou Medical University from May 2019 to April 2020 were retrospectively analysed. Data was collected from May 2019 to October 2019 on 487 pregnant women who formed a training cohort. A multivariate logistic regression model was used to identify the independent risk factors associated with intrapartum fever during vaginal birth, and a nomogram was developed to predict the occurrence. To verify the nomogram, data was collected from January 2020 to April in 2020 from 209 pregnant women who formed a validation cohort. Results The incidence of intrapartum fever in the training cohort was found in 72 of the 487 parturients (14.8%), and the incidence of intrapartum fever in the validation cohort was 31 of the 209 parturients (14.8%). Multivariate logistic regression analysis showed that the following factors were significantly related to intrapartum fever: primiparas (odds ratio [OR] 2.43; 95% confidence interval [CI] 1.15–5.15), epidural labour analgesia (OR 2.89; 95% CI 1.23–6.82), premature rupture of membranes (OR 2.37; 95% CI 1.13–4.95), second stage of labour ≥ 120 min (OR 4.36; 95% CI 1.42–13.41), amniotic fluid pollution degree III (OR 10.39; 95% CI 3.30–32.73), and foetal weight ≥ 4000 g (OR 7.49; 95% CI 2.12–26.54). Based on clinical experience and previous studies, the duration of epidural labour analgesia also appeared to be a meaningful factor for intrapartum fever; therefore, these seven variables were used to develop a nomogram to predict intrapartum fever in parturients. The nomogram achieved a good area under the ROC curve of 0.86 and 0.81 in the training and in the validation cohorts, respectively. Additionally, the nomogram had a well-fitted calibration curve, which also showed excellent diagnostic performance. Conclusion We constructed a model to predict the occurrence of fever during childbirth and developed an accessible nomogram to help doctors assess the risk of fever during childbirth. Such assessment may be helpful in implementing reasonable treatment measures. Trial registration Clinical Trial Registration: (www.chictr.org.cnChiCTR2000035593)

BACKGROUND Jianpi formulas have been widely used to treat atopic dermatitis (AD) by traditional Chinese medicine (TCM) practitioners, but the efficacy and safety need further evaluation. A meta-analysis of randomized controlled trials was performed to assess the efficacy and tolerability of Jianpi formulas for AD. METHODS We searched the following databases up to October 2020: PubMed, Embase, China National Knowledge Infrastructure database (CNKI), and Wanfang database. All randomized controlled trials (RCTs) evaluated Jianpi formulas add-on effect for AD were included for meta-analysis. The primary outcome was minor remission. Secondary outcomes include complete remission, marked remission, and decrease of SCORAD. RESULTS Totally eleven studies were included. Nine studies were included in qualitative analysis and seven were included in quantitative analysis. The common herbs were poria, glycyrrhiza uralensis, rhizoma atractylodis, atractylodes macrocephala, and semen coicis. The Jianpi formulas add-on therapy showed consistent higher effectiveness rate in complete remission (RR1.528, 95%CI 1.176-1.984. p

Very few studies have investigated the relationship between body mass index (BMI) and risk of urinary tract infection (UTI), and conclusions from these available studies have been inconsistent. To resolve this inconsistency, we performed a systematic review and meta-analysis to precisely examine the association between BMI and UTI. This meta-analysis was performed based on the PRISMA recommendations. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases were searched for all published observational studies that reported the risk of UTI based on BMI categories up to March 2020. Fourteen (n = 14) articles comprising 19 studies in different populations met our inclusion criteria. The overall analysis showed a significant increased risk of UTI in subjects affected by obesity vs. individuals without obesity (RR = 1.45; 95% CI: 1.28 − 1.63; I2 = 94%), and a non-significant increased risk of UTI in subjects who were overweight (RR = 1.03; 95% CI: 0.98 − 1.10; I2 = 49.6%) and underweight (RR = 0.99; 95% CI: 0.81 − 21; I2 = 0.0%) when compared to subjects who had normal weight. In the stratified analysis, we showed that obesity increased the risk of UTI in females (RR = 1.63; 95% CI: 1.38 − 1.93) and in subjects below 60 years old (RR = 1.53; 95% CI: 1.33 − 1.75). This systematic review and meta‐analysis recognized a significant relationship between BMI and incidence of UTI in obese vs. non-obese subjects, as well as in females and in individuals below 60 years old.

Introduction Upper urinary tract calculus is a common disease of the urinary system. Aim To compare the therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi. Material and methods A total of 146 patients were randomly divided into control and experimental groups (n = 73). The control group received flexible ureteroscopy lithotripsy, and the experimental group underwent the same but combined with external physical vibration. The rate of finding stones in the urine on the day after treatment, clearance rate, components of stones, levels of renal function indices blood urea nitrogen (BUN) and serum creatinine (Scr), and incidence of complications were compared. The stone-free rate during 1-year follow-up was analysed by Kaplan-Meier method. Results The rate of finding stones in the urine on the day after treatment was higher in the experimental group (100%) than that in the control group (29.73%) (p < 0.05). The clearance rates on the day, at 1 week, and at 2 weeks after treatment in the experimental group were 71.23%, 87.67%, and 95.89%, respectively, which surpassed those of the control group at corresponding time points (p < 0.05). BUN and Scr levels decreased after treatment in both groups, especially in the experimental group (p < 0.05). The stone-free rate during 1-year follow-up in the experimental group (n = 71 (97.26%)) exceeded that of the control group (n = 61 (83.56%)) (p < 0.05). Conclusions External physical vibration combined with flexible ureteroscopy lithotripsy significantly increased the rate of finding stones in the urine the day after treatment, the clearance rate of upper urinary tract calculi, and the ameliorated renal function and reduced the stone re-formation rate.

Abstract. Background: Stroke is a major global health problem that contributes to a significant burden of morbidity and mortality. The association of several foods and nutrients with stroke has been well-established. However, the effect of the whole diet on stroke is poorly understood. In this work, we aimed to examine the association between the quality of whole diet, as measured using Alternate Healthy Eating Index-2010 (AHEI-2010), and risk of stroke in Iranian adults. Methods: In this hospital-based case-control study, 193 stroke patients (diagnosed based on clinical and brain CT findings) and 193 controls with no history of cerebrovascular diseases or neurologic disorders were included. The participants’ dietary intakes were examined using a validated 168-item semi-quantitative food frequency questionnaire. AHEI-2010 was constructed based on earlier studies. Participants were classified according to tertiles of AHEI-2010 scores and multivariate logistic regression was used to evaluate the association between whole diet quality and risk of stroke. Results: Individuals with greater adherence to AHEI-2010 had a higher intake of fruits, vegetables, nuts and legumes, whole grains and carbohydrate, and a lower intake of trans-fatty acids, sugar-sweetened beverages, total energy and fat (P

Inconsistencies exist with regard to the influence of omega-3 supplementation on 25-hydroxyvitamin D (25(OH)D) levels, which could be attributed to many factors, such as the duration and dose of omega-3 supplementation, and individuals' baseline 25(OH)D levels. Therefore, to address the inconsistencies, we conducted a systematic review and dose-response meta-analysis to accurately determine the effect of omega-3 supplementation on 25(OH)D levels in humans.We performed a comprehensive literature search in Web of Science, PubMed/Medline, Scopus, and Embase databases from inception up to January 2020. We included only randomized controlled trials (RCTs). We used weighted mean difference (WMD) with 95% confidence interval (CI) to assess the influence of omega-3 supplementation on serum 25(OH)D levels using the random-effects model.Our pooled results of 10 RCTs demonstrated an overall significant increase in 25(OH)D levels following omega-3 intake (WMD = 3.77 ng/ml, 95% CI: 1.29, 6.25). In addition, 25(OH)D levels were significantly increased when the intervention duration lasted8 weeks and when the baseline serum 25(OH)D level was ˂20 ng/ml. Moreover, omega-3 intake ≤1000 mg/day resulted in higher 25(OH)D levels compared to omega-3 intake1000 mg/day.In conclusion, omega-3 supplementation increased 25(OH)D concentrations, particularly with dosages ≤1000 mg/day and intervention durations8 weeks.

Inconsistencies exist with regard to influence of fasting and energy-restricting diets on markers of glucose and insulin controls. To address these controversial, this study was conducted to determine the impact of fasting diets on fasting blood sugars (FBSs), insulin, homeostatic model assessment insulin resistance (HOMA-IR) and hemoglobin A1c (HbA1c) levels. A comprehensive systematic search was carried out in electronic databases, i.e., Scopus, PubMed, and Web of Science through June 2019 for RCTs that investigated the impact of fasting and energy-restricting diets on circulating FBS, insulin, HOMA-IR and HbA1c levels from. Weighted mean difference (WMD) with the 95% CI were used for estimating combined effect size. The subgroup analysis was applied to specify the source of heterogeneity among articles. Pooled results from 30 eligible articles with 35 arms demonstrated a significant decrease in FBS (WMD): -3.376 mg/dl, 95% CI: -5.159, -1.594

Background and aims Dehydroepiandrosterone (DHEA) supplementation has gained attention in individuals with adrenal insufficiency, and as a tool for increasing androgens and estrogens whereby is proposed to improve the accretion of muscle and bone mass. However, DHEA supplementation has demonstrated negative effects on the lipid profile and, thus, we aimed to analyze the body of evidence in this regard. Methods and results A systematic review and dose-response meta-analysis of randomized controlled trials (RCTs) was performed employing in Scopus, PubMed/Medline, Web of Science, Embase and Google Scholar, then including relevant articles that addressed the effects of DHEA supplementation on the lipid profile, up to February 2020. Combined findings were generated from 23 eligible articles. Hence, total cholesterol (TC) (weighted mean difference (WMD): −3.5 mg/dl, 95% confidence interval (CI): −8.5 to 1.6)), low-density lipoprotein-cholesterol (LDL-C) (WMD: 0.34 mg/dl, 95% CI: −3 to 3.7) and triglycerides (TG) levels (WMD: −2.85 mg/dl, 95% CI: −9.3 to 3.6) did not alter in DHEA group compared to the control, but HDL-C levels significantly reduced in DHEA group (WMD: −3.1 mg/dl, 95% CI: −4.9 to −1.3). In addition, a significant reduction in HDL-C values was observed in studies comprising women (WMD: −5.1 mg/dl, 95% CI: −7.2 to −3) but not in males (WMD: 0.13 mg/dl, 95% CI: −1.4 to 1.7). Conclusions Overall, supplementation with DHEA did not change circulating values of TC, LDL-C and TG, whereas it may decrease HDL-C levels. Further long-term RCTs are required to investigate the effects of DHEA particularly on major adverse cardiac events.

Insufficient vaccine doses and the lack of therapeutic agents for yellow fever put global health at risk, should this virus emerge from sub-Saharan Africa and South America.In phase 1a of this clinical trial, we assessed the safety, side-effect profile, and pharmacokinetics of TY014, a fully human IgG1 anti-yellow fever virus monoclonal antibody. In a double-blind, phase 1b clinical trial, we assessed the efficacy of TY014, as compared with placebo, in abrogating viremia related to the administration of live yellow fever vaccine (YF17D-204; Stamaril). The primary safety outcomes were adverse events reported 1 hour after the infusion and throughout the trial. The primary efficacy outcome was the dose of TY014 at which 100% of the participants tested negative for viremia within 48 hours after infusion.A total of 27 healthy participants were enrolled in phase 1a, and 10 participants in phase 1b. During phase 1a, TY014 dose escalation to a maximum of 20 mg per kilogram of body weight occurred in 22 participants. During phases 1a and 1b, adverse events within 1 hour after infusion occurred in 1 of 27 participants who received TY014 and in none of the 10 participants who received placebo. At least one adverse event occurred during the trial in 22 participants who received TY014 and in 8 who received placebo. The mean half-life of TY014 was approximately 12.8 days. At 48 hours after the infusion, none of the 5 participants who received the starting dose of TY014 of 2 mg per kilogram had detectable YF17D-204 viremia; these participants remained aviremic throughout the trial. Viremia was observed at 48 hours after the infusion in 2 of 5 participants who received placebo and at 72 hours in 2 more placebo recipients. Symptoms associated with yellow fever vaccine were less frequent in the TY014 group than in the placebo group.This phase 1 trial of TY014 did not identify worrisome safety signals and suggested potential clinical benefit, which requires further assessment in a phase 2 trial. (Funded by Tysana; ClinicalTrials.gov number, NCT03776786.).

Na3Bi has attracted significant interest in both bulk form as a three-dimensional topological Dirac semimetal and in ultra-thin form as a wide-bandgap two-dimensional topological insulator. Its extreme air sensitivity has limited experimental efforts on thin- and ultra-thin films grown via molecular beam epitaxy to ultra-high vacuum environments. Here we demonstrate air-stable Na3Bi thin films passivated with magnesium difluoride (MgF2) or silicon (Si) capping layers. Electrical measurements show that deposition of MgF2 or Si has minimal impact on the transport properties of Na3Bi whilst in ultra-high vacuum. Importantly, the MgF2-passivated Na3Bi films are air-stable and remain metallic for over 100 hours after exposure to air, as compared to near instantaneous degradation when they are unpassivated. Air stability enables transfer of films to a conventional high-magnetic field cryostat, enabling quantum transport measurements which verify that the Dirac semimetal character of Na3Bi films is retained after air exposure.

Neuroinflammation is a complex biological process and has been known to play an important role in age-related cerebrovascular and neurodegenerative disorders, such as cerebral ischemia, Alzheimer's disease, and Parkinson's disease. Cysteinyl leukotrienes (CysLTs) are potent inflammatory lipid mediators that exhibit actions mainly through activating type 1 and type 2 CysLT receptors (CysLT1 and CysLT2). Accumulating evidence shows that CysLT1 and CysLT2 are activated at different stages of pathological process in various cell types in the brain such as vascular endothelial cells, astrocytes, microglia, and neurons in response to insults. However, the precise roles and mechanisms of CysLT1 and CysLT2 in regulating the pathogenesis of cerebral ischemia, Alzheimer's disease, and Parkinson's disease are not fully understood. In this article, we focus on current advances that link activation of CysLT1 and CysLT2 to the pathological process during brain ischemia and neurodegeneration and discuss mechanisms by which CysLT1 and CysLT2 mediate inflammatory process and brain injury. Multitarget anti-inflammatory potentials of CysLT1 and CysLT2 antagonism for neuroinflammation and brain injury will also be reviewed.

We aimed to investigate the prevalence of true rectocele and obstructed defecation (OD) in patients with pelvic organ prolapse (POP), to investigate the correlation between true rectocele and OD, and to understand the diagnostic value of translabial ultrasound (TLUS) in the diagnosis of true rectocele. The patients who scheduled for POP surgery were enrolled in this study. Patients who had previous reconstructive pelvic surgery or repair of rectocele were excluded. Birmingham Bowel and Urinary symptoms questionnaires and Longo’s obstructed defecation syndrome scoring system were used to assess the bowel symptoms of patients. TLUS was used to evaluate anatomical defects. P value

BackgroundProgrammed death-ligand 1 (PD-L1) monoclonal antibody therapy has recently gained approval for treating metastatic triple-negative breast cancer (TNBC) -, in particular in the PD-L1+patient subgroup of the recent IMpassion130 trial. The SP142 PD-L1 antibody clone was used as a predictive assay in this trial, but this clone was found to be an outlier in previous harmonisation studies in lung cancer.AimsTo address the comparability of PD-L1 clones in TNBC, we evaluated the concordance between conventional immunohistochemistry (IHC) and multiplex immunohistochemistry/immunofluorescence (mIHC/IF) that allowed simultaneous quantification of three different PD-L1 antibodies (22C3, SP142 and SP263).MethodsOur cohort comprised 25 TNBC cases, 12 non-small-cell lung carcinomas and 8 other cancers. EpCAM labelling was used to distinguish tumour cells from immune cells.ResultsModerate-to-strong correlations in PD-L1 positivity were found between results obtained through mIHC/IF and IHC. Individual concordance rates in the study ranged from 67% to 100%, with Spearman’s rank correlation coefficient values up to 0.88.ConclusionsmIHC/IF represents a promising tool in the era of cancer immunotherapy, as it can simultaneously detect and quantify PD-L1 labelling with multiple antibody clones, and allow accurate evaluation of tumour and immune cells. Clinicians and pathologists require this information to predict patient response to anti-PD-1/PD-L1 therapy. The adoption of this assay may represent a significant advance in the management of therapeutically challenging cancers. Further analysis and assay harmonisation are essential for translation to a routine diagnostic setting.

Standards with imprecise guidelines require interpretation by users. In this study we investigate how investors' perceptions of earnings management vary with their interpretations of imprecise standards and the type of company reputation. We design a quasi-experiment that exploits the role of the press as a “watchdog” of corporate activities to focus the attention of investors on the financial reporting practices of companies. The results show that both factors interact to influence investors' perceptions. Investors, whose interpretations of the imprecise standard are inconsistent with that of the company, are more likely to suspect earnings management when the company has a financial rather than non-financial reputation. Investors in the inconsistent/financial reputation condition are also more likely to sell their investments than those in the inconsistent/non-financial reputation condition. The type of reputation does not show a significant effect on investors' perceptions when investors' interpretations are consistent with that of the company. JEL Classifications: M40; M41.

Small studies have suggested that patients with chronic obstructive pulmonary disease (COPD) have poor sleep quality. Our aim was to examine the prevalence of subjective sleep-related complaints and predictors of poor sleep quality in a large community-based COPD cohort. We analyzed cross-sectional data on sleep questionnaire responses from the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study, a population-based, prospective longitudinal cohort study across Canada. The cohort comprises a COPD group and two matched non-COPD (never-smokers and ever-smokers) groups. Sleep-related symptoms were assessed using questionnaires including Pittsburgh Sleep Quality Index (PSQI). A total score of PSQI > 5 is indicative of poor sleep quality. Health-related quality of life measures and the presence of mood disturbance were assessed using Short Form-36™ Health Survey (SF-36) multi-item questionnaires and Hospital Anxiety and Depression Scale (HADS), respectively. Predictors of poor sleep quality were analyzed using multivariable logistic regression analysis. Of the 1123 subjects, 263 were healthy controls, 323 at-risk controls, and 537 had COPD (297 had mild, 240 with moderate to severe disease). The mean PSQI score was not significantly different between groups. COPD patients with poor sleep quality had lower diffusion capacity, higher HADS anxiety and depression scores and lower SF-36 mental and physical component summary scores than COPD patients classified as good sleepers. The presence of restless legs and obstructive sleep apnea symptoms, waist circumference, predicted diffusion capacity and HADS anxiety and depression scores were identified as independent predictors of poor sleep quality.

This article presents an X/Ku dual-band switch-free reconfigurable GaAs low-noise amplifier (LNA) realized by inter-stage and output-stage coupled lines. This article is the first switch-free reconfigurable LNA design in the coupled lines structure. After amplified by the broadband drive stage, the input signal is divided into two parallel single-band stages (consists of a high-band stage and a low-band stage) by the proposed inter-stage coupled line. Two split-band signals are combined by the proposed output-stage coupled line into the output port after amplified by the single-band stages. The proposed coupled lines are also included in LNA matching networks. Dual-band operation of the proposed reconfigurable LNA is achieved by turning off drain voltages of the unused single-band transistors. The reconfigurable LNA is designed in a 0.15-μm E-mode GaAs pHEMT process. The fabricated LNA features small-signal gains of 25-25.2/20.1-28 dB, noise figure (NF) of 1.28-1.41/1.23-1.51 dB, and output 1-dB compression point of 0.5-1.7/2.2-5 dBm over 8-10/12-20 GHz, while consuming 76/91 mA of dc current, with a size of 2.0 × 1.8 mm2.

The identification of grape leaf diseases based on deep learning is critical to controlling the spread of diseases and ensuring the healthy development of the grape industry. Focusing on the lack of training images of grape leaf diseases, this paper proposes a novel model named Leaf GAN, which is based on generative adversarial networks (GANs), to generate images of four different grape leaf diseases for training identification models. A generator model with degressive channels is first designed to generate grape leaf disease images; then, the dense connectivity strategy and instance normalization are fused into an efficient discriminator to identify real and fake disease images by utilizing their excellent feature extraction capability on grape leaf lesions. Finally, the deep regret gradient penalty method is applied to stabilize the training process of the model. Using a total of 4,062 grape leaf disease images, the Leaf GAN model ultimately generates 8,124 grape leaf disease images. The generated grape leaf disease images based on Leaf GAN model can obtain better performance than DCGAN and WGAN in terms of the Fréchet inception distance. The experimental results show that the proposed Leaf GAN model generates sufficient grape leaf disease images with prominent lesions, providing a feasible solution for the data augmentation of grape leaf disease images. For the eight prevailing classification models with the expanded dataset, the identification performance based on CNNs indicated higher accuracies, whereby all the accuracies were better than those of the initial dataset with other data augmentation methods. Among them, Xception achieves a recognition accuracy of 98.70% on the testing set. The results demonstrate that the proposed data augmentation method represents a new approach to overcoming the overfitting problem in disease identification and can effectively improve the identification accuracy.

Graph Convolutional Networks (GCNs) have drawn tremendous attention in the past three years. Compared with other deep learning modalities, high-performance hardware acceleration of GCNs is as critical but even more challenging. The hurdles arise from the poor data locality and redundant computation due to the large size, high sparsity, and irregular non-zero distribution of real-world graphs. In this paper we propose a novel hardware accelerator for GCN inference, called I-GCN, that significantly improves data locality and reduces unnecessary computation. The mechanism is a new online graph restructuring algorithm we refer to as islandization. The proposed algorithm finds clusters of nodes with strong internal but weak external connections. The islandization process yields two major benefits. First, by processing islands rather than individual nodes, there is better on-chip data reuse and fewer off-chip memory accesses. Second, there is less redundant computation as aggregation for common/shared neighbors in an island can be reused. The parallel search, identification, and leverage of graph islands are all handled purely in hardware at runtime working in an incremental pipeline. This is done without any preprocessing of the graph data or adjustment of the GCN model structure. Experimental results show that I-GCN can significantly reduce off-chip accesses and prune 38% of aggregation operations, leading to performance speedups over CPUs, GPUs, the prior art GCN accelerators of 5549x, 403x, and 5.7x on average, respectively., Comment: Published in MICRO 2022

Background and aim Although some earlier studies have indicated the effect of phytosterol (PS) supplementation on serum lipoprotein(a) (Lp(a)) and free fatty acid (FFA) concentration, findings are still conflicting. We aimed to assess the impact of PS supplementation on serum Lp(a) and FFA concentration through a systematic review and meta-analysis of available RCTs. Methods and results We performed a systematic search of all available RCTs conducted up to 21 February 2019 in the following databases: PubMed, Scopus, and Cochrane. The choice of fixed- or random-effect model for analysis was determined according to the I2 statistic. Effect sizes were expressed as weighted mean difference (WMD) and 95% confidence interval (CI). Pooling of 12 effect sizes from seven articles revealed a significant reduction of Lp(a) levels following PS supplementation (MD: −0.025 mg/dl, 95% CI: −0.045, −0.004, p = 0.017) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.599). Also, PS supplementation significantly lowered FFA (MD: −0.138 mg/dl, 95% CI: −0.195, −0.081, p = 0.000) without significant heterogeneity among the studies (I2 = 0.0%, p = 0.911). The results for meta-regression and sensitivity analysis were not significant. Conclusion The meta-analysis suggests that oral PS supplementation could cause a significant reduction in serum Lp(a) and FFA.

The objective of this study is to demonstrate a novel method for the reconstruction of right recurrent laryngeal nerve (RLN) by transforming into nonrecurrent RLN: the end-to-free vagal laryngeal branch end anastomosis. Here we report a case of locally advanced thyroid carcinoma. The patient underwent radical thyroid surgery with inevitably partial RLN resection and immediate right RLN reconstruction at our institution. With the guidance of intraoperative neuromonitoring (IOMN), we completed a novel end-to-free vagal laryngeal branch end anastomosis. The whole procedure was deliberately monitored by IOMN. Surgeons can procure adequate free nerve for tension-free anastomosis by transforming the right RLN into nonrecurrent nerve. Follow-up laryngoscope showed improved adductory movement of the right arytenoid. The end-to-free vagal end anastomosis is an effective way to reconstruct segmental nerve resection of right RLN. Its long-term postoperative result needs to be further warranted.

With the development of blockchain technologies, many Ponzi schemes disguise themselves under the veil of smart contracts. The Ponzi scheme contracts cause serious financial losses, which has a bad effect on the blockchain. Existing Ponzi scheme contract detection studies have mainly focused on extracting hand-crafted features and training a machine learning classifier to detect Ponzi scheme contracts. However, the hand-crafted features cannot capture the structural and semantic feature of the source code. Therefore, in this study, we propose a Ponzi scheme contract detection method called MTCformer (Multi-channel Text Convolutional Neural Networks and Transofrmer). In order to reserve the structural information of the source code, the MTCformer first converts the Abstract Syntax Tree (AST) of the smart contract code to the specially formatted code token sequence via the Structure-Based Traversal (SBT) method. Then, the MTCformer uses multi-channel TextCNN (Text Convolutional Neural Networks) to learn local structural and semantic features from the code token sequence. Next, the MTCformer employs the Transformer to capture the long-range dependencies of code tokens. Finally, a fully connected neural network with a cost-sensitive loss function in the MTCformer is used for classification. The experimental results show that the MTCformer is superior to the state-of-the-art methods and its variants in Ponzi scheme contract detection.

The ESR1 rs9340799 polymorphism has been frequently investigated with regard to its association with breast cancer (BC) susceptibility, but the findings have been inconclusive. In this work, we aimed to address the inconsistencies in study findings by performing a systematic review and meta-analysis. Eligible studies were identified from the Web of Science, PubMed, Scopus, China National Knowledge Infrastructure, VIP and Wanfang databases based on the predefined inclusion and exclusion criteria. The pooled odds ratio (OR) was then calculated under five genetic models: homozygous (GG vs. AA), heterozygous (AG vs. AA), dominant (AG + GG vs. AA), recessive (GG vs. AA + AG) and allele (G vs. A). Combined results from 23 studies involving 34,721 subjects indicated a lack of significant association between the polymorphism and BC susceptibility (homozygous model, OR = 1.045, 95% CI 0.887–1.231, P = 0.601; heterozygous model, OR = 0.941, 95% CI 0.861–1.030, P = 0.186; dominant model, OR = 0.957, 95% CI 0.875–1.045, P = 0.327; recessive model, OR = 1.053, 95% CI 0.908–1.222, P = 0.495; allele model, OR = 0.987, 95% CI 0.919–1.059, P = 0.709). Subgroup analyses by ethnicity, menopausal status and study quality also revealed no statistically significant association (P > 0.05). In conclusion, our results showed that the ESR1 rs9340799 polymorphism was not associated with BC susceptibility, suggesting its limited potential as a genetic marker for BC.

PURPOSE Many studies have investigated the association between serum IGF-1 and IGFBP levels with gastric cancer (GC), but the results remained inconclusive. In this work, we performed a systematic review and meta-analysis to examine the precise association of serum levels of IGF-1 and IGFBP with GC. METHODS A comprehensive systematic search was carried out in PubMed/MEDLINE, SCOPUS, Web of Science, and EMBASE databases for (nested) case-control studies that reported the levels of IGF-1 and IGFBP in GC cases and healthy controls, from inception until October 2020. Weighted mean difference (WMD) was calculated for estimating combined effect size. Subgroup analysis was performed to identify the source of heterogeneity among studies. RESULTS We found eight and five eligible studies (with 1541 participants) which provided data for IGF-1 and IGFBP, respectively. All studies on IGFBP reported the IGFBP-3 isoform. The pooled results indicate that GC patients had significantly lower serum IGF-1 [WMD = -26.21 ng/mL (95% CI, -45.58 to -6.85; P = .008)] and IGFBP-3 [WMD = -0.41 ng/mL (95% CI, -0.80 to -0.01; P = .04; I2 = 89.9%; P

Lasers with orbital angular momentum (OAM) holds promise for compact, at-source solutions for applications in imaging and communications. In this work, we demonstrate an electrically pumped terahertz vector vortex quantum cascade laser, (THz-VV-QCL) which is fabricated by monolithically integrating a ring resonator with periodic double slits scattering elements, bus waveguide, and a distributed feedback QCL. To compensate for radiation and material losses, the ring resonator is pumped by the metallic air bridge. The mode purities of left/right-circularly polarized light are 87.7%/91%, respectively. The integrated THz-VV-QCL shows the great potential for application in THz communication and image.

Neural networks (NNs) are beneficial to many services, and we believe systems—such as OSes, databases, networked systems—are not an exception. But applying NNs in these critical systems is challenging: people have to risk getting unexpected outcomes from NNs because NN behaviors are not well-defined. To tame these undefined behaviors, we introduce a framework ouroboros, which builds verified NNs that follow user-defined specifications. These specifications comprise input and output constraints which characterize the behaviors of a NN. We do a case study on database learned indexes to demonstrate that training verified NN models is possible. Though many challenges remain, ouroboros enables us, for the first time, to apply NNs in critical systems with _confidence_.

BackgroundThe pandemic of coronavirus disease-19 (Covid-19) continues to afflict the lives and livelihoods of many as global demand for vaccine supply remains unmet.MethodsPhase 1 of this trial (N=42) assessed the safety, tolerability and immunogenicity of ascending levels of one-dose ARCT-021, a self-amplifying mRNA vaccine against Covid-19. Phase 2 (N=64) tested two-doses of ARCT-021 given 28 days apart. Both young and older adults were enrolled. The primary safety outcomes were local and systemic solicited adverse events (AEs) reported immediately and up to 7 days post-inoculation and unsolicited events reported up to 56 days after inoculation. Secondary and exploratory outcomes were antibody and T cell responses to vaccination, respectively.ResultsARCT-021 was well tolerated up to one 7.5 μg dose and two 5.0 μg doses. Local solicited AEs, namely injection-site pain and tenderness, as well as systemic solicited AEs, such as fatigue, headache and myalgia, were more common in ARCT-021 than placebo recipients, and in younger than older adults. Seroconversion rate for anti-S IgG was 100% in all cohorts except for the 1 μg one-dose in younger adults and the 7.5 μg one-dose in older adults, which were each 80%. Neutralizing antibody titers increased with increasing dose although the responses following 5.0 μg and 7.5 μg ARCT-021 were similar. Anti-S IgG titers overlapped with those in Covid-19 convalescent plasma. ARCT-021 also elicited T-cell responses against the S glycoprotein.ConclusionTaken collectively, the favorable safety and immunogenicity profiles support further clinical development of ARCT-021.

Studies investigating the effects of tocotrienols on inflammation and oxidative stress have yielded inconsistent results. This systematic review and meta-analysis aimed to evaluate the effects of tocotrienols supplementation on inflammatory and oxidative stress biomarkers. We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials from inception until 13 July 2020 to identify randomized controlled trials supplementing tocotrienols and reporting circulating inflammatory or oxidative stress outcomes. Weighted mean difference (WMD) and corresponding 95% confidence interval (CI) were determined by pooling eligible studies. Nineteen studies were included for qualitative analysis, and 13 studies were included for the meta-analyses. A significant reduction in C-reactive protein levels (WMD: −0.52 mg/L, 95% CI: −0.73, −0.32, p < 0.001) following tocotrienols supplementation was observed, but this finding was attributed to a single study using δ-tocotrienols, not mixed tocotrienols. There were no effects on interleukin-6 (WMD: 0.03 pg/mL, 95% CI: −1.51, 1.58, p = 0.966), tumor necrosis factor-alpha (WMD: −0.28 pg/mL, 95% CI: −1.24, 0.68, p = 0.571), and malondialdehyde (WMD: −0.42 μmol/L, 95% CI: −1.05, 0.21, p = 0.189). A subgroup analysis suggested that tocotrienols at 400 mg/day might reduce malondialdehyde levels (WMD: −0.90 μmol/L, 95% CI: −1.20, −0.59, p < 0.001). Future well-designed studies are warranted to confirm the effects of tocotrienols on inflammatory and oxidative stress biomarkers, particularly on different types and dosages of supplementation. PROSPERO registration number: CRD42020198241.

Objectives: Electrocardiogram (ECG) can be affected by autonomic nerves with body position changes. The study aims to explore the ECG changes of children with dilated cardiomyopathy (DCM) when their posture changes.Materials and methods: Sixty-four children diagnosed with DCM were recruited as research group and 55 healthy children as control group. T-wave amplitude and QT interval in ECG were recorded, and their differences between supine and orthostatic ECG were compared in both groups. Subsequently, the children with DCM were followed up and the differences before and after treatment compared.Results: ① Comparisons in differences: Differences of T-wave amplitude in lead II and III, aVF, and V5 and differences of QT interval in lead II, aVL, aVF, and V5 were lower in the research group than in the control group. ② Logistic regression analysis and diagnostic test evaluation: The differences of T-wave amplitude in lead III and QT interval in lead aVL may have predictive value for DCM diagnosis. When their values were 0.00 mV and 30 ms, respectively, the sensitivity and specificity of the combined index were 37.5 and 83.6%. ③ Follow-up: In the response group, the T-wave amplitude difference in lead aVR increased and the difference of QT interval in lead V6 decreased after treatment. In the non-response group, there was no difference before and after treatment. When the combined index of the differences of T-wave amplitude difference in lead aVR and QT interval difference in lead V6, respectively, were −0.05 mV and 5 ms, the sensitivity and specificity of estimating the prognosis of DCM were 44.4 and 83.3%.Conclusions: The differences of T-wave amplitude and QT interval may have a certain value to estimate DCM diagnosis and prognosis.

Reconfigurable architectures are today experiencing a renewed interest for their ability to provide specialization without sacrificing the capability to adapt to disparate workloads. Coarse-grained reconfigurable arrays (CGRAs) provide higher flexibility than application-specific integrated circuits (ASICs) while offering increased hardware efficiency with respect to field-programmable gate arrays (FPGAs). This makes CGRAs a promising alternative to enable power-/area-efficient acceleration across different application domains. Unfortunately, specializing and implementing a CGRA for a specific application domain requires the exploration in a large design space (e.g., applying appropriate loop transformation on each application, specializing the reconfigurable processing elements of the CGRA, refining the network topology, deciding the size of the data memory, etc.) and involves enormous software/hardware engineering effort (e.g., modeling, testing, and evaluating the CGRA, map operations onto the CGRA, etc). In this paper, we discuss a hardware/software co-design framework* to automatically specialize and implement optimal CGRA designs given a set of applications of interest.

Breast cancer is the most common and deadliest cancer in women worldwide. Although notable advances have been achieved in the treatment of breast cancer, the overall survival rate of metastatic breast cancer patients is still considerably low due to the development of resistance to breast cancer chemotherapeutic agents and the non-optimal specificity of the current generation of cancer medications. Hence, there is a growing interest in the search for alternative therapeutics with novel anticancer mechanisms. Recently, antimicrobial peptides (AMPs) have gained much attention due to their cost-effectiveness, high specificity of action, and robust efficacy. However, there are no clinical data available about their efficacy. This warrants the increasing need for clinical trials to be conducted to assess the efficacy of this new class of drugs. Here, we will focus on the recent progress in the use of AMPs for breast cancer therapy and will highlight their modes of action. Finally, we will discuss the combination of AMP-based therapeutics with other breast cancer therapy strategies, including nanotherapy and chemotherapy, which may provide a potential avenue for overcoming drug resistance.

Objective: To compare and explore the effects of needling acupoints at different nerve segments on the oxytocin (OT) neurons in the paraventricular nucleus of hypothalamus (PVN) and the intragastric pressure, and discuss the possible mechanisms.

Background: Expression of the programmed death-ligand 1 (PD-L1) in medullary thyroid carcinoma (MTC) has been rarely reported. In this study, we evaluated PD-L1 positivity in MTC and analyzed its c...

This paper proposes and experimentally assesses two zero-sequence current control strategies that allow continuous operation of the three-phase dual-inverter drive using an open-end winding permanent magnet synchronous machine (PMSM) when freewheel diodes (or semiconductor switches) in either inverters fail open circuit. With an identified failure present, the proposed control strategies inject zero-sequence current to bias the phase current(s) of the faulted phase(s) such that the phase current(s) are unipolar, thereby eliminating current flow in the device(s) that have failed. Two possible injection modes are proposed. The first mode injects the minimum required zero-sequence current to bias the current in the phase that has a semiconductor open-circuit failure(s). The injected zero-sequence current varies over a fundamental cycle. This minimizes the increase in total rms currents in the phases yielding higher torque capability in fault conditions. The second mode injects a zero-sequence current that has a constant value over a fundamental cycle to bias all three-phase currents appropriately. This mode is used if more than one phase has suffered a fault. Additional thermal and current stresses resulting from both techniques were assessed and compared. A detailed electromagnetic torque model was also developed to demonstrate that the zero-sequence current does not affect the average torque output. Experimental results verify the theoretical treatment and are used to examine the advantages of techniques and show the improvement in the maximum available torque under fault conditions.

Background Globally, ~500 000 people with severe dengue (SD) require hospitalization yearly; ~12 500 (2.5%) die. Secondary hemophagocytic lymphohistiocytosis (sHLH) is a potentially fatal hyperinflammatory condition for which HLH-directed therapy (as etoposide and dexamethasone) can be life-saving. Prompted by the high mortality in SD and the increasing awareness that patients with SD may develop sHLH, our objectives were to (1) determine the frequency of dengue-HLH in SD, (2) describe clinical features of dengue-HLH, (3) assess mortality rate in SD and dengue-HLH, and (4) identify mortality-associated risk factors in SD. Methods A 5-year retrospective single-center study in all adult patients with SD admitted to a tertiary intensive care unit in Malaysia. Results Thirty-nine of 180 (22%) patients with SD died. Twenty-one of 180 (12%) had HLH defined as an HLH probability ≥70% according to histo score (HScore); 9 (43%) died. Similarly, 12 of 31 (39%) fulfilling ≥4 and 7 of 9 (78%) fulfilling ≥5 HLH-2004 diagnostic criteria died. Peak values of aspartate aminotransferase (AST), alanine aminotransferase, lactate dehydrogenase, and creatinine correlated to fatality (odds ratios [ORs], 2.9, 3.4, 5.8, and 31.9; all P < .0001), as did peak ferritin (OR, 2.5; P = .0028), nadir platelets (OR, 1.9; P = .00068), hepatomegaly (OR, 2.9; P = .012), and increasing age (OR, 1.2; P = .0043). Multivariable logistic regression revealed peak AST (OR, 2.8; P = .0019), peak creatinine (OR, 7.3; P = .0065), and SOFA (Sequential Organ Failure Assessment) score (OR, 1.4; P = .0051) as independent risk factors of death. Conclusions Be observant of dengue-HLH due to its high mortality. A prospective study is suggested on prompt HLH-directed therapy in SD patients with hyperinflammation and evolving multiorgan failure at risk of developing dengue-HLH., Patient with severe dengue (SD) may develop secondary hemophagocytic lymphohistiocytosis (HLH), which is potentially fatal but treatable. We report an SD mortality of 22% and dengue-HLH mortality ~40%. Consider prompt HLH-directed therapy in patients with, or at risk of, dengue-HLH.

A design of high-temperature superconducting bandpass filter based on split-ring resonator (SRR) structures is presented in this paper. The SRR has been considered as a classical element for metamaterials and exhibits characteristics of subwavelength resonator, hence can aid in the compact design of filters. Filter has been simulated and optimized using Sonnet software. The measured results of the filter have good consistency with the simulated results and show good band pass characteristics. The center frequency of the filter measured at 70 K was 2.515 GHz, the rectangle coefficient was 1.22, and the insertion loss was 0.1 dB at the center frequency.

This paper presents the framework of a power-dispatching automation system (PDAS) based on a virtual private cloud, which extracts advantages of technologies, such as a virtual private cloud, a virtual private network, an https protocol, etc. Unlike existing on-premise or public cloud hosted PDASs that are vulnerable and may be subject to blackouts due to extreme conditions, such as natural disasters or cyberattacks, the proposed framework operates more safely and securely under those conditions, while at the same time meeting the reliability requirements for power systems as well. This paper presents the theory, architectural design, characteristics, and implementation process of the system, as well as its reliability and cyber security measurements. The annual failure time of the proposed system is reduced from 61.2 to about 0.43 min, about 142 times less than those of existing PDASs. This framework has been implemented in the Lipu power system in China since May 2016. Results show that the proposed system is reliable, safe, and cost-effective, with a bright prospect for future applications.

Objective: To evaluate the effectiveness of acupuncture in patients with vascular cognitive impairment no dementia (VCIND) in comparison with citicoline, an agent for cognitive disturbances associated with chronic cerebral disorders. Design: A randomized controlled multicenter trial. Setting: In three hospitals in Beijing, China. Subjects: A total of 216 patients with VCIND were recruited. Interventions: Patients with VCIND (mean age of 65.4 years) were randomized to receive acupuncture (two sessions per week) or oral citicoline (100 mg three times daily) over three months. Main measures: The primary outcome was the change from baseline to three months in cognitive symptom, measured by Alzheimer’s disease Assessment Scale, cognitive subscale (ADAS-cog). Secondary outcomes included changes from baseline to six months in ADAS-cog, executive function measured by the Clock Drawing Test (CDT), and functional disability measured by the Ability of Daily Living (ADL) scale at three and six months. Results: At three months, the acupuncture group had a greater decrease in mean ADAS-cog score (−2.33 ± 0.31) than the citicoline group (−1.38 ± 0.34) with a mean difference of −0.95 (95% CI, −1.84 to −0.07, P = 0.035). The mean change from baseline to six months in ADAS-cog also significantly favored acupuncture treatments (acupuncture change −2.61 vs citicoline −1.25, difference: −1.36 points; 95% CI, −2.20 to −0.51; P = 0.002). There was no difference between the two groups on CDT and ADL scores at either time point. Conclusion: Compared with citicoline, acupuncture has comparable and even superior efficacy with improved cognitive and daily living performance as a complementary and alternative medicine treatment for VCIND.

Background Whether goal-directed fluid therapy based on dynamic predictors of fluid responsiveness (GDFTdyn) alone improves clinical outcomes in comparison with standard fluid therapy among patients undergoing surgery remains unclear. Methods PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched for relevant studies. Studies comparing the effects of GDFTdyn with that of standard fluid therapy on clinical outcomes among adult patients undergoing surgery were considered eligible. Two analyses were performed separately: GDFTdyn alone versus standard fluid therapy and GDFTdyn with other optimization goals versus standard fluid therapy. The primary outcomes were short-term mortality and overall morbidity, while the secondary outcomes were serum lactate concentration, organ-specific morbidity, and length of stay in the intensive care unit (ICU) and in hospital. Results We included 37 studies with 2910 patients. Although GDFTdyn alone lowered serum lactate concentration (mean difference (MD) − 0.21 mmol/L, 95% confidence interval (CI) (− 0.39, − 0.03), P = 0.02), no significant difference was found between groups in short-term mortality (odds ratio (OR) 0.85, 95% CI (0.32, 2.24), P = 0.74), overall morbidity (OR 1.03, 95% CI (0.31, 3.37), P = 0.97), organ-specific morbidity, or length of stay in the ICU and in hospital. Analysis of trials involving the combination of GDFTdyn and other optimization goals (mainly cardiac output (CO) or cardiac index (CIx)) showed a significant reduction in short-term mortality (OR 0.45, 95% CI (0.24, 0.85), P = 0.01), overall morbidity (OR 0.41, 95% CI (0.28, 0.58), P

Objective The aim of this study is to examine the relationship between rectal–vaginal pressure and symptomatic rectocele in patients with pelvic organ prolapse (POP). Method Patients with posterior vaginal prolapse staged III or IV in accordance with the POP Quantitation classification method who were scheduled for pelvic floor reconstructive surgery in the years 2016–2019 were included in the study. Rectocele was diagnosed using translabial ultrasound, and obstructed defecation (OD) was diagnosed in accordance with the Roma IV diagnostic criteria. Both rectal and vaginal pressure were measured using peritron manometers at maximum Vasalva. To ensure stability, the test was performed three times with each patient. Results A total of 217 patients were enrolled in this study. True rectocele was diagnosed in 68 patients at a main rectal ampulla depth of 19 mm. Furthermore, 36 patients were diagnosed with OD. Symptomatic rectocele was significantly associated with older age (p p p 2O) compared with patients with asymptomatic rectocele (16.9 ± 8.4 cm H2O, p 2O, p Conclusion The rectal–vaginal pressure gradient was found to be a risk factor for symptomatic rectocele in patients with POP. A rectal–vaginal pressure gradient of > 27.5 cm H2O was suggested as the cut-off point of the elevated pressure gradient.

Background RNA vaccines against coronavirus disease 2019 (COVID-19) have demonstrated ∼95% efficacy in phase III clinical trials. Although complete vaccination consisted of 2 doses, the onset of protection for both licensed RNA vaccines was observed as early as 12 days after a single dose. The adaptive immune response that coincides with this onset of protection could represent the necessary elements of immunity against COVID-19. Methods Serological and T cell analysis was performed in a cohort of 20 healthcare workers after receiving the first dose of the Pfizer/BioNTech BNT162b2 vaccine. The primary endpoint was the adaptive immune responses detectable at days 7 and 10 after dosing. Findings Spike-specific T cells and binding antibodies were detectable 10 days after the first dose of the vaccine, in contrast to receptor-blocking and severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) neutralizing antibodies, which were mostly undetectable at this early time point. Conclusions Our findings suggest that early T cell and binding antibody responses, rather than either receptor-blocking or virus neutralizing activity, induced early protection against COVID-19. Funding The study was funded by a generous donation from The Hour Glass to support COVID-19 research., Graphical abstract, Context and significance RNA vaccines have shown efficacy in preventing coronavirus disease 2019 (COVID-19) as early as 12 days after the first dose. Vaccine efficacy onset presents a unique opportunity to define the necessary elements of immunity against COVID-19. Kalimuddin et al. tracked the serological and T cell responses longitudinally in 20 healthcare workers after the first Pfizer/BioNTech BNT162b2 vaccine dose. Anti-spike immunoglobulin G (IgG) and IgA antibodies and spike-specific T cells were detectable at day 10 after the first dose; neutralizing and receptor-blocking antibodies remained mostly undetectable at this time point. These results suggest that binding antibodies and T cell responses are responsible for early protection against COVID-19 and call for circumspection on the prevailing notion that neutralizing antibodies are absolutely required for protection., Kalimuddin et al. show that spike protein-binding antibodies and spike-specific T cells, but not neutralizing antibodies, could explain the onset of vaccine efficacy after the first dose of BNT162b2 vaccination. Their findings provide insight into the components of the adaptive immune response necessary for protection against COVID-19.

Purpose Leptin and adiponectin are adipokines which have been commonly implicated in carcinogenesis. As such, many studies have investigated the association of circulating leptin and adiponectin levels with colorectal cancer (CRC) risk. However, the results remained inconsistent. Methods In this work, we performed a systematic review and meta-analysis to precisely examine the association between circulating levels of leptin and adiponectin and CRC risk. A systematic literature search was performed in PubMed/MEDLINE, Scopus, Web of Science, and EMBASE databases from inception until October 2020. The pooled effect size was then estimated by calculating the odds ratio (OR). Results A total of 23 records (comprising 26 studies) were included in the meta-analysis. The overall analysis found that circulating levels of leptin and adiponectin were not significantly associated with CRC risk (P > 0.05). Interestingly, subgroup analysis revealed that a higher level of adiponectin was significantly associated with an increased CRC risk among overweight individuals (OR = 1.16; 95 % CI: 1.02, 1.32), and a decreased CRC risk among normal weight individuals (OR = 0.76; 95 % CI: 0.62, 0.92). Besides, a higher level of adiponectin was also significantly associated with a decreased risk of CRC in men (OR = 0.76; 95 % CI: 0.59, 0.98). Conclusions In conclusion, circulating leptin level was not associated with CRC risk, but that of adiponectin was associated with CRC risk only in specific subgroups.

Dear Editor,We read with immense interest a recent meta-analysis published in Archives of Physiology and Biochemistry on the association between VDR gene polymorphisms and the risk of osteoporosis ...