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• Several cardiovascular/hemostatic disturbances haves been reported in patients with COVID-19, but the real frequency and their potential association with the pathogenic mechanisms of SARS-CoV-19 still remain to be defined. • We investigated the relative frequency of acute coronary syndrome, deep venous thrombosis, pulmonary embolism, stroke and upper gastrointestinal bleeding in COVID patents attending emergency departments (EDs), before hospitalization and compared them with frequencies in the general ED population attending 50 Spanish EDs. • We found that the risk of pulmonary embolism is clearly increased in COVID patients, with an OR of 4.53 with respect to non-COVID patients (95% confidence interval 4.03- 5.10). Additionally, the diagnosis of pulmonary embolism was 2 fold more frequent among ED comers in 2020 compared to 2019, suggesting a SARS-CoV-2 role in such increment of cases.. The remaining entities studied were not found to be unequivocally increased in the present study and need further investigation.

Biologic therapy has become standard therapy for pediatric Inflammatory Bowel Disease (IBD) patients with moderate-to-severe disease. Despite medical management, many patients still require surgical intervention. We aim to identify the risk of postoperative complications within 30 days in pediatric IBD patients treated with biologic therapy who require intra-abdominal surgery. A retrospective chart review was completed of pediatric IBD patients on biologic therapy at Children’s National Hospital. Mann–Whitney U test and Fisher’s exact test were used for statistical analysis. Two hundred and sixty-nine pediatric IBD patients on biologic therapy age were identified. In total, 5.2% of patients required surgical intervention despite medical management with biologic therapy. All patients identified were diagnosed with Crohn’s disease; the majority of patients requiring surgical intervention were female and of Caucasian race. Twenty-one percent of patients who required surgical intervention developed postoperative complications related to infectious etiology. All patients had biologic therapy held perioperatively. Those in delay with re-initiation of therapy were at risk for nonresponse or anaphylaxis. Presence of anemia was significantly associated with postoperative complications (p = 0.05). A minority of IBD patients on biologic therapy required surgical intervention despite treatment with biologic therapy. Presence of anemia may be associated with risk of postoperative complications. More studies are needed to further these findings.

Introduction. Celiac disease, an autoimmune enteropathy, occurs in susceptible individuals and is treatable with a gluten-free diet. These may not be supplemented with vitamins. Objective. To assess the nutritional health of children who have biopsy-proven celiac disease. Methods. Charts were reviewed between July 1, 2007, and June 30, 2017. Results. A total of 252 children ages 0 to 21 years had biopsy-proven celiac disease, mean age 11 ± 4.1 years. Body mass index Z-score was 0.2 ± 1.2 at diagnosis. Except for vitamin D, few had deficiencies at diagnosis. At 1-year follow-up, there was no significant change in anthropomorphics or vitamin status. Adherence to follow-up was poor; at 5 years after diagnosis, 39% adhered to follow-up. Conclusion. Despite a rigorous, proactive protocol for contacting and following children with celiac disease, adherence to follow-up was poor. New strategies, such as follow-up through the primary care provider, are needed.

Funding Information: This work is supported in part by the Academy of Finland 6Genesis Flagship program (Grant No. 318927), the Ministry of Economic Affairs, Innovation, Digitalisation and Energy of the State of North Rhine-Westphalia (MWIDE NRW) along with the Competence Center 5G.NRW under Grant No. 005-01903-0047, the Deutsche Forschungsgemeinschaft (DFG) within the Collaborative Research Center SFB 876 “Providing Information by Resource-Constrained Analysis”, project A4, European Union’s Horizon 2020 Research and Innovation Program under Grant 732174 (ORCA Project), European Commission through the Next Generation Internet Project “iNGENIOUS: Next-Generation IoT solutions for the universal supply chain” (H2020-ICT-2020-1 call) under Grant 957216, the Scientific and Technological Research Council of Turkey (TUBITAK) under 3501-Career Development Program (CAREER) Grant #118E920, Institute for Information & Communications Technology Promotion (IITP) Grant funded by the Korea government (MSIT) (No. 2020-0-01316, International cooperation and collaborative research on 5G+ technologies for ultra-reliability low latency communications) and the Indonesian Ministry of Finance under the LPDP RISPRO for the Grant under the project of “Prevention and Recovery Networks for Indonesia Natural Disasters Based on the Internet-of-Things (PATRIOT-Net)”. The authors would like to acknowledge the contributions of their colleagues in the project, although the views expressed in this work are those of the authors and do not necessarily represent the project. Publisher Copyright: © 2021, The Author(s). The recently introduced 5G New Radio is the first wireless standard natively designed to support critical and massive machine type communications (MTC). However, it is already becoming evident that some of the more demanding requirements for MTC cannot be fully supported by 5G networks. Alongside, emerging use cases and applications towards 2030 will give rise to new and more stringent requirements on wireless connectivity in general and MTC in particular. Next generation wireless networks, namely 6G, should therefore be an agile and efficient convergent network designed to meet the diverse and challenging requirements anticipated by 2030. This paper explores the main drivers and requirements of MTC towards 6G, and discusses a wide variety of enabling technologies. More specifically, we first explore the emerging key performance indicators for MTC in 6G. Thereafter, we present a vision for an MTC-optimized holistic end-to-end network architecture. Finally, key enablers towards (1) ultra-low power MTC, (2) massively scalable global connectivity, (3) critical and dependable MTC, and (4) security and privacy preserving schemes for MTC are detailed. Our main objective is to present a set of research directions considering different aspects for an MTC-optimized 6G network in the 2030-era.

Background & Aims Non-alcoholic steatohepatitis (NASH) in children is a significant public health concern. Oxidative stress is an important component in the pathophysiology of NASH. Several enzymatic antioxidant mechanisms protect the liver from oxidative injury. Examination of the expression of these enzymes in NASH livers may provide insight on the roles for these antioxidant mechanisms in the pathophysiology of NASH. Methods The mRNA expression of catalase, glutathione peroxidase 1 (GPX1), glutathione reductase (GSR), paraoxonase 1 (PON1) and other reactive oxygen species-related genes was evaluated by microarray and quantitative real-time PCR analyses. The PON1 protein levels were evaluated in liver and serum by Western blot analyses. Serum enzymatic activities of GPX, GSR and PON1 (paraoxonase and arylesterase activities) were examined. Results NASH livers exhibited elevated mRNA expression of catalase and PON1, but not GPX1 or GSR. No difference in serum GPX or GSR activity was detected between NASH patients and controls. Elevated expression of PON1 mRNA and protein was detected in NASH livers, but serum PON1 protein and activities were not elevated. Conclusions Elevated expression of catalase and PON1 suggests protective roles for these antioxidants in NASH livers. Given the importance of oxidative stress in the pathophysiology of NASH, future studies focusing on these enzymes could identify important targets for therapeutic or preventive interventions for NASH patients.

Iron may be an important factor in the pathogenesis of non-alcoholic steatohepatitis (NASH) as it catalyzes the production of potent reactive oxygen species. We aim to examine iron status in pediatric NASH.Serum indices of NASH patients (N = 36) were compared to those in the U.S. National Health and Nutrition Examination Survey database (N = 802). Iron related gene expression was examined in NASH livers and normal livers, using microarray and quantitative real-time PCR (10 NASH livers and 6 controls). Transferrin and catalase expression were also examined in hydrogen peroxide treated HepG2 cells.Serum iron concentration (P0.01) and soluble transferrin receptor 1 (P0.0001) were decreased while serum ferritin was elevated in NASH patients (P0.01). No detectable iron was observed in NASH liver by Perls' Prussian blue staining. Transferrin (P0.01) and transferrin receptor 2 (P0.01) mRNA were elevated in NASH patients. Of particular interest, transferrin mRNA was positively correlated with catalase mRNA (r = 0.9338, P0.0001). H2O2 treatment of HepG2 cells induced mRNA expression of transferrin and catalase.Pediatric NASH patients exhibited decreased serum iron concentration and no detectable iron was observed in any NASH liver by Perls' Prussian blue staining. These changes are consistent with the facts that most NASH patients are obese and exhibit chronic inflammation. In line with a status of iron deficiency, gene expression studies suggested decreased expression of transferrin and transferrin receptor 2 in NASH livers. Induction of transferrin by H2O2, and consequently, decreased iron absorption, suggests a novel mechanism for iron deficiency in NASH patients.

A analise da eficiencia espectral de uma rede celular e fundamental para se otimizar o aproveitamento da banda com cobertura na celula. Neste trabalho, o desempenho do enlace reverso de redes celulares e obtido em termos de sua eficiencia espectral media. O cenario estudado considera um canal com perda de propagacao exponencial, desvanecimento plano e lento Rayleigh e interferencia de co-canal (ICC). A modelagem matematica do sistema leva em consideracao varios parâmetros de planejamento, incluindo o fator de reuso de frequencia, arranjo de antenas na estacao radio base (ERB), esquema de combinacao por diversidade do tipoMRC (maximal ratio combining), modulacao adaptativa e controle de potencia. Neste contexto, uma expressao analitica da probabilidade de erro de bit (PEB) para o esquema de modulacao M-QAM (multilevel quadrature amplitude modulation) e obtida em funcao da relacao sinal-ruido por bit (Eb/N0) e da relacao sinal-interferencia (SIR, do ingles signal-to-interference power ratio), considerando a presenca de um interferente dominante. Esta expressao constitui uma ferramenta importante para a avaliacao correta do desempenho de sistemas digitais celulares. Os resultados mostram que utilizar um fator de reuso de 1, conjuntamente com controle de potencia, em geral, e a maneira mais eficiente de se usar o espectro, garantindo cobertura total na celula Abstract