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Background The safety and immunogenicity profile of COVID-19 vaccines when administered concomitantly with seasonal influenza vaccines have not yet been reported. We therefore aimed to report the results of a substudy within a phase 3 UK trial, by evaluating the safety, immunogenicity, and efficacy of NVX-CoV2373 when co-administered with licensed seasonal influenza vaccines. Methods We did a planned exploratory substudy as part of the randomised, observer-blinded, placebo-controlled, phase 3 trial of the safety and efficacy of the COVID-19 vaccine (NVX-CoV2373) by co-administrating the influenza vaccine at four study hospitals in the UK. Approximately, the first 400 participants meeting the main study entry criteria—with no contraindications to influenza vaccination—were invited to join the substudy. Participants of the main study were randomly assigned (1:1) to receive two intramuscular injections of either NVX-CoV2373 (5 μg) or placebo (normal saline) 21 days apart; participants enrolled into the substudy were co-vaccinated with a single (0·5 mL) intramuscular, age-appropriate (quadrivalent influenza cell-based vaccine [Flucelvax Quadrivalent; Seqirus UK, Maidenhead] for those aged 18–64 years and adjuvanted trivalent influenza vaccine [Fluad; Seqirus UK, Maidenhead] for those ≥65 years), licensed, influenza vaccine on the opposite deltoid to that of the first study vaccine dose or placebo. The influenza vaccine was administered in an open-label manner and at the same time as the first study injection. Reactogenicity was evaluated via an electronic diary for 7 days after vaccination in addition to monitoring for unsolicited adverse events, medically attended adverse events, and serious adverse events. Immunogenicity was assessed with influenza haemagglutination inhibition and SARS-CoV-2 anti-spike protein IgG assays. Vaccine efficacy against PCR-confirmed, symptomatic COVID-19 was assessed in participants who were seronegative at baseline, received both doses of study vaccine or placebo, had no major protocol deviations affecting the primary endpoint, and had no confirmed cases of symptomatic COVID-19 from the first dose until 6 days after the second dose (per-protocol efficacy population). Immunogenicity was assessed in participants who received scheduled two doses of study vaccine, had a baseline sample and at least one post-vaccination sample, and had no major protocol violations before unmasking (per-protocol immunogenicity population). Reactogenicity was analysed in all participants who received at least one dose of NVX-CoV2373 or placebo and had data collected for reactogenicity events. Safety was analysed in all participants who received at least one dose of NVX-CoV2373 or placebo. Comparisons were made between participants of the substudy and the main study (who were not co-vaccinated for influenza). This study is registered with ClinicalTrials.gov, number NCT04583995. Findings Between Sept 28, 2020, and Nov 28, 2020, a total of 15 187 participants were randomised into the main phase 3 trial, of whom 15 139 received treatment (7569 received dose one of NVX-CoV2373 and 7570 received dose one of placebo). 431 participants were co-vaccinated with a seasonal influenza vaccine in the substudy (217 received NVX-CoV2373 plus the influenza vaccine and 214 received placebo plus the influenza vaccine). In general, the substudy participants were younger, more racially diverse, and had fewer comorbid conditions than those in the main study. Reactogenicity events were more common in the co-administration group than in the NVX-CoV2373 alone group: tenderness (113 [64·9%] of 174 vs 592 [53·3%] of 1111) or pain (69 [39·7%] vs 325 [29·3%]) at injection site, fatigue (48 [27·7%] vs 215 [19·4%]), and muscle pain (49 [28·3%] vs 237 [21·4%]). Incidences of unsolicited adverse events, treatment-related medically attended adverse events, and serious adverse events were low and balanced between the co-administration group and the NVX-CoV2373 alone group. No episodes of anaphylaxis or deaths were reported within the substudy. Co-administration resulted in no change to influenza vaccine immune response although a reduction in antibody responses to the NVX-CoV2373 vaccine was noted. NVX-CoV2373 vaccine efficacy in the substudy (ie, participants aged 18 to

BACKGROUND ＆ AIMS: Optimizing treatments balancing prognosis and therapeutic invasiveness is important in the management of pancreatic cancer (PC) owing to global ageing. This study aimed to verify the different utility of biomarkers by patients' age. MATERIALS ＆ METHODS: This is a single-center, retrospective cohort analysis involving 160 patients who undertook pancreaticoduodenectomy (PD) for PC. After comparing clinicopathological factors and survival after PD between aged (≥70 y/o) and young (＜70 y/o) patients, we compared neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), controlling nutrition (CONUT) score, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 as well as clinicopathological factors between long and short survivors in each group. We also performed Kaplan-Meyer analysis between patients stratified by biomarkers. RESULTS: Overall survival (OS) was significantly worse in aged patients (p = 0.002). In aged patients, CEA was significantly higher in short survivors. In young patients, CONUT score and CA19-9 were higher in short survivors. Kaplan-Meyer analysis showed that NLR and CEA stratified OS in aged patients, whereas CONUT score and CA19-9 could stratify OS in young patients. CONCLUSION: Our current results suggest that these biomarkers had different impact on survivals according to the patients' age.

Using security-level holdings for all euro-area investors, we study portfolio rebalancing during the quantitative easing program from March 2015 to December 2017. Foreign investors outside the euro area accommodated most of the Eurosystem’s purchases. Duration, government credit, and corporate credit risk did not get concentrated in particular regions or investor sectors. We estimate a demand system for government bonds by instrumental variables to relate portfolio rebalancing to yield changes. Government bond yields decreased by 65 basis points on average, and this estimate varies from 38 to 83 basis points across countries.

Background /Objectives: This study aimed to elucidate the efficacy of CT findings and perioperative characteristics to predict post-pancreatectomy hemorrhage (PPH): a critical complication after pancreaticoduodenectomy. Methods The records of 590 consecutive patients who underwent pancreaticoduodenectomy at three institutes between 2012 and 2018 were included. The presence of a vascular wall abnormality or ascites with high density (vascular abnormality) on postoperative day (POD) 5–10 contrast-enhanced CT (early CT), perioperative characteristics, and any PPH or pseudoaneurysm formation (PPH events) were analyzed through a multivariate analysis. Results PPH events occurred in 48 out of 590 patients (8%). The vascular abnormality on early CT and the C-reactive protein (CRP) value on POD 3 were independent risk factors for PPH events after POD5 (vascular abnormality: odds ratio 6.42, p = 0.001; CRP on POD 3: odds ratio 1.17, p = 0.016). The sensitivity of vascular abnormality for PPH events was 24% (7/29), and the positive predictive value was 30% (7/23). The combination of vascular abnormality and a high CRP value (≥15.5 mg/dL) on postoperative day 3 had a higher positive predictive value of 64% (7/11) than the vascular abnormality alone. None of the seven PPH events that occurred more than one month after surgery were foreseen via early CT. Conclusion The combination of vascular abnormality and high CRP value was associated with increasing risk of PPH events after pancreaticoduodenectomy, but the low sensitivity of early CT must be noted as an important shortcoming. The normal findings on early CT could not eliminate the risk of late PPH.

International audience; Understanding the channels through which financial inclusion affects poverty reduction remains a key policy issue in development debates. Considering that labour is the main asset of the poor, this paper investigates the effect of financial outreach on the number of workers living below the poverty line. It also analyses whether this effect may occur through increasing investment, remittances, private credit and the number of rich workers who can provide employment opportunities to the poorest. The study finds that improving financial outreach through additional bank branches reduces the number of poor workers, especially in developing countries hit by macro economic instability. In addition, this effect occurs mainly through credit expansion, while other channels substitute financial outreach in countries with a low level of financial development.

Nitrogen-doped porous carbons were prepared via chemical activation of chitosan using alkali-metal carbonates (Na2CO3, K2CO3, Rb2CO3, and Cs2CO3), and the water adsorption isotherms of prepared carbons were measured to estimate the performance of the carbons in adsorption heat pump/desiccant cooling. Pre-doping of an alkali carbonate activator into the chitosan precursor resulted in a highly developed micropore structure and the introduction of macropores. The macropore structure clearly depended on the alkali carbonate activator. Na2CO3 resulted in two-dimensional macropores because of the hard-template effect, whereas the other alkali carbonate activators resulted in three-dimensional macropores with different cell sizes. A density functional theory calculation study based on X-ray photoelectron spectroscopy analyses of nitrogen-doped activated carbons indicated that pyridinic (pyridine, pyridone, and pyridine N-oxide), amide, and quaternary N groups might be effective for low-pressure water adsorption. Although the water adsorption capacities of the prepared carbons at P/P0 > 0.5 increased with increasing micropore volume, those at the low-pressure region (P/P0

A previously healthy 13-year-old Japanese girl with a BCG vaccination history and no tuberculosis (TB) exposure history presented to the hospital with mild dyspnea for 1 month and fever for 5 days. Computed tomography showed consolidation with a pleural effusion, obstructed left main bronchus with an air bronchogram, and traction bronchiectasis of the left upper lobe (Fig. 1A, B). No improvement was observed with ampicillin. Computed tomography on day 23 showed a new granular shadow in the right upper lobe (Fig. 1C). Despite a negative interferon-gamma release assay (IGRA) result, the sputum on day 55 was positive for acid-fast bacilli on a ZiehlNeelsen stain and Mycobacterium tuberculosis on polymerase chain reaction. A fourdrug antituberculous regimen was initiated and she recovered rapidly. TB exposure history, positive tuberculin skin test or IGRA, and typical imaging findings are the triad for primary TB diagnosis (Perez-Velez and Marais, 2012; Lewinsohn et al., 2017; Ahmed et al., 2020). In pediatric primary TB, consolidation may be present and can be misdiagnosed as bacterial pneumonia; however, massive consolidation is rare (GriffithRichards et al., 2007). Primary pulmonary TB should be considered in children with lung consolidation that is unresponsive to antibiotics, despite negative IGRA and TB exposure history.

We study a dynamic model of collateralized credit markets with asymmetric information, which allows for a rich set of signaling strategies based on the path of debt and repayment. Whether credit history reveals private information about credit quality depends on the degree of uncertainty in collateral value. When uncertainty is low, good borrowers fully and costlessly separate by deleveraging, that is borrowing a sufficiently high amount such that subsequent repayment reveals the presence of unobservable income. When uncertainty is higher, good borrowers pay an adverse selection cost through a higher interest rate because bad borrowers could default, and asymmetric information is not always resolved.

Measurements of three-dimensional (3D) dose distribution of electron-beams in water are important for high-energy electron beams from medical linear accelerators (LINAC). Although ionization chambers are commonly used for this purpose, measurements take a long time for precise 3D dose distribution. To solve the problem, we tried the measurements of the 3D dose distributions using a scintillator plate combined with a mirror. After we placed a 1 mm thick plastic scintillator plate at the upper inside of a black box, a water phantom was set above the plastic scintillator plate outside the black box, and electron beam was irradiated to the water phantom from the upper side. The attenuated electron-beam by the water in the phantom was detected by the plastic scintillator plate and the scintillation image was formed in the plate. The image was reflected by a surface mirror set below the plastic scintillator plate and detected by a cooled charge coupled device (CCD) camera from the side. We changed the depths of the water in the phantom, obtained the scintillation images, and calculated a 3D scintillation image using the measured images. Measurements were made for 9 MeV and 12 MeV electron-beams using the imaging system. From the images, we could successfully form 3D scintillation images. The depth profiles measured from the 3D images showed almost identical distribution with those calculated by the planning system within the difference of 5%. The lateral profiles also showed almost identical within the difference of the widths less than 2.5 mm. We conclude that the proposed method is promising for 3D dose distribution measurements of electron-beams.

CHA zeolite (chabazite) crystals and membranes were prepared from organic structural directing agents-free (OSDA-free) gels. Chabazite membranes were grown on the tubular alumina supports. The effect of cesium and fluoride salts on the crystallization of chabazite crystals and membranes were investigated. Highly crystalline chabazite and uniform chabazite membranes were only obtained from the gel containing the cesium and fluoride salts. Single CO2, N2 and CH4 permeances and mixed gas separations in CO2/N2 and CO2/CH4 binary mixtures through chabazite membranes were measured. Temperature and pressure affected the permeances and separation selectivities in two mixtures. The best membrane showed CO2/N2 and CO2/CH4 separation selectivities as high as 16 and 46 together with CO2 permeances of ~ 1.0 × 10-7 mol/(m2 s Pa) at a high temperature of 473 K in equimolar dry CO2/N2 and CO2/CH4 binary mixtures, respectively. The CO2/N2 and CO2/CH4 selectivities lost only 11% and 15%, and CO2 permeances lost only 18% and 20% in equimolar wet CO2/N2 and CO2/CH4 mixtures (8% in mole of water vapor) at 473 K compared to these values in dry mixtures, respectively. The OSDA-free chabazite membranes were hydrothermally stable in the presence of vapor water for 4 d at 378 K.

Among different RNA modifications, the helix 69 (H69) region of the bacterial ribosomal RNA (rRNA) contains three pseudouridines (Ψs). H69 is functionally important due to its location in the heart of the ribosome. Several structural and functional studies have shown the importance of Ψ modifications in influencing the H69 conformation as well as maintaining key interactions in the ribosome during protein synthesis. Therefore, a need exists to understand the influence of modified nucleosides on conformational dynamics of the ribosome under solution conditions that mimic the cellular environment. In this review on chemical probing, we provide detailed protocols for the use of dimethyl sulfate (DMS) to examine H69 conformational states and the influence of Ψ modifications under varying solution conditions in the context of both ribosomal subunits and full ribosomes. The use of DMS footprinting to study the binding of aminoglycosides to the H69 region of bacterial rRNA as a potential antibiotic target will also be discussed. As highlighted in this work, DMS probing and footprinting are versatile techniques that can be used to gain important insight into RNA local structure and RNA-ligand interactions, respectively.

A CAE-based process design method was developed to improve formability in hot stamping by controlling the temperature distribution during the forming step. Specifically, areas where deformation is not desired should be cooled to make them harder, and areas where deformation is desired should be kept at higher temperature. In this study, a tailored initial temperature distribution was calculated through three-step analysis of the deformation behavior by a thermo-mechanical forming simulation. First, the deformation severity was evaluated from the damage value for each finite element by using a forming limit diagram (FLD) at elevated temperature. The cautionary damage value was then defined to determine whether the element should be cooled. Finally, the tailored initial temperature was calculated based on the temperature-dependent flow stress. This procedure was applied to a high-rigidity pillar model that could not be formed by the conventional hot stamping process without cracking. The improved formability was confirmed experimentally. Thus, controlling the temperature distribution increases the diversity of shapes achievable by hot stamping.

Objectives This study aimed to determine the relative risks of addiction to the Internet, online gaming and online social networking of college students in six Asian countries/regions (Singapore, Hong Kong [HK]/Macau, China, South Korea, Taiwan and Japan) compared with students in the United States (US). It also explored the relative risks of depression and anxiety symptoms among students with Internet-related addictions from these countries/regions. Study design This is a cross-sectional survey. Methods A convenience sample of 8067 college students aged between 18 and 30 years was recruited from seven countries/regions. Students completed a survey about their use of the Internet, online gaming and online social networking as well as the presence of depression and anxiety symptoms. Results For all students, the overall prevalence rates were 8.9% for Internet use addiction, 19.0% for online gaming addiction and 33.1% for online social networking addiction. Compared with the US students, Asian students showed higher risks of online social networking addiction but displayed lower risks of online gaming addiction (with the exception of students from HK/Macau). Chinese and Japanese students also showed higher risks of Internet addiction compared with the US students. In general, addicted Asian students were at higher risks of depression than the addicted US students, especially among Asian students who were addicted to online gaming. Addicted Asian students were at lower risks of anxiety than the addicted US students, especially among Asian students who were addicted to online social networking, and addicted students from HK/Macau and Japan were more likely to have higher relative risks of depression. Conclusions There are country/regional differences in the risks of Internet-related addictions and psychiatric symptoms. It is suggested that country/region-specific health education programmes regarding Internet-related addictions are warranted to maximise the efficiency of prevention and intervention. These programmes should attempt to tackle not only problematic Internet-related behaviours but also mood disturbances among college students.

Inorganic-organic hybrid membranes consisting of an aliphatic backbone and amorphous TiO2 nanoparticles (NPs) were synthesized from tetraallyloxytitanium and phosphonic acid methacrylate via a simple copolymerization-hydrolysis method. Tetraallyoxytitanium (TAT) was copolymerized with 2-hydroxyethyl methacrylate acid phosphate (HEMAP), and then hydrolyzed, yielding inorganic-organic hybrid composites. IR and 13C NMR spectroscopy confirmed the formation of the inorganic-organic hybrid structure. TEM and SAXS showed that amorphous TiO2 NPs were dispersed in the polymer matrix. The membranes exhibited good thermal stability up to 180 °C. The aliphatic chains of the methacrylate derivative dispersed with TiO2 NPs improved the mechanical properties of the membranes. The tensile modulus of the HEMAP/TAT membrane with a composition of 95:5 was 505 MPa. The conductivity of the 95:5 membranes was 4.1 × 10-2 S cm-1 at 130 °C and 100% relative humidity (RH), while it was 4.7 × 10-4 S cm-1 at 130 °C and 19.3% RH. The peak power of the 95:5 membrane was 4.8 mW/cm2 at 140 °C and 30% RH. The cell utilizing the hybrid membrane was operated at 140 °C and 30% RH for 72 h without any drop in cell voltage.