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In this letter, a high-performance dual circularly polarized (CP) circular waveguide horn antenna operating in the V -band (54–60 GHz) is analyzed, built, and tested. The antenna is designed from a cylindrical waveguide section and consists of two mutually orthogonal side-fed ports, a mono-groove, and a conical horn section. The mono-groove is an annulus sector placed at 45° with respect to both the input ports and provides a phase delay of 90° to generate right-hand circular polarization (RHCP) and left-hand circular polarization (LHCP). Simulation results show that the proposed CP horn antenna has interport isolation more than 15 dB, axial ratio (AR) below 2.2 dB, and polarization isolation over 25 dB in the impedance matching bandwidth from 54 to 60 GHz. Also, the proposed antenna provides symmetric radiation patterns. A prototype of this antenna has been fabricated using computer numerical control (CNC) machining technique. The experimental results show good agreement with the simulation results.

The recent COVID-19 pandemic has affected the world and has the potential to disproportionately affect and disrupt the lives of cancer survivors, including those currently in treatment, those who have completed treatment, and those who are now living cancer-free. There are currently over 17 million cancer survivors in the USA [1] and millions more around the world [2, 3]. Much has been published over the past several decades about the late and long-term effects of cancer treatment, alongside both the challenges and potential solutions to help patients navigate the healthcare system in order to receive high-quality survivorship care [4, 5]. To date, a number of organizations have provided the cancer survivorship community (both patients and healthcare providers) recommendations pertaining to COVID-19 (Box 1). Unfortunately, at this time, there is limited evidence regarding the impact of COVID-19 on cancer survivors, particularly those who have completed treatment. As the pandemic continues to evolve and scientific evidence emerges, more directed recommendations and guidelines will follow. As editors of the Journal of Cancer Survivorship, the only international peer-reviewed publication dedicated to expanding and disseminating knowledge pertaining directly to this patient population, we wrote this commentary to describe how COVID-19 may impact the physical, psychosocial, and healthcare delivery concerns of cancer survivors. We hope that this information may be helpful in addressing the needs of cancer survivors at the present time and frame the issues that will warrant attention in the future.

A sidelobe-suppression technique for the reflector antenna is proposed. Compared to the conventional reflector antenna analysis technique, the proposed technique adopts the novel quasi-actual feed ...

OBJECTIVES The purpose was to compare the effects of 3 different dose combinations of bupivacaine and sufentanil on the onset of analgesia and the occurrence of side effects. MATERIALS AND METHODS One hundred sixty-nine pregnant women were randomly assigned to 3 groups: the B1S5 group received 0.1% bupivacaine+5 μg sufentanil in 15 mL; the B125S5 group received 0.125% bupivacaine+5 μg sufentanil in 15 mL; and the B1S10 group received 0.1% bupivacaine+10 μg sufentanil in 15 mL. The primary outcome was the analgesic onset time, and the secondary outcomes were mode of delivery, patient satisfaction, maternal and neonatal side effects (pruritus, hypotension, sedation, motor block, decreased fetal heart rate, fever, and interference with breastfeeding). RESULTS The median (inter-quartile range) time to achieve effective analgesia was significantly faster in the B125S5 group than in the B1S5 group (10 [11-14 {4-30}] min vs. 15 [17-20 {5-30}] min, P

Epidermolysis bullosa acquisita (EBA) is an autoimmune blistering disorder characterized and caused by autoantibodies against type VII collagen (COL7). Although it has been noticed that EBA in both patients and mice is associated with an increased scratching, it is not clear whether and how the scratching contributes to disease manifestation. Hence, we here aimed to validate this clinical observation and also to investigate the potential contribution of increased scratching in EBA pathogenesis in mice. Longitudinal assessment of scratching behavior revealed an increased frequency of scratching as early as 12 hours after injection of anti-COL7 IgG into the skin of mice. Subsequently, scratching events became even more frequent in mice. In contrast, mice injected with a control antibody showed an unaltered scratching behavior throughout the observation period. Based on these observations, we hypothesized that mechanical irritation may promote the induction of inflammation in experimental EBA. To challenge this assumption, the local anesthetic dyclonine hydrochloride was topically applied before injection of anti-COL7 IgG. Dyclonine hydrochloride reduced the scratching events and impaired clinical disease manifestation. In therapeutic experimental settings, i.e. administration of the local anesthetic 24 hours after injection of anti-COL7 IgG, dyclonine hydrochloride only inhibited the scratching behavior, but had no significant effect on clinical disease development. In addition, eosinophils were detected in the skin before the injection of anti-COL7 IgG and significantly increased 48 hours after the antibody injection. Collectively, our results suggest that scratching behavior contributes to the initiation phase of disease manifestation in experimental EBA.

Since the inception of the Journal of Cancer Survivorship (JCSU), the founding editor-in-chief, the associate editors, editorial board members, and peer reviewers have played important roles in influencing the knowledge base published in JCSU. The journal editors represent key disciplines, practice areas, and research expertise in cancer survivorship, which includes oncology and hematology, pediatric oncology, health psychology/behavior medicine, primary care, oncology nursing, exercise oncology, epidemiology, rehabilitation sciences, health services research, health policy, public health, and sociology. Over the years, the journal editors have worked to facilitate peer review and provide quality reviews to prospective authors. Earlier this year, Chan et al. [1] provided an overview of the evolution of JCSU since its inception in 2007 to 2020. Chan et al.’s [1] paper included a comprehensive description of the content, impact metrics, and top cited papers. In addition, they created a neural network using the key terms of published articles (Fig. 1) that depicted both minor and major themes published since the inception of JCSU.

Class I phosphoinositide 3-kinases (PI3K) have been implemented in pathogenesis of experimental epidermolysis bullosa acquisita (EBA), an autoimmune skin disease caused by type VII collagen (COL7) autoantibodies. Mechanistically, inhibition of specific PI3K isoforms, namely PI3Kβ or PI3Kδ, impaired immune complex (IC)-induced neutrophil activation, a key prerequisite for EBA pathogenesis. Data unrelated to EBA showed that neutrophil activation is also modulated by PI3Kα and γ, but their impact on the EBA has, so far, remained elusive. To address this and to identify potential therapeutic targets, we evaluated the impact of a panel of PI3K isoform-selective inhibitors (PI3Ki) on neutrophil function in vitro, and in pre-clinical EBA mouse models. We document that distinctive, and EBA pathogenesis-related activation-induced neutrophil in vitro functions depend on distinctive PI3K isoforms. When mice were treated with the different PI3Ki, selective blockade of PI3Kα (alpelisib), PI3Kγ (AS-604850), or PI3Kβ (TGX-221) impaired clinical disease manifestation. When applied topically, only TGX-221 impaired induction of experimental EBA. Ultimately, multiplex kinase activity profiling in the presence of disease-modifying PI3Ki identified unique signatures of different PI3K isoform-selective inhibitors on the kinome of IC-activated human neutrophils. Collectively, we here identify topical PI3Kβ inhibition as a potential therapeutic target for the treatment of EBA.

Aiping Ma,1,* Lifang Wen,2,* Junping Yin,3 Yi Hu,4 Xiaoyang Yue,3 Jiurong Li,1 Xiaoru Dong,2 Yask Gupta,5 Ralf J Ludwig,5 Susanne Krauss-Etschmann,3,6 Gabriela Riemekasten,7 Frank Petersen,3 Xinhua Yu2,3 1Department of Respiratory Medicine, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 2Xiamen-Borstel Joint Laboratory of Autoimmunity, The Medical College of Xiamen University; 3Priority Area Asthma and Allergy, Research Center Borstel, Airway Research Center North (ARCN), Members of the German Center for Lung Research (DZL), Borstel, Germany; 4Department of Clinical Laboratory, The First Affiliated Hospital, School of Medicine, Xiamen University, Xiamen, People’s Republic of China; 5Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany; 6Institute for Experimental Medicine, Christian-Albrechts-Universitaetzu Kiel, Kiel, Germany; 7Department of Rheumatology, University of Lübeck, Lübeck 23538, Germany*These authors contributed equally to this workCorrespondence: Xinhua YuPriority Area Asthma and Allergy, Research Center Borstel, Borstel 23845, GermanyTel +49 453 7188 2520Email xinhuayu@fz-borstel.deBackground: Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease leading to irreversible airflow limitation and is characterized by chronic pulmonary inflammation, obstructive bronchiolitis and emphysema. Etiologically, COPD is mediated by toxic gases and particles, eg, cigarette smoke, while the pathogenesis of the disease is largely unknown. Several lines of evidence indicate a link between COPD and autoimmunity but comprehensive studies are lacking.Methods: By using a protein microarray assaying more than 19,000 human proteins we determined in this study the autoantibody profiles of COPD and non-COPD smokers. The discovery cohort included 5 COPD patients under acute exacerbation (AECOPD) and 5 age- and gender-matched non-COPD smokers. One putative candidate autoantibody, anti-lactoferrin IgG, was further investigated by using immunoblotting with a large validation cohort containing 124 healthy controls, 92 patients with AECOPD and 52 patients with stable COPD.Results: We show that i) autoantigens targeted by autoantibodies with higher titers in COPD patients were enriched in extracellular regions, while those with lower titers in COPD patients were enriched in intracellular compartments. ii) levels of IgG autoantibodies against many neutrophil granule proteins were significantly higher in COPD patients than in non-COPD smokers. Furthermore, increased levels of anti-lactoferrin antibodies in COPD patients were confirmed in a cohort with a large number of samples.Conclusion: The comprehensive autoantibody profiles from COPD patients established in this study demonstrated for the first time a shift in the cellular localization of antigens targeted by autoantibodies in COPD.Keywords: chronic obstructive pulmonary disease, autoimmunity, autoantibody profile, neutrophil granule proteins, lactoferrin

To explore initial outcomes of the Optimizing Care Model's impact on patient care through technician product verification after the first 3 months of implementation, including the model's impact on pharmacist workday composition, rates of patient care services delivered, and rates of product selection errors not identified during final product verification.Fourteen chain and independent community pharmacies licensed and located in Tennessee.The Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery through task delegation to pharmacist extenders.A quasiexperimental 1-group pretest-posttest design was used. Study sites self-reported data from 3 months before and 3 months after implementation of the intervention.Overall pharmacist time spent delivering patient care services increased significantly on implementation of the Optimizing Care Model (25% vs. 43%; P0.001), and time spent performing dispensing-related activities decreased significantly (63% vs. 37%; P = 0.02). There was a total increase in quantity of clinical services delivered to patients from baseline, but data from initial study outcomes did not reach statistical significance. At least 1 new clinical service provided under a collaborative practice agreement had been implemented by all 14 sites (100%) as of Spring 2018. Total undetected error rates were significantly less in the Optimizing Care Model phase compared to the traditional model (0.063% vs. 0.085%; P0.001).Initial results of the Optimizing Care Model demonstrate improved patient care through increased clinical service delivery versus the traditional model. Undetected error detection rates were low in both models, but lower in the Optimizing Care Model. The Optimizing Care Model may represent a novel approach to improving care for patients while creating efficiencies through a staff delegation model, providing pharmacists the opportunity to further evolve their practice and advance clinical care for patients.

To determine the potential survival benefit associated with robotic-assisted laparoscopic prostatectomy (RALP) compared to open radical prostatectomy (ORP) for prostate cancer.RALP has become the dominant surgical approach for localized disease in the absence of randomized clinical evidence and despite of the factor that RALP is more expensive than ORP.We performed a cohort study involving patients who underwent RALP and ORP for localized prostate cancer at the Commission on Cancer- accredited hospitals in the United States. Overall survival was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. An interrupted time-series analysis using the surveillance, epidemiology, and end results program database was also performed.From 2010 to 2011, 37,645 patients received RALP and 12,655 patients received ORP. At a median follow-up of 60.7 months, RALP was associated with improved overall survival by both univariate [hazard ratio (HR), 0.69; P0.001] and multivariate analysis (HR, 0.76; P0.001) compared with ORP. Propensity score-matched analysis demonstrated improved 5-year all-cause mortality (3.9% vs 5.5%, HR, 0.73; P0.001) for RALP. The interrupted time-series analysis demonstrated the adoption of robotic surgery coincided with a systematic improvement in the 5-year cancer-specific survival rate of 0.17% (95% confidence interval, 0.06-0.25) per year after 2003 (P = 0.004 for change of trend), as compared to the time before adoption of RALP (1998-2003, annual percentage change, 0.01%; 95% confidence interval, -0.06 to 0.08). Sensitivity analysis suggested that the results from the interrupted time-series analysis were consistent with the improvement in the all-cause mortality demonstrated in the survival analysis (P = 0.87).In this epidemiologic analysis, RALP was associated with a small but statistically significant improvement in 5-year all-cause mortality compared to ORP for localized prostate cancer. This is the first time in the literature to report a survival benefit with RALP. Our findings have significant quality and cost implications, and provide assurance regarding a dominant adoption of more expensive technology in the absence of randomized controlled trials.

ObjectiveThe contribution of sustained autologous autoantibody production by B cells to the pathogenesis of systemic sclerosis (SSc) and granulomatosis with polyangiitis (GPA) is not fully understood. To investigate this, a humanized mouse model was generated by transferring patient-derived peripheral blood mononuclear cells (PBMC) into immunocompromised mice.MethodsPBMC derived from patients with SSc and GPA as well as healthy controls (HD) were isolated, characterized by flow cytometry, and infused into Rag2-/-/IL2rg-/- mice. In addition, PBMC from SSc patients treated with rituximab were transferred into mice. Twelve weeks later, human autoantibodies were determined in blood of the recipient mice and affected tissues were analyzed for pathological changes by histology and immunohistochemistry.ResultsMice engrafted with PBMC derived from SSc patients developed autoantibodies such as antinuclear antibodies (ANA) mimicking the pattern of the respective donors. Moreover, cellular infiltrates dominated by B cells were observed in lung, kidney and muscles of the recipient mice. By contrast, PBMC derived from HD or GPA patients survived in recipient mice after transfer, but neither human autoantibodies nor inflammatory infiltrates in tissues were detected. Furthermore, these pathological changes were absent in mice transferred with PBMC from rituximab-treated SSc patients.ConclusionThis humanized mouse model is indicative for cross-reactivity of human lymphocytes to murine autoantigens and argues for a pivotal role of B cells as well as of sustained autoimmunity in the pathogenesis of SSc. It provides a powerful tool to study interstitial lung disease and so far, under-recognized disease manifestations such as myositis and interstitial nephritis.

BACKGROUND Intraoperative hypothermia is a common complication after neuraxial block in cesarean delivery. At least 1 animal study has found that carbohydrate loading can maintain the body temperature of rats during general anesthesia, but it is unclear whether carbohydrate loading is beneficial for body temperature maintenance in parturient women during combined spinal-epidural anesthesia (CSEA) for elective cesarean delivery. METHODS Women undergoing elective cesarean delivery were randomized into a control group (group C), an oral carbohydrate group (group OC), or an oral placebo group (group OP), with 40 women in each group. Core body temperature (Tc) and body surface temperature (Ts) before and after cesarean delivery, changes in Tc (ΔTc) and Ts (ΔTs), and the incidence of side effects (eg, intraoperative shivering) were compared among the groups. RESULTS The postoperative Tc (core body temperature after cesarean delivery [Tc2]) of group OC (36.48 [0.48]°C) was higher than those of group C (35.95 [0.55]°C; P < .001), and group OP (36.03 [0.49]°C; P = .001). The ΔTc (0.30 [0.39]°C) in group OC was significantly smaller than those in group C (0.73 [0.40]°C; P = .001) and group OP (0.63 [0.46]°C; P = .0048). CONCLUSIONS Oral carbohydrate loading 2 hours before surgery facilitated body temperature maintenance during CSEA for elective cesarean delivery.

The COVID-19 pandemic created a number of rapidly emerging and unprecedented challenges for those engaged in substance use disorder (SUD) treatment, forcing service providers to improvise their treatment strategies as the crisis deepened. Drawing from five ongoing federally funded SUD projects in Appalachian Tennessee and hundreds of hours of meetings and interviews, this article explores the pandemic's impact on an already structurally disadvantaged region, its recovery community, and those who serve it. More specifically, we note detrimental effects of increased isolation since the implementation of COVID-19 safety measures, including stakeholders' reports of higher incidences of relapse, overdose, and deaths in the SUD population. Treatment providers have responded with telehealth services, but faced barriers in technology access and computer literacy among clients. Providers have also had to restrict new clients to accommodate social distancing, faced delays in health screening those they can accept, and denied family visitations, which has affected retention. In light of these challenges, several promising lessons for the future emerged--such as preparing for an influx of new and returning clients in need of SUD treatment; making arrangements for long-term housing and facility modification; developing a hybrid care delivery model, taking advantage of new regulations enabling telemedicine; budgeting for and storing personal protective equipment (PPE) and related supplies; and developing disaster protocols to withstand threats to intake, retention, and financial solvency.

Background:More than 300 million smokers make China the largest cigarette consumer globally, which is a huge economic burden. Smoking cessation (SC) clinics can offer counseling and follow-up services. The operational experience of SC clinics in China needs to be summarized and improved based on research evidence.Purpose:The objectives of this study were to describe quit rates among attendees of SC clinics in Hunan and assess predictors of successful SC.Methods:The participants in this study were smokers who visited the SC clinic of Hunan Cancer Hospital from February 1, 2015 to September 30, 2018. Individuals who received individual counseling and assessment from the SC clinic staff and were willing to quit smoking were eligible for inclusion. Those with critical illness or cancer were excluded. Application of smoking cessation clinic registration form (unified by Chinese Center for Disease Control and Prevention) was used to assess participants at the consultation. Follow-ups and counseling were performed over telephone at 1 week, 1 month, and 3 months after the initial cessation consultation or in times of need. Successful SC was checked for at 3 months after the start of SC.Results:A total of 328 smokers (mean age 45.67 ± 12.38 years) had participated. The abstinence rate at 3 months was 28.4%. Binary regression analysis revealed significant independent predictors to be the total numbers of SC follow up sessions, previous SC attempts, and participants' decision on when to quit smoking (The relative to quit immediately group, quit within 30 days, quit after 30 days, and undecided quit were less likely to succeed in quitting. while quit within seven days had no statistical significance.Conclusion:SC clinics can achieve a desirably high quit rate. Participant's previous attempts at quitting, three or more follow-ups, and the decision to quit immediately or within seven days were factors helpful in predicting the success of SC.

ObjectivesThe coordinated immune response of the host is the key of the successful combat of the body against SARS-CoV-2 infection and is decisive for the development and progression of COVID-19. In this study, we aimed to investigate whether the immunological phenotype of patients are associated with duration of illness in patients with severe COVID-19.MethodIn this single-center study, 69 patients with severe or critical COVID-19 were recruited retrospectively. Immunological parameters including counts of white blood cells, neutrophils, lymphocytes, the neutrophil-to-lymphocyte ratio, and levels of circulating cytokines and cytokine receptors were screened for their association with disease severity, survival and duration of illness of COVID-19.ResultsOur data confirmed previous results that neutrophil-to-lymphocyte ratio and circulating levels of IL-6 represent prominent biomarker for the prediction of disease severity and survival of COVID-19. However, this study shows for the first time that duration of illness in patients with severe COVID-19 is positively associated with serum levels of IL-8 (P=0.004) and soluble IL-2Rα (P=0.025).ConclusionThe significant association of duration of illness with circulating levels of IL-8 and soluble IL-2Rα in patients with severe COVID-19 implicates that neutrophils and T cells are involved in the evolution of COVID-19.

SARS-CoV-2 enters into human airway epithelial cells via membrane fusion or endocytosis, and this process is dependent on ACE2, TMPRSS2, and cathepsin L. In this study, we examined the expression profiles of the three SARS-CoV-2 entry genes in primary human airway epithelial cells isolated from smokers, non-smokers, patients with chronic obstructive pulmonary disease or lung cancer. An exhaustive search of the GEO database was performed to identify eligible data on 1st June 2020. In total, 46 GEO datasets comprising transcriptomic data of 3,053 samples were identified as eligible data for further analysis. All meta-analysis were performed using RStudio. Standardized mean difference was utilized to assess the effect size of a factor on the expression of targeted genes and 95% confidence intervals (CIs) were calculated. This study revealed that (i) cigarette smoking is associated with an increased expression of ACE2 and TMPRSS2 and a decreased expression of cathepsin L; (ii) significant alternations in expression of ACE2, TMPRSS2, and cathepsin L were observed between current smokers and former smokers, but not between former smokers and never smokers; (iii) when compared with healthy controls with identical smoking status, patients with COPD or lung cancer showed negligible changes in expression of ACE2, TMPRSS2, and cathepsin L. Therefore, this study implicates cigarette smoking might contribute to the development of COVID-19 by affecting the expression of SARS-CoV-2 entry genes, while smoking cessation could be effective to reduce the potential risk.

A shaping technique using the actual feed(AF) to illuminate the reflector antenna is proposed, which is compared with the conventional simulated feed(SF) after optimizing the reflector antenna patterns. The corresponding reflector shape is transformed by the non-uniform rational Bspline method, and its scattering field is gotten through the physical optics and Gauss-Legendre quadrature algorithms(PO-GLQ). The consequent calculated patterns by means of the actual feed are closer to the measured far-field ones than simulated feed.

Objective: Health inequalities were often exacerbated during the emerging epidemic. This study examined urban and non-urban inequalities in health services among COVID-19 patients aged 65 years or above in Florida, USA, from 2 March to 27 May 2020. Methods: A retrospective time series analysis was conducted using individual patient records. Multivariable Poisson’s and logistic models were used to calculate adjusted incidence of COVID-19 and the associated rates of emergency department visits, hospitalizations, and deaths. Results: As of 27 May 2020, there were 13,659 elderly COVID-19 patients (people aged 65 years or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas might be less likely to be confirmed with COVID-19 infection than those living in large metropolitan areas. The emergency department visit and hospitalization rates decreased significantly across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% vs 41%). Elderly women aged 75 years or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those counterparts living in large metropolitan areas (29% vs 46%; odds ratio: 0.37 (0.25–0.54), p Conclusion: For elderly people living in Florida, USA, those living in small metropolitan or rural areas were less likely to receive adequate health care than those living in large or medium metropolitan areas during the COVID-19 pandemic.

The inherent characteristic of both front and back radiations for the slot antenna limits its application in the unidirectional requirement if the thickness can’t increase. Thus, a back-radiation reducing technology which doesn’t increase the thickness is presented in this paper. Here, the slot antenna is fed by a microstrip line, and then two additional short reflectors are added symmetrically beside the feed. These two reflectors start from the direction of the feeding point end and their lengths across the slot a little. The reflectors play a role to guide the energy from the terminal of the microstrip line to themselves and as well reduce the radiation of slot. The simulated results show that the front-to-back radiation improves 5.11dB comparing with that of the conventional slot antenna and the realized gain is also enhanced 0.55dB by the reflected energy of the reflectors.

Aims There is limited research focusing on how never tobacco users respond to claims associated with modified risk tobacco products (MRTPs). The purpose of the present study is twofold: (1) to identify how never tobacco users perceive hypothetical modified risk tobacco product (MRTP) claims; and (2) to assess whether these perceptions impact their intentions of using MRTPs described as “less harmful” and “less addictive.” Method The present study draws upon a nationally representative dataset of US adults aged ≥ 18 years (n = 850) from a cross-sectional survey (HINTS-FDA, Cycle 2, 2017). Weighted unadjusted and adjusted logistic regression analyses were performed to analyze the data. Results Participants who perceived tobacco products labeled as having “no additives” to be less harmful were close to three times more likely to report intentions of using “less harmful” (Adjusted OR = 2.93 [95% CI: 1.12–7.65]) and “less addictive” (Adjusted OR = 2.72 [95% CI: 1.03–7.21]) tobacco products than those who perceived them to be more/equally harmful. Participants who believed that tobacco products could be manufactured without some chemicals were over five and six times more likely to report intentions of using “less harmful” (Adjusted OR = 5.53 [95% CI: 1.59–19.25]) and “less addictive” (Adjusted OR = 6.60 [95% CI: 2.65–16.46]) tobacco products than those who were unlikely to believe it. Conclusions Our findings have implications for FDA’s regulation of MRTPs and provides insights regarding how the marketing of authorized MRTPs could impact population health in the future.

IntroductionThe optimal dosage of dexmedetomidine (DEX) as an adjuvant combined with ropivacaine for postoperative analgesia in laparoscopic myomectomy is still controversial. The main aim of this prospective clinical trial was to evaluate the analgesic effect and relevant adverse effects of different doses of dexmedetomidine applied locally for ropivacaine-induced bilateral transmuscular quadratus lumborum block (TQLB).MethodsTQLB was conducted using different doses of dexmedetomidine per side (R group: control group; DEX1 group: 0.1μg/kg; DEX2 group: 0.3μg/kg; DEX3 group: 0.5μg/kg). Numeric rating scales (NRS) of pain score, heart rate (HR) and blood pressure (BP) were assessed at different time points after performing TQLB. Dosage of additional analgesics via patient-controlled analgesia pump, recovery time for anal exsufflation, hospital stay and clinical events such as nausea, vomiting and pruritus were also compared among groups.ResultsA total of 200 patients underwent laparoscopic myomectomy were enrolled in this study and divided into 4 groups (R, DEX1, DEX2 and DEX3 group) randomly, 50 for each group. Compared with R group, NRS pain score was significantly lower in DEX2 group and DEX3group (pConclusion0.3μg/kg per side of dexmedetomidine as an adjuvant for TQLB was recommended to effectively relieve postoperative pain after laparoscopic myomectomy.Trial registrationChinese Clinical Trial Registry with registration number ChiCTR1900028509. Date of registration: 24 November 2019. http://www.chictr.org.cn/edit.aspx?pid=42635=htm=4

SARS-CoV-2 enters into human airway epithelial cells via membrane fusion or endocytosis, and this process is dependent on ACE2, TMPRSS2, and cathepsin L. In this study, we examined the expression profiles of the three SARS-CoV-2 entry-related genes in primary human airway epithelial cells isolated from donors with different physiological and pathological backgrounds such as smoking, COPD, asthma, lung cancer, allergic rhinitis, cystic fibrosis, or viral infections. By reanalyzing 54 GEO datasets comprising transcriptomic data of 3428 samples, this study revealed that i) smoking is associated with an increased expression of ACE2 and TMPRSS2 and a decreased expression of cathepsin L; ii) infection of rhinovirus as well as poly(I:C) stimulation leads to high expression of all three SARS-CoV-2 entry-related genes; iii) expression of ACE2 and cathepsin L in nasal epithelial cells are decreased in patients with asthma and allergic rhinitis. In conclusion, this study implicates that infection of respiratory viruses, cigarette smoking and allergic respiratory diseases might affect the susceptibility to and the development of COVID-19.

BACKGROUND AND PURPOSE Autoantibodies targeting the GluN1(NR1) subunit of the anti-N-methyl-D-aspartate receptor (NMDAR) cause encephalitis. Although it has been shown that anti-NMDAR encephalitis is associated with human leukocyte antigen (HLA) loci, susceptibility genes for the disease outside the HLA loci remain unidentified. In this study, we aimed to explore the association of anti-NMDAR encephalitis with non-HLA genes. METHODS Two Chinese anti-NMDAR encephalitis cohorts from Han populations were recruited for this study. The North Chinese case-control set consisted of 98 patients and 460 controls, while the South Chinese case-control set included 78 patients and 541 controls. All participants were genotyped for 28 single nucleotide polymorphisms that are associated with autoimmune disorders or infectious diseases. RESULTS In two independent case-control sets, we identified significant associations of anti-NMDAR encephalitis with IRF7 rs1131665 (odds ratio [OR] 3.34, 95% confidence interval [CI] 1.99-5.63; P

Sjogren's syndrome (SS) is a complex rheumatoid disease that mainly affects exocrine glands, resulting in xerostomia (dry mouth) and xerophthalmia (dry eye). SS is characterized by autoantibodies, infiltration into exocrine glands, and ectopic expression of MHC II molecules on glandular epithelial cells. In contrast to the well-characterized clinical and immunological features, the etiology and pathogenesis of SS remain largely unknown. Animal models are powerful research tools for elucidating the pathogenesis of human diseases. To date, many mouse models of SS, including induced models, in which disease is induced in mice, and genetic models, in which mice spontaneously develop SS-like disease, have been established. These mouse models have provided new insight into the pathogenesis of SS. In this review, we aim to provide a comprehensive overview of recent advances in the field of experimental SS.

Background: The COVID-19 pandemic has incurred significant disease burden worldwide, particularly on the elderly population. This study aims to explore how risks of coronavirus infection interact across age groups using data from South Korea. Methods: Daily new COVID-19 cases from 10 March to 30 April 2020 were scraped from online open sources. A multivariate vector autoregressive model for time series of count data was used to examine the risk interactions across age groups. Case counts from previous days were included as predictors to dynamically examine the change of risk patterns. Results: In South Korea, the risk of coronavirus infection among elderly people was significantly affected by other age groups. An increase in virus infection among people aged 20&ndash, 39 was associated with a double risk of infection among elderly people. Meanwhile, an increase in virus infection among elderly people was also significantly associated with risks of infection among other age groups. The risks of infection among younger people were relatively unaffected by that of other age groups. Conclusions: Protecting elderly people from coronavirus infection could not only reduce the risk of infection among themselves but also ameliorate the risks of virus infection among other age groups. Such interventions should be effective and for the long term.

Background and objectiveAetiology and pathogenesis of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, the most common autoimmune encephalitis, is largely unknown. Since an association of the disease with the human leucocyte antigen (HLA) has not been shown so far, we here investigated whether anti-NMDAR encephalitis is associated with the HLA locus.MethodsHLA loci of 61 patients with anti-NMDAR encephalitis and 571 healthy controls from the Chinese Han population were genotyped and analysed for this study.ResultsOur results show that the DRB1*16:02 allele is associated with anti-NMDAR encephalitis (OR 3.416, 95% CI 1.817 to 6.174, p=8.9×10−5, padj=0.021), with a higher allele frequency in patients (14.75%) than in controls (4.82%). This association was found to be independent of tumour formation. Besides disease susceptibility, DRB1*16:02 is also related to the clinical outcome of patients during treatment, where patients with DRB1*16:02 showed a lower therapeutic response to the treatment than patients with other HLA alleles (p=0.033). Bioinformatic analysis using HLA peptide-binding prediction algorithms and computational docking suggested a close relationship between the NR1 subunit of NMDAR and the DRB1*16:02.ConclusionsThis study for the first time demonstrates an association between specific HLA class II alleles and anti-NMDAR encephalitis, providing novel insights into the pathomechanism of the disease.

The purpose of this study was to examine the impact of physical limitations, functional limitations and self-assessed health status on mortality and healthcare utilization among older cancer survivors. National Medicare Current Beneficiary Survey (MCBS) cost and use data from 2008 to 2013 were used for analysis. Physical limitations, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) were assessed on multiple questions, and self-assessed health was measured on a five-point scale (1–5: Excellent–Poor). Multivariable logistic regression and Poisson regression models were used for hospitalization, re-hospitalization and mortality rates based on three follow up years. This study included 17,715 cancer patients with a mean age of 75 years and 57% females. Cancer survivors with poor self-assessed health had a higher rate of hospitalizations (adjusted Odds Ratio: aOR: 1.60, 95% Confidence Interval: CI: 1.47–1.72, p

Background Networks formed of numerous autoantibodies (aabs) directed against G-protein coupled receptors (GPCR) have been suggested to play important role in autoimmune disorders. In present study, we aimed to evaluate the association between anti-GPCR antibodies and primary Sjogren’s syndrome (pSS) to determine the potential pathogenic factors. Methods By applying a cell membrane-based ELISA technique, which is capable of detecting aabs against conformational epitopes within GPCR, serum levels of fourteen GPCR were determined in well-characterized patients with pSS (n = 52) and gender-matched healthy controls (n = 54). Comparisons between groups were analyzed by two-tailed Mann-Whitney U test, Bonferroni correction was applied for multiple comparisons. Spearman`s rank correlation coefficients were calculated between variables and visualized by heat map. Results Compared to healthy subjects, sera of patients with pSS showed significantly higher binding to β2AR and ETAR, but lower binding to C5aR1, C3aR1, CXCR3, and CXCR4. Autoantibodies against C5aR1, C3aR1, CXCR3, and CXCR4 were also decreased in patients with rheumatoid arthritis. In pSS patients, levels of anti-CXCR3 and anti-CXCR4 antibodies were negatively correlated with circulating lymphocyte counts. Furthermore, correlation signatures of anti-GPCR antibodies changed dramatically in the patients with pulmonary involvement. Conclusions This study demonstrates an association between pSS and autoantibodies recognizing GPCR, especially those functionally involved in immune cell migration and exocrine glandular secretion.

SSc is a complex rheumatoid disease characterized by autoimmunity, fibrosis and vasculopathy. Mouse models provide powerful research tools for exploring the pathogenesis of the human diseases. Each mouse model can represent a specific way leading to the development of disease. Moreover, mouse models can be used to investigate the role of candidate molecule in the pathogenesis of disease. So far, more than twenty mouse models for SSc have been established and provide new insights in the understanding of the pathogenesis of SSc. In this review, we provide an overview on recent advances in the field of experimental SSc. We introduce novel mouse models generated in the recent years and discuss their relevance to the SSc pathogenesis. Moreover, we summarize and discuss recent findings in the pathogenesis of classical SSc mouse models.

Early diagnosis and treatment of lung cancer are of significant importance. In this paper, a system-theoretic method is introduced to analyze the diagnosis-to-treatment process for lung cancer patients who receive surgical resections. The complex care delivery process is decomposed into a collection of serial processes, each consisting of combinations of various tests and procedures. Closed formulas are derived to estimate the mean and coefficient of variation of waiting time during the diagnosis-to-surgery process. Simple indicators based on the data collected on the clinic/hospital floor are derived to identify the bottlenecks, i.e., the waiting times that impede the whole delivery process in the strongest manner. In addition, by approximating waiting times using Gamma distributions, an algorithm is introduced to evaluate the waiting-time performance, i.e., the probability to finish the diagnosis-to-surgery process within a desired or given time interval. Finally, a case study at Baptist Memorial Health System is introduced to illustrate the applicability of the method and provide recommendations for improvement. Note to Practitioners —Lung cancer is the primary cause of cancer deaths in the U.S. It has a very low five-year survival rate, and only a small percentage of lung cancer cases are diagnosed at an early stage. Particularly, the diagnosis-to-treatment process is a long, complex procedure in which patients experience substantial delays. Thus, reducing diagnosis-to-treatment time is critical, as prolonged waiting times may lead to advanced cancer stage and/or decreased survival rates. In this paper, to analyze the diagnosis-to-treatment process for lung cancer patients who receive surgical resections, a novel analytical method is introduced. First, five critical steps in diagnosis-to-surgery process are considered: 1) chest X-ray and/or CT scan; 2) diagnostic biopsy; 3) noninvasive staging; 4) invasive staging; and 5) surgery. Then, we decompose the complex care delivery process into multiple serial processes, where each process represents a unique sequence of diagnosis steps that patients may go through. To evaluate the system performance, formulas to calculate the mean and variability of waiting time during the diagnosis-to-surgery process are derived. An approximation algorithm is developed to evaluate the probability to finish the diagnosis-to-surgery process within a desired or given time interval, referred to as waiting-time performance. In addition, to identify the bottleneck waiting time whose improvement will lead to the largest reduction in overall waiting time, we present simple indicators based on the data collected on the clinic/hospital floor. Finally, we introduce a case study at Baptist Memorial Hospital. It is shown that the steps between chest X-ray and/or CT scan and diagnostic biopsy and the steps between noninvasive staging and surgery are the most critical ones. Such a method provides a quantitative tool for the analysis and improvement of lung cancer diagnosis-to-surgery process.

Background and Objective: Low serum levels of bilirubin and albumin are associated with multiple autoimmune diseases, but their role in anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is unknown. Methods: Serum bilirubin and albumin levels were evaluated in 60 patients with anti-NMDAR encephalitis, 50 cryptococcal encephalitis, and 145 healthy controls (CTLs). Of the 60 anti-NMDAR encephalitis patients, 30 had a follow-up evaluation at 3 months after admission. Results: Serum bilirubin and albumin levels were both significantly lower in anti-NMDAR encephalitis than in CTLs, and serum bilirubin levels were significantly lower in anti-NMDAR encephalitis than in cryptococcal encephalitis. Serum bilirubin levels were significantly lower in patients with psychiatric symptoms, with severe impairment, and with limited responses to treatment than those without psychiatric symptoms, with mild impairment, and with favorable responses to treatment, respectively. A follow-up evaluation of 30 patients revealed that the modified Rankin Scale scores were significantly decreased after treatment. Serum bilirubin significantly associated with serum albumin, and plasma hemoglobin. Conclusions: Our results revealed for the first time an association between the serum levels of bilirubin in the anti-NMDAR encephalitis. Further studies investigating the role of bilirubin and albumin in anti-NMDAR encephalitis are required.

It is challenging for the governmental agencies to provide an instant response and to systematically analyze the huge number of odor complaints which are received frequently by them. This study aimed to establish a data analysis framework featuring trajectory and proximity analyses to confirm odor origins, assess impact areas, and identify determinants and mechanisms of odor episodes based on odor reports. The investigation used 273 odor complaints reported in northern Collierville, Tennessee, between January 1st, 2019 and December 15th, 2020. The location of each complaint was geocoded in Google Map, and the backward wind trajectories were calculated using the web-based Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) model. The nearby Eplex Landfill and Collierville Northwest Sewage Treatment Plant were targeted for the analyses. Odor impacts were evaluated with temporal and spatial characteristics of reported odor episodes. Logistic models were performed to identify weather parameters that significantly influenced odor occurrence. The field inspections indicated two periods targeting different sources. Period 1: from January 1st, 2019 to October 31st, 2020, the landfill appeared as the major source; Period 2: from November 1st, 2020 to December 15th, 2020, the sewage plant emerged as the major source. In Period 1, 65% of the complaints had wind transporting from the landfill, and 88% occurred at residences within 500 m of the landfill. In Period 2, 33% of the complaints had wind that blew from the sewage plant and 85% occurred at residences within 1000 m from the sewage plant. The likelihood of an odor episode day was significantly associated with wind speed [Odds Ratio (OR) = 0.66, 95% Confidence Interval (CI): 0.56–0.77], temperature (OR = 0.97, 95% CI: 0.95–0.98), and rainfall (OR = 1.02, 95% CI: 1.00–1.04). The odor issue in Collierville reflected poor zoning between the odor sources and residential areas. Separation distances of 500 m and 1000 m from the landfill and sewage facilities, respectively, are suggested to prevent odor issues. The proposed data analysis framework can be adopted by governmental agencies for fast responses to odor complaints, odor assessment, and environmental odor management.

Our objective was to determine the factors associated with residential moving during pregnancy, as it may increase stress during pregnancy and affect birth outcomes. Data were obtained from the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study. Participants were recruited from December 2006 to June 2011 and included 1,448 pregnant women. The average gestational age at enrollment was 23 weeks. The primary outcome of residential mobility was defined as any change in address during pregnancy. Multivariate regression was used to assess the adjusted associations of factors with residential mobility. Out of 1,448 participants, approximately 9 percent moved between baseline (enrollment) and delivery. After adjusting for covariates, mothers with lower educational attainment [less than high school (adjusted odds ratio [aOR] = 3.74, 95% confidence interval [CI] = 1.78, 7.85) and high school/technical school (aOR = 3.57, 95% CI = 2.01, 6.32) compared to college degree or higher], and shorter length of residence in neighborhood were more likely to have moved compared to other mothers. Length of residence was protective of mobility (aOR = 0.91, 95% CI = 0.86, 0.96 per year). Increased understanding of residential mobility during pregnancy may help improve the health of mothers and their children.

The study was conducted to evaluate the relationship between the blood lactic acid (BLA) level, serum procalcitonin (PCT), C-reactive protein (CRP) and the severity and prognosis of neonatal sepsis. A retrospective analysis was conducted on 90 children with sepsis admitted into the Intensive Care Unit (ICU) of the Hubei Institute for Nationalities Af liated Hospital hospital. Patients were divided into the non-survival group and the survival group. Severity of the 90 patients was evaluated according to Neonatal Critical Illness Score (NCIS). Observations were made on changes of the levels of BLA, PCT and CRP, correlation between BLA, PCT, CRP and NCIS as well as the association of the levels of these proteins with the prognosis of the patients. The 90 sick children were divided into the survival group (61 cases, 67.7%) and the non-survival group (29 cases, 32.2%). They were further stratified into the extremely severe group (n=20), severe group (n=39) and non-severe group (n=31) according to NCIS scoring standard. The BLA and NCIS scores of the non-survival group were significantly greater than those of the survival group. The difference was statistically significant (P

Pulmonary fibrosis (PF) is one of the leading causes of death in systemic sclerosis (SSc) patients. Although all SSc patients are characterized by autoimmunity, only part of them suffer from PF, suggesting that beside autoimmunity, some additional factors are involved in the initiation of PF in SSc. In this study, we aimed to identify genetic polymorphisms associated with the status of PF in SSc. We performed that an exhaustive search of the PubMed database was performed to identify eligible studies. Then, a comprehensive meta-analysis was performed by comparing PF+-SSc and PF−-SSc patients to identify genetic polymorphisms associated with the status of PF in SSc. Among eight SSc-associated susceptibility polymorphisms which were applied for meta-analysis, IRF5 rs2004640 polymorphism (OR 1.12; 95% CI 1.02–1.22, P = 1.39 × 10−2), STAT4 rs7574865 polymorphism (OR 1.25; 95% CI 1.07–1.47, P = 5.3 × 10−3), IRAK1 rs1059702 polymorphism (OR 1.20; 95% CI 1.05–1.37, P = 0.007), and CTGF G-945C polymorphism (OR 1.42; 95% CI 1.18–1.71, P = 0.002) are associated with PF status in SSc, while TNFAIP3 rs5029939, CD226 rs763361, CD247 rs2056626, and IRF5 rs10488631 polymorphisms are not. Since IRF5, STAT4, and IRAK1 are important regulatory factors in the control of innate immune responses and CTGF is involved in the synthesis of extracellular matrix, these results suggest a role of the innate immunity and matrix compounds in the pathogenesis of PF in SSc.

The human leukocytes antigen (HLA)-DRB1*16:02 allele has been suggested to be associated with many autoimmune diseases. However, a validation of the results of the different studies by a comprehensive analysis of the corresponding meta data is lacking. In this study, we performed a meta-analysis of the association between HLA-DRB1*16:02 allele with various autoimmune disorders. Our analysis shows that HLA-DRB1*16:02 allele was associated with systemic lupus erythematosus, anti-N-Methyl- d -Aspartate receptor (NMDAR) encephalitis, Graves' disease, myasthenia gravis, neuromyelitis optica and antibody-associated systemic vasculitis with microscopic polyangiitis (AASV-MPA). However, no such association was found for multiple sclerosis, autoimmune hepatitis type 1, rheumatoid arthritis, type 1 diabetes and Vogt-Koyanagi-Harada syndrome. Re-analysis of the studies after their categorization into autoantibody-dependent and T cell-dependent autoimmune diseases revealed that the HLA-DRB1*16:02 allele was strongly associated with disorder predominantly mediated by autoantibodies (OR = 1.93; 95% CI = 1.63–2.28, P = 1.95 × 10−14) but not with those predominantly mediated by T cells (OR = 1.08; 95% CI = 0.87–1.34, P = .474). In addition, amino acid sequence alignment of common HLA-DRB1 subtypes demonstrated that HLA-DRB1*16:02 carries a unique motif of amino acid residues at position 67–74 which encodes the third hypervariable region. Taken together, the distinct pattern of disease association and the unique amino acid sequence of the third hypervariable region of the HLA-DRB1 provide some hints on how HLA-DRB1*16:02 is involved in the pathogenesis of autoimmune diseases.

Heatwave studies typically estimate heat-related mortality and morbidity risks at the city level, few have addressed the heterogeneous risks by socioeconomic status (SES) and location within a city. This study aimed to examine the impacts of heatwaves on mortality outcomes in Memphis, Tennessee, a Mid-South metropolitan area top-ranked in morbidity and poverty rates, and to investigate the effects of SES and urbanicity. Mortality data were retrieved from the death records in 2008&ndash, 2017, and temperature data from the Applied Climate Information System. Heatwave days were defined based on four temperature metrics. Heatwave effects on daily total-cause, cardiovascular, and respiratory mortality were evaluated using Poisson regression, accounting for temporal trends, sociodemographic factors, urbanicity, and air pollution. We found higher cardiovascular mortality risk (cumulative RR (relative risk) = 1.25, 95% CI (confidence interval): 1.01&ndash, 1.55) in heatwave days defined as those with maximum daily temperature &gt, 95th percentile for more than two consecutive days. The effects of heatwaves on mortality did not differ by SES, race, or urbanicity. The findings of this study provided evidence to support future heatwave planning and studies of heatwave and health impacts at a coarser geographic resolution.

In this paper, a 3D metal printed dual circular-polarized horn antenna operating in the V-band is proposed, built and tested. This antenna consists of a horn and a circular waveguide, a single groove polarizer and is side-fed by orthogonally placed rectangular waveguide ports. The groove is placed at 45° with respect to the input ports and provides a phase delay of 90° to generate right- or left-hand circular polarization (RHCP or LHCP). The proposed antenna provides symmetric patterns for all planes and exhibits polarization isolation of more than 30 dB at broadside. This antenna is analyzed to realize wide impedance matching bandwidth and wide 3dB axial ratio (AR) bandwidth. A prototype of the horn antenna has been fabricated using 3D metal printing technology. Metal material with finite surface roughness is considered when modeling this antenna.

Objective: This study examines effects of physical and functional limitations on health care utilization among older cancer survivors, compared with those without cancer and without physical and functional limitations. Method: Medicare Current Beneficiary Survey data from 2008 to 2011 were used. Physical limitations (PL), activities of daily living (ADL), and instrumental activities of daily living (IADL) were measured on a 5-point scale. Propensity score weighting was developed using logistic regressions. Results: Older cancer survivors with physical and functional limitations had higher rate of emergency department visits than those without limitations (PL: 21.8% vs.17%, adjusted odds ratio [aOR]:1.72, 95% confidence interval [CI]: [1.26, 2.35], p < .05; ADL: 25.8% vs.17.4%, aOR: 2.68, 95% CI: [1.86, 3.86], p < .001), and higher cost of hospitalization (IADL: M = US$24,916, SD: 3,877.1). Conclusion: Older cancer survivors with physical and functional limitations had higher health care utilization compared with those without cancer. Addressing complex and unique health care needs in this population will help reduce excess burden on the health care system.

Objective Abdominal obesity and wall thickness of the central arteries have been associated with higher risk of cardiovascular disease. Despite the higher burden of overweight and cardiovascular disease among African Americans, limited data are available on the association of abdominal obesity with aortic wall thickness in African Americans. We assessed the cross-sectional and the longitudinal associations of abdominal obesity with aortic intima-media thickness (aIMT) in a cohort of African Americans from the Jackson Heart Study. Methods Data on aIMT and repeated measures of waist circumference (WC) and waist to height ratio from 1,572 participants, as well as on abdominal subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), and aIMT from 1,223 participants, were analyzed. aIMT was measured at proximal ascending aorta (PA-aIMT), proximal descending aorta (PD-aIMT), and distal aorta (bifurcation) using cardiac magnetic resonance. SAT and VAT were measured using computerized tomography. Results WC and WHtR were longitudinally associated with PA-aIMT and PD-aIMT; SAT and VAT were associated with PA-aIMT only. Only WC was associated with distal aIMT. Conclusions Abdominal obesity measures are associated with increased proximal aIMT in adult African Americans. Only WC is associated with wall thickness in all three segments of the aorta.

Paraneoplastic autoimmune disorders (PAD) represent a group of autoimmune diseases associated with neoplasms. As a consequence of a remote autoimmunity-mediated effect, PAD are found in multiple organs or tissues, including the skin, blood and nervous system. Compared with non-paraneoplastic autoimmune diseases, PAD have different aetiologies, pathologies, disease symptoms and treatment responses. There are two main origins of autoimmunity in PAD: neoplasm-mediated dysregulated homeostasis in immune cells/organs and in autoantigens. Pathologically, PAD are mediated predominantly by either autoantibodies or autoreactive T-cells. In the past decade, significant progress has been achieved in increasing our understanding of the aetiology and pathology of PAD. In this review article, we aim to provide a comprehensive overview of the recent advances in this field.

Background Systemic sclerosis (SSc) is an autoimmune connective tissue disease featured by autoimmunity, fibrosis and vasculopathy. Although many autoantibodies have been detected in the sera of patients with SSc, it is not clear whether they play a role in the pathogenesis of disease. It has been reported that autoantibodies against the angiotensin-II receptor type 1 (AT1R) are present in the sera of SSc patients and are associated with several clinical symptoms of the disease, suggesting that these autoantibodies may act as pathogenic drivers. Recently, our group has developed a novel mouse model for SSc by immunizing mice with human AT1R (hAT1R). From this model we were able to generate functional monoclonal antibodies agonizing AT1R. Objectives In the current study, we aim to clarify, whether B cells and antibodies directed against AT1R are involved in the pathogenesis of experimental SSc in vivo. Methods To investigate the role of B cells in the hAT1R-induced mouse model of SSc, we immunized B-cell deficient mice with hAT1R. Nine weeks after the first immunization, mice were sacrificed and sera and tissues were collected for further evaluation. To investigate the pathogenicity of anti-AT1R antibodies in the disease, monoclonal autoantibodies against hAT1R were applied to the ear of C57Bl/6 mice by single or repetitive injection. Mice were sacrificed 24 hours or 14 days after the first injection for single and repeated application, respectively, and ear and lung tissues were collected for further evaluation. Results Compared to the wild type C57Bl/6 mice, hAT1R-immunized B-cell deficient mice were resistant against experimental SSc with regard to autoantibody production, inflammation in the lung and skin, and skin fibrosis. Furthermore, both single and repetitive injection of monoclonal antibodies against hAT1R induced inflammation in ears of mice. Despite this local effect, repetitive injection of anti-AT1R monoclonal antibodies provoked also inflammation in the lung of mice. Conclusion Our data demonstrate that i) B cells are indispensable for the pathogenesis of the hAT1R-induced mouse model for SSc and ii) monoclonal antibodies against hAT1R can induce inflammation in mice. Therefore, our results support a role of autoantibodies against AT1R in the pathogenesis of SSc. References [1] Yannick Allanore, et al. Nat Rev Dis Primers2015. [2] Gabriela Riemekasten, et al. Ann Rheum Dis2011. [3] Mike O. Becker, et al. Am J Respir Crit Care Med2014. Disclosure of Interests Junping Yin: None declared, Xiaoqing Wang: None declared, Xiaoyang Yue: None declared, Gabriela Riemekasten Consultant for: Chugai, F. Hoffmann-La Roche, Speakers bureau: Chugai, F. Hoffmann-La Roche, Xinhua Yu: None declared, Frank Petersen: None declared

The literature is inconsistent regarding milk intake and physical growth. This study aims to evaluate the association of milk intake with body height and weight in a nationally representative sample of Chinese children. A total of 41,439 children ages 6–17 were recruited from 30 provinces in mainland China in 2013–2016 using a multistage stratified cluster sampling approach. Milk intake information was collected using a questionnaire aided with standard containers. Weight and height were measured using a standard physician beam scale with a height rod. Milk intake was categorized into no-, low-, and high-intake groups based on the intake rate, and weight status into normal, overweight, and obese groups based on the body-mass-index (BMI). Associations between height/weight status and milk intake were evaluated using multivariate weighted linear and logistic regression models. Chinese children had low milk intake: 1/5 of children did not drink milk, and those drinking milk had a median intake of 100 ml/month. The low- and high-intake groups were 0.83 cm (95% confidence interval: 0.00, 1.68 cm) and 1.26 cm (0.34, 2.19 cm) taller than the no-intake group for girls, respectively, after adjusting for confounding factors. Boys with high milk intake had lower BMI (−0.56, 95% CI: −1.00, −0.12 kg/m2) and risk of obesity (OR = 0.67, 95% CI: 0.46, 0.97) than those without milk intake. This study revealed the association of increased milk intake with increased body height and lowered obesity risk among Chinese children. Given the cross-sectional nature of the study and the possibility of residual confounding, further research is warranted to uncover the role of milk intake in promoting children’s growth.

Hematological parameters have been shown to be associated with morbidity and/or mortality of various disorders such as inflammatory diseases and cancer. In this study, we performed a comprehensive comparison of hematological parameters among 39 diseases, including cancer, inflammatory, autoimmune, allergic and infectious diseases as well as some further common disorders. In total, 19,038 patients and 23,610 matched healthy controls were recruited and evaluated. Our results revealed distinct hematological profiles among disease groups in which erythrocyte-related parameters were specifically associated with cancer, neutrophil- and lymphocyte-related parameters were associated with inflammatory diseases, viral infectious diseases, cancer, autoimmune and allergic diseases and platelets-related parameters were associated with viral infectious diseases. Furthermore, both neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios were significantly higher in patients with inflammatory diseases, cancer, autoimmune and allergic diseases than corresponding controls. In addition, receiver operating characteristic curve analysis showed that several hematological parameters showed good diagnostic values for cancer, inflammatory diseases, and viral infectious diseases. Therefore, our results provide a valuable resource of hematological abnormalities in common diseases.

With the increasing demand for telecommunications services in recent years, in order to minimize the number of antennas on spacecraft, this paper proposed a wide-band compact corrugated horn feed antenna for Broadcast Satellite Services (BSS) and Fixed Satellite Services (FSS). Simulation is done to verify the performances of the design. The simulation results indicate that the horn antenna can cover the 10.7GHz-21.2GHz frequency band with return loss less than −28 dB and the antenna has good pattern symmetry in both E-plane and H-plane with phase center stability. The proposed corrugated horn feed antenna has wide application prospects in the field of satellite communication.

In this paper, a high-conversion converter is proposed, which uses the phase gradient metasurface (PGM), and can achieve efficient mutual conversion between spatially propagating waves (PW) and surface waves (SW). Simulations show that the converter has a PW-SW conversion of 99.99%, at 7.5 GHz, 0.09% higher than that of the similar type of designs available.

A good-symmetrical Ku-band corrugated horn feed with small diameter for directional radiation is proposed in this paper which is composed of a corrugated radiator and a mode converter. To concentrate the impedance transformation, 15 radial grooves are curved inside the horn. And the mode converter is slotted in the radial direction where the corresponding groove depth is changed from $\lambda/2$ to $\lambda/4$ to realize the conversion from TE 11 to HE 11 . Then, the converted HE 11 mode is transmitted to the corrugated horn and a good directional pattern is obtain. To verify the design, a horn prototype is fabricated and measured. The measured results show that the VSWR is 1.2:1 covering the range from 12.25 to 15.5 GHz and the good symmetry of the patterns are also gotten, while the simulations indicate the designed horn has low side lobes.