Article type: Research LetterTitle: Dupilumab therapy in children aged 6 months to 12 years with uncontrolled moderate-to-severe atopic dermatitis: a Chinese real-world study

The development of cloud computing has significantly altered how services are built, deployed, and made accessible to users outside of the organization. In actuality, the pay-as-you-go model of dispersed IT supported by the cloud computing paradigm calls for the outsourcing of software services and applications. In this situation, the capacity to ensure effective cloud performance management and to facilitate automated scalability become fundamental prerequisites. Users of the cloud are becoming more and more interested in a transparent and coherent image of the cloud, where performance is guaranteed in a variety of situations and under a variety of loads. In this essay, We examine the advantages of an integrated scalability approach at various cloud stack layers, concentrating on the database and compute infrastructure layers. In order to achieve this, we offer various performance measurements and a set of rules based on them to assess the cloud stack’s condition and scale it as needed to maintain stable performance. Then, using a proof-of-concept architecture, we empirically investigate three scaling scenarios for cloud performance: database only, computing infrastructure solely, and the scenario where computing infrastructure and database compete for resources.

The Terasort benchmark and the YCSB benchmark are the two most used cloud computing benchmarks. Despite the fact that these benchmarks are quite helpful, data warehouse systems and associated OLAP technologies were not the focus of their creation. We initially introduce cloud computing and data warehouse systems in this essay. Then, we contend that the TPC-H benchmark, which is the most well- known benchmark for decision support systems, conflicts with the justifications for cloud computing (scalability, elasticity, pay-per-use, fault-tolerance characteristics), and customer relationship management (end- user satisfaction, Quality of Service features). Finally, we propose updated specifications for a benchmark for cloud data warehouse systems. The suggested specifications ought to make it possible to fairly compare the products offered by various cloud system providers .

Demand Response (DR) is quickly becoming a critical component of the contemporary energy industry, notably in EU energy markets. As a result, substantial work has gone into standardizing demand response data models. As a result, an increasing number of demand response concepts are based on these standards. As a result, an increasing number of demand response concepts are based on these standards. These approaches, however, are often centralized, and those that rely on cloud solutions employ the cloud as a centralized data repository, assuming that the data is already homogenised when saved, i.e. all data has the same structure and type. In practice, however, DR plans rely on a number of components that deliver data in a variety of forms and types. Furthermore, the various DR standards establish models for various data formats, which impede data sharing between different DR systems. This article introduces CIM, a generic technology that allows current disaster recovery systems to disperse their components in the cloud while providing a robust security and privacy foundation for data interaction. Furthermore, the CIM includes a semantic interoperability layer capable of transforming data into a normalised form when transferred, allowing it to be consumed transparently by DR components. Experiments support the CIM as a solution for DR systems to decentralize their designs and share heterogeneous data with other DR systems that adhere to other DR standards.

Commercialized passivated emitter and rear cell (PERC) silicon solar cells feature direct contact of metal with silicon, which leads to severe recombination loss and low open circuit voltage (Voc). To overcome the loss, the authors demonstrate a highly stable and thickness-tolerant dopant-free electron-selective contact consisting of a strontium fluoride/aluminium (SrF2/Al) stack. The inserting dielectric SrF2 layer can mitigate the Fermi-level pinning effect between the silicon substrate and the Al electrode. Besides, a comparatively small Ohmic contact resistivity of 2 mΩ·cm2 on lightly doped n-type c-Si can be achieved when using 4 nm of SrF2. Moreover, the formed contact within 9 nm SrF2 is stable for over 5000 hours in the air without encapsulation. Solar cells with this novel dopant-free electron-selective contact reach a power conversion efficiency (PCE) of 21.56%. The promising results and its stable nature, indicate its potential to serve as cost-efficient electron-selective contact for various optoelectronic devices.

This paper presents an energy-efficient digital-to-analog converter (DAC) switching method with low common-mode variations for high resolution successive approximation register (SAR) analog-to-digital converters (ADCs), while enabling to implement resolutions such as 14-bit as compared to the typical 10-bit. The proposed switching method enables high resolution by having a nearly constant common-mode voltage and employing input-swapping to use the reference voltage (Vref) only in the sampling phase. This method eliminates the need for the third reference voltage during the entire DAC switching steps, which reduces the required number of switches even compared to the state-of-the-art methods that use low number of switches. The use of lower number of switches not only lowers the DAC control logic complexity, but also results in a faster operation, lower power, and smaller area. When compared to conventional 10-bit SAR ADCs, the proposed switching method in a 10-bit implementation reduces the average switching energy and area by 93.7 % and 75 %, respectively, while offering high resolution implementation options such as 14 bits.

An explosion accident in an enclosed cable trench caused by the discharge of 10 kV three-phase cable joints is discussed. Combined with the disassembly analysis, the fault recording data analysis, and the validation of experiment, the evolution of the cable joint fault is deduced and discussed. The results show that the trigger of the cable joint fault is the creepage discharge at the XLPE-SiR insulation interface. This results in the partial breakdown and the grounding failure of three-phase cable joints. Under the long-term floating potential and current thermal effect, the insulations are gradually ablated and decomposed into a large amount of combustible gas. Finally, the accumulated combustible gas is ignited by the arc caused by a three-phase short circuit at the moment of the reclosing operation. The analytical method and conclusions proposed in this paper can provide suggestions and guidance for the analysis of similar fault accidents in the future.

Title: Complex regional pain syndrome of the knee after COVID-19 Vaccine in an adult patient

The continuous exploitation of groundwater has made wetland degradation an ecological and geological environmental problem that cannot be ignored and which has had impacts on the ecological environment and human production and life. In this study, with the help of Visual MODFLOW software, we used numerical simulation technology to simulate the wetland–aquifer interaction during the multiyear pumping process, establish a quasi-ideal model of wetlands based on the actual area of the Baiyangdian Basin, simulate the relationship of water quantity change between wetlands and piedmont plain aquifers during groundwater exploitation and its natural recovery process, and quantify the attenuation of the contribution of groundwater to wetlands caused by groundwater overexploitation. The results show that the impact of groundwater overexploitation on wetland degradation is mainly divided into two parts: one is the reduced base flow from the piedmont plain to the wetland, and the other is the induced infiltration caused by the reverse recharge of groundwater from the wetland due to the pumping effect. At the beginning of pumping, the effect of reduced base flow on wetland degradation is dominant, but with a longer pumping time, the effect of induced infiltration on wetland degradation exceeds the effect of reduced base flow. After stopping pumping, the effect of induced infiltration on wetland degradation responds instantly and decreases rapidly, while the effect of reduced base flow on wetland degradation continues for a long time. The total water reduction of wetlands increases with increasing hydraulic conductivity, and in actual wetland areas, if groundwater overexploitation is not restricted or artificial supply measures are not taken, the amount of wetland water will gradually decrease until it is exhausted.

Intro: Removal of bacterial plaque and stains are a crucial part of non-surgical periodontal treatment. Following scaling, polishing by air-powdered devices is widely used. The aim of this study is to evaluate the changes caused by three different air-powder abrasives from the same company (sodium bicarbonate, glycine, and erythritol) on the enamel and exposed root surface. Methods: The enamel and exposed cementum surface were air polished at an instrumentation time of 5s, combinations of medium and maximum power, medium water settings, the distance of 5mm, and angulation of 60 0. Samples were scanned in a micro-computed tomography (micro-CT) at baseline and then after air-polishing powder applications, and the defect depth, defect volume, demineralization depth, and tissue mineral density (TMD) values were evaluated. Results: Sodium bicarbonate-based powder is more abrasive than glycine and erythritol-based powders ( p<0.05). All powders caused more abrasion at the maximum power setting ( p<0.05). There were statistically significant differences between the mean TMD values before and after the application in all groups ( p<0.05). After the application, the average TMD was found to be lower. Conclusion: We can conclude that glycine and erythritol-based powders can be used for supragingival air polishing in patients with gingival recession, in addition, we can recommend that the power setting be set to the minimum level at which stain, and plaque can be effectively removed.

Black and Hispanic children with leukemia experience inferior survival compared to non-Hispanic White (NHW) children. Identifying modifiable social determinants of health can inform intervention targets to address inequities. We characterized the frequency of income poverty and household material hardship (HMH) by race/ethnicity in a clinical trial cohort with de novo acute lymphoblastic leukemia. Compared to NHW families, Black and Hispanic families reported more frequent HMH (19% vs. 47% vs. 68% respectively); low-income (27% vs. 52% vs. 74%), and combined low-income and HMH (12% vs. 37% vs. 52%) poverty exposures. Disparate poverty exposures are interventional targets to address racial/ethnic outcome inequities.

Thoracic air leak syndrome (TALS) is a complication related to chronic pulmonary graft-versus-host disease (pGvHD) and is defined as the occurrence of any form of air leak in the thorax. Four patients, aged 16 to 25 years, underwent surgical procedures for TALS between January 2016 and March 2021. All the patients experienced at least two episodes before surgery. After surgery, patients were temporarily free from air leak symptoms. All the patients eventually died because of respiratory failure. Surgery provides temporary relief to symptoms related to TALS. When TALS develops, pulmonary function progressively worsens toward respiratory failure and death.

Background: Chemotherapy-induced nausea and vomiting (CINV) is one of the most common side effects of chemotherapy in patients. Although sufficient evidence regarding its assessment and treatment in adults exists, CINV is more complicated in children. There are established guidelines for its prevention and treatment endorsed by several reputable organizations; however, their adherence varies between institutions. Therefore, this study aimed to assess the incidence and severity of CINV in pediatric patients receiving any form of chemotherapy in the acute and delayed phases and evaluated our institution’s adherence to published guidelines endorsed by the Pediatric Oncology Group of Ontario. Procedure: This was a prospective longitudinal single-center study. A structured assessment was administered twice to patients or their caregivers during the acute and delayed phases. Baxter Animated Retching Faces scale was used. Results: A total of 186 patients completed 236 surveys, including those for acute and delayed phases. Incidence of acute nausea was reported in 33% patients of both phases, while vomiting was observed in 20.3% and 18.8% of the acute and delayed phases, respectively. A total of 31% patients met the criteria for proper adherence in case of prescribed appropriate antiemetic agent(s)/class irrespective of the dose. Conclusion: CINV is a major side effect among children who receive high and moderate emetogenic chemotherapy compared to those receiving minimal and low regimens. Despite the low rate of adherence to the guidelines, the incidence and severity of CINV reported in our study were acceptable and indicate good clinical practice. Further research should seek strategies to better implement and standardize these guidelines.

Respiratory infections are a common cause of cytopenia in pediatric cancer patients undergoing treatment, with rhinovirus being the most frequent culprit. We aimed to assess the impact of rhinovirus infections during low-intensity chemotherapy maintenance in children with acute lymphoblastic leukemia (ALL). Clinical characteristics and outcomes of patients infected with rhinovirus between 2011-2021 were analyzed. Of the 207 patients on maintenance, 22% presented rhinovirus infection, with 50% experiencing associated cytopenia leading to treatment interruptions in 37%. No increase in relapses or mortality was observed. These findings suggest that rhinovirus infections can cause bone marrow toxicity during maintenance phase of ALL. Thus, the screening for rhinovirus infection should be considered as part of the investigation in cases of unexpected pancytopenia.

Vulvovaginal candidiasis (VVC) is an inflammatory disease primarily caused by candidiasis albicans infection. Metabolomics has been applied to research a variety of inflammatory diseases. In the present study, the vaginal metabolic profiles of VVC patients and healthy populations were explored by a non-targeted metabolomics approach. In total, 211 differential metabolites were identified, with the VVC group having 128 over-expressed and 83 under-expressed metabolites compared with healthy individuals. Functional analysis showed that these metabolites were mainly involved in amino acid metabolism and lipid metabolism. In addition, network software analysis indicated that the differential metabolites were associated with MAPK signaling and NF-κB signaling. Further molecular docking suggested that linoleic acid can bind to the ACSL1 protein, which has been shown to be associated with multiple inflammatory diseases and is an upstream regulator of the MAPK and NF-κB signaling pathways that mediate inflammation. Therefore, our preliminary analysis results suggest that VVC has a unique metabolic profile. Linoleic acid, a significantly elevated unsaturated fatty acid in the VVC group, may promote VVC development through the ACSL1/MAPK and ACSL1/NF-κB signaling pathways. This study’s findings contribute to further exploring the mechanism of VVC infection and providing new perspectives for the treatment of Candida albicans vaginal infection.

Intestinal parasites affect the health of birds and pose a risk of transmitting diseases. This study utilized fecal examination to assess the occurrence of intestinal parasites in two captive waterbird species, revealing a high infection rate and a diverse range of parasite groups. Nematodes were found to be the most common intestinal parasite species in two duck species, Common teal (Anas. crecca) and Bailkal teal (Sibirionetta formosa). A total of 96 fecal samples were collected and analyzed using the modified floating and sedimentary McMaster technique, revealing an overall infection rate of 78.13% (75/96), with 42.67% (35/72) being single infections and 57.33% (43/75) mixed infections. Nematodes were the most prevalent with an infection rate of 66.67% (64/96), followed by protozoa (34.48%), trematode (14.42%), and cestode (5.21%). Three nematode species were identified in both ducks, including Cappillaria spp., Strongyloides spp., and Ascaris spp. The mean egg per gram (EPG) of Strongyloides spp. was highest in Common teal while Baikal teal had a higher mean EPG of Cappillaria spp. Duck species, genders and seasons were observed as factors, result showed a significant difference in occurrence rate and mean OPG/EPG between males and females in both duck species, and a higher occurrence during the summer than in the autumn and winter seasons. The high occurrence of intestinal parasites in these two dabbling ducks, particularly nematode species, may reflect the health status of waterbirds in captive. The results are important for understanding the status of intestinal parasites and assessing the risk of epidemics.

Tetraodontiformes is a special group of higher teleosts, with a long and problematic taxonomic history due to their wide distribution and species diversity. It is a difficult task for both professionals and nonprofessionals to accurately identify all species only according to morphological characteristics. DNA barcoding can identify species at the molecular level. In this study, we collected 616 specimens of Tetraodontiformes and their DNA barcodes from the coastal waters of China. According to the morphological characteristics, 50 species were preliminarily identified, belonging to 23 genera, 6. Among them, DNA barcoding analysis showed that Takifugu pseudommus and Takifugu chinensis are the synonyms of Takifugu rubripes. And Lagocephalus wheeleri is the synonym of Lagocephalus Spadiceus. The third important finding is that the species of Takifugu have close genetic relationship. If T. rubripes, T. pseudommus and T. chinensis are taken as one species, the average interspecific genetic distance of Takifugu is 6.21 times of the average intraspecific genetic distance, which does not reach the DNA barcode threshold of more than 10 times proposed by Hebert. Among them, the genetic distance between T. oblongus and T. stictonotus is the largest, 0.045; And between T. bimaculatus and T. flavidus is the smallest, only 0.013. However, species can be clustered into separate clades in the NJ tree. In conclusion, this study provided molecular basis for solving the problem of confusion in the classification of Tetraodontiformes, it found that there are synonym phenomena in the order, and provided molecular evidence for clarifying the valid species names of Lagocephalus Spadiceus and Takifugu rubripes. The results can provide reliable DNA barcoding information for the identification and classification of Tetraodontiformes, and also provide technical support for the development and utilization of puffer fish resources and the identification of the original components of related commodities on the aquatic product market.

Lactate dehydrogenase reflects the status of ultra-high-risk neuroblastoma in a child under treatmentAkinori Yaguchi, Junya Fujimura, Ayane Yakabe, Megumi Fujiwara, Takeshi Ishibashi, Osamu Tomita, Toshiaki ShimizuDepartment of Pediatrics, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan

One of the most potent greenhouse gases is methane, which is the most basic hydrocarbon in the paraffin series. With a GWP of roughly 28, this is the second most significant greenhouse gas. Since there is a lot of it in the Indian subcontinent, it is important to monitor and research this gas. This study analyses satellite readings that were taken all over the world between 2003 and 2015 and are retrieved for the Indian region. This study made use of the satellite-based SCIAMACHY and TANSO-FTS equipment. Additionally, the work examines how a change in concentration levels depends on a region's location and climate by estimating the rate of change of methane levels through time and obtaining information on the change in concentration. According to this study, it is rising quickly over the Indo-Gangetic Plain, the Northeast, and certain coastal areas. The majority of the sources are man-made, such as fossil fuels and the energy industry, as well as natural sources like wetlands. Both instruments indicate that methane content is rapidly rising in the area, depending on a number of variables and seasonal fluctuations. Methane emissions must be decreased otherwise it will be the main cause of the greenhouse effect.

Aims: Intravenous ibuprofen (IVIB) has been approved in the treatment of postoperative pain and fever in adults, but the application of multiple- or single- dosage IVIB remains divergent in clinical practice. This study aims to evaluate the efficacy and safety of IVIB in the management of postoperative pain and fever in adults who were unable to take oral medicine. Methods: A systematic review and meta-analysis was conducted based on randomized controlled trials (RCTs) regarding postoperative pain and fever management comparing IVIB with placebo, or other analgesic and antipyretic agents from 8 databases. Risk of bias and quality of evidence assessment were performed. The primary outcomes mainly included visual analogue scale (VAS) score within postoperative 24h and the reduction of temperature. Results: Twenty-three RCTs with 3716 participants were included. For postoperative pain, moderate-to-low certainty evidence indicated that IVIB was associated with lower postoperative VAS scores than placebo, with MD ranging between -3.53 (95% CI, -4.32 to -2.75) at 0 minute to -0.96 (95% CI, -1.35 to -0.57) at 24 hours. Compared to intravenous acetaminophen, IVIB appeared lower VAS scores (MD, -1.54 at 0min; -0.36 at 24h). For fever, IVIB appeared satisfactory antipyretic efficiency in a short period of time, but there was no difference between IVIB and intravenous acetaminophen. Moderate-to-low certainty evidence indicated that IVIB was well tolerated in both pain and fever management. Conclusions: Moderate-to-low certainty evidence supported that adults with postoperative pain and fever who were unable to take oral medicine would benefit from IVIB.

Taxilli Herba (TH) is famous for its semi-parasitic feature, with hundreds of host species. The molecular mechanisms governing the accumulation of bioactive constituents in TH from different hosts have yet to be completely understood. The purpose of this study was to investigate the differences in synthesis and accumulation of bioactive constituents in TH from Morus alba L. and Liquidambar formosana Hance. The proteome of TH from two hosts were compared, and proteins were identified using tandem mass tag (TMT) technology. Sixteen bioactive constituents were quantitatively determined and analyzed in conjunction with the results of proteomics. A total of 5681 proteins were detected, of which 259 were significantly up-regulated and 274 significantly down-regulated in expression levels. Differentially expressed proteins (DEPs) were shown to be mostly engaged in cellular process and metabolic process by GO analysis. DEPs were considerably abundant in amino acid metabolic pathways, according to KEGG pathway analysis. The changes in the contents of 16 bioactive constituents were mostly compatible with the expression patterns of relevant structural proteins. The results of this study will provide basic information for the role of protein in the secondary metabolism biosynthesis pathway and the molecular mechanism of the quality formation of TH.

1. Conservation of species that rely on mutualistic partners such as pollinators may be better studied using interaction networks and indicators of ecological functions. 2. We used a novel systems-ecology approach using network analysis and bee morphology indicators to investigate ecological structure and bee body condition in the context of a conservation practice known as prairie strips established within row-crop fields compared to unrestored field margins. 3. We found the increased flower resources in prairie strips produced a nested network supporting higher bee richness and a greater chance for bee-mediated plant pollination. 4. Some, but not all, bee groups showed improved body condition at prairie strip sites with variation due to taxonomic group, foraging preferences, and body size. 5. This study supports a growing body of literature on the utility of network analysis in more broadly assessing the effect of conservation practices on ecological communities.

Objective To assess the influence of proficiency-based progression (PBP) training in robot-assisted laparoscopic (RAL) surgery for endometrial cancer on peri-operative and survival outcomes. Design Observational cohort study. Setting Tertiary referral and subspecialty training centre. Population All women with primary endometrial cancer treated with RAL surgery between 2015 and 2022. Methods Proficiency-based progression training cases were identified pre-operatively by consultant surgeons based on clinical factors, such as BMI and comorbidities, and case complexity matching the experience of the trainee. Main Outcome Measures Intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theatre rates and 5-year disease-free and disease-specific survival for training versus non-training cases. Results Training cases had a lower BMI than non-training cases (30 versus 32 kg/m 2), but were comparable in age, performance status and comorbidities. Training had no influence on intra- and post-operative complications, blood transfusions, readmissions < 30 days, return to theatre rates and median 5-year disease-free and disease-specific survival. Operating time was longer in training cases (161 versus 137 min). Estimated blood loss, conversion rates, CCU-admissions and lymphoedema rates were comparable. Conclusions Proficiency based progression training can be safely used to teach RAL surgery for women with endometrial cancer. Prospective trails are needed to further investigate the influence of distinct parts of RAL surgery performed by a trainee on endometrial cancer outcomes.

CF is considered a rare disease among the non-Caucasian population. The clinical phenotypes and genotypic spectrum of Chinese CF patients are reported to be different from that observed in Caucasians[(1)](#ref-0001). Our patient carried compound heterozygous mutations which are not included in the Caucasian CFTR common mutation-screening panel and have not been reported yet. CFTR dysfunction causes a spectrum of diseases, with a range in the number of organs involved and varying disease severity. Typical phenotypic features of CF include respiratory diseases (bronchiectasis with persistent airway-based infection and inflammation), gastrointestinal diseases (meconium ileus (MI)), hepatobiliary manifestations (pancreatic insufficiency), and male infertility[(2)](#ref-0002). Our patient presented severe manifestations, namely colonic perforation, meconium thorax, severe pneumonia, diaphragmatic defects-caused marked diaphragm elevation and respiratory failure. It’s difficult to ascertain whether the diaphragmatic defects in our patient is related to CF. MI is often the first manifestation of CF and occurs in approximately 20% of CF patients. CF should therefore be high in the differential diagnosis of any infant presenting with MI[(3)](#ref-0003).