Th1/Th2 cytokine pattern in Arab children with severe asthma

BACKGROUND: Bronchial Asthma has recently emerged as one of the most prevalent diseases in Arab countries. Environmental and geographical influences were shown to be the reasons of the variations in the rates of prevalence; no analyses have nevertheless yet been performed on the immunologic background associated with this condition in Arabic children. OBJECTIVES: To examine the cytokine production from T cells in children with and without asthma, and to determine the role of the most related cytokine patterns in childhood asthma. METHODS: A total of 195 Saudis children (98 asthma pediatric patients and 97 healthy controls) were randomly selected from the Riyadh Cohort Study for inclusion. Asthma was based on established pediatric diagnosis and medications taken. RESULTS: Significant differences were observed between the two groups, thus, GMCSF, INF-\u3b3, IL-5, IL-6, IL-8 and IgG-3 were reduced in patients compared to controls; in these same patients IgE, resistin, IL-4 and IgG-4 were significantly increased. In contrast with these results no differences between patients and controls were seen in CRP, TNF-\u3b1, IL-1, IL-2, IL-7, IL-10, IL-13, IgG-1, IgG-2, IgG-A and IgG-M. Result of a principal component analysis suggested that IL4. INF-\u3b3 and IgE are major players in the pathogenesis of asthma in Arabic children. CONCLUSION: These are the first data obtained in asthmatic children in Saudi; data herein confirm that this disease is associated with a profound degree of immune impairment independently of the peculiar genetic of the analyzed individuals, and of the environmental conditions that are present in this part of the world

A novel ultra local based-fuzzy PIDF controller for frequency regulation of a hybrid microgrid system with high renewable energy penetration and storage devices

A new ultra-local control (ULC) model and two marine predator algorithm (MPA)-based controllers; MPA-based proportional-integral-derivative with filter (PIDF) and MPA-based Fuzzy PIDF (FPIDF) controllers; are combined to enhance the frequency response of a hybrid microgrid system. The input scaling factors, boundaries of membership functions, and gains of the FPIDF con-troller are all optimized using the MPA. In order to further enhance the frequency response, the alpha parameter of the proposed ULC model is optimized using MPA. The performance of the pro-posed controller is evaluated in the microgrid system with different renewable energy sources and energy storage devices. Furthermore, a comparison of the proposed MPA-based ULC-PIDF and ULC-FPIDF controllers against the previously designed controllers is presented. Moreover, a vari-ety of scenarios are studied to determine the proposed controller’s sensitivity and robustness to changes in wind speed, step loads, solar irradiance, and system parameter changes. The results of time-domain simulations performed in MATLAB/SIMULINK are shown. Finally, the results demonstrate that under all examined conditions, the new ULC-based controllers tend to further enhance the hybrid microgrid system’s frequency time response

Synthesis and theoretical characterization of ternary Cux(Ge30Se70)100−x glasses

The Cux(Ge30Se70)100−x (0 ≤ x ≤ 12 at.%) chalcogenide alloys have been synthesized by the conventional melt quenching technique. The physical properties such as the mean coordination number, density, molar volume, compactness, overall bond energy, and cohesive energy were estimated for the Cu doped Ge-Se glassy alloys. The chemical bond approach (CBA) was used to predict the type and proportion of the formed bonds in the studied glasses. Subsequently, several structural and physical properties have been estimated. The results show that the studied glasses are rigidly connected, having an average coordination number increase from 2.6 to 2.77. The density and glass compactness show an increase with the Cu content, whereas the main atomic volume decreases. The cohesive energy and the heat of atomization show a similar behavior trend with the enhancement of Cu % in the Ge-Se binary glasses. The optical band gap was estimated theoretically compared with the previously published experimental values for the Cux(Ge30Se70)100−x (0 ≤ x ≤ 12 at.%) thin films. The covalency parameter >91% for the studied glasses so that the compositions may be used as a stable glass former. Furthermore, the mechanical properties as the elastic bulk modulus, Poisson's ratio, Young's modulus, micro-hardness, and Debye temperature were investigated as a function of the Cu content. © 2021The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University , Saudi Arabia, for funding this work through the General Research Project Under Grant Number ( GRP/146/42 )

Increased circulating ANG II and TNF-α represents important risk factors in obese Saudi adults with hypertension irrespective of diabetic status and BMI

Central adiposity is a significant determinant of obesity-related hypertension risk, which may arise due to the pathogenic inflammatory nature of the abdominal fat depot. However, the influence of pro-inflammatory adipokines on blood pressure in the obese hypertensive phenotype has not been well established in Saudi subjects. As such, our study investigated whether inflammatory factors may represent useful biomarkers to delineate hypertension risk in a Saudi cohort with and without hypertension and/or diabetes mellitus type 2 (DMT2). Subjects were subdivided into four groups: healthy lean controls (age: 47.9±5.1 yr; BMI: 22.9±2.1 Kg/m2), non-hypertensive obese (age: 46.1±5.0 yr; BMI: 33.7±4.2 Kg/m2), hypertensive obese (age: 48.6±6.1 yr; BMI: 36.5±7.7 Kg/m2) and hypertensive obese with DMT2 (age: 50.8±6.0 yr; BMI: 35.3±6.7 Kg/m2). Anthropometric data were collected from all subjects and fasting blood samples were utilized for biochemical analysis. Serum angiotensin II (ANG II) levels were elevated in hypertensive obese (p<0.05) and hypertensive obese with DMT2 (p<0.001) compared with normotensive controls. Systolic blood pressure was positively associated with BMI (p<0.001), glucose (p<0.001), insulin (p<0.05), HOMA-IR (p<0.001), leptin (p<0.01), TNF-α (p<0.001) and ANG II (p<0.05). Associations between ANG II and TNF-α with systolic blood pressure remained significant after controlling for BMI. Additionally CRP (p<0.05), leptin (p<0.001) and leptin/adiponectin ratio (p<0.001) were also significantly associated with the hypertension phenotype. In conclusion our data suggests that circulating pro-inflammatory adipokines, particularly ANG II and, TNF-α, represent important factors associated with a hypertension phenotype and may directly contribute to predicting and exacerbating hypertension risk

A Protocol for the Secure Linking of Registries for HPV Surveillance

In order to monitor the effectiveness of HPV vaccination in Canada the linkage of multiple data registries may be required. These registries may not always be managed by the same organization and, furthermore, privacy legislation or practices may restrict any data linkages of records that can actually be done among registries. The objective of this study was to develop a secure protocol for linking data from different registries and to allow on-going monitoring of HPV vaccine effectiveness.A secure linking protocol, using commutative hash functions and secure multi-party computation techniques was developed. This protocol allows for the exact matching of records among registries and the computation of statistics on the linked data while meeting five practical requirements to ensure patient confidentiality and privacy. The statistics considered were: odds ratio and its confidence interval, chi-square test, and relative risk and its confidence interval. Additional statistics on contingency tables, such as other measures of association, can be added using the same principles presented. The computation time performance of this protocol was evaluated.The protocol has acceptable computation time and scales linearly with the size of the data set and the size of the contingency table. The worse case computation time for up to 100,000 patients returned by each query and a 16 cell contingency table is less than 4 hours for basic statistics, and the best case is under 3 hours.A computationally practical protocol for the secure linking of data from multiple registries has been demonstrated in the context of HPV vaccine initiative impact assessment. The basic protocol can be generalized to the surveillance of other conditions, diseases, or vaccination programs

Immunoglobulin, glucocorticoid, or combination therapy for multisystem inflammatory syndrome in children: a propensity-weighted cohort study

Background: Multisystem inflammatory syndrome in children (MIS-C), a hyperinflammatory condition associated with SARS-CoV-2 infection, has emerged as a serious illness in children worldwide. Immunoglobulin or glucocorticoids, or both, are currently recommended treatments. Methods: The Best Available Treatment Study evaluated immunomodulatory treatments for MIS-C in an international observational cohort. Analysis of the first 614 patients was previously reported. In this propensity-weighted cohort study, clinical and outcome data from children with suspected or proven MIS-C were collected onto a web-based Research Electronic Data Capture database. After excluding neonates and incomplete or duplicate records, inverse probability weighting was used to compare primary treatments with intravenous immunoglobulin, intravenous immunoglobulin plus glucocorticoids, or glucocorticoids alone, using intravenous immunoglobulin as the reference treatment. Primary outcomes were a composite of inotropic or ventilator support from the second day after treatment initiation, or death, and time to improvement on an ordinal clinical severity scale. Secondary outcomes included treatment escalation, clinical deterioration, fever, and coronary artery aneurysm occurrence and resolution. This study is registered with the ISRCTN registry, ISRCTN69546370. Findings: We enrolled 2101 children (aged 0 months to 19 years) with clinically diagnosed MIS-C from 39 countries between June 14, 2020, and April 25, 2022, and, following exclusions, 2009 patients were included for analysis (median age 8·0 years [IQR 4·2–11·4], 1191 [59·3%] male and 818 [40·7%] female, and 825 [41·1%] White). 680 (33·8%) patients received primary treatment with intravenous immunoglobulin, 698 (34·7%) with intravenous immunoglobulin plus glucocorticoids, 487 (24·2%) with glucocorticoids alone; 59 (2·9%) patients received other combinations, including biologicals, and 85 (4·2%) patients received no immunomodulators. There were no significant differences between treatments for primary outcomes for the 1586 patients with complete baseline and outcome data that were considered for primary analysis. Adjusted odds ratios for ventilation, inotropic support, or death were 1·09 (95% CI 0·75–1·58; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids and 0·93 (0·58–1·47; corrected p value=1·00) for glucocorticoids alone, versus intravenous immunoglobulin alone. Adjusted average hazard ratios for time to improvement were 1·04 (95% CI 0·91–1·20; corrected p value=1·00) for intravenous immunoglobulin plus glucocorticoids, and 0·84 (0·70–1·00; corrected p value=0·22) for glucocorticoids alone, versus intravenous immunoglobulin alone. Treatment escalation was less frequent for intravenous immunoglobulin plus glucocorticoids (OR 0·15 [95% CI 0·11–0·20]; p<0·0001) and glucocorticoids alone (0·68 [0·50–0·93]; p=0·014) versus intravenous immunoglobulin alone. Persistent fever (from day 2 onward) was less common with intravenous immunoglobulin plus glucocorticoids compared with either intravenous immunoglobulin alone (OR 0·50 [95% CI 0·38–0·67]; p<0·0001) or glucocorticoids alone (0·63 [0·45–0·88]; p=0·0058). Coronary artery aneurysm occurrence and resolution did not differ significantly between treatment groups. Interpretation: Recovery rates, including occurrence and resolution of coronary artery aneurysms, were similar for primary treatment with intravenous immunoglobulin when compared to glucocorticoids or intravenous immunoglobulin plus glucocorticoids. Initial treatment with glucocorticoids appears to be a safe alternative to immunoglobulin or combined therapy, and might be advantageous in view of the cost and limited availability of intravenous immunoglobulin in many countries. Funding: Imperial College London, the European Union's Horizon 2020, Wellcome Trust, the Medical Research Foundation, UK National Institute for Health and Care Research, and National Institutes of Health