Effects of nutritional intake on disease severity in children with sickle cell disease.

BACKGROUND: Children with Sickle Cell Disease (SCD) may show growth failure in comparison to healthy peers. Many factors as hematological status, endocrine and/or metabolic dysfunction, and nutritional status, may play an important role in growth failure. The aim of this study was to assess whether impaired growth and nutritional intake can affect SCD severity during childhood. METHODS: We conducted an observational study on children with SCD referring to our clinic for routine follow-up visits in a 6-month period. We collected information on weight, height and body mass index (BMI) and calculated their respective standardized scores (z). The nutritional intake was assessed through the last 24-h recall intake of total calories, macro- (proteins, lipids, carbohydrates) and micronutrients (calcium, iron, phosphorus, vitamins B1, PP, A, C, B2). Disease severity was assessed through total hemoglobin (Hb) and fetal hemoglobin (HbF), and lactic dehydrogenase (LDH) levels, and through the total number and days of hospitalizations, as well as the lifetime episodes of acute chest syndrome (ACS). RESULTS: Twenty nine children (14 males, 15 females) with SCD were enrolled; their mean age was 9.95 years (SD 3.50, min 3.72, max 17.18). Z-weight and z-BMI were significantly directly related to total Hb. Food intake resulted significantly unbalanced in terms of total calorie intake, macro- and micronutrients, especially calcium, iron, vitamin B1 and C. Low intake of calcium and vitamin B1 were significantly inversely correlated with number and days of hospitalizations per year. Protein, lipid, phosphorus, and vitamin PP intakes resulted adequate but were inversely correlated with number and days of hospitalizations. Carbohydrate, lipid, iron, phosphorus, vitamins B1 and B2 intakes were significantly inversely correlated to HbF levels. CONCLUSIONS: This study showed that, in our population, inadequate nutritional intake, weight and BMI have a significant impact on SCD severity indices

Dynamic QuantiFERON Response in Psoriasis Patients Taking Long-Term Biologic Therapy

INTRODUCTION: The risk of active tuberculosis is increased in psoriasis patients receiving biologic drug therapy. The QuantiFERON-TB Gold In-Tube assay (QFT) is used for latent tuberculosis screening in these patients. This study presents a retrospective analysis on repeated QFT assays, investigating the influence of biologic drugs and isoniazid therapy on the outcome of the assay. METHODS: Serial QFTs of 58 psoriasis patients, who received biologic drug therapy, were evaluated at baseline and after 12 months of treatment. Patients were retrospectively divided in four groups according to QFT results at baseline and at follow-up: patients having a QFT reversion (from positive to negative results); patients with a conversion (from negative to positive); patients confirming the baseline results, either positive or negative. RESULTS: At the end of the 12-months period, 11.1% of patients with a negative QFT result at baseline presented a conversion, showing low interferon (IFN)-gamma values, whereas 6.9% of positive patients presented a QFT reversion. When the test was repeated after 2–3 months without isoniazid chemoprophylaxis, patients with QFT conversion showed negative results. No patient developed active tuberculosis. CONCLUSIONS: In patients undergoing biologic therapy, a positive QFT assay needs to be further confirmed, as false-positive results may occur after long-term therapy. Repeating QFT tests in patients with low IFN-gamma values could reduce the incidence of false-positive latent tuberculosis infection diagnosis, thus preventing unnecessary tuberculosis chemoprophylaxis. In conclusion, a dynamic QFT response is possible in psoriasis patients undergoing biologic therapy

Innovative RFID Sensors for Internet of Things Applications

Radio-Frequency IDentification (RFID) devices and sensors are among the main innovations of the last years, with an enormous impact on the Internet of Things (IoT) physical communication layer as well as on logistics and robotics. The aim of the present paper is to review the main technologies available for RFID sensors, and to identify the corresponding state-of-the-art when these technologies are applied to realistic IoT scenarios. Firstly, the concepts of radio backscattering and harmonic backscattering are analyzed, highlighting the pros and cons of each approach. Then, state-of-the-art solutions are reported, and the performance of each of them are discussed, to provide an overview of the potential of RFID-based sensing in different scenarios

3-D-Printing-Based Selective-Ink-Deposition Technique Enabling Complex Antenna and RF Structures for 5G Applications up to 6 GHz

This paper introduces a novel additive-manufacturing technique to obtain high-resolution selective-ink-deposition on complex 3-D objects, packages, and modules for 5G applications. The technique consists of embossing the desired pattern directly on the 3-D printed dielectric surface and then applying ink with a suitable tool. This approach is tested in combination with stereolithography 3-D printing technology to obtain selectively metallized 3-D circuits. In particular, the "clear" resin from FormLab is utilized for the 3-D printed dielectric, while the metallization is performed with silver nanoparticle ink from Suntronic. As a preliminary study, test samples containing lines with different widths are manufactured, demonstrating a pitch down to $135~\mu \text {m}$ and satisfactory sheet resistance of $0.011~\Omega /\text {sq.}$ (the electromagnetic characterization of the dielectric resin is reported in the Appendix). Then, two broadband multiport RF structures are developed to show the versatility of the proposed technology. First, an ultrawideband 3-D crossover, operating in the range 100 MHz–5 GHz, is conceived to test the suitability of the proposed technology to perform selective metallization on curved semienclosed areas. Then, the technology is applied to a multiple-input–multiple-output (MIMO) antenna system, based on four proximity-fed annular slot antennas, arranged on the lateral sides of a cube and decoupled by introducing a cross-shaped structure in the interior of the cube. This circuit offers a broad range of metallization challenges, as it features embossed and engraved parts, high-resolution patterns (line widths down to 0.7 mm) and sharp edges. Each slot radiates unidirectionally with the same polarization and uses the cube and its internal cross-shaped structure as a resonant cavity. The antenna system is designed to operate in the band 3.4–3.8 GHz, which is one of the sub-6-GHz 5G bands in Europe, and it is thought for hotspot and access-point applications. The final antenna topology is composed of only two blocks, weighs 21.29 g, and occupies a volume of $44.4\times 45.8\times 45.8\,\,\text {mm}^{3}$ , featuring an envelope correlation coefficient (ECC) lower than 0.005 and a total active reflection coefficient (TARC) lower than −6 dB in all the bands of interests

A Ka-Band Receiver Front-End With Noise Injection Calibration Circuit for CubeSats Inter-Satellite Links

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Next-generation IoT devices: sustainable eco-friendly manufacturing, energy harvesting, and wireless connectivity

This invited paper presents potential solutions for tackling some of the main underlying challenges toward developing sustainable Internet-of-things (IoT) devices with a focus on eco-friendly manufacturing, sustainable powering, and wireless connectivity for next-generation IoT devices. The diverse applications of IoT systems, such as smart cities, wearable devices, self-driving cars, and industrial automation, are driving up the number of IoT systems at an unprecedented rate. In recent years, the rapidly-increasing number of IoT devices and the diverse application-specific system requirements have resulted in a paradigm shift in manufacturing processes, powering methods, and wireless connectivity solutions. The traditional cloud-centering IoT systems are moving toward distributed intelligence schemes that impose strict requirements on IoT devices, e.g., operating range, latency, and reliability. In this article, we provide an overview of hardware-related research trends and application use cases of emerging IoT systems and highlight the enabling technologies of next-generation IoT. We review eco-friendly manufacturing for next-generation IoT devices, present alternative biodegradable and eco-friendly options to replace existing materials, and discuss sustainable powering IoT devices by exploiting energy harvesting and wireless power transfer. Finally, we present (ultra-)low-power wireless connectivity solutions that meet the stringent energy efficiency and data rate requirements of future IoT systems that are compatible with a batteryless operation

Lunar Gravitational-Wave Antenna

Monitoring of vibrational eigenmodes of an elastic body excited by gravitational waves was one of the first concepts proposed for the detection of gravitational waves. At laboratory scale, these experiments became known as resonant-bar detectors first developed by Joseph Weber in the 1960s. Due to the dimensions of these bars, the targeted signal frequencies were in the kHz range. Weber also pointed out that monitoring of vibrations of Earth or Moon could reveal gravitational waves in the mHz band. His Lunar Surface Gravimeter experiment deployed on the Moon by the Apollo 17 crew had a technical failure rendering the data useless. In this article, we revisit the idea and propose a Lunar Gravitational-Wave Antenna (LGWA). We find that LGWA could become an important partner observatory for joint observations with the space-borne, laser-interferometric detector LISA, and at the same time contribute an independent science case due to LGWA's unique features. Technical challenges need to be overcome for the deployment of the experiment, and development of inertial vibration sensor technology lays out a future path for this exciting detector concept.Comment: 29 pages, 17 figure

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Energy-Efficient Harmonic Transponder Based on On-Off Keying Modulation for Both Identification and Sensing

This paper presents a novel passive Schottky-diode frequency doubler equipped with an on-off keying (OOK) modulation port to be used in harmonic transponders for both identification and sensing applications. The amplitude modulation of the second-harmonic output signal is achieved by driving a low-frequency MOSFET, which modifies the dc impedance termination of the doubler. Since the modulation signal is applied to the gate port of the transistor, no static current is drained. A proof-of-concept prototype was manufactured and tested, operating at 1.04 GHz. An on/off ratio of 23 dB was observed in the conversion loss of the doubler for an available input power of &minus;10 dBm. The modulation port of the circuit was excited with a square wave (fm up to 15 MHz), and the measured sidebands in the spectrum featured a good agreement with the theory. Then, the doubler was connected to a harmonic antenna system and tested in a wireless experiment for fm up to 1 MHz, showing an excellent performance. Finally, an experiment was conducted where the output signal of the doubler was modulated by a reed switch used to measure the rotational speed of an electrical motor. This work opens the door to a new class of frequency doublers, suitable for ultra low-power harmonic transponders for identification and sensing applications