Benefits of high-dose intravenous immunoglobulin on mortality in patients with severe COVID-19: An updated systematic review and meta-analysis

BackgroundThe clinical benefits of high-dose intravenous immunoglobulin (IVIg) in treating COVID-19 remained controversial.MethodsWe systematically searched databases up to February 17, 2022, for studies examining the efficacy of IVIg compared to routine care. Meta-analyses were conducted using the random-effects model. Subgroup analysis, meta-regression, and trial series analysis w ere performed to explore heterogeneity and statistical significance.ResultsA total of 4,711 hospitalized COVID-19 patients (1,925 IVIg treated and 2786 control) were collected from 17 studies, including five randomized controlled trials (RCTs) and 12 cohort studies. The application of IVIg was not associated with all-cause mortality (RR= 0.89 [0.63, 1.26], P= 0.53; I2 = 75%), the length of hospital stays (MD= 0.29 [-3.40, 6.44] days, P= 0.88; I2 = 96%), the needs for mechanical ventilation (RR= 0.93 ([0.73, 1.19], P= 0.31; I2 = 56%), or the incidence of adverse events (RR= 1.15 [0.99, 1.33], P= 0.06; I2 = 20%). Subgroup analyses showed that overall mortality among patients with severe COVID-19 was reduced in the high-dose IVIg subgroup (RR= 0.33 [0.13, 0.86], P= 0.02, I2 = 68%; very low certainty).ConclusionsResults of this study suggest that severe hospitalized COVID-19 patients treated with high-dose IVIg would have a lower risk of death than patients with routine care.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021231040, identifier CRD42021231040

CD4+ T cell counts and soluble programmed death-1 at baseline correlated with hepatitis B surface antigen decline in HIV/HBV coinfection during combined antiretroviral therapy

BackgroundSeveral studies have described the rapid decline and clearance of hepatitis B surface antigen (HBsAg) in human immunodeficiency virus (HIV)/hepatitis B virus (HBV) coinfection after initiating combined antiretroviral therapy (cART). Early decline of HBsAg levels is associated with HBsAg seroclearance in the treatment of chronic HBV infection. This study aims to evaluate the HBsAg kinetics and the determinants of early HBsAg decline in patients with HIV/HBV coinfection during cART.MethodsA total of 51 patients with HIV/HBV coinfection were enrolled from a previously established HIV/AIDS cohort and followed for a median of 59.5 months after cART initiation. Biochemical tests, virology and immunology assessments were measured longitudinally. The kinetics of HBsAg during cART were analyzed. Soluble programmed death-1 (sPD-1) levels and immune activation markers (CD38 and HLA-DR) were measured at baseline, 1-year and 3-year during treatment. HBsAg response was defined as a decline of more than 0.5 log10 IU/ml at 6 months from the baseline after initiation of cART.ResultsHBsAg declined faster (0.47 log10 IU/mL) in the first six months and attained a decrease of 1.39 log10 IU/mL after 5-year therapy. Seventeen (33.3%) participants achieved a decline of more than 0.5 log10 IU/ml at the first 6 months of cART(HBsAg response) of which five patients achieved HBsAg clearance at a median of 11 months (range: 6-51 months). Multivariate logistic analysis showed the lower baseline CD4+ T cell levels (OR=6.633, P=0.012) and sPD-1 level (OR=5.389, P=0.038) were independently associated with HBsAg response after cART initiation. The alanine aminotransferase abnormality rate and HLA-DR expression were significantly higher in patients who achieved HBsAg response than in those who did not achieve HBsAg response after cART initiation.ConclusionLower CD4 + T cells, sPD-1, and immune activation were related to a rapid HBsAg decline in patients with HIV/HBV-coinfection after the initiation of cART. These findings imply that immune disorders induced by HIV infection may disrupt immune tolerance to HBV, leading to a faster decline in HBsAg levels during coinfection

Dynamic and efficient vehicular cloud management scheme with privacy protection

The vehicular cloud (VC) formed by vehicles is used for localization processing and consumption of traffic sensing data to achieve timely intelligent traffic management.The vehicle cloud is highly dynamic, self-organizing and timely, in which the identity and location privacy of vehicle users need to be protected as this poses challenges to the vehicular cloud management.A dynamic and self-organizing vehicle cloud management scheme based on the asymmetric group key agreement protocol was designed, where the vehicle cloud is automatically formed through the self-organized group key agreement of vehicles.The group key was used to control the provision and access of vehicle cloud services, and the dynamic management of the vehicle cloud was implemented through group key update.The scheme used traceable one-time pseudonym technology to achieve anonymous authentication and conditional privacy protection of vehicle users, and the group key agreement stage only included one bilinear pair operation to achieve high efficiency.In addition, the key negotiation and update process used lightweight signatures, supporting batch verification, to achieve efficient message source authentication and integrity authentication.Then the security and efficiency of vehicle cloud communications in the self-organizing environment can be ensured.The dynamic key update mechanism of the key agreement protocol realized the dynamic joining or exiting of vehicles in the vehicle cloud, adapting to the dynamic characteristics of the vehicle cloud.Under the random oracle model and the difficult assumption of the inverse computational Diffie Hellman (ICDH) problem, it was proved that the asymmetric group key agreement scheme satisfied the selective-plaintext security.The security analysis shows that the scheme can protect the identity and location privacy of vehicle users, realize the legal tracking of malicious vehicles, and ensure the confidentiality, integrity and anti-counterfeiting of communications, as well as the forward security of vehicle cloud dynamic management.The performance comparison analysis shows that this scheme has certain advantages in communication and computing efficiency under the condition of the same function and security level

A Truthful Auction Mechanism for Mobile Crowd Sensing With Budget Constraint

The selfishness and randomness of users in the mobile crowd sensing network could cause them unwilling to participate in sensing activities and lead to lower completion rates of sensing tasks. In order to deal with these problems, this paper proposes a novel incentive mechanism based on a new auction model for mobile crowd sensing, which consists of two consecutive stages. In the first stage, a novel Incentive Method based on Reverse Auction for Location-aware sensing (IMRAL) is proposed to maximize user utility. By introducing a task-centric method to determine the winning bids, it can provide higher user utility and higher task coverage ratio. To ensure the truthfulness of IMRAL, we design a unique payment determination algorithm based on critical payment for the incentive platform. In the second stage, we propose a user-interaction incentive model (UIBIM) to cover the situation that a user may drop out of the sensing activity. This new incentive model includes a dynamic double auction framework prompting users’ interaction and a user matching algorithm based on a bipartite graph. The proposed new mechanism achieves the goal of improving task completion rates without increasing the cost of the incentive platform. The simulation results show that comparing with other solutions, such as a truthful auction for location-aware collaborative sensing in mobile crowdsourcing and incentive mechanism for crowdsourcing in the single-requester single-bid-model, IMRAL can achieve better performance in terms of average user utility and tasks coverage ratio, and the UIBIM can significantly improve task completion rates

Biochemical metabolic levels and vitamin D receptor FokⅠ gene polymorphisms in Uyghur children with urolithiasis.

Because of lacking studies of urolithiasis in children, we detected the biochemical metabolic levels and FokⅠ polymorphisms in the vitamin D receptor (VDR) in Uyghur children with urolithiasis, and evaluated the associations of biochemical metabolic levels with FokⅠ genotypes. We included 142 Uyghur children (108 males) under age 14 years with a diagnosis of urolithiasis and 238 Uyghur children (154 males) under age 14 years without a history of urolithiasis as controls. Baseline information and data for serum and urine parameters were obtained from medical records. PCR-restriction fragment length polymorphism (PCR-RFLP) was used to analyze the VDR FokⅠ polymorphisms. In univariate analyses adjusting for age and sex, carbon dioxide combining power (CO2CP) (odds ratio [OR] = 1.13, 95% confidence interval [CI]: 1.07-1.19), serum magnesium (Mg) (OR = 1.27, 95% CI: 1.03-1.56) and serum chlorine (Cl) (OR = 0.93, 95% CI: 0.88-0.97) were related to Uyghur children urolithiasis risk. A multiple logistic regression model showed CO2CP (OR = 1.17, 95% CI: 1.09-1.26), levels of uric acid (OR = 1.01, 95% CI: 1.00-1.01) and serum sodium (Na) (OR = 0.90, 95% CI: 0.82-0.99) were associated with pediatric urolithiasis. The risk of urolithiasis was increased with the F versus f allele overall (OR = 1.42; 95% CI: 1.01-2.00) and for males (OR = 1.52, 95% CI: 1.02-2.27). However, metabolic levels did not differ by FokⅠ genotypes. In our population, CO2CP and levels of uric acid and serum Na as well as polymorphism of the F allele of the VDR FokⅠ may provide important clues to evaluate the risk of urolithiasis in Uyghur children

Efficiency Analysis of Scale-free Network Cascading Failures under Different Types of Attacks

Cascading failures are common in most of the networks, which can result in a congestion regime with degradation in the network performance. In order to investigate how a small shock can trigger avalanches mechanisms affecting a considerable fraction of the network, lots of failure models have been constructed. In this paper, Based on our AHP network cascading model, we have estimated how the efficiency will be affected when coefficients of K, S, T changed, we  find the fact  that the network efficiency of BA network is determined by its attacked types, and  the efficiency  is largely influenced by the attacked types of K and S, and under the same number of failure node, the efficiency under attacks of types T and I are relatively higher than that of the efficiency under attacks of types S and K , and the importance I is largely determined by the proportion of T, when the node failure number is equal, the higher proportion of T, the  higher efficiency it is  under I type attacks. We also tabled some proposals for reducing the damage that the networks suffered from the cascading failures. DOI: http://dx.doi.org/10.11591/telkomnika.v11i10.296

Blockchain-Based Method for Pre-Authentication and Handover Authentication of IoV Vehicles

The Internet of Vehicles (IoV) is an important supporting technology for intelligent transportation systems that connects traffic participants, such as vehicles, pedestrians, and roads, through wireless networks and enables information exchange to enhance traffic safety and improve traffic efficiency. The IoV is a unique network that involves many network security risks, which must be controlled through authentication, encryption, and other protective measures. To solve problems, such as high computing overhead and low handover authentication efficiency of the existing vehicle access authentication of the IoV, a compact consensus pre-authentication and handover authentication method was designed based on blockchain features such as decentralization and security. The proposed method is based on ensuring authentication security and reduces the consensus time, saves computing resources, and effectively solves the problems of high computing cost and high communication cost arising from frequent vehicle authentication handovers. A performance and security analysis demonstrates that our approach can reduce the computational overhead by up to 88.14% for a vehicle and by more than 60% for a roadside unit (RSU). The overall communication overhead of the solution is reduced by up to 71.31%. The data illustrate that the proposed method can safely and significantly improve the efficiency of vehicle handover authentication