Obesity has been associated with increased risk of adult asthma, however, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity ...measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of sixteen studies (63,952 cases and 1,161,169 participants) were included in the quantitative synthesis. The summary RR was 1.32 (95% CI 1.21-1.44, I
= 94.6%, p
< 0.0001, n = 13) per 5 kg/m
increase in BMI, 1.26 (95% CI 1.09-1.46, I
= 88.6%, p
< 0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI 1.22-1.44, I
= 62.3%, p
= 0.05, n = 4) per 10 kg increase in weight gain. Although the test for nonlinearity was significant for BMI (p
< 0.00001), weight change (p
= 0.002), and waist circumference (p
= 0.02), there was a clear dose-response relationship between higher levels of adiposity and asthma risk. The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of overweight and obesity.
Despite several ongoing efforts in biomedicine and traditional medicine, there are no drugs or vaccines for coronavirus disease 2019 (COVID-19) as of May 2020; Kabasura Kudineer (KSK), a polyherbal ...formulation from India's Siddha system of medicine, has been traditionally used for clinical presentations similar to that of COVID-19. We explored the efficacy of KSK in reducing viral load and preventing the disease progression in asymptomatic, COVID-19 cases.
A prospective, single-center, open-labeled, randomized, controlled trial was conducted in a COVID Care Centre in Chennai, India. We recruited reverse-transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19 of 18 to 55 years of age, without clinical symptoms and co-morbidities. They were randomized (1:1 ratio) to KSK (60 mL twice daily for 7 days) or standard of care (7 days supplementation of vitamin C 60,000 IU morning daily and zinc 100 mg evening daily) groups. The primary outcomes were reduction in the SARS-CoV-2 load as measured by cyclic threshold (CT) value of RT-PCR, prevention of progression of asymptomatic to symptomatic state, and changes in the immunity markers including interleukins (IL-6, IL-10, IL-2), interferon gamma (IFNγ), and tumor necrosis factor (TNF α). Siddha clinical assessment and the occurrence of adverse effects were documented as secondary outcomes. Paired t-test was used in statistical analysis.
Viral load in terms of the CT value (RdRp: 95% CI = 1.89 to 5.74) declined significantly on the seventh day in the KSK group and that of the control group, more pronounced in the study group. None progressed to the symptomatic state. There was no significant difference in the biochemical parameters. We did not observe any changes in the Siddha-based clinical examination and adverse events in both groups.
KSK significantly reduced SARS-CoV-2 viral load among asymptomatic COVID-19 cases and did not record any adverse effect, indicating the use of KSK in the strategy against COVID-19. Larger, multi-centric trials can strengthen the current findings.
Clinical Trial Registry of India CTRI2020/05/025215 . Registered on 16 May 2020.
The primary objectives of this study are to determine efficacy of Siddha medicine, Kabasura kudineer in reduction of SARS-CoV-2 viral load and reducing the onset of symptoms in asymptomatic COVID-19 ...when compared to Vitamin C and Zinc (CZ) supplementation. In addition, the trial will examine the changes in the immunological markers of the Siddha medicine against control. The secondary objectives of the trial are to evaluate the safety of the Siddha medicine and to document clinical profile of asymptomatic COVID-19 as per principles of Siddha system of Medicine.
A single centre, open-label, parallel group (1:1 allocation ratio), exploratory randomized controlled trial.
Cases admitted at non-hospital settings designated as COVID Care Centre and managed by the State Government Stanley Medical College, Chennai, Tamil Nadu, India will be recruited. Eligible participants will be those tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain reaction (RT-PCR) aged 18 to 55 years without any symptoms and co-morbidities like diabetes mellitus, hypertension and bronchial asthma. Those pregnant or lactating, with severe respiratory disease, already participating in COVID trials and with severe illness like malignancy will be excluded.
Adopting traditional methods, decoction of Kabasura kudineer will be prepared by boiling 5g of KSK powder in 240 ml water and reduced to one-fourth (60ml) and filtered. The KSK group will receive a dose of 60ml decoction, orally in the morning and evening after food for 14 days. The control group will receive Vitamin C (60000 IU) and Zinc tablets (100mg) orally in the morning and evening respectively for 14 days.
The primary outcomes are the reduction in the SARS-CoV-2 load as measured by cyclic threshold (CT) value of RT-PCR from the baseline to that of seventh day of the treatment, prevention of progression of asymptomatic to symptomatic state (clinical symptoms like fever, cough and breathlessness) and changes in the immunity markers Interleukins (IL) 6, IL10, IL2, Interferon gamma (IFNγ) and Tumor Necrosis Factor (TNF) alpha. Clinical assessment of COVID-19 as per standard Siddha system of medicine principles and the occurrence of adverse effects will be documented as secondary outcomes.
The assignment to the study or control group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and informed consent procedures.
This study is unblinded. The investigators will be blinded to data analysis, which will be carried out by a statistician who is not involved in the trial.
Sample size could not be calculated, as there is no prior trial on KSK. This trial will be a pilot trial. Hence, we intend to recruit 60 participants in total using a 1:1 allocation ratio, with 30 participants randomised into each arm.
Protocol version 2.0 dated 16
May 2020. Recruitment is completed. The trial started recruitment on the 25
May 2020. We anticipate study including data analysis will finish on November 2020. We also stated that protocol was submitted before the end of data collection TRIAL REGISTRATION: The study protocol was registered with clinical trial registry of India (CTRI) with CTRI/2020/05/025215 on 16 May 2020.
The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).
Study objectives
Because dexmedetomidine (DEX)-induced sedation mimics non-rapid eye movement (NREM) sleep, its utility in sedating children with REM-predominant disease is unclear. We sought to ...determine the effectiveness of pediatric drug-induced sleep endoscopy (DISE) using DEX and ketamine for children with REM-predominant OSA, specifically whether or not at least one site of obstruction could be identified.
Methods
A retrospective case series of children without tonsillar hypertrophy undergoing DISE at a tertiary pediatric hospital from 10/2013 through 9/2015 who underwent subsequent surgery to address OSA with polysomnography (PSG) before and after.
Results
We included 56 children, mean age 5.6±5.4 years, age range 0.1-17.4 years, mean BMI 20.3±7.4 kg/m2 (76±29 percentile). At least one site of obstruction was identified in all patients, regardless of REM- or NREM-predominance. The mean obstructive apnea-hypopnea index (oAHI) improved (12.6 ± 10.7 to 9.0 ± 14.0 events/h) in children with REM-predominant (
P
= 0.013) and NREM-predominant disease (21.3 ± 18.9 to 10.3 ± 16.2 events/h) (
P
= 0.008). The proportion of children with a postoperative oAHI < 5 was 53% and 55% for REM- and NREMpredominant OSA, respectively. Unlike children with NREM-predominant disease, children with REM-predominant disease had significant improvement in the mean saturation nadir (
P
< 0.001), total sleep time (
P
= 0.006), and sleep efficiency (
P
= 0.015).
Conclusions
For children with OSA without tonsillar hypertrophy, DISE using DEX/ketamine was useful to predict at least one site of obstruction, even for those with REM-predominant OSA. DISE-directed outcomes resulted in significant improvements in mean oAHI, total sleep time, sleep efficiency, saturation nadir, and the proportion with oAHI < 5, after surgery for some children with REM-predominant disease.
Lightweight Cryptography is a constituent of cryptography that is applicable in the Internet of Things (IoT) platform. IoT is a promising technology with an embedded device that assembles collection ...of objects. Such objects can be smart devices, computers, humans and etc., that connect together using the internet and can communicate with each other for information sharing. However, smart devices are lightweight, resource-restricted devices, such as limited memory, processing speed and limited key size. The IoT has many problems and challenges due to the inherent features of smart devices. Security and privacy are one of the key concerns in IoT since devices exchange data in open wireless network and an attacker can easily access the network and performs different types of malfunctions such as viewing and modifying the valuable data. In order to solve these issues, a variety of cryptographic algorithms have been proposed and each one has its own characteristics. Based on the investigation of cryptography algorithms, there is a need to construct a cipher known as FibGeoPresent, a lightweight block cipher. The proposed cipher was compared to the existing cipher over different metrics. The results of the evaluation show that the proposed cipher is directly applicable and ensures security in lightweight devices.
Objectives/Hypothesis
Although adenotonsillectomy is accepted as a first‐line therapy for pediatric obstructive sleep apnea (OSA), there is currently no consensus regarding optimal methods for ...identifying the sites of obstruction or treatment of children with persistent disease after surgery. With this in mind, our aim was to systematically review the English‐language literature pertaining to these issues.
Study Design
Systematic review.
Methods
We searched all indexed years of Pubmed, Cochrane CENTRAL, DynaMed, UpToDate, CINAHL, and Scopus for English‐language articles containing original human data, with ≥ 7 participants, all < 18 years old. Data regarding study design, demographics, clinical characteristics/outcomes, level of evidence, and risk of bias were obtained. Articles were independently reviewed by two investigators.
Results
Of 758 identified s, 24 articles (combined population = 960) were ultimately included. Seventeen (71%) described methods to identify site(s) of obstruction: drug‐induced sleep endoscopy (11/24), cine magnetic resonance imaging (MRI) (3/24), and alternative imaging (3/24). Treatment options included lingual tonsillectomy (n = 6), with success rates of 57% to 88% (Cohen's effect size d = 1.38), as well as supraglottoplasty (n = 4), with success rates of 58% to 72% (d = 0.64). Additional treatments included medications and surgery (e.g., partial midline glossectomy and tongue suspension).
Conclusions
Drug‐induced sleep endoscopy and cine MRI are the most commonly reported tools to identify sites of obstruction for children with persistent OSA; however, these techniques have not yet been clearly linked to outcomes. Evidence for treatment is extremely limited and focuses primarily on lingual tonsillectomy and supraglottoplasty. Also, reports regarding appropriate patient selection and outcomes in obese or otherwise healthy children are scant. Laryngoscope, 126:491–500, 2016
Cybersecurity is a vital technology and measures intended to protect networks, computers, information, and programs from threats and illegal access, modification, or damage. A security model covers a ...network and a computer safety method. Each system has antivirus software, firewalls, and an intrusion detection system (IDS). IDS helps in discovering and identifying illegal system behavior such as usage, copying, alteration, and damage. By estimating network traffic anomalies and patterns, deep learning (DL) models can enhance the detection abilities of IDS when compared to traditional rule-based methods. These models learn complex representations from data, authorizing them to recognize subtle and developing attack patterns. Techniques like recurrent neural network (RNN) and convolutional neural network (CNN) can be applied to progress consecutive or spatial features in network data, correspondingly. This manuscript empowers Cybersecurity by utilizing an Enhanced Rat Swarm Optimizer with a Deep Stack-Based Ensemble Learning (ERSO-DSEL) model. The ERSO-DSEL approach leverages feature selection (FS) with EL strategies to boost cybersecurity. In the ERSO-DSEL system, Z-score normalization is employed to measure the input data. Besides, an improved equilibrium optimizer (IEO) based FS approach is applied to choose a set of features. For cyberattack recognition, the ERSO-DSBEL approach uses the DSEL approach comprising three models namely deep neural network (DNN), long short-term memory (LSTM), and bidirectional LSTM (Bi-LSTM). Furthermore, the hyperparameter selection of these DL models takes place using the ERSO system. The solution result of the ERSO-DSBEL model is executed on a benchmark IDS database. A wide-contrast study reported that the ERSO-DSBEL model accomplishes an enhanced accuracy outcome of 99.67% over other models of cybersecurity.
Lightweight cryptography (LWC) is a compact and advancing cryptography protocol. Internet of Things (IoT) is a cutting edge technology which is developed for resource constrained devices for ...communicating and sharing of information among fellow devices over internet. IoT smart objects are smallest tiny devices and it has limited processing and storage capacities and that often runs on small, low power, battery. IoT devices have many issues and challenges due to inherent properties of IoT and one of the major challenges is security. Success of IoT depends on how smart devices countermeasure the different security attacks. There are many cryptographic algorithms with different services are exist. Each one has some unique properties as well as limitations or constraints. After studying these cryptographic algorithms, the authors decided to propose a new lightweight block cipher, PriPresent. Also, this paper depicts the comparison results of proposed cipher with existing cipher over different metrics.
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