Enterovirus 71 (EV71) is a major causative agent of hand, foot, and mouth disease (HFMD) in children. The role of T follicular helper (TFH) cells in EV71-infected children remains unclear in regulating humoral immunity. The frequency of circulating ICOShigh/PD-1highCXCR5+CD4+ TFH cells in the children with mild and severe EV71 infection and healthy controls (HC) was detected by flow cytometry, respectively. IL-21 and IL-6 mRNA expression and their serum levels, Bcl-6 mRNA expression, and specific neutralizing antibodies against EV71 (NAb-EV71) were measured. In the acute stage of patients with EV71 infection, increased frequencies of circulating TFH cells with ICOShigh and PD-1high expression in the mild and severe patients were observed, and the positive correlations among the frequencies of circulating TFH cells and the serum levels of IL-21, IL-6, and NAb-EV71 titres were detected, respectively. Moreover, the expressions of IL-6 and IL-21 mRNA in PBMCs from patients were also significantly higher than those of HC. However, further analysis did not reveal any significant differences between mild and severe patients. These data indicate a role of TFH cells and associated cytokines in modulating the humoral response during the pathogenesis of EV71 infection.

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Self-testing has been a rich area of study in quantum information theory. It allows an experimenter to interact classically with a black box quantum system and to test that a specific entangled state was present and a specific set of measurements were performed. Recently, self-testing has been central to high-profile results in complexity theory as seen in the work on entangled games PCP of Natarajan and Vidick \cite{low-degree}, iterated compression by Fitzsimons et al. \cite{iterated-compression}, and NEEXP in MIP* due to Natarajan and Wright \cite{neexp}. The most studied self-test is the CHSH game which features a bipartite system with two isolated devices. This game certifies the presence of a single EPR entangled state and the use of anti-commuting Pauli measurements. Most of the self-testing literature has focused on extending these results to self-test for tensor products of EPR states and tensor products of Pauli measurements.In this work, we introduce an algebraic generalization of CHSH by viewing it as a linear constraint system (LCS) game, exhibiting self-testing properties that are qualitatively different. These provide the first example of LCS games that self-test non-Pauli operators resolving an open questions posed by Coladangelo and Stark \cite{RobustRigidityLCS}. Our games also provide a self-test for states other than the maximally entangled state, and hence resolves the open question posed by Cleve and Mittal \cite{BCSTensor}. Additionally, our games have 1 bit question and log⁡n bit answer lengths making them suitable candidates for complexity theoretic application. This work is the first step towards a general theory of self-testing arbitrary groups. In order to obtain our results, we exploit connections between sum of squares proofs, non-commutative ring theory, and the Gowers-Hatami theorem from approximate representation theory. A crucial part of our analysis is to introduce a sum of squares framework that generalizes the solution group of Cleve, Liu, and Slofstra \cite{BCSCommuting} to the non-pseudo-telepathic regime. Finally, we give the first example of a game that is not a self-test. Our results suggest a richer landscape of self-testing phenomena than previously considered.

Background United States Medical Licensing Examination Step 1 will transition from numeric grading to pass/fail, sometime after January 2022. The aim of this study was to compare how program directors in orthopaedics and internal medicine perceive a pass/fail Step 1 will impact the residency application process. Methods A 27-item survey was distributed through REDCap to 161 U.S. orthopaedic residency program directors and 548 U.S. internal medicine residency program directors. Program director emails were obtained from the American Medical Association’s Fellowship and Residency Electronic Interactive Database. Results We received 58 (36.0%) orthopaedic and 125 (22.8%) internal medicine program director responses. The majority of both groups disagree with the change to pass/fail, and felt that the decision was not transparent. Both groups believe that the Step 2 Clinical Knowledge exam and clerkship grades will take on more importance. Compared to internal medicine PDs, orthopaedic PDs were significantly more likely to emphasize research, letters of recommendation from known faculty, Alpha Omega Alpha membership, leadership/extracurricular activities, audition elective rotations, and personal knowledge of the applicant. Both groups believe that allopathic students from less prestigious medical schools, osteopathic students, and international medical graduates will be disadvantaged. Orthopaedic and internal medicine program directors agree that medical schools should adopt a graded pre-clinical curriculum, and that there should be a cap on the number of residency applications a student can submit. Conclusion Orthopaedic and internal medicine program directors disagree with the change of Step 1 to pass/fail. They also believe that this transition will make the match process more difficult, and disadvantage students from less highly-regarded medical schools. Both groups will rely more heavily on the Step 2 clinical knowledge exam score, but orthopaedics will place more importance on research, letters of recommendation, Alpha Omega Alpha membership, leadership/extracurricular activities, personal knowledge of the applicant, and audition electives.

Purpose: To assess the repeatability of keratometric measurements obtained using a reflectance and swept-source optical coherence tomography (SS-OCT) based biometer and to compare these values with those obtained with a dual Scheimpflug–Placido (S-P) disk–based tomographer/topographer. Setting: Department of Ophthalmology, Penn State College of Medicine, Hershey, Pennsylvania, USA. Design: Prospective consecutive case series. Methods: Patients undergoing cataract evaluation were prospectively enrolled. Surgery-naive eyes without corneal pathology were measured 3 times with the reflectance/SS-OCT biometer and once with the dual S-P disk tomographer/topographer. Intradevice repeatability for anterior (K), posterior (PK), and total corneal keratometry (TK) readings were evaluated using within-eye SDs, test–retest repeatability (TRT), coefficients of variance, and intraclass correlation coefficients (ICCs). Bland-Altman analysis was used to assess agreement between devices. Results: Eighty-two eyes from 48 patients met inclusion criteria. The TRT for the anterior, posterior, and total corneal powers were 0.33, 0.08, and 0.36 diopter (D), respectively. TRT for the anterior, posterior, and total keratometric astigmatism were 0.58, 0.14, and 0.64 D, respectively. Anterior keratometric indices had higher ICCs than posterior indices. Bland-Altman analysis revealed that the SS-OCT consistently reported flatter posterior corneal curvatures than the S-P. Conclusions: The SS-OCT posterior keratometric measurements contain more noise (lower ICCs), but still have lower within-eye SDs and TRTs than that of anterior measurements. This may be due to the small index of refraction change at the cornea-aqueous interface. Although keratometric indices from the 2 devices are highly correlated, measurements taken using SS-OCT and S-P devices were not interchangeable.

BackgroundA novel avian influenza A (H7N9) virus emerged in eastern China in February 2013. 413 confirmed human cases, including 157 deaths, have been recorded as of July 31, 2014.MethodsClinical specimens, including throat swabs, sputum or tracheal aspirates, etc., were obtained from patients exhibiting influenza-like illness (ILIs), especially from those having pneumonia and a history of occupational exposure to poultry and wild birds. RNA was extracted from these samples and a multiplex one-step real-time RT-PCR assay was developed to specifically detect the influenza A virus (FluA). PCR primers targeted the conserved M and Rnase P (RP) genes, as well as the hemagglutinin and neuraminidase genes of the H7N9 virus.ResultsThe multiplex assay specifically detected the avian H7N9 virus, and no cross-reaction with other common respiratory pathogens was observed. The detection limit of the assay was approximately 0.05 50% tissue culture infective doses (TCID50), or 100 copies per reaction. Positive detection of the H7N9 virus in sputum/tracheal aspirates was higher than in throat swabs during the surveillance of patients with ILIs. Additionally, detection of the matrix (M) and Rnase P genes aided in the determination of the novel avian H7N9 virus and ensured the quality of the clinical samples.ConclusionsThese results demonstrate that the multiplex assay detected the novel avian H7N9 virus with high specificity and sensitivity, which is essential for the early diagnosis and treatment of infected patients.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2334-14-541) contains supplementary material, which is available to authorized users.

De Russische invasie in Oekraïne kan de voedselonzekerheid in de wereld verergeren, aangezien beide landen een belangrijke exporteur van granen en andere landbouwproducten zijn. In deze modelgebaseerde scenariostudie worden de middellangetermijneffecten van de oorlog op de landbouwproductie, de handelsstromen, de marktprijzen en de voedselzekerheid gekwantificeerd. De scenario's richten zich op de mogelijke gevolgen van de macro-economische gevolgen en de gevolgen voor de landbouwproductie in Oekraïne, de gevolgen van handelssancties tegen Rusland, en de daarmee samenhangende hogere energieprijzen. Vanuit het oogpunt van de voedselzekerheid kan worden geconcludeerd dat er op mondiaal niveau voldoende voedsel is, maar dat hogere voedselprijzen een probleem kunnen worden voor een deel van de bevolking dat een laag inkomen heeft en een groot deel van zijn voedsel aan granen besteedt. Voor sommige landen die sterk afhankelijk zijn van de invoer van Oekraïens en Russisch graan, zoals Egypte, Turkije en het Midden-Oosten, zal de beschikbaarheid van voedsel enigszins onder druk komen te staan. Voor de EU zijn de gevolgen voor de voedselzekerheid zeer gering, aangezien de beschikbaarheid van voedsel in de EU geen probleem is en de bevolking over het algemeen een klein deel van haar voeding aan op granen gebaseerde voedingsproducten besteedt.The Russian invasion of Ukraine has the potential to exacerbate food insecurity around the world as both countries are a major exporter of grains and other agricultural products. In this model based scenario study, medium-term effects of the war on agricultural production, trade flows, market prices, and food security are quantified. The scenarios focus on the possible consequences of macro-economic and agricultural production impacts in Ukraine, consequences of trade sanction measures against Russia, and related higher energy prices. From a food security perspective, we can conclude that there is enough food on the global level, but higher food prices could become a problem for a part of the population that has a low income and spends a large part of their food on cereals. For some countries highly dependent on imports of Ukrainian and Russian cereals like Egypt, Turkey and Middle East, food availability will come under some pressure. Food security impacts are very minor for the EU, as food availability is not a problem in the EU and in general people spend a small part on cereal-based food products.

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