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The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE) underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate SARS-CoV-2-exposed masks and respirators. We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus.
The two arms of the study included: 1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment, and 2) PPE treatment with MBL for 5 cycles of decontamination (5CD) to determine maintenance of PPE performance.
MBL treatment was used to inactivate coronaviruses on three N95 filtering facepiece respirator (FFR) and two medical mask (MM) models. We inoculated FFR and MM materials with three coronaviruses, including SARS-CoV-2, and treated with 10 µM MB and exposed to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5CD using multiple US and international test methods and compared to the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method.
Overall, MBL robustly and consistently inactivated all three coronaviruses with 99.8 - to >99.9% virus inactivation across all FFRs and MMs tested. FFR and MM integrity was maintained after 5 cycles of MBL treatment, whereas one FFR model failed after 5 cycles of VHP+O3.
MBL treatment decontaminated respirators and masks by inactivating three tested coronaviruses without compromising integrity through 5CD. MBL decontamination is effective, low-cost and does not require specialized equipment, making it applicable in all-resource settings.
Consumption of sugar-sweetened beverages (SSB) by infants and young children are less explored in Asian populations. The Growing Up in Singapore Towards healthy Outcomes cohort study examined associations between SSB intake at 18 months and 5 years of age, with adiposity measures at 6 years of age. We studied Singaporean infants/children with SSB intake assessed by FFQ at 18 months of age (n 555) and 5 years of age (n 767). The median for SSB intakes is 28 (interquartile range 5·5–98) ml at 18 months of age and 111 (interquartile range 57–198) ml at 5 years of age. Association between SSB intake (100 ml/d increments and tertile categories) and adiposity measures (BMI standard deviation scores (sd units), sum of skinfolds (SSF)) and overweight/obesity status were examined using multivariable linear and Poisson regression models, respectively. After adjusting for confounders and additionally for energy intake, SSB intake at age 18 months were not significantly associated with later adiposity measures and overweight/obesity outcomes. In contrast, at age 5 years, SSB intake when modelled as 100 ml/d increments were associated with higher BMI by 0·09 (95 % CI 0·02, 0·16) sd units, higher SSF thickness by 0·68 (95 % CI 0·06, 1·44) mm and increased risk of overweight/obesity by 1·2 (95 % CI 1·07, 1·23) times at age 6 years. Trends were consistent with SSB intake modelled as categorical tertiles. In summary, SSB intake in young childhood is associated with higher risks of adiposity and overweight/obesity. Public health policies working to reduce SSB consumption need to focus on prevention programmes targeted at young children.
Knowledge of proper clinical management of drug overdose and chemical and biological toxin exposure is important for the neurocritical care specialist. Many of the common offenders principally affect the central nervous system (CNS). Even those that do not will lead to a severely incapacitated state when overdosed such that the afflicted patient will require critical care in an intensive care unit (ICU).
Evidence on long-term influences of maternal vitamin B12 deficiency or concentrations on infant cognition is limited. We examined associations between maternal plasma vitamin B12 and cognitive development in 24-month-old infants. Maternal plasma vitamin B12 concentrations were measured at 26–28 weeks’ gestation; infant cognitive development was assessed with the Bayley Scales of Infant and Toddler Development-III at 24 months, for 443 mother–infant pairs from the Growing Up in Singapore Towards Healthy Outcomes cohort. Linear regressions adjusted for key confounders examined associations of maternal vitamin B12 with cognitive, receptive and expressive language, fine and gross motor subscales. Co-occurrence of maternal vitamin B12 with folate or vitamin B6 insufficiencies on child’s cognition was explored. Average maternal plasma vitamin B12 concentrations was 220·5 ± 80·5 pmol/l; 15 % and 41 % of mothers were vitamin B12 deficient (<148 pmol/l) and insufficient (148–220·9 pmol/l), respectively. Infants of mothers with vitamin B12 deficiency had 0·42 (95 % CI −0·70, −0·14) sd lower cognitive scores, compared with infants of mothers with sufficient vitamin B12. Co-occurrence of maternal vitamins B12 and B6 insufficiencies was associated with 0·37 (95 % CI −0·69, −0·06) sd lower cognitive scores in infants compared with infants of mothers sufficient in both vitamins. No significant associations were observed with other subscales. Study findings suggest the possible need to ensure adequate vitamin B12 during pregnancy. The impact of co-occurrence of maternal B-vitamins insufficiencies on early cognitive development warrants further investigation.
As part of a national initiative to reduce child obesity, a comprehensive school-based nutrition education intervention to change eating behaviours among grade 4 primary-school students was developed, implemented and evaluated.
The intervention was developed by school staff, with technical assistance from outside health education specialists. The programme included school facility upgrades, school teacher/staff training, curriculum changes and activities for parents. Student scores on nine key eating behaviours were assessed prior to and after the programme. The quality of programme implementation in the schools was monitored by technical assistance teams.
Shandong Province (high household income) and Qinghai Province (low household income), China. Three programme schools and three control schools in each province.
Students in grade 4 (age 8–9 years).
There were significant positive changes in self-reported eating behaviour scores from pre- to post-assessment in programme schools. At post-test students in programme schools had significantly higher scores than students in control schools after controlling for other variables. The programme was more effective in the high-income province. Observations by the technical assistance teams suggested the programme was implemented more completely in Shandong. The teams noted the challenges for implementing and evaluating programmes like these.
This intervention increased healthy eating behaviours among 4th graders in both provinces and had more effect in the more affluent province. Results suggest that a scaled-up initiative using existing school and public health resources could change eating practices in a large population over time. The intervention also provided lessons for implementing and evaluating similar nutrition programmes.
Vector-borne diseases are one of the world's major public health threats and annually responsible for 30–50% of deaths reported to the national notifiable disease system in China. To control vector-borne diseases, a unified, effective and economic surveillance system is urgently needed; all of the current surveillance systems in China waste resources and/or information. Here, we review some current surveillance systems and present a concept for an integrated surveillance system combining existing vector and vector-borne disease monitoring systems. The integrated surveillance system has been tested in pilot programmes in China and led to a 21·6% cost saving in rodent-borne disease surveillance. We share some experiences gained from these programmes.
Spontaneous regression of solid malignancy is extremely rare. It is virtually unheard of in the last half century in the published literature. The overwhelming majority of medical professionals do not know that this phenomenon exists.
This paper reports such a case involving a patient with proven laryngeal squamous cell carcinoma in New Zealand. Whilst waiting for definitive treatment, he was afflicted with prolonged septicaemia secondary to peritonitis from percutaneous endoscopic gastrostomy tube insertion. Following a total laryngectomy, histology of the specimen did not contain any evidence of neoplasia.
Based predominantly on work established by Dr William Coley, we believe that a period of prolonged pyrexia preceding definitive surgery contributed to this apparent ‘miracle’. The time may be ripe to further debate on whether the medical profession should consider pyrexia therapy as a last resort treatment for patients deemed incurable by conventional methods.
Early life environments interact with genotype to determine stable phenotypic outcomes. Here we examined the influence of a variant in the brain-derived neurotropic factor (BDNF) gene (Val66Met), which underlies synaptic plasticity throughout the central nervous system, on the degree to which antenatal maternal anxiety associated with neonatal DNA methylation. We also examined the association between neonatal DNA methylation and brain substructure volume, as a function of BDNF genotype. Infant, but not maternal, BDNF genotype dramatically influences the association of antenatal anxiety on the epigenome at birth as well as that between the epigenome and neonatal brain structure. There was a greater impact of antenatal maternal anxiety on the DNA methylation of infants with the methionine (Met)/Met compared to both Met/valine (Val) and Val/Val genotypes. There were significantly more cytosine–phosphate–guanine sites where methylation levels covaried with right amygdala volume among Met/Met compared with both Met/Val and Val/Val carriers. In contrast, more cytosine–phosphate–guanine sites covaried with left hippocampus volume in Val/Val infants compared with infants of the Met/Val or Met/Met genotype. Thus, antenatal Maternal Anxiety × BDNF Val66Met Polymorphism interactions at the level of the epigenome are reflected differently in the structure of the amygdala and the hippocampus. These findings suggest that BDNF genotype regulates the sensitivity of the methylome to early environment and that differential susceptibility to specific environmental conditions may be both tissue and function specific.
Stars are tidally disrupted and accreted when they approach massive black holes (MBHs) closely, producing a flare of electromagnetic radiation. The majority of the (approximately two dozen) tidal disruption events (TDEs) identified so far have been discovered by their luminous, transient X-ray emission. Once TDEs are detected in much larger numbers, in future dedicated transient surveys, a wealth of new applications will become possible. Here, we present the proposed Einstein Probe mission, which is a dedicated time-domain soft X-ray all-sky monitor aiming at detecting X-ray transients including TDEs in large numbers. The mission consists of a wide-field micro-pore Lobster-eye imager (60° × 60°), and is designed to carry out an all-sky transient survey at energies of 0.5-4 keV. It will also carry a more sensitive telescope for X-ray follow-ups, and will be capable of issuing public transient alerts rapidly. Einstein Probe is expected to revolutionise the field of TDE research by detecting several tens to hundreds of events per year from the early phase of flares, many with long-term, well sampled lightcurves.
Severe fever with thrombocytopenia syndrome virus (SFTSV) has been prevalent for some time in China and it was first identified in 2010. However, the seroprevalence of SFTSV in the general population in southeastern China and risk factors associated with the infection are currently unclear. Blood samples were collected from seven counties across Zhejiang province and tested for the presence of SFTSV-specific IgG antibodies by ELISA. A total of 1380 blood samples were collected of which 5·51% were seropositive for SFTSV with seroprevalence varying significantly between sites. Seroprevalence of SFTSV in people who were family members of the patient, lived in the same village as the patient, or lived in a different village than the patient varied significantly. There was significant difference in seroprevalence between participants who bred domestic animals and participants who did not. Domestic animals are probably potential reservoir hosts and contact with domestic animals may be a transmission route of SFTSV.
Our ability to fabricate multipodal and multilayer TiO2 nanotube arrays enables us to increase performance and functionality in light harvesting devices such as excitonic solar cells and photocatalysts. Using a combination of simulations and experiments, we show that multilayer nanotube arrays enable photon management in the active toward enhancing the absorption and utilization of incident light. We show that the simultaneous utilization of TiO2 nanotubes with large (∼450 nm) and small (∼80 nm) diameters in stacked multilayer films increased light absorption and photocurrent in solar cells. Such enhanced light absorption is particularly desirable in the near-infrared region of the solar spectrum in which most excitonic solar cells suffer from poor quantum efficiencies and for blue photons at the TiO2 band-edge where significant room exists for improvement of photocatalytic quantum yields. Under AM 1.5 one sun illumination, multilayer nanotube arrays afforded us an approximately 20% improvement in photocurrent over single layer nanotube array films of the same thickness for N-719 sensitized liquid junction solar cells. Also, the possibility of multipodal TiO2 nanotube growth with different electrolyte recipes is presented.
Although communicable diseases have hitherto played a small part in illness associated with Olympic Games, an outbreak of infection in a national team, Games venue or visiting spectators has the potential to disrupt a global sporting event and distract from the international celebration of athletic excellence. Preparation for hosting the Olympic Games includes implementation of early warning systems for detecting emerging infection problems. Ensuring capability for rapid microbiological diagnoses to inform situational risk assessments underpins the ability to dispel rumours. These are a prelude to control measures to minimize impact of any outbreak of infectious disease at a time of intense public scrutiny. Complex multidisciplinary teamwork combined with laboratory technical innovation and efficient information flows underlie the Health Protection Agency's preparation for the London 2012 Olympic and Paralympic Games. These will deliver durable legacies for clinical and public health microbiology, outbreak investigation and control in the coming years.
Background: This study examined the use of low doses of antipsychotic medications (300 mg/day CPZeq or less) in older Asian patients with schizophrenia and its demographic and clinical correlates.
Methods: Information on hospitalized patients with schizophrenia, aged 55 years or older, was extracted from the database of the Research on Asian Psychotropic Prescription Patterns (REAP) study (2001–2009). Data on 1,452 patients in eight Asian countries and territories including China, Hong Kong, Japan, Korea, Singapore, Taiwan, India, and Malaysia were analyzed. Sociodemographic and clinical characteristics and antipsychotic prescriptions were recorded using a standardized protocol and data collection procedure.
Results: The prescription frequency for low doses of antipsychotic medications was 40.9% in the pooled sample. Multiple logistic regression analysis of the whole sample showed that patients on low doses of antipsychotic medications were more likely to be female, have an older age, a shorter length of illness, and less positive symptoms. Of patients in the six countries and territories that participated in all the surveys between 2001 and 2009, those in Japan were less likely to receive low doses of antipsychotics.
Conclusion: Low doses of antipsychotic medications were only applied in less than half of older Asian patients with schizophrenia.
Mechanical cues in cellular microenvironment are central in directing a
class of cellular behaviors such as the dynamic of cell adhesion, migration,
and differentiation. Several advanced optical techniques, such as
structured-illumination nano-profilometry (SINAP), have been developed for a
better resolution of these dynamic processes. These techniques however
require culturing cells on materials of refractive index close to that of
glass, while most studies regarding the effects of mechanical cues on
cellular dynamics were conducted on hydrogel-based substrates. Here we
report the development of culturing substrates of tunable rigidity and
refractive index suitable for SINAP studies. Polyvinyl chloride (PVC)-based
substrates were mixed with a softener called Di(isononyl)
Cyclohexane-1,2-Dicarboxylate (DINCH) and cured by heating. The volume
ratios of PVC to DINCH were varied from 1:1 to 3:1. The Young’s modulus of
the resulting substrates ranged from 18 kPa to 40 kPa. The yielded
refractive indices of the composite substrates as measured by phase contrast
tomography ranged from 1.47 to 1.53. Human lung adenocarcinoma cells CL1-5
were cultured on the composite substrates and cell viability was examined
using the MTT assay. The dynamics of cell adhesion and filopodia activities
were examined using SINAP. Preliminary results suggest that PVC based
culturing substrates have a great potential in the application of SINAP
As critical dimensions decrease, key dimension-related dielectric etch challenges emerge, including via and trench uniformity and etch depth profile. The transition to ultra-low-k films such as BDIII (Black Diamond; k=2.55) dielectrics requires consideration of film sensitivity to compositional modification, polymer interactions at pores, and the effect of diffusion. Use of N2/O2 plasma at 60 ˚C to modify the M1 trench profile has been demonstrated to lower the RC delay by 14% as compared to traditional CO2 plasmas at 60˚C. Use of a DHF solution to clean the etching residue in the dual damascene structure results in >97% yield with a tight range of via chain resistance.
Knowledge of proper clinical management of drug overdose and chemical and biological toxin exposure is important for the neurocritical care specialist. Many of the common off enders principally affect the central nervous system (CNS). Even those that do not will lead to a severely incapacitated state when overdosed such that the afflicted patient will require critical care in an intensive care unit (ICU).
Typically, drug overdose that occurs outside of the hospital is first managed in the emergency department and then, if critical care is needed, in the medical intensive care unit. However, there are medications that are used in the neurocritical care unit (NCCU) that may lead to toxic overdose either through inadvertent provider error or because of changes in a patient's drug elimination. The most common offending medications are analgesics, antipyretics, mood stabilizers, and sedativehypnotics.
Sadly, there is another circumstance in which the neurointensivist may be called on to treat patients suffering from toxic overdose: a chemical or biological terrorist act. In this situation, emergency medicine and medical critical care physicians will be quickly overwhelmed, and it is certain that the neurocritical care specialist will be called upon to assist. Thus, a discussion of the clinical management of patients suffering from exposure to the leading known chemical weapons is warranted.
The most common medications leading to overdose are analgesics, antipyretics, sedative hypnotics, anticonvulsants, anticoagulants, antidepressants, bronchodilators, and antiarrhythmics. All are common medications used in the NCCU.
One hundred and two Shigella spp. isolated in two hospitals in Hong Kong were analysed for antibiotic resistances, resistance plasmids and plasmid profiles. Three quarters of the isolates were S.flexneri. All isolates harboured plasmids, up to a maximum of ten within one strain. Plasmids of 220 kb encoding resistances to tetracycline, chloramphenicol and sulphonamide and probably also associated with invasivenes in the Sereny test were found in 80 strains and were transferable in 18% of cases. Resistance plasmids of 92 and 99 kb were found in 27 and 15 strains respectively and encoded resistances to ampicillin, tetracycline, chloramphenicol, kanamycin, sulphonamide, trimethoprim, cotrimoxazole and gentamicin; these plasmids were usually transferable. Four plasmids of 3·9, 2·8, 2·2 and 1·8 kb were commonly found in S. flexneri strains, but were rare in other species. In contrast, there was no predominant plasmid profile in S. sonnei. S. flexneri is endemic in Hong Kong and these plasmid studies suggest that the strains in circulation are derived from only a few clones.