ABSTRACT
With the outbreak of COVID-19, disinfection protection has become a necessary measure to prevent infection. As a new type of disinfectant, potassium peroxymonosulfate compound salt (PMS) has the advantages of good bactericidal effect, non-toxicity, high safety and stability. However, the current PMS products with irregular particle shapes lead to poor flowability, high hygroscopicity, poor stability of reactive oxygen species (ROS) and serious caking problems. In this work, an agglomeration-dissolution mechanism was designed to prepare spherical PMS particles with large size (>300 mm) and high sphericity (up to 90%), effectively addressing the above problems. Shaping (dissolution and abrasion) is the key to improving sphericity, which is mainly controlled by the design of the heating mode, residence time and stirring rate. Compared with the irregular PMS particles, the large spherical particles present better flowability (angle of repose decreased by 35.80%, Carr's index decreased by 64.29%, Hausner's ratio decreased by 19.14%), lower hygroscopicity (decreased by 38.0%), lower caking ratio (decreased by 84.50%), and higher stability (the monthly loss of ROS was reduced by 61.68%). The agglomeration -dissolution mechanism demonstrates the crystallization, agglomeration, dissolution and abrasion pro-cess of inorganic salt crystals, providing an opportunity to prepare high-end inorganic crystal materials with high-quality morphologies.(c) 2022 Chinese Society of Particuology and Institute of Process Engineering, Chinese Academy of Sciences. Published by Elsevier B.V. All rights reserved.
ABSTRACT
With the outbreak of COVID-19, disinfection protection has become a necessary measure to prevent infection. As a new type of disinfectant, potassium peroxymonosulfate compound salt (PMS) has the advantages of good bactericidal effect, non-toxicity, high safety and stability. However, the current PMS products with irregular particle shapes lead to poor flowability, high hygroscopicity, poor stability of reactive oxygen species (ROS) and serious caking problems. In this work, an agglomeration-dissolution mechanism was designed to prepare spherical PMS particles with large size (>300 μm) and high sphericity (up to 90%), effectively addressing the above problems. Shaping (dissolution and abrasion) is the key to improving sphericity, which is mainly controlled by the design of the heating mode, residence time and stirring rate. Compared with the irregular PMS particles, the large spherical particles present better flowability (angle of repose decreased by 35.80%, Carr's index decreased by 64.29%, Hausner's ratio decreased by 19.14%), lower hygroscopicity (decreased by 38.0%), lower caking ratio (decreased by 84.50%), and higher stability (the monthly loss of ROS was reduced by 61.68%). The agglomeration-dissolution mechanism demonstrates the crystallization, agglomeration, dissolution and abrasion process of inorganic salt crystals, providing an opportunity to prepare high-end inorganic crystal materials with high-quality morphologies. © 2022 Chinese Society of Particuology and Institute of Process Engineering, Chinese Academy of Sciences
ABSTRACT
As an important part of China's excellent traditional culture, Traditional Chinese Medicine (TCM) culture contains rich philosophical thoughts and has made important contributions to human health. The advent of the all media era has provided an opportunity for the full effect communication of TCM culture. On the basis of clarifying the scientific connotation of all media, this paper analyzed the dilemma faced by the all media communication of TCM culture under the background of the epidemic, and explored the all media communication path of TCM culture from four aspects: New ecology of content, new system of technology, new model of management, and new targeting of audience, so as to improve the communication, guidance, influence and credibility of the all media of TCM culture. © 2022, Editorial department of Chinese Medical Ethics. All rights reserved.
ABSTRACT
Background: Detrimental impact of COVID-19 on renal function unraveled over time. Nephrology community was in a dilemma whether transplantation should continue under such circumstances. We investigated which States within the US continued to perform kidney transplantation despite such odds. Methods: Retrospective data from Organ Procurement and Transplantation Network (OPTN) regions for kidney transplant alone (KTA) performed across the US from 2019 to 2020, reflecting the peak of the first wave of COVID -19 pandemic were analyzed. To address whether the COVID-19 had an impact on transplanted kidneys, we analyzed graft survival at 3-and 6-months post-transplant during that era. We further investigated the statewide variation of KTA in both deceased donor (DD) transplants and living donor (LD) transplants. Results: There was a 3.1% decrease in KTA from 2019 to 2020 (22,429 to 21,731). There was an overall trend of a decrease in number of transplants across all states with a peak decline in March-April 2019 era and rebound in May 2019 onwards. Statewide regional decline or variation of DD KTA was most significant in region 9 (NY, Vermont) while regions 4 (Oklahoma and Texas) continued to perform transplants unabated. In 2019, 30.6% of KTA were from LD while in 2020 the rate decreased to 24.1%. The transplantations of DD increased from 15,562 to 16,497 in 2020. Overall, 3-month graft survival was significantly negatively impacted for DD KTA performed between February and May. The decrease in KTA in the southern regions was less compared to the northeastern regions. Conclusions: The COVID-19 pandemic had a major impact on kidney transplantation with a significant reduction within all OPTN regions. While LD transplantation could presumably be rescheduled, DD organs must be procured immediately, or they are lost. Therefore, the number of DD transplants decreased initially between March and May but recovered afterwards. Transplanted kidneys during COVID-19 first wave pandemic era performed reasonably well but with an increase rate of injury and rejection.
ABSTRACT
Objectives: Advanced modeling techniques have been employed by BCBSLA to predict the risk of hospitalization (ROH) among its members. BCBSLA noted a strong association between members who were predicted as “high risk” in their ROH AI Predictive Model and members who actually had a COVID-19 admission. As a result, BCBSLA was asked to create a simplified model that could extend to the entire state of Louisiana knowing that detailed member data would not be available to score Louisiana’s entire population. Methods: The current ROH model employed by BCBSLA for its members was simplified for State use by focusing on available health factors that could be easily assessed. The simplified model was tested using 2019 BCBSLA membership to predict all future hospitalizations between Jan-Jun 2020. Results: The factors chosen for the new simplified model were age, comorbid conditions (diseases of the circulatory system, Hypertension, etc.) and particular events such as hospital or skilled nursing home facility admission within the past 12 months. The simplified model was shown to be highly predictive of future all-cause hospitalizations. The top 20% of predicted high risk members accounted for 70% of all admissions;AUC was very good at 0.89. The model was also predictive of COVID-19 admissions on a naïve population. The top 20% of members captured nearly 50% of COVID-19 admissions, AUC 0.74. The model performance was good considering early COVID-19 admissions were likely misclassified in claims data. Conclusions: Using simplified rules, BCBSLA was able to modify their current ROH model so that Louisiana’s health department could identify patients who would be at the highest risk for hospitalized if they contracted COVID-19.
ABSTRACT
Background: Corona Virus Disease-19 (CoVID-19) infection associated with AKI and ARDS results in a mortality of 80%. In AA population COVID 19 presentations and outcomes are worse. NIH and Interim WHO guidelines suggest against steroids use unless in the context of clinical trials. We conducted a retrospective analysis on the impact of 2 different doses of IV steroids in AA adult population. Methods: 75 patients between March 1 and April 30, 2020 were enrolled. Primary outcomes (21-day mortality) and secondary outcomes (improvement in lung function and renal function) were analyzed. Comparisons between the steroid doses (methylprednisolone 1 mg/kg/day or 2 mg/kg/day) and no-steroid groups were performed with the Wilcoxon, Kruskal-Wallis, and Chi-Square tests. Factors affecting the recovery of AKI or ARDS were analyzed. AKI recovery was defined as 50% increase of GFR, and cessation of RRT;lung function recovery was defined as improved oxygenation by P/F ratio > 200 and extubation. Results: 38 out 75 patients received steroids. Survival in the steroids group reached 73% at 21 days compared to 36% in the non-steroids group (p<0.0006). Steroids improved the likelihood of renal function improvement by 300% (p=0.06). Lung functionwas 73% in the steroids group versus 45% in the other (p=0.01). Use of anticoagulants (16% vs 51%, p= 0.001) seemed to be interacting with steroids on outcomes. Low dose steroids had the most beneficial impact. Conclusions: In patients with COVID-19 infection and ARDS with AKI, low dose IV methylprednisolone was associated with a significantly lower incidence of mortality and higher likelihood of renal and lung function recovery. Further investigation with a randomized control trial consisting of low dose steroids seems warranted. (Figure Presented).
ABSTRACT
Background: Since the start of COVID-19 pandemic, concerns have been raised about specific populations being at potential higher risk for developing more severe diseases, and patients living with HIV (PLWH) are among them. SARS-CoV-2, a newly isolated virus from the Corona Virus family, is enveloped, positive-sense single-stranded RNA virus that causes multi-organ failure, especially acute kidney injury (AKI) which is proved to be associated with significantly elevated mortality rate. It dysregulates human immunity especially on T lymphocytes which is shared by HIV as the mechanism of causing related diseases. We reviewed our hospital data to examine if HIV infection resulted in worse outcomes in COVID-19 patients who developed AKI. Methods: Retrospective chart review of all admitted patients to Kings County Hospital (KCH), a municipal hospital in Brooklyn, New York City between 3/1 to 5/15, 2020, from the electronic medical record. Patients were reviewed in groups of COVID infection without history of HIV, HIV patients admitted without COVID infection and patients with history of HIV who were admitted because of COVID infection. The rate of AKI and mortality were extracted and analyzed suing Chi-squared test in SPSS. Results: A total of 1092 patients with confirmed COVID-19 diagnosis were admitted in the above time period, out of which 22 were diagnosed with COVID-19 and HIV. In the COIVD-19 without HIV diagnosis group, 450 patients developed AKI and 213 patients died, with a mortality rate of 47.3%;in the COVID-19 with HIV group, 9 patients developed AKI and 4 expired, mortality rate is 44.4%. There's no significant difference between these two groups (p=0.86). Compared to these two groups, 21 out of 93 PLWH without COVID infection had AKI during hospitalization with 2 patients deceased, and a mortality rate of 9.5% which is significantly lower (p=0.03). Conclusions: Data from our hospital bewtween 3/1 and 5/15/2020 shows the mortality rates of patients with HIV and COVID-19 co-infection with AKI and COVID patients without HIV who developed AKI are not statiscally different, but significantly higher than patients with HIV who developed AKI.
ABSTRACT
Background: We are an inner-city hospital in New York that had a surge of patients diagnosed with COVID-19. Many of these patients had acute kidney injury (AKI) and required renal replacement therapy (RRT). NYC Health + Hospitals/Kings County has 40 adult intensive care unit (ICU) beds. ICU capacity expanded to a potential of 150 beds during the COVID-19 surge. The surge included patients transferred from other NY innercity hospitals for critical care and RRT. Sequential obstacles were faced in providing hemodialysis (HD) to this expanded pool of AKI patients. Additional machines, supplies, staffing and organization were helpful. Clinicians noted that COVID-19 complications included hypercoaguability and we observed an increased frequency of clotting of hemodialysis catheters (HDC). Methods: We examined the percentage COVID-19 tested renal failure patients with clotting of HDC access during the period March 1, 2020 to May 15, 2020. We collected data on 146 patients during the above period who had HD. We then compared those who were COVID-19+ positive confirmed by testing to those who were not COVID-19+ by testing. HDC clotting was identified by the use of alteplase. We compared our findings of the two groups to historical controls during a similar time period prior to the COVID-19 surge, between January 1 to February 29, 2020. Results: We had 3,665 admissions between March 1 and May 15, 2020, of which 1,075 patients had a confirmed COVID + test during the admission. Of these, 773 patients were noted to have AKI from diagnosis codes in the electronic medical record. Of the146 patients who needed HD (including patients with AKI and CKD) 97 were COVID-19+ and 49 were negative. HDC clotting identified by the use of alteplase was noted in 27% of those who were COVID-19 + compared to 10% of those who were COVID-19 negative. (P value= 0.02 by Chi-square using SPSS Version 24). The percentage of patients with clotting of catheters in the non-COVID-19 group was comparable to historical controls. Conclusions: Significantly more COVID-19+ patients had HD catheter clotting compared to non-COVID-19 patients. Increased clotting was noted as a barrier to providing optimal HD therapy. For this and other reasons, we initiated an urgent start acute peritoneal dialysis program to mitigate the challenges in delivering HD to COVID-19 patients.