The impact of oxygen supply flow rates on the distribution of aerosols between the patient and the surgeon during lung intubation

The outbreak of COVID-19 has caused a worldwide pandemic. The widespread infection of the medical staff has caused great attention from all quarters of society. There is a particular concern when considering intubation treatment in the emergency operating room, where a significant amount of virus droplets are typically spread within the room, exposing the medical staff to a high risk of infection. Hence, there is currently a pressing need to develop an effective protection mechanism for the medical staff to prevent them from being infected during routine work. In order to understand the spread of droplets and aerosols when different oxygen supply devices are used for intubation therapy, this study uses particle image velocimetry (PIV) technology to analyze the airflow distribution between the medical staff and the patient. In the experiment, a simple version of the respirator was established to reproduce the breathing of human lungs. This model used oil to create smoke as a tracer aerosol, then a high-sensitivity camera was used to record the scattering light from this smoke (which is irradiated by the green laser sheet). Ultimately, after applying post-processing techniques, the airflow distribution is analyzed. PAO aerosol is the primary aerosol source in this experiment, and it is used to quantify the patient's breathing;the concentration of PAO aerosol was measured at three different points: head, trunk, and feet. In addition, flow field visualization can effectively present the flow field distribution of the entire operating room;also, the results can be mutually verified with the PAO concentration measurement results. Aerosol concentrations were measured for six different oxygen supply devices with various tidal volumes of the artificial respirator, and the results were ranked from high to low concentrations for different oxygen supply devices and their operational oxygen supply flowrates: HFNC (70 l/min) > CPAP (40 l/min) > HFNC (30 l/min) > nasal cannula (15 l/min) > NRM (15 l/min) > VAPOX (28 l/min). © 2022, The Author(s).

HCV core antigen and residual HCV RNA in the native liver of living donor liver transplant recipients with chronic hepatitis C

Background: With the highly effective direct-acting antiviral (DAA) therapy, the number of liver transplants for hepatitis C virus (HCV) has decreased worldwide. However, similar to the phenomenon occurring in COVID-19 infection, the residual virus reservoirs in target organ is warranted to be explored due to the potential replication and disease recurrence. Hence, we aim to investigate the significance of hepatic HCV RNA identification as well as the discrepancy between HCV RNA and HCV core antigen (HCV Ag) in native liver of chronic hepatitis C recipients undergoing living donor liver transplantation (LDLT). Methods: Between Feb 2016 to Aug 2019, we prospectively enrolled 80 serum anti-HCV positive recipients who underwent LDLT. HCV RNA extracted from the native liver tissues was subjected to one-step reverse transcribed qPCR, using the TopScript One Step qRT PCR Probe Kit with HCV qPCR probe assay and human GAPDH qPCR probe assay on ViiA 7 Real Time PCR System. Hepatic HCV Ag was identified from the native liver tissues by employing the qualitative enzyme immunoassay technique. All experimental steps were based on the protocol provided by Human HCV Ag ELISA Kit (Cat. No. MBS167758). Results: Among 80 recipients, 85% (68/80) positive HCV-RNA was significantly higher in the native liver tissues than in the serum before (29/80, 36.3%;p = 0.000) and after LDLT (3/80, 4.4%;p = 0.000). In contrast, hepatic HCV Ag was 100% negative identified in all 80 explanted native liver. Conclusions: Significant positive HCV-RNA identification in the native liver suggested that pre-LDLT serum HCV RNA should be underestimated in the real status of HCV activity. HCV Ag assay may have lack of sensitivity and negative predictive value in liver tissues. In contrast to serum HCV RNA and HCV Ag, a great discrepancy might be described between hepatic HCV RNA and HCV Ag in the liver tissue. (Figure Presented).

Development of Ultrapure and Potent Tannic Acids as a Pan-coronal Antiviral Therapeutic

The rampageous transmission of SARS-CoV-2 has been devastatingly impacting human life and public health since late 2019. The waves of pandemic events caused by distinct coronaviruses at present and over the past decades have prompted the need to develop broad-spectrum antiviral drugs against them. In this study, our Pentarlandir ultrapure and potent tannic acids (UPPTA) showed activities against two coronaviral strains, SARSCoV-2 and HCoV-OC43, the earliest-known coronaviruses. The mode of inhibition of Pentarlandir UPPTA is likely to act on 3-chymotrypsin-like protease (3CLpro) to prevent viral replication, as supported by results of biochemical analysis, a 3CLpro assay, and a "gain-of-function" 3CLpro overexpressed cell-based method. Even in the 3CLpro overexpressed environment, Pentarlandir UPPTA remained its antiviral characteristic. Utilizing cell-based virucidal and cytotoxicity assays, the 50% effective concentrations (EC50) and 50% cytotoxicity concentration (CC50) of Pentarlandir UPPTA were determined to be similar to 0.5 and 52.5 mu M against SARS-CoV-2, while they were 1.3 and 205.9 mu M against HCoV-OC43, respectively. In the pharmacokinetic studies, Pentarlandir UPPTA was distributable at a high level to the lung tissue with no accumulation in the body, although the distribution was affected by the food effect. With further investigation in toxicology, Pentarlandir UPPTA demonstrated an overall safe toxicology profile. Taking these findings together, Pentarlandir UPPTA is considered to be a safe and efficacious pancoronal antiviral drug candidate that has been advanced to clinical development.

SARS-CoV-2-specific antibodies and neutralization capacity in breast milk following infection vs vaccination.

Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies have been found in breast milk following both natural SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) vaccination. This was a prospective study to evaluate the temporal changes in amount and neutralization capacity of anti-SARS-CoV-2 antibodies in breast milk stimulated by natural infection and by vaccination. Serial breast milk samples were collected from postnatal women who were recruited through convenience sampling. We found a rapid increase in neutralizing SARS-CoV-2-specific antibodies in breast milk from both study groups. Amongst the infection group, the median immunoglobulin A (IgA) level was 16.99 (range, 0-86.56) ng/mL and median binding capacity was 33.65% (range, 0-67.65%), while in the vaccination group these were 30.80 (range, 0-77.40) ng/mL and 23.80% (range, 0-42.80%), respectively. In both groups, both binding capacity and IgA levels decreased progressively over time after peaking. Neutralizing activity had become undetectable by about 150 days after the first dose of the vaccine, but a vaccine booster dose restored secretion of neutralizing IgA, albeit with different levels of response in different individuals. This highlights the importance of the vaccine booster dose in sustaining neutralizing antibody levels in breast milk, which may potentially provide protection for very young children, who cannot receive the COVID-19 vaccine. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

Strategic coupling and institutional innovation in times of upheavals: the industrial chain chief model in Zhejiang, China

For regions that are deeply integrated into the global economy, the question of how to remain competitive and resilient in times of uncertainty is a key concern. While strategic coupling is a useful concept for understanding local-global economic dynamics, the idea that a region can simultaneously couple into multiple production networks organised at different spatial scales and that regional actors can increase their autonomy by creatively combining different coupling scenarios has been little explored. This paper explores how regional institutional innovations can facilitate such multiple couplings. We focus on the industrial chain chief model in China's Zhejiang province, which emerged against the backdrop of the U.S.-China trade war and the COVID-19 pandemic. We argue that this institutional innovation offers a different way of thinking for regions that have long been exposed to the influence of globalisation, and that it increases the agency of local actors in global production networks.

Traditional Chinese medicine as a tourism recovery drawcard to boost China's inbound tourism after COVID-19

Purpose: This paper explores the role of traditional Chinese medicine (TCM) as a tourism recovery drawcard to boost China's inbound tourism after COVID-19. Design/methodology/approach: This paper employed a mixed method involving a cross-disciplinary literature review along with reflections from experts in TCM and health communication to inform tourism management. Specifically, this paper examines TCM and its potential benefits as a medical tourism drawcard to combat COVID-19. The selected literature focusses on the image and merits of TCM to frame how this medical philosophy can be used to position China as a tourist destination. Reflections on the use of TCM as a tourism marketing tool can guide promotional strategies from the Chinese government and destination managers during and after COVID-19. Findings: The Chinese government, the tourism industry (e.g. destination managers), the media and tourists must focus on three aspects of the role of TCM: to provide medical benefits to travellers amid COVID-19 and beyond, elevate China as a destination for global medical tourists and be leveraged as a tool for economic recovery. Practical implications: The paper builds a tourism recovery framework for stakeholders to adopt tailored TCM communication strategies to boost its inbound tourism programme. Originality/value: This paper is the first academic paper to review TCM comprehensively and critically in relation to China tourism and post-COVID-19 recovery measures. © 2021, Emerald Publishing Limited.

Relationship between viral load, infection-to-delivery interval and mother-to-child transfer of anti-SARS-CoV-2 antibodies.

OBJECTIVE: To investigate the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load and infection-to-delivery interval with maternal and cord serum concentrations of anti-SARS-CoV-2 immunoglobulin G (IgG) antibodies and transplacental transfer ratio in pregnant women with active or recovered SARS-CoV-2 infection. METHODS: This was a prospective case series of consecutive pregnant women with laboratory-confirmed SARS-CoV-2 infection between 27 March 2020 and 24 January 2021. We collected information regarding deep throat saliva or nasopharyngeal swab (NPS) reverse transcription polymerase chain reaction (RT-PCR) test results, serial cycle threshold (Ct) values at and after diagnosis, demographic, clinical and outcome data, and neonatal NPS RT-PCR results. Qualitative and quantitative analysis of IgG and immunoglobulin M (IgM) antibodies against SARS-CoV-2 was performed in maternal and cord blood serum samples obtained at delivery. Correlation of maternal Ct values, infection-to-delivery interval, infection duration and viral load area under the curve (AUC) with gestational age (GA) at diagnosis, maternal and cord serum IgG concentrations and transplacental transfer ratio of IgG were evaluated using Pearson's correlation. RESULTS: Twenty pregnant women who consented to participate and who had delivered their babies by 31 January 2021 were included in the study, comprising 14 who had recovered from coronavirus disease 2019 (COVID-19) and six with active infection at delivery. The median GA at clinical manifestation was 32.7 (range, 11.9-39.4) weeks. The median infection-to-delivery interval and infection duration were 41.5 (range, 2-187) days and 10.0 (range, 1-48) days, respectively. The median GA at delivery was 39.1 (range, 32.4-40.7) weeks and the median seroconversion interval was 14 (range, 1-19) days. Of 13 neonates born to seropositive mothers with recovered infection at delivery, 12 tested positive for anti-SARS-CoV-2 IgG. All neonatal NPS samples were negative for SARS-CoV-2 and all cord sera tested negative for IgM. The median transplacental transfer ratio of IgG was 1.3 (interquartile range, 0.9-1.6). There was a negative correlation between infection-to-delivery interval and anti-SARS-CoV-2 IgG concentrations in maternal (r = -0.6693, P = 0.0087) and cord (r = -0.6554, P = 0.0068) serum and a positive correlation between IgG concentration in maternal serum and viral load AUC (r = 0.5109, P = 0.0310). A negative correlation was observed between transfer ratio and viral load AUC (r = -0.4757, P = 0.0409). CONCLUSIONS: In pregnant women who have recovered from COVID-19, anti-SARS-CoV-2 IgG concentrations at delivery increased with increasing viral load during infection and decreased with increasing infection-to-delivery interval. The median transplacental transfer ratio of IgG was 1.3 and it decreased with increasing viral load during infection. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.