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SARS-CoV-2 is a new threat to public health due to its increased transmissibility and immune evasion. Angiotensin-converting enzyme 2 (ACE2) plays a critical role in SARS-CoV-2 infection as its serve as the virus's major entry receptor in humans. Vaccines have been authorized for emergency use to control the current pandemic and they have greatly reduced the spread of SARS-CoV-2 and mortality rates, nevertheless this coronavirus has shown the ability to endure crucial mutations that increases its infectivity which makes it likely that the virus will continue to mutate and disseminate. There is a need to find and introduce alternative and effective methods of controlling SARS-CoV-2. Notably, low-level laser therapy (LLLT) is a method of exposing cells or tissue to low levels of red and near infrared light which has a high success rate for treatment of other ailments. The aim of the study is to determine for the first time, the effects of LLLT on SARS-CoV-2 infected HEK293/ACE2 cells and compare them to uninfected ones. Both infected and uninfected HEK293/ACE2 cells were irradiated at a wavelength of 640 nm, at different doses. Then, the effects of laser irradiation on the cells and the virus were evaluated using luciferase, cytotoxicity, and cell viability assays. Preliminary results showed that irradiated uninfected cells had no changes in cell viability and cytotoxicity, while there were changes in irradiated infected cells. In addition, laser irradiation caused cell membrane damage in infected cells. Lastly, uninfected irradiated cells showed no luciferase activity while laser irradiation reduced luciferase activity in infected cells. © 2023 SPIE.
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This paper examines the relevance of the use of a single irradiation of lungs in treatment of pneumonia caused by a new coronavirus infection. Clinical observations are presented that demonstrate perspectives in the treatment of this disease. Patients with severe pneumonia who were prescribed LD-RT (low-dose radiation therapy) at a dose of 0.5-1.5 Gy showed shorter recovery times and no complications. This method of treatment has shown its effectiveness in a number of studies from different countries, predicting success and economic benefits in its further use and study. A literature search containing information on relevant studies was carried out in PubMed, EMBASE, Web of Science and Google Scholar systems. Attention was focused on full-text articles given their general availability in a pandemic.Copyright © 2021 VIDAR Publishing House. All right reserved.
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Objective: To explore the clinical characteristics of nucleic acid negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicron variant BA. 5.1.3) in Sanya area, and to provide evidence for understanding its clinical characteristics. Methods: A retrospective analysis was performed on 14 neonates with negative nucleic acid delivered by pregnant women who tested positive for SARS-CoV-2 (Omicron variant BA.5.1.3) in Sanya Central Hospital (the Third People's Hospital of Hainan Province) from June 2022 to September 2022 (observation group, n=14). The corresponding nucleic acid-negative newborns delivered by pregnant women detected negative with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) were set as the control group (n=56), and the general data and clinical characteristics of neonates in the two groups were compared. Results: There was no significant difference between the observation group and the control group in pregnancy diabetes, pregnancy induced hypertension, gestational pre-eclampsia, fetal intrauterine distress, premature rupture of membranes (P > 0.05);there was no significant difference between the observation group and the control group in terms of sex, gestational age, birth weight, age, mode of delivery, birth Apgar score, heart screening, pulmonary disease, glucose 6-phosphate dehydrogenase (G6PD) deficiency, thalassemia, breast milk jaundice, hemolytic jaundice (P > 0.05). The bilirubin level, blue light irradiation cases and the duration of blue light irradiation of the newborns in the observation group at 7 days after birth were higher than those in the control group (P < 0.05);the ratio of blood oxygen saturation 90% in the observation group was lower than that in the control group (21.43% vs 89.29%, P < 0.05), and the ratio of blood oxygen saturation occasionally<90% was higher than that in the control group (57.14% vs 10.71%, P < 0.05). The ratio of blood oxygen saturation<90% had no significant difference compared with that in the control group (7.14% vs 0, P > 0.05), and the ratio of blood oxygen saturation reduced to the required oxygen uptake was higher than that in the control group (14.29% vs 0, P < 0.05). Conclusions: The jaundice manifestation of the nucleic acid-negative newborns delivered by pregnant women infected with SARS-CoV-2 (Omicronon variant strain BA.5.1.3) in Sanya area is relatively obvious, with blood oxygen saturation easily lower than 90% and even requiring oxygen inhalation in severe cases.
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BACKGROUND/AIM: A recommendation of radiotherapy for patients with malignant gliomas may trigger emotional distress. Frequency and risk factors of this complication were investigated. PATIENTS AND METHODS: Prevalence of six emotional problems and 11 potential risk factors were evaluated in 103 patients irradiated for grade II-IV gliomas. p-Values <0.0045 were considered significant. RESULTS: Seventy-six patients (74%) had ≥1 emotional problem. Prevalence of specific emotional problems ranged between 23% and 63%. Associations were found between ≥5 physical problems and worry (p=0.0010), fear (p=0.0001), sadness (p=0.0023), depression (p=0.0006), and loss of interest (p=0.0006), and Karnofsky performance score ≤80 and depression (p=0.0002). Trends were found for physical problems and nervousness (p=0.040), age ≥60 years and depression (p=0.043) or loss of interest (p=0.045), grade IV glioma and sadness (p=0.042), and ≥2 involved sites and loss of interest (p=0.022). CONCLUSION: Three-fourths of glioma patients had pre-radiotherapy emotional distress. Psychological support should be offered very soon, particularly for high-risk patients.
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Brain Neoplasms , Glioma , Psychological Distress , Humans , Middle Aged , Brain Neoplasms/radiotherapy , Brain Neoplasms/pathology , Glioma/radiotherapy , Glioma/pathology , Radiotherapy Dosage , Risk FactorsABSTRACT
Microbial contamination of indoor air in public spaces plays an important role in the SARSCoV-2 pandemic. So far, most studies on the reduction of airborne microbial load by UVC irradiation have been conducted as simulations or in laboratory environments. The aim of our study is to demonstrate the efficiency of Upper-Room Ultraviolet Germicidal Irradiation (UVGI) in a real environment like a supermarket. Restrictions on the use of harmful SARSCoV-2 particles for testing in public areas could be circumvented by using airborne germs as indicators. The results of this study show significant germ (bacterial and fungal) reductions by use of UVGI during business hours in a supermarket. Referring to known susceptibility values of airborne germs from previous work, we were able to estimate the effectiveness of the UVGI-system used against corona viruses. It met the requirements for complete disinfection. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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This study investigated upper-room germicidal ultraviolet (UR-GUV) light application in a music rehearsal room with a high ceiling (7.5 m). The focus was on the influences of the elevation and height of UV zone on disinfection of airborne viruses. This study assumed a uniform UV fluence rate of 0.2 W/m2 in the UV irradiation zone. According to the Computational Fluid Dynamics (CFD) results, average viral concentrations (Ca), fraction remaining (FR), and equivalent air exchange rate (λe) attributed to GUV, have power relationships with UV zone height. Ca and FR decreased with UV zone height, while λe did the opposite. UV zone elevation showed little influence on UR-GUV performance, indicating well-mixed air in the rehearsal room. High ceiling makes it possible to achieve adequate UV dose by increasing both UV zone height and UV light intensity. Using open fixtures improved energy efficiency and reduced operational costs of the UR-GUV system. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.
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Objective To systematically evaluate the efficacy of low dose whole-lung irradiation in COVID-19 pneumonia based on the present evidence. Methods All literature related to the application of low dose whole-lung irradiation in COVID-19 pneumonia were retrieved from Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar, Scoupus, CNKI, Wanfang database, VIP database until May 2022. Two researchers independently screened the literature. For the literature that met the inclusion criteria, both data extraction and literature quality evaluation were blinded. Revman 5.3 software was used for statistical analysis. Results A total of 5 controlled clinical trials involving 194 patients met the inclusion criteria. No statistically significant differences were detected in the low dose whole-lung irradiation group compared with the best supportive care group for clinical recovery rates, intubation rates, radiographic improvement rates and 28 d-overall survival. Conclusions In patients of COVID-19 pneumonia, low dose whole-lung irradiation conferred no significant benefit to clinical outcomes. Currently, the routine use of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia is not recommended.Copyright © Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.
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Background: Cyclophosphamide (Cy) is used in hematopoietic stem cell transplant (HSCT) preparative regimens and lymphodepletion for chimeric antigen receptor T-cell (CAR-T) therapy. We describe a case of cyclophosphamide hypersensitivity in a pediatric patient during CAR-T therapy. Case description: A 13 year old boy was diagnosed with very high risk ALL in 2015 and had 2 isolated CNS relapses treated with intensified chemotherapy (chemo) and cranial radiation (1st relapse) and Blinatumomab with intrathecal (IT) chemo followed by sibling donor HSCT (2nd relapse). At age 19, and 18 months after HSCT, he had a 3rd CNS relapse treated with IT chemo and referral for CAR-T therapy. At our center, leukapheresis and CAR-T production (Novartis) were performed. Later, during lymphodepletion with fludarabine (Flu) and Cy, physiologic replacement hydrocortisone (HC) was briefly held to prevent interference with CAR-T function. After 3 days of Flu/Cy, he developed fever and hypotension requiring inotropic support. Hypotension and fever resolved with stress dose HC and antibiotics and was attributed to culture-negative sepsis and adrenal crisis. CAR-T infusion was subsequently delayed by skin GVHD requiring glucocorticoids and COVID-19 infection treated with convalescent plasma and nirmatrelvir/ritonavir. Physiologic HC replacement was continued when he was re-admitted for CAR-T therapy, but he again developed fever, diffuse erythema and shock in hours following the first dose of Cy necessitating stress dose HC, antibiotics, inotropes, and mechanical ventilation. Negative blood cultures and ongoing physiologic HC replacement suggested an alternative explanation for shock. Case reports of anaphylaxis to Cy metabolites implicated Cy as the causative agent so it was discontinued. After recovery, CAR-T cells were infused without complications. In the following weeks, he had no evidence of recurrent leukemia but was persistently pancytopenic. A sibling donor stem cell boost was proposed but the patient accepted only palliative care. He had several opportunistic infections before succumbing to E. coli sepsis. Discussion(s): The first episode of shock was initially attributed to adrenal crisis and sepsis, although no organism was identified. The second episode appeared anaphylactic in timing and clinical presentation with adequate HC replacement and negative cultures, suggesting Type I hypersensitivity. The patient previously received Cy uneventfully before HSCT, suggesting that the donor-derived immune system was the source of new Cy hypersensitivity. Onset of anaphylaxis within hours rather than minutes after Cy administration supports hypersensitivity to Cy metabolites rather than to the drug itself. This case highlights the importance of consideration of sensitivity to Cy metabolites as well as acquired donor-specific allergy even when alternative explanations are likely.Copyright © 2023 American Society for Transplantation and Cellular Therapy
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UV-LED irradiation has attracted attention in water and wastewater disinfection applications. However, no studies have quantitatively investigated the impact of light intensity on the UV dosage for the same magnitude of disinfection. This study presents a powerful 280 nm UV-LED photoreactor with adjustable light intensity to disinfect municipal wastewater contaminated with E. coli, SARS-CoV-2 genetic materials and others. The disinfection performance of the 280 nm LED was also compared with 405 nm visible light LEDs, in terms of inactivating E. coli and total coliforms, as well as reducing cATP activities. The results showed that the UV dose needed per log reduction of E. coli and total coliforms, as well as cATP, could be decreased by increasing the light intensity within the investigated range (0–9640 µW/cm2). Higher energy consumption is needed for microbial disinfection using the 405 nm LED when compared to 280 nm LED. The signal of SARS-CoV-2 genetic material in wastewater and the SARS-CoV-2 spike protein in pure water decreased upon 280 nm UV irradiation. © 2023 by the authors.
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222-nm Far-UVC light is an emerging and promising tool for rapidly inactivating airborne pathogens. In this study, we experimentally evaluated the performance of a 222-nm Far-UVC upper-room disinfection system with a 15 W Far-UVC lamp in a full-scale chamber (11.9 m3). One gram-positive bacteria, namely Staphylococcus epidermidis and two gram-negative bacteria, namely Escherichia coli and Salmonella enterica were selected for the experiments. The aerosolized bacteria were injected into the chamber and exposed to 222-nm Far-UVC light. The first-order decay rates of indoor bioaerosols concentration with and without Far-UVC treatment were estimated. According to the results, the 222-nm Far-UVC induced decay rates of three bacteria were 0.0611 ± 0.003, 0.409 ± 0.048, and 0.474 ± 0.015 min−1, respectively. Besides, the UV susceptibility constants (Z-values) of these three bacteria were estimated as 0.157, 0.974, and 1.18 m2/J, respectively. The gram-positive bacteria, S. epidermidis, showed higher resistance to Far-UVC light as compared to the gram-negative bacteria, E. coli and S. enterica. In addition, a case study on airborne SARS-CoV-2 indoor transmission was simulated, and the infection risk of SARS-CoV-2 was compared using the Far-UVC and enhanced ventilation approaches. The results showed that both UV inactivation and ventilation approaches can significantly reduce the infection risk. More importantly, the Far-UVC may be a feasible and sustainable solution for reducing infection risk and improving indoor air quality. © 2023 Elsevier Ltd
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Nonpharmacological approaches can be useful to control infectious diseases. Historically infection has been successfully managed with oxidation therapy methods that support the body's own innate defenses. Several modalities include ozone and hyperbaric oxygen therapy, ultraviolet blood irradiation (UBI), intravenous hydrogen peroxide, and ascorbate therapies. Oxidation therapies are virtually 100% safe, and repeatedly reported as highly and quickly effective in quelling infection (bacterial and viral) either as stand-alone therapies or adjunctive with drugs. They are directly and indirectly germicidal, and modulate the immune system via pro-oxidant signaling molecules. Oxidation therapies especially enhance oxygen delivery and metabolism, critical for all infection defenses. Ozone has remitted Ebola, COVID-19, and bacterial infections. UBI defeated most preantibiotic era infections in hospitals. Not being drug therapy, the effects of oxidation defenses, used by planetary animal life for millions of years, are not diminished by antibiotic-resistant organisms. Oxidation, depending on delivery method, can be very inexpensive and third world adaptable. This chapter summarizes the use of these key modalities, by exploring known published literature. © 2022 Elsevier Inc. All rights reserved.
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INTRODUCTION: Many landmark trials have challenged the need for extensive axillary surgery and radiation in breast cancer patients. De-escalation of axillary treatment could potentially result in less breast cancer-related lymphedema (BCRL). Our study aims to define the incidence and trends of BRCL over the last 15 years. METHOD(S): Since 2005, our institution has prospectively screened breast cancer patients for lymphedema during and after treatment with a Perometer. 2,334 women diagnosed with breast cancer with baseline arm volume measurements and at least 2 follow-up measurements were divided into 3 cohorts based on date of surgery (Cohort 1: 2005-2010, Cohort 2:2011-2016, Cohort 3: 2016-2022). The cohorts were selected to coincide with publications of the landmark trials NSABP B-32, ASCOG Z0011, ASCOG Z1071, and EORTC 10981-22023 AMAROS which demonstrated safety in reducing the number of axillary lymph node dissections (ALND). Lymphedema was defined as a relative volume change of 10% or greater from preoperative baseline at least 3 months post-operatively. In cases of bilateral surgery, the weight-adjusted arm volume change equation was utilized. Cohort, age, BMI, axillary surgery type, chemotherapy timing, radiation type, and surgery type were all included in the multivariate analysis. RESULT(S): The overall incidence of BCRL was 12.8%, with a 29.6% incidence for those undergoing ALND and a 6.4% incidence for those undergoing sentinel lymph node biopsy. While the number of ALND performed decreased between cohorts (Figure 1), there was no significant difference in BCRL between assigned cohorts (HR 1.02 (95% CI [0.69, 1.51], p=0.930 for cohort 3 vs cohort 1). On multivariate analysis, significant associations with development of BCRL were identified with older age (HR 1.02;95% CI [1.01, 1.03], p=0.002), higher BMI (HR 1.05;95% CI [1.04, 1.07], p< 0.0001) and ALND (HR increased the risk of (HR 3.67;95% CI [2.62, 5.13], p< .0001). Regional lymph node radiation was not significantly associated with BCRL. CONCLUSION(S): Despite a reduction in the number of ALND performed over time, we did not see a dramatic reduction in the incidence of BCRL. Interestingly, between cohort 2 and cohort 3 there was a stable incidence of ALND which could be related to the COVID pandemic with an increase in more advanced cancers and a decrease in the ability to screen patients for BCRL during that time period.
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Escherichia coli O157:H7 is a major cause of foodborne disease outbreaks throughout the world, while methicillin-resistant Staphylococcus aureus (MRSA) is responsible for many difficult-to-treat infections in humans. Ultraviolet (UV) irradiation is commonly used for disinfection in food processing, medical facilities, and water treatment to prevent the transmission of these pathogen. With increased use of UV disinfection technologies over the last few years because of COVID-19 and concerns about other communicable disease, it has become a concern that microbial species could develop tolerance to UV irradiation, especially when it is applied continuously. To elucidate the effect of continuous UV exposure at different wavelengths and power levels on the tolerance development of bacteria, Escherichia coli O157:H7 and MRSA)USA300 growths were investigated by continuously exposing inoculated agar plates to six different commercially available UV sources at wavelengths of 222 nm, 254 nm, 275 nm, and 405 nm. The agar plates in these experiments were partially covered by a thin acrylic sheet, which provided either complete protection from the UV to the cells directly under the sheet, no protection if significantly away from the sheet, or partial protection near the edges of the sheet due to shading or small amounts of UV reflection under the sheet at the edges. In these experiments, tolerant cells of E. coli and S. aureus were found from the 222 nm, the 405 nm, and one of the 254 nm sources. Upon examination of the power of each UV source, it was shown that the 275 nm and 254 nm sources that resulted in no tolerant cells had surface power densities [at 25 cm (10 in.)] that were more than 10-200 times greater than those that had tolerant cells. These results suggests that bacterial cells have a higher chance to develop UV tolerance under lower power UV sources (under the experimental conditions in our laboratory). Genome investigation of the tolerant colonies revealed that there are no significant differences between the cells that developed tolerance and the original organism, hinting at the need to explore the role of epigenetics mechanisms in the development of UV tolerance in these bacteria. © 2023 American Society of Civil Engineers.
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Existing indoor closed ultraviolet-C (UVC) air purifiers (UVC in a box) have faced technological challenges during the COVID-19 breakout, owing to demands of low energy consumption, high flow rates, and high kill rates at the same time. A new conceptual design of a novel UVC-LED (light-emitting diode) air purifier for a low-cost solution to mitigate airborne diseases is proposed. The concept focuses on performance and robustness. It contains a dust-filter assembly, an innovative UVC chamber, and a fan. The low-cost dust filter aims to suppress dust accumulation in the UVC chamber to ensure durability and is conceptually shown to be easily replaced while mitigating any possible contamination. The chamber includes novel turbulence-generating grids and a novel LED arrangement. The turbulent generator promotes air mixing, while the LEDs inactivate the pathogens at a high flow rate and sufficient kill rate. The conceptual design is portable and can fit into ventilation ducts. Computational fluid dynamics and UVC ray methods were used for analysis. The design produces a kill rate above 97% for COVID and tuberculosis and above 92% for influenza A at a flow rate of 100 L/s and power consumption of less than 300 W. An analysis of the dust-filter performance yields the irradiation and flow fields.
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Objective To systematically evaluate the efficacy of low dose whole-lung irradiation in COVID-19 pneumonia based on the present evidence. Methods All literature related to the application of low dose whole-lung irradiation in COVID-19 pneumonia were retrieved from Pubmed, Embase, the Cochrane Library, Web of Science, Google scholar, Scoupus, CNKI, Wanfang database, VIP database until May 2022. Two researchers independently screened the literature. For the literature that met the inclusion criteria, both data extraction and literature quality evaluation were blinded. Revman 5.3 software was used for statistical analysis. Results A total of 5 controlled clinical trials involving 194 patients met the inclusion criteria. No statistically significant differences were detected in the low dose whole-lung irradiation group compared with the best supportive care group for clinical recovery rates, intubation rates, radiographic improvement rates and 28 d-overall survival. Conclusions In patients of COVID-19 pneumonia, low dose whole-lung irradiation conferred no significant benefit to clinical outcomes. Currently, the routine use of low dose whole-lung irradiation for the treatment of moderate to severe COVID-19 pneumonia is not recommended.Copyright © Chinese Medical Journals Publishing House Co.Ltd. All Rights Reserved.
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The Covid-19 epidemic has been the most consequential global health crisis since the era of the influenza pandemic of 1918 [1]. Due to its high spreading rate, the virus disseminated across the world in a very short time span, forcing the World Health Organization to declare Covid-19 a global pandemic after just 3 months from the first reported case in China. At the beginning of the pandemic, when no vaccines were available, people entrust their safety to very few devices such as personal protective equipment (face masks, shields, and gloves), lock-down, and social distancing. The lack of alternative and not conventional techniques to suppress the spread of airborne epidemics among humans has pushed the research to develop new antiviral devices. The SAVE-US project (Suppression of Airborne Viral Epidemic Spread by UV-Light Barriers) aims at developing and demonstrating an innovative antimicrobial device based on 222nm-radiation. As known from the literature, the UVC radiation (200-280 nm) is the most effective wavelength for the inactivation of viruses and bacteria, corresponding to the DNA and RNA absorption peaks, but may also be mutagenic. For this reason, UVC-light sterilization is commonly performed in the absence of living organisms. Radiation in the far-UVC, especially at 222 nm, has been recently investigated because it shows a good antimicrobial efficacy, tested already on both bacteria [2] and virus [3] models including coronavirus, with very limited risks to human health. The low risk is associated to the small penetration depth of 222 nm light (a few mum): the energy is absorbed by the superficial stratum corneum of the skin that contains dead cells, with negligible irradiation of the underlying live tissue [4]. We will present the first version of a new prototype of 222 nm-illuminator and some preliminary results on its characterization;the presented device will be used in successive in vitro and in vivo experiments with SARS-CoV-2 virus. The device embeds a far-UVC lamp emitting at 222 nm, optical filters, and the controlling electronics. We show results on the spatial homogeneity of the emission intensity and the dependence on the lamp-virus distance. We also report on the ozone production due to absorption of far-UVC light from molecular oxygen naturally present in the air in order to evaluate its safety for human being and to properly evaluate its photo-killing efficacy.Copyright © 2023
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Atmospheric water harvesting (AWH) is a potentially promising small-scale approach to alleviate the water crisis in arid or semiarid regions. Inspired by the asymmetric structure of tillandsia leaves, a plant species native to semiarid regions, we report the development of a bioinspired composite (BiC) to draw moisture for AWH applications. With the advent of the post-COVID era, the nonwoven materials in used masks are discarded, landfilled, or incinerated along with the masks as medical waste, and the negative impact on the environment is inevitable. The nonwoven sheet has porosity, softness, and certain mechanical strength. We innovatively developed BiCs, immobilizing hygroscopic salt with a nonwoven mask for fast vapor liquefaction and using a polymer network to store water. The resulting BiC material manages to achieve a high-water adsorption capacity of 1.24 g g-1 under a low-moderate humidity environment and a high-water release ratio of ca. 90% without the use of photothermal materials, while maintaining high structural integrity in cyclic testing. © 2023 American Chemical Society.
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Ferrate (Fe(VI), FeO42-) has been widely used in the degradation of micropollutants with the advantages of high redox potential, no secondary pollution and inhibition of disinfection byproducts. However, the low transformation of Fe(V) and/or Fe(IV) by Fe(VI) and incomplete mineralization of pollutants limit their application. In this work, we designed a photo electric cell with TiO2 nanotubes (TNTs) and Pt serving as the anode and cathode to enhance the utilization of Fe(VI) (Fe(VI)-TNTs system). TNTs accelerated the generation of â¢OH via hVB+ oxidation of OH- and photogenerated electrons at Pt boosted the transformation of Fe(VI) to Fe(V) and/or Fe(IV), resulting in a 22.2 % enhancement of chloroquine (CLQ) removal compared to Fe(VI) alone. The results from EPR and quenching tests showed that Fe(VI), Fe(V), Fe(IV), â¢OH, O2â¢- and hVB+ coexisted in the Fe(VI)-TNTs system, among which Fe(V) and Fe(IV) were testified as the primary reactive substances accounting for 59 % of CLQ removal. The performance tests and recycling tests demonstrated that the Fe(VI)-TNTs system maintained excellent performance in an authentic water environment. The plausible degradation pathway of CLQ oxidized in the Fe(VI)-TNTs system was proposed with nine identified oxidation products via N-C cleavage, electrophilic addition and carboxylation processes. Based on the ECOSAR calculation, the constructed reaction system allowed a decrease in acute and chronic toxicity. Our findings provide a highly efficient and cost-effective strategy to enhance Fe(VI) application for micropollutant degradation in the future.