CRYSTAL: A novel and effective method to remove clouds in daily nighttime light images by synergizing spatiotemporal information

Satellite nighttime light (NTL) images offer a valuable depiction of the rapidly changing world by revealing the presence of artificial illumination. Thus, daily NTL images are increasingly applied to monitor human dynamics and environmental events. However, data gaps caused by cloud contamination and low-quality observations inevitably impair the effectiveness of such applications. Although a temporal gap-filling method is employed in recent Black Marble NTL products to produce seamless images, the filled images are unsuitable for quantitative analysis. Therefore, we developed an effective method, named as Cloud Removing bY Synergizing spatio-TemporAL information (CRYSTAL), to generate cloud-free NTL images with satisfactorily accurate pixel brightness and spatial continuity. Simulation experiments show that CRYSTAL can produce more accurate results than the temporal gap-filling method in fifteen cities worldwide, with an average RMSE reduction of 33.69%. Images generated by CRYSTAL restore temporal variances in NTL and are thus suitable for multi-temporal quantitative analysis. CRYSTAL can reconstruct daily NTL time series by filling gaps using available partially clear images. Experiments in two cities demonstrated that the reconstructed time series had 31.85% more valid values than the original time series and effectively revealed urban dynamics during the early stages of the coronavirus disease 2019 pandemic. In summary, CRYSTAL is a novel and effective gap-filling method for the restoration of invalid NTL observations and has the potential to generate high-quality NTL data for use in future applications.

Using Absorbable Suture For Traumatic Wound Closure To Avoid Additional Hospital Visit For Suture Removal During The Covid 19 Pandemic: A Randomized Controlled Trial

Introduction: The COVID-19 pandemic worldwide forced governments to undertake intervention measures to encourage social distancing. Meanwhile, traumatic skin lacerations require multiple hospital visits for dressing, changings, and suture removal since they are usually repaired with non-absorbable sutures. In a matter of fact, these visits can be avoided by using absorbable sutures instead. However, absorbable sutures carry the theoretical risk of wound infection. In this study, our aim was to determine whether absorbable sutures are better than non-absorbable sutures in repairing lacerations during the COVID-19 pandemic. The first and second objectives were to assess the rate of infection and the number of postoperative hospital visits. Method(s): A sample of 469 patients with traumatic skin lacerations were analysed during the COVID-19 pandemic in April-July 2020. In the control group, wounds were repaired using non-absorbable sutures, while rapid-onset absorbable sutures were used in the treatment group. By conducting a phone call follow-up after 21 days, several parameters regarding infection signs and hospital visits were compared between both groups. Result(s): No statistically significant difference was observed between both groups regarding wound infection (p-value= 0.623). Using absorbable sutures resulted in fewer postoperative hospital visits than non-absorbable sutures (p-value= 0.001). This study is limited because the assessment of wound infection was subjective to the patient by a phone call follow-up. Conclusion(s): Using absorbable sutures to close traumatic skin lacerations is safe. They should be considered during a pandemic to reduce hospital visits for suture removal, which will subsequently enhance social distancing and relieve hospital load.

Incidence of heparin resistance and heparin failure in patients receiving extracorporeal membrane oxygenation - an exploratory retrospective analysis

Objectives: Unfractionated heparin (UFH) remains the anticoagulation of choice at most centres for patients receiving extracorporeal membrane oxygenation (ECMO). One disadvantage of UFH relies on its individual dosing requirement to achieve target values. In this context heparin resistance has been described, defined as doses exceeding 35,000 IU UFH/d. However, the incidence of heparin resistance and its association with thromboembolic complications despite anticoagulation within target ranges remains unknown. Method(s): This retrospective study included adults receiving venovenous (VV) and venoarterial (VA) ECMO, or extracorporeal CO2-removal (ECCO2R) between 2010 and May 2022. The primary outcome was the incidence of heparin resistance (>35,000 IU of UFH/d). Secondary outcomes were heparin failure (thromboembolic complications despite anticoagulation within target ranges) and survival. A multivariable poisson regression model was fitted to analyse the effect of heparin resistance, COVID-19 and ECMO type on the incidence rate of thromboembolic events. Result(s): Of 197 included patients, 33 (16.8%) had heparin resistance. Patients with COVID-19 (n=51) had a higher rate of heparin resistance compared to nonCOVID-19 patients (37% vs. 9.6%, P<0.001). Thromboembolic complications occurred at a rate of 5.89/100 ECMO days. There was a significant effect of COVID-19 (incidence rate ratio (IRR) 2.12, 95% confidence interval (CI) 1.4 to 3.3, P<0.001) and ECMO type (VA ECMO: IRR 2.35;95% CI 1.43 to 3.87, P<0.001;ECCO2R: IRR 2.63, 95% CI 1.37 to 4.9, P=0.003;reference VV ECMO) on incidence rate of thromboembolic events, but not of heparin resistance (IRR 1.11, 95% CI 0.7 to 1.76, P=0.7). ECMO duration was longer (25d (IQR 11-33) vs. 8d (IQR 4-18), P<0.001) in patients with heparin resistance, but hospital survival did not differ (23 (70%) vs. 91 (57%), P=0.2). Conclusion(s): The study revealed a high incidence of heparin failure in ECMO patients, especially in those with COVID-19. Heparin resistance had no effect on the incidence rate of thromboembolic events, whereas our data suggest an increased risk in patients with COVID19, VA ECMO and ECCO2R.

Covid19 Disease Assessment Using CNN Architecture

Recently, the COVID-19 pandemic has emerged as one of the world's most critical public health concerns. One of the biggest problems in the present COVID-19 outbreak is the difficulty of accurately separating COVID-19 cases from non-COVID-19 cases at an affordable price and in the initial stages. Besides the use of antigen Rapid Test Kit (RTK) and Reverse Transcription Polymerase Chain Reaction (RT-PCR), chest x-rays (CXR) can also be used to identify COVID-19 patients. Unfortunately, manual checks may produce inaccurate results, delay treatment or even be fatal. Because of differences in perception and experience, the manual method can be chaotic and imprecise. Technology has progressed to the point where we can solve this problem by training a Deep Learning (DL) model to distinguish the normal and COVID-19 X-rays. In this work, we choose the Convolutional Neural Network (CNN) as our DL model and train it using Kaggle datasets that include both COVID-19 and normal CXR data. The developed CNN model is then deployed on the website after going through a training and validation process. The website layout is straightforward to navigate. A CXR can be uploaded and a prediction made with minimal effort from the patient. The website assists in determining whether they have been exposed to COVID-19 or not. © 2023 IEEE.

A droplet digital PCR chip with passive bubble removal for absolute nucleic acid quantification

Droplet digital polymerase chain reaction (ddPCR) is an extremely sensitive method for the precisely determining the concentration of target nucleic acids. However, air bubbles between droplets during amplification can cause significant droplet loss and decreased accuracy in results. In the present study, an all-in-one microfluidic chip that integrates emulsification, passive bubble removal, droplet monolayer storage, on-chip nucleic acid amplification, and droplet fluorescence signal readout is proposed. The integrated passive bubble removal structures automatically complete the trapping and guiding of the bubbles, ensuring that the droplets do not touch the bubbles during amplification and thus is not lost. The ddPCR device with optimized key parameters proved to be effective and efficient by completely removing bubbles between droplets and having a dead volume of less than 1 %. The ability of the ddPCR chip to accurately quantify nucleic acids was evaluated by measuring plasmids with the SARS-CoV-2N gene at concentrations ranging from 10 to 50 000 copies/μL. The innovative ddPCR device satisfies the requirement for accurate nucleic acid quantification and is expected to accelerate the popularity of dPCR due to its low processing difficulty, ease of use and high robustness.

Social anxiety and depression symptoms in Chinese left-behind children after the lifting of COVID-19 lockdown: A network analysis.

BACKGROUND: Returning to social life after the lifting of COVID-19 lockdown may increase risk of social anxiety, which is highly co-morbid with depression. However, few studies have reported the association between them. AIMS: To explore the complex relationship between social anxiety and depression symptoms in left-behind children after the lifting of the COVID-19 lockdown. METHODS: A cross-sectional survey was conducted 6 months after the lockdown removal. A total of 3,107 left-behind children completed the survey with a mean age of 13.33 and a response rate of 87.77%. Depression and social anxiety severity were assessed by the DSM-5 Patient Health Questionnaire for Adolescents and the DSM-5 Social Anxiety Disorder Questionnaire, respectively. The symptom-level association between the two disorders was examined using network analysis. RESULTS: After the lifting of COVID-19 lockdown, the prevalence of depression and social anxiety in left-behind children was 19.57% and 12.36%, respectively, with a co-morbidity rate of 8.98%. Network analysis showed that "Social tension" and "Social avoidance" had the greatest expected influence; "Humiliation" and "Motor" were bridge symptom nodes in the network. The directed acyclic graph indicated that "Social fright" was at the upstream of all symptoms. CONCLUSION: Attention should be paid to social anxiety symptoms in left-behind children after the lifting of COVID-19 lockdown. Prevention and intervention measures should be taken promptly to reduce the comorbidity of social anxiety and depression symptoms in the left-behind children after the lifting of lockdown.

SAM C-GAN: a method for removal of face masks from masked faces.

The past years of COVID-19 have attracted researchers to carry out benchmark work in face mask detection. However, the existing work does not focus on the problem of reconstructing the face area behind the mask and completing the face that can be used for face recognition. In order to address this problem, in this work we have proposed a spatial attention module-based conditional generative adversarial network method that can generate plausible images of faces without masks by removing the face masks from the face region. The method proposed in this work utilizes a self-created dataset consisting of faces with three types of face masks for training and testing purposes. With the proposed method, an SSIM value of 0.91231 which is 3.89% higher and a PSNR value of 30.9879 which is 3.17% higher has been obtained as compared to the vanilla C-GAN method.

Invasive Mechanical Ventilation in COVID-19

Patients with severe COVID-19 pneumonia present with severe hypoxemic respiratory failure, typically meet the clinical criteria for acute respiratory distress syndrome (ARDS) and often require invasive mechanical ventilation. While peculiar pathophysiological aspects deserve discussion to better tailor the mechanical ventilation settings in these patients, most recommendations on the ventilatory management of these patients are derived from studies in patients with ARDS from causes other than COVID-19. Protective ventilation is recommended in most COVID-19 patients, tidal volume should be kept around 6 mL per kg of predicted body weight, positive end-expiratory pressure (PEEP) should be titrated individually considering that in many patients with COVID-19 improvement of oxygenation at higher PEEP is often accompanied by worsening of respiratory system compliance. Therefore, attention should be paid in limiting plateau and driving pressures to avoid excessive strain potentially resulting in ventilator-induced lung injury. Prone positioning has been used extensively in COVID-19 patients, but its impact on mortality is uncertain. Inhaled nitric oxide, extracorporeal CO2 removal (ECCO2R), and extracorporeal membrane oxygenation (ECMO) should be considered in selected patients as rescue measures. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

The fate of SARS-CoV-2 viral RNA in coastal New England wastewater treatment plants

Municipal sewage carries SARS-CoV-2 viruses shed in the human stool by infected individuals to wastewater treatment plants (WWTPs). It is well-established that increasing prevalence of COVID-19 in a community increases the viral load in its WWTPs. Despite the fact that wastewater treatment facilities serve a critical role in protecting downstream human and environmental health through removal or inactivation of the virus, little is known about the fate of the virus along the treatment train. To assess the efficacy of differing WWTP size and treatment processes in viral RNA removal we quantified two SARS-CoV-2 nucleocapsid (N) biomarkers (N1 and N2) in both liquid and solids phases for multiple treatment train locations from seven coastal New England WWTPs. SARS-CoV-2 biomarkers were commonly detected in the influent, primary treated, and sludge samples (returned activated sludge, waste activated sludge, and digested sludge), and not detected after secondary clarification processes or disinfection. Solid fractions had 470 to 3,700-fold higher concentrations of viral biomarkers than liquid fractions, suggesting considerably higher affinity of the virus for the solid phase. Our findings indicate that a variety of wastewater treatment designs are efficient at achieving high removal of SARS CoV-2 from effluent;however, quantifiable viral RNA was commonly detected in wastewater solids at various points in the facility. This study supports the important role municipal wastewater treatment facilities serve in reducing the discharge of SARS-CoV-2 viral fragments to the environment and highlights the need to better understand the fate of this virus in wastewater solids.

Performance of in-duct bipolar ionization devices on pollutant removal and potential byproduct formation in indoor environments

The COVID-19 pandemic has highlighted the importance of indoor air quality (IAQ) since SARS-CoV-2 may be transmitted through virus-laden aerosols in poorly ventilated spaces. Multiple air cleaning technologies have been developed to mitigate airborne transmission risk and improve IAQ. In-duct bipolar ionization technology is an air cleaning technology that can generate ions for inactivating airborne pathogens and increasing particle deposition and removal while without significant byproducts generated. Many commercial in-duct ionization systems have been developed but their practical performance on pollutant removal and potential formation of byproducts have not been investigated comprehensively. The results in this study showed that the in-duct bipolar ionization technology can significantly improve the particle removal efficiency of the regular filter, while no significant ozone and ion were released to the indoor air. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Effectiveness of upper-room UVGI system in a classroom with mixing and displacement ventilation

This study investigates the effectiveness of an upper-room UVGI system in a small classroom. Mixing ventilation can increase virus removal when combined with a UVGI system more effectively than displacement ventilation combined with a UVGI system, especially in cases where the ventilation rate is low. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Gravity Settling of Particles and Ventilation Characteristics by Natural Ventilation Method

It has been suggested that COVID-19 causes airborne infection by fine particles called droplet nuclei and reducing the risk of indoor infection by ventilation is attracting attention as an infection control measure. However, the characteristics of fine particles are not considered in indoor ventilation plans, and the behavior and removal effect of particles by ventilation have not been sufficiently clarified. Therefore, in this study, numerical analysis using a single aperture model is performed under various conditions to evaluate how indoor concentration trends and ventilation rates are affected by these factors in order to properly evaluate the outflow characteristics of chemical species and particulate matter due to ventilation. © 2022 17th International Conference on Indoor Air Quality and Climate, INDOOR AIR 2022. All rights reserved.

Plastic or plastic-free life: From formation to removal.

Microplastics (MPs) and nanoplastics (NPs) have caused global environmental concerns due to their ubiquitous existence in our surrounding environment and the potential threats posed to the ecosystem and human health. This review aims to extend current knowledge on the formation and degradation of MPs and NPs. The paper presents the potential sources of MPs and NPs including plastic containers, textiles, cosmetics, personal care products, COVID-19 wastes, and other plastic products. Once in the natural environment, the fragmentation and degradation of plastic wastes are thought to be initiated by physical, chemical, and biological factors. The corresponding degradation mechanism will be presented in the present review. Given the plastic life and environment, humans are inevitably exposed to MPs and NPs through ingestion, inhalation, and dermal contact. The potential risks MPs/NPs pose to humans will be also discussed in our study. Currently, the relevance of MP/NP exposure to human health outcomes is still controversial and not yet fully understood. Deciphering the translocation and degradation of plastics in the human body will be helpful to reveal their potential organotoxicity. In this case, available approaches to alleviate MP/NP pollution and advanced strategies to reduce MP/NP toxicity in humans are recommended to build a plastic-free life.

Clinical characteristics of the host DNA-removed metagenomic next-generation sequencing technology for detecting SARS-CoV-2, revealing host local immune signaling and assisting genomic epidemiology.

Background: Metagenomic next-generation sequencing (mNGS) technology has been central in detecting infectious diseases and helping to simultaneously reveal the complex interplay between invaders and their hosts immune response characteristics. However, it needs to be rigorously assessed for clinical utility. The present study is the first to evaluate the clinical characteristics of the host DNA-removed mNGS technology for detecting SARS-CoV-2, revealing host local immune signaling and assisting genomic epidemiology. Methods: 46 swab specimens collected from COVID-19 patients were assayed by two approved commercial RT-qPCR kits and mNGS. The evolutionary tree of SARS-CoV-2 was plotted using FigTree directly from one sample. The workflow of removing the host and retaining the host was compared to investigate the influence of host DNA removal on the performances of mNGS. Functional enrichment analysis of DEGs and xCell score were used to explore the characteristics of host local immune signaling. Results: The detection rate of mNGS achieved 92.9% (26/28) for 28 samples with a Ct value ≤ 35 and 81.1% (30/37) for all 46 samples. The genome coverage of SARS-CoV-2 could reach up to 98.9% when the Ct value is about 20 in swab samples. Removing the host could enhance the sensitivity of mNGS for detecting SARS-CoV-2 from the swab sample but does not affect the species abundance of microbes RNA. Improving the sequencing depth did not show a positive effect on improving the detection sensitivity of SARS-CoV-2. Cell type enrichment scores found multiple immune cell types were differentially expressed between patients with high and low viral load. Conclusions: The host DNA-removed mNGS has great potential utility and superior performance on comprehensive identification of SARS-CoV-2 and rapid traceability, revealing the microbiome's transcriptional profiles and host immune responses.

Influence of perioperative oral nutritional supplementation on short-term efficacy of laparoscopic sleeve gastrectomy for obesity patients: a prospective study

Objective: To investigate the effect of perioperative oral nutritional supplementation on the short-term curative effect of obese patients after laparoscopic sleeve gastrectomy (LSG). Methods: A prospective research method was adopted. The clinical data of 218 obese patients who underwent LSG in Ningxia Medical University General Hospital from January 2018 to December 2021 were selected. The patients who received oral nutritional supplement therapy during the perioperative period were set as the experimental group, and those who received conventional treatment were set as the control group. Observation indicators: (1) Grouping of enrolled patients. (2) Postoperative and follow-up situation. (3) Nutrition-related indicators. (4) Diet compliance. (5) Status of weight loss-related indicators. Follow-up visits were conducted by telephone, We Chat and outpatient visits. The patients were followed up once 30 days after discharge, including albumin (Alb), hemoglobin (Hb), dietary compliance and weight loss-related indicators. The follow-up time will end in February 2022. The measurement data with normal distribution were expressed as x+or-s, and the comparison between groups was performed by independent sample t test. The measurement data is represented by M (range), and the comparison between groups is performed by Mann?Whitney U test. Enumeration data were expressed as absolute numbers or percentages, and the X2 test was used for comparison between groups. Repeated measures data were analyzed by repeated measures analysis of variance. The rank sum test was used to compare the rank data. Results (1) Grouping of the enrolled patients. Screened 218 eligible patients;42 males and 176 females;age (32+or-9) years;body mass index (BMI) (39+or-7) kg/m2. Among the 218 patients, there were 109 cases in the test group and 109 cases in the control group. Gender (male, female), age, BMI, preoperative Alb, and preoperative Hb of patients in the test group were 17 and 92 cases, (33+or-9) years old, (39+or-7) kg/m2, (40.6+or-4.8) g /L, (141.7+or-13.9) g/L;the above indicators in the control group were 25 and 84 cases, (31+or-8) years old, (39+or-8) kg/m2, (40.9+or-4.2) g/L, (142.9+or-9.7) g/L;there was no significant difference in the above (X2=1.89, t=-1.52, 0.51, 0.40, 0.71, P > 0.05). (2) Postoperative and follow-up situation. The first hospitalization time and first hospitalization expenses of the patients in the experimental group were (9.1+or-2.9) d and (3.6+or-0.5) ten thousand yuan respectively;the above indicators of the patients in the control group were (4.9+or-1.0) ten thousand yuan respectively;There were statistically significant differences in the above indicators between the two groups (t=5.58, 12.38, P < 0.05). Among the 218 patients, 119 were followed up, including 62 in the experimental group and 57 in the control group. The 119 patients were followed up for 31.0 (25.0-38.0) days. Among the 218 patients, 14 cases had postoperative complications and led to rehospitalization, including 2 cases in the experimental group, 1 case of nausea and vomiting and 1 case of intestinal obstruction;12 cases in the control group, 10 cases of nausea and vomiting, gastric fistula 2 cases;there was a statistically significant difference between the two groups in hospital readmission (X2=7.63, P < 0.05). The time interval between re-admission and first discharge of 14 patients was (22.0+or-6.7) days. (3) Nutrition-related indicators. The Alb and Hb levels of 62 patients in the experimental group who were followed up before operation, before the first discharge, and 1 month after operation were (40.4+or-5.5) g/L, (35.9+or-3.8) g/L, (45.4+or-2.9) g/L, respectively and (140.8+or-13.9) g/L, (130.5+or-16.9) g/L, (147.8+or-17.2) g/L;the above indicators of 57 patients in the control group were (41.2+or-3.9) g/L, (34.2 +or-3.9) g/L, (42.7+or-5.3) g/L and (143.0+or-9.7) g/L, (122.9+or-12.8) g/L, (139.0+or-11.4) g/L;There was a statistically significant difference between the Alb and Hb groups from preoperative to postoperative 1 mont

Enhanced performance of algal-bacterial aerobic granular sludge in comparison to bacterial aerobic granular sludge for treating surfactant-containing wastewater

Increasing amounts of surfactants are used and emitted into the environment due to the COVID-19 pandemic, posing potential threats to ecological health. Algal-bacterial aerobic granular sludge (A-BAGS), with the advantages of compact structure, high-efficient nutrient uptake, and high tolerance to harsh conditions, was attempted in this study to treat surfactant-containing wastewater at relatively high concentrations. The treatment performance was also compared to bacterial AGS (BAGS). Results showed that A-BAGS is preferable for treating wastewater containing a high SDS concentration (30 mg/L), achieving nutrient removal efficiency of 86.3 % for organic carbon, 60.5 % for total nitrogen, and 58.7 % for total phosphorus within a short duration, compared to 70.1 %, 52.8 % and 42.3 % in BAGS reactor. Besides, the removal rate of ammonia nitrogen by A-BAGS was much faster than that of BAGS. The above results confirmed that A-BAGS is a promising technology for treating surfactant-containing wastewater with high nutrient removal efficiency being maintained.Copyright © 2023 Elsevier Ltd

Estimating aerosol particle removal in indoor air by ion-enhanced deposition

Small air ions have the ability to charge airborne particles, thereby increasing their accumulation on surfaces. Indoor air purification by applying ionization uses electrostatic particle deposition. Respiratory pathogens, including viruses and respiratory droplets carrying viruses or other pathogens, represent bioaerosols, whose particle size distributions contain increasingly larger proportion of fine and ultrafine particles, as the evaporation process proceeds. We have generated two model aerosols: the nebulized NaCl solution, resembling human saliva, and the cigarette smoke, having relatively low water content. We have conducted real life experiments of such surrogate aerosol particle deposition without ionization, using bipolar ionization, as well as using unipolar negative air ions. Particle number concentrations have been measured in the 10 nm–10 μm particle size range. The calculated deposition rates and aerosol particle half-life times were correlated with bioaerosol pathogens based on the core pathogen sizes. Bipolar ionizers emitting equal concentrations of positive and negative ions had low impact to the particle concentration decrease. Intense negative air ionization resulted in pronounced deposition rate increases, particularly in the particle size range of viruses including the SARS-CoV-2. The impact of negative air ionization was most pronounced in the same size range where the deposition rates without ionization were the lowest. Therefore, the results are very promising from the standpoint of air purification and bioaerosol pathogen removal, bearing in mind that the effect of ions will be most pronounced if the unipolar ion rich air stream is directed towards the breathing zone.

Clinical and morphological symptoms of gangrenous appendicitis in children with laboratory-confirmed novel coronavirus infection

Over recent years, amid the novel coronavirus disease (COVID-19) pandemic the prevalence of appendicitis in children has increased. However, its morphological characteristics are not described completely. The article elucidates clinical and morphological features of gangrenous appendicitis in hospitalized children with laboratory-confirmed COVID-19 diagnosis. The authors present the clinical, laboratory, instrumental and morphological findings in schoolchildren with gangrenous appendicitis associated with SARS-CoV-2, confirmed by nasopharyngeal swab PCR-testing. The disease was characterized by an acute onset, rapid development of abdominal pain syndrome and typical inflammatory changes in the clinical blood analysis: moderate leukocytosis (15.6×109/l), pronounced neutrophilia (82.2%), and thrombocytopenia (103 to 144×109/l). All patients had echographic signs of inflammatory transformation of the appendix which was removed on the first day of hospitalization (the first day of the disease) by laparoscopic technique. The examination of the removed biomaterial revealed a tendency to thrombosis in the small vessels of the process and ulcerative changes accompanied by necrosis. There is a discussion of the relationship between the development of gangrenous appendicitis and the clinical course of COVID-19 infection. It is necessary to continue investigations, perform in-depth analysis of the factors causing pathological changes, and to clarify the role of SARS-CoV-2 disease with the aim of preventing the spread of COVID-19. © 2023, Meditsina-Inform LLC. All rights reserved.

Combined extracorporeal CO2 removal and renal replacement therapy in a pregnant patient with COVID-19: a case report.

Background. Pregnant women are at high risk of Coronavirus disease 2019 (COVID-19) complications, including acute respiratory distress syndrome. Currently, one of the cornerstones in the treatment of this condition is lung-protective ventilation (LPV) with low tidal volumes. However, the occurrence of hypercapnia may limit this ventilatory strategy. So, different extracorporeal CO2 removal (ECCO2R) procedures have been developed. ECCO2R comprises a variety of techniques, including low-flow and high-flow systems, that may be performed with dedicated devices or combined with continuous renal replacement therapy (CRRT). Case description. Here, we report a unique case of a pregnant patient affected by COVID-19 who required extracorporeal support for multiorgan failure. While on LPV, because of the concomitant hypercapnia and acute kidney injury, the patient was treated with an ECCO2R membrane inserted in series after a hemofilter in a CRRT platform. This combined treatment reducing hypercapnia allowed LPV maintenance at the same time while providing kidney replacement and ensuring maternal and fetal hemodynamic stability. Adverse effects consisted of minor bleeding episodes due to the anticoagulation required to maintain the extracorporeal circuit patency. The patient's pulmonary and kidney function progressively recovered, permitting the withdrawal of any extracorporeal treatment. At the 25th gestational week, the patient underwent spontaneous premature vaginal delivery because of placental abruption. She gave birth to an 800-gram female baby, who three days later died because of multiorgan failure related to extreme prematurity. Conclusions. This case supports using ECCO2R-CRRT combined treatment as a suitable approach in the management of complex conditions, such as pregnancy, even in the case of severe COVID-19.

Electrospray-on-Electrospun Breathable, Biodegradable, and Robust Nanofibrous Membranes with Photocatalytic Bactericidal Activity

The increasing emergence of infectious diseases like COVID-19 has created an urgent need for filtration/purification materials coupled with multifunctional features such as mechanical integrity, excellent airflow/filtration, and antibacterial/antimicrobial properties. Polymer membranes and metal-organic frameworks (MOFs) have demonstrated high effectiveness in air filtration and purification. MOF nanoparticles have been introduced into electrospun polymer nanofibrous membranes through embedding or postsolution growth. However, the derived hybrids are still facing the issue of (1) limited MOF exposure, which leads to low efficacy;and (2) uncontrollable growth, which leads to pore blocking and low breathability. In this work, we customized an electrospray-on-electrospinning in situ process to dynamically integrate MOF nanoparticles into a robust and elastic continuous nanofibrous membrane for advanced properties including high mechanical strength and flexibility, excellent breathability, particle filtration, and good antimicrobial performance. Biodegradable polylactic acid was reinforced by the poly(hydroxybutyrate)-di-poly(DLA-CL)x copolymer (PHBR) and used as an electrospinning matrix, while MOF nanoparticles were simultaneously electrically sprayed onto the nanofibers with easily controllable MOF loading. The MOF nanoparticles were homogeneously deposited onto nanofibers without clogging the pores in the membrane. The collision of PLA and MOF under the wet status during electrospinning and the hydrogen bonding through C=O and N-H bonds strengthen the affinity between PLA nanofibers and MOF nanoparticles. Because of these factors, the MOF-incorporated PLA/PHBR nanofibrous membrane achieved over 95% particle filtration efficiency with enhanced mechanical properties while maintaining high breathability. Meanwhile, it exhibits excellent photocatalytic antibacterial performance, which is necessary to kill microbes. The electrospray-on-electrospinning in situ process provides an efficient and straightforward way to hybridize one-dimensional (1D) or two-dimensional (2D) nanomaterials into a continuous nanofibrous membrane with strong interaction and controllable loading. Upon integrating proper functionalities from the materials, the obtained hybrids are able to achieve multifunctionalities for various applications.