Development and validation of technologies suitable for the decontamination and re-use of contaminated N95 filtering facepiece respirators in response to the COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has brought significant challenges to society globally, particularly in the area of healthcare provision. A pressing need existed in protecting those tasked with delivering healthcare solutions during the COVID-19 crisis by providing solutions for preserving adequate supplies of effective personal protective equipment (PPE). AIM: To evaluate and validate available methods for the decontamination of N95 filtering facepiece respirators (FFRs) while maintaining functionality during re-use. METHODS: Multiple low-temperature steam and vaporized hydrogen peroxide (VHP) technologies were assessed for inactivation of Mycobacterium spp. and feline calicivirus (employed as representatives of the contamination challenge). FINDINGS: Virus (≥3log10) and Mycobacterium spp. (≥6log10) inactivation was achieved on various types of N95 FFRs using an array of heat (65-71oC), humidity (>50% relative humidity) and VHP without affecting the performance of the PPE. CONCLUSION: The methods have been validated and were authorized by the US Food and Drug Administration under a temporary emergency use authorization. Based on the findings, opportunities exist for development and deployment of decontamination methods made from simple, general purpose materials and equipment should a future need arise.

Radial optic neurotomy for central retinal vein occlusion: a retrospective pilot study of 11 consecutive cases.

PURPOSE: Retinal vascular occlusive disease is the second leading cause of permanent retinal blindness. The etiology of central retinal vein occlusion (CRVO) is not well understood. The anatomy of the optic disk including the cribriform plate and scleral ring may contribute to the development of retinal vaso-oclussive diseases. Neurovascular compression within the confined space at this location may play a pathoetiologic role in CRVO. The authors performed radial optic neurotomy in patients with CRVO to relax this space and relieve pressure on the central retinal vein. METHODS: Radial optic neurotomy (RON) was performed on 11 consecutive patients with severe, hemorrhagic CRVO with visual acuities of 20/400 or less. A microvitreoretinal blade was used to relax the scleral ring, cribriform plate, and adjacent sclera of the optic disk. Reperfusion of the retina was achieved via decompressing the central retinal vein. RESULTS: Radial optic neurotomy was performed successfully in all 11 patients. There were no complications noted with this procedure. All patients had clinical improvement as determined by fundus examination, photography, and fluorescein angiography. Postoperative visual acuities were equal or improved in 82% of patients. Eight of the patients (73%) had rapid improvement of visual acuity with an average gain of five lines of vision. CONCLUSIONS: Surgical decompression of CRVO via RON is a technically feasible and initially safe procedure that is associated with rapid reperfusion of the retina. Resolution of the intraretinal hemorrhage, edema, and ischemia may improve the visual prognosis in patients with this common retinal disorder.

Investigation of germination and aging in Moravian III barley grain by nuclear magnetic resonance.

High-resolution, solid-state 1H nuclear magnetic resonance (NMR) techniques are used for the first time to study germination in imbibed Moravian III barley grains. Whereas magic-angle spinning 1H NMR spectra reveal the water and lipid components in barley grains, combined rotation and multiple-pulse spectroscopy techniques provide 1H NMR spectra of grains that reveal the protein and carbohydrate as well as the water and lipid components. Spectra of grains are compared with spectra of model compounds to verify assignments. 1H T1 and T2 measurements using magic-angle spinning only and combined rotation and multiple-pulse spectroscopy techniques provide information about molecular mobility within the grains during inhibition. Some grains were subjected to artificial aging conditions. 1H NMR spectral comparisons are made between normal, viable grains and artificially aged grains.

Multifield magic-angle spinning and double-rotation nuclear magnetic resonance studies of a hydrated aluminophosphate molecular sieve: AlPO4-H2.

AlPO4-H2 is a microporous hydrated aluminophosphate, structurally related to VPI-5, whose framework has highly elliptical 10-ring channels (2.9 x 7.6 A) parallel to the c crystallographic axis. To resolve a previously reported discrepancy between nuclear magnetic resonance (NMR) and X-ray diffraction (XRD) data a highly crystalline AlPO4-H2 has been further characterized with 27Al and 31P magic-angle spinning (MAS) NMR at 11.7 T and 27Al double-rotation (DOR) NMR at 4.7 T. These present NMR data definitively show that the true space group symmetry of the AlPO4-H2 framework structure is triclinic rather than the higher orthorhombic symmetry proposed earlier from XRD studies.

Management of early stage endometrial papillary adenocarcinoma.

This retrospective study examined the outcome in 42 women with early stage (FIGO I/II) endometrial adenocarcinoma (papillary, n = 22 and nonpapillary, n = 20). In patients with papillary carcinoma, median survival was longer when surgery and/or radiotherapy was applied (18 to 36 months) than when such treatment was not used or systemic progestational therapy was employed (6 to 9 months). Among those evaluable women, the 5-year survival rate was significantly (p = 0.01) better in the nonpapillary than the papillary type adenocarcinoma, 45% (9/20) versus 6% (1/16) respectively. However, abdominal failure and distant metastasis rates in papillary carcinoma were 5% while local recurrence and distant metastasis rates in the nonpapillary variety were correspondingly 20% and 15%.

Treatment of Chlamydia trachomatis identified with Chlamydiazyme during pregnancy. Impact on perinatal complications and infants.

A rapid enzyme immunoassay antigen detection system (Chlamydiazyme) was used to screen 199 asymptomatic, third-trimester women. Fifty-two (26%) were Chlamydiazyme positive; they were mostly primiparous, single, young and black. Infected women were offered erythromycin therapy, counseling and posttherapy retesting. Sexual partners were treated likewise. Erythromycin compliance, determined by a questionnaire, was high (92%), and side effects (16%) were tolerable. Pregnancy outcome and infant illnesses were monitored to determine the effectiveness of therapy. There were no significant differences in pregnancy outcome in the Chlamydiazyme-negative and treated, Chlamydiazyme-positive women. Prospective evaluation of infants born to 48 negative and 50 treated, Chlamydiazyme-positive women revealed no significant differences in the incidence of respiratory tract illnesses or conjunctivitis. Chlamydiazyme can be used in a screening program to identify and treat third-trimester women infected with C trachomatis. As previously reported, erythromycin therapy for colonized women interrupted the expected transmission of C trachomatis to their infants.