Experience on postmortem minimally invasive tissue sampling to ascertain the cause of death determination in South African children: A case for implementing as standard of care.

Determining the death burden for prioritising public health interventions necessitates detailed data on the causal pathways to death. Postmortem minimally invasive tissue sampling (MITS), incorporating histology, molecular and microbial culture diagnostics, enhances cause-of-death attribution, particularly for infectious deaths. MITS proves a valid alternative to full diagnostic autopsies, especially in low- and middle-income countries. In Soweto, South Africa (SA), the Child Health and Mortality Prevention Surveillance (CHAMPS) programme has delineated over 1 000 child and stillbirth deaths since 2017. This SA CHAMPS site supports advocating for the use of postmortem MITS as routine practice, for more granular insights into under-5 mortality causes. This knowledge is crucial for SA's pursuit of Sustainable Development Goal 3.2, targeting reduced neonatal and under-5 mortality rates. This commentary explores the public health advantages and ethicolegal considerations surrounding implementing MITS as standard of care for stillbirths, neonatal and paediatric deaths in SA. Furthermore, based on the data from CHAMPS, we present three pragmatic algorithmic approaches to the wide array of testing options for cost-effectiveness and scalability of postmortem MITS in South African state facilities.

Methods for the separation of hydraulic retention time and solids retention time in the application of photosynthetic microorganisms in photobioreactors: a review.

Photosynthetic microorganisms have a wide range of biotechnical applications, through the application of their versatile metabolisms. However, their use in industry has been extremely limited to date, partially because of the additional complexities associated with their cultivation in comparison to other organisms. Strategies and developments in photobioreactors (PBRs) designed for their culture and applications are needed to drive the field forward. One particular area which bears examination is the use of strategies to separate solid- and hydraulic-residence times (SRT and HRT), to facilitate flow-through systems and continuous processing. The aim of this review is to discuss the various types of PBRs and methods which are currently demonstrated in the literature and industry, with a focus on the separation of HRT and SRT. The use of an efficient method of biomass retention in a PBR may be advantageous as it unlocks the option for continuous operation, which may improve efficiency, and improve economic feasibility of large-scale implementation of photosynthetic biocatalysts, especially where biomass is not the primary product. Due to the underexplored nature of the separation of HRT and SRT in reactors using photosynthetic microorganisms, limited literature is available regarding their performance, efficiencies, and potential issues. This review first introduces an overview into photosynthetic microorganisms cultivated and commonly exploited for use in biotechnological applications, with reference to bioreactor considerations specific to each organism. Following this, the existing technologies used for the separation of HRT and SRT in PBRs are explored. The respective advantages and disadvantages are discussed for each PBR design, which may inform an interested bioprocess engineer.

Presence of procoagulant peripheral blood mononuclear cells in severe COVID-19 patients relate to ventilation perfusion mismatch and precede pulmonary embolism.

PURPOSE: Pulmonary emboli (PE) contribute substantially to coronavirus disease 2019 (COVID-19) related mortality and morbidity. Immune cell-mediated hyperinflammation drives the procoagulant state in COVID-19 patients, resulting in immunothrombosis. To study the role of peripheral blood mononuclear cells (PBMC) in the procoagulant state of COVID-19 patients, we performed a functional bioassay and related outcomes to the occurrence of PE. Secondary aims were to relate this functional assay to plasma D-dimer levels, ventilation perfusion mismatch and TF expression on monocyte subsets. METHODS: PBMC from an ICU biobank were obtained from 20 patients with a computed tomography angiograph (CTA) proven PE and compared to 15 COVID-19 controls without a proven PE. Functional procoagulant properties of PBMC were measured using a modified fibrin generation time (MC-FGT) assay. Tissue factor (TF) expression on monocyte subsets were measured by flow cytometry. Additional clinical data were obtained from patient records including end-tidal to arterial carbon dioxide gradient. RESULTS: MC-FGT levels were highest in the samples taken closest to the PE detection, similar to the end-tidal to arterial carbon dioxide gradient (ETCO2 - PaCO2), a measurement to quantify ventilation-perfusion mismatch. In patients without proven PE, peak MC-FGT relates to an increase in end-tidal to arterial carbon dioxide gradient. We identified non-classical, CD16 positive monocytes as the subset with increased TF expression. CONCLUSION: We show that the procoagulant state of PBMC could aid in early detection of PE in COVID-19 ICU patients. Combined with end-tidal to ETCO2 - PaCO2 gradient, these tests could improve early detection of PE on the ICU.