Adapting re-usable elastomeric respirators to utilise anaesthesia circuit filters using a 3D-printed adaptor - a potential alternative to address N95 shortages during the COVID-19 pandemic.

The COVID-19 pandemic has increased the demand for disposable N95 respirators. Re-usable elastomeric respirators may provide a suitable alternative. Proprietary elastomeric respirator filters may become depleted as demand increases. An alternative may be the virus/bacterial filters used in anaesthesia circuits, if they can be adequately fitted onto the elastomeric respirators. In addition, many re-usable elastomeric respirators do not filter exhaled breaths. If used for sterile procedures, this would also require modification. We designed a 3D-printed adaptor that permits elastomeric respirators to interface with anaesthesia circuit filters and created a simple modification to divert exhaled breaths through the filter. We conducted a feasibility study evaluating the performance of our modified elastomeric respirators. A convenience sample of eight volunteers was recruited. Quantitative fit testing, respiratory rate and end-tidal carbon dioxide were recorded during fit testing exercises and after 1 h of wear. All eight volunteers obtained excellent quantitative fit testing throughout the trial. The mean (SD) end-tidal carbon dioxide was 4.5 (0.5) kPa and 4.6 (0.4) kPa at baseline and after 1 h of wear (p = 0.148). The mean (SD) respiratory rate was 17 (4) breaths.min-1 and 17 (3) breaths.min-1 at baseline and after 1 h of wear (p = 0.435). Four out of eight subjects self-reported discomfort; two reported facial pressure, one reported exhalation resistance and one reported transient dizziness on exertion. Re-usable elastomeric respirators to utilise anaesthesia circuit filters through a 3D-printed adaptor may be a potential alternative to disposable N95 respirators during the COVID-19 pandemic.

The use of feathers to monitor heavy metal contamination in herons, Korea.

This study measured concentrations of iron, manganese, zinc, copper, lead, and cadmium in environmental substrates (water and sediment) as well as in the diet and feathers of Black-crowned Night Heron Nycticorax nycticorax and Grey Heron Ardea cinerea chicks from Pyeongtaek heronry, Gyeonggi-do, Korea. Zinc and cadmium concentrations in sediment were relatively high, but lead was low. In the diet, only copper concentrations were higher in Black-crowned Night Herons than in Grey Herons. Cadmium concentrations in the diet of two heron species from a Pyeongtaek heron colony were also higher than reported in other studies. In feathers, iron, copper, and lead concentrations were significantly different between heron species. Iron and copper concentrations were higher in Black-crowned Night Heron chicks than in Grey Heron chicks, but lead concentrations were not. Therefore, with the exception of lead, heavy metal concentrations in feathers were not related to concentrations in the diet. Zinc, iron, and lead concentrations in heron feathers were within the ranges reported by other heron studies, but manganese, copper, and cadmium were much higher. Lead and cadmium concentrations in feathers of Black-crowned Night Heron and Grey Heron chicks were elevated to lead and cadmium concentrations in the diet. Therefore, we suggest that lead and cadmium concentrations in heron feathers reflect contamination of breeding sites and are useful bioindicators of local contamination.

Kaurane diterpenes from Isodon japonicus inhibit nitric oxide and prostaglandin E2 production and NF-kappaB activation in LPS-stimulated macrophage RAW264.7 cells.

A methanolic extract of the whole plant of Isodon japonicus (Labiatae) showed potent inhibition on the LPS-induced nitric oxide (NO) and prostaglandin E2 (PGE2) production in RAW264.7 cells. Four known kaurane diterpenes were isolated by activity-guided fractionation and their structures were identified as kamebanin (1), kamebacetal A (2), kamebakaurin (3), excisanin A (4). All compounds also inhibited the LPS-induced NF-kappaB activation as assessed by NF-kappaB reporter assay and electrophoretic mobility shift assay (EMSA). Compounds 2-4 showed comparable inhibitory effects on the LPS-induced production of NO and PGE2, and activation of NF-kappaB without affecting cell viability. These results suggest that kaurane diterpenes could exert their inhibitory effects on the production of NO and PGE2 through the suppression of NF-kappaB activation, and be partially responsible for the anti-inflammatory activities of the genus Isodon.

A sesquiterpene lactone, costunolide, from Magnolia grandiflora inhibits NF-kappa B by targeting I kappa B phosphorylation.

A sesquiterpene lactone, costunolide (CTN), was identified from Magnolia grandiflora together with parthenolide (PTN) by its strong inhibition of LPS-induced NF-kappa B activation. CTN, which showed more potent inhibition than PTN in the NF-kappa B activation, strongly suppressed nitric oxide (NO) production in LPS-stimulated RAW 264.7 cells. RT-PCR and Western blot analyses demonstrated that CTN suppressed the expression of iNOS mRNA and protein in a dose-dependent manner. CTN also significantly inhibited LPS-induced DNA-binding activity of NF-kappa B as well as the LPS-induced degradation of I kappa B-alpha and -beta. Furthermore, CTN inhibited LPS-induced phosphorylation of I kappa B-alpha. These findings support that CTN inhibits NO production by down-regulating iNOS expression, at least, in part through the inhibition of I kappa Bs' phosphorylation and degradation, which are essential for the activation of NF-kappa B.

Treatment of total hyphema with relatively low-dose tissue plasminogen activator.

The purpose of this study is to investigate the efficacy of tissue plasminogen activator (tPA) in the treatment of total hyphema following ocular trauma or intraocular surgery. Three patients (3 eyes) representing unresolved total hyphema for more than 5 days and uncontrolled high intraocular pressure received intracameral injections of 10 microgram of recombinant tPA. Intracameral tPA injection resulted in complete resolution of hyphema in all 3 eyes. Resolution occurred mostly within 24 to 48 hours after injection. Possible side effects of tPA injection, such as increased intraocular pressure and corneal edema, were not observed. However, 1 eye had vitreous hemorrhage after repeated injections of tPA. Intracameral injection of tPA seems to be a safe and effective method for the treatment of unresolved total hyphema. However, repeated intracameral tPA injections may cause unwanted complications such as vitreous hemorrhage.