Impact of the COVID-19 Pandemic on the Incidence and Characteristics of Culture-Positive Microbial Keratitis at a Tertiary Eye Hospital in the UK.

Purpose: The COVID-19 pandemic has led to drastic changes to the daily lives of those living in the United Kingdom. We hypothesized that the effect of the imposed lockdown on both behaviour and social interaction has the potential to influence the characteristics of microbial keratitis presenting locally to Manchester Royal Eye Hospital - a major tertiary eye centre in the UK. Methods: We conducted a retrospective case-note review of all positive corneal scrape cultures identified by our local microbiology laboratory during the year since the announcement of lockdown measures in the UK (23 March 2020 to 23 March 2021). Culture results were compared with previously collated, published "baseline" data from prior to the onset of the COVID-19 pandemic (2004-2019). Statistical analysis was undertaken, predominantly looking at the incidence of microbial keratitis and the variety of cultured pathogens. Results: A total of 6243 corneal scrape results were reviewed. Comparison of data between the COVID-19 pandemic and subsequent lockdown did not show a significant change in the incidence of culture-positive microbial keratitis: mean annual positive samples during 2004-2019 were 128 (35%) vs 91 (29%) during lockdown (P=0.096). No statistically significant shifts in the incidence of organism subtypes - fungi, acanthamoeba, Gram-positive bacteria, or Gram negative bacteria - were identified (P=0.196, 1, 0.366, and 0.087, respectively). Conclusion: Contrary to our hypothesis, our results suggest that the COVID-19 pandemic did not alter the incidence or characteristics of microbial keratitis presenting to Manchester Royal Eye Hospital in the year following the implementation of lockdown measures in the UK.

Leaching of heavy metals from E-waste in simulated landfill columns.

In recent history the volume of electronic products purchased by consumers has dramatically escalated. As a result this has produced an ever-increasing electronic waste (E-waste) stream, which has generated concerns regarding the E-waste's potential for adversely impacting the environment. The leaching of toxic substances from obsolete personal computers (PCs) and cathode ray tubes (CRTs) of televisions and monitors, which are the most significant components in E-waste stream, was studied using landfill simulation in columns. Five columns were employed. One column served as a control which was filled with municipal solid waste (MSW), two columns were filled with a mixture of MSW and CRTs, and the other two were filled with MSW and computer components including printed wire boards, hard disc drives, floppy disc drives, CD/DVD drives, and power supply units. The leachate generated from the columns was monitored for toxic materials throughout the two-year duration of the study. Results indicate that lead (Pb) and various other heavy metals that were of environmental and health concern were not detected in the leachate from the simulators. When the samples of the solids were collected from underneath the E-waste in the columns and were analyzed, significant amount of Pb was detected. This indicates that Pb could readily leach from the E-waste, but was absorbed by the solids around the E-waste materials. While Pb was not observed in the leachate in this study, it is likely that the Pb would eventually enter the leachate after a long term transport.

Near-peer medical student simulation training.

BACKGROUND: There is growing concern that medical students are inadequately prepared for life as a junior doctor. A lack of confidence managing acutely unwell patients is often cited as a barrier to good clinical care. With medical schools investing heavily in simulation equipment, we set out to explore if near-peer simulation training is an effective teaching format. METHODS: Medical students in their third year of study and above were invited to attend a 90-minute simulation teaching session. The sessions were designed and delivered by final-year medical students using clinical scenarios mapped to the Sheffield MBChB curriculum. Candidates were required to assess, investigate and manage an acutely unwell simulated patient. Pre- and post-simulation training Likert scale questionnaires were completed relating to self-reported confidence levels. There is growing concern that medical students are inadequately prepared for life as a junior doctor RESULTS: Questionnaires were completed by 25 students (100% response rate); 52 per cent of students had no prior simulation experience. There were statistically significant improvements in self-reported confidence levels in each of the six areas assessed (p < 0.005). Thematic analysis of free-text comments indicated that candidates enjoyed the practical format of the sessions and found the experience useful. DISCUSSION: Our results suggest that near-peer medical student simulation training benefits both teacher and learner and that this simplistic model could easily be replicated at other medical schools. As the most junior members of the team, medical students are often confined to observer status. Simulation empowers students to practise independently in a safe and protected environment. Furthermore, it may help to alleviate anxiety about starting work as a junior doctor and improve future patient care.

Directing cell therapy to anatomic target sites in vivo with magnetic resonance targeting.

Cell-based therapy exploits modified human cells to treat diseases but its targeted application in specific tissues, particularly those lying deep in the body where direct injection is not possible, has been problematic. Here we use a magnetic resonance imaging (MRI) system to direct macrophages carrying an oncolytic virus, Seprehvir, into primary and metastatic tumour sites in mice. To achieve this, we magnetically label macrophages with super-paramagnetic iron oxide nanoparticles and apply pulsed magnetic field gradients in the direction of the tumour sites. Magnetic resonance targeting guides macrophages from the bloodstream into tumours, resulting in increased tumour macrophage infiltration and reduction in tumour burden and metastasis. Our study indicates that clinical MRI scanners can not only track the location of magnetically labelled cells but also have the potential to steer them into one or more target tissues.

Dynamic leaching test of personal computer components.

A dynamic leaching test (DLT) was developed and used to evaluate the leaching of toxic substances for electronic waste in the environment. The major components in personal computers (PCs) including motherboards, hard disc drives, floppy disc drives, and compact disc drives were tested. The tests lasted for 2 years for motherboards and 1.5 year for the disc drives. The extraction fluids for the standard toxicity characteristic leaching procedure (TCLP) and synthetic precipitation leaching procedure (SPLP) were used as the DLT leaching solutions. A total of 18 elements including Ag, Al, As, Au, Ba, Be, Cd, Cr, Cu, Fe, Ga, Ni, Pd, Pb, Sb, Se, Sn, and Zn were analyzed in the DLT leachates. Only Al, Cu, Fe, Ni, Pb, and Zn were commonly found in the DLT leachates of the PC components. Their leaching levels were much higher in TCLP extraction fluid than in SPLP extraction fluid. The toxic heavy metal Pb was found to continuously leach out of the components over the entire test periods. The cumulative amounts of Pb leached out of the motherboards in TCLP extraction fluid reached 2.0 g per motherboard over the 2-year test period, and that in SPLP extraction fluid were 75-90% less. The leaching rates or levels of Pb were largely affected by the content of galvanized steel in the PC components. The higher was the steel content, the lower the Pb leaching rate would be. The findings suggest that the obsolete PCs disposed of in landfills or discarded in the environment continuously release Pb for years when subjected to landfill leachate or rains.