The school in the province of Santa Fe and the COVID-19 pandemic: previous trends, evolution and impact, 2020-2021

Here analyzes how the educational system of the province of Santa Fe overpass the pandemic since March 2020. It provides a general picture of the characteristics of households, their previous conditions to this crisis and some pre-existing trends in the educational system before the crisis that COVID-19 would unleash worldwide. The characteristics assumed by school continuity in 2020 and 2021 from official surveys and the working conditions of teaching. The relationship between the opening of schools and infections throughout 2021 is also presented. It works with official documents produced by the Ministry of Education and Health of the nation and the province, data from the provincial government, surveys and union reports, systematized information from local newspapers. The difficulty in preparing a detailed situation table is shown given the absence of systematically collected inputs. There are some issues that should be monitored. © 2022 Seccion Historia. Instituto Superior del Profesorado 'Eduardo Lafferriere'. All rights reserved.

Cost Advantages of Far East/Europe Trunk Route Deployment with Port Selection in East Asia

To cater to the gradually increasing sizes of ships, several traditional container ports in East Asia built deep-water wharves to attract shipping carriers to berth, a decision that is considered highly reasonable because it allows for shipping carriers to gain a cost advantage. For traditional Far East/Europe (F/E) trunk routes, shipping carriers must deploy vessels that are large enough at hub ports to maintain low transshipment costs. However, for a port to attract shipping carriers, it should be able to first meet the cargo demand of these carriers. The port would also need to improve the loading ratio to enjoy the cost advantage. Simultaneously, the port should leverage the loading and unloading efficiency of the terminal to gain a competitive advantage. Although the port congestion observed at the F/E trunk during COVID-19 was not as serious as that in North American ports, it was sufficient to affect the route deployment and port selection decisions of shipping carriers. Currently, because the size of container carriers is the most critical factor in the reduction of shipping costs, as demonstrated in this study, the upsizing trend of container ships is regarded as a highly relevant aspect in the deployment of trunk routes and the selection of hub ports. © 2023 National Taiwan Ocean University.

Measuring Total Filtration Efficiency of Surgical and Community Face Masks: Impact of Mask Design Features

Surgical and community face masks are used worldwide to reduce the transmission of respiratory infections in indoor environments. Performance parameters for these loose-fitting devices are mainly focused on material filtering efficiency, while, differently from face respirators, there are no standard methods for measuring the fraction of air leaking at the face seal. This study quantifies the total filtration efficiency (TFE), a parameter based both on filter efficiency and air leakage, of 50 face mask models with the aim of understanding the role of several mask design features on TFE performance. An instrumented head form equipped with sensors for measuring volumetric airflow and differential pressure was used to simulate the air exhalation from the mouth of a person wearing a face mask. A response surface method (RSM) was used to model the TFE experimental data. Results showed that TFE values ranged over a wide interval (from 5% to 73%), with better values at higher flow rates. A significant positive correlation was found between TFE and filter breathability. The presence of a nosepiece (NP) showed to increase the TFE on average from 4% to 6%, according to the flow rate. Significant improvements were associated only to nosepieces incorporating a metallic wire. The RSM model evidenced that the increase in the number of the filter layers and the use of a meltblown layer result in higher TFE only when a nosepiece is in place. Differently, the benefit of the nosepiece is less marked for masks made of highly breathable filters. To improve overall mask performance, the design of loose-fitting face masks should carefully compromise between breathability and filtration efficiency of the filter materials. The addition of a metallic nosepiece helps improving the TFE by limiting the air leaking at the face seal. © 1963-2012 IEEE.

Fe(VI) activation system mediated by a solar-driven TiO2 nanotubes electrode for CLQ degradation: Performances, mechanisms and pathways.

Ferrate (Fe(VI), FeO42-) has been widely used in the degradation of micropollutants with the advantages of high redox potential, no secondary pollution and inhibition of disinfection byproducts. However, the low transformation of Fe(V) and/or Fe(IV) by Fe(VI) and incomplete mineralization of pollutants limit their application. In this work, we designed a photo electric cell with TiO2 nanotubes (TNTs) and Pt serving as the anode and cathode to enhance the utilization of Fe(VI) (Fe(VI)-TNTs system). TNTs accelerated the generation of •OH via hVB+ oxidation of OH- and photogenerated electrons at Pt boosted the transformation of Fe(VI) to Fe(V) and/or Fe(IV), resulting in a 22.2 % enhancement of chloroquine (CLQ) removal compared to Fe(VI) alone. The results from EPR and quenching tests showed that Fe(VI), Fe(V), Fe(IV), •OH, O2•- and hVB+ coexisted in the Fe(VI)-TNTs system, among which Fe(V) and Fe(IV) were testified as the primary reactive substances accounting for 59 % of CLQ removal. The performance tests and recycling tests demonstrated that the Fe(VI)-TNTs system maintained excellent performance in an authentic water environment. The plausible degradation pathway of CLQ oxidized in the Fe(VI)-TNTs system was proposed with nine identified oxidation products via N-C cleavage, electrophilic addition and carboxylation processes. Based on the ECOSAR calculation, the constructed reaction system allowed a decrease in acute and chronic toxicity. Our findings provide a highly efficient and cost-effective strategy to enhance Fe(VI) application for micropollutant degradation in the future.

Removal Performance and Mechanism of Emerging Pollutant Chloroquine Phosphate from Water by Iron and Magnesium Co-Modified Rape Straw Biochar.

Chloroquine phosphate (CQP) is effective in treating coronavirus disease 2019 (COVID-19); thus, its usage is rapidly increasing, which may pose a potential hazard to the environment and living organisms. However, there are limited findings on the removal of CQP in water. Herein, iron and magnesium co-modified rape straw biochar (Fe/Mg-RSB) was prepared to remove CQP from the aqueous solution. The results showed that Fe and Mg co-modification enhanced the adsorption efficiency of rape straw biochar (RSB) for CQP with the maximum adsorption capacity of 42.93 mg/g (at 308 K), which was about two times higher than that of RSB. The adsorption kinetics and isotherms analysis, as well as the physicochemical characterization analysis, demonstrated that the adsorption of CQP onto Fe/Mg-RSB was caused by the synergistic effect of pore filling, π-π interaction, hydrogen bonding, surface complexation, and electrostatic interaction. In addition, although solution pH and ionic strength affected the adsorption performance of CQP, Fe/Mg-RSB still had a high adsorption capability for CQP. Column adsorption experiments revealed that the Yoon-Nelson model better described the dynamic adsorption behavior of Fe/Mg-RSB. Furthermore, Fe/Mg-RSB had the potential for repeated use. Therefore, Fe and Mg co-modified biochar could be used for the remediation of CQP from contaminated water.

Enhanced activation of PMS by a novel Fenton-like composite Fe3O4/S-WO3 for rapid chloroxylenol degradation.

Chloroxylenol (PCMX) is widely used as disinfectant since the epidemic outbreak due to its effective killing of Covid-19 virus. Its stable chemical properties make it frequently detected in surface water. Herein, we successfully modified Fe3O4 nanoparticles with S-WO3 (X-Fe3O4/S-WO3) to accelerate the Fe2+/Fe3+ cycle. The composite has outstanding PCMX degradation and peroxymonosulfate (PMS) decomposition efficiency over a wide pH range (3.0 âˆ¼ 9.0). 80-Fe3O4/S-WO3/PMS system not only increased PMS decomposition efficiency from 27.7% to 100.0%, but also realized an enhancement of PCMX degradation efficiency by 16 times in comparison with that of Fe3O4 alone. The catalyst utilization efficiency reached 0.3506 mmol∙g-1∙min-1 which stands out among most Fenton-like catalysts. The composite has excellent degradation ability to a variety of emerging pollutants, such as antibiotics, drugs, phenols and endocrine disrupters, and at least a 90% removal efficiency reached in 10 min. The degradation of PCMX was dominated by HO•, SO4 •- and 1O2. The degradation pathways of PCMX were analyzed in detail. The component WS2 in S-WO3 plays a co-catalytic role instead of WO3. And the exposed active W4+ surf. efficiently enhanced the Fe3+/Fe2+ cycle, thereby complete PMS decomposition and high catalytic efficiency were achieved. Our findings clarify that applying two-dimensional transition metal sulfide WS2 to modify heterogeneous Fe3O4 is a feasible strategy to improve Fenton-like reaction and provide a promising catalyst for PCMX degradation.

Survival-Based Feature Extraction - Application in Supply Management for Dispersed Vending Machines

The outbreak of the COVID pandemic revealed that supply chains are not resilient to such a type of turmoil, and the food industry appeared to be particularly vulnerable. Meanwhile, customers expect uninterrupted deliveries and the products' selection responding to their preferences. In this article, we discuss several topics related to supply management that allow preparing a delivery plan for a distributed network of vending machines, considering each location individually. The developed solution takes advantage of the state-of-the-art machine learning methods. However, it is human-centric and aligned with the concept of Industry 5.0. We present the conceptual and technological side of the solution with a particular emphasis on the developed feature extraction framework, which uses selected indicators from the survival analysis. We present an analysis of the real data confirming that the proposed approach copes well with high uncertainty in data, addressing the cold-start problem. © 2005-2012 IEEE.

Foreign Bodies Detector Based on DETR for High-Resolution X-Ray Images of Textiles

Foreign bodies (FBs) detection for X-ray images of textiles is a novel and challenging task. To solve the problem of poor performance of anchor-based detectors for FBs detection, we propose a feature-enhanced object detection framework with transformer (FE-DETR). Based on the split-attention of residual split-attention network (ResNeSt), we add convolutional block attention module (CBAM) between residual blocks and replace the $3\times $ 3 convolutional layer of the last residual block with deformable convolution network (DCN) to adapt FBs with different scales. Then, we propose a multiscale feature encoding (MSFE) module to solve the feature dispersion caused by deep convolution. Meanwhile, the transformer module is selected as the prediction head of the detector. During training, several heuristic strategies are used to further optimize the performance of FE-DETR. In addition, we construct a benchmark dataset for the textile FBs detection task. With end-to-end training, FE-DETR achieves higher performance than the baseline and mainstream state-of-the-art methods, with mean average precision (mAP) = 0.74, average precision (AP) = 0.992, average recall (AR) = 0.971, and $F1$ -score = 0.987. This article has been applied to the production line of medical protective clothing during the Corona Virus Disease 2019 (COVID-19) period and has yielded impressive results in actual production. © 1963-2012 IEEE.

Three birds, one stone: Disinfecting and turning waste medical masks into valuable carbon dots for sodium hydrosulfite and Fe3+ detection enabled by a simple hydrothermal treatment.

Disposable medical masks are widely used to prevent respiratory infections due to their ability to block virus particles from entering the human body. The coronavirus disease 2019 (COVID-19) pandemic highlighted the importance of medical masks, leading to their widespread use around the world. However, a large number of disposable medical masks have been discarded, some carrying viruses, which have posed a grave threat to the environment and people's health, as well as wasting resources. In this study, a simple hydrothermal method was used for the disinfection of waste medical masks under high-temperature conditions as well as for their transformation into high-value-added carbon dots (CDs, a new type of carbon nanomaterial) with blue-emissive fluorescence, without high energy consumption or environmental pollution. Moreover, the mask-derived CDs (m-CDs) could not only be used as fluorescent probes for sensing sodium hydrosulfite (Na2S2O4), which is widely used in the food and textile industries but is seriously harmful to human health, but also be used for detecting Fe3+ which is harmful to the environment and human health due to its wide use in industries.

SARS-CoV-2 Infection Dysregulates Host Iron (Fe)-Redox Homeostasis (Fe-R-H): Role of Fe-Redox Regulators, Ferroptosis Inhibitors, Anticoagulants, and Iron-Chelators in COVID-19 Control.

Severe imbalance in iron metabolism among SARS-CoV-2 infected patients is prominent in every symptomatic (mild, moderate to severe) clinical phase of COVID-19. Phase-I - Hypoxia correlates with reduced O2 transport by erythrocytes, overexpression of HIF-1α, altered mitochondrial bioenergetics with host metabolic reprogramming (HMR). Phase-II - Hyperferritinemia results from an increased iron overload, which triggers a fulminant proinflammatory response - the acute cytokine release syndrome (CRS). Elevated cytokine levels (i.e. IL6, TNFα and CRP) strongly correlates with altered ferritin/TF ratios in COVID-19 patients. Phase-III - Thromboembolism is consequential to erythrocyte dysfunction with heme release, increased prothrombin time and elevated D-dimers, cumulatively linked to severe coagulopathies with life-threatening outcomes such as ARDS, and multi-organ failure. Taken together, Fe-R-H dysregulation is implicated in every symptomatic phase of COVID-19. Fe-R-H regulators such as lactoferrin (LF), hemoxygenase-1 (HO-1), erythropoietin (EPO) and hepcidin modulators are innate bio-replenishments that sequester iron, neutralize iron-mediated free radicals, reduce oxidative stress, and improve host defense by optimizing iron metabolism. Due to its pivotal role in 'cytokine storm', ferroptosis is a potential intervention target. Ferroptosis inhibitors such as ferrostatin-1, liproxstatin-1, quercetin, and melatonin could prevent mitochondrial lipid peroxidation, up-regulate antioxidant/GSH levels and abrogate iron overload-induced apoptosis through activation of Nrf2 and HO-1 signaling pathways. Iron chelators such as heparin, deferoxamine, caffeic acid, curcumin, α-lipoic acid, and phytic acid could protect against ferroptosis and restore mitochondrial function, iron-redox potential, and rebalance Fe-R-H status. Therefore, Fe-R-H restoration is a host biomarker-driven potential combat strategy for an effective clinical and post-recovery management of COVID-19.

A photoelectrochemical immunosensor based on magnetic all-solid-state Z-scheme heterojunction for SARS-CoV-2 nucleocapsid protein detection.

Rapid, convenient and accurate detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is urgently needed to timely diagnosis of coronavirus pandemic (COVID-19) and control of the epidemic. In this study, a signal-off photoelectrochemical (PEC) immunosensor was constructed for SARS-CoV-2 nucleocapsid (N) protein detection based on a magnetic all-solid-state Z-scheme heterojunction (Fe3O4@SiO2@TiO2@CdS/Au, FSTCA). Integrating the advantages of magnetic materials and all-solid-state Z-scheme heterostructures, FSTCA was implemented to ligate the capture antibody to form magnetic capture probe (FSTCA/Ab1). It can simplify the separation and washing process to improve reproducibility and stability, while allowing immune recognition to be performed in the liquid phase instead of the traditional solid-liquid interface to improve anti-interference. Besides, the heterojunction inhibited the recombination of photogenerated electron/hole (e-/h+) and promoted the light absorption to provide superior photoelectric substrate signal. The mechanism of photogenerated e-/h+ transfer of FSTCA were investigated by the electron spin resonance (ESR) spectroscopy. SiO2 spheres loaded with Au NPs utilized as an efficient signal quencher. The steric hindrance effect of SiO2@Au labeled detection antibodies (SiO2@Au-Ab2) conjugates significantly diminished light absorption and hindered the transfer of photogenerated electrons, further amplifying the signal change value. Based on the above merits, the elaborated immunosensor had a wide linear range of 10 pg mL-1-100 ng mL-1 and a low detection limit down to 2.9 pg mL-1 (S/N = 3). The fabricated PEC immunosensor demonstrated strong anti-interference, easy operation, and high sensitivity, showing enormous potential in clinical diagnosis of SARS-CoV-2.

Simultaneously ultrasensitive and quantitative detection of influenza A virus, SARS-CoV-2, and respiratory syncytial virus via multichannel magnetic SERS-based lateral flow immunoassay.

Respiratory viruses usually induced similar clinical symptoms at early infection. Herein, we presented a multichannel surface-enhanced Raman scattering-based lateral flow immunoassay (SERS-based LFA) using high-performance magnetic SERS tags for the simultaneous ultrasensitive detection of respiratory viruses, namely influenza A virus (H1N1), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) in biological samples. As-prepared magnetic SERS tags can directly enrich and capture target viruses without pretreatment of samples, avoiding the interference of impurities in the samples as well as improving the sensitivity. With the capture-detection method, the detection limits of the proposed assay reached 85 copies mL-1, 8 pg mL-1, and 8 pg mL-1 for H1N1, SARS-CoV-2 and RSV, respectively. Moreover, the detection properties of the proposed method for target viruses in throat swab samples were verified, suggesting its remarkable potential for the early and rapid differential diagnosis of respiratory viruses.

Colorimetric and Raman dual-mode lateral flow immunoassay detection of SARS-CoV-2 N protein antibody based on Ag nanoparticles with ultrathin Au shell assembled onto Fe3O4 nanoparticles.

Serological antibody tests are useful complements of nuclei acid detection for SARS-CoV-2 diagnosis, which can significantly improve diagnostic accuracy. However, antibody detection in serum or plasma remains challenging to do with high sensitivity. In this study, Ag nanoparticles with ultra-thin Au shells embedded with 4-mercaptobenzoic acid (MBA) (AgMBA@Au) were manufactured and then assembled onto Fe3O4 surface by electrostatic interaction to construct the Fe3O4-AgMBA@Au nanoparticles (NPs) with magnetic-Raman-colorimetric properties. Based on the composite nanoparticles, a colorimetric and Raman dual-mode lateral flow immunoassay (LFIA) for ultrasensitive identification of SARS-CoV-2 nucleocapsid (N) protein antibody was constructed. The magnetic nanoparticles (Fe3O4 NPs) were acted as the core and coated a layer of AgMBA@Au particles on the surface by electrostatic interaction to prepare Fe3O4-AgMBA@Au NPs, which can amplify the SERS signal due to multiple AgMBA@Au particles concentrated on a single magnetic nanoparticle. Moreover, the Fe3O4-AgMBA@Au NPs facilitated pre-purifying sample using magnetic separation, and complex matrix interference would be greatly decreased in the detection. The Fe3O4-AgMBA@Au NPs modified with N protein recognized and bound with N protein antibodies, which were trapped on the T-line, forming color band for observing detection. Under optimal conditions, the N protein antibodies could be qualitatively detected in colorimetric mode with the visual limit of 10-8 mg/mL and quantitatively detected by SERS signals between 10-6 and 10-10 mg /mL with 0.08 pg/mL detection limit. The coefficients variations (CV) of intra-assay was 8.0%, whereas of inter-assay was 11.7%, confirming of good reproducibility. Finally, this approach was able to discriminate between positive, negative, and weakly positive samples when detecting 107 clinical serum samples. The process enables highly sensitive quantitative assays that are valuable for evaluating disease processes and guiding treatment. Colorimetric and Raman dual-mode LFIA detection of SARS-CoV-2 N protein antibody based on Fe3O4-AgMBA@Au nanoparticles.

Preparation of LiFePO4/C cathode material by extracting Fe2O3 from laterite nickel ore by ammonium jarosite method

In the context of the COVID-19 pandemic and the war between Russia and Ukraine, domestic oil prices have skyrocketed. Saving resources and develop lithium ion batteries with excellent performance are particularly important. In view of unreasonable utilization of non-target elements in laterite nickel ore and high energy consumption of traditional sulfate roasting laterite nickel ore, a pioneering idea was adopted to combine laterite nickel ore with LiFePO 4 , which not only meets the resource saving but also prepares lithium ion batteries with excellent performance, in this study. Using ammonium sulfate roasting laterite nickel ore-ammonium jarosite iron precipitation and hydrolysis preparation of Fe 2 O 3 -carbon thermal reduction preparation of LiFePO 4 /C process means, to achieve the ultimate goal of preparing LiFePO 4 from laterite nickel ore. Determining the optimum conditions of each part of experiment by single factor experiment and orthogonal experiment. It was concluded that under the optimal preparation conditions, the discharge specific capacity of lithium ion battery was 164.56 mAh/g at the rate of 0.5 C, and it was 94% of the theoretical capacity. After 100 cycles, we could find that the discharge specific capacity could be maintained at 162.78 mAh/g, and the capacity retention rate still reached 98%. • Preparation of LiFePO 4 /C cathode material from laterite nickel ore for rational utilization of resources. • Ammonium sulfate roasting laterite nickel ore can greatly improve the recovery rate of nickel and iron resources • The ammonium jarosite method has high iron precipitation rate, simple operation and less pollution. • The preparation of LiFePO 4 /C cathode material by carbothermal reduction method is conducive to practical applications. [ FROM AUTHOR]

Fe Element Analysis in the Spleen Tissue by Using EDS and ICP-MS after Aminated Silica Shelled Magnetite (Fe3O4) Administered to the Tail Vein of Mice

The suppression of cytokine storm in severe coronavirus disease 2019 (COVID-19) patients can be treated with monoclonal antibody therapy against CD3 for T cell receptor inhibition. An optimized liquid phase as a CD3 antibody-magnetic nanoparticle (Ab-MNP) conjugate can inhibit the overactivation of T cells. We aim to ana-lyze the distribution of Fe in the spleen after acute administration of silica-conjugated amine magnetite (Fe3O4) nanoparticles (35 nm) delivered by intravenous injection. The Fe element distribution and concentration levels in spleen tissue were analyzed using energy dispersive spectroscopy (EDS) and inductively coupled plasma-mass spectrometry (ICP-MS). The experimental result is a difference in the concentration of Fe elements, which was 1.89×103 mg/kg in the spleen of a control mouse not administered with MNPs, whereas increases sig-nificantly to 1.93×103 mg/kg in that of a mouse administered with MNPs. Further, time kinetic analysis of bio-chemical and immunological parameters is required to confirm its suitability in bio-administration. © 2022 Journal of Magnetics.

Are we sure that the prevalence of SARS-CoV-2 infection is not underestimated? Usefulness of serological antibodies assays in children and adolescents with type 1 diabetes

Introduction: The true incidence of SARS-CoV-2 infection in children and young people (CYP) is unclear and data are influenced by testing strategies. CYP have so far accounted for 17.5- 22% of diagnosed infections. In adults, diabetes was identified as risk factor for severe symptoms and hospitalization with the COVID-19. Eighteen months into the pandemic, studies in CYP with type 1 diabetes (T1D) reported only an increased prevalence of diabetic ketoacidosis (DKA) at T1D onset. Objective(s): To investigate the prevalence and clinical characteristics of SARS-CoV-2 infection in CYP with T1D. Method(s): SARS-CoV-2 infection was defined according to self-reported previous SARS-CoV-2 nasal swab PCR results in 210 CYP followed during 18 months of the pandemic and seroprevalence of antibodies against the SARS-CoV-2 spike protein assessed in 85 CYP (previous negative nasal swab PCR or never performed) from January to June 2021, before COVID-19 vaccination era. SARS-CoV-2 IgG were assessed using a chemiluminescent immunoassay (CLIA). Data on clinical characteristics as well as glycemic control were collected before (T0) and 3-months after (T1) infection. Result(s): SARS-CoV-2 infection was detected in 39 patients (males 61.5%;median age 13.5 and T1D duration 5.49 yrs.) during second and third wave: 26 (66.6%) based on the self-reported nasal swab PCR results and 13 (33.4%) on the SARS-CoV-2 IgG assay. All patients detected by CLIA were asymptomatic. Four patients detected by nasal swab PCR were asymptomatic (15.4%). Other patients reported >=1 symptoms lasting a median of 5 days and including: fever (46.1%), headache (28.2%), anosmia and/or ageusia (25.6%), nasal congestion (15.4%), and fatigue/myalgia (10.2%). Dry cough, pharyngeal erythema, nausea and/or vomiting, diarrhea, abdominal pain, and arthralgia were less reported (2.56%). None had dyspnea, skin lesion, and MIS-C. Hospitalizations, DKA, and severe hypoglycemic events were not recorded. Glycemic control was not impaired from T0 to T1 (see Table). Conclusion(s): We found evidence for increased prevalence of SARS-CoV-2 infection among CYP with T1D using antibodies against the SARS-CoV-2 spike protein assessment. Asymptomatic subjects were 43%. COVID-19 pandemic had no impact on glycemic control and acute complications. Our data suggest that serological assay is useful to diagnose previous SARS-CoV-2 infection in not vaccinated CYP and to reconstruct the disease prevalence.

Erythroderma and Eosinophilia with Multi-System Involvement, a Case of Vress

Introduction: Resembling Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Virus Reactivation with Eosinophilia and Systemic Symptoms (VRESS) occurs triggered by members of Herpesviridae family viruses. Case Description: A 12-year-old male was hospitalized with a 5-day history of fever, pruritic erythematous rash on the trunk and extremities, and facial edema. The patient was exposed to a cousin diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) 10 days prior. No history of traveling, unusual food intake, URI, drug ingestion during the prior 3 months. Patient was treated with clindamycin x 10 days for possible Staphylococcal Scalded Skin Syndrome. Patient was noted to have eosinophilia of >2000 that persisted through the hospital course and thereafter, transaminitis with direct bilirubinemia, transient microscopic hematuria, elevated CRP and C3, normal EKG and chest radiograph, normal T/B/NKC counts, normal levels of immunoglobulins and elevated IgE (2163>1579IU/mL). IgG and IgM were negative for: CMV, adenovirus, strongyloidces, HAV, HBV, and HIV. IgG positive to: EBV, HHV-6, mycoplasma, HHV-6, HSV1, and parvovirus. Negative cultures for MRSA and group A Streptococcus. Negative PCRs for COVID -19. At 8 week follow up, skin erythema evolved into desquamation in the fingers and eosinophilia persisted. Discussion(s): VRESS should be on the differential for patients presenting with a DRESS-like symptoms in the absence of drug exposures. VRESS is often triggered by members of the Herpesviridae family of viruses including EBV and HHV-6, to both of which this patient was exposed to in the past. While diagnosis is one of exclusion, early identification can guide appropriate management. Copyright © 2022

Management of Urogynaecological Problems in Pregnancy and Postpartum Period during Covid

Background: Urogynaecological problems are the gynae related disorders of urinary system which affect women during pregnancy and postpartum period. Covid-19 also had an impact on these disorders. Objective(s): The main objective of this study is to find out how urogynaecological problems occur in pregnancy and postpartum period and how these problems were managed during covid 19. Study Design: Cross-sectional study Place and Duration: Gynaecology and Obstetrics department of Al-Nafees Medical College and Hospital, Islamabad, from 5th February 2020 to 6th August 2021. Method(s): We included 220 pregnant women in our study. Their age, body mass index, gestational age, mode of delivery, fetal age at the time of delivery were measured. Prevalence of urogynaecological problems in pregnant women was also noted. Among these 220 females, 50 females got infected with covid. We compared their complications with complications of pregnant women who weren't infected with covid. Result(s): Body mass index of pregnant women with urogynaecological problems was 22 to 36 kg/m2. 12 to 14 kg weight increased during pregnancy. Gestational age at delivery was 38 to 42 weeks. Fetal weight was 2 to 4 kg at the time of birth. 62% women had vaginal mode of delivery while 38% had cesarian. Prevalence of urinary tract infections was 7%, stress urinary incontinence was 18 to 70%, uterine prolapse was 5 to 8% in pregnant women. 45% pregnant women had increased micturition frequency. Their were also some chances of formation of renal stones during pregnancy. Pregnant women who got infected with covid -19 had to face several other complications as well. These complications were managed with hygiene behaviour, balanced diet, exercise and medications. Conclusion(s): Urogynaecological problems are commonly found in pregnant women due to enlargement of kidneys and increased GFR during pregnancy. During pregnancy, uterus size increases which leads to compression of ureters and increased bacterial growth. Increased growth of bacteria causes urinary tract infections. Vaginal mode of delivery increases the risk of uterine prolapse. Covid-19 also had an impact on urogynaecological problems. These problems were managed during pandemic by avoiding direct contact. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

Summary of global surveillance data of infectious diseases in October 2022

In October 2022, a total of 67 infectious diseases were reported globally, affecting 235 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (235), monkeypox (109), dengue fever (30), measles (27) and cholera (14). The top five infectious diseases with highest case fatality rates were Rift Valley fever (48.9%), Ebola virus disease (38.7%), Crimean-Congo haemorrhagic fever (27.3%), Lassa fever (18.2%) and West Nile fever (7.1%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, cholera, measles and dengue fever. The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, cholera, yellow fever, Lassa fever, malaria and monkeypox, the prevalent infectious diseases in America were COVID-19, cholera, dengue fever and monkeypox, the prevalent infectious disease in Europe were COVID-19, monkeypox and West Nile fever.

Assessment of Readmission Risk Factors after Index Hospital Discharge for Covid-19 Patients

INTRODUCTION: During the COVID-19 pandemic, the burden on the healthcare system makes it critical to examine readmission patterns. In this study, we evaluated the readmission rates and risk factors associated with COVID-19 from the large SCCM Discovery VIRUS: COVID-19 Registry. METHOD(S): This was a retrospective, cohort study including hospitalized adult patients from 181 hospitals in 24 countries within the VIRUS: COVID-19 Registry. Demographic, clinical, and outcome data were extracted and divided into two groups: Patients with readmission with COVID-19 in 30 days from discharge and those who were not. A univariate analysis is done using chi-square and t-test as appropriate. Multivariable logistic regression was used to measure risk factor associations with 30-day readmission. RESULT(S): Among 20,283 patients, 1,195 (5.9%) were readmitted within 30 days from discharge. The median (IQR) age of readmitted patients was 66 (55-78) years and 45.2% were female, 60.2% were white, and 78.9% non-Hispanic. Higher odds of readmission were observed in patients aged >60 vs 18-40 years (OR 2.76;95% CI, 2.23-3.41), moderate COVID-19 disease (WHO Ordinal scale 4-5) vs Severe COVID-19 (WHO Ordinal scale 6-9) (OR 1.23;95% CI, 1.10-1.39), no ICU admission at index hospitalization (OR 1.70;95% CI, 1.32-1.80), and Hospital length of stay <=14 vs >14 days (OR 1.53;95% CI, 1.32-1.80) vs those not readmitted (p= < 0.001). Comorbidities including coronary artery disease (OR 2.14;95% CI 1.84-2.48), hypertension (OR 1.58;95% CI 1.40-1.78), congestive Heart Failure (OR 2.54;95% CI 2.16-2.98), chronic pulmonary disease (OR 2.26;95% CI 1.94-2.63), diabetes (OR 1.32;95% CI 1.17-1.49) or chronic kidney disease (CKD) (OR 2.41;95% CI 1.2.09-2.78) were associated with higher odds of readmission. In multivariate logistic regression adjusted for age group, hospital length of stay <=14 days and, highest WHO COVID-19 ordinal scale and index ICU admission coronary artery disease, congestive heart failure, chronic pulmonary disease, chronic kidney disease, hospital length of stay <=14 days and age >60 years remained independent risk factors for readmission within 30 days. CONCLUSION(S): Among hospitalized patients with COVID-19, those readmitted had a higher burden of comorbidities compared to those non-readmitted.