Evaluating the Performance of UV Disinfection across the 222-365 nm Spectrum against Aerosolized Bacteria and Viruses.

Bioaerosols play a significant role in the transmission of many infectious diseases, especially in enclosed indoor environments. Ultraviolet (UV) disinfection has demonstrated a high efficacy in inactivating microorganisms suspended in the air. To develop more effective and efficient UV disinfection protocols, it is necessary to evaluate and optimize the effectiveness of UV disinfection against aerosolized bacteria and viruses across the entire UV spectrum. In this study, we evaluated the performance of UV disinfection across the UV spectrum, ranging from 222 to 365 nm, against aerosolized bacteria and viruses, including Escherichia coli, Staphylococcus epidermidis, Salmonella enterica, MS2, P22, and Phi6. Six commonly available UV sources, including gas discharge tubes and light-emitting diodes with different emission spectra, were utilized, and their performance in terms of inactivation efficacy, action spectrum, and energy efficiency was determined. Among these UV sources, the krypton chloride excilamp emitting at a peak wavelength of 222 nm was the most efficient in inactivating viral bioaerosols. A low-pressure mercury lamp emitting at 254 nm performed well on both inactivation efficacy and energy efficiency. A UV light-emitting diode emitting at 268 nm demonstrated the highest bacterial inactivation efficacy, but required approximately 10 times more energy to achieve an equivalent inactivation level compared with that of the krypton chloride excilamp and low-pressure mercury lamp. This study provides insights into UV inactivation on bioaerosols, which can guide the development of effective wavelength-targeted UV air disinfection technologies and may significantly help reduce bioaerosol transmission in public areas.

On the estimation of the effect of weight change on a health outcome using observational data, by utilising the target trial emulation framework.

BACKGROUND/OBJECTIVES: When studying the effect of weight change between two time points on a health outcome using observational data, two main problems arise initially (i) 'when is time zero?' and (ii) 'which confounders should we account for?' From the baseline date or the 1st follow-up (when the weight change can be measured)? Different methods have been previously used in the literature that carry different sources of bias and hence produce different results. METHODS: We utilised the target trial emulation framework and considered weight change as a hypothetical intervention. First, we used a simplified example from a hypothetical randomised trial where no modelling is required. Then we simulated data from an observational study where modelling is needed. We demonstrate the problems of each of these methods and suggest a strategy. INTERVENTIONS: weight loss/gain vs maintenance. RESULTS: The recommended method defines time-zero at enrolment, but adjustment for confounders (or exclusion of individuals based on levels of confounders) should be performed both at enrolment and the 1st follow-up. CONCLUSIONS: The implementation of our suggested method [adjusting for (or excluding based on) confounders measured both at baseline and the 1st follow-up] can help researchers attenuate bias by avoiding some common pitfalls. Other methods that have been widely used in the past to estimate the effect of weight change on a health outcome are more biased. However, two issues remain (i) the exposure is not well-defined as there are different ways of changing weight (however we tried to reduce this problem by excluding individuals who develop a chronic disease); and (ii) immortal time bias, which may be small if the time to first follow up is short.

[Application and clinical significance of intercellular proximity labeling technique in chronic myelogenous leukemia].

Objective: This study aimed to explore the application of interaction-dependent fucosyl-biotinylation (FucoID), a chemical biology-based proximity labeling technique, in capturing tumor antigen-specific T cells and its clinical value in chronic myelogenous leukemia (CML) . Methods: Flow cytometry and fluorescence microscopy were employed to evaluate the experimental parameters for FucoID in CML. Peripheral blood samples were obtained from 14 newly diagnosed CML patients in the chronic phase. These samples underwent flow cytometry-based sorting and were subsequently labeled with FucoID to facilitate the isolation of tumor cells and T cells, followed by the immunophenotypic identification of tumor antigen-specific T cells. Finally, the diagnostic and therapeutic potential of FucoID in CML was assessed. Results: Initially, the experimental parameters for FucoID in CML were established. The proportion of CD3(+) T cells in patients was (8.96±6.47) %, exhibiting a marked decrease compared with that in healthy individuals at (38.89±22.62) %. The proportion of tumor-specific antigen-reactive T cells was (3.34±4.49) %, which demonstrated interpatient variability. In addition, the proportion of tumor-specific antigen-active T cells in CD4(+) T cells was (3.95±1.72) %, which was generally lower than the proportion in CD8(+) T cells at (5.68±2.18) %. Compared with those in tumor-specific antigen-nonreactive T cells, CCR7(-)CD45RA(-) effector memory T cells and CCR7(-)CD45RA(+) effector T cells were highly enriched in tumor-specific antigen-reactive T cells. Moreover, the intensity of tumor immune reactivity in patients exhibited a significant correlation with white blood cell count (WBC) and hemoglobin (HGB) levels in peripheral blood, while no such correlation was observed with other clinical baseline characteristics. Conclusion: The combination of FucoID and flow cytometry enables the rapid identification and isolation of tumor antigen-specific T cells in CML. The successful application of this method in CML and the implications of our findings suggest its potential clinical value in the field of hematologic malignancies.

Synergistic disinfection of aerosolized bacteria and bacteriophage by far-UVC (222-nm) and negative air ions.

Air ionizers and 222-nm krypton-chlorine (KrCl) excilamp have proven to be effective disinfection apparatus for bacteria and viruses with limited health risks. We determined inactivation efficiencies by operating them individually and in combined modules. Gram-positive and gram-negative bacteria, non-enveloped dsDNA virus, and enveloped dsRNA virus were examined in a designed air disinfection system. Our results showed that the bioaerosols were inactivated efficiently by negative ionizers and far-UVC (222-nm), either used individually or in combination. Among which the combined modules of negative ionizers and KrCl excilamp had the best disinfection performance for the bacteria. The aerosolized virus P22 and Phi 6 were more susceptible to 222-nm emitted by KrCl excilamp than negative air ions. Significant greater inactivation of bacterial bioaerosols were identified after treated by combined treatment of negative air ion and far-UVC for 2 minutes (Escherichia coli, 6.25 natural log (ln) reduction; Staphylococcus epidermidis, 3.66 ln reduction), as compared to the mean sum value of inactivation results by respective individual treatment of negative ionizers and KrCl excilamp (Escherichia coli, 4.34 ln; Staphylococcus epidermidis, 1.75 ln), indicating a synergistic inactivation effect. The findings provide important baseline data to support the design and development of safe and high-efficient disinfection systems.

Trends in negative emotions throughout the COVID-19 pandemic in the United States.

OBJECTIVES: This study aimed to identify trends in the prevalence of negative emotions in the United States throughout the COVID-19 pandemic between March 2020 and November 2021. STUDY DESIGN: This was a descriptive, repeated cross-sectional analysis of nationally representative survey data. METHODS: Data originated from Gallup's COVID-19 web survey, encompassing 156,684 observations. Prevalence estimates for self-reported prior-day experience of sadness, worry, stress, anger, loneliness, depression, and anxiety were computed, plotted using descriptive trend graphs, and compared with 2019 estimates from the Gallup World Poll. Differences between estimates were evaluated by inspecting confidence intervals. RESULTS: Stress and worry were the most commonly experienced negative emotions between March 2020 and November 2021; worry and anger were significantly more prevalent than prepandemic. The prevalence of sadness, worry, stress, and anger fluctuated considerably over time and declined steadily to prepandemic levels by mid-2021. Distinctive spikes in the prevalence of several negative emotions, especially sadness and anger, were observed following the murder of George Floyd. CONCLUSIONS: Several negative emotions exhibited excess prevalence during the pandemic, especially in spring/summer 2020. Despite recent reductions to prepandemic levels, continued monitoring is necessary to inform policies and interventions to promote population well-being.

Venular amyloid accumulation in transgenic Fischer 344 Alzheimer's disease rats.

Strong evidence demonstrates a significant association between cerebral amyloid angiopathy (CAA) and Alzheimer's disease (AD). For this reason, interest in understanding the underlying vascular pathologies that contribute to AD remain. CAA research has primarily focused on arterioles and capillaries, overlooking the draining venules. Therefore, this study sought to examine venular amyloid pathology and its relationship to arteriolar amyloidosis throughout AD progression in the TgF344-AD rat model. Antibodies targeting the amyloid-beta peptide (Aß) sequence suggest morphological differences between arteriolar and venular amyloid. Mass spectrometric analyses of isolated cortical parenchymal plaques, arteriolar and venular amyloid demonstrated presence of Aß in all three samples, as well as proteins known to be associated with AD. Histopathological analysis indicates a significant age effect for both arteriolar and venular amyloid accumulation, with accumulation initiated in the somatosensory cortex followed by the motor and cingulate cortex. Lastly, significant arteriolar amyloid accumulates relative to venular amyloid deposition in AD progression. Overall, understanding venular and arteriolar amyloid pathology provides insight into the complex connection between CAA and AD.

SARS-CoV-2 detection in primary thyroid sarcoma: coincidence or interaction?

INTRODUCTION: Thyroid dysfunctions associated with SARS-CoV-2 are emerging in scientific literature. During the second COVID-19 epidemic spread, we evaluated a patient with the suspect of subacute thyroiditis. METHODS AND RESULTS: Specimen from fine-needle aspiration of a hypoechoic undefined area was analyzed for cytology and for SARS-CoV-2 detection. SARS-CoV-2 was retrieved by real-time polymerase chain reaction on the cytologic sample, which was then cultured on Vero E6 cells and demonstrated to be cytopathic. Whole-genome sequence was deposited. Histological exam diagnosed a rare case of primary thyroid sarcoma with diffuse and strong expression of mouse double minute 2 homolog (MDM2) oncoprotein. Ultrastructural examination confirmed, in several neoplastic cells, the presence of viral particles in cytoplasmic vacuoles. CONCLUSIONS: In our hypothesis, SARS-CoV-2 and sarcoma coexistence could represent a synergistic interplay, ultimately favoring both viral persistence and tumor proliferation: the overexpression of MDM2 in tumor cells might have generated a favorable immunological niche for SARS-CoV-2 localization and, in turn, SARS-CoV-2 could have favored tumor growth by inducing MDM2-mediated p53 downregulation. Functional studies are needed to confirm this suggestive pathway.

A survey of noise-induced auditory symptoms in manufacturing workers in Brunei Darussalam.

Noise-induced auditory symptoms (NIASs) refer to symptoms that develop after exposure to loud noise, where common symptoms are tinnitus and hearing difficulty. If not detected early or prevented, NIASs may lead to the development of noise-induced hearing loss (NIHL). This cross-sectional study aimed to investigate the prevalence rate of common NIASs and contributing occupational factors among manufacturing workers in Brunei Darussalam. The response rate for this study was 81.7%. The prevalence rate of NIASs was 18% and the most commonly reported symptom was 'ears feeling full after leaving a very noisy place' (10.5%). This study showed a strong association between the absence of hearing protective device use (adjusted odds ratio = 2.118, p = 0.040) and having at least one reported NIAS. The study findings can be used to plan and implement policies where there is a risk of occupational noise exposure to prevent NIASs and further development of NIHL.

Obesity during the COVID-19 pandemic: both cause of high risk and potential effect of lockdown? A population-based electronic health record study.

OBJECTIVES: Obesity is a modifiable risk factor for coronavirus disease 2019 (COVID-19)-related mortality. We estimated excess mortality in obesity, both 'direct', through infection, and 'indirect', through changes in health care, and also due to potential increasing obesity during lockdown. STUDY DESIGN: The study design of this study is a retrospective cohort study and causal inference methods. METHODS: In population-based electronic health records for 1,958,638 individuals in England, we estimated 1-year mortality risk ('direct' and 'indirect' effects) for obese individuals, incorporating (i) pre-COVID-19 risk by age, sex and comorbidities, (ii) population infection rate and (iii) relative impact on mortality (relative risk [RR]: 1.2, 1.5, 2.0 and 3.0). Using causal inference models, we estimated impact of change in body mass index (BMI) and physical activity during 3-month lockdown on 1-year incidence for high-risk conditions (cardiovascular diseases, diabetes, chronic obstructive pulmonary disease and chronic kidney disease), accounting for confounders. RESULTS: For severely obese individuals (3.5% at baseline), at 10% population infection rate, we estimated direct impact of 240 and 479 excess deaths in England at RR 1.5 and 2.0, respectively, and indirect effect of 383-767 excess deaths, assuming 40% and 80% will be affected at RR = 1.2. Owing to BMI change during the lockdown, we estimated that 97,755 (5.4%: normal weight to overweight, 5.0%: overweight to obese and 1.3%: obese to severely obese) to 434,104 individuals (15%: normal weight to overweight, 15%: overweight to obese and 6%: obese to severely obese) would be at higher risk for COVID-19 over one year. CONCLUSIONS: Prevention of obesity and promotion of physical activity are at least as important as physical isolation of severely obese individuals during the pandemic.

Using Geant4 Monte Carlo toolkit to evaluate a low power X-ray tube generator configuration.

Monte Carlo technique has been widely used as an important tool to develop new irradiation equipment, prototype medical equipment parts, and test methodologies for dosimetry. In this manuscript, we present a methodology to design a low power X-ray tube generator using the Geant4 Monte Carlo toolkit. The simulations were performed considering a large number of variables, namely, the material composition of the target track, the window thickness, and the air pressure of the X-ray tube. The X-ray production was simulated considering monoenergetic electron beams impinging on targets of tungsten and copper with incident kinetic energies ranging from 20 keV to 60 keV and initial divergences from 5° to 30°. For the polyenergetic emission, a conservative approach with Gaussian energy distribution was adopted. The analysis indicates that among the evaluated parameters, the incident kinetic energy, and the target material produced the most notable changes in the spectra shape and conversion efficiency (CE), significantly impacting the X-ray tube design. The studies provide a reliable methodology to explore general configurations for X-ray tube generators, defining the best geometry, material compositions, and thicknesses to be used on spectroscopy applications.

Change in newly diagnosed Graves' disease phenotype between the twentieth and the twenty-first centuries: meta-analysis and meta-regression.

PURPOSE: According to a few recent studies, the clinical phenotype of Graves' disease (GD) at onset is becoming milder in recent years, in terms of prevalence and severity of hyperthyroidism, goiter and overt eye disease. The aim of this study was to assess the change in GD phenotype across the late twentieth and the early twenty-first centuries. MATERIALS AND METHODS: We carried out a systematic search of studies published between 1/1/1980 and 12/31/2017 describing naïve GD patients at diagnosis. We collected epidemiological, clinical, biochemical and serological data reported in the selected studies, and (1) conducted a single-arm meta-analysis to compare clinical and biochemical characteristics of naïve GD patients before and after year 2000 and (2) performed a meta-regression to identify the trend of the observed clinical presentations. RESULTS: Eighty selected articles were related to the period before the year 2000, 30 to the years 2000-2017. According to demographics, the two defined populations were homogeneous at meta-analysis: overall estimated female prevalence was 81% [95% CI 79-82], mean estimated age of the entire population was 39.8 years [95% CI 38.4-41.1], with no significant differences between pre- and post-2000 groups (p > 0.05). The overall estimated prevalence of smokers was 40% [95% CI 33-46], with no significant difference between the two groups (p > 0.05). Mean estimated free thyroxine (FT4) and free triiodothyronine (FT3) levels at diagnosis were higher in the pre-2000 group: 4.7 ng/dl [95% CI 4.5-4.9] for FT4 and 14.2 pg/ml [95% CI 13.3-15.1] for FT3, as compared to the post-2000 group: 3.9 ng/dl [95% CI 3.6-4.2] for FT4 and 12.1 pg/ml [95% CI 11.0-13.3] for FT3 (all p < 0.01). Goiter estimated prevalence was higher in the pre-2000 group, 87% [95% CI 84-90], than in the post-2000 group, 56% [95% CI 45-67]. Estimated prevalence for Graves' Orbitopathy (GO) was 34% [95% CI 27-41] in the pre-2000 group and 25% [95% CI 19-30] in the post-2000 group (p = 0.03). Accordingly, meta-regression adjusted for covariates showed an average annual reduction of FT4 (- 0.040 ± 0.008 ng/dl, p < 0.0001), FT3 (- 0.316 ± 0.019 pg/ml, p < 0.0001), goiter prevalence (- 0.023 ± 0.008%, p = 0.006), and goiter size (- 0.560 ± 0.031 ml, p < 0.0001). CONCLUSIONS: Our meta-analysis and meta-regression confirmed that GD phenotype at diagnosis is nowadays milder than in the past; we hypothesize that conceivable factors involved in this change are iodoprophylaxis, worldwide decrease in smoking habits, larger use of contraceptive pill and micronutrient supplementation, as well as earlier diagnosis and management.

In vivo oscillations of the soleus muscle can be quantified using b-mode ultrasound imaging during walking and running in humans.

Impact forces, due to the foot contacting the ground during locomotion, can be considered input signals to the body that must be dissipated to prevent impact-related injuries. One proposed mechanism employed by the body to damp the impact is through vibrations of the skeletal muscles. However, there is yet to be direct in vivo measures of muscle oscillations during locomotion. This study investigated the use of 2D ultrasound imaging to quantify transverse muscle oscillations (deep-superficial displacement of the muscle boundary relative to the skin) in response to impact forces elicited by walking and running at a range of speeds. Increases in vertical impact forces with faster walking and running was consistent with changes in both magnitude and frequency in the measured oscillations of the soleus muscle; one of the main human ankle plantar flexors. Muscle oscillations contained more higher frequency components at fast running (50% signal power in frequencies below ~ 14 Hz) compared with slow walking (50% signal power contained in frequencies below ~ 5 Hz). This study provides a platform for ultrasound imaging to examine muscle oscillation responses to impact forces induced by changes in external interfaces such as shoe material, locomotion type and ground surface properties.

Home-made masks with filtration efficiency for nano-aerosols for community mitigation of COVID-19 pandemic.

OBJECTIVES: The novel coronavirus disease 2019 (COVID-19) epidemic that emerged in December 2019 has rapidly evolved in recent months to become a worldwide and ongoing pandemic. Shortage of medical masks remains an unresolved problem. This study aims to investigate the filtration efficiency (FE) of home-made masks that could be used as alternatives for community mitigation of COVID-19. STUDY DESIGN: Experimental observational analytic study. METHODS: The FE of home-made masks and medical masks (as the control) were tested under laminar flow within a scaled air duct system using nebulised NaCl aerosols sized 6-220 nm. The size-resolved NaCl aerosol count was measured using a scanning mobility particle-sizer spectrometer. Home-made masks with an external plastic face shield also underwent a splash test. In addition, the fibre structures of medical masks were studied under an electron microscope after treatment with either 75% alcohol or soap and water at 60 °C. RESULTS: The FE of the home-made masks at 6-200 nm were non-inferior to that of medical masks (84.54% vs 86.94%, P = 0.102). Both types of masks achieved an FE of 90% at 6-89 nm. A significantly higher FE was achieved when one piece of tissue paper was added adjacent to the inner surface of the medical mask than medical mask alone (6-200 nm: 91.64% vs 86.94%, P < 0.0001; 6-89 nm: 94.27% vs 90.54%, P < 0.0001; 90-200 nm: 82.69% vs 73.81%, P < 0.0001). The plastic face shield prevented the home-made mask from fluid splash. The fibre structures of the external surface of medical masks were damaged after treatment with either 75% alcohol or soap and water at 60 °C. CONCLUSIONS: The home-made masks in this study, which were made of one piece of tissue paper and two pieces of kitchen towels, layered from face to external, had an FE at 6-200 nm non-inferior to that of medical mask materials, which had a certified FE of ≥95% at 3 µm. In the current COVID-19 pandemic with the shortage of medical masks, these home-made masks combined with an external plastic shield could be used as an alternative to medical masks for community mitigation. In addition, one piece of tissue paper could be placed adjacent to the inner surface of a medical mask to prolong effective lifespan of the medical mask. These demand reduction strategies could be used to reserve medical masks for use in healthcare and certain high-risk community settings, such as symptomatic persons, caregivers and attendees to healthcare institutions.

Body location of "New World" cutaneous leishmaniasis lesions and its impact on the quality of life of patients in Suriname.

Cutaneous leishmaniasis (CL) is a chronic skin infection caused by Leishmania parasites, causing single or multiple skin nodules and ulcers on the exposed body locations. Healing of lesions is followed by scar formation. Active and healed CL lesions may affect patient's health related quality of life (HRQL). The aim of this study was to determine whether the body location of the leishmaniasis lesions affects the HRQL of localized CL patients in Suriname. The HRQL of 163 patients with CL was assessed by Skindex-29 and EQ-5D/VAS questionnaires. Forty-six patients out of the total study population also participated in a qualitative anthropological study involving in depth interviews. All patients were allocated in 4 groups in the following hierarchy: head and face, upper limbs, lower limbs and trunk. Patients with lesions on the lower limbs had significantly higher Skindex-29 scores, indicating worse HRQL, in the symptom scale compared to lesions on head/face and trunk. The lower limb group was more likely to report problems in the dimensions self-care, mobility, daily activities and pain/discomfort of the EQ-5D. Little to no social stigma was reported in the in-depth interviews. The findings of this study indicate that Surinamese patients with CL lesions located on the lower limbs had more impairment in HRQL than on other body locations. Stigma related to CL seems to be virtually absent in Suriname.

Radiological retrograde ureteric stent exchange in women: a single-centre review.

AIM: To evaluate the safety and efficacy of modified wire loop technique for retrograde stent exchange. MATERIALS AND METHODS: All patients were from the KK Women and Children's Hospital where there is no on-site urology service. Patients were identified retrospectively from the institutional radiological information system (RIS) database. In total, 270 stents were removed and 238 replaced for 79 patients between January 2012 to December 2016. Success rates for stent removal and exchange as well as skin dose and fluoroscopy time were assessed. RESULTS: Stent exchange was successful in 234/238 (98%) of cases. Failure was due to loss of access (one case), inability to snare stent due to distorted anatomy (two cases), and extensive encrustation of stent (one case). In 252/270 (93%) cases, stent was removed using modified snare while in 18 (7%) cases, other snare devices were used. Average fluoroscopy time per stent for stent exchange was 573 seconds and average skin dose was 12,494 DAP/mGy•cm2. CONCLUSION: Fluoroscopy-guided retrograde ureteric stent exchange using the modified snare loop technique is effective, quick, and can be performed easily with equipment used in daily intervention practice. It may also be coupled with ureteroplasty, which may help the patient achieve eventual stent-free status.