Oral mouthwashes for asymptomatic to mildly symptomatic adults with COVID-19 and salivary viral load: a randomized, placebo-controlled, open-label clinical trial.

BACKGROUND: Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. METHODS: We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. RESULTS: Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). CONCLUSIONS: In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.

Protocol for a Randomized, Open-Label Clinical Trial on the Effect of Mouthwash on Salivary SARS-CoV-2 Load.

Mouthwashes containing cetylpyridinium chloride (CPC) or on-demand aqueous chlorine dioxide (ACD) have potential to reduce the salivary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load in individuals with SARS-CoV-2 infection. This study will evaluate the effect of CPC and on-demand ACD mouthwashes on salivary SARS-CoV-2 levels in individuals with acute asymptomatic or mild SARS-CoV-2 infection (COVID-19) staying in a residential recuperation facility in Osaka, Japan. This randomized, open-label clinical trial will include three equal-sized groups (CPC mouthwash, on-demand ACD mouthwash, and placebo), with 30 participants per group. A stratified replacement block method will be used to ensure balanced allocation based on symptom presence and days since symptom onset. Participants will use mouthwash at set times for 7 days or until the end of recuperation. Saliva samples will be collected at multiple time points and tested for SARS-CoV-2 using quantitative reverse transcription polymerase chain reaction. The primary outcome will be changes in salivary SARS-CoV-2 viral load 2 h after the first mouthwash use compared with the pre-mouthwash level. Secondary outcomes will include changes in salivary viral load and clinical parameters at different time points. This study was registered with the Japan Registry of Clinical Trials on 18 October 2022 (jRCTs051220107).

An Aqueous Redox Flow Battery Using CO2 as an Active Material with a Homogeneous Ir Catalyst.

For the application of CO2 as an energy storage material, a H2 storage system has been proposed based on the interconversion of CO2 and formic acid (or formate). However, energy losses are inevitable in the conversion of electrical energy to H2 as chemical energy (≈70 % electrical efficiency) and H2 to electrical energy (≈40 % electrical efficiency). To overcome these significant energy losses, we developed a system based on the interconversion of CO2 and formate for the direct storage and generation of electricity. In this paper, we report an aqueous redox flow battery system using homogeneous Ir catalysts with CO2 -formate redox pair. The system exhibited a maximum discharge capacity of 10.5 mAh (1.5 Ah L-1 ), capacity decay of 0.2 % per cycle, and total turnover number of 2550 after 50 cycles. During charging-discharging, in situ fluorescence X-ray absorption fine structure spectroscopy based on an online setup indicated that the active species was in a high valence state of IrIV .

Coordination Structure of Samarium Diiodide in a Tetrahydrofuran-Water Mixture.

Chemoselective reductive conversion of organic and inorganic compounds has been developed by the combination of samarium(II) diiodide (SmI2) and water. Despite the extensive previous studies to elucidate the role of water in the reactivity of SmI2, the direct structural data of the reactive Sm2+-water complexes, SmI2(H2O)n, in an organic solvent-water mixture have not been reported experimentally so far. Herein, we performed the structure analysis of the Sm2+-water complex in tetrahydrofuran (THF) in the presence of water by in situ X-ray absorption spectroscopy using high-energy X-rays (Sm K-edge, 46.8 keV). The analysis revealed the dissociation of the Sm2+-I bonds in the presence of ≥ eight equivalents of water in the THF-water mixture. The origin of the peak shift in the UV/visible absorption spectra after the addition of water into SmI2/THF solution was proposed based on electron transitions simulated with time-dependent density-functional-theory calculations using optimized structures in THF or water. The obtained structural information provides the fundamental insights for elucidating the reactivity and chemoselectivity in the Sm2+-water complex system.

Synergistic Effect of Redox Dual PdO x /MnO x Cocatalysts on the Enhanced H2 Production Potential of a SnS/α-Fe2O3 Heterojunction via Ethanol Photoreforming.

In the quest for optimal H2 evolution (HE) through ethanol photoreforming, a dual cocatalyst-modified heterocatalyst strategy is utilized. Tin(II) sulfide (SnS) was hybridized with α-Fe2O3 to form the heterocatalyst FeOSnS with a p-n heterojunction structure as confirmed by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), UV-vis diffusive reflectance spectroscopy (UV-vis DRS), and Brunauer-Emmett-Teller (BET) techniques. PdO x and PdO x /MnO x cocatalysts were loaded onto the FeOSnS heterocatalyst through the impregnation method, as verified by high-resolution transform electron microscopy (HRTEM), X-ray photoelectron spectroscopy (XPS), and elemental mapping. Photocatalytic ethanol photoreforming resulted in the production of H2 as the main product with a selectivity of 99% and some trace amounts of CH4. The FeOSnS2-PdO x 2%/MnO x 1% photocatalyst achieved the highest HE rate of 1654 µmol/g, attributed to the synergistic redox contribution of the PdO x and MnO x species.

Phase I Study to Assess the Safety and Immunogenicity of an Intradermal COVID-19 DNA Vaccine Administered Using a Pyro-Drive Jet Injector in Healthy Adults.

We conducted a nonrandomized, open-label phase I study to assess the safety and immunogenicity of an intradermal coronavirus disease 2019 (COVID-19) DNA vaccine (AG0302-COVID-19) administered using a pyro-drive jet injector at Osaka University Hospital between Yanagida November 2020 and December 2021. Twenty healthy volunteers, male or female, were enrolled in the low-dose (0.2 mg) or high-dose (0.4 mg) groups and administered AG0302-COVID19 twice at a 2-week interval. There were no adverse events that led to discontinuation of the study drug vaccination schedule. A serious adverse event (disc protrusion) was reported in one patient in the high-dose group, but the individual recovered, and the adverse event was not causally related to the study drug. In the analysis of the humoral immune response, the geometric mean titer (GMT) of serum anti-SARS-CoV-2 spike glycoprotein-specific antibody was low in both the low-dose and high-dose groups (246.2 (95% CI 176.2 to 344.1, 348.2 (95% CI 181.3 to 668.9)) at the 8 weeks after first vaccination. Regarding the analysis of the cellular immune, the number of IFN-γ-producing cells responsive to the SARS-CoV-2 spike glycoprotein increased with individual differences after the first dose and was sustained for several months. Overall, no notable safety issues were observed with the intradermal inoculations of AG0302-COVID19. Regarding immunogenicity, a cellular immune response was observed in some subjects after AG0302-COVID19 intradermal inoculation, but no significant antibody production was observed.

Comparison of extraction-based and elution-based polymerase chain reaction testing, and automated and rapid antigen testing for the diagnosis of severe acute respiratory syndrome coronavirus 2.

We aimed to compare the differences in testing performance of extraction-based polymerase chain reaction (PCR) assays, elution-based direct PCR assay, and rapid antigen detection tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We used nasopharyngeal swab samples of patients with coronavirus disease 2019 (COVID-19). We used the MagNA Pure 24 System (Roche Diagnostics K.K.) or magLEAD 12gC (Precision System Science Co., Ltd.) for RNA extraction, mixed the concentrates with either the LightMix Modular SARS-CoV PCR mixture (Roche Diagnostics K.K.) or Takara SARS-CoV-2 direct PCR detection kit (Takara Bio Inc.), and amplified it using COBAS® z480 (Roche Diagnostics K.K.). For elution-based PCR, we directly applied clinical samples to the Takara SARS-CoV-2 direct PCR detection kit before the same amplification step. Additionally, we performed Espline SARS-CoV-2 (Fuji Rebio Co., Ltd.) for rapid diagnostic test (RDT), and used Lumipulse SARS-CoV-2 antigen (Fuji Rebio Co., Ltd.) and Elecsys SARS-CoV-2 antigen (Roche Diagnostics K.K.) for automated antigen tests (ATs). Extraction-based and elution-based PCR tests detected the virus up to 214-216 and 210 times dilution, respectively. ATs remained positive up to 24-26 times dilution, while RDT became negative after 22 dilutions. For 153 positive samples, positivity rates of the extraction-based PCR assay were 85.6% to 98.0%, while that of the elution-based PCR assay was 73.2%. Based on the RNA concentration process, extraction-based PCR assays were superior to elution-based direct PCR assays for detecting SARS-CoV-2.

Ligand-to-metal charge transfer of a pyridine surface complex on TiO2 for selective dehydrogenative cross-coupling with benzene.

Dehydrogenative cross-coupling (DCC) between pyridine and benzene proceeded selectively using a TiO2 photocatalyst under visible light irradiation at optimized concentrations of the substrates. Visible light induces ligand-to-metal charge transfer (LMCT) between pyridine and a TiO2 surface to give a pyridine radical cation, which produces a pyridyl radical by its deprotonation or oxidation of another pyridine molecule. The pyridyl radical attacks a benzene ring to form an sp2C-sp2C bond and a hydrogen atom is subsequently removed to complete DCC. Selective excitation of the pyridine LMCT complex in the presence of an excess amount of benzene would be the key for higher selectivity.

Alkali hexatitanate photocatalysts with various morphologies for selective reduction of carbon dioxide with water.

Various alkali-metal hexatitanate photocatalysts were examined for photocatalytic reduction of carbon dioxide with water. Four types of alkali-metal hexatitanate samples (A2Ti6O13, A = Na, K, Rb, and Cs) were correctly prepared by either a flux method or a solid-state reaction method. Among them, the potassium hexatitanate (K2Ti6O13: KTO) photocatalyst exhibited the highest activity and selectivity to CO formation. Further development of the KTO photocatalyst was examined by changing preparation conditions such as different fluxes, the ratio of flux and substrate, and the calcination temperature, which provided various morphologies, structures, and photocatalytic activities. Among the examined samples, an Ag/KTO photocatalyst consisting of rod-like KTO crystals with a suitable length and width, prepared with a KCl flux at 1273 K for 10 hours and loaded with an Ag cocatalyst, gave the highest activity for CO evolution (4.3 µmol h-1) and the highest selectivity toward CO (96%).

10-Year survey on serum antibody positivity rates and titers for measles and rubella in healthcare workers; an observational study at a Japanese university hospital.

BACKGROUND: We evaluated the effect of the two-dose vaccination strategy, which has been a widely adopted as childhood routine schedule worldwide to acquire herd immunity, on healthcare workers (HCWs) in Japan. METHODS: Between 2010 and 2019, antibody titers for measles and rubella were measured annually among newly employed HCWs at Osaka University Hospital, Japan, using Enzygnost® assays (Siemens Healthcare Diagnostics Co. Ltd., Marburg, Germany). The data were categorized by age to compare the antibody positivity rates and antibody titers among no-vaccine, single-dose, and two-dose groups. RESULTS: Over the 10-year period, the annual antibody positivity rates for measles and rubella were 84.0%-95.3% and 90.0%-94.5%, respectively, without any particular trend. The antibody titers for measles (median [interquartile range]: 8.4 [3.9, 20] vs. 6.1 [3.5, 12]) and rubella (11 [5.5, 20] vs. 6 [3.7, 11]) were statistically lower (p < 0.001) in the two-dose generation than in the single-dose generation. DISCUSSION: A shift from single-dose to two-dose vaccination did not yield an increase in antibody positivity rates for both measles and rubella among HCWs. Notably, antibody titers were significantly lower in the two-dose generation. CONCLUSION: Despite several limitations, our data suggests a paradoxical vulnerability in young HCWs who received the two-dose vaccination in a view of sero-positivity rates.

Anti-Markovnikov Hydroamination of Alkenes with Aqueous Ammonia by Metal-Loaded Titanium Oxide Photocatalyst.

A completely new route was established to synthesize valuable primary amines from alkenes by using aqueous ammonia, that is, a simple photocatalytic hydroamination of alkenes using aqueous ammonia with a metal-loaded TiO2 photocatalyst. Although the photochemical hydroamination prefers to form amines according to the Markovnikov rule, the new photocatalytic hydroamination gives anti-Markovnikov products predominantly. With an Au-loaded TiO2 photocatalyst, the amine yield reached up to 93% and the regioselectivity of anti-Markovnikov products was above 98%. The reaction mechanism was proposed for the new photocatalytic hydroamination.

Pressure-induced dehydrogenative coupling of methane to ethane by platinum-loaded gallium oxide photocatalyst.

Pt/Ga2O3 exhibited high activity for dehydrogenative coupling of methane into ethane (2CH4 → C2H6 + H2) in a fixed-bed flow reactor at 25 °C under 254 nm UV irradiation. The C2H6 formation was negligible at CH4 pressure of 10 kPa, but it was linearly increased with an increase in the pressure to 300 kPa.

Structural characterization of molybdenum-dinitrogen complex as key species toward ammonia formation by dispersive XAFS spectroscopy.

The structural characterization of a hardly-isolatable molybdenum-dinitrogen complex bearing a PNP-type pincer ligand, which is assumed to be a key reactive complex in the stoichiometric transformation of a molybdenum triiodide complex [MoI3(PNP)] into the corresponding molybdenum nitride complex under an atmospheric pressure of dinitrogen, was carried out by using dispersive XAFS.

Comparison of platinum photodeposition processes on two types of titanium dioxide photocatalysts.

The photodeposition method is useful for the preparation of metal-loaded photocatalysts, by which the metal precursors are adsorbed on the photocatalyst surface and reduced by photoexcited electrons to typically form metallic nanoparticles. In the present study, the photodeposition process of Pt nanoparticles was investigated on anatase and rutile TiO2 photocatalysts. It was found that on the anatase surface, only some of the Pt4+ precursors were first adsorbed in an adsorption equilibrium and reduced to form a smaller number of initial metal species; then, they functioned as electron receivers to reduce the remaining precursors on their metallic surfaces and become larger particles. In contrast, the rutile surface can adsorb most of the precursors and quickly reduce them upon photoirradiation to form nanoparticles, giving a larger number of small nanoparticles. As a result, the Pt-loaded rutile photocatalyst exhibited higher activity in hydrogen evolution from an aqueous methanol solution than the Pt-loaded anatase photocatalyst.

Correction: A silver-manganese dual co-catalyst for selective reduction of carbon dioxide into carbon monoxide over a potassium hexatitanate photocatalyst with water.

Correction for 'A silver-manganese dual co-catalyst for selective reduction of carbon dioxide into carbon monoxide over a potassium hexatitanate photocatalyst with water' by Xing Zhu et al., Chem. Commun., 2019, 55, 13514-13517.

Mycobacterium kansasii arthritis of the elbow in an immunocompetent patient with a suspected soft-tissue tumor.

Mycobacterium kansasii is one of the major non-tuberculous mycobacteria species that typically cause pulmonary diseases. M. kansasii is known to cause septic arthritis as an extrapulmonary disease in immunosuppressed patients or chronic skin disease. Herein, we present a case of M. kansasii arthritis involving the elbow of an immunocompetent patient, which was initially suspected to be a soft-tissue tumor. A 70-year-old man presented with a swollen left elbow that had progressed for 18 months with deteriorating arthralgia and limited range of motion. Magnetic resonance imaging revealed filling of the intra-articular space of the elbow and surrounding of the radial head with a soft tissue mass with mixed signal intensity. Initial incisional biopsy was performed via the lateral approach to the elbow joint, and pathological examination of the mass did not reveal any evidence of malignancy. One year after the first operation, arthroscopic surgery was performed to excise the mass following the recurrence of swelling and limited function of the elbow. Pathological examination of the resected synovium revealed epithelioid granulomas containing a multinucleated giant cell and inflammatory cell infiltration, characteristic of mycobacterial infection. M. kansasii was cultured after 2 weeks of incubation of the synovial sample. He experienced full resolution of the swelling and limited function following a combination of synovectomy and multidrug antimycobacterial treatment (rifampin 600 mg/day, clarithromycin 800 mg/day, and ethambutol 750 mg/day). This case highlights the need to consider this rare infection in the differential diagnosis of intra-articular soft tissue tumor-like lesions even in immunocompetent patients.

A silver-manganese dual co-catalyst for selective reduction of carbon dioxide into carbon monoxide over a potassium hexatitanate photocatalyst with water.

A Ag-Mn dual co-catalyst deposited on a K2Ti6O13 photocatalyst significantly enhances the photocatalytic CO2 reduction into CO with an extremely high selectivity of 98% by using H2O as an electron donor, owing to the properties of Ag and MnOx species for promoting CO and O2 formation, respectively.

Flux synthesis of Ba2Li2/3Ti16/3O13 and its photocatalytic performance.

Barium-lithium titanate (Ba2Li2/3Ti16/3O13) was synthesized by using a flux method under some conditions with various chloride salts as the flux, thermal treatment temperatures, solute concentrations, and cooling rates. As a result, fine particles of this material with a rod-like morphology were obtained for the first time. It is suggested that this morphology with high crystallinity is responsible for the increase in the photocatalytic activity of this material without any co-catalyst for H2 and CO evolution from water and CO2. The observed photocatalytic performance is discussed taking into consideration the differences in physicochemical properties, obtained as a result of the synthesis using this method under the different conditions.

Rapid screening and early precautions for carbapenem-resistant Acinetobacter baumannii carriers decreased nosocomial transmission in hospital settings: a quasi-experimental study.

Background: Active surveillance has the potential to prevent nosocomial transmission of carbapenem-resistant Acinetobacter baumannii (CRAB). We assessed whether rapid diagnosis using clinical specimen-direct loop-mediated isothermal amplification (LAMP), a rapid molecular diagnostic assay, and subsequent intervention, could reduce CRAB nosocomial transmission in intensive care units (ICUs). Methods: A before and after (quasi-experimental) study was conducted in two ICUs at the Mahidol University Faculty of Medicine Ramathibodi Hospital with 3 months of observational period followed by 9 months of interventional period. All patients were screened for CRAB using both the culture and LAMP method from rectal swab and/or bronchial aspirates (intubated patients only) upon admission, weekly thereafter, and upon discharge. During the pre-intervention period, we performed contact precautions based on culture results. In contrast, during the intervention period, we initiated contact precautions within a few hours after sample collection on the basis of LAMP results. Results: A total of 1335 patients were admitted to the ICUs, of which 866 patients (pre-intervention period: 187; intervention period: 679) were eligible for this study. Incidence rate of CRAB infection decreased to 20.9 per 1000 patient-days in the intervention period from 35.2 in the pre-intervention period (P < 0.02). The calculated hazard ratio of CRAB transmission was 0.65 (95% confidence interval [CI], 0.44-0.97). Risk factors for CRAB acquisition included exposure to carbapenem (hazard ratio, 2.54 [95% CI: 1.61-5.57]). Conclusions: LAMP screening for CRAB upon ICU admission proved feasible for routine clinical practice. Rapid screening using LAMP followed by early intervention may reduce CRAB transmission rates in ICUs when compared to conventional intervention.