Safe and adequate quantity of water is crucial for the implementation of infection prevention and control measures during the prevention of COVID-19. Rainwater harvesting could be an optional water source to fulfill or support the emergency water demand in areas where there is abundant rainfall. The study aimed to assess the rainwater harvesting potential and storage requirements for households and selected institutions and to determine its adequacy to satisfy the emergency water demand for the prevention of COVID-19 in Dilla town, Southern Ethiopia. Rainwater harvesting potential for households and selected institutions were quantified using 17 years\' worth of rainfall data from the Ethiopian Meteorology Agency. To address the rainfall variability, we computed the confidence limits of monthly harvest-able rainwater potential using confidence intervals about the mean as well as confidence intervals using Coefficient of Variation (COV) of monthly rainfall. The storage requirements were also estimated by considering the driest and west seasons and months. The average annual rainfall in Dilla town was 1464 mm. Households with a roof area of 40 and 100 m2 have the potential to harvest 7.2-39.66 m3 and 19.11-105.35 m3 of rainwater respectively. Similarly, the rainwater harvesting potential for the selected institutions was in the range of 34524.5-190374.5, 4070.8-14964.8 , 1140.4-6288.6, 4561.7-25154.3, 5605.8-14152.8 , and 402.4-2219.1 m3 of rainwater for colleges, vocational schools, secondary schools, primary schools, Dilla University Referral Hospital and health centers respectively. These institutional rainwater harvesting potentials can address, 24-132.2, 222.4 -817.8, 59.4-327.3, 34.6-190.9, 94.5-238.5, and 28.2-155.7 % of the colleges, vocational schools, secondary schools, primary schools, Dilla University referral hospital, and, health centers emergency water demand respectively. Rainwater can be an alternative water source for the town in the prevention and control of COVID-19. Further applied researches must be conducted that can address the rainwater quality and treatment for ease of use.

UNASSIGNED: People with disabilities may be at higher risk for COVID-19 infection and death as a result of their impairments and/or medical conditions, and systemic inequities and disadvantages. People with disabilities are also a very heterogenous group, with many people with disabilities being multiply marginalized. The aim of this study was to examine differences in COVID-19 diagnosis and vaccination between people with and without disabilities, and to explore sociodemographic differences in COVID-19 diagnosis and vaccination among the disability community itself.
UNASSIGNED: To do so, we analyzed secondary United States Census Bureau data from 444,422 people (52,890 adults with disabilities and 391,532 adults without disabilities) about COVID-19 diagnosis, vaccination, and sociodemographics. Frequency person-weights were applied.
UNASSIGNED: In this study, 19.3% of adults with disabilities were diagnosed with COVID-19 during the pandemic compared to 16.7% of adults without disabilities. People with disabilities were 1.20 times more likely to be diagnosed with COVID-19 than adults without disabilities. Among people with disabilities, the following groups were more likely to be diagnosed with COVID-19: people with cognitive disabilities; cisgender women; Black people; Hispanic people; people with some college or associate\'s degrees; people with employer and/or private insurance; and people who lived in larger households. There was not a significant difference in vaccination between people with and without disabilities; however, there were vaccination disparities among the disability community.
UNASSIGNED: Many of the people with disabilities who were more likely to face health care disparities prior to the pandemic were also more likely to be diagnosed with COVID-19 during the pandemic.

Alcohol-associated liver disease is one of the main causes of chronic liver disease. It comprises a clinical-histologic spectrum of presentations, from steatosis, steatohepatitis, to different degrees of fibrosis, including cirrhosis and severe necroinflammatory disease, called alcohol-associated hepatitis. In this focused update, we aim to present specific therapeutic interventions and strategies for the management of alcohol-associated liver disease. Current evidence for management in all spectra of manifestations is derived from general chronic liver disease recommendations, but with a higher emphasis on abstinence and nutritional support. Abstinence should comprise the treatment of alcohol use disorder as well as withdrawal syndrome. Nutritional assessment should also consider the presence of sarcopenia and its clinical manifestation, frailty. The degree of compensation of the disease should be evaluated, and complications, actively sought. The most severe acute form of this disease is alcohol-associated hepatitis, which has high mortality and morbidity. Current treatment is based on corticosteroids that act by reducing immune activation and blocking cytotoxicity and inflammation pathways. Other aspects of treatment include preventing and treating hepatorenal syndrome as well as preventing infections although there is no clear evidence as to the benefit of probiotics and antibiotics in prophylaxis. Novel therapies for alcohol-associated hepatitis include metadoxine, interleukin-22 analogs, and interleukin-1-beta antagonists. Finally, granulocyte colony-stimulating factor, microbiota transplantation, and gut-liver axis modulation have shown promising results. We also discuss palliative care in advanced alcohol-associated liver disease.

UNASSIGNED: Brazil is the second largest country with COVID-19 positive cases worldwide. Due to the potent spread of the virus and the scarcity of kits and supplies, the Brazilian Ministry of Health has granted authorization for the use of kits available during this emergency, without an accurate evaluation of their performance. This study compared the performance and cost-effectiveness of seven molecular assays/kits available in São Paulo, Brazil, for SARS-CoV-2 diagnosis.
UNASSIGNED: A total of 205 nasopharyngeal/oropharyngeal samples from suspected cases of COVID-19, were tested using the following assays: (i) GeneFinder COVID-19 plus RealAmp kit; (ii) 2019-nCoV RNA PCR-Fluorescence Probing, Da An Gene Co.; (iii) in-house RT-qPCR SARS-CoV-2 IAL; (iv) 2019-nCoV kit, IDT; (v) molecular SARS-CoV-2 (E) kit, Bio-Manguinhos; (vi) Allplex 2019-nCoV modified Assay, Seegene Inc, and (vii) Biomol one-step COVID-19 kit, IBMP. The criteria for determining a SARS-CoV-2 true positive result included the cycle threshold cut-off values, the characteristics of exponential/linear curves, the gene target diversity, and a positive result in at least two assays.
UNASSIGNED: The overall sensitivity of the assays listed were GeneFinder 83.6%, Da An Gene 100.0%, IAL 90.4%, IDT 94.6%, Bio-Manguinhos 87.7%, Allplex 97.3%, and IBMP 87.7%. The minor sensitive gene target was RdRP. Although all assays had a Cohen\'s Kappa index ≥0.893, the best tests used multiplex assays identifying N-gene and/or E-gene targets.
UNASSIGNED: All assays tested accurate for diagnosis, but considering cost-effectiveness (cost, time consumption, number of samples tested, and performance), the in-house IAL assay was ideal for COVID-19 diagnosis in São Paulo, Brazil.

BACKGROUND: Highly accurate and sensitive method to measure testosterone in hypogonadal male, female and children is vital for proper diagnosis of hormone-related conditions and their treatment.
OBJECTIVE: To develop an accurate and robust total testosterone ESI-LC-MS/MS quantification method with a simple sample preparation workflow and sufficient sensitivity for serum or plasma samples of all gender and age groups, via ketone functional group derivatization (using Amplifex™ Keto Reagent).
METHODS: A simple sample preparation method to accommodate both low and high numbers of samples was developed using simultaneous protein precipitation and derivatization with Amplifex™ Keto reagent, followed by centrifugation and direct injection of supernatant into an LC-MS/MS system (SCIEX Topaz™ IVD LC-MS/MS, in which MS is equivalent to a SCIEX 4500MD Mass Spectrometer). Total testosterone in human serum or plasma samples was quantified using an external calibration curve generated by calibrators spanning a broad concentration range of ∼1-2000 ng/dL (10-20,000 pg/mL), traceable to NIST 971 SRM. 13C3-enriched testosterone was used as an internal standard to correct for both analyte loss during sample preparation and matrix effect during analysis (Supplementary Information: SI Fig. 4C). Two methods, one using a 96-well filter plate and another using Eppendorf tubes, were developed. Both methods were certified by the Centers for Disease Control (CDC) hormone standardization (HoSt) program for total serum testosterone. The feasibility of implementing the method for plasma and serum samples was tested via a small-scale method comparison study between matched pediatric serum and plasma samples derived from the same donor. In addition, plasma samples originating from the same donor collected in two different anticoagulant tube types (Li-heparin and K2EDTA) were compared.
RESULTS: Using in-house formulated NIST 971-traceable calibrators, the method was linear (r2 > 0.999) between 1 and 2000 ng/dL (10 and 20,000 pg/mL) with a limit of detection of approximately 1 ng/dL (10 pg/mL). The testosterone concentration bias against 40 reference samples from the HoSt certification program was absolute <3% with an average %CV of ∼3-4%. More than 78% of samples passed the CDC bias criterion of ±6.4%. Comparison between pediatric matched serum and plasma samples resulted in high correlation (r2 = 0.997) and bias of <5%. The calculated % difference between matched adult serum and plasma samples was ∼1%.
CONCLUSIONS: Feasibility for an accurate and streamlined method suitable for measuring total testosterone in all human samples was demonstrated with a choice of sample preparation workflow to suit low or high number of samples. The method can potentially be used for plasma matrix from different blood collection tubes (Li-Heparin and K2EDTA).

Multisystem inflammatory syndrome of children (MIS-C) continues to be a highly concerning diagnosis in those recently infected with SARS-CoV-2. The diagnosis of MIS-C cases will likely become even more challenging as vaccine uptake and natural immunity in previously infected persons leads to lower circulating rates of SARS-CoV-2 infection and will make cases sporadic. Febrile children presenting with cardiac dysfunction, symptoms overlapping Kawasaki disease or significant gastrointestinal complaints warrant a thorough screen in emergency departments, urgent care centers, and outpatient pediatric or family medicine practices. An increased index of suspicion and discussion regarding higher level of care (transferring to pediatric tertiary care centers or to intensive care) continues to be recommended. Herein we outline a broad approach with a multidisciplinary team for those meeting the case definition and believe such an approach is crucial for successful outcomes.

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With the 2019 emergence of coronavirus disease 19 (colloquially called COVID-19) came renewed public concern about airborne and aerosolized virus transmission. Accompanying this concern were many conflicting dialogues about which forms of personal protective equipment best protect dental health care practitioners and their patients from viral exposure. In this comprehensive review we provide a thorough and critical assessment of face masks and face shields, some of the most frequently recommended personal safeguards against viral infection. We begin by describing the function and practicality of the most common mask types used in dentistry: procedural masks, surgical masks, and filtering respirator facemasks (also called N95s). This is followed by a critical assessment of mask use based on a review of published evidence in three key domains: the degree to which each mask type is shown to protect against airborne and aerosolized disease, the reported likelihood for non-compliance among mask users, and risk factors associated with both proper and improper mask use. We use this information to conclude our review with several practical, evidence-based recommendations for mask use in dental and dental educational clinics.

There is growing evidence that vaping has the potential to cause adverse health effects. Vaping is affecting the younger and healthier population which is a public concern. Mycoplasma pneumoniae pneumonia is a benign condition and is usually underdiagnosed and is managed in an outpatient setting. Here we present a case of fulminant MPP in a young adult probably associated with VAPI. A 24-year-old woman presented to our hospital for severe hypoxic respiratory failure needing intubation and intensive care unit admission. She had a history for vaping for 2 years prior to presentation. She had fever and an elevated white count. Her Chest X-Ray and CT scan of the chest were consistent with bilateral predominantly lower lobe patchy opacities. She had mildly elevated serum LDH and Urine toxicology screen was positive for THC. Serum IgM Mycoplasma level was positive and her BAL fluid analysis showed lipid-laden macrophages. She was diagnosed as a probable case of VAPI per CDC guidelines with superimposed fulminant MPP. Vaping is known to increase the risk of viral and bacterial pneumonia by compromising the respiratory local immune response. Vaping also causes lipoid pneumonia where the alveoli are filled with lipid-laden macrophages with surrounding inflammation. We hypothesize that this patient had fulminant MPP in the setting of background VAPI. The association between vaping and MPP infection has not been established in the literature and this is the first documented report to establish a link between e-cigarettes and fulminant MPP. Further research is needed to confirm this association.

BACKGROUND: Surgical masks (SMs) are used to reduce bacterial shedding from the mouth, nose and face. This study aimed to investigate whether SMs may be a potential source of bacterial shedding leading to an increased risk of surgical site infection.
METHODS: Bacterial contamination of the SMs was tested by making an impression of the external surface of the mask on sterile culture media immediately. We investigated the difference in bacterial counts between the SMs worn by surgeons and those placed unused in the operating room (OR), and the bacterial count variation with indicated wearing time. Moreover, the difference in bacterial counts on the external surface between the first and second layers of double-layered SMs was also assessed.
RESULTS: The bacterial count on the surface of SMs increased with extended operating times; significant difference was found between the 4- to 6-hour and 0-hour groups (p < 0.05). When we analysed the bacterial counts from the same surgeon, a significant increase was noted in the 2-hours group. Moreover, the bacterial counts were significantly higher among the surgeons than the OR. Additionally, the bacterial count of the external surface of the second mask was significantly higher than that of the first one.
CONCLUSIONS: The source of bacterial contamination in SMs was the body surface of the surgeons rather than the OR environment. Moreover, we recommend that surgeons should change the mask after each operation, especially those beyond 2 hours. Double-layered SMs or those with excellent filtration function may also be a better alternative.
UNASSIGNED: This study provides strong evidence for the identification that SMs as source of bacterial contamination during operative procedures, which should be a cause for alarm and attention in the prevention of surgical site infection in clinical practice.