Outcomes following extracorporeal membrane oxygenation for severe COVID-19 in pregnancy or post partum

IMPORTANCE: Existing reports of pregnant patients with COVID-19 disease who require extracorporeal membrane oxygenation (ECMO) are limited, with variable outcomes noted for the maternal-fetal dyad. OBJECTIVE: To examine maternal and perinatal outcomes associated with ECMO used for COVID-19 with respiratory failure during pregnancy. DESIGN, SETTING, AND PARTICIPANTS: This retrospective multicenter cohort study examined pregnant and postpartum patients who required ECMO for COVID-19 respiratory failure at 25 hospitals across the US. Eligible patients included individuals who received care at one of the study sites, were diagnosed with SARS-CoV-2 infection during pregnancy or up to 6 weeks post partum by positive nucleic acid or antigen test, and for whom ECMO was initiated for respiratory failure from March 1, 2020, to October 1, 2022. EXPOSURES: ECMO in the setting of COVID-19 respiratory failure. MAIN OUTCOME AND MEASURES: The primary outcome was maternal mortality. Secondary outcomes included serious maternal morbidity, obstetrical outcomes, and neonatal outcomes. Outcomes were compared by timing of infection during pregnancy or post partum, timing of ECMO initiation during pregnancy or post partum, and periods of circulation of SARS-CoV-2 variants. RESULTS: From March 1, 2020, to October 1, 2022, 100 pregnant or postpartum individuals were started on ECMO (29 [29.0%] Hispanic, 25 [25.0%] non-Hispanic Black, 34 [34.0%] non-Hispanic White; mean [SD] age: 31.1 [5.5] years), including 47 (47.0%) during pregnancy, 21 (21.0%) within 24 hours post partum, and 32 (32.0%) between 24 hours and 6 weeks post partum; 79 (79.0%) had obesity, 61 (61.0%) had public or no insurance, and 67 (67.0%) did not have an immunocompromising condition. The median (IQR) ECMO run was 20 (9-49) days. There were 16 maternal deaths (16.0%; 95% CI, 8.2%-23.8%) in the study cohort, and 76 patients (76.0%; 95% CI, 58.9%-93.1%) had 1 or more serious maternal morbidity events. The largest serious maternal morbidity was venous thromboembolism and occurred in 39 patients (39.0%), which was similar across ECMO timing (40.4% pregnant [19 of 47] vs 38.1% [8 of 21] immediately postpartum vs 37.5% postpartum [12 of 32]; P \u3e .99). CONCLUSIONS AND RELEVANCE: In this multicenter US cohort study of pregnant and postpartum patients who required ECMO for COVID-19-associated respiratory failure, most survived but experienced a high frequency of serious maternal morbidity

AI is a viable alternative to high throughput screening: a 318-target study

High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, high-quality X-ray crystal structures, or manual cherry-picking of compounds. We show that the molecules selected by the AtomNet® model are novel drug-like scaffolds rather than minor modifications to known bioactive compounds. Our empirical results suggest that computational methods can substantially replace HTS as the first step of small-molecule drug discovery

Shoreline Erosion in the Commonwealth of Virginia: Problems, Practices, and Possibilities

This report, Shoreline Erosion in the Commonwealth of Virginia: Problems, Practices, and Possibilities, is a report on the physical, legal, and economic aspects of shoreline erosion in Virginia. Although erosion is a physical process, it generally is not perceived as a problem until it has an economic impact on either an individual, community, or resource. As management of the impacts of erosion involves land use, economic, and legal issues as well as a technical assessment of the problem, an interdisciplinary approach was required. Authors Byrne and Hobbs are physical scientists with experience and interest in the workings of the shoreline. Theberge is a lawyer specializing in marine affairs. Kerns, Langeland, and Scheid are resource economists and environmental planners; and Barber and Olthof are land use planners. The division of responsibilities followed the obvious lines. The physical scientists described the problem and its causes and provided the technical analysis of the shoreline. The economists explored the costs of erosion and of combating erosion and , .. developed the economic decision framework. The planners considered the institutional arrangements and policies necessary for the rational treatment of erosion; and the legal experts researched the existing body of law pertaining to shoreline erosion. The four groups functioned as a team with continuous interaction and discussion among all participants

ZnO nanorods for efficient third harmonic UV generation.

ZnO nanorods grown by both high temperature vapour phase transport and low temperature chemical bath deposition are very promising sources for UV third harmonic generation. Material grown by both methods show comparable efficiencies, in both cases an order of magnitude higher than surface third harmonic generation at the quartz-air interface of a bare quartz substrate. This result is in stark contrast to the linear optical properties of ZnO nanorods grown by these two methods, which show vastly different PL efficiencies. The third harmonic generated signal is analysed using intensity dependent measurements and interferometric frequency resolved optical gating, allowing extraction of the laser pulse parameters. The comparable levels of efficiency of ZnO grown by these very different methods as sources for third harmonic UV generation provides a broad suite of possible growth methods to suit various substrates, coverage and scalability requirements. Potential application areas range from interferometric frequency resolved optical gating characterization of few cycle fs pulses to single cell UV irradiation for biophysical studies

Antigen presenting cells link the female genital tract microbiome to mucosal inflammation, with hormonal contraception as an additional modulator of inflammatory signatures

The microbiome of the female genital tract (FGT) is closely linked to reproductive health outcomes. Diverse, anaerobe-dominated communities with lo

Turbomachinery and Pump Vibrations

Discussion GroupThis group will discuss plant machinery vibration detection, monitoring, and diagnosis, from a Plant O&M point-of-view. All attendees will be encouraged (but not required) to participate in discussions, and contribute topics worthy of discussion. Likely topics presently suggested, which will be affirmed or rejected by attendee vote, include the following: • Condition monitoring vibration sensors and methods • Effectiveness of vibration condition monitoring on rotating equipment for detecting problems • “Diagnostics” versus “prognostics” • Value of, and ROI of, condition-based monitoring of vibration • Vertical pump monitoring, including below ground monitoring • Vibration standards for various pumps and turbomachinery types, sizes, and applications • Vibration test method options, and their proper selection and use • Standard locations for vibration measurement on machinery • Wireless devices: radio noise, effectiveness, experiences, security • Troubleshooting methods for typical vibration problems, and fix options • Operating Deflection Shapes and integration with condition-based monitoring • Finite element analysis application in support of machinery selection and troubleshooting • Rotordynamics analysis use in machinery selection and troubleshooting • Hydraulically-induced vibration: structural, system, rotor, acoustic • Measurement of presence, location, and severity of pump cavitation • Effect of high GVF (gas volume fraction) in centrifugal pumps • Mechanical installation (e.g. piping, foundation, alignment) issues affecting vibration • Seal and bearing effects on vibration, and vibration effects on bearings and seal

Toxic Substances

This part of the CBP Synthesis Report summarizes and integrates the research findings and reconnnendations of 13 projects of the Chesapeake Bay Toxic Substances Program performed between July 1978 and October 1981. The following sections describe research on potentially toxic substances, or toxicants, in water-sediments and selected biota. The subjects considered include a brief review of metals, their sources, distribution and behavior, and then a review of sources and distribution of organic chemicals. Finally, information concerning the significance of toxicants in the- Bay and their pattern of enrichment is provided. Most information synthesized in this report can be traced to its origin in scientific project reports listed in Appendix A.https://scholarworks.wm.edu/vimsbooks/1097/thumbnail.jp