Prolonged treatment of COVID-19 pneumonia with high-flow nasal oxygen: A story of oxygen and resilience

The COVID-19 pandemic has placed significant strain on the oxygen delivery infrastructure of health facilities in resource-constrained health systems. In this case report, we describe a patient with severe COVID-19 pneumonia who was managed with high-flow nasal oxygen for 40 days, with an eventual successful outcome. We discuss the oxygen delivery infrastructure needed to offer this intervention, as well as the psychosocial impact on those undergoing treatment

Sustainability transitions for smallholder farmers: How can government, research and development programs support profitable goat markets in Tete?

For Mozambique the goat sector provides huge opportunities for reducing rural poverty levels, improving food security and contributing to the national economy. Mozambique has a huge demand for goat meat and products. Large and medium size buyers fail to source enough goats of the right quality and supply consistently to feed the growing demand in urban markets. Despite its potential, the goat sector is not fully developed. Improved goat production can provide an additional annual income of US$50 million at the national level. In the short term farmers can double their income from goats. Though farmers realize the critical role of goats as source of saving and possible source of investment, they do not invest much in goats and are not able to make an adequate profit from selling their goats. Mortality rates of around 15%, poor quality of goats being sold to markets, and livestock theft are losses to entire rural economies. There are many causes for the low productivity, the primary reasons being: a) Lack of a market structure through which farmers and the private sector can interact; b) Absence of a grading system that rewards farmers for their investments in quality production; and c) Livestock theft that destroys community trust, and eventually hampers collective action among farmers..

Characterization of Recurrence Patterns and Outcomes of Medulloblastoma in Adults: The University of Texas MD Anderson Cancer Center Experience

BACKGROUND: Medulloblastoma in adults is rare and treatment decisions are largely driven from pediatric literature. We sought to characterize recurrent medulloblastoma in adults. METHODS: From a single-institution dataset of 200 adult patients diagnosed with medulloblastoma during 1978-2017, those with recurrence were analyzed for clinical features, treatment, and outcome. RESULTS: Of the 200 patients, 82 (41%) with median age of 29 years (18-59) had recurrence after a median follow-up time of 8.4 years (95% CI = 7.1, 10.3). Of these, 30 (37%) were standard-risk, 31 (38%) were high-risk, and 21 (26%) had unknown-risk diseases at the time of initial diagnosis. Forty-eight (58%) presented with recurrence outside the posterior fossa, of whom 35 (43%) had distant recurrence only. Median Progression-free survival (PFS) and OS from initial surgery were 33.5 and 62.4 months, respectively. Neither PFS nor OS from initial diagnosis differed between the standard-risk and high-risk groups in those who experience recurrence ( CONCLUSIONS: Recurrent medulloblastoma in adults has a poor prognosis irrespective of initial risk stratification. Recurrence commonly arises outside the posterior fossa years after initial diagnosis

Risk factors for Coronavirus Disease 2019 (COVID-19) death in a population cohort study from the Western Cape Province, South Africa

BACKGROUND. Risk factors for coronavirus disease 2019 (COVID-19) death in sub-Saharan Africa and the effects of human immunodeficiency virus (HIV) and tuberculosis on COVID-19 outcomes are unknown. METHODS. We conducted a population cohort study using linked data from adults attending public-sector health facilities in the Western Cape, South Africa. We used Cox proportional hazards models, adjusted for age, sex, location, and comorbidities, to examine the associations between HIV, tuberculosis, and COVID-19 death from 1 March to 9 June 2020 among (1) public-sector “active patients” (≥1 visit in the 3 years before March 2020); (2) laboratory-diagnosed COVID-19 cases; and (3) hospitalized COVID-19 cases. We calculated the standardized mortality ratio (SMR) for COVID-19, comparing adults living with and without HIV using modeled population estimates. RESULTS. Among 3 460 932 patients (16% living with HIV), 22 308 were diagnosed with COVID-19, of whom 625 died. COVID- 19 death was associated with male sex, increasing age, diabetes, hypertension, and chronic kidney disease. HIV was associated with COVID-19 mortality (adjusted hazard ratio [aHR], 2.14; 95% confidence interval [CI], 1.70–2.70), with similar risks across strata of viral loads and immunosuppression. Current and previous diagnoses of tuberculosis were associated with COVID-19 death (aHR, 2.70 [95% CI, 1.81–4.04] and 1.51 [95% CI, 1.18–1.93], respectively). The SMR for COVID-19 death associated with HIV was 2.39 (95% CI, 1.96–2.86); population attributable fraction 8.5% (95% CI, 6.1–11.1). CONCLUSIONS. While our findings may overestimate HIV- and tuberculosis-associated COVID-19 mortality risks due to residual confounding, both living with HIV and having current tuberculosis were independently associated with increased COVID-19 mortality. The associations between age, sex, and other comorbidities and COVID-19 mortality were similar to those in other settings.The Western Cape Provincial Health Data Centre from the Western Cape Department of Health, the US National Institutes for Health (grant numbers R01 HD0804, the Bill and Melinda Gates Foundation, the United States Agency for International Development and the Wellcome Trust.https://academic.oup.com/cid/am2023Veterinary Tropical Disease

Electrospun poly(vinyl alcohol) nanofibres with biocidal additives for application in filter media, 1 : properties affecting fibre morphology and characterisation

Aqueous solutions of PVA containing the biocide AquaQure are electrospun into nanofibrous membranes with antimicrobial properties. AquaQure contains, amongst others, Cu2+ and Zn2+ ions. Fibre morphology is observed under a scanning electron microscope, and effects of instrument parameters and solution characteristics on the morphology of electrospun PVA fibres are investigated. The average fibre diameter can be varied from 87¿±¿14 to 246¿±¿50¿nm. It is found that addition of AquaQure has significant effects on fibre diameter due to changes in solution conductivity, surface tension and viscosity. The presence of AquaQure in the fibres is confirmed via several technique

Electrospun poly(vinyl alcohol) nanofibres with biocidal additives for application in filter media, 2 - Antimicrobial activity, regeneration, leaching and water stability

Antimicrobial poly(vinyl alcohol) nanofibres are produced using AquaQure biocide as additive to the polymer solution. AquaQure is an aqueous antimicrobial agent containing mainly Cu2+ and Zn2+. Antimicrobial tests show that the fibres achieve up to a 5 log reductions in populations of E. coli, S. aureus, S. typhimurium, P. aeruginosa and K. pneumoniae bacteria. Reusability of the nanofibre membranes is investigated to establish if the nanofibres retain their morphology and antimicrobial effectiveness over six cycles of water filtration. Leaching of AquaQure constituents from the nanofibres into filtered water is assessed and found to be at acceptable levels