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Far UV light in water treatment via producing reactive oxidative species 远紫外光在水处理中通过产生活性氧化物质
Pub Date : 2023-11-15 DOI: 10.21203/rs.3.rs-3577108/v1
Jingyun Fang, Kaiheng Guo, Sining Wu, Liping Wang, Wenlei Qin, Ruijie Xie, Xuchun Li
Abstract Far UV light at 222 nm (UV 222 ) is gaining much attention for water treatment due to its high disinfection efficiency and safety to human, and the mechanism is deemed direct photolysis. We found that UV 222 is much more efficient than UV 254 for the abatement of 18 organic micropollutants and inactivation of pathogens, and the phenomenon is related to the production of reactive oxidative species (ROS). Multiple ROS are identified, including hydroxyl radical (HO • ), singlet oxygen ( 1 O 2 ), superoxide radical anion ( • O 2 − ) and ozone (O 3 ). The degradation of micropollutants is mainly due to HO • , which results from water homolysis and oxygen (O2) photodissociation. The quantum yield of HO• is 0.893, and the concentration of HO • reaches 10 -13 M under neutral conditions. This study is the first that reports the efficient production of ROS upon UV 222 photolysis, which facilitates chemical-free advanced oxidation processes in water.
摘要222 nm远紫外光(UV 222)因其消毒效率高且对人体安全,在水处理中受到广泛关注,其作用机制被认为是直接光解。研究发现,UV 222对18种有机微污染物的去除和病原菌的灭活效果明显优于UV 254,这一现象与活性氧(reactive oxidative species, ROS)的产生有关。鉴定出多种活性氧,包括羟基自由基(HO•)、单线态氧(1 O 2)、超氧自由基阴离子(•O 2−)和臭氧(O 3)。微污染物的降解主要是由水均解和氧(O2)光解产生的HO•。在中性条件下,HO•的量子产率为0.893,HO•的浓度达到10 -13 M。这项研究首次报道了UV 222光解作用下活性氧的高效产生,这有助于水中无化学物质的高级氧化过程。
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引用次数: 0
Code-switching in mental health recovery narratives of Hong Kong storytellers 香港讲故事人精神健康康复叙事中的语码转换
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3440199/v1
Stephanie Ng, Olga Zayts-Spence
Abstract Background Considering persistently high levels of mental health stigma in Hong Kong in recent years, scholars and mental health professionals alike have demonstrated strong interest in combating this issue. Existing research suggests that recovery storytelling, which involves an individual with a lived experience of mental illness sharing their personal story publicly, is one of the most effective anti-stigma strategies to date. Methods Using a narrative inquiry approach, we examined the recovery stories of seven Cantonese-speaking individuals who participated in the More than a Label mental health anti-stigma campaign in Hong Kong. We specifically examined how the discursive strategy of code-switching functioned to clarify, emphasize, or distract from certain elements of the story. Results Our analysis demonstrated that code-switching in our data functioned in three distinct ways, namely as: (1) a distancing strategy when discussing troubling past experiences; (2) an authenticating strategy when recalling interactions carried out in English-speaking settings; and (3) a foregrounding strategy to highlighting the main points in the story. Conclusions Our study highlights the importance of linguistic research in informing the development of person-centred approaches in both mental health clinical and advocacy work. We suggest that recognizing linguistic behaviours such as code-switching allows mental health clinical and organizational staff to be more sensitive to signs of potential distress and probe further inquiry amongst clients and lived-experience storytellers. We discuss how these findings can be used to educate lived-experience storytellers on the rhetorical functions of language use such as code-switching.
背景近年来,香港的精神健康污名问题持续严重,学者和精神健康专业人士都对解决这一问题表现出浓厚的兴趣。现有的研究表明,康复故事是迄今为止最有效的反污名策略之一,它涉及到有精神疾病生活经历的个人公开分享他们的个人故事。方法采用叙事探究法,研究了7名参与香港“不只是标签”心理健康反污名运动的粤语人士的康复故事。我们特别研究了语码转换的话语策略如何在澄清、强调或转移故事的某些元素方面发挥作用。结果我们的分析表明,数据中的代码转换以三种不同的方式起作用,即:(1)在讨论令人不安的过去经历时保持距离的策略;(2)在回忆英语环境下的互动时的认证策略;(3)突出故事要点的前景策略。我们的研究强调了语言研究在精神卫生临床和宣传工作中为以人为本的方法的发展提供信息的重要性。我们建议,识别语言行为,如代码转换,可以使心理健康临床和组织工作人员对潜在的痛苦迹象更加敏感,并在客户和亲身经历的故事讲述者之间进行进一步的调查。我们讨论了如何利用这些发现来教育生活经验故事讲述者语言使用的修辞功能,如代码转换。
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引用次数: 0
Lymphedema after Saphenous Harvesting for Coronary Artery Bypass Surgery: Case Report and Literature Review 冠状动脉搭桥术隐静脉切除术后淋巴水肿:病例报告及文献复习
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3468789/v1
Seyed Mohsen Mirhosseini, Masood Soltanipur, Hossein Yarmohammadi, Mahdi Rezaei, Zahra Sheikhi
Abstract Different causes have been reported for secondary lymphedema as reported in this article. A 75-year-old man was diagnosed with lymphedema about one decade after saphenous harvesting for coronary artery bypass surgery. It took two years for him to find out his diagnosis and receive the proper treatment. After standard complete decongestive therapy, his volume and pain decreased and his quality of life was improved, especially its physical aspect. It is important to recognize the possibility of lymphedema development after saphenous harvesting among patients undergoing coronary artery bypass surgery to prevent significant disturbance of quality of life with timely management.
摘要本文报道了继发性淋巴水肿的不同病因。一名75岁的男子在冠状动脉搭桥手术后大约十年被诊断为淋巴水肿。他花了两年时间才发现自己的诊断并接受了适当的治疗。经过标准的完全去充血治疗后,患者的体积和疼痛减少,生活质量得到改善,尤其是身体方面。在接受冠状动脉搭桥手术的患者中,认识到隐静脉切除术后淋巴水肿发展的可能性是很重要的,以防止生活质量受到严重影响,及时处理。
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引用次数: 0
Feasibility and acceptability of integrating an early childhood development intervention into the health-facility setting in Siaya County: findings of a qualitative study 将儿童早期发展干预措施纳入西亚亚县卫生设施环境的可行性和可接受性:一项定性研究的结果
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3347606/v1
Silas Onyango, Patricia Kitsao-Wekulo, Kenneth Okelo, Margaret Nampijja, Beatrice Oyugi, Christopher Obongo, Dickens Omedo, Debjeet Sen, Elizabeth Kimani-Murage
Abstract Background This paper explores the perceptions and experiences of stakeholders to understand the feasibility and acceptability of integrating early childhood development (ECD) intervention into the health system. Method Data were derived from an endline qualitative survey, which was part of a larger ECD study conducted in Siaya County, Kenya. Purposive sampling was used to select participants for the qualitative interviews. We conducted KIIs, focus group discussions (FGDs), and in-depth interviews (IDIs). Analyses were organized according to the preselected thematic areas. Result Political goodwill, proper coordination and support, and good linkages between the community and the health facility facilitated the implementation despite the challenges of a shortage of personnel and staff transfers. Integration of ECD intervention into the health system seems feasible in terms of its performance, service provision, information provided, and efficiency. In addition, stakeholders willingly supported the implementation of the intervention at different levels and capacities, which led to perceived acceptability. Furthermore, there was general satisfaction with the implementation due to perceived benefits that could potentially improve children’s developmental outcomes. Conclusion This study demonstrates the feasibility of integrating ECD interventions into the health system. Future interventions integrating ECD messages into nutrition and health programs can leverage key drivers identified through this study for smooth and effective integration.
摘要背景本文探讨了利益相关者的看法和经验,以了解将儿童早期发展(ECD)干预纳入卫生系统的可行性和可接受性。数据来源于一项终端定性调查,该调查是在肯尼亚Siaya县进行的一项更大规模的ECD研究的一部分。定性访谈采用有目的抽样的方法进行。我们进行了kii、焦点小组讨论(fgd)和深度访谈(IDIs)。根据预先选定的专题领域组织了分析。结果:尽管面临人员短缺和工作人员调动的挑战,但政治善意、适当的协调和支持以及社区与保健设施之间的良好联系促进了执行工作。从其绩效、服务提供、信息提供和效率来看,将幼儿发展干预纳入卫生系统似乎是可行的。此外,利益相关者愿意支持不同层次和能力的干预措施的实施,这导致了感知的可接受性。此外,由于可能潜在地改善儿童的发展结果,人们普遍对实施感到满意。结论本研究证明了将幼儿发展干预措施纳入卫生系统的可行性。将幼儿发展信息纳入营养和健康规划的未来干预措施可以利用本研究确定的关键驱动因素,实现顺利有效的整合。
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引用次数: 0
Exploratory study: Health promotion through Wikipedia outreach and educational activities 探索性研究:通过维基百科外展和教育活动促进健康
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3568640/v1
Thais Morata, Fernanda Zucki, Adriano Jorge Arrigo, Priscila C. Cruz, Wei Gong, Hector Gabriel Matos, Alexandre Montilha, João Peschanski, Maria Julia Cardoso, Adriana Lacerda, Ana Paula Berberian, Eliene Araujo, Débora Luders, Josilene Luciene Duarte, Regina T.S. Jacob, Shelly Chadha, Daniel Mietchen, Lane Rasberry, Katia F. Alvarenga, Lilian Cassia Jacob
Abstract Background Several health institutions developed strategies to improve health content on Wikimedia platforms, given their unparalleled reach. The objective of this study was to compare an online a volunteer-based Wikimedia outreach campaign and Wikipedia university course assignments in terms of the reach of the contributions and evaluate the extent of the students' input. Methods In 2022, researchers from seven Brazilian universities and a Canadian university, in coordination with the National Institute for Occupational Safety and Health, the World Health Organization, the Ronin Institute, and Wiki Movimento Brasil, received a grant from the State of São Paulo (Brazil) that supported the 1) coordination of improvements in hearing and healthcare content through educational programs using Wikimedia platforms and 2) participation in the global campaign Wiki4WorldHearingDay2023. We examined the feasibility and the implementation of the two strategies and compared the contributions from those enrolled in educational activities versus volunteer activities from Wikipedia editors to a global campaign. Results The strategy was demonstrated to be feasible. It increased the availability of quality plain language information on hearing conditions and hearing care. By May 1, 2023, Wiki4WorldHearingDay2023, 145 participants (78 from educational programs) had contributed 167,000 words, 259 + references and 140 images to 322 Wikipedia articles (283 existing and 39 new ones), which were viewed by 16.5 million readers. Contributions occurred in 6 languages. Edits in Portuguese, mainly by those involved in educational programs, led the number of articles (226 or 70.2%) that were expanded or created during the 5-month tracking period. Conclusions The crowdsourcing of expertise and knowledge is relevant for public health. This study’s approach can be applied in other contexts. In addition to the coordination with educational programs, the elements that contributed to the success of these initiatives include an impact topic, international collaborations, the connection with a robust local Wikimedia affiliate, and the use of a technical infrastructure that gives us metrics and coordination mechanisms. The partnerships, the dissemination of the work in several platforms, the participation of multidisciplinary teams, and the availability of resources through institutional support and funding were additional elements that contributed to the success of these initiatives.
背景:鉴于维基媒体平台无与伦比的影响力,一些卫生机构制定了改善其健康内容的策略。本研究的目的是比较基于志愿者的在线维基媒体推广活动和维基百科大学课程作业的贡献范围,并评估学生投入的程度。2022年,来自七所巴西大学和一所加拿大大学的研究人员与国家职业安全与健康研究所、世界卫生组织、罗宁研究所和巴西维基运动组织合作,获得了圣保罗州(巴西)的一笔赠款,用于1)通过使用维基媒体平台的教育项目协调改善听力和医疗保健内容,以及2)参与全球活动Wiki4WorldHearingDay2023。我们检查了这两种策略的可行性和实施情况,并比较了参与教育活动和维基百科编辑志愿者活动对全球运动的贡献。结果该策略是可行的。它增加了关于听力状况和听力保健的高质量简明语言信息的可用性。截至2023年5月1日,即Wiki4WorldHearingDay2023, 145名参与者(78名来自教育项目)为322篇维基百科文章(283篇现有文章和39篇新文章)贡献了16.7万字、259多篇参考文献和140张图片,被1650万读者阅读。贡献来自6种语言。在5个月的跟踪期内,葡萄牙语编辑(主要是参与教育项目的编辑)增加或创建的文章数量最多(226篇,占70.2%)。结论专业知识和知识的众包与公共卫生相关。这项研究的方法可以应用于其他情况。除了与教育项目的协调外,促成这些举措成功的因素还包括一个有影响力的主题、国际合作、与强大的本地维基媒体分支机构的联系,以及使用技术基础设施,为我们提供指标和协调机制。伙伴关系、在若干平台上传播工作、多学科小组的参与以及通过机构支助和供资提供的资源,都是促进这些举措取得成功的其他因素。
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引用次数: 0
Country-specific roadmaps for scaling up integrated care in Belgium, Slovenia, and Cambodia - Lessons learned from the SCUBY project 比利时、斯洛文尼亚和柬埔寨扩大综合护理的国别路线图——SCUBY项目的经验教训
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3585711/v1
Martin Heine, Monika Martens, Daniel Boateng, Grace Marie Ku, Roy Remmen, Edwin Wouters, Srean Chhim, Antonjia Poplas Susič, Wim van Damme, Josefien van Olmen, Kerstin Klipstein-Grobusch, on behalf of the SCUBY consortium
Abstract Introduction The SCUBY project aimed to provide knowledge on the scaling-up of an Integrated Care Package (ICP) for type 2 diabetes and hypertension across three distinct health systems (Cambodia, Slovenia, and Belgium). Here, we analyse the different elements of the country-specific scale-up roadmaps to identify similarities and differences, and share lessons learned. Methods Thematic analysis was used to derive crucial roadmap elements from key SCUBY documents (n = 20), including policy briefs, interim reports, research outputs, and consortium meeting notes. Results Roadmap elements differed according to priority needs, features of the (health) systems, and partly reflected the position of the SCUBY research team within each country. Common cross-country elements were: task-shifting to patients themselves, nurses and community health workers; strengthening monitoring and evaluation; and creating an enabling environment for ICP implementation. Discussion Scale-up of complex interventions requires continuous engagement of multiple stakeholders and contextualization of action plans. The linkage of research teams with key implementation stakeholders and policy makers creates change-teams, allowing advancement from formative research to implementation of roadmap strategies and full scale-up in due time. Conclusion The development processes and contents of the roadmaps provided essential and reciprocal learnings. These help shape future policy dialogues and best practices to tackle chronic disease in each participating country.
SCUBY项目旨在提供关于在三个不同的卫生系统(柬埔寨、斯洛文尼亚和比利时)扩大2型糖尿病和高血压综合护理包(ICP)的知识。在此,我们分析了具体国家扩大规模路线图的不同要素,以确定相似性和差异,并分享经验教训。方法采用专题分析方法,从关键SCUBY文件(n = 20)中提取关键路线图元素,包括政策简报、中期报告、研究成果和联盟会议记录。路线图要素根据优先需求和(卫生)系统的特点而有所不同,并部分反映了SCUBY研究小组在每个国家的地位。常见的跨国因素有:任务转移给病人自己、护士和社区卫生工作者;加强监测和评价;为实施ICP创造有利的环境。扩大复杂干预措施需要多个利益攸关方的持续参与和行动计划的背景化。研究团队与关键实施利益相关者和政策制定者的联系创建了变革团队,允许从形成性研究推进到路线图战略的实施,并在适当的时候全面扩大规模。结论路线图的制定过程和内容提供了必要和相互借鉴的经验。这些有助于形成未来的政策对话和最佳做法,以应对每个参与国的慢性病。
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引用次数: 0
Impact of TLS Overhead with Forward Secrecy on Segmented Network for Multiple Cloud Database Systems 带前向保密的TLS开销对多云数据库系统分段网络的影响
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3589550/v1
Jitendra Kurmi, Suresh Prasad Kannojia
Abstract Cloud database serves flexible, affordable, and versatile database frameworks. Indeed, even the cloud database is secure with Transport Layer Security (TLS). However, the performance overhead that TLS presents while executing procedures on the five major No SQL databases: Mongo DB, Apache Cassandra DB, Amazon Dynamo DB, Redis DB, and Couch DB regarding dormancy. We proposed a Multiple Replica Database Architecture (MRD-ARC) to investigate TLS execution overhead with forward secrecy for five NoSql databases, we performed two tests mimicking average database utilization designs with TLS cipher suite ECDHE-prime256v1. We examined connection pooling, where an application involves a solitary connection for some databases activities. Then, we considered one request for each connection. An application opens a connection, executes an interaction, and quickly shuts the connection in the wake of finishing the activity based on read-only throughput, read-only response, and connection throughput. Our experimental result shows that applications that cannot persevere through tremendous overhead execution should be sent inside an appropriately portioned network instead of empowering TLS with forward secrecy. Applications utilizing TLS should utilize a connection pool instead of a connection for each request. We also compare the TLS overhead with forward secrecy in terms of latency of five databases and found that Mongo DB is the best cloud database system with less overhead.
云数据库服务于灵活、经济、通用的数据库框架。实际上,即使是云数据库也可以通过传输层安全性(TLS)来保证安全。然而,TLS在五个主要的No SQL数据库上执行过程时所带来的性能开销:mongodb DB、Apache Cassandra DB、Amazon Dynamo DB、Redis DB和Couch DB。我们提出了一个多副本数据库架构(MRD-ARC)来研究5个NoSql数据库的前向保密TLS执行开销,我们使用TLS密码套件ecdhei -prime256v1进行了两次模拟平均数据库利用率设计的测试。我们研究了连接池,其中应用程序涉及一些数据库活动的单独连接。然后,我们考虑每个连接的一个请求。应用程序打开连接,执行交互,并在基于只读吞吐量、只读响应和连接吞吐量完成活动后快速关闭连接。我们的实验结果表明,不能忍受巨大开销执行的应用程序应该在适当分配的网络中发送,而不是为TLS赋予前向保密功能。使用TLS的应用程序应该为每个请求使用连接池而不是连接。在五个数据库的延迟方面,我们还比较了TLS开销和前向保密,发现mongodb是开销较小的最佳云数据库系统。
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引用次数: 0
Optimization of nitrogen management reduce nitrogen stress and enhance productivity of super- seeder sown wheat under rice residue incorporation 优化氮素管理,减少氮素胁迫,提高超种小麦混播稻渣的产量
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3406436/v1
Peace Raising L, Virendra Pratap Singh, Subhash Chandra, Anil Shukla, Navneet Pareek, R Rustum Zhiipao, Kadapa Sreenivas Re, Hriipulou Duo, Lham Dorjee, Rayapati Karthik, VK Singh, Peace Raising L
Abstract The in-situ management of rice straw incorporation is now an essential practice in the rice-wheat cropping system with the growing adoption of super-seeder among farmers. This machinery has made it easier to incorporate rice residues into the soil, crushing and spreading straw evenly for cleaner cultivation. However, the effect of nutrient immobilization due to incorporation of massive organic residues at the initial stage of the decomposition is a major constraint for enhancing yield and productivity. This study investigates the effect of bio-decomposer, nitrogen (N) level, and N scheduling on N immobilization status, dry matter, N accumulation, remobilization, productivity and soil quality variables in super-seeder sown wheat for two consecutive years (2020-21 and 2021-22). The experiment was laid in split-split-plot design without (B0) and with (B1) application of bio-decomposer in main plot and two nitrogen levels 150 (N1) and 180 (N2) kg ha -1 in sub-plot; and three N splits (%) viz ., 50: 25:25 (S1), 40: 30: 30 (S2), and 30 :35:35 (S3) in sub-sub-plot and replicated thrice. N concentration and uptake at pre- and post-anthesis were recorded significantly higher with N2 and S1 compared to N1 and S2 and S3 in both years. Post-anthesis N accumulation (post-NA) and N remobilization (NR) with N2 was significantly higher to the tune of 22% and 17% than N1. Dry matter accumulation (DMA) at anthesis and harvest with N2 was significantly higher by 5.7%, while with S1 there is an improvement of 6.2% over S3. The grain yield with N2 and S1 significantly improved by 8.3% and 10.9% (two years mean) compared to N1 and S3, respectively. Soil urease activity (UA) was significantly enhanced with the application of microbial formulation (bio-decomposer), N2, and S1 in comparison to B0, N1 and S3 at 30 and 60 DAS (days after sowing). Besides, use of bio-decomposer also improved soil microbial biomass carbon (SMBC). Hence, the present study revealed that the application of higher N level coupled with higher proportion of basal N resulted in overcoming N stress and could be propounded for sustainable production and higher productivity. The result presented here assumes great significance in proper utilization and conservation of rice residue under rice-wheat cropping system.
摘要随着超级播种机的普及,稻秸秆就地还田管理已成为稻麦种植制度的重要环节。这种机器可以更容易地将水稻残留物融入土壤,粉碎和均匀地铺开秸秆,以实现更清洁的耕作。然而,由于在分解初期大量有机残留物的掺入,营养固定的影响是提高产量和生产力的主要制约因素。本研究连续2年(2020-21年和2021-22年)研究了生物分解剂、氮素水平和氮素调度对超级播小麦氮素固定状态、干物质、氮素积累、再动员、生产力和土壤质量变量的影响。试验采用主小区不施(B0)和施(B1)生物分解剂,次小区施150 (N1)和180 (N2) kg ha -1两个氮肥水平的分块-分块设计;和三个N分裂(%),即50:25:25 (S1), 40:30:30 (S2)和30:35:35 (S3)在sub-sub-plot中复制三次。在花前和花后,N2和S1处理的氮素浓度和吸收量均显著高于N1和S2和S3处理。花后氮素积累(post-NA)和氮素再动员(NR)与N1相比显著提高22%和17%。氮处理显著提高了水稻开花期和收获期干物质积累量(DMA) 5.7%, S1处理比S3处理提高了6.2%。与N1和S3处理相比,N2和S1处理的产量分别显著提高8.3%和10.9%(两年平均)。在播种后30和60天,施用微生物制剂(生物分解剂)、N2和S1比施用B0、N1和S3显著提高了土壤脲酶活性(UA)。此外,生物分解剂的使用也提高了土壤微生物生物量碳(SMBC)。因此,本研究表明,施用高施氮水平和高施基氮比例可以克服氮胁迫,并可以提出可持续生产和提高生产力的建议。研究结果对合理利用和保护稻谷-小麦种植制度下的稻渣具有重要意义。
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引用次数: 0
Difference in impact of coinfections on antibiotic use in patients hospitalized with COVID- 19 between the Omicron-dominant period and the pre-Omicron period omicron优势期与前omicron期合并感染对住院COVID- 19患者抗生素使用影响的差异
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3543280/v1
Yasushi Murakami, Yasuhiro Nozaki, Mika Morosawa, Masanobu Toyama, Hitoshi Ogashiwa, Takashi Ueda, Kazuhiko Nakajima, Ryoya Tanaka, Yoshio Takesue
Abstract Background Excessive antibiotic use in patients with coronavirus disease 2019 (COVID-19) can cause an increase in multidrug-resistant (MDR) organisms. This study evaluated antibiotic stewardship during the COVID-19 pandemic. Methods Antibiotic use in patients with COVID-19 was compared in a community hospital between 2022 when the Omicron variant was prevalent (n = 225) and 2021 when previous variants were prevalent (n = 257). Antibiotics were categorized as antibiotics predominantly used for community-acquired infections (CAIs) and antibiotics predominantly used for health care-associated infections (HAIs), and days of therapy per 100 bed days (DOT) was evaluated. Results Patients during the Omicron period were older and had more comorbidities. The rate of critically ill patients was around 10% in both periods. During the pre-Omicron period, > 90% of hospitalized patients were unvaccinated, whereas 41.8% of patients received a booster dose during the Omicron period. Ground-glass opacities, bilateral shadows, and a peripheral distribution on CT were observed in most patients in the pre-Omicron period and there were significant differences in comparison with the Omicron period. Although only 0.9% of patients had bacterial coinfection on admission in the pre-Omicron period, 38.9% of patients had the coinfection during the Omicron period and were less likely to receive COVID-19-directed therapy. Coinfection before /after admission was an independent risk factor for composite adverse events in both periods (odds ratio [OR] 3.77, 95% confidence interval [CI] 1.13–12.59, and OR 9.15, 95% CI 3.85–21.74). DOT in antibiotics for CAIs were significantly fewer in the COVID-19 ward than in general wards in the pre-Omicron period but increased in the Omicron period (from 3.60 ± 3.15 to 17.83 ± 10.00). Numerically lower DOT of antibiotics for HAIs was demonstrated in the COVID-19 ward than in the general wards (pre-Omicron, 3.33 ± 6.09 versus 6.37 ± 1.10; Omicron, 3.84 ± 2.93 versus 5.22 ± 0.79). No MDR gram-negative organisms were isolated in the COVID-19 ward. Conclusions Antibiotic use on admission was limited in the pre-Omicron period but increased in the Omicron period because of a high coinfection rate on admission. Excessive use of antibiotics for HAIs was avoided during both periods.
背景2019冠状病毒病(COVID-19)患者过度使用抗生素可导致多药耐药(MDR)细菌增加。本研究评估了COVID-19大流行期间的抗生素管理。方法比较2022年Omicron变异流行(n = 225)和2021年既往变异流行(n = 257)期间某社区医院COVID-19患者的抗生素使用情况。抗生素被分类为主要用于社区获得性感染(CAIs)的抗生素和主要用于卫生保健相关感染(HAIs)的抗生素,并评估每100个床位日的治疗天数(DOT)。结果欧米克隆期患者年龄较大,合并症较多。两个时期危重病人的比例都在10%左右。在前欧米克隆时期,>90%的住院患者未接种疫苗,而41.8%的患者在欧米克隆期间接受了加强剂量。多数患者在前Omicron期CT表现为磨玻璃影、双侧阴影、周围分布,与Omicron期比较差异有统计学意义。虽然入院时仅有0.9%的患者在“欧米克隆”前出现了细菌合并感染,但在“欧米克隆”期间,38.9%的患者出现了细菌合并感染,接受针对covid -19的治疗的可能性较小。入院前/入院后合并感染是两期复合不良事件的独立危险因素(优势比[OR] 3.77, 95%可信区间[CI] 1.13-12.59,优势比[OR] 9.15, 95% CI 3.85-21.74)。冠状病毒病区CAIs抗生素使用DOT在预Omicron期明显低于普通病区,但在Omicron期有所增加(从3.60±3.15增加到17.83±10.00)。COVID-19病房的抗生素DOT数值低于普通病房(omicron前,3.33±6.09 vs 6.37±1.10;欧米克隆,3.84±2.93比5.22±0.79)。COVID-19病房未分离到耐多药革兰氏阴性菌。结论入院时抗生素的使用在欧米克隆前是有限的,但在欧米克隆期间由于入院时合并感染率较高而增加。在这两个时期都避免了对艾滋病患者过度使用抗生素。
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引用次数: 0
Green Synthesis of Silver Nanoparticles From Pineapple (Ananas Comosus) Peel Extract: Physical-chemical Characterization and in Vitro Biological Activities 绿色合成菠萝(Ananas Comosus)果皮提取物纳米银:理化性质和体外生物活性
Pub Date : 2023-11-14 DOI: 10.21203/rs.3.rs-3590638/v1
Márcia Mourão Ramos Azevedo, Cléo Rodrigo Bressan, Lorena Pereira Ferreira, Carla Beatriz dos Santos Torres, Yan Vitor Silva Oliveira, Gerson Nakazato, Lucas Marcelino dos Santos Souza, Alan Kelbis Oliveira Lima, Mônica Pereira Garcia, Kashif Gul, Paulo Sérgio Taube
Abstract The objective of this work was to synthesize, characterize and evaluate silver nanoparticles (AgNPs) obtained from the aqueous extract of pineapple peel. After optimizing the synthesis of AgNPs, colloidal solutions of AgNPs showed maximum absorbance around 460 nm. The AgNPs in the final concentration of 1, 3 and 5 mmol L -1 showed average values of Z-average of 142.3, 127.0, 135.6 and, 153.2, 117.0 131.8 synthesized by water bath and ultrasound, respectively. Regarding PdI, all AgNPs showed low to moderate polydispersity. Zeta potential values ranged from -21.4 to -10.1. Images obtained by TEM for AgNPs prepared both by the water bath method and by the ultrasound method show particles with predominantly spherical morphologies, smooth and irregular edges. The synthesized AgNPs showed higher concentrations of total phenolic compounds (159.92 to 326.9 mg AG 100 g -1 ) when compared to the aqueous extract of pineapple peel (132.0 mg AG 100 g -1 ). The pineapple peel extract showed a higher ABTS radical inhibition value (88.16%) in relation to the value referring to AgNPs (19.11% to 77.90%). By the iron reduction method (FRAP), it was verified that the ability of AgNPs to reduce Fe 3+ to Fe 2+ was greater (4.49 to 6.83 mM of FeSO 4 for 10% solution) than that of the aqueous extract of the bark of pineapple (3.72 mM FeSO 4 for 10% solution). The AgNPs synthesized from the aqueous extract of pineapple peel were effective against Gram-negative bacteria E. coli and Pseudomonas aeruginosa and against Gram-positive bacteria S. aureus . The MIC varied between 2.6 and 21.25 mg.mL -1 for Gram-negative bacteria and from 21.25 to 42.25 mg.mL -1 for Gram-positive bacteria, pointing to Gram-negative bacteria as being the bacteria more susceptible to inhibitory and bactericidal actions after exposure to AgNPs. The results of the present study infer that the AgNPs obtained by water bath or ultrasound, regardless of the concentration, showed significant cytotoxic activity when tested in human breast cancer cells of the MCF-7 lineage and B16F10 murine melanoma cancer cells. IC50 values were similar for AgNPs obtained from different energy sources (water bath or ultrasound), but with the same AgNO3 concentration, indicating that there is no difference between using AgNPs obtained by water bath or ultrasound. These results suggest that the AgNPs synthesized from the aqueous extract of pineapple peel have potential and can be used in several areas, mainly in biomedical applications.
摘要:本研究的目的是合成、表征和评价菠萝皮水提物中银纳米颗粒(AgNPs)。优化AgNPs的合成后,AgNPs胶体溶液在460 nm附近的吸光度最大。水浴法和超声法合成的终浓度为1、3和5 mmol L -1的AgNPs的z -平均值分别为142.3、127.0、135.6和153.2、117.0、131.8。在PdI方面,所有AgNPs表现出低至中等的多分散性。Zeta电位值范围为-21.4 ~ -10.1。水浴法制备的AgNPs和超声法制备的AgNPs的透射电镜图像显示,AgNPs的颗粒形貌以球形为主,边缘光滑且不规则。所得AgNPs的总酚类化合物含量为159.92 ~ 326.9 mg AG 100 g -1,高于凤梨皮水提液(132.0 mg AG 100 g -1)。菠萝皮提取物对ABTS自由基的抑制值(88.16%)高于AgNPs的抑制值(19.11% ~ 77.90%)。通过铁还原法(FRAP)验证了AgNPs将fe3 +还原为fe2 +的能力(10%溶液中feso4为4.49 ~ 6.83 mM)大于菠萝皮水提液(10%溶液中feso4为3.72 mM)。菠萝皮水提物制备的AgNPs对革兰氏阴性菌大肠杆菌和铜绿假单胞菌以及革兰氏阳性菌金黄色葡萄球菌均有较好的抑制作用。MIC在2.6到21.25毫克之间变化。革兰氏阴性菌为mL -1, 21.25 ~ 42.25 mg。革兰氏阳性细菌的mL -1,表明革兰氏阴性细菌在暴露于AgNPs后更容易产生抑制和杀菌作用。本研究的结果推断,通过水浴或超声波获得的AgNPs,无论浓度如何,在MCF-7谱系的人乳腺癌细胞和B16F10小鼠黑色素瘤癌细胞中检测时都显示出显著的细胞毒活性。不同能量来源(水浴或超声)获得的AgNPs的IC50值相似,但AgNO3浓度相同,表明使用水浴或超声获得的AgNPs没有差异。这些结果表明,由菠萝皮水提物合成的AgNPs具有广阔的应用前景,主要应用于生物医学领域。
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