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Purpose: Deep sedation is sometimes needed in acute respiratory distress syndrome. Ketamine is a sedative that has been shown to have analgesic and sedating properties without having a detrimental impact on hemodynamics. This pharmacological profile makes ketamine an attractive sedative, potentially reducing the necessity for other sedatives and vasopressors, but there are no studies evaluating its effect on these medications in patients requiring deep sedation for acute respiratory distress syndrome., Materials and Methods: This is a retrospective, observational study in a single center, quaternary care hospital in southeast Texas. We looked at adults with COVID-19 requiring mechanical ventilation from March 2020 to September 2020., Results: We found that patients had less propofol requirements at 72 h after ketamine initiation when compared to 24 h (median 34.2 vs 54.7 mg/kg, p = 0.003). Norepinephrine equivalents were also significantly lower at 48 h than 24 h after ketamine initiation (median 38 vs 62.8 mcg/kg, p = 0.028). There was an increase in hydromorphone infusion rates at all three time points after ketamine was introduced., Conclusions: In this cohort of patients with COVID-19 ARDS who required mechanical ventilation receiving ketamine we found propofol sparing effects and vasopressor requirements were reduced, while opioid infusions were not., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: It is unknown if COVID-19 will exhibit seasonal pattern as other diseases e.g., seasonal influenza. Similarly, some environmental factors (e.g., temperature, humidity) have been shown to be associated with transmission of SARS-CoV and MERS-CoV, but global data on their association with COVID-19 are scarce., Objective: To examine the association between climatic factors and COVID-19., Methods: We used multilevel mixed-effects (two-level random-intercepts) negative binomial regression models to examine the association between 7- and 14-day-lagged temperature, humidity (relative and absolute), wind speed and UV index and COVID-19 cases, adjusting for Gross Domestic Products, Global Health Security Index, cloud cover (%), precipitation (mm), sea-level air-pressure (mb), and daytime length. The effects estimates are reported as adjusted rate ratio (aRR) and their corresponding 95% confidence interval (CI)., Results: Data from 206 countries/regions (until April 20, 2020) with ≥100 reported cases showed no association between COVID-19 cases and 7-day-lagged temperature, relative humidity, UV index, and wind speed, after adjusting for potential confounders, but a positive association with 14-day-lagged temperature and a negative association with 14-day-lagged wind speed. Compared to an absolute humidity of <5 g/m 3 , an absolute humidity of 5-10 g/m 3 was associated with a 23% (95% CI: 6-42%) higher rate of COVID-19 cases, while absolute humidity >10 g/m 3 did not have a significant effect. These findings were robust in the 14-day-lagged analysis., Conclusion: Our results of higher COVID-19 cases (through April 20) at absolute humidity of 5-10 g/m 3 may be suggestive of a 'sweet point' for viral transmission, however only controlled laboratory experiments can decisively prove it., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The conservation of sturgeons is of critical importance, and optimization of long-term storage is crucial to cell survival. This study aimed to examine the viability rates of several variations of sturgeon testicular cells storage at -80 °C for purpose of a short-term storage in a deep freezer or shipment on dried ice. Testes extracted from three immature fish were cut into small pieces, immersed in a cryomedium composed of phosphate buffered saline with 0.5% bovine serum albumin, 50 mM glucose, and 1.5 M ethylene glycol as a cryoprotectant, chilled from 10 to -80 °C at a cooling rate of 1 °C per min, and stored under varying conditions. Our results revealed a significant effect of storage conditions on the number of living and dead cells (p > 0.05). Samples that were stored for 7 days at -80 °C showed a considerable decline in terms of cell viability compared to samples stored for 2 days storage at -80 °C or in LN. This result indicated that testicular cells can be stored at -80 °C and/or on dry ice, for 2 days with minimum loss of viability., (Copyright © 2016 Elsevier Inc. All rights reserved.)

The World Health Organization's (WHO) concept of primary healthcare as the basis for comprehensive healthcare delivery for developing countries has not been effectively applied in many of these countries. The Kingdom of Lesotho, one of the world's least-developed countries, has been able to provide a fairly comprehensive healthcare system for its citizenry based on prmary healthcare principles and a strong commitment on the part of the government despite severe limitations of finance and human resource capacity as well as difficult mountainous terrains. This paper presents the highlights of this system of healthcare delivery with the hope that other developing countries would draw some lessons from the model.