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Abstract Background Acute necrotizing encephalopathy (ANE) and myocarditis are both acute, life-threatening conditions that can be triggered by COVID-19. We report a case of sequential ANE and myocarditis following a COVID-19 infection. Case presentation A 27-year-old female patient was brought to the emergency department due to episodes of fever for two days and a 9-h altered state of consciousness. Her condition rapidly developed into stuporous and hemodynamic instability within serval hours. Veno-arterial extracorporeal membrane oxygenation (ECMO) was rapidly initiated with other supportive treatments. The following-up MRI showed bilateral, symmetrically distributed lesions in the brainstem, bilateral hippocampal regions, and bilateral basal ganglia, consistent with ANE. The diagnosis was confirmed through the detection of SARS-CoV-2 and the exclusion of other potential causes. After weeks of medical treatment, her condition stabilized, and she was transferred for further rehabilitation treatment. Conclusions This case study indicates that COVID-19 may simultaneously and rapidly affect the central nervous system and cardiovascular system, leading to poor outcomes. Accurate diagnosis and timely invasive bridging therapy, when necessary, can be lifesaving. Further exploration of potential mechanisms underlying COVID-19 central nervous system (CNS) and cardiovascular system manifestations will be important.

BackgroundThis study assesses the changes over time and geographical locations in the disease burden of type 2 diabetes (T2D) attributed to ambient particulate matter pollution (APMP) from 1990 to 2019 in 204 countries and regions with different socio-demographic indexes (SDI).MethodsThe Global Burden of Diseases Study 2019 (GBD2019) database was used to analyze the global burden of T2D attributed to APMP. This study evaluated both the age-standardized death rate (ASDR) and disability-adjusted life years (DALYs) related to T2D, comparing data from 1990 to 2019. Estimated Annual Percentage Changes (EAPCs) were also utilized to investigate the trends over the 30-year study period.ResultsThe global age-standardized DALY rate and ASDR exhibited an increasing trend, with an EAPC of 2.21 (95% CI: 2.15 to 2.27) and 1.50 (95% CI: 1.43 to 1.58), respectively. This rise was most notable among older adult populations, men, regions in Africa and Asia, as well as low-middle SDI regions. In 2019, the ASDR for T2D caused by APMP was recorded at 2.47 per 100,000 population, while the DALY rate stood at 108.98 per 100,000 population. Males and countries with middle SDI levels displayed significantly high age-standardized death and DALY rates, particularly noticeable in Southern Sub-Saharan Africa. Conversely, regions with high SDI levels like High-income North America demonstrated decreasing trends.ConclusionThis study reveals a significant increase in T2D worldwide as a result of APMP from 1990 to 2019, with a particular emphasis on its impact on men, the older adult, and regions with low to middle SDI levels. These results underscore the urgent necessity for implementing policies aimed at addressing air pollution in order to reduce the prevalence of T2D, especially in the areas most heavily affected.

The mechanism of improving the anaerobic fermentation performance of waste active sludge by using dielectric barrier discharge (DBD) plasma pretreatment technology was investigated. The maximum accumulation of short-chain fatty acids (SCFAs) was observed on the 7th day of anaerobic fermentation when the DBD power was 76.50 W, which was 1726.70 mg COD/L, 1.50 times of the control group. The ratio of acetic acid in DBD group was 9.30% higher than that in the control. Further mechanism research indicated that DBD pretreatment can destroy the structure of extracellular polymer substances and release organic substances such as protein and polysaccharide. The dissolved organic matter analysis indicated that the DBD technique could increase the release of biodegradable organics (eg., tyrosine proteins, soluble microbial by-products), thus accelerate the biotransformation of organic substance. Bacterial community structure analysis showed that the increase in the abundance of Firmicutes and Bacteroidetes and the decrease in the abundance of Proteobacteria in DBD group were beneficial to the accumulation of SCFAs. Besides, further archaeal analysis indicated that the decrease of Methanosaeta sp. and Methanosarcina sp. abundance in the DBD group facilitate acetic acid accumulation. This study demonstrated that the DBD technique can be used as an effective and potential pretreatment method to improve sludge anaerobic fermentation performance.