Improving oxygen capacity at ITBP Referral Hospital during the second wave of COVID-19 infections in Greater Noida, India An operative targeted intervention

Due to factors that still remain under debate, both social and virological, the COVID-19 pandemic has continued to flare up in India, particularly in northern and western areas. This has led to an incidence of approximately 350,000 cases per day and a daily death toll of around 4,000 in the weeks between the 1st and 14th May 2021. The current pandemic is testing the adaptability of the oxygen distribution and consumption. Following India’s request for support, the EU Civil Protection Mechanism coordinated the response agreed by EU Member States providing shipments of oxygen and equipment. In this scenario, our Emergency Medical Team (EMT)-2, based in Italy, organized a cargo and a twelve member team of technicians and medical professionals with the main objective of installing a novel source of oxygen. The installation of a PSA oxygen plant provided the ITBP hospital in Greater Noida, India, with a sustainable solution to combat oxygen shortage in less than 48 hours. The supply of oxygen could not be deemed a successful intervention without a proper plan to guarantee the rational use of the source so additional training was carried out. Our EMT were among the first responders in mitigating this public health crisis.

National hospital readiness for COVID-19 in Lesotho: evidence for oxygen ecosystem strengthening

SETTING:Sub-Saharan African country, Lesotho, during the SARS-CoV-2 COVID-19 pandemic.OBJECTIVE: To evaluate COVID-19 hospital capacity in Lesotho.DESIGN: We conducted a pragmatic assessment of all public hospitals in Lesotho using a WHO COVID-19 hospital assessment tool during July 2020 (baseline), with targeted follow-up in December 2020. We adapted the WHO tool into a questionnaire with a focus on hospital services and included oxygen ecosystem elements (pulse oximeters, oxygen, and advanced respiratory care). We converted qualitative questionnaire answers into quantitative ordinal variables and used standard statistics for analysis.RESULTS: At baseline, we found all 12 questionnaire domains demonstrate both hospital preparedness and weakness in infection prevention and control. Key baseline gaps were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Targeted follow-up after 5 months revealed improvement in the availability of pulse oximetry, oxygen capacity, and heated high-flow nasal cannula devices.CONCLUSION: Our baseline findings may reflect uneven early pandemic care quality; targeted follow-up suggests strengthening of the oxygen ecosystem.

Does GPAQ exhibit a higher correlation with the maximum oxygen capacity than IPAQ among young adults?

International Physical Activity Questionnaire (IPAQ) and the Global Physical Activity Questionnaire (GPAQ) are the two most widely used to measure physical activity (PA). Yet, their convergent validation with the maximum oxygen capacity (VO2Max) among Indonesian young adults is unknown. This study compared physical activity (PA) assessments using IPAQ and GPAQ and their correlations with the maximal oxygen capacity (VO2Max) in the young adult population. This study was a cross-sectional descriptive study on 63 Sports Science students (84.13% Male age ranged 18-22 years). PA was measured using both the GPAQ and IPAQ to calculate the total PA and PA in each domain (i.e. work-related, transport-related, and leisure). One additional domain which was household-related was assessed exclusively for the IPAQ based on the scoring guideline. The VO2Max was measured using a standard equation based on participants’ performance on a 1-mile run. Paired sample t-test was conducted to compare total PA based on GPAQ and IPAQ while the Wilcoxon sign rank test was conducted to compare GPAQ and IPAQ domains. Pearson or Spearman correlation test assessed the correlations among the VO2Max, total PA, and PA on each GPAQ’s and IPAQ domain. No significant difference in the total PA per week between IPAQ and GPAQ was found. Significant differences, however, were found in work and transport domains, but not in the leisure domains. A moderate correlation among GPAQ and IPAQ (r=0.56, p=0.01), a moderate correlation between GPAQ and VO2Max (r=0.41, p= 0.01) but a weak correlation between IPAQ dan VO2Max (r=0.25, p<0.05) were demonstrated. While, this study has indicated convergent validity of both GPAQ and IPAQ, GPAQ has a higher correlation with VO2Max compared to the IPAQ. Therefore, GPAQ is more recommended to be used to measure PA levels among Indonesian young adults compared to IPAQ.

Impact of calcium nitrate supplementation on the oxygen-carrying capacity of lactating sows and their offspring

Calcium nitrate supplementation has recently been suggested to provide potential benefits to sows and, in particular, their offspring when administered at a level of 1,200 ppm in feed shortly before farrowing through lactation. More specifically, nitrate supplementation has been suggested as one opportunity for improved placental and/or fetal blood flow and has been hypothesized in previous work to be important to the swine industry in light of the global trend toward larger litter sizes. The benefit is likely manifested through exposure to the nitrate moiety, but interestingly, nitrate has historically been considered a compound of concern for swine. High levels of nitrate once metabolized to nitrite can interfere with the oxygen-carrying capacity of hemoglobin, resulting in increased methemoglobin and, subsequently, methemoglobinemia (MetHb) if the animal is deprived of significant amounts of oxygen; however, the level of nitrate exposure necessary to induce MetHb in sows is not clearly defined. This work was undertaken to examine methemoglobin levels in sows and piglets exposed to the potentially beneficial levels of 1,200 and 6,000 ppm nitrate added to their diets over the course of the periparturient period. Other oxygen capacity blood variables were evaluated (e.g., hemoglobin, hematocrit, and various measures of hemoglobin and red blood cell volumes and concentrations), as well as performance endpoints (weight changes and feed intake) and general observations over the 27-day period. No evidence of treatment-related toxicity manifestation was observed at these supplemental levels. Nearly all oxygen-related variables were affected by time (independent of treatment), indicating adaptive general effects of farrowing. These findings support the hypothesis that MetHb is not a concern up to at least 6,000 ppm supplemental nitrate exposure, even in combination with additional nitrate in the sow’s daily diet. This work is important to help swine producers understand that consideration of nitrate benefit should outweigh concern for risk of nitrate-induced toxicity.

Biological functions of cobalt and its toxicology and detection in anti-doping control

Objectives. Over the last decade, hematopoietic stimulants have grown increasingly popular in elite sports. This is supported by the growing number of high-profile doping scandals linked to their use. A group of these stimulants includes cobalt salts, which cause an increase in the oxygen capacity of the blood as well as a powerful stimulation of metabolic processes, resulting innoticeable competitive advantages. The use of cobalt salts is regulated according to the Prohibited List of the World Anti-Doping Agency (WADA). Currently, only a few works have been dedicated to solving the problem of detecting the abuse of cobalt salts in anti-doping control. Only a few laboratories have included cobalt salt determination in their methodological bases. The purpose of this review is to attract the attention of the scientific community to the toxicity of cobalt compounds, consequences of their intake, and pharmacokinetics, as well as the problems in their detection methods due to their widespread availability in the modern market and the growing number of abuse cases.Results. The main biological functions of cobalt, cellular levels of exposure, toxicity, and symptoms of cobalt salt poisoning are presented in detail in this review article. The data from the literature on the main methods for detecting cobalt as a doping agent have been generalized and systematized. There is a major focus on the amount of cobalt in dietary supplements that could cause an athlete to test positive for cobalt when they are consumed.Conclusions. After analyzing promising cobalt detection approaches and methods, it was determined that high-performance liquid chromatography in combination with inductively coupled plasma mass spectrometry has an undeniable advantage for detecting cobalt as a doping agent. The lack of explicit WADA requirements for detection methods and the lack of its obligation to determine cobalt make it tempting for unscrupulous athletes to use its salts. Therefore, antidoping laboratories must implement the abovementioned method as soon as possible.

National hospital readiness for COVID-19 in Lesotho: Evidence for oxygen ecosystem strengthening

The COVID-19 pandemic continues to challenge healthcare systems globally. To understand hospital capacity, including critical oxygen capacity, a pragmatic assessment of all public hospitals in Lesotho was made in July 2020 (baseline), with follow-up in December 2020. We developed a qualitative hospital services questionnaire modeled on the World Health Organization COVID-19 assessment tool and converted answers into quantitative ordinal variables. At baseline we found all 12 domains had areas demonstrating preparedness and weakness. Key baseline gaps within infection prevention and control were lack of a dedicated team, and insufficient personal protective equipment and space for donning and doffing. Substantial limitations were noted in hypoxemia diagnosis and treatment; information management and care coordination pathways were also suboptimal. Our baseline findings may reflect uneven early pandemic care quality. Targeted follow-up after five months revealed marked improvement in the availability of pulse oximetry, oxygen capacity, and heated high flow nasal cannula devices.