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Keywords: Acute kidney injury, COVID-19, Dexamethasone, Intensive care unit

Background Group A Streptococcus is responsible for severe and potentially lethal invasive conditions requiring intensive care unit (ICU) admission, such as streptococcal toxic shock-like syndrome (STSS). A rebound of invasive group A streptococcal (iGAS) infection after COVID-19-associated barrier measures has been observed in children. Several intensivists of French adult ICUs have reported similar bedside impressions without objective data. We aimed to compare the incidence of iGAS infection before and after the COVID-19 pandemic, describe iGAS patients’ characteristics, and determine ICU mortality associated factors. Methods We performed a retrospective multicenter cohort study in 37 French ICUs, including all patients admitted for iGAS infections for two periods: two years before period (October 2018 to March 2019 and October 2019 to March 2020) and a one-year after period (October 2022 to March 2023) COVID-19 pandemic. iGAS infection was defined by Group A Streptococcus isolation from a normally sterile site. iGAS infections were identified using the International Classification of Diseases and confirmed with each center's microbiology laboratory databases. The incidence of iGAS infections was expressed in case rate. Results Two hundred and twenty-two patients were admitted to ICU for iGAS infections: 73 before and 149 after COVID-19 pandemic. Their case rate during the period before and after COVID-19 pandemic was 205 and 949/100,000 ICU admissions, respectively ( p  < 0.001), with more frequent STSS after the COVID-19 pandemic (61% vs. 45%, p  = 0.015). iGAS patients ( n  = 222) had a median SOFA score of 8 (5–13), invasive mechanical ventilation and norepinephrine in 61% and 74% of patients. ICU mortality in iGAS patients was 19% (14% before and 22% after COVID-19 pandemic; p  = 0.135). In multivariate analysis, invasive mechanical ventilation (OR = 6.08 (1.71–21.60), p  = 0.005), STSS (OR = 5.75 (1.71–19.22), p  = 0.005), acute kidney injury (OR = 4.85 (1.05–22.42), p  = 0.043), immunosuppression (OR = 4.02 (1.03–15.59), p  = 0.044), and diabetes (OR = 3.92 (1.42–10.79), p  = 0.008) were significantly associated with ICU mortality. Conclusion The incidence of iGAS infections requiring ICU admission increased by 4 to 5 after the COVID-19 pandemic. After the COVID-19 pandemic, the rate of STSS was higher, with no significant increase in ICU mortality rate.

Pulse oximetry is a ubiquitous non-invasive medical sensing method for measuring pulse rate and arterial blood oxygenation. Conventional pulse oximeters use expensive optoelectronic components that restrict sensing locations to finger tips or ear lobes due to their rigid form and area-scaling complexity. In this work, we report a pulse oximeter sensor based on organic materials, which are compatible with flexible substrates. Green (532 nm) and red (626 nm) organic light-emitting diodes (OLEDs) are used with an organic photodiode (OPD) sensitive at the aforementioned wavelengths. The sensor’s active layers are deposited from solution-processed materials via spin-coating and printing techniques. The all-organic optoelectronic oximeter sensor is interfaced with conventional electronics at 1 kHz and the acquired pulse rate and oxygenation are calibrated and compared with a commercially available oximeter. The organic sensor accurately measures pulse rate and oxygenation with errors of 1% and 2%, respectively. Pulse oximetry is a non-invasive means for measuring blood oxygen saturation and pulse rate, with typical sensors based on rigid electronics. Here, the authors develop a pulse oximeter based solely on organic materials, allowing flexible devices and hence increasing the potential sensing locations on the body.

In bulk heterojunction (BHJ) organic solar cells (OSCs) both the electron affinity (EA) and ionization energy (IE) offsets at the donor–acceptor interface should equally control exciton dissociation. Here, we demonstrate that in low-bandgap non-fullerene acceptor (NFA) BHJs ultrafast donor-to-acceptor energy transfer precedes hole transfer from the acceptor to the donor and thus renders the EA offset virtually unimportant. Moreover, sizeable bulk IE offsets of about 0.5 eV are needed for efficient charge transfer and high internal quantum efficiencies, since energy level bending at the donor–NFA interface caused by the acceptors’ quadrupole moments prevents efficient exciton-to-charge-transfer state conversion at low IE offsets. The same bending, however, is the origin of the barrier-less charge transfer state to free charge conversion. Our results provide a comprehensive picture of the photophysics of NFA-based blends, and show that sizeable bulk IE offsets are essential to design efficient BHJ OSCs based on low-bandgap NFAs. A systematic analysis of a series of donor–acceptor organic blends shows that in solar cells based on low-bandgap non-fullerene acceptors an ionization energy offset of about 0.5 eV is required to ensure efficient charge separation.

The reported power conversion efficiencies (PCEs) of nonfullerene acceptor (NFA) based organic photovoltaics (OPVs) now exceed 14% and 17% for single‐junction and two‐terminal tandem cells, respectively. However, increasing the PCE further requires an improved understanding of the factors limiting the device efficiency. Here, the efficiency limits of single‐junction and two‐terminal tandem NFA‐based OPV cells are examined with the aid of a numerical device simulator that takes into account the optical properties of the active material(s), charge recombination effects, and the hole and electron mobilities in the active layer of the device. The simulations reveal that single‐junction NFA OPVs can potentially reach PCE values in excess of 18% with mobility values readily achievable in existing material systems. Furthermore, it is found that balanced electron and hole mobilities of >10−3 cm2 V−1 s−1 in combination with low nongeminate recombination rate constants of 10−12 cm3 s−1 could lead to PCE values in excess of 20% and 25% for single‐junction and two‐terminal tandem OPV cells, respectively. This analysis provides the first tangible description of the practical performance targets and useful design rules for single‐junction and tandem OPVs based on NFA materials, emphasizing the need for developing new material systems that combine these desired characteristics. The efficiency limits in non‐fullerene organic solar cells are examined using a numerical simulator. Power conversion efficiency (PCE) of over 18% using recently reported carrier mobility values and voltage losses, are predicted. Increasing the mobility to >10−3 cm2 V−1 s−1 and decreasing the recombination constant to <10−12 cm3 s−1 is shown to yield a single‐junction and 2T‐tandem cell with PCEs of >20% and >25%, respectively.

Transmission-mode pulse oximetry, the optical method for determining oxygen saturation in blood, is limited to only tissues that can be transilluminated, such as the earlobes and the fingers. The existing sensor configuration provides only singlepoint measurements, lacking 2D oxygenation mapping capability. Here, we demonstrate a flexible and printed sensor array composed of organic light-emitting diodes and organic photodiodes, which senses reflected light from tissue to determine the oxygen saturation. We use the reflectance oximeter array beyond the conventional sensing locations. The sensor is implemented to measure oxygen saturation on the forehead with 1.1% mean error and to create 2D oxygenation maps of adult forearms under pressure-cuff–induced ischemia. In addition, we present mathematical models to determine oxygenation in the presence and absence of a pulsatile arterial blood signal. The mechanical flexibility, 2D oxygenation mapping capability, and the ability to place the sensor in various locations make the reflectance oximeter array promising for medical sensing applications such as monitoring of real-time chronic medical conditions as well as postsurgery recovery management of tissues, organs, and wounds.

Non-communicable disease is a leading threat to global health. Physical inactivity is a large contributor to this problem; in fact, the WHO ranks it as the fourth leading risk factor for overall morbidity and mortality worldwide. In Canada, at least 4 of 5 adults do not meet the Canadian Physical Activity Guidelines of 150 min of moderate-to-vigorous physical activity per week. Physicians play an important role in the dissemination of physical activity (PA) recommendations to a broad segment of the population, as over 80% of Canadians visit their doctors every year and prefer to get health information directly from them. Unfortunately, most physicians do not regularly assess or prescribe PA as part of routine care, and even when discussed, few provide specific recommendations. PA prescription has the potential to be an important therapeutic agent for all ages in primary, secondary and tertiary prevention of chronic disease. Sport and exercise medicine (SEM) physicians are particularly well suited for this role and should collaborate with their primary care colleagues for optimal patient care. The purpose of this Canadian Academy and Sport and Exercise Medicine position statement is to provide an evidence-based, best practices summary to better equip SEM and primary care physicians to prescribe PA and exercise, specifically for the prevention and management of non-communicable disease. This will be achieved by addressing common questions and perceived barriers in the field.Author note This position statement has been endorsed by the following nine sport medicine societies: Australasian College of Sports and Exercise Physicians (ACSEP), American Medical Society for Sports Medicine (AMSSM), British Association of Sports and Exercise Medicine (BASEM), European College of Sport & Exercise Physicians (ECOSEP), Norsk forening for idrettsmedisin og fysisk aktivite (NIMF), South African Sports Medicine Association (SASMA), Schweizerische Gesellschaft für Sportmedizin/Swiss Society of Sports Medicine (SGSM/SSSM), Sport Doctors Australia (SDrA), Swedish Society of Exercise and Sports Medicine (SFAIM), and CASEM.

The fall armyworm, Spodoptera frugiperda (J. E. Smith)(Lepidoptera: Noctuidae), is an important agricultural pest of the Western Hemisphere noted for its broad host range, long distance flight capabilities, and a propensity to develop resistance to pesticides that includes a subset of those used in genetically modified corn varieties. These characteristics exacerbate the threat fall armyworm poses to agriculture, with the potential that a resistance trait arising in one geographical location could rapidly disseminate throughout the hemisphere. A region of particular concern is the Caribbean, where a line of islands that extends from Florida to Venezuela provides a potential migratory pathway between populations from North and South America that could allow for consistent and substantial genetic interactions. In this study, surveys of populations from Peru, Bolivia, Paraguay, and Trinidad & Tobago expand on previous work in South America that indicates a generally homogeneous population with respect to haplotype markers. This population differs from that found in most of the Lesser Antilles where a combination of genetic and meteorological observations is described that indicate fall armyworm migration from Puerto Rico to as far south as Barbados, but does not support significant incursion into Trinidad & Tobago and South America. Air transport projections demonstrate that the wind patterns in the Caribbean region are not conducive to consistent flight along the north-south orientation of the Lesser Antilles, supporting the conclusion that such migration is minor and sporadic, providing few opportunities for genetic exchanges. The implications of these findings on the dissemination of deleterious traits between the two Western Hemisphere continents are discussed.

In patients with symptomatic atrial fibrillation and heart failure, pulmonary-vein isolation was found to be superior to atrioventricular-node ablation with biventricular pacing. Isolation of the pulmonary veins by means of ablation is a viable option for patients with refractory atrial fibrillation and heart failure. In patients with symptomatic atrial fibrillation and heart failure, pulmonary-vein isolation was found to be superior to atrioventricular-node ablation with biventricular pacing. Trials of ablation for atrial fibrillation have shown the procedure to be efficacious in reducing morbidity, improving the quality of life and functional capacity, and, in a retrospective analysis comparing ablation and antiarrhythmic medications, reducing mortality. 1 – 7 Increasingly, patients with heart failure have atrial fibrillation as well, and studies have shown that the efficacy rates for ablation are similar in this population with a low ejection fraction and among patients with heart failure alone. 8 – 10 Atrioventricular-node ablation has been used to treat symptomatic atrial fibrillation with poor rate control, although few patients in these studies had a low ejection fraction. . . .

Interactions between zinc (Zn) and phosphate (Pi) nutrition in plants have long been recognized, but little information is available on their molecular bases and biological significance. This work aimed at examining the effects of Zn deficiency on Pi accumulation in Arabidopsis thaliana and uncovering genes involved in the Zn-Pi synergy. Wild-type plants as well as mutants affected in Pi signalling and transport genes, namely the transcription factor PHR1, the E2-conjugase PHO2, and the Pi exporter PHO1, were examined. Zn deficiency caused an increase in shoot Pi content in the wild type as well as in the pho2 mutant, but not in the phr1 or pho1 mutants. This indicated that PHR1 and PHO1 participate in the coregulation of Zn and Pi homeostasis. Zn deprivation had a very limited effect on transcript levels of Pi-starvation-responsive genes such as AT4, IPS1, and microRNA399, or on of members of the high-affinity Pi transporter family PHT1. Interestingly, one of the PHO1 homologues, PHO1;H3, was upregulated in response to Zn deficiency. The expression pattern of PHO1 and PHO1;H3 were similar, both being expressed in cells of the root vascular cylinder and both localized to the Golgi when expressed transiently in tobacco cells. When grown in Zn-free medium, pho1;h3 mutant plants displayed higher Pi contents in the shoots than wild-type plants. This was, however, not observed in a pho1 pho1;h3 double mutant, suggesting that PHO1;H3 restricts root-to-shoot Pi transfer requiring PHO1 function for Pi homeostasis in response to Zn deficiency.