Background: Inadequate supply of filtering facepiece respirators (FFR) for healthcare workers during a global pandemic such as the novel coronavirus outbreak (SARS-CoV-2) is a serious public health issue. Aim: The objective of this review was to synthesize existing data on the effectiveness of ultraviolet germicidal irradiation (UVGI) on N95 FFR decontamination. Methods: We conducted a systematic review on UVGI in N95 FFRs by using Embase, Medline, Global Health, Google Scholar, WHO feed, and MedRxiv. Two reviewers independently determined study eligibility and extracted and verified predefined data fields. Original research reporting on N95 FFR function, decontamination, or mask fit following UVGI were included. Findings and Conclusions: Twelve studies were identified, comprising of 53 different UVGI intervention arms and 43 N95 FFR models. In all cases, FFRs maintained National Institute for Occupational Safety and Health (NIOSH) certification standards following UVGI. Aerosol penetration averaged 1.19% (0.70-2.48%) and 1.14% (0.57-2.63%) for control and UVGI arms respectively. Airflow resistance for the control arms averaged 9.79 mm H2O (7.97-11.70 mm H2O) vs 9.85 mm H2O (8.33-11.44 mm H2O) for UVGI treatment arms. All UVGI protocols employing a cumulative dose >20,000 J/m2 resulted in a 2 log reduction in viral load. A >3 log reduction was observed in 7 UVIG arms using a dose >40,000 J/m2. Impact of UVIG on fit was evaluated in two studies (16,200; 32,400 J/m2) and did not find evidence of compromise. Altogether, our findings suggest that further work in this area should use a cumulative UV-C dose of 40,000 J/m2 or greater, and confirm appropriate mask fit following decontamination.

ObjectiveTo systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures.MethodsTen databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups.ResultsThe review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant.ConclusionsThe majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.

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CHD patients had significant dysfunction of the vitamin D axis immediately postoperatively, demonstrated by both a significant intraoperative decline in calcitriol and inability to increase levels. Interventional research will be required to determine whether the use of calcitriol, in addition to cholecalciferol, reduces postoperative illness severity.

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