COVID-19 Autopsies, Oklahoma, USA Barton, Lisa M; Duval, Eric J; Stroberg, Edana ...
American journal of clinical pathology,
06/2020, Letnik:
153, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Abstract
Objectives
To report the methods and findings of two complete autopsies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive individuals who died in Oklahoma (United ...States) in March 2020.
Methods
Complete postmortem examinations were performed according to standard procedures in a negative-pressure autopsy suite/isolation room using personal protective equipment, including N95 masks, eye protection, and gowns. The diagnosis of coronavirus disease 2019 (COVID-19) was confirmed by real-time reverse transcriptase polymerase chain reaction testing on postmortem swabs.
Results
A 77-year-old obese man with a history of hypertension, splenectomy, and 6 days of fever and chills died while being transported for medical care. He tested positive for SARS-CoV-2 on postmortem nasopharyngeal and lung parenchymal swabs. Autopsy revealed diffuse alveolar damage and chronic inflammation and edema in the bronchial mucosa. A 42-year-old obese man with a history of myotonic dystrophy developed abdominal pain followed by fever, shortness of breath, and cough. Postmortem nasopharyngeal swab was positive for SARS-CoV-2; lung parenchymal swabs were negative. Autopsy showed acute bronchopneumonia with evidence of aspiration. Neither autopsy revealed viral inclusions, mucus plugging in airways, eosinophils, or myocarditis.
Conclusions
SARS-CoV-2 testing can be performed at autopsy. Autopsy findings such as diffuse alveolar damage and airway inflammation reflect true virus-related pathology; other findings represent superimposed or unrelated processes.
Device-to-device (D2D) communication technology of 5G has brought significant advantages for short distance communication in wireless networks. Dew computing speeds up computing services across ...devices and allows data output to be generated very quickly. In this article, we have proposed an architecture based on dew computing and D2D communication technology with coalition formation game. In the proposed scheme, devices exchange data directly between themselves and each device computes data according to its capabilities and transfers that result to destination nodes. The devices are cooperatively connected to each other through D2D communication. Each device has a certain amount of dew computing storage, which increases depending on the amount of data in Internet of Things (IoT) devices. If the amount of data is low, then the amount of dew storage is less and when the amount of data increases, the amount of dew storage increases equally. So, there is no difficulty in computing any data. The proposed DewGame network has reduced delay and power consumption by about
∼
28–66% and
∼
12–70%, respectively, from other networks. In addition, the DewGame network has increased signal-to-interference-plus-noise ratio (SINR) and spectral efficiency by about
∼
2–10% and
∼
4–12%, respectively, from other networks, proving that the proposed DewGame network is suitable for the IoT environment.
A weighted majority cooperative game (WMCG) theory-based heterogeneous fog architecture with fog-to-fog (F2F) communication is proposed in this article to reduce the delay and power consumption of ...the network. The fog devices are participated as players in the game, and they are operated cooperatively to perform a task. If one fog device is unable to complete the task, only a part of task is completed by it and the remaining task is completed by neighbour fog devices. Among the neighbour fog devices, the high majority fog device is selected using WMCG. The proposed TARA has generated
∼
7–24, 9–28 and 11–30% less delay and
∼
9–28, 11–31, and 12–32% less power consumption for transmitting 1 Kb, 5 Kb, and 10 Kb of data, respectively, than other networks. Results show that the proposed TARA is a delay and power efficient network.
Cognitive Internet of things (CIoT) is the solution for resource allocation problem in an exponentially increasing number of Internet of things in fifth generation wireless networks. Two-tier massive ...multiple-input-multiple-output (MIMO) and multiple-input-single-output small cell-based CIoT using weighted majority cooperative game (WMCG) is deployed in RAM. We have proposed a two-level WMCG theoretic model and two utility functions, to detect the channel is free or not and for allocating the spectrum to a high majority CIoT device by the spectrum manager based on their applied maximum weight or price values. In RAM, we have calculated power consumption, signal-to-interference-plus-noise ratio (SINR), spectral efficiency, and energy efficiency of the proposed network. We have simulated the RAM using QualNet 7.1 simulator. The power consumption of the RAM has been shown to decrease by approximately 15–30%, and SINR has been shown to increase by approximately 6–7% as compared to the existing approaches.
Green communication is important for next generation wireless network to connect massive number of mobile devices into the network. The deployment of femtocell without proper densification, the ...interference was increases and resources were not properly utilized. We address the small cell dynamically clustering under microcell base station and resource allocation among the small cells using weighted majority cooperative game theory in fifth generation (5G) mobile heterogeneous network (HetNet). We proposed three utility functions. The first utility function is used for minimizing the interference into the cluster. The addition or deletion of small cell in a cluster depends on the proposed utility function based on signal-to-interference-plus-noise-ratio (SINR). The weight means the number of small cell present into the cluster. In each cluster, a high majority small cell is selected using second utility function based on the minimum path loss values between the microcell and small cell base station. The high majority small cell act as a spectrum manager into the cluster. Other small cells submit a price value based on the user type and requirement data rate for a subcarrier to the high majority small cell spectrum manager. The high majority small cell allocates resources to the small cells using proposed algorithm based on price value and the third utility function. In the proposed work, we have calculated the power consumption, SINR, spectral efficiency of the network. The power consumption of the proposed network decreases approximately 30%, SINR and spectral efficiency are increased approximately 40% and 45% than existing approaches respectively.
The rapid escalation of user traffic and service innovation has made the deployment of small cell base stations essential for eventually decreasing energy consumption in future generation wireless ...network. An energy efficient small cell zooming strategy is proposed using weighted majority cooperative game for two-tier fifth generation (5G) mobile network. The proposed strategy is referred as ‘5G-ZOOM-Game’. Small cells ‘zoom in’ and ‘zoom out’ dynamically according to the proposed ‘5G-ZOOM-Game’ algorithm. Different frequency sets are assigned to small cells based on adjacency for reducing interference. In the proposed approach femtocells are used as small cells. The proposed algorithm is applied between two adjacent femtocells. Out of two adjacent femtocells, higher majority femtocell is selected based on weighted majority game; this femtocell zooms its coverage area. The utility function of the proposed approach is defined to connect maximum possible number of mobile devices by increasing the higher majority femtocell’s coverage area. Higher majority femtocell is chosen based on the load and minimum distance between mobile device and femtocell base station. Proposed 5G-ZOOM-Game network reduces ~ 35% of power consumption and increases signal-to-interference-plus-noise-ratio (SINR) and spectral efficiency by ~ 30% and ~ 60% respectively than the existing approaches.
Abstract Most pathologists are familiar with the microscopic features of tuberculosis and the need to examine special stains for acid-fast bacteria (AFB) in cases of granulomatous lung disease. ...However, misconceptions do exist, including the concept that finding AFB in “caseating granulomas” confirms the diagnosis of tuberculosis. This dogma is attributable to the high prevalence of tuberculosis in many countries, as well as unfamiliarity with the microscopic spectrum of non-tuberculous mycobacterial lung disease. This review aims to provide surgical pathologists with practical tips to identify AFB, illustrate the histologic overlap between pulmonary tuberculosis and non-tuberculous mycobacterial lung disease, and highlight the importance of cultures in this setting. M. tuberculosis and non-tuberculous mycobacteria cannot be reliably differentiated either on the basis of the tissue reaction or by bacterial morphology on acid-fast stains. Although a presumptive clinical diagnosis of tuberculosis can be made without culture-confirmation, the only definitive means to determine the true identity of AFB is by cultures or molecular methods. Making this distinction is most critical when AFB are found in incidentally detected lung nodules in geographic locations where the incidence of tuberculosis is low, because in such settings AFB in necrotizing granulomas of the lung are more likely to be non-tuberculous mycobacteria than M. tuberculosis.
Plastic bronchitis is a rare, underdiagnosed and potentially fatal condition. It is characterised by the formation and expectoration of branching gelatinous plugs that assume the shape of the ...airways. These airway plugs differ from the allergic mucin that characterises allergic bronchopulmonary aspergillosis and mucoid impaction of the bronchi. Plastic bronchitis is most often encountered in the paediatric population following corrective cardiac surgery, such as the Fontan procedure. It also occurs in adults. Plastic bronchitis in adults is rare, heterogeneous in its aetiology, and can lead to respiratory distress or even life-threatening airway obstruction. Plastic bronchitis in adulthood should not be overlooked, particularly in patients with chronic inflammatory lung diseases. This review presents current understanding of the presentation, aetiology, pathogenesis, pathology and management of plastic bronchitis in adults.
PDF
