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Why Blood Group A Individuals Are at Risk Whereas Blood Group O Individuals Might Be Protected from SARS-CoV-2 (COVID-19) Infection: A Hypothesis Regarding How the Virus Invades the Human Body via Abo(H) Blood Group-Determining Carbohydrates

While the angiotensin converting enzyme 2 (ACE2) protein is defined as the primary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) receptor, the viral serine molecule might be mobilized by the host's transmembrane protease serine subtype 2 (TMPRSS2) enzyme from the viral spike (S) protein and hijack the host’s N-acetyl-D-galactosamine (GalNAc) metabolism. The resulting hybrid, serologically A-like/Tn (T-nouvelle) structure potentially acts as a host–pathogen functional molecular bridge. In humans, this intermediate structure will hypothetically be replaced by ABO(H) blood group-specific, mucin-type structures, in the case of infection hybrid epitopes, implicating the phenotypically glycosidic accommodation of plasma proteins. The virus may, by mimicking the synthetic pathways of the ABO(H) blood groups, bind to the cell surfaces of the blood group O(H) by formation of a hybrid H-type antigen as the potential precursor of hybrid non-O blood groups, which does not affect the highly anti-glycan aggressive anti-A and anti-B isoagglutinin activities, exerted by the germline-encoded nonimmune immunoglobulin M (IgM). In the non-O blood groups, which have developed from the H-type antigen, these IgM activities are downregulated by phenotypic glycosylation, while adaptive immunoglobulins might arise in response to the hybrid A and B blood group structures, bonds between autologous carbohydrates and foreign peptides, suggesting the exertion of autoreactivity. The non-O blood groups thus become a preferred target for the virus, whereas blood group O(H) individuals, lacking the A/B phenotype-determining enzymes and binding the virus alone by hybrid H-type antigen formation, have the least molecular contact with the virus and maintain the critical anti-A and anti-B isoagglutinin activities, exerted by the ancestral IgM, which is considered the humoral spearhead of innate immunity.

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Point-of-care tests for influenza A and B viruses and RSV in emergency departments – indications, impact on patient management and possible gains by syndromic respiratory testing, Capital Region, Denmark, 2018

BACKGROUND: Point-of-care tests (POCT) for influenza A and B viruses and respiratory syncytial virus (RSV) were implemented in emergency departments of all hospitals in the Capital Region of Denmark in 2018. AIM: To establish whether POC testing for influenza viruses or RSV is based on a valid respiratory symptom indication, whether changes in patient management based on a positive result are safe and whether syndromic POC testing may benefit patients with influenza or RSV. METHODS: Samples from 180 children (< 18 years) and 375 adults tested using POCT between February and July 2018 were retested for 26 respiratory pathogens. Diagnosis, indication for POC testing, hospitalisation time, antimicrobial therapy and readmission or death within one month of testing were obtained from patient records. RESULTS: A valid indication for POC testing was established in 168 (93.3%) of children and 334 (89.1%) of adults. A positive POCT result significantly reduced antibiotic prescription and median hospitalisation time by 44.3 hours for adults and 14.2 hours for children, and significantly increased antiviral treatment in adults. Risk of readmission or death was not significantly altered by a positive result. Testing for 26 respiratory pathogens established that risk of coinfection is lower with increasing age and that POCT for adults should be restricted to the influenza and RSV season. CONCLUSION: Positive POCT resulted in changed patient management for both children and adults, and was deemed safe. POCT for additional pathogens may be beneficial in children below 5 years of age and outside the influenza and RSV season.

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Implementation of Brain Breaks(®) in the Classroom and Its Effects on Attitudes towards Physical Activity in a Chinese School Setting

This study aimed to examine the effects of three-months of classroom-based Brain Breaks Physical Activity Solution (Brain Breaks(®)) on attitudes toward physical activity levels of primary school children in Henan Province, China. The participants were 704 children enrolled in grades 3–5 who were randomly assigned to either an experimental or a control group. The experimental group participated in Brain Breaks(®) video intervention for 3–5 min daily, at low-to-moderate intensity for three consecutive months. The control group resumed their normal routine. The children’s attitudes in both groups towards physical activity (PA) were evaluated using the self-reported Attitudes toward Physical Activity Scale (APAS), before and after the intervention. The effects of the intervention on APAS scores were analyzed using mixed model analysis of variance with Time as within-subject, and Group as between-subject factors. The analysis revealed evidence in support of the positive effect of classroom video interventions such as Brain Break on children’s attitudes toward importance, fun, and trying to do their personal best in physical activity. Also revealed was the important role the teacher plays in this process.

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Seroprevalence of hospital staff in a province with zero COVID-19 cases

BACKGROUND: COVID-19 seroprevalence data, particularly in less developed countries with a relatively low incidence, has been scant. We aimed to explore the seroprevalence of hospital staff in the area with zero confirmed COVID-19 case to shed light on the situation of COVID-19 infection in zero or low infection rate countries where mass screening was not readily available. METHODS: A locally developed rapid immunoglobulin M (IgM)/immunoglobulin G (IgG) test kit was used for hospital staff screening of Ranong hospital which is located in a province with zero COVID-19 prevalence in Thailand from 17th April to 17th May 2020. All staff was tested, 100 of which were randomly invited to have a repeating antibody test in one month. (Thai Clinical Trials Registry: TCTR20200426002). RESULTS: Of 844 hospital staff, 82 were tested twice one month apart (response rate for repeating antibody test 82%). Overall, 0.8% of the participants (7 of 844) had positive IgM, none had positive IgG. Female staff had 1.0% positive IgM (95% CI: 0.5-2.1%) while male had 0.5% positive IgM (95% CI: 0.1-2.6%). No participants with a history of travel to the high-risk area or close contact with PCR-confirmed COVID-19 case developed SARS-CoV-2 antibodies. Among 844 staff, 811 had no symptoms and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between SARS-CoV-2 IgM status and gender, history of travel to a high-risk area, close contact with PCR-confirmed or suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed SARS-CoV-2 IgG. CONCLUSIONS: COVID-19 antibody test could detect a considerable number of hospital staff who could be potential silent spreaders in a province with zero COVID-19 cases. Accurate antibody testing is a valuable screening tool, particularly in asymptomatic healthcare workers. Trial registration: This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No.236/63) and the Institutional Review Board of Ranong Hospital. (Thai Clinical Trials Registry: TCTR20200426002).

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Bioactive compounds from marine resources against novel corona virus (2019-nCoV): in silico study for corona viral drug.

Present research reports the molecular docking analysis of 2019-nCoV inhibition by antiviral compounds from marine natural resources. For this study, the structure of ligand (antiviral compound) and 2019-nCoV main protease (Mpro) was received from the databases of PubChem and Protein Data Bank (PDB), respectively. Molecular Docking was performed by Autodock version 4.2.6 software. Eight antiviral compounds identified showed inhibitory activities against novel 2019-nCoV protease. Of these compounds, Esculetin ethyl ester (-8.42 kcal/mol) from Marine Sponges Axinella cf. corrugata, has the strongest interaction with the protease enzyme of 2019-nCoV and it may be considered as an effective 2019-nCoV antiprotease drug.

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Implementation of the cobas Liat influenza point-of-care test into an emergency department during a high-incidence season: a retrospective evaluation following real-world implementation

The cobas Liat influenza A/B and respiratory syncytial virus (RSV) assay (Liat) was used in the adult emergency department of a large London hospital from 21(st) January 2018 to 14(th) April 2018. Influenza was detected in 308 of 1027 (30%) samples tested; influenza A in 157 (15.3%), influenza B in 149 (14.5%) and RSV in 28 (2.7%). When compared against Fast Track Diagnostics Respiratory Pathogens 21 multiplex polymerase chain reaction and Cepheid Xpert Xpress Flu/RSV assay, Liat performance for the detection of influenza A or B was: sensitivity 85% [95% confidence interval (CI) 76–92)], specificity 98% (95% CI 97–99), negative predictive value 94% (95% CI 92–96) and positive predictive value 95% (95% CI 91–97).

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Wie ernähre ich mich am besten in Zeiten der Corona-Pandemie?: COVID-19 und Ernährungsmedizin

Die aktuelle Corona-Pandemie betrifft nahezu alle Bereiche der Medizin und des täglichen Lebens. Dementsprechend häufig tauchen Fragen zum Stellenwert der Ernährung auf, z. B. welche Ernährung einen Schutz vor der Corona-Infektion bieten kann und welche Bedeutung die Ernährung im Krankheitsverlauf hat.

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Psychological impact of COVID-19 lockdown in children and adolescents from San Carlos de Bariloche, Argentina: Parents' perspective./ Impacto psicológico del aislamiento por COVID-19 en jóvenes de San Carlos de Bariloche, Argentina: la mirada de los padres

INTRODUCTION: From an infectious perspective, children and adolescents were not highly affected by the COVID-19 pandemic. However, social isolation measures have deeply changed their lifestyle, which is believed to have a psychological impact on them. The objective was to assess the impact of COVID-19 lockdown on the emotional health of children and adolescents attending primary or secondary school. POPULATION AND METHODS: Parents of children and adolescents from San Carlos de Bariloche participated in the study. Adults' perception of the emotional and behavioral impact of lockdown on children and adolescents, changes in sleeping habits, screen use, sports-related activities, eating, and medical consultations, was assessed. RESULTS: A total of 267 parents were included. Of them, 96.3 % noticed emotional and behavioral changes. The most common ones were that their children were more bored (76.8 %), more irritable (59.2 %), more reluctant (56.9 %), and angrier (54.7 %). It was observed that they woke up and went to bed later, and slept 30 minutes more. Moreover, leisure screen use increased by 3 hours on weekdays. Time dedicated to physical activities did not change, but the type of activities did: swimming and team sports were replaced by biking, walking, and skiing. CONCLUSIONS: COVID-19 lockdown affected the emotional health and habits of children and adolescents. Boredom, irritability, and reluctance were more present during lockdown. The possibility of doing outdoor physical activities allowed them to keep practicing sports.

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Efficacy and safety of hydroxychloroquine as add-on therapy in uncontrolled type 2 diabetes patients who were using two oral antidiabetic drugs

OBJECTIVE: To evaluate the Safety and Efficacy of Hydroxychloroquine as add-on therapy in uncontrolled type 2 diabetes patients who were using two oral antidiabetic drugs. MATERIALS AND METHODS: This was a double blind, placebo controlled, parallel group study in 304 inadequately controlled type 2 diabetes (T2DM) subjects with two oral antidiabetic drugs (glimepiride 4 mg and metformin 500 mg) were randomised to hydroxychloroquine (HCQ) 200 mg, 300 mg, 400 mg once daily (OD) or placebo. Dose of hydroxychloroquine was selected as per body weight of the subject. Primary end point was glycated haemoglobin (HbA1c) change at week 12 from baseline. Secondary endpoint was change in fasting plasma glucose (FPG), post prandial plasma glucose (PPG), body weight and any adverse reaction including no of hypoglycemic events, as well as a change in the percentage of subjects with A1C < 7.0% and > 6.5% after 12 weeks of treatment.. In follow-up of 400 mg once daily was once again divided to 200 mg twice daily (BD) to study the effect on tolerability profile for further 12 weeks. RESULTS: Hydroxychloroquine was associated with significant reduction in HbA1c from baseline (7–8.5%) in 12 weeks −0.78%, −0.91% and 1.2% for hydroxychloroquine 200 mg, 300 mg and 400 mg OD, respectively, versus 0.13% with placebo (P < 0.005). FPG and PPG were reduced by −25 to −38 mg/dl and 34–53 mg/dl, respectively. Body weight also reduced in each group of HCQ. Hypoglycemia was reported only with 300 mg (1.2%) and 400 mg (2.1%) group of HCQ. It was observed that patients who complains with mild GI disturbance with HCQ 400 mg glycemic efficacy was maintained with 200 mg BD with significant relief of the symptoms. CONCLUSION: Hydroxychloroquine added to sulphonylurea and metformin, improves glycemic control significantly in T2DM patients. Glycemic effect of different dose of hydroxychloroquine is dose dependent. The safety/tolerability profile of hydroxychloroquine was favourable except GI disturbance which is more frequent with 400 mg. This can be avoided with 200 mg BD without compromise on efficacy.

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Qualitative study on the shifting sociocultural meanings of the facemask in Hong Kong since the severe acute respiratory syndrome (SARS) outbreak: implications for infection control in the post-SARS era

BACKGROUND: The clinical importance and efficacy of facemasks in infection prevention have been documented in the international literature. Past studies have shown that the perceived susceptibility, the perceived severity of being afflicted with life-threatening diseases, and the perceived benefits of using a facemask are predictors of a person’s use of a facemask. However, I argue that people wear a facemask not merely for infection prevention, and various sociocultural reasons have been motivating people to wear (and not wear) a facemask. Facemasks thus have sociocultural implications for people. Research on the sociocultural meanings of facemasks is scant, and even less is known on how the shifting sociocultural meanings of facemasks are related to the changing social environment, which, I argue, serve as remarkable underlying factors for people using (and not using) facemasks. As new infectious diseases such as avian influenza and Middle East Respiratory Syndrome have been emerging, threatening people’s health worldwide, and because facemasks have been documented to have substantial efficacy in the prevention of infection transmission, understanding the sociocultural meanings of facemasks has significant implications for public health policymakers and health care providers in designing a socially and culturally responsive public health and infection control policy for the community. METHODS: A qualitative research design involving the use of 40 individual, in-depth semistructured interviews and a phenomenological analysis approach were adopted. RESULTS: The sociocultural meanings of the facemask have been undergoing constant change, from positive to negative, which resulted in the participants displaying hesitation in using a facemask in the post-SARS era. Because it represents a violation of societal ideologies and traditional Chinese cultural beliefs, the meanings of the facemask that had developed during the SARS outbreak failed to be sustained in the post-SARS era. CONCLUSION: The changes in meaning not only influenced the participants’ perceptions of the facemask but also influenced their perceptions of people who use facemasks, which ultimately influenced their health behavior, preventing them from using facemasks in the post-SARS era. These findings have critical implications for designing a culturally responsive infection prevention and facemask usage policy in the future.

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Confronting medication scarcity in the era of COVID-19

Over the past decade, US patients and clinicians have endured medication shortages of nearly every class, including many lifesaving medications These shortages have persisted despite determined efforts by federal, academic, and professional organizations Medication shortages have resulted in lost lives, medication errors, and substantial financial cost Economic drivers are the primary cause for drug shortages, exacerbated by manufacturing and quality problems, and unreliable and uncertain sources for many raw materials required to synthesize these drugs Drug shortages force clinicians to make untenable choices and decide which of their patients should receive a lifesaving scarce medication The COVID-19 pandemic has stressed many hospitals’ ability to provide basic care and aggravated existing drug shortages The influx of patients suffering from COVID-19 has exposed flaws in the fractured manner in which essential medications reach patients The unique nature of COVID-19, often requiring prompt and decisive clinical decision-making, challenges the accepted approach for ethical analysis adopted by clinical ethicists The author, a clinician and bioethicist, notes the ethical challenges he and other frontline providers have faced in deciding which patients are “more deserving” of a scarce medication © The Author(s) 2020

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Modeling Shock Propagation on Supply Chain Networks: A Stochastic Logistic-Type Approach

Supply Chains have been more and more suffering from unexpected industrial, natural events, or epidemics that might disrupt the normal flow of materials, information, and money. The recent pandemic triggered by the outbreak of the new COVID-19 has pointed out the increasing vulnerability of supply chain networks, prompting companies (and governments) to implement specific policies and actions to control and reduce the spread of the disease across the network, and to cope with exogenous shocks. In this paper, we present a stochastic Susceptible-Infected-Susceptible (SIS) framework to model the spread of new epidemics across different distribution networks and determine social distancing/treatment policies in the case of local and global networks. We highlight the relevance of adaptability and flexibility of decisions in unstable and unpredictable scenarios. © 2021, IFIP International Federation for Information Processing.

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Computational insight of dexamethasone against potential targets of SARS-CoV-2

The health sector has been on the race to find a potent therapy for coronavirus disease (COVID)-19, a diseases caused by severe acute respiratory syndrome coronavirus (SARS-CoV)-2. Repurposed anti-viral drugs have played a huge role in combating the virus, and most recently, dexamethasone (Dex) have shown its therapeutic activity in severe cases of COVID-19 patients. The study sought to provide insights on the anti-COVID-19 mechanism of Dex at both atomic and molecular level against SARS-CoV-2 targets. Computational methods were employed to predict the binding affinity of Dex to SARS-CoV-2 using the Schrodinger suite (v2020-2). The target molecules and ligand (Dex) were retrieved from PDB and PubChem, respectively. The selected targets were SARS-CoV-2 main protease (Mpro), and host secreted molecules glucocorticoid receptor, and Interleukin-6 (IL-6). Critical analyses such as Protein and ligand preparation, molecular docking, molecular dynamic (MD) simulations, and absorption, distribution, metabolism, excretion (ADME), and toxicity analyses were performed using the targets and the ligand as inputs. Dex showed stronger affinity to its theoretical (glucocorticoid) receptor with a superior docking score of -14.7 and a good binding energy value of -147.48 kcal/mol; while short hydrogen bond distances were observed in both Mpro and IL-6 when compared to glucocorticoid receptor. Based on these findings, Dex-target complexes were used to perform MD simulations to analyze Dex stability at 50 ns. This study demonstrates that Dex could bind to both the viral and host receptors as a potential drug candidate for COVID-19. To ascertain the biological fitness of this study, other SARS-CoV-2 targets should be explored. Also, the in vitro studies of dexamethasone against several SARS-CoV-2 targets warrant further investigation. Communicated by Ramaswamy H. Sarma.

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COVID-19, recovery policies and the resilience of EU ETS

COVID-19 pandemic and its recovery bring opportunities and threats for global climate governance and further challenge climate related assets. In this study, we analyze the efficiency of government response policies and fiscal policies on green recovery by observing the variation characteristics of carbon allowance prices in the EU emission trading system (EU ETS). Using the OLS and threshold methods in the original time scales, we find that: (1) The EUA prices had an inverted U-shaped relationship with the number of new confirmed cases and deaths. (2) Government response policies had a better effect than fiscal policies when mitigating the negative impact of the pandemic. After decomposing and reconstructing the time series, the multiscale analysis indicates that: (3) The carbon price fluctuated in the short term with the increasing number of newly confirmed cases (or deaths) but gradually recovered due to the recovery policies. (4) Government response policies had a “stop-loss” effect in the short term, and then working alongside fiscal policies, sustained and promoted the development of the EU ETS and green recovery. In the post-COVID-19 era, we suggest the combination of various policies to convert the current health crisis into opportunities for climate change mitigation.

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Measles transmission during a large outbreak in California

A large measles outbreak in 2014–2015, linked to Disneyland theme parks, attracted international attention, and led to changes in California vaccine policy. We use dates of symptom onset and known epidemic links for California cases in this outbreak to estimate time-varying transmission in the outbreak, and to estimate generation membership of cases probabilistically. We find that transmission declined significantly during the course of the outbreak (p = 0.012), despite also finding that estimates of transmission rate by day or by generation can overestimate temporal decline. We additionally find that the outbreak size and duration alone are sufficient in this case to distinguish temporal decline from time-invariant transmission (p = 0.014). As use of a single large outbreak can lead to underestimates of immunity, however, we urge caution in interpretation of quantities estimated from this outbreak alone. Further research is needed to distinguish causes of temporal decline in transmission rates.

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Tourism recovery strategy against COVID-19 pandemic

Travel is requisite for tourism activity, therefore, any factor that hinders traveling may have a profound impact on the tourism industry. This includes pandemics such as COVID-19. Therefore, it is important to have well thought out tourism crisis and disaster management (TCDM) to mitigate the impact and help with post-crisis recovery. This study uses a qualitative research method to examine the TCDM during the current crisis. Interviews were conducted and transcribed. The text-based data was analyzed using SPSS modeler 14.1 and results were discussed. The result indicates that open communication is a key to successfully combat pandemic and government-sponsored loans are crucial to the survival of tourism industry. Future research directions are also proposed.

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Implementation of a fracture liaison service for patients with hip fracture cared for on a hospital medicine service.

OBJECTIVE Hip fracture is a common and morbid condition. Prior studies have shown that the majority of patients with fragility fracture are not treated for underlying osteoporosis. Our hospitalist-led co-management service for patients with acute hip fracture had no system for evaluating and treating osteoporosis in this cohort. Our objective was to implement a fracture liaison service (FLS) to assist patients with acute hip fracture and assess subsequent impact on diagnosis and treatment of osteoporosis. METHODS We conducted a pre-post study design at our tertiary academic center, including patients >50 years old hospitalized with acute hip fracture. We implemented a FLS, whereby all patients received endocrinology consultation. Outcome measures included the proportion of patients evaluated for osteoporosis by time of hospital discharge, comparing pre-implementation (12 months) and post-implementation (9 months) cohorts. We also measured the proportions of patients evaluated for and offered treatment for osteoporosis within three months of discharge for patients with post-discharge encounters visible in the medical record. RESULTS We identified 167 patients before and 124 after FLS implementation. In univariate analysis, the proportion of patients evaluated for osteoporosis before discharge increased from 0.6% to 72.6% (p<0.001) pre- vs. post-implementation. The proportion of patients offered osteoporosis treatment within three months after discharge increased from 25.3% to 46.3% (p=0.01). In multivariate analysis, post-implementation patients had higher odds of osteoporosis evaluation while hospitalized (OR = 470.4, p < 0.001) and higher odds of being offered osteoporosis treatment within three months (OR = 2.8, p = 0.008). CONCLUSIONS Establishment of a FLS partnered with a hospitalist-led co-management service for patients with hip fracture was associated with significant improvements in the proportions of patients evaluated and offered treatment for osteoporosis. Wider adoption of this model has the potential to improve care for patients with hip fracture by narrowing the osteoporosis treatment gap.

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Burnout among Portuguese radiographers during the COVID-19 pandemic

INTRODUCTION: The COVID-19 pandemic has had a global impact, including in health services, placing health professionals under enormous tension, pressure, and stress. Professionals involved in the care, diagnosis, and treatment of COVID-19-infected patients have been subject to emotional and physical distress that can potentially enhance the development of occupational diseases. The aim of this study was to assess the impact of the COVID-19 pandemic on the incidence of burnout among Portuguese radiographers. METHODS: This was a cross-sectional, quantitative study. Burnout levels were estimated using the Maslach Burnout Inventory-Human Services Survey, composed of 22 questions. Specific questions were developed to characterize the socio-demographic situation and the impact of the pandemic on the radiographers. Data were descriptively analyzed and Mann-Whitney and Kruskal-Wallis tests were used for correlation analysis. RESULTS: The study sample comprised 386 radiographers, 68.7% of whom where female and 31.3% male. The mean sample age was 36.3 (±9.1) years. A total of 43.5% and 45.5% of subjects had a high level of emotional exhaustion and depersonalization, respectively, and 59.8% experienced low personal accomplishment. Altogether, 23.3% of study participants were at high risk of burnout in the three dimensions assessed and 77.2% in at least one. CONCLUSION: Study results showed that radiographers were at high risk of developing burnout in the COVID-19 pandemic setting. Health institutions should actively monitor these professional's mental health and develop restorative strategies that enable their emotional wellbeing, preventing absenteeism and increasing patients' quality of care. IMPLICATIONS FOR PRACTICE: Burnout of health professionals has a strong impact on health services organization, resulting in increased absenteeism and error probability, frequent work delays, low productivity and job satisfaction, inter- and intra-professional conflicts, high job turnover, high job quit, and decreased quality of care perceived by users.

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From Zero to a National Data Set in 2 Weeks: Reflections on a COVID-19 Collaborative Survey Project

In March 2020, like much of the rest of the world, we went into lockdown A week into our new reality, we decided to do a survey study about how people were experiencing the COVID-19 pandemic In this piece, we describe what motivated us to do the study, how we went about it, and what others can learn from our experiences

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Prediction Models for the Clinical Severity of Patients With COVID-19 in Korea: Retrospective Multicenter Cohort Study

BACKGROUND: Limited information is available about the present characteristics and dynamic clinical changes that occur in patients with COVID-19 during the early phase of the illness. OBJECTIVE: This study aimed to develop and validate machine learning models based on clinical features to assess the risk of severe disease and triage for COVID-19 patients upon hospital admission. METHODS: This retrospective multicenter cohort study included patients with COVID-19 who were released from quarantine until April 30, 2020, in Korea. A total of 5628 patients were included in the training and testing cohorts to train and validate the models that predict clinical severity and the duration of hospitalization, and the clinical severity score was defined at four levels: mild, moderate, severe, and critical. RESULTS: Out of a total of 5601 patients, 4455 (79.5%), 330 (5.9%), 512 (9.1%), and 301 (5.4%) were included in the mild, moderate, severe, and critical levels, respectively. As risk factors for predicting critical patients, we selected older age, shortness of breath, a high white blood cell count, low hemoglobin levels, a low lymphocyte count, and a low platelet count. We developed 3 prediction models to classify clinical severity levels. For example, the prediction model with 6 variables yielded a predictive power of >0.93 for the area under the receiver operating characteristic curve. We developed a web-based nomogram, using these models. CONCLUSIONS: Our prediction models, along with the web-based nomogram, are expected to be useful for the assessment of the onset of severe and critical illness among patients with COVID-19 and triage patients upon hospital admission.

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Novel COVID-19 Screening Using Cough Recordings of A Mobile Patient Monitoring System

Since the COVID-19 pandemic began, research has shown promises in building COVID-19 screening tools using cough recordings as a convenient and inexpensive alternative to current testing techniques. In this paper, we present a novel and fully automated algorithm framework for cough extraction and COVID-19 detection using a combination of signal processing and machine learning techniques. It involves extracting cough episodes from audios of a diverse real-world noisy conditions and then screening for the COVID-19 infection based on the cough characteristics. The proposed algorithm was developed and evaluated using self-recorded cough audios collected from COVID-19 patients monitored by Biovitals® Sentinel remote patient management platform and publicly available datasets of various sound recordings. The proposed algorithm achieves a duration Area Under Receiver Operating Characteristic curve (AUROC) of 98.6% in the cough extraction task and a mean cross-validation AUROC of 98.1% in the COVID-19 classification task. These results demonstrate high accuracy and robustness of the proposed algorithm as a fast and easily accessible COVID-19 screening tool and its potential to be used for other cough analysis applications.

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The relationship between new PCR positive cases and going out in public during the COVID-19 epidemic in Japan

The suppression of the first wave of COVID-19 in Japan is assumedly attributed to people’s increased risk perception after acquiring information from the government and media reports. In this study, going out in public amidst the spread of COVID-19 infections was investigated by examining new polymerase chain reaction (PCR) positive cases of COVID-19 and its relationship to four indicators of people going out in public (the people flow, the index of web searches for going outside, the number of times people browse restaurants, and the number of hotel guests, from the Regional Economic and Social Analysis System (V-RESAS). Two waves of COVID-19 infections were examined using cross-correlation analysis. In the first wave, all four indicators of going out changed to be opposite the change in new PCR positive cases, showing a lag period of –1 to +6 weeks. In the second wave, the same relationship was only observed for the index of web searches for going outside, and two indicators showed the positive lag period of +6 to +12 weeks after the change in new PCR positive cases. Moreover, each indicator in the second wave changed differently compared to the first wave. The complexity of people’s behaviors around going out increased in the second wave, when policies and campaigns were implemented and people’s attitudes were thought to have changed. In conclusion, the results suggest that policies may have influenced people’s mobility, rather than the number of new PCR positive cases.

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Polio Virotherapy of Malignant Glioma Engages the Tumor Myeloid Infiltrate and Induces Diffuse Microglia Activation

Malignant gliomas commandeer abundant inflammatory infiltrates with glioma-associated macrophages and microglia (GAMM) actively promoting tumor progression. Like all cells in the mononuclear phagocytic system, macrophages and microglia constitutively express the poliovirus receptor, CD155. Besides myeloid cells, CD155 is widely upregulated ectopically in the neoplastic compartment of malignant gliomas (and solid cancers in general). Intratumor treatment with the highly attenuated rhino:poliovirus chimera, PVSRIPO, yielded long-term survival with durable radiographic responses in patients with recurrent glioblastoma (Desjardins et al. New England Journal of Medicine, 2018). Here, we studied mechanisms of PVSRIPO immunotherapy in mouse brain tumor models to decipher contributions of myeloid vs. malignant cells to antitumor efficacy. PVSRIPO treatment caused intense engagement of the GAMM infiltrate associated with substantial, but transient tumor regression. This was accompanied by diffuse microglia activation and proliferation in the normal central nervous system (CNS) surrounding the tumor, extending to the ipsilateral and even the contralateral hemispheres. PVSRIPO-instigated microglia activation occurred against a backdrop of sustained innate antiviral inflammation, associated with induction of the PD-L1 immune checkpoint on GAMM. Combining PVSRIPO with PD1/PD-L1 blockade led to durable remissions. Our work implicates GAMM as active drivers of PVSRIPO-induced antitumor inflammation and reveals profound and widespread neuroinflammatory activation of the CNS-resident myeloid compartment by PVSRIPO.

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The road to a human-centred digital society: opportunities, challenges and responsibilities for humans in the age of machines

The growing adoption of intelligent technologies has brought us to a crossroad. The creators of intelligent technologies are acquiring the power to influence a wide variety of outcomes that are important to human end-users. In doing so, those same intelligent technologies are being used to undermine and even actively harm the interests of those same end-users. In the absence of a recalibration, we are almost certainly headed down a path wherein intelligent technologies will primarily serve the interests of developers and owners of technology rather than humankind at large. In an attempt to push for such a recalibration, we present parallels between the 2008 financial crisis and the current state of affairs. Following which, we present a list of recommendations and implications to be used when in the pursuit of creating responsible and human-centred AI.

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Using Student Insights for Ideas on Video Creation for Chemistry Classes

Creation of videos is one of the many ways faculty and teachers have had to cope with the limitations of teaching chemistry laboratory at this time of COVID-19 restrictions In this communication, I describe ideas for videos generated by students in a class I taught entitled Teaching of Biology The students were required to interview different faculty about a course they had previously taken and develop two course improvements to add value to that class In one of our class discussions, the students initially suggested the idea of creating short videos of laboratory activities for introductory chemistry This was well before our restrictions to be on campus Then, as part of their thought process for course improvements in chemistry, several students proposed additional types of videos that they felt would add value to chemistry classes based on their experiences as students in those courses In this work, I provide the specific suggestions of the students and discuss the value of incorporating students ideas for videos in chemistry lecture and laboratory classes

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Using a genetic algorithm to fit parameters of a COVID-19 SEIR model for US states

Background: A Susceptible-Exposed-Infected-Removed (SEIR) model was developed to forecast the spread of the novel coronavirus (SARS-CoV-2) in the United States and the implications of re-opening and hospital resource utilization The model relies on the specification of various parameters that characterize the virus and the population being modeled However, several of these parameters can be expected to vary significantly between states Therefore, a genetic algorithm was developed that adjusts these population-dependent parameters to fit the SEIR model to data for any given state Methods: Publicly available data was collected from each state in terms of the number of positive COVID-19 cases and the number of COVID-19-caused deaths and used as inputs into a SEIR model to predict the spread of COVID infections in a given population A genetic algorithm was designed where the genes are the state-dependent parameters from the model The algorithm operates by determining the fitness of a given set of genes, applying selection, using selected agents to reproduce with cross-over, applying random mutation, and simulating several generations Findings and Conclusions: Use of the genetic algorithm produces exceptionally good agreement between the model and available data Deviations in the parameters were examined to see if the trends were reasonable

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Understanding national trends in COVID-19 vaccine hesitancy in Canada: results from five sequential cross-sectional representative surveys spanning April 2020–March 2021

OBJECTIVE: To examine rates of vaccine hesitancy and their correlates among Canadian adults between April 2020 and March 2021. DESIGN: Five sequential cross-sectional age, sex and province-weighted population-based samples who completed online surveys. SETTING: Canada. PARTICIPANTS: A total of 15 019 Canadians aged 18 years and over were recruited through a recognised polling firm (Leger Opinion). Respondents were 51.5% female with a mean age of 48.1 (SD 17.2) years (range 18–95 years) and predominantly white (80.8%). PRIMARY AND SECONDARY OUTCOME MEASURES: Rates of vaccine hesitancy over the five surveys (time points) and their sociodemographic, clinical and psychological correlates. RESULTS: A total of 42.2% of respondents reported some degree of vaccine hesitancy, which was lowest during surveys 1 (April 2020) and 5 (March 2021) and highest during survey 3 (November 2020). Fully adjusted multivariate logistic regression analyses revealed that women, those aged 50 and younger, non-white, those with high school education or less, and those with annual household incomes below the poverty line in Canada were significantly more likely to report vaccine hesitancy, as were essential and healthcare workers, parents of children under the age of 18 and those who do not get regular influenza vaccines. Endorsing prevention behaviours as important for reducing virus transmission and high COVID-19 health concerns were associated with 77% and 54% reduction in vaccine hesitancy, respectively. Having high personal financial concerns was associated with 1.33 times increased odds of vaccine hesitancy. CONCLUSIONS: Results highlight the importance of targeting vaccine efforts to specific groups by emphasising the outsized health benefits compared with risks of vaccination. Future research should monitor changes in vaccine intentions and behaviour to better understand underlying factors.

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The folate antagonist methotrexate diminishes replication of the coronavirus SARS-CoV-2 and enhances the antiviral efficacy of remdesivir in cell culture models

The search for successful therapies of infections with the coronavirus SARS-CoV-2 is ongoing. We tested inhibition of host cell nucleotide synthesis as a promising strategy to decrease the replication of SARS-CoV-2-RNA, thus diminishing the formation of virus progeny. Methotrexate (MTX) is an established drug for cancer therapy and to induce immunosuppression. The drug inhibits dihydrofolate reductase and other enzymes required for the synthesis of nucleotides. Strikingly, the replication of SARS-CoV-2 was inhibited by MTX in therapeutic concentrations around 1 µM, leading to more than 1000-fold reductions in virus progeny in Vero C1008 (Vero E6) and ∼100-fold reductions in Calu-3 cells. Virus replication was more sensitive to equivalent concentrations of MTX than of the established antiviral agent remdesivir. MTX strongly diminished the synthesis of viral structural proteins and the amount of released virus RNA. Virus replication and protein synthesis were rescued by folinic acid (leucovorin) and also by inosine, indicating that purine depletion is the principal mechanism that allows MTX to reduce virus RNA synthesis. The combination of MTX with remdesivir led to synergistic impairment of virus replication, even at 100 nM MTX. The use of MTX in treating SARS-CoV-2 infections still awaits further evaluation regarding toxicity and efficacy in infected organisms, rather than cultured cells. Within the frame of these caveats, however, our results raise the perspective of a two-fold benefit from repurposing MTX for treating COVID-19. Firstly, its previously known ability to reduce aberrant inflammatory responses might dampen respiratory distress. In addition, its direct antiviral activity described here would limit the dissemination of the virus.

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Natural Substances in the Fight of SARS-CoV-2: A Critical Evaluation Resulting from the Cross-Fertilization of Molecular Modeling Data with the Pharmacological Aspects

The recent pandemic due to SARS-CoV-2, the last isolated human beta-coronavirus, has revolutionized modern knowledge of the pathogenesis of viral pneumonia. The lack of specific antiviral drugs and the need to develop adequate research for new antiviral drugs capable of treating this new form of the disease undertook three different research paths quickly. The first one is aimed to test antiviral molecules already present in therapeutic use, with a mechanism of an action directed towards viral proteins functional to replication or adsorption; the second one, it is the repositioning of molecules with known pharmacological activity for which various chemistry studies have been prepared in an attempt to find new and specific viral targets; the third, it is the search for molecules of natural origin for which to demonstrate a specific anti-coronavirus activity. Many databases of natural and synthetic substances have been used for the identification of potent inhibitors of various viral targets. The field of computer-aided drug design seems to be promising and useful for the identification of SARS-CoV-2 inhibitors; hence, different structure- and ligand-based computational approaches have been used for their identification. This review analyzes in-depth and critically the most recent publications in the field of applied computational chemistry to find out molecules of natural origin with potent antiviral activity. Furthermore, a critical and functional selection of some molecules with the best hypothetical anti-SARS-CoV-2 activity is made for further studies by biological tests.

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More eyes on COVID-19: Perspectives from Ethics The most powerful health-promoting forces in COVID-19 are social

As the COVID-19 pandemic rages through the world, all aspects of life globally are being disrupted by mounting death rates and governments' responses The first ethical lesson has been the realization that the increasing instability of the world, characterized by diverging trajectories of health and well-being, with a minority (25%) benefiting from spectacular human development and progress, and a majority (75%) suffering from inadequate human and social development, is amplified in South Africa as a failing state, with its even wider disparities and continuing, pervasive poverty, hunger, unemployment and heavy burden of disease The second lesson relates to the complexity of the challenge for the government and people of a middle-income country seeking a balance between efforts to: mitigate and control the pandemic for long enough to prepare already inadequate overall health facilities to save as many lives as possible, and prevent severe damage to our fragile and crumbling economy in order to avoid deaths from starvation and other neglected health needs Here, Benatar discusses the ethical challenges highlighted by the pandemic

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The decrease of CD4 T cell is associated with mortality in critical inpatients with COVID-19

Background: The 2019 novel coronavirus (SARS-CoV-2) has caused an outbreak in the world. The critically ill patients had a high mortality. However, the possible risk factors of critical patients with coronavirus disease 2019 (COVID-19) are not fully known. We aim to investigate the risk factors in critical patients with COVID-19 and to address their role in predicting disease progression.Methods In this single-centered, retrospective, observational study, we enrolled 91 critically ill adult patients with COVID-19 in Renmin Hospital of Wuhan University between Jan 20, 2020 and Feb 28, 2020. Data were collected using a standard method including clinical records and laboratory findings.Results 39 patients (42.9%) were dead and 52 patients (57.1%) were cured and discharged before Mar 22, 2020. CD4 T cell count, CD8 T cell count and glomerular filtration rate were significantly lower in non-survivors than in survivors. However, the non-survivors presented a higher proportion of D-dimer, Cardiac troponin and immunoglobulin G than in survivors. Intravenous immunoglobulin was more common in survivors than in non-survivors. On multivariate analysis, D-dimer (༞1 µg/mL, OR = 9.53, 95% CI, 2.53–35.88), CD4 + T count (༜200/µl, OR = 9.68, 95%CI, 2.76-40.00 ) and cardiac troponin (༞0.04 ng/mL, OR = 5.73, 95% CI, 1.86–17.66) were independent risk factors for mortality.Conclusion The decrease of CD4 T cell is associated with higher risk mortality in critical inpatients with COVID-19. Intravenous immunoglobulin was more common in survivors than in non-survivors.

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Modeling COVID-19 Dynamics in Illinois under Nonpharmaceutical Interventions

We present modeling of the COVID-19 epidemic in Illinois, USA, capturing the implementation of a stay-at-home order and scenarios for its eventual release We use a non-Markovian age-of-infection model that is capable of handling long and variable time delays without changing its model topology Bayesian estimation of model parameters is carried out using Markov chain Monte Carlo methods This framework allows us to treat all available input information, including both the previously published parameters of the epidemic and available local data, in a uniform manner To accurately model deaths as well as demand on the healthcare system, we calibrate our predictions to total and in-hospital deaths as well as hospital and ICU bed occupancy by COVID-19 patients We apply this model not only to the state as a whole but also its subregions in order to account for the wide disparities in population size and density Without prior information on nonpharmaceutical interventions, the model independently reproduces a mitigation trend closely matching mobility data reported by Google and Unacast Forward predictions of the model provide robust estimates of the peak position and severity and also enable forecasting the regional-dependent results of releasing stay-at-home orders The resulting highly constrained narrative of the epidemic is able to provide estimates of its unseen progression and inform scenarios for sustainable monitoring and control of the epidemic © 2020 authors

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An Open-Source Modular Framework for Automated Pipetting and Imaging Applications

The number of samples in biological experiments are continuously increasing, but complex protocols and human experimentation in many cases lead to suboptimal data quality and hence difficulties in reproducing scientific findings. Laboratory automation can alleviate many of these problems by precisely reproducing machine-readable protocols. These instruments generally require high up-front investments and due to lack of open APIs they are notoriously difficult for scientists to customize and control outside of the vendor-supplied software. Here, we demonstrate automated, high-throughput experiments for interdisciplinary research in life science that can be replicated on a modest budget, using open tools to ensure reproducibility by combining the tools Openflexure, Opentrons, ImJoy and UC2. Our automated sample preparation and imaging pipeline can easily be replicated and established in many laboratories as well as in educational contexts through easy-to-understand algorithms and easy-to-build microscopes. Additionally, the creation of feedback loops, with later pipetting or imaging steps depending on analysis of previously acquired images, enables the realization of smart microscopy experiments, featuring completely autonomously performed experiments. All documents and source-files are publicly available (https://beniroquai.github.io/Hi2) to prove the concept of smart lab automation using inexpensive, open tools. We believe this democratizes access to the power and repeatability of automated experiments.

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“‘Ninja’ levels of focus”: Therapeutic holding environments and the affective atmospheres of telepsychology during the COVID-19 pandemic

The COVID-19 crisis in Australia led to a rapid increase in the use of telehealth services to offer psychological therapy (often referred to as ‘telepsychology’). In this article, we discuss the intersection of the social psychology concepts of therapeutic holding spaces and containment with more-than-human theory as it relates to Australia's mental health sector during the COVID-19 crisis. Drawing on our recent qualitative survey research into Australian psychologists' use of telepsychology during the crisis, we consider the ways that they worked to build and maintain therapeutic holding spaces and alliances over teleconferencing platforms during this extraordinary time of social crisis and isolation. We explore and contextualise three important findings from our study: 1) the limited viewing area of a flat screen makes it difficult for therapists to read and respond to their client's body language and requires different forms of returned bodily gestures in order to show empathy;2) most respondents implemented different affective and relational strategies online to ensure they were not missing important non-verbal cues from their clients;and 3) the traditionally ‘safe’ therapeutic holding space created in face-to-face therapy can be easily subverted by client-end interruptions, and concerns around safety or personal privacy in the client's home environment. In bringing these issues to the fore, we highlight the online therapeutic holding space as a temporally and socially situated human-technological assemblage in which a series of affective, spatial, relational and sense-making agencies coverage, opening or closing off capacities for therapists and their clients. © 2021

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Shedding a new light on Huntington's disease: how blood can both propagate and ameliorate disease pathology.

Huntington's disease (HD) is a monogenic neurodegenerative disorder resulting from a mutation in the huntingtin gene. This leads to the expression of the mutant huntingtin protein (mHTT) which provokes pathological changes in both the central nervous system (CNS) and periphery. Accumulating evidence suggests that mHTT can spread between cells of the CNS but here, we explored the possibility that mHTT could also propagate and cause pathology via the bloodstream. For this, we used a parabiosis approach to join the circulatory systems of wild-type (WT) and zQ175 mice. After surgery, we observed mHTT in the plasma and circulating blood cells of WT mice and post-mortem analyses revealed the presence of mHTT aggregates in several organs including the liver, kidney, muscle and brain. The presence of mHTT in the brain was accompanied by vascular abnormalities, such as a reduction of Collagen IV signal intensity and altered vessel diameter in the striatum, and changes in expression of Glutamic acid decarboxylase 65/67 (GAD65-67) in the cortex. Conversely, we measured reduced pathology in zQ175 mice by decreased mitochondrial impairments in peripheral organs, restored vessel diameter in the cortex and improved expression of Dopamine- and cAMP-regulated phosphoprotein 32 (DARPP32) in striatal neurons. Collectively, these results demonstrate that circulating mHTT can disseminate disease, but importantly, that healthy blood can dilute pathology. These findings have significant implications for the development of therapies in HD.

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A Prediction Model for High Risk of Positive RT-PCR Tests in Discharged Patients with COVID-19 Based on Random Forest Model

Several recent studies have reported that a few patients had positive SARS-CoV-2 RNA tests after hospital discharge. The high-risk factors associated with these patients remain to be identified. A total of 463 patients with COVID-19 discharged from Leishenshan Hospital in Wuhan, China, between February 8 and March 8, 2020 were initially enrolled, and 351 patients with at least two weeks of follow-up were finally included. Seventeen of the 351 discharged patients had positive tests for SARS-CoV-2 RNA. Based on clinical characteristics and mathematical modeling, patients with shorter hospital stays and less oxygen desaturation were at higher risk of SARS-CoV-2 RNA reoccurrence after discharge. Notably, traditional Chinese medicine treatment offered extensive benefits to reduce risk. Particular attention should be paid to those patients with high risk, and traditional Chinese medicine should be advocated.Funding Statement: The study was supported by National Key Research and Development Plan of China (2020YFC0845500).Declaration of Interests: All authors have no conflicts of interest or financial ties to disclose.Ethics Approval Statement: The study was approved by the ethics committee of Zhongnan Hospital of Wuhan University (No. 2020074). The informed consent of the patients was waived for this infectious disease by the ethics committee.

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Acute abdominal pain due to internal herniation of the sigmoid colon, fallopian tube and left ovary, a rare presentation of Allen Masters syndrome.

In 1955, Allen and Masters describe a painful syndrome which associates traumatic delivery to laceration found on the posterior leaf of the broad ligament. Herniation through this defect is a rare entity, accounted for about 4-7% of all internal hernias. Normally, it involves the small bowel. The authors present the case of a multiparous woman admitted at emergency for constipation and abdominal pain. The CT scan showed an extremely rare case of internal hernia of the sigmoid colon, fallopian tube and left ovary through a large defect of the broad ligament. The patient underwent a full laparoscopic surgery that allowed the reduction of the hernia and the suture of the defect with very good outcome.

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COVID-19 and ECT - a Victorian perspective

OBJECTIVES: (i) to describe the operational strategies implemented to practise electroconvulsive therapy (ECT) safely, and (ii) to explore the effect of the lockdown and operational strategies on the characteristics of patients who received ECT during the initial 6 months of the COVID-19 lockdown. METHODS: At first, the operational strategies that were implemented at the Broadmeadows ECT suite were summarised. Subsequently, the characteristics of patients who received ECT in the lockdown period (16 March-16 September 2020) and in the comparison period (16 March-16 September 2019) were compared. RESULTS: Many safety measures were implemented, and there was no COVID-19 infection among mental health staff and patients. In the lockdown period, the number of patients (23.9%) and the total number of ECTs (29.4%) were less. This pattern was more prominent among the aged patients. CONCLUSION: Safe practices are essential to provide ECT during lockdowns even when the community transmission of COVID-19 is high.

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The Relationship between Suicidality and Socio-Demographic Variables, Physical Disorders, and Psychiatric Disorders: Results from the Singapore Mental Health Study 2016

Suicidality encompasses suicidal ideation, plans, and attempts. This paper aims to establish associations between suicidality and sociodemographic variables, physical disorders, and psychiatric disorders. The Singapore Mental Health Study 2016 was a population-level epidemiological survey, which determined the prevalence of physical disorders, psychiatric disorders, and suicidality. Questionnaires were used to determine socio-demographic information. A total of 6216 respondents were interviewed. Lifetime prevalence of suicidal ideation, planning, and attempts were 7.8%, 1.6%, and 1.6%, respectively. All components of suicidality were more likely in those with major depressive disorder, bipolar disorder, generalized anxiety disorder, alcohol use disorder, and chronic pain. Suicidal ideation and attempts were more likely in those with diabetes. Age above 65, being male, and a monthly household income of ≥ SGD 10,000 were associated with a lower likelihood of suicidal ideation. These findings indicate that there are high-risk groups for whom suicidality is a concern, and for whom interventions may be needed.

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Knowledge, Anxiety, Depression, and Sleep Quality Among Medical Staff in Central South Areas of China During the Break of COVID-19: Does the Level of Hospitals Make a Difference?

Purpose: To evaluate the knowledge, anxiety, depression, and sleep quality toward COVID-19 among Chinese medical staff from tertiary and basic-level hospitals in central south areas of China. Method: A structured questionnaire was composed of Demographic and clinical characteristics of medical staff, Knowledge toward COVID-19 including epidemiology and clinical manifestations, The Self-rating anxiety scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), and The Pittsburgh Sleep Quality Index (PSQI). It was administered to medical staff from tertiary hospitals (Group A) (n = 407) and basic-level hospitals (Group B) (n = 388) during February 2020 and May 2020. Results: Medical staff in group A had a stronger knowledge toward COVID-19 than group B (23.69 ± 5.83 & 18.15 ± 6.35, p < 0.001). Mild anxiety symptoms were found in both groups. The SAS scores (Mean ± SD) of group B were 58.87 ± 10.17, which was significantly higher than that of group A (52.59 ± 12.09, p < 0.001). There were no significant differences in CES-D scores between the two groups (p = 0.981). The mean score of total PSQI in group B (8.41 ± 3.03) was statistically higher than that of group A (7.31 ± 3.74, p < 0.001). Additionally, the scores of sub-components of group B, including subjective sleep quality, sleep latency, sleep disorder, sleeping medication use and daytime dysfunction, were significantly higher compared to Group A (p < 0.05). Conclusions: Our study showed greater anxiety, more severe depression and poorer sleep quality among medical staff in central south areas of China during the COVID-19 outbreak. Additionally, compared to the tertiary hospital group, medical staff from basic-level hospitals had poorer knowledge toward COVID-19 and worse mental health conditions. In addition, residence, specialty, title and education level may also be factors of knowledge of COVID-19 and psychiatry problems. In light of this information, more attention should be paid to early identification and intervention of symptoms of anxiety and depression in susceptible medical staff from the basic-level hospitals.

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Cyber-Physical Systems Security: Limitations, Issues and Future Trends

Typically, Cyber-Physical Systems (CPS) involve various interconnected systems, which can monitor and manipulate real objects and processes. They are closely related to Internet of Things (IoT) systems, except that CPS focuses on the interaction between physical, networking and computation processes. Their integration with IoT led to a new CPS aspect, the Internet of Cyber-Physical Things (IoCPT). The fast and significant evolution of CPS affects various aspects in people’s way of life and enables a wider range of services and applications including e-Health, smart homes, e-Commerce, etc. However, interconnecting the cyber and physical worlds gives rise to new dangerous security challenges. Consequently, CPS security has attracted the attention of both researchers and industries. This paper surveys the main aspects of CPS and the corresponding applications, technologies, and standards. Moreover, CPS security vulnerabilities, threats and attacks are reviewed, while the key issues and challenges are identified. Additionally, the existing security measures are presented and analyzed while identifying their main limitations. Finally, several suggestions and recommendations are proposed benefiting from the lessons learned throughout this comprehensive review.

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Vietnamese living habits, wellbeing and working adaptation in face of COVID-19's strictest lockdown

Purpose This study explores the impacts of COVID-19's strictest lockdown on Vietnamese citizens' living habits, wellbeing and work-from-home effectiveness. Design/methodology/approach The study uses a survey questionnaire to gather relevant data from Vietnamese adults during the most recent, strictest lockdown in their cities/provinces since July 2021. The study employs ordinal regression and mediation models to examine the effects of the strict lockdown difficulties on the changes in living habits, wellbeing and work effectiveness of Vietnamese respondents. Findings The empirical result demonstrates that the strictest lockdown adversely affected the living habits of Vietnamese citizens, thus impacting people's wellbeing. Work-from-home lockdown difficulties led to unexpected health issues that bring produce lower working effectiveness. Originality/value This is the first study to investigate the changes in citizens' living habits, health and working conditions in adherence to Vietnam's strictest COVID-19 lockdown. This is also the first study to examine the impacts of lockdown difficulties on human wellbeing with the mediating effect of changes in living habits, and the influence of work-from-home lockdown difficulties on work effectiveness, with the mediating effect of lower wellbeing based on the literature. Our study suggests solutions to improve Vietnamese people's health and working productivity during and after a strict lockdown.

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Using Andersen’s model of health care utilization to assess factors associated with COVID-19 testing among adults in nine low-and middle-income countries: an online survey

BACKGROUND: This study aimed to investigate, using Andersen’s model of health care utilization, factors associated with COVID-19 testing among adults in nine low- and middle- income countries. METHODS: In between 10 December 2020 and 9 February 2021, an online survey was organized in nine low- and middle-income countries. In total 10,183 adults (median age 45 years, interquartile range 33–57 years, range 18–93 years), including 6470 from Brazil, 1738 Malaysia, 1124 Thailand, 230 Bangladesh, 219 DR Congo, 159 Benin, 107 Uganda, 81 Malawi and 55 from Mali participated in the study. COVID-19 testing/infection status was assessed by self-report. RESULTS: Of the 10,183 participants, 40.3% had ever tested for COVID-19, 7.3% tested positive, and 33.0% tested negative. In an adjusted logistic regression model, predisposing factors (residing in Brazil, postgraduate education), enabling/disabling factors (urban residence, higher perceived economic status, being a student or worker in the health care sector, and moderate or severe psychological distress), and need factors (having at least one chronic condition) increased the odds of COVID-19 testing. Among those who were tested, participants residing in Bangladesh, those who had moderate to severe psychological distress were positively associated with COVID-19 positive diagnosis. Participants who are residing in Malaysia and Thailand, and those who had higher education were negatively associated with a COVID-19 positive diagnosis. Considering all participants, higher perceived economic status, being a student or worker in the health sector, and moderate or severe psychological distress were positively associated with a COVID-19 positive diagnosis, and residing in Malaysia, Thailand or five African countries was negatively associated with a COVID-19 positive diagnosis. CONCLUSION: A high rate of COVID-19 testing among adults was reported in nine low-and middle-income countries. However, access to testing needs to be increased in Africa. Moreover, COVID-19 testing programmes need to target persons of lower economic status and education level who are less tested but most at risk for COVID-19 infection.

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SARS-CoV-2 encephalitis is a cytokine release syndrome: evidences from cerebrospinal fluid analyses

BACKGROUND: Recent findings indicated that SARS-CoV-2 related neurological manifestations involve cytokine release syndrome along with endothelial activation, blood brain barrier dysfunction, and immune‐mediated mechanisms. Very few studies have fully investigated the CSF correlates of SARS-CoV-2 encephalitis. METHODS: Patients with PCR-confirmed SARS-CoV-2 infection and encephalitis (COV-Enc), encephalitis without SARS-CoV-2 infection (ENC) and healthy controls (HC) underwent an extended panel of CSF neuronal (NfL, T-tau), glial (GFAP, TREM2, YKL-40) and inflammatory biomarkers (IL-1β, IL-6, Il-8, TNF- α, CXCL-13 and β2-microglobulin). RESULTS: Thirteen COV-Enc, 21 ENC and 18 HC entered the study. In COV-Enc cases, CSF was negative for SARS-CoV-2 real-time PCR but exhibited increased IL-8 levels independently from presence of pleocytosis/hyperproteinorracchia. COV-Enc patients showed increased IL-6, TNF- α, and β2-microglobulin and glial markers (GFAP, sTREM-2, YKL-40) levels similar to ENC but normal CXCL13 levels. Neuronal markers NfL and T-Tau were abnormal only in severe cases. CONCLUSIONS: SARS-CoV-2-related encephalitis were associated with prominent glial activation and neuroinflammatory markers, whereas neuronal markers were increased in severe cases only. The pattern of CSF alterations suggested a cytokine-release syndrome as the main inflammatory mechanism of SARS-CoV-2 related encephalitis.

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Lessons and Recommendations from a Pentobarbital Shortage: US and Canada 2021

SIMPLE SUMMARY: Pentobarbital sodium is a common animal euthanasia drug in the United States and Canada, as well as in other countries with access to it. A shortage of the drug in 2021 created a dilemma for those needing to perform the euthanasia procedure in animals facing negative welfare conditions. The reason for the shortage was attributed to chemical production issues. The veterinary community worked together to conserve what euthanasia drug was available, and to identify alternative methods that could be quickly implemented, while still adhering to safety and efficacy requirements. Through collaborative efforts, useful guidelines were created and shared with a variety of animal industries to ensure euthanasia procedures could still be facilitated when necessary. While pentobarbital sodium has increased in availability in 2022, lessons have been learned to support animal care should the shortage occur again. ABSTRACT: In 2021, a shortage in the supply of the euthanasia drug pentobarbital sodium affected animal care professionals around the world, including in the United States and Canada. Pentobarbital sodium is the drug of choice for companion animal euthanasia in both countries. The decreased availability of pentobarbital sodium affected a number of animal care industries, forcing conservation of the drug and the use of alternative methods and other agents to facilitate humane death for all manner of animal species. Veterinary medical groups, laboratory research institutions, and the animal sheltering industry worked together to identify the best path forward to maintain routine euthanasia practices and to protect the welfare of animals. This article aims to explore the reasons behind the shortage and to highlight the necessary responses and adjustments made in order to continue providing euthanasia services in North America. Recommendations for handling future pentobarbital shortages are included.

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Multinational Study to Assess Stress Levels Among the Health Care Workers of Radiation Oncology Community at the Outset of the COVID-19 Pandemic

PURPOSE: To evaluate stress levels among the health care workers (HCWs) of the radiation oncology community in Asian countries. METHODS: HCWs of the radiation oncology departments from 29 tertiary cancer care centers of Bangladesh, India, Indonesia and Nepal were studied from May 2020 to July 2020. A total of 758 eligible HCWs were identified. The 7-Item Generalized Anxiety Disorder, 9-Item Patient Health Questionnaire, and 22-Item Impact of Events Scale-Revised were used for assessing anxiety, depression, and post-traumatic stress disorder. Univariate and multivariate analysis was done to identify the causative factors affecting mental health. RESULTS: A total of 758 participants from 794 HCWs were analyzed. The median age was 31 years (IQR, 27-28). The incidence of moderate to severe levels of anxiety, depression, and stress was 34.8%, 31.2%, and 18.2%, respectively. Severe personal concerns were noticed by 60.9% of the staff. On multivariate analysis, the presence of commonly reported symptoms of COVID-19 during the previous 2 weeks, contact history (harzard ratio [HR], 2.04; CI, 1.15 to 3.63), and compliance with precautionary measures (HR, 1.69; CI, 1.19 to 2.45) for COVID-19 significantly predicted for increasing anxiety (HR, 2.67; CI, 1.93 to 3.70), depression (HR, 3.38; CI 2.36 to 4.84), and stress (HR, 2.89; CI, 1.88 to 4.43) (P < .001). A significant regional variation was also noticed for anxiety, stress, and personal concerns. CONCLUSION: This survey conducted during the COVID-19 pandemic revealed that a significant proportion of HCWs in the radiation oncology community experiences moderate to severe levels of anxiety, depression, and stress. This trend is alarming and it is important to identify and intervene at the right time to improve the mental health of HCWs to avoid any long-term impacts.

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Spatiotemporal Variation of Air Quality (PM and NO2) in Southern Paris during COVID-19 Lockdown Periods

In urban areas, road transportation is the main source of pollutants, and weather impacts spatiotemporal variation of air quality. In this paper, we demonstrate the spatiotemporal variabilities of particulate matter (PM10 and PM2.5) and NO2 in the south of Paris, with an emphasis on the comparison of air pollutant levels between COVID-19 lockdown and non-lockdown days according to meteorological conditions. The influence of COVID-19 lockdowns could be region-specific. Thus, it is worthwhile to conduct investigations across different regions and via different methodologies. This manuscript contains data that could be relied upon to evaluate available options for mitigation of urban air pollution. Using Airparif data and mobile survey data collected by Aeroqual 500 sensors, this study confirms that road traffic seems to be the determining factor of air quality in the southern part of Paris. The daily average concentrations of NO2, PM2.5 and PM10 calculated in 2020 show a strong spatiotemporal variability explained by the type of weather on the one hand and by the proximity of emission sources on the other hand. Mobile surveys show that during lockdowns in 2020, when the weather was stable, in 13th arrondissement of Paris, NO2 values exceeded 250 µg/m3 with PM10 values over 70 µg/m3, mainly in three locations: the area between Rue Tolbiac and Rue Nationale, along Rue de Chevaleret, and on Boulevard Périphérique.

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Effects of COVID-19-related life changes on mental health in Syrian refugees in Turkey

BACKGROUND: Mental disorders are currently the greatest global health burden. The coronavirus diseases 2019 (COVID-19) pandemic is having an adverse impact on people's mental health, particularly in vulnerable populations, such as refugees. AIMS: The present study was designed to examine the association between COVID-19 and changes in mental health in Syrian refugees in Turkey. METHOD: We conducted a two-wave panel survey of a representative sample of 302 of the estimated 500 000 Syrian refugees (ages 18 and older) living under humanitarian support in Istanbul (first wave between 9 and 15 July 2020 and the follow-up between 11 and 14 September 2020). We administered seven items from the CoRonavIruS Health Impact Survey in addition to one-context specific item about life changes because of COVID-19, and measures of depression (10-item Center for Epidemiologic Study Depression Scale, CESD-10), anxiety (6-item State-Trait Anxiety Inventory, STAI-6) and perceived stress (Perceived Stress Scale, PSS-4). RESULTS: A factor analysis yielded three COVID-19 factors, labelled ‘social relationships’, ‘stress’ and ‘hope.’ We conducted a series of cross-lag panel analyses to test associations between the COVID-19 factors and mental health. We found associations between all COVID-19 factors and CESD-10, between COVID-19 ‘stress’ and STAI-6, and between COVID-19 ‘stress’ and COVID-19 ‘hope’ and PSS-4. CONCLUSIONS: Our measures of life changes because of the COVID-19 pandemic are associated with changes in the mental health of Syrian refugees living in Istanbul. It is therefore important that they are provided with services to reduce what may be particularly debilitating consequences of COVID-19.

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Athletes and Coaches through the COVID-19 Pandemic: A Qualitative View of Goal Management

Since the end of 2019 and throughout 2020, the world has been devastated by the COVID-19 pandemic. The sports world suddenly had to deal with a massive reorganization of events with important implications for the physical and psychological preparation of athletes and coaches. The purpose of this study was to explore how these changes impacted coaches’ and athletes’ goal-setting strategies and their experience of goal adjustment. As part of a wider mixed-method project involving 2162 coaches and 1354 athletes, an online qualitative survey was used, and data collected were analyzed using reflexive thematic analysis. Findings highlighted three overarching themes, in response to goal adjustment: “Moving on toward new goals”, “Letting go of goals”, and “Trying to hold on”, with several themes and sub-themes identifying different nuances of athletes’ and coaches’ experiences. The implications of such findings for the mental preparation of high-level athletes are discussed in two ways. Firstly, in light of existing literature on goal setting from an applied perspective; secondly, in the broader perspective of the sports culture and the application of our themes to other challenging moments that sports professionals might encounter.

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Neural-IR-Explorer: A Content-Focused Tool to Explore Neural Re-ranking Results

In this paper we look beyond metrics-based evaluation of Information Retrieval systems, to explore the reasons behind ranking results. We present the content-focused Neural-IR-Explorer, which empowers users to browse through retrieval results and inspect the inner workings and fine-grained results of neural re-ranking models. The explorer includes a categorized overview of the available queries, as well as an individual query result view with various options to highlight semantic connections between query-document pairs. The Neural-IR-Explorer is available at: https://neural-ir-explorer.ec.tuwien.ac.at/.

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High-resolution CT (HRCT) chest findings in PCR positive patients of covid-19 at combined military hospital Rawalpindi

Objective: To study High resolution computed tomography chest findings in polymerase chain reaction (PCR) positive patients of COVID-19. Study Design: Cross sectional study. Place and Duration of Study: Combined Military Hospital Rawalpindi, from May to Jun 2020. Methodology: Study included high resolution computed tomography chest of 200 patients admitted to COVID ward who were polymerase chain reaction positive. Patients having previously diagnosed Interstitial lung disease were excluded. Informed consent from patients were taken. Different findings on High resolution computed tomography chest were summarized as percent of total cases. British society of thoracic imaging (BSTI) classification was used to classify high resolution computed tomography chest patterns of COVID-19 pneumonia. Results: Out of 200 patients included in study, 7 had previous changes on their chest imaging and were excluded. 193 patients (145 males and 48 females) enrolled had a median age of 52 years. One hundred and two patients (52.9%) showed classical pattern for COVID-19, 81 patients (41.9%) had indeterminate changes, 3 patients (1.6%) had atypical changes while 7 (3.6%) had normal high resolution computed tomography chest. Four had pleural effusions while 5 had mediastinal lymphadeno-pathy. One hundred and eight nine (97.9%) patients had bilateral lung involvement, 145 (75.1%) had central and peripheral while 48 (24.9%) had peripheral invol-vement only. One hundred and forteen (59%) patients had ground glass opacities while 70 (36.3%) had ground glass opacities with consolidation. Nine (4.7%) patients presented with consolidation only. Conclusion: High resolution computed tomography chest and COVID polymerase chain reaction done at the same time gives better diagnostic accuracy and helps in classifying these patients into different categories with early detection and treatment of patients. © 2021, Army Medical College. All rights reserved.

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Phonon-Induced Relocation of Valence Charge in Boron Nitride Observed by Ultrafast X-Ray Diffraction

The impact of coherent phonon excitations on the valence charge distribution in cubic boron nitride is mapped by femtosecond x-ray powder diffraction. Zone-edge transverse acoustic (TA) two-phonon excitations generated by an impulsive Raman process induce a steplike increase of diffracted x-ray intensity. Charge density maps derived from transient diffraction patterns reveal a spatial transfer of valence charge from the interstitial region onto boron and nitrogen atoms. This transfer is modulated with a frequency of 250 GHz due to a coherent superposition of TA phonons related to the ^{10}B and ^{11}B isotopes. Nuclear and electronic degrees of freedom couple through many-body Coulomb interactions.

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COVIDOM : une expérience de télémédecine unique pour la gestion du COVID-19

Introduction Afin d’éviter l’engorgement du système de soin et de soulager les praticiens ainsi que d’éviter les contaminations hospitalières, le dispositif de télésuivi COVIDOM a été mis en place en urgence à l’échelle de l’Ile de France. Il permet le suivi des patients à domicile atteint du COVID-19. Il s’agit d’une initiative réalisée en partenariat entre l’AP-HP (Assistance des Hôpitaux de Paris), l’ARS (Agence régionale de Santé) et l’URPS (Union régionale des professionnels de santé) Ile-de-France. Nous présentons ce dispositif. Matériels et méthodes Description et évaluation du dispositif COVIDOM déployé en Ile-de-France. Résultats COVIDOM est un dispositif de télésuivi reposant sur des questionnaires renseignés par le patient, atteint de COVID, 1 ou 2 fois par jour ; 7 items étaient renseignés (fréquence cardiaque, dyspnée, fréquence respiratoire, température, malaise, frissons, difficulté au confinement) et généraient des alertes vertes, oranges ou rouges en fonction des seuils définis. Les alertes étaient traitées par un plateau de télésurveillance supervisé par des médecins représentant au total plus de 2 000 personnes sur l’ensemble de la période. Les patients pouvaient être inclus en consultation (de ville ou hospitalière), en sortie d’hospitalisation ou par la régulation du SAMU et étaient suivi 30j au total. Finalement du 9 mars au 8 juin 2020, 70 914 patients ont été inclus par 10 000 médecins, l’âge médian des patients était de 43 ans avec un sexe ratio de 0,71. Au total 266 619 alertes ont été générés dont 22 958 alertes rouges et 243 661 oranges. Au pic de l’épidémie, jusqu’à 10.000 alertes/jour ont été prises en charge par 40 « cellules » de télésurveillance, soit 200 postes de travail 7j/7 de 8h à 20h. La capacité de suivi était d’environ 1.200 patients par cellule. Sur le plateau 1.100 intervenants de télésurveillance (ITS) ont été formés : externes médecine/dentaires, professionnels de santé (kiné, pharmaciens, IDE, dentistes, cadres de santé), plus de 990 médecins référents (salariés AP-HP, libéraux, retraités) et enfin plus de 500 bénévoles, ces derniers étaient chargé s de rappeler les patients « non répondants ». Au total, le délai moyen avant prise en charge d’une alerte rouge était de 4,24minutes et 427 appels SAMU ont été déclenchés par la plateforme, 858 patients ont été hospitalisés et 73 sont décédés. Conclusion COVIDOM est un dispositif efficace et sécurisé, simple aisément transposable et reproductible. Il s’agit de la première expérience de télémédecine de cette envergure deployée dans le cadre d’une pathologie infectieuse aiguë. Il a participé à éviter l’engorgement des structures de soin qui ont pu se consacrer à la prise en charge des patients sévères.

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Local Factors and the Spread of COVID-19 in Germany

Due to the high level of infectivity the spread of COVID-19 is closely related to the number of daily face-to-face contacts between humans Whereas the extent i

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Globalization and Regionalization: Empirical Evidence from Itinerary Structure and Port Organization of World Cruise of Cunard

Cruise tourism is an obviously global industry in different dimensions From a geographical perspective, cruise ships are mobile and capable of being repositioned at a company’s notice, which forms the inherent basis for its global spatial layout As a branch of the cruise industry, the world cruise is clearly globalizing in geographical space by offering long itinerary, even round-the-world trips, for everyone Using the schedule data from 2018 to 2019, this paper analyzes the spatial characteristics of the itinerary and port organization of Cunard, a world cruise company We find that the itinerary distribution and port organization of Cunard are both globalization and regionalization, and the latter is the core and main component of the former Under the influence of the COVID-19 epidemic, the global mobility of cruises has ground to a halt, while local mobility offers the possibility of its resumption as soon as possible Turning to the regional voyage with the shorter and simple itinerary is feasible for Cunard and other world cruises, which is conducive to the realization of the resuming voyage as soon as possible Moreover, strict boarding and safety onboard are essential

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Curvature effects in charge-regulated lipid bilayers

We formulate a theory of electrostatic interactions in lipid bilayer membranes where both monolayer leaflets contain dissociable moieties that are subject to charge regulation. We specifically investigate the coupling between membrane curvature and charge regulation of a lipid bilayer vesicle using both the linear Debye-H\"uckel (DH) and the non-linear Poisson-Boltzmann (PB) theory. We find that charge regulation of an otherwise symmetric bilayer membrane can induce charge symmetry breaking, non-linear flexoelectricity and anomalous curvature dependence of free energy. The pH effects investigated go beyond the paradigm of electrostatic renormalization of the mechano-elastic properties of membranes.

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Elevated fasting blood glucose within the first week of hospitalization was associated with progression to severe illness of COVID-19 in patients with preexisting diabetes: A multicenter observational study

Highlights Fasting blood glucose < 10 mmol/L was proposed as a target of glycemic control during the first week of hospitalization in patients with preexisting diabetes. Poor HbA1c levels prior to coronavirus disease 2019 (COVID-19) might not be associated with severity among patients with preexisting diabetes. Mean blood glucose seemed not to be associated with poor prognosis of COVID-19.

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Innovation in an authoritarian society: China during the pandemic crisis

Purpose: This paper aims to understand the role of government played in the innovation process during the social crisis, and to investigate the innovation activities of the authoritarian state when dealing with social crisis Design/methodology/approach: Secondary data pertaining to eight impactful technological innovations in China during the COVID-19 crisis reveal how interactions and joint efforts by commercial firms and government organizations emerged as spontaneous responses Findings: The analysis of eight innovations – health code adoption, health omnichannel construction, noncontact service provision, distance education provision, public emotion consolation service, cross-boundary project promotion, cloud office adoption and medical material production – reveals a matrix of best practices that details the roles of government (controller or endorser) and the value creation orientation (pro-social or pro-economic value) Originality/value: This study enriches innovation literature by providing a new perspective on the relationship between governmental force and technological innovation during social crises As these new insights reveal, technological innovation can contribute to social crisis management China’s example provides helpful implications for other countries suffering from the COVID-19 crisis © 2020, Emerald Publishing Limited

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Countering social stigma and discrimination during the COVID-19 pandemic through solidarity

A recent article highlighted the difference between the attitude and mental health of domestic and overseas Chinese college students. It suggests that this difference is due to the social stigma and discrimination inflicted on overseas Chinese students. In this correspondence, the author proposes solidarity, analogous to the Chinese notion of ren, as a means of countering social stigma and discrimination.

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Economic thoughts on COVID-19 for Canadian food processors

In this paper, I explore the potential effects of the COVID-19 pandemic on Canadian food processors. First, COVID-19 may have an impact on food processing economic activities because of supply and demand shocks. Second, the impact of COVID-19 on food processing may depend on the type of products and the size of the processors. The effects of measures taken by the government to flatten the epidemiological curve on the economic activities of the food processing sector are uncertain. This article is protected by copyright. All rights reserved.

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Effectiveness of lifestyle modification on quality of life among uncontrolled diabetics and hypertensives in India – Community based intervention study

BACKGROUND: Diabetes and hypertension contribute to more than half of morbidity, mortality and years lived with disability in developing countries like India. It impacts the quality of life (QoL) of patients and their family. Management of these diseases is in infancy and emphasis is laid on pharmacological interventions. Though nonpharmacological measures are crucial for management, their implementation is questionable. Hence, this study was conducted to measure the effectiveness of lifestyle modifications on QoL among uncontrolled hypertensives and diabetics in rural India. METHODS: An interventional study was done in 3 villages with 100 participants each, where village one received lifestyle modification as intervention and village two physical activity and village three control receiving standard care. The baseline data included socio-demographic characteristics such as awareness of hypertension, diabetes, lifestyle pattern and physical activity, and WHO QoL. The participants were trained, followed up, and assessed after 12 months following intervention. QoL scores between groups and pre- and post-intervention in the group were compared using Mann–Whitney U and Wilcoxon signed-rank test, respectively. RESULTS: In this study, there was a significant improvement in overall QoL and in all the four domains, namely physical, psychological, social relationship, and environmental domains in both the intervention villages. QoL was significantly better in both the intervention groups following intervention than compared to the control group. CONCLUSIONS: QoL improves with intervention on uncontrolled diabetics and hypertensives. It is time to emphasize on the collaboration among physicians and on the holistic integrative health services delivery for non-communicable diseases.

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Recomendaciones para el manejo de la faringoamigdalitis aguda del adulto()

Acute pharyngitis in adults is one of the most common infectious diseases seen in general practitioners’ consultations. Viral aetiology is the most common. Among bacterial causes, the main agent is Streptococcus pyogenes or group A β-haemolytic streptococcus (GABHS), which causes 5%-30% of the episodes. In the diagnostic process, clinical assessment scales can help clinicians to better predict suspected bacterial aetiology by selecting patients who should undergo a rapid antigen detection test. If these techniques are not performed, an overdiagnosis of streptococcal pharyngitis often occurs, resulting in unnecessary prescriptions of antibiotics, most of which are broad spectrum. Consequently, management algorithms that include the use of predictive clinical rules and rapid tests have been set up. The aim of the treatment is speeding up symptom resolution, reducing the contagious time span and preventing local suppurative and non-suppurative complications. Penicillin and amoxicillin are the antibiotics of choice for the treatment of pharyngitis. The association of amoxicillin and clavulanate is not indicated as the initial treatment of acute infection. Neither are macrolides indicated as first-line therapy; they should be reserved for patients allergic to penicillin. The appropriate diagnosis of bacterial pharyngitis and proper use of antibiotics based on the scientific evidence available are crucial. Using management algorithms can be helpful in identifying and screening the cases that do not require antibiotic therapy.

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Effectiveness of isolation, testing, contact tracing and physical distancing on reducing transmission of SARS-CoV-2 in different settings

Isolation of symptomatic cases and tracing of contacts has been used as an early COVID-19 containment measure in many countries, with additional physical distancing measures also introduced as outbreaks have grown. To maintain control of infection while also reducing disruption to populations, there is a need to understand what combination of measures - including novel digital tracing approaches and less intensive physical distancing - may be required to reduce transmission. Using a model of individual-level transmission stratified by setting (household, work, school, other) based on BBC Pandemic data from 40,162 UK participants, we simulated the impact of a range of different testing, isolation, tracing and physical distancing scenarios. As well as estimating reduction in effective reproduction number, we estimated, for a given level of COVID-19 incidence, the number of contacts that would be newly quarantined each day under different strategies. Under optimistic but plausible assumptions, we estimated that combined testing and tracing strategies would reduce transmission more than mass testing or self-isolation alone (50-65% compared to 2-30%). If limits are placed on gatherings outside of home/school/work (e.g. maximum of 4 daily contacts in other settings), then manual contact tracing of acquaintances only could have a similar effect on transmission reduction as detailed contact tracing. In a scenario where there were 10,000 new symptomatic cases per day, we estimated in most contact tracing strategies, 140,000 to 390,000 contacts would be newly quarantined each day. Consistent with previous modelling studies and country-specific COVID-19 responses to date, our analysis estimates that a high proportion of cases would need to self-isolate and a high proportion of their contacts to be successfully traced to ensure an effective reproduction number that is below one in the absence of other measures. If combined with moderate physical distancing measures, self-isolation and contact tracing would be more likely to achieve control.

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SARS-CoV-2 – Wie kann und muss sich medizinisches Personal schützen?

The SARS-CoV‑2 pandemic represents a great challenge worldwide not only under the aspect of treatment but also of prevention. The infection curve could be flattened by the rapid implementation of simple distance and hygiene measures. In order to ensure current and future patient care in conjunction with protection of medical personnel working in the healthcare system during this pandemic, adequate protective equipment is essential. Routine care can only be resumed if there is sufficient and adequate personal protective equipment (PPE). If recommended hygiene protective measures including the necessary PPE are seriously taken into account both elective interventions and emergency care can be carried out without an increased risk of infection. This is very important in vascular surgery with a high proportion of urgent and emergency disease management.

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Alemtuzumab in Covid era

BACKGROUND: The SARS-CoV-2 pandemic impact on people with Multiple Sclerosis (pwMS) continues to worry. The disease modifying therapies in pwMS can add a more severe risk of infection when compared to the general population. Alemtuzumab is an anti-CD52 monoclonal antibody and it is one of the most immunosuppressive drugs used in Multiple Sclerosis (MS). CASE DESCRIPTION: We present a case of Covid-19 infection that occurred in a 24-year-old woman with MS and treated with alemtuzumab. The infection occurred 4 months after administration of the first course of alemtuzumab and had a benign course with subsequent development of antibodies. Furthermore, we present a brief review of the literature on similar published cases. DISCUSSION: We reviewed 17 articles concerning COVID-19 infection in MS patients in treatment with Alemtuzumab. In our case and all screened cases no severe course of disease was noted and no fatality was observed. Systematic compilation of this observation comforts clinicians about the course of Covid-19 infection despite alemtuzumab immunosuppressive treatment CONCLUSIONS: The risk of serious COVID-19 disease in MS patients treated with alemtuzumab is unknown. Physicians need to monitor carefully pwMS treated with alemtuzumab and to consider COVID-19 infection related relapse in the MS patients. Further research is recommended to evaluate the beneficial-risk profile of alemtuzumab in pandemic era.

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Childhood-onset systemic lupus erythematosus and immune thrombocytopenia: Prevalence and risk factors

BACKGROUND: There are few studies examining the prevalence and clinical risk factors for subsequent systemic lupus erythematosus (SLE) development after long-term follow-up in childhood immune thrombocytopenia (ITP). The aims of this study were to evaluate the prevalence and risk factors for subsequent SLE development in childhood ITP. METHODS: The medical records of childhood ITP patients aged under 15 years in a major tertiary care center in Southern Thailand were retrospectively reviewed. The Kaplan-Meier method was used to estimate the cumulative probability of subsequent SLE development after ITP. Logistic regression analysis was used to identify independent risk factors for SLE development. RESULTS: A total of 473 childhood ITP cases were included in the study. During a mean follow-up time of 6.1 ± 6.7 years, the prevalence of subsequent SLE development was 2.96%. Older age at ITP diagnosis (odds ratio [OR]: 1.24, 95% CI: 1.07-1.45) and chronic ITP (OR: 24.67, 95% CI: 3.14-100.0) were independent risk factors. The cumulative probabilities of subsequently developing SLE at 5 and 10 years after diagnosis of ITP were 3.8% (95% CI: 1.4-6.2) and 6.5% (95% CI: 2.9-9.8), respectively. CONCLUSION: Older age at ITP diagnosis and chronic ITP were risk factors for subsequent SLE developed in childhood ITP.

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The Pandemic of Productivity: A Narrative Inquiry into the Value of Leisure Time

This study explored narratives derived from in-depth interviews to demonstrate how an increase in leisure time could positively affect both our subjective well-being, through a better balance of work and "self", and the environment, through a change in consumption practices. Firstly, the analysis of the interviews provided insight into the social function of work. Work creates feelings of connection and belonging;however, it can also create the opposite, negatively affecting our experience of leisure time, our productivity, and our well-being. Participants described how paid work provided structure and routine, which resulted in an increased feeling of subjective well-being. However, a lack of structure and routine during the COVID-19 pandemic negatively affected feelings of "usefulness" and "productivity". Secondly, an increase in leisure time created more opportunities for autonomy, leading to more unforced leisure activities and a better balance between work and self. Moreover, an increase in autonomy could be achieved through both increased work flexibility and a shorter working week. Lastly, this study aimed to demonstrate that more leisure time during lockdown periods can change how we spend our free time, therefore resulting in more pro-environmental consumer behaviour. This study intended to contribute to a gap in the literature: effects of leisure time on the balance between work and the "self". The research setting offered limited opportunities for researching intentional, sustainable consumer behaviour, which provides an opportunity for further research.

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SARS-CoV-2 antibody persistence in COVID-19 convalescent plasma donors: Dependency on assay format and applicability to serosurveillance

BACKGROUND: Antibody response duration following severe acute respiratory syndrome coronavirus 2 infection tends to be variable and depends on severity of disease and method of detection. STUDY DESIGN AND METHODS: COVID-19 convalescent plasma from 18 donors was collected longitudinally for a maximum of 63-129 days following resolution of symptoms. All the samples were initially screened by the Ortho total Ig test to confirm positivity and subsequently tested with seven additional direct sandwich or indirect binding assays (Ortho, Roche, Abbott, Broad Institute) directed against a variety of antigen targets (S1, receptor binding domain, and nucleocapsid [NC]), along with two neutralization assays (Broad Institute live virus PRNT and Vitalant Research Institute [VRI] Pseudovirus reporter viral particle neutralization [RVPN]). RESULTS: The direct detection assays (Ortho total Ig total and Roche total Ig) showed increasing levels of antibodies over the time period, in contrast to the indirect IgG assays that showed a decline. Neutralization assays also demonstrated declining responses; the VRI RVPN pseudovirus had a greater rate of decline than the Broad PRNT live virus assay. DISCUSSION: These data show that in addition to variable individual responses and associations with disease severity, the detection assay chosen contributes to the heterogeneous results in antibody stability over time. Depending on the scope of the research, one assay may be preferable over another. For serosurveillance studies, direct, double Ag-sandwich assays appear to be the best choice due to their stability; in particular, algorithms that include both S1- and NC-based assays can help reduce the rate of false-positivity and discriminate between natural infection and vaccine-derived seroreactivity.

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Fetal Gallstones in a Newborn after Maternal COVID-19 Infection

Fetal gallstones are rare incidental findings on ultrasound during pregnancy. We describe a newborn girl with gallstones that was born to a mother who had COVID-19 infection during her last trimester. The baby remained asymptomatic, and the stones resolved spontaneously without any treatment or complications within six weeks of birth. Several conditions predispose to fetal gallstones, and it is unclear if the recent maternal COVID-19 infection had any role in the occurrence of these abnormalities or was merely coincidental. This is the first case describing an association of fetal gallstones with a COVID-19 infection in pregnancy.

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Comparison of the effects of platelet-rich or growth factor-rich plasma on intestinal anastomosis healing in pigs.

BACKGROUND The use of autologous platelet-rich plasma (PRP) and plasma rich in growth factors (PRGF) has been proposed for the treatment of several acute and chronic syndromes, such as corneal epithelial defects and dry eye syndrome, gum bleeding during oral surgery, and in orthopaedic surgery. We hypothesized that PRGF, rather than PRP, could be more effective because of its intrinsic characteristics in promoting the healing of intestinal anastomosis. The purpose of the present study was to evaluate and compare the effects of PRP and PRGF on various parameters of anastomotic healing in a swine model. METHODS Eight female pigs were randomly assigned to two groups and subjected to hand sewn jeujuno-jejunal appositional extramucosal anastomoses. For each animal, a total of six anastomoses were performed: two were considered controls and received no treatment, while the remaining four anastomoses were treated with PRP or PRGF of which both were prepared at a platelet concentration that was respectively 3.4-fold and 2.81-fold higher than the original platelet count. In each animal, either PRP or PRGF was used as a treatment, to avoid interference among products. Animals were euthanized after 8 days and the anastomoses were evaluated and compared for the presence of adhesions, anastomotic leakage, bursting pressure, and histological appearance. RESULTS The concentration of platelets in PRP was 3.41-fold higher (range, 3.20-4.24) that the concentration in whole blood, while the concentration in PRGF was 2.81-fold higher (range, 2.89-4.88). The results obtained from the present study highlighted that there are no differences between anastomotic samples treated with either PRP or PRGF preparations, except for a significant increase in epithelization of the intestinal mucosa at the anastomotic site in the PRGF group. CONCLUSIONS Both PRP and PRGF suspensions should be considered a safe strategy and represent a relatively low-cost technology that is flexible enough to be applied in several therapeutic fields. No true benefit could be proven in our study compared to the no treatment following anastomoses formation, with the exception of enhanced epithelization of the mucosa in the PRGF group.

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Management of hepatitis B virus reactivation due to treatment of COVID-19

The world has made significant progress in developing novel treatments for COVID-19 since the pandemic began. Some treatments target the patient’s dysregulated inflammatory response during COVID-19 infection and may cause hepatitis B reactivation (HBVr) in patients with current or past hepatitis B virus (HBV) infection. This review summarizes the risk and management of HBVr due to different treatments of COVID-19 in patients who have current or past HBV infection. Abnormal liver function tests are common during COVID-19 infection. Current evidence suggests that current or past HBV infection is not associated with an increased risk of liver injury and severe disease in COVID-19 patients. Among patients who received high-dose corticosteroids, various immunosuppressive monoclonal antibodies and inhibitors of Janus kinase, the risk of HBVr exists, especially among those without antiviral prophylaxis. Data, however, remain scarce regarding the specific use of immunosuppressive therapies in COVID-19 patients with HBV infection. Some results are mainly extrapolated from patients receiving the same agents in other diseases. HBVr is a potentially life-threatening event following profound immunosuppression by COVID-19 therapies. Future studies should explore the use of immunosuppressive therapies in COVID-19 patients with HBV infection and the impact of antiviral prophylaxis on the risk of HBVr.

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A computational methodology to diagnose sequence-variant dynamic perturbations by comparing atomic protein structures

MOTIVATION: The objective is to diagnose dynamics perturbations caused by amino acid mutations as prerequisite to assess protein functional health or drug failure, simply using network models of protein X-ray structures. RESULTS: We find that the differences in the allocation of the atomic interactions of each amino acid to 1D, 2D, 3D, 4D structural levels between variants structurally robust, recover experimental dynamic perturbations. The allocation measure validated on two B-pentamers variants of AB(5) toxins having 17 mutations, also distinguishes dynamic perturbations of pathogenic and non-pathogenic Transthyretin single-mutants. Finally, the main proteases of the coronaviruses SARS-CoV and SARS-CoV-2 exhibit changes in the allocation measure, raising the possibility of drug failure despite the main proteases structural similarity. AVAILABILITY: The Python code used for the production of the results is available at github.com/lorpac/protein_partitioning_atomic_contacts. The authors will run the analysis on any PDB structures of protein variants upon request. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

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Impact of Cannabinoid Compounds on Skin Cancer

SIMPLE SUMMARY: Recent research has suggested that the endocannabinoid system offers several pharmacotherapeutic targets for drug administration as new options for the treatment and prophylaxis of skin cancer. This review focused on the anticarcinogenic mechanisms of cannabinoids at the different levels of skin cancer progression, such as inhibition of tumour growth, proliferation, invasion and angiogenesis, as well as inducing apoptosis and autophagy. ABSTRACT: Drugs targeting the endocannabinoid system are of interest as potential systemic chemotherapeutic treatments and for palliative care in cancer. In this context, cannabinoid compounds have been successfully tested as a systemic therapeutic option in preclinical models over the past decades. Recent findings have suggested an essential function of the endocannabinoid system in the homeostasis of various skin functions and indicated that cannabinoids could also be considered for the treatment and prophylaxis of tumour diseases of the skin. Cannabinoids have been shown to exert their anticarcinogenic effects at different levels of skin cancer progression, such as inhibition of tumour growth, proliferation, invasion and angiogenesis, as well as inducing apoptosis and autophagy. This review provides an insight into the current literature on cannabinoid compounds as potential pharmaceuticals for the treatment of melanoma and squamous cell carcinoma.

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Technology-based counselling in dementia (TeCoDem): study protocol of a mixed-methods systematic review with qualitative comparative analysis and meta-analysis

INTRODUCTION: Information technology can enhance timely and individual support for people with dementia and informal carers. There is some evidence that people with dementia and informal carers would benefit from technology-based counselling. However, it remains unclear which features of those interventions relate to beneficial outcomes and which aspects are necessary for a successful implementation. Therefore, the primary objectives are: (1) to identify conditions of successful implementation of technology-based counselling interventions in dementia and (2) to investigate the effectiveness of those interventions. METHODS AND ANALYSIS: We will conduct a mixed-methods systematic review. The first primary objective requires evidence from various study designs addressing aspects on effective and non-effective implementation of technology-based counselling. This could be telephone-based, web-based or mobile-based interventions for people with dementia and informal carers. For the second primary objective, randomised controlled trials (RCTs) dealing with any outcomes will be included. Year of publication and language will not be restricted. We will search CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science up to April 2021. Additionally, we will perform web searching and citation tracking. To achieve the first primary objective, a Qualitative Comparative Analysis (QCA) will be conducted. The QCA enables us to identify necessary or sufficient components for a successful implementation. To reach the second primary objective, a meta-analysis will be performed with respect to potential clinical and statistical heterogeneity of RCTs. The revised Risk of Bias tool 2.0 will be used to check the risk of bias in RCTs. For all other study designs, the Mixed Method Appraisal Tool will be used. ETHICS AND DISSEMINATION: Ethics approval is not required for this review. We will disseminate our findings through scientific and non-scientific journal articles and conference presentations as well as formats directed to the public and decision-makers in healthcare. PROSPERO REGISTRATION NUMBER: CRD42021245473.

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The Economic Cost of Burnout in Veterinary Medicine

The purpose of this study is to estimate the economic cost of burnout in the veterinary profession and highlight the financial reasons why the industry should address the burnout crisis from an organizational perspective. Using data from 5,786 associate veterinarians in private practice, information was obtained using employment information related to compensation, work hours, hour preferences, and job turnover. Burnout was measured using the Professional Quality of Life Scale and used to calculate conditional probabilities on turnover and reduced working hours due to burnout. Lost revenue from each outcome (turnover and reduced working hours) was then used to calculate the economic costs to the veterinary services industry. The attributable cost of burnout of veterinarians to the US industry is between $1 and 2 billion annually in lost revenue, though there is a large amount of uncertainty. The cost is dependent on whether veterinary technicians are included in the analysis. The highest economic cost per veterinarian is among food animal practitioners, while the lowest is among equine. This study demonstrates that there are significant economic costs due to burnout among veterinarians and veterinary technicians. We suggest pursuing organizational interventions as these have shown the most impact in decreasing burnout and increasing satisfaction among human health physicians.

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Good practices recommendations from the Brazilian Society of Nephrology to Peritoneal Dialysis Services related to the new coronavirus (Covid-19) epidemic

Considering the new coronavirus epidemic (Covid-19), the Brazilian Society of Nephrology, represented by the Peritoneal Steering Committee, in agreement with the and the Dialysis Department, developed a series of recommendations for good clinical practices for peritoneal dialysis (PD) clinics, to be considered during the period of the Covid-19 epidemic. We aim to minimize the disease spread, protecting patients and staff, and ensuring the quality of the treatment provided and adequate follow-up for PD patients. The recommendations suggested at this moment must be adapted to each clinic’s reality and the conditions of the structural and human resources, dependent on the adequate financial provision of the public health system for its full implementation.

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Insights From Veterinary Disciplinary Actions in California 2017–2019

There is increasing concern within the veterinary medical community (veterinarians and veterinary students) that disgruntled clients are unfairly leveraging various legal tools against veterinarians. Clinical veterinarians and veterinary students should be aware of the most common types of problems arising within the clinic and how they can lead to formal consumer complaints. The study describes and categorizes with greater detail the types of violations or “causes for discipline” that occur, as well as specific sanctions imposed on veterinarians formally disciplined for standard of care-related violations between 2017 and 2019, for California. In addition, the study calculated the frequency of disciplinary actions and their basic summary statistics regarding the temporal aspect of how lawsuits typically unfold. Using public documents from California, the study describes the analysis and trends for the purpose of providing contextual evidence to inform and guide potential veterinary educational interventions. Although specific to California, this study can serve as a template methodology for comparisons to other states.

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Principles and Algorithms for Forecasting Groups of Time Series: Locality and Globality

Forecasting groups of time series is of increasing practical importance, e.g. forecasting the demand for multiple products offered by a retailer or server loads within a data center. The local approach to this problem considers each time series separately and fits a function or model to each series. The global approach fits a single function to all series. For groups of similar time series, global methods outperform the more established local methods. However, recent results show good performance of global models even in heterogeneous datasets. This suggests a more general applicability of global methods, potentially leading to more accurate tools and new scenarios to study. Formalizing the setting of forecasting a set of time series with local and global methods, we provide the following contributions: 1) Global methods are not more restrictive than local methods, both can produce the same forecasts without any assumptions about similarity of the series. Global models can succeed in a wider range of problems than previously thought. 2) Basic generalization bounds for local and global algorithms. The complexity of local methods grows with the size of the set while it remains constant for global methods. In large datasets, a global algorithm can afford to be quite complex and still benefit from better generalization. These bounds serve to clarify and support recent experimental results in the field, and guide the design of new algorithms. For the class of autoregressive models, this implies that global models can have much larger memory than local methods. 3) In an extensive empirical study, purposely naive algorithms derived from these principles, such as global linear models or deep networks result in superior accuracy. In particular, global linear models can provide competitive accuracy with two orders of magnitude fewer parameters than local methods.

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Genome-wide analysis of 10664 SARS-CoV-2 genomes to identify virus strains in 73 countries based on single nucleotide polymorphism

Since the onslaught of SARS-CoV-2, the research community has been searching for a vaccine to fight against this virus. However, during this period, the virus has mutated to adapt to the different environmental conditions in the world and made the task of vaccine design more challenging. In this situation, the identification of virus strains is very much timely and important task. We have performed genome-wide analysis of 10664 SARS-CoV-2 genomes of 73 countries to identify and prepare a Single Nucleotide Polymorphism (SNP) dataset of SARS-CoV-2. Thereafter, with the use of this SNP data, the advantage of hierarchical clustering is taken care of in such a way so that Average Linkage and Complete Linkage with Jaccard and Hamming distance functions are applied separately in order to identify the virus strains as clusters present in the SNP data. In this regard, the consensus of both the clustering results are also considered while Silhouette index is used as a cluster validity index to measure the goodness of the clusters as well to determine the number of clusters or virus strains. As a result, we have identified five major clusters or virus strains present worldwide. Apart from quantitative measures, these clusters are also visualized using Visual Assessment of Tendency (VAT) plot. The evolution of these clusters are also shown. Furthermore, top 10 signature SNPs are identified in each cluster and the non-synonymous signature SNPs are visualised in the respective protein structures. Also, the sequence and structural homology-based prediction along with the protein structural stability of these non-synonymous signature SNPs are reported in order to judge the characteristics of the identified clusters. As a consequence, T85I, Q57H and R203M in NSP2, ORF3a and Nucleocapsid respectively are found to be responsible for Cluster 1 as they are damaging and unstable non-synonymous signature SNPs. Similarly, F506L and S507C in Exon are responsible for both Clusters 3 and 4 while Clusters 2 and 5 do not exhibit such behaviour due to the absence of any non-synonymous signature SNPs. In addition to all these, the code, SNP dataset, 10664 labelled SARS-CoV-2 strains and additional results as supplementary are provided through our website for further use.

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Antibody rapid test positive health care workers at a german university hospital: First wave characteristics

Background: Freiburg was among the most heavily affected German cities during the first wave of Sars-Cov-2 infections in spring 2020. Consequently, the University Medical Center Freiburg was one of the first hospitals in Germany to treat Covid19 patients. Objectives: To assess the proportion and characteristics of health care workers (HCW) that have been infected during that first wave SARS-CoV-2 serum IgG and IgM antibodies were measured. Methods: HCW (n=902, mean age: 40.7 years) participated in this study, and filled out an epidemiological questionnaire. Serum samples were analysed for SARS-Cov-2 IgG/IgM antibodies via rapid diagnostic test (RT) and via ELISA. Statistical analyses were performed using STATA 14.2. An exposure prevention score was developed to quantify the adherence to preventive measures in everyday life. Results: 902 HCW were tested by RT, and 499 by ELISA. In total, 11.5% of recruited HCW were antibody-positive in the RT, 12.2% in the ELISA. 87.5% of RT positives, 98% of ELISA-positives reported symptoms, compared to 74.6% and 78% of negatives, respectively. Symptoms such as cough (57%/46%), loss of smell and taste (34%/5.2%), fatigue (68%/45%), fever (48%/24%), body aches (45%/22%), and headaches (58%/46%) were reported by significantly more RT positives compared to negatives. The respective differences were even more pronounced (p<0.001) among ELISA-positives compared to negatives with >50% of those positive reported impaired smell or taste compared to less than 7% among the group of ELISA-negatives (p<0.00001). In logistic regression models, shift work and belonging to the lowest quartile of the exposure prevention score were significantly associated with seropositivity in both tests. Exposure towards children was inversely associated with seropositivity, however, in the finally adjusted model only significant for those that were RT-positive, but not ELISA-positive, reflecting the lower specificity of the former. Conclusion: The endemic infection rate in HCW was high. HCW adhering to preventive measures in everyday life had lower infection rates. Disclosure of Interests: Manuel Beck: None declared, Alexandra Nieters: None declared, Marta Rizzi: None declared, Ulrich Salzer: None declared, Jens Thiel Speakers bureau: BMS, Nils Venhoff Speakers bureau: Novartis, Nicole Peter: None declared, Hermann Eibel: None declared, Reinhard Voll Speakers bureau: Novartis, Grant/research support from: BMS, Pfizer, Novartis, Stephanie Finzel Speakers bureau: Novartis.

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Factors associated with nosocomial SARS-CoV transmission among healthcare workers in Hanoi, Vietnam, 2003

BACKGROUND: In March of 2003, an outbreak of Severe Acute Respiratory Syndrome (SARS) occurred in Northern Vietnam. This outbreak began when a traveler arriving from Hong Kong sought medical care at a small hospital (Hospital A) in Hanoi, initiating a serious and substantial transmission event within the hospital, and subsequent limited spread within the community. METHODS: We surveyed Hospital A personnel for exposure to the index patient and for symptoms of disease during the outbreak. Additionally, serum specimens were collected and assayed for antibody to SARS-associated coronavirus (SARS-CoV) antibody and job-specific attack rates were calculated. A nested case-control analysis was performed to assess risk factors for acquiring SARS-CoV infection. RESULTS: One hundred and fifty-three of 193 (79.3%) clinical and non-clinical staff consented to participate. Excluding job categories with <3 workers, the highest SARS attack rates occurred among nurses who worked in the outpatient and inpatient general wards (57.1, 47.4%, respectively). Nurses assigned to the operating room/intensive care unit, experienced the lowest attack rates (7.1%) among all clinical staff. Serologic evidence of SARS-CoV infection was detected in 4 individuals, including 2 non-clinical workers, who had not previously been identified as SARS cases; none reported having had fever or cough. Entering the index patient's room and having seen (viewed) the patient were the behaviors associated with highest risk for infection by univariate analysis (odds ratios 20.0, 14.0; 95% confidence intervals 4.1–97.1, 3.6–55.3, respectively). CONCLUSION: This study highlights job categories and activities associated with increased risk for SARS-CoV infection and demonstrates that a broad diversity of hospital workers may be vulnerable during an outbreak. These findings may help guide recommendations for the protection of vulnerable occupational groups and may have implications for other respiratory infections such as influenza.

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Non-Central Limit Theorem Statistical Analysis for the"Long-tailed"Internet Society

This article presents a statistical analysis method and introduces the corresponding software package"tailstat,"which is believed to be widely applicable to today's internet society. The proposed method facilitates statistical analyses with small sample sets from given populations, which render the central limit theorem inapplicable. A large-scale case study demonstrates the effectiveness of the method and provides implications for applying similar analyses to other cases.

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Construct Dimensionality of Personal Energy at Work and Its Relationship with Health, Absenteeism and Productivity

Personal energy at work has become a popular topic among HRM scholars and practitioners because it has proven to impact performance. Based on the outcomes of previous research and the call for further exploration of the construct of personal energy at work, we executed this quantitative study. We explored the factor structure of the construct and its relationships with health and productivity by examining the construct that addresses four dimensions: physical, emotional, mental and spiritual energy. Data were collected from 256 employees in an international health tech company and used to analyze construct dimensionality and relationships with health, absenteeism and productivity. The results provided support for the four-dimensional structure of personal energy at work and show that the construct of personal energy at work is related to the outcomes of health, absenteeism and productivity. Implications for theory and practice, as well as directions for future research, are discussed.

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Addressing students’ emotional needs during the COVID-19 pandemic: a perspective on text versus video feedback in online environments

This paper reflects on the findings of Borup et al. (Educ Technol Res Dev 63:161–184, 2015) regarding the efficiency and affect of text and video feedback in the context of the rapid shift to online education due to the COVID-19 pandemic. Based on reports of diminished mental wellness, increased depression, and anxiety among learners and instructors, this paper offers ideas on how to apply the findings from Borup et al. (Educ Technol Res Dev 63:161–184, 2015) from a combination of practice, research, design, and inclusion perspectives to ensure emotional support, mental wellness, and social presence during times of crisis, even at the expense of efficiency of instruction.

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Knowledge, Attitudes, and Practices Regarding COVID-19 Among Health Care Workers in Public Health Facilities in Eastern Ethiopia: Cross-sectional Survey Study

BACKGROUND: On March 13, 2020, Ethiopia reported the first confirmed case of COVID-19 in Addis Ababa. COVID-19 is likely to overwhelm an already-fragile health care delivery system and reduce the availability of essential health services. This analysis of data from the Somali Region of Eastern Ethiopia on health care workers’ (HCWs) knowledge, attitudes, and practices regarding the prevention and control of COVID-19 may be used in planning health education programs about the emerging viral disease. OBJECTIVE: This study aimed to investigate the knowledge, attitudes, and practices of HCWs regarding COVID-19 infection. METHODS: This cross-sectional study was conducted among HCWs in three public health facilities in the Somali Region, Eastern Ethiopia. A self-administered questionnaire was shared with all HCWs working at the public health facilities. A total of 15 knowledge questions were scored as 1 or 0 for correct or incorrect responses, respectively. A total of 14 practice questions were scored on a 3-point scale from 1 (“always”) to 3 (“never”). A total of six attitude questions were rated on a 5-point Likert scale, in a negative dimension, as follows: 1 (“strongly agree”), 2 (“agree”), 3 (“neutral”), 4 (“disagree”), and 5 (“strongly disagree”). Mean scores were calculated and used as a cut point to dichotomize the outcome variables (>13.7 indicated good knowledge, <18.8 indicated good practices, and ≤10.5 indicated favorable attitudes). We used t tests and analyses of variance (ie, F tests) to analyze the mean score differences of knowledge, attitudes, and practices between the independent variables. Spearman correlation was used to assess the relationship between mean knowledge and attitude scores. RESULTS: Of the 686 HCWs approached, a total of 434 HCWs responded (63.3% response rate). The mean age of the participants was 27.6 (SD 5.3) years, and the majority of the participants were male (293/434, 67.5%). The mean knowledge score was 13.7 (SD 2.6), and 73.3% (318/434) of participants had sufficient knowledge. The mean attitude score was 10.5 (SD 4.1), and 54.8% (238/434) of the participants had a good attitude toward COVID-19. The mean practice score was 18.8 (SD 5.8), and 61.5% (267/434) of the participants practiced precautionary measures to prevent COVID-19. There was a negative correlation between knowledge and attitude scores (r=–0.295, P<.001) and between knowledge and practice scores (r=–0.298, P<.001). CONCLUSIONS: The overall levels of knowledge and practice were relatively better than the attitude level. This highlights the need to implement strategies that enhance the positive attitudes and safe practices of the HCWs for better containment of the pandemic and supporting of essential health care services.

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Refundable income annuities: Feasibility of money-back guarantees

Refundable income annuities (IA), such as cash-refund and instalment-refund, differ in material ways from the life-only version beloved by economists. In addition to lifetime income they guarantee the annuitant or beneficiary will receive their money back albeit slowly over time. We document that refundable IAs now represent the majority of sales in the U.S., yet they are mostly ignored by insurance and pension economists. And, although their pricing, duration, and money's-worth-ratio is complicated by recursivity which will be explained, we offer a path forward to make refundable IAs tractable. A key result concerns the market price of cash-refund IAs, when the actuarial present value is grossed-up by an insurance loading. We prove that price is counterintuitively no longer a declining function of age and older buyers might pay more than younger ones. Moreover, there exists a threshold valuation rate below which no price is viable. This may also explain why inflation-adjusted IAs have all but disappeared.

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Epidemiology and Treatment Options for COVID-19: A Review.

The Coronavirus disease 19 (COVID-19) is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China and spread around the world. As of 19 June 2020 data from the World Health Organization (WHO) have shown that more than 8457305 confirmed cases have been identified in more than 200 countries, with the number of cases cutting across all continents. On 30th January 2020, the WHO declared COVID-19 as the sixth public health emergency of international concern. Genomic analysis revealed that SARS-CoV-2 is phylogenetically related to severe acute respiratory syndrome-like (SARS-like) bat viruses; therefore, bats could be the possible primary reservoir. The intermediate source of origin and transfer to humans is not known, however, the rapid human-to-human transfer has been confirmed widely via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.

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SARS-CoV-2 (COVID-19): Zoonotic origin and susceptibility of domestic and wild animals

Coronaviruses (CoVs) are responsible for causing economically significant diseases both in animals and humans. The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), causing Coronavirus Diseases (COVID-19), outbreak has become the first pandemic of the 21st century and is the deadliest pandemic after the 1918 Spanish Flu. Except, the two previous epidemics, SARS-CoV (2002 epidemic, China) and MERS-CoV (2012 epidemic, Middle Eastern region), CoVs are known the world over as the mild pathogens of humans and animals. Despite several measures to control the COVID-19 pandemic, it has affected more than 210 countries and regional territories distressing more than 5.3 million people and claiming nearly 0.34 million lives globally. Several findings point towards the appearance of the SARS-CoV-2 virus in the humans through animals, especially the wild animals of the Chinese live seafood wet market. The ongoing COVID-19 pandemic is another example of diseases originating from the human-animal interface and spreading through international borders causing global health emergencies. Most of the countries around the globe are stumbling due to the COVID-19 pandemic with severe threats and panic among the mass population. World Health Organization (WHO), international and national health authorities are working with excessive efforts for effective and impactful interventions to contain the virus. It is significant to comprehend the inclination of these viruses to jump between different species, and the establishment of infection in the entirely new host, identification of significant reservoirs of coronaviruses. Several animal species such as cats, dogs, tiger, and minks have been confirmed to get SARS-CoV-2 infections from COVID-19 infected person. Laboratory investigations point out those cats are the most susceptible species for SARS-CoV-2, and it can evidence with clinical disease. The studies carried out on animal's susceptibility to SARS-CoV-2 further support the human-to-animal spread of the virus. In this review, we focus on addressing COVID-19 infections in domestic and wild animals.

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The effects of the first national lockdown in England on geographical inequalities in the evolution of COVID-19 case rates: An ecological study

Background Socio-economic inequalities in COVID-19 case rates have been noted worldwide. Previous studies have compared case rates over set phases. There has been no analysis of how inequalities in cases changed overtime and were shaped by national mitigation strategies (e.g. lock downs). This paper provides the first analysis of the evolution of area-level inequalities in COVID-19 cases by deprivation levels in the first wave of the pandemic (January to July 2020) in England - with a focus on the effects of the first national lockdown (March - July 2020). Methods Weekly case rates per Middle Super Output Area (MSOA, n=4412) in England from 2020-03-15 to 2020-07-04 were obtained, and characteristics of local epidemics were calculated, e.g. the highest case rate per area. Simple linear and logistic regression analyses were employed to assess the association of these metrics with index of multiple deprivation (IMD). Local authority-level (n=309) cases were used similarly in a sensitivity analysis, as these data were available daily and extended further back in time. The impact of lockdown was assessed by comparing the cumulative case rate in the most deprived 20% of MSOAs to the least deprived 20%, for the periods before the lockdown, and by the end of lockdown. Findings Less deprived areas began recording COVID-19 cases earlier than more deprived areas and were more likely to have peaked by March 2020. More deprived areas case rates grew faster and peaked higher than less deprived areas. During the first national lockdown in the UK, the relative excess in case rates in the most deprived areas increased to 130% of that of the least deprived ones. Interpretation The pattern of disease spread in England confirm the hypothesis that initial cases of a novel infectious disease are likely to occur in more affluent communities, but more deprived areas will overtake them once national mitigation strategies begin, and bear the brunt of the total case load. The strict first national lockdown served to increase case rate inequalities in England.

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Bacillus Calmette-Guerin vaccination Policy and Consumption of Ammonium Chloride-Enriched Confectioneries May Be Factors Reducing COVID-19 Death Rates in Europe

BACKGROUNDThe 2019 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic continued into 2020, and the coronavirus disease-2019 (COVID-19) associated death toll increased OBJECTIVESTo analyze COVID-19 death rates in European countries or regions to determine whether there was a significant association between bacillus Calmette-Guérin (BCG) vaccination policy and lower rates of COVID-19 related deaths METHODSCertain Northern European countries or regions had low death rates regardless of BCG policy The authors assumed the consumption of foods containing salmiak (NH4Cl) was a common and peculiar cause of the reduced COVID-19 related death rates in these countries, because NH4Cl is a known lysosomotropic agent, which has been indicated to inhibit or prevent SARS-CoV infection To check the possible effectiveness of salmiak consumption against COVID-19 related death, the authors used a linear regression model with the death rate as the dependent variable and BCG-policy and salmiak consumption score as independent variables RESULTSUsing least squares regression and a robust standard error algorithm, the authors found a significant effect exerted by the independent variables (P &lt; 0 0005 for BCG and P = 0 001 for salmiak) Salmiak score alone was significant (P = 0 016) when using least squares regression with robust error algorithm CONCLUSIONSThe results seem to confirm an association between BCG-positive vaccination policy and salmiak consumption, and lower death rates from COVID-19 Implementing BCG vaccination policy and fortification of foods with salmiak (NH4Cl) may have a significant impact on the control of SARS-CoV epidemic

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Limitations of posterior spinal fusion to L5 for flaccid neuromuscular scoliosis focusing on pelvic obliquity.

STUDY DESIGN Retrospective comparison based on the degree of pelvic obliquity (PO). PURPOSE To assess the controversial indications for and limitations of ending the instrumentation for posterior spinal fusion (PSF) at L5 in patients with flaccid neuromuscular scoliosis (fNMS). METHODS We reviewed the cases of 45 patients with progressive spinal deformity as a result of fNMS treated by PSF to L5 and followed for an average of 4 years postoperatively with adequate clinical and radiological data. Anterior-posterior and lateral whole spine radiographs were evaluated. We divided patients into two groups based on the degree of pelvic obliquity (PO) at the final follow-up. Radiographic data from the two groups were analyzed to identify the indications and limitations of this surgical method focusing on PO. RESULTS Preoperatively, there were significant differences between the two groups in Cobb angle, PO, thoracolumbar kyphosis, and lumbar lordosis (LL) while sitting; Cobb angle and LL while supine (Supine Cobb, and Supine LL); and major curve flexibility. Multivariate logistic regression analysis identified Supine Cobb and Supine LL as independent risk factors for residual PO at the final follow-up (Supine Cobb: odds ratio, 1.1; 95% confidence interval 1.0-1.2, Supine LL: odds ratio, 0.9; 95% confidence interval 0.8-1.0). CONCLUSION Patients with larger preoperative Cobb angle and smaller LL while supine may not achieve adequate spine and pelvic correction and this may lead to deterioration in the PO over time, even after spinal fusion ending at L5.

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Performing gynecologic cancer surgery during the COVID-19 pandemic in Turkey: A multicenter retrospective observational study

OBJECTIVE: To report the perioperative outcomes of 200 patients with gynecologic cancer who underwent surgery during the Novel Coronavirus Disease (COVID-19) pandemic and the safety of surgical approach. METHODS: Data of patients operated between March 10 and May 20, 2020, were collected retrospectively. Data were statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows v. SP21.0. RESULTS: Data of 200 patients were included. Their mean age was 56 years. Of the patients, 54% (n=108), 27.5% (n=55), 12.5% (n=25), and 2% (n=4) were diagnosed as having endometrial, ovarian, cervical, and vulvar cancer, respectively. Of them, 98% underwent non-emergent surgery. A minimally invasive surgical approach was used in 18%. Stage 1 cancer was found in 68% of patients. Surgeons reported COVID-related changes in 10% of the cases. The rate of postoperative complications was 12%. Only two patients had cough and suspected pneumonic lesions on thoracic computed tomography postoperatively, but neither was positive for COVID-19 on polymerase chain reaction testing. CONCLUSION: Based on the present findings, it is thought that gynecologic cancer surgery should continue during the COVID-19 pandemic while adhering to the measures. Postponement or non-surgical management should only be considered in patients with documented infection. Gynecologic cancer surgery should continue during the COVID-19 pandemic while adhering to measures. Only 1% of patients developed COVID-19-related symptoms during the postoperative follow-up period.

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Antiviral Potential of Nanoparticles-Can Nanoparticles Fight Against Coronaviruses?

Infectious diseases account for more than 20% of global mortality and viruses are responsible for about one-third of these deaths. Highly infectious viral diseases such as severe acute respiratory (SARS), Middle East respiratory syndrome (MERS) and coronavirus disease (COVID-19) are emerging more frequently and their worldwide spread poses a serious threat to human health and the global economy. The current COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of 27 July 2020, SARS-CoV-2 has infected over 16 million people and led to the death of more than 652,434 individuals as on 27 July 2020 while also causing significant economic losses. To date, there are no vaccines or specific antiviral drugs to prevent or treat COVID-19. Hence, it is necessary to accelerate the development of antiviral drugs and vaccines to help mitigate this pandemic. Non-Conventional antiviral agents must also be considered and exploited. In this regard, nanoparticles can be used as antiviral agents for the treatment of various viral infections. The use of nanoparticles provides an interesting opportunity for the development of novel antiviral therapies with a low probability of developing drug resistance compared to conventional chemical-based antiviral therapies. In this review, we first discuss viral mechanisms of entry into host cells and then we detail the major and important types of nanomaterials that could be used as antiviral agents. These nanomaterials include silver, gold, quantum dots, organic nanoparticles, liposomes, dendrimers and polymers. Further, we consider antiviral mechanisms, the effects of nanoparticles on coronaviruses and therapeutic approaches of nanoparticles. Finally, we provide our perspective on the future of nanoparticles in the fight against viral infections.

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Organizing Pneumonias

Organizing pneumonia is a particular type of inflammatory and reparative reaction of the lung parenchyma characterized by fibroblast proliferation in the distal airspaces with overall preservation of the lung architecture. When microscopic, it is an asymptomatic and nonspecific reaction of little clinical significance accompanying many pathological processes. When macroscopic and affecting large portions of the lung parenchyma, it manifests by restrictive ventilatory defect and gas exchange impairment leading to dyspnea, cough, hypoxemia, alveolar opacities at chest imaging, and symptoms of systemic inflammation such as fever, malaise, and weight loss. This picture constitutes the clinico-pathological syndrome of organizing pneumonia, which has been recognized and characterized as a distinct entity in the past 30 years. Although the classical features of organizing pneumonia are increasingly familiar to chest physicians, and the efficacy of corticosteroid treatment makes it appear at first sight as an easy problem to resolve, atypical clinical presentations, similarities with other diseases, severe forms, histological variants, side effects of therapy, and relapses can make the management more difficult than initially expected. This chapter will address the classical and less common features of organizing pneumonia, and will provide practical clues to the diagnosis and management of this disorder.

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Olfactory Dysfunction in Coronavirus Disease 2019 Patients: Observational Cohort Study and Systematic Review

Background: Olfactory dysfunction (OD) has been reported in coronavirus disease 2019 (COVID-19). However, there are knowledge gaps about the severity, prevalence, etiology, and duration of OD in COVID-19 patients. Methods: Olfactory function was assessed in all participants using questionnaires and the butanol threshold test (BTT). Patients with COVID-19 and abnormal olfaction were further evaluated using the smell identification test (SIT), sinus imaging, and nasoendoscopy. Selected patients received nasal biopsies. Systematic review was performed according to PRISMA guidelines. PubMed items from January 1, 2020 to April 23, 2020 were searched. Studies that reported clinical data on olfactory disturbances in COVID-19 patients were analyzed. Results: We included 18 COVID-19 patients and 18 controls. Among COVID-19 patients, 12 of 18 (67%) reported olfactory symptoms and OD was confirmed in 6 patients by BTT and SIT. Olfactory dysfunction was the only symptom in 2 patients. Mean BTT score of patients was worse than controls (P =. 004, difference in means = 1.8; 95% confidence interval, 0.6-2.9). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy revealed the presence of infiltrative CD68+macrophages harboring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen in the stroma. Olfactory dysfunction persisted in 2 patients despite clinical recovery. Systematic review showed that the prevalence of olfactory disturbances in COVID-19 ranged from 5% to 98%. Most studies did not assess olfaction quantitatively. Conclusions: Olfactory dysfunction is common in COVID-19 and may be the only symptom. Coronavirus disease 2019-related OD can be severe and prolonged. Mucosal infiltration by CD68+macrophages expressing SARS-CoV-2 viral antigen may contribute to COVID-19-related OD.

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A luciferase immunosorbent assay for quantitative detection of IgG antibodies against SARS-CoV-2 nucleoprotein

In this study, we developed and evaluated a luciferase immunosorbent assay (LISA) for quantitative detection of IgG antibody against SARS-CoV-2 nucleoprotein (NP). Anti-SARS-CoV-2 NP antibody in serum or plasma samples was captured by protein G-coated microtiter plate and detected using the crude cell lysates expressing Nanoluc luciferase (Nluc) enzyme fused with SARS-CoV-2 NP. After the addition of furimazine substrate, the levels of anti-SARS-CoV-2 NP IgG antibody were quantitatively measured as luciferase light units. As expected, SARS-CoV-2 NP showed cross-reactivity with the monoclonal antibodies against SARS-CoV NP, but not MERS-CoV NP-specific monoclonal antibodies or the monoclonal antibodies against SARS-CoV Spike protein. LISA for detecting murine monoclonal antibody against SARS-CoV NP showed a low limit of detection of 0.4 pg/µl and linear detection range from 0.4 pg/µl to 75 pg/µl. Furthermore, LISA had a sensitivity of 71 % when testing COVID-19 patients at the second week post onset and a specificity of 100 % when testing healthy blood donors.

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A Hybridized Stochastic SIR-Vasiček Model in Evaluating a Pandemic Emergency Financing Facility

In the context of the present global health crisis, we examine the design and valuation of a pandemic emergency financing facility (PEFF) akin to a catastrophe (CAT) bond. While a CAT bond typically enables fund generation to the insurers and re-insurers after a disaster happens, a PEFF or pandemic bond's payout is linked to random thresholds that keep evolving as the pandemic continues to unfold. The subtle difference in the timing and structure of the funding payout between the usual CAT bond and PEFF complicates the valuation of the latter. We address this complication, and our analysis identifies certain aspects in the PEFF's design that must be simplified and strengthened so that this financial instrument is able to serve the intent of its original creation. An extension of the compartmentalized deterministic epidemic model--which describes the random number of people in three classes: susceptible (S), infected (I), and removed (R) or SIR for short--to its stochastic analog is put forward. At time t, S(t), I(t), and R(t) satisfy a system of interacting stochastic differential equations in our extended framework. The payout is triggered when the number of infected people exceeds a predetermined threshold. A CAT-bond pricing setup is developed with the Vasiček-based financial risk factor correlated with the SIR dynamics for the PEFF valuation. The probability of a pandemic occurrence during the bond's term to maturity is calculated via a Poisson process. Our sensitivity analyses reveal that the SIR's disease transmission and recovery rates, as well as the interest rate's mean-reverting level, have a substantial effect on the bond price. Our proposed synthesized model was tested and validated using a Canadian COVID-19 dataset during the early development of the pandemic. We illustrate that the PEFF's payout could occur as early as seven weeks after the official declaration of the pandemic, and the deficiencies of the most recent PEFF sold by an international financial institution could be readily rectified. IEEE

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LncRNA FGD5-AS1 promotes the malignant phenotypes of ovarian cancer cells via targeting miR-142-5p.

Long non-coding RNAs (lncRNAs) have been reported to participate in regulating gene expression and are related to tumor progression. FGD5 antisense RNA 1 (FGD5-AS1) facilitates the progression of various tumors. However, the expression and function of FGD5-AS1 in ovarian cancer (OC) and its mechanism of action are not yet clear. Real-time polymerase chain reaction (RT-PCR) was employed to explore the expression levels of FGD5-AS1 and miR-142-5p in OC. The relationship between the expression of FGD5-AS1 and clinicopathological indicators of OC patients was analyzed by χ2 test. CCK-8 assay, BrdU assay, and Transwell assay were carried out to detect cell proliferation, migration, as well as invasion, respectively. Subcutaneous tumorigenesis experiment and lung metastasis model were used to examine the biological effects of FGD5-AS1 in OC in vivo. Dual luciferase reporter gene assay or RIP experiment was employed to explore the targeting relationship between FGD5-AS1 and miR-142-5p, as well as miR-142-5p and PD-L1 3'UTR. First, we found that FGD5-AS1 was markedly up-regulated in OC. Moreover, its high expression level was associated with positive local lymph node metastasis and higher T stage in OC patients. Gain-of-function and loss-of-function assays demonstrated that FGD5-AS1 facilitated the proliferation, migration, as well as invasion of OC cells. Mechanistically, it was revealed that FGD5-AS1 targeted miR-142-5p to repress its expression and function. Furthermore, miR-142-5p has a binding site for 3' UTR of PD-L1, and FGD5-AS1 could positively regulate PD-L1 expression via repressing miR-142-5p. The present study reports that FGD5-AS1/miR-142-5p/PD-L1 axis is involved in regulating OC progression.

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COVID-19 during pregnancy: an overview of maternal characteristics, clinical symptoms, maternal and neonatal outcomes of 10,996 cases described in 15 countries

The objective of this review was to identify the most significant studies reporting on COVID-19 during pregnancy and to provide an overview of SARS-CoV-2 infection in pregnant women and perinatal outcomes. Eligibility criteria included all reports, reviews; case series with more than 100 individuals and that reported at least three of the following: maternal characteristics, maternal COVID-19 clinical presentation, pregnancy outcomes, maternal outcomes and/or neonatal/perinatal outcomes. We included eight studies that met the inclusion criteria, representing 10,966 cases distributed in 15 countries around the world until July 20, 2020. The results of our review demonstrate that the maternal characteristics, clinical symptoms, maternal and neonatal outcomes almost 11,000 cases of COVID-19 and pregnancy described in 15 different countries are not worse or different from the general population. We suggest that pregnant women are not more affected by the respiratory complications of COVID-19, when compared to the outcomes described in the general population. We also suggest that the important gestational shift Th1-Th2 immune response, known as a potential contributor to the severity in cases of viral infections during pregnancy, are counter-regulated by the enhanced-pregnancy-induced ACE2-Ang-(1-7) axis. Moreover, the relatively small number of reported cases during pregnancy does not allow us to affirm that COVID-19 is more aggressive during pregnancy. Conversely, we also suggest, that down-regulation of ACE2 receptors induced by SARS-CoV-2 cell entry might have been detrimental in subjects with pre-existing ACE2 deficiency associated with pregnancy. This association might explain the worse perinatal outcomes described in the literature.

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The Research of SEIJR Model with Time-Delay based on 2019-nCov

A global epidemic disease known as the novel coronavirus (2019-nCov) had seriously hit the most area around the whole world causing unpredictable loss of manpower and finance during the past one year. Modeling the spread and development of infectious diseases represented by new Coronavirus has become an important part of public health work in the world. Estimation of possible infection population and prospective suggestion of handling spread based on exist data are of crucial importance. Considering of the biology parameters obtained based on Chinese clinical data in Wuhan and real spread feature of 2019-nCov in Italy, we build a more applicable model called SEIJR with log-normal distributed time delay to forecast the trend of spreading. Adopting Particle Swarm Optimization (PSO), we estimate the early period average spreading velocity (α0) and implement inversion analysis of time point (T0) when the virus first hit the Italy. Based on fixed α0 and T0, we then obtained the average spreading velocity α1 after the area lockdown using PSO. The result shows that it will be helpful in addressing the infection by generating the prediction trends of different αwhich we considered. Finally, our research applies Logistic regression, Neutral Network embedding LSTM layer, which are two representative machine learning algorithms, to directly predict future infection trend and compare the forecast with result yielded by mathematical model adopting differential equations. Not only solved the complex, nondifferentiable equation of epidemic model, this research also performs well in inversion analysis based on PSO which conveys informative outcomes for further discussion on precautious action. The comparison with the machine learning algorithms shows that the 2019-nCov based epidemic dynamics assumption is reasonable and helpful to mathematical model, which is better than the data driven machine learning algorithms. Code can be freely downloaded from https://github.com/Summerwork/2019-nCov-Prediction. Author

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