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Does the Level of Confidence Exhibited by Dental Students Predict the Outcome of Complete Denture Therapy?

Materials and Methods: Fifty-seven final-year dental students in the year 2019 and the first edentulous patient managed by them were recruited for the study. A fourteen-item questionnaire was given to the students to assess their level of confidence just before commencement of the treatment. Questionnaire for the patients was used to assess their satisfaction both with the operator and the dentures. Clinical outcome of dentures was assessed using ten criteria. Results: The average confidence level of the students was found to be 2.17 in a 4-point scale. A two-sample test indicated that there is a significant difference in the overall level of confidence between female and male students (p value = 0.004). Moreover, a nonparametric correlation analysis revealed that there is no significant correlation between the overall level of confidence of each student and patient satisfaction regarding student performance, level of satisfaction of patients regarding dentures, and the quality of dentures as assessed by the clinicians (p value = 0.545, 0.877, and 0.801, respectively). Conclusions: Students' level of confidence in carrying out complete denture procedures is satisfactory. Male students exhibited a better overall level of confidence than female students. However, the level of confidence exhibited by the dental students does not predict patient satisfaction or clinical outcome.

The Impact of the COVID-19 Pandemic on Unhealthy Eating in Populations with Obesity

OBJECTIVE: To examine the impact of the COVID-19 pandemic on patronage to unhealthy eating establishments in populations with obesity. METHODS: Anonymized movement data accounting for roughly 10% of devices in the United States at 138,989 unhealthy eating locations from December 1st 2019 through April 2020 and the percentage of adults with obesity, the poverty rate, and the food environment index in 65% of United States counties were collected and merged. A cluster corrected Poisson spline regression was performed predicting patronage by day, the percentage of adults with obesity in the establishment's county, the county's poverty rate, and its food environment index, as well as their interactions. RESULTS: Patronage to unhealthy eating establishments was higher where there was a higher percentage of the adult population with obesity. A similar pattern was observed for counties with a lower food environment index. These disparities appear to have increased as the COVID-19 pandemic spread. CONCLUSIONS: These results suggest unhealthy eating patterns during the COVID-19 pandemic are higher in already at-risk populations. Policy makers can use these findings to motivate interventions and programs aimed at increasing healthy food intake in at-risk communities during crises.

The Impact of the COVID-19 Pandemic on Unhealthy Eating in Populations with Obesity

OBJECTIVE: To examine the impact of the COVID-19 pandemic on patronage to unhealthy eating establishments in populations with obesity METHODS: Anonymized movement data accounting for roughly 10% of devices in the United States at 138,989 unhealthy eating locations from December 1(st) 2019 through April 2020 and the percentage of adults with obesity, the poverty rate, and the food environment index in 65% of United States counties were collected and merged A cluster corrected Poisson spline regression was performed predicting patronage by day, the percentage of adults with obesity in the establishment's county, the county's poverty rate, and its food environment index, as well as their interactions RESULTS: Patronage to unhealthy eating establishments was higher where there was a higher percentage of the adult population with obesity A similar pattern was observed for counties with a lower food environment index These disparities appear to have increased as the COVID-19 pandemic spread CONCLUSIONS: These results suggest unhealthy eating patterns during the COVID-19 pandemic are higher in already at-risk populations Policy makers can use these findings to motivate interventions and programs aimed at increasing healthy food intake in at-risk communities during crises

Human-Automation Trust to Technologies for Naïve Users Amidst and Following the COVID-19 Pandemic

OBJECTIVE AND BACKGROUND: Trust is a critical factor that influences the success or failure of human-automation interaction in a variety of professional domains such as transportation, military, and healthcare. The unprecedented COVID-19 crisis will likely accelerate the implementation of automation and create unique problems involving human-automation trust for naïve users of automated technologies in the future. METHOD: We briefly review factors that can influence the development of human-automation trust amidst and following the COVID-19 pandemic. We focus on two theories on human-automation trust and how naïve users develop and maintain their trust in unfamiliar technologies. RESULTS: The current review identifies user workload and perceived risk as critical factors that will impact human-automation trust during the COVID-19 pandemic. Both theories predict that it is important for naïve users to accumulate and analyze behavioral evidence of automated technologies to maintain appropriate trust levels as the pandemic progresses. CONCLUSION AND APPLICATION: Theories of human-automation trust inform trajectories of trust development toward unfamiliar technologies for naïve users. In application, manufacturers and distributers should focus on communicating system information effectively to retain users who may be "forced" to use unfamiliar technologies during the COVID-19 pandemic.

Chest CT and Coronavirus Disease (COVID-19): A Critical Review of the Literature to Date

OBJECTIVE. Coronavirus disease (COVID-19) is a global pandemic. Studies in the radiology literature have suggested that CT might be sufficiently sensitive and specific in diagnosing COVID-19 when used in lieu of a reverse transcription-polymerase chain reaction test; however, this suggestion runs counter to current society guidelines. The purpose of this article is to critically review some of the most frequently cited studies on the use of CT for detecting COVID-19. CONCLUSION. To date, the radiology literature on COVID-19 has consisted of limited retrospective studies that do not substantiate the use of CT as a diagnostic test for COVID-19.

Chest CT and Coronavirus Disease (COVID-19): A Critical Review of the Literature to Date

OBJECTIVE. Coronavirus disease (COVID-19) is a global pandemic. Studies in the radiology literature have suggested that CT might be sufficiently sensitive and specific in diagnosing COVID-19 when used in lieu of a reverse transcription-polymerase chain reaction test; however, this suggestion runs counter to current society guidelines. The purpose of this article is to critically review some of the most frequently cited studies on the use of CT for detecting COVID-19. CONCLUSION. To date, the radiology literature on COVID-19 has consisted of limited retrospective studies that do not substantiate the use of CT as a diagnostic test for COVID-19.

Does COVID-19 affect pregnant women?

The author discusses the set of guidelines on the coronavirus disease 2019 (COVID-19) and its effects on pregnant women released by health organizations such as the Royal College of Obstetricians and Gynaecologists (RCOG) on March 21, 2020 Topics covered include the lack of evidence that pregnant women who get COVID-19 are more at risk of serious complications than healthy people, the lack evidence to suggest a risk of miscarriage, and expert opinion that the baby is unlikely to be exposed

Cancerona: Challenges of Cancer Management in Times of COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) has infected millions of people worldwide and emerged to be the biggest global health threat claiming hundreds of thousands of lives at exponential rates The severity of the disease increases with old age and presence of underlying health conditions, such as cancer Managing cancer patients under these circumstances is rather challenging, given their compromised immunity and the overwhelmed health care services by COVID-19 community transmission Thus, it is prudent to establish common guidelines for the monitoring and treatment of cancer patients In this review, we comprehensively investigate the various aspects of cancer care during the COVID-19 pandemic, discuss challenges faced while treating cancer patients, and propose potential approaches to manage COVID-19 among this vulnerable population We also discuss molecular aberrations and genetic changes associated with cancer and their role in affecting the virus' infectivity and severity Lastly, we shed light on therapeutic approaches that can encompass both diseases without compromising one over the other

Suggestions casted to the novel coronavirus nucleic acid amplification test from viral pneumonia pathogenesis/ 中华检验医学杂志

An outbreak of Novel Coronavirus (2019-nCoV), results in Coronavirus disease that began in Wuhan, China, has spread rapidly with cases now confirmed in multiple countries. Nucleic acid amplification test (NAAT), represent by reverse-transcriptase polymerase chain reaction (RT-PCR) plays an important role in disease diagnosis and treatment evaluation. The test results by RT-PCR have attracted much attention recently. As understanding to this novel pathogen is still limited, it would be much help to combine the knowledge about its pathogenesis to judge the test results, in addition to review the quality control in laboratory. This review will focus on understanding the specific RT-PCR performance of the 2019-nCoV, under the background of viral pneumonia. The purpose of this review is to add value to NAAT of 2019-nCoV, with combined knowledge of epidemiology, pathogenesis, clinical characteristics and pre-analysis quality control from viral pneumonia.

Distinct clinical and immunological features of SARS-CoV-2-induced multisystem inflammatory syndrome in children

BACKGROUNDPediatric SARS-CoV-2 infection can be complicated by a dangerous hyperinflammatory condition termed multisystem inflammatory syndrome in children (MIS-C). The clinical and immunologic spectrum of MIS-C and its relationship to other inflammatory conditions of childhood have not been studied in detail.METHODSWe retrospectively studied confirmed cases of MIS-C at our institution from March to June 2020. The clinical characteristics, laboratory studies, and treatment response were collected. Data were compared with historic cohorts of Kawasaki disease (KD) and macrophage activation syndrome (MAS).RESULTSTwenty-eight patients fulfilled the case definition of MIS-C. Median age at presentation was 9 years (range: 1 month to 17 years); 50% of patients had preexisting conditions. All patients had laboratory confirmation of SARS-CoV-2 infection. Seventeen patients (61%) required intensive care, including 7 patients (25%) who required inotrope support. Seven patients (25%) met criteria for complete or incomplete KD, and coronary abnormalities were found in 6 cases. Lymphopenia, thrombocytopenia, and elevation in inflammatory markers, D-dimer, B-type natriuretic peptide, IL-6, and IL-10 levels were common but not ubiquitous. Cytopenias distinguished MIS-C from KD and the degree of hyperferritinemia and pattern of cytokine production differed between MIS-C and MAS. Immunomodulatory therapy given to patients with MIS-C included intravenous immune globulin (IVIG) (71%), corticosteroids (61%), and anakinra (18%). Clinical and laboratory improvement were observed in all cases, including 6 cases that did not require immunomodulatory therapy. No mortality was recorded in this cohort.CONCLUSIONMIS-C encompasses a broad phenotypic spectrum with clinical and laboratory features distinct from KD and MAS.FUNDINGThis work was supported by the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Allergy and Infectious Diseases; Rheumatology Research Foundation Investigator Awards and Medical Education Award; Boston Children's Hospital Faculty Career Development Awards; the McCance Family Foundation; and the Samara Jan Turkel Center.

Best Practice Recommendations for Pediatric Otolaryngology during the COVID-19 Pandemic

OBJECTIVE: To review the impact of coronavirus disease 2019 (COVID-19) on pediatric otolaryngology and provide recommendations for the management of children during the COVID-19 pandemic. DATA SOURCES: Clinical data were derived from peer-reviewed primary literature and published guidelines from national or international medical organizations. Preprint manuscripts and popular media articles provided background information and illustrative examples. METHODS: Included manuscripts were identified via searches using PubMed, MEDLINE, and Google Scholar, while organizational guidelines and popular media articles were identified using Google search queries. Practice guidelines were developed via consensus among all authors based on peer-reviewed manuscripts and national or international health care association guidelines. Strict objective criteria for inclusion were not used due to the rapidly changing environment surrounding the COVID-19 pandemic and a paucity of rigorous empirical evidence. CONCLUSIONS: In the face of the COVID-19 pandemic, medical care must be judiciously allocated to treat the most severe conditions while minimizing the risk of long-term sequelae and ensuring patient, physician, and health care worker safety. IMPLICATIONS FOR PRACTICE: The COVID-19 pandemic will have a profound short- and long-term impact on health care worldwide. Although the full repercussions of this disease have yet to be realized, the outlined recommendations will guide otolaryngologists in the treatment of pediatric patients in the face of an unprecedented global health crisis.

Contrast-Enhanced Ultrasound in Patients With COVID-19: Pneumonia, Acute Respiratory Distress Syndrome, or Something Else?

Coronavirus disease 2019 (COVID-19) represents a very heterogeneous disease. Some aspects of COVID-19 pneumonia question the real nature of ground glass opacities and its consolidative lesions. It has been hypothesized that COVID-19 lung involvement could represent not only a viral effect but also an immune response induced by the infection, causing epithelial/endothelial lesions and coagulation disorders. We report 3 cases of COVID-19 pneumonia in which contrast-enhanced ultrasound was suggestive of consolidations with perfusion defects, at least in part caused by ischemic or necrotic changes and not only by inflammatory or atelectasis events.

Contrast-Enhanced Ultrasound in Patients With COVID-19: Pneumonia, Acute Respiratory Distress Syndrome, or Something Else?

Coronavirus disease 2019 (COVID-19) represents a very heterogeneous disease. Some aspects of COVID-19 pneumonia question the real nature of ground glass opacities and its consolidative lesions. It has been hypothesized that COVID-19 lung involvement could represent not only a viral effect but also an immune response induced by the infection, causing epithelial/endothelial lesions and coagulation disorders. We report 3 cases of COVID-19 pneumonia in which contrast-enhanced ultrasound was suggestive of consolidations with perfusion defects, at least in part caused by ischemic or necrotic changes and not only by inflammatory or atelectasis events.

Topological Indices of Some Chemical Structures Applied for the Treatment of COVID-19 Patients

The novel coronavirus disease 2019 (COVID-19) emerged in Wuhan, China, and has spread rapidly to nearly every part of the world. Unfortunately, no drug or vaccine has been accepted for the treatment of this pandemic. Researchers have established the efficacy of some existing antiviral drugs to control COVID-19 in vitro. Some of them are remdesivir (GS-5734), chloroquine, hydroxychloroquine, theaflavin. Topological indices are mathematical interpretations of a molecule generated by an algorithm implemented to a given molecular representation. Topological indices are used to model different physicochemical properties and biological activities of chemical compounds. In this work, some degree-based and neighborhood degree sum-based topological indices are investigated for the aforesaid antiviral drugs using polynomial approach. The results obtained can aid in the design of new medicine for the treatment of COVID-19.

Impacts of COVID-19 control measures on tropospheric NO$_2$ over China, South Korea and Italy

Tropospheric nitrogen dioxide (NO$_2$) concentrations are strongly affected by anthropogenic activities. Using space-based measurements of tropospheric NO$_2$, here we investigate the responses of tropospheric NO$_2$ to the 2019 novel coronavirus (COVID-19) over China, South Korea, and Italy. We find noticeable reductions of tropospheric NO$_2$ columns due to the COVID-19 controls by more than 40% over E. China, South Korea, and N. Italy. The 40% reductions of tropospheric NO$_2$ are coincident with intensive lockdown events as well as up to 20% reductions in anthropogenic nitrogen oxides (NO$_x$) emissions. The perturbations in tropospheric NO$_2$ diminished accompanied with the mitigation of COVID-19 pandemic, and finally disappeared within around 50-70 days after the starts of control measures over all three nations, providing indications for the start, maximum, and mitigation of intensive controls. This work exhibits significant influences of lockdown measures on atmospheric environment, highlighting the importance of satellite observations to monitor anthropogenic activity changes.

The effects of the COVID-19 pandemic on levels of physical fitness

INTRODUCTION: The COVID-19 pandemic, caused by infections from a novel human coronavirus, has been reported since December 2019 in China but was only made official in March 2020. Since then, it has had an impact worldwide, both due to its aggressiveness and its fast propagation. Society has been facing this pandemic by following the recommendations and determinations of the WHO and the strategies deployed by governmental institutions. Among these, social isolation has been shown to be the most important, because when isolating, society tends to move less, with a consequent increase in physical inactivity and sedentary behavior, affecting its levels of physical fitness. The objectives of this review were: to review the most important effects of physical inactivity and sedentary behavior on the physical fitness levels of the population during the COVID-19 pandemic. CONCLUSION: The role of a regular practice of activities on the levels of physical fitness is fundamental to define the balance of quality of life during a COVID-19.

Saudi Society for Cardiac Surgeons consensus document on COVID-19, April 1, 2020

The COVID-19 pandemic represents an international health crisis that is challenging to all governments. Health practitioners in different fields have a duty to guide people and governments to achieve safe health practices. The Saudi Society for Cardiac Surgeons recognizes that it is difficult to establish evidence-based guidelines for safe cardiac surgery practices in such a crisis because this is an unprecedented health pandemic. So we decided to work with our colleagues in other societies by reviewing different recommendations and safe practices issued by different health organizations and scientific societies. The aim was to come up with recommendations that could guide hospitals, physicians, and other members of the healthcare team on the best available practices that are applicable to our community and that will not only ensure optimum patient care delivery but also protect healthcare workers from the risk of infection and aid the national effort in containing and managing this worldwide pandemic.

Saudi Society for Cardiac Surgeons consensus document on COVID-19, April 1, 2020

The COVID-19 pandemic represents an international health crisis that is challenging to all governments. Health practitioners in different fields have a duty to guide people and governments to achieve safe health practices. The Saudi Society for Cardiac Surgeons recognizes that it is difficult to establish evidence-based guidelines for safe cardiac surgery practices in such a crisis because this is an unprecedented health pandemic. So we decided to work with our colleagues in other societies by reviewing different recommendations and safe practices issued by different health organizations and scientific societies. The aim was to come up with recommendations that could guide hospitals, physicians, and other members of the healthcare team on the best available practices that are applicable to our community and that will not only ensure optimum patient care delivery but also protect healthcare workers from the risk of infection and aid the national effort in containing and managing this worldwide pandemic.

Chest computed tomography findings in hospitalized COVID-19 patients: a systematic review and meta-analysis

Most studies evaluating chest computed tomography (CT) features in coronavirus disease 2019 (COVID-19) have been small-sized and have presented varied findings. We aim to systematically review these studies and to conduct a meta-analysis of their results to provide a well-powered assessment of chest CT findings in patients with COVID-19. PubMed and EMBASE databases were systematically searched to identify published studies that evaluated chest CT findings in COVID-19 patients. Data regarding study characteristics and CT findings, including distribution of lesions, the lobe of lung involved, lesion densities, and radiological patterns, were extracted. Arcsine transformed proportions from individual studies were pooled using a random-effects model to derive pooled proportions (PPs) and 95% confidence intervals (CIs). A total of fifty-four studies (n=2693 confirmed COVID-19 patients) were included in the final review. Prevalence of different CT findings varied across studies; however, the most common findings were bilateral pulmonary involvement (PP: 74.1% [68.4%, 79.5%]; I2 = 85.76%), ground glass opacification (PP: 64.6% [57.6%, 71.4%]; I2 = 91.52%), involvement of the left lower lobe (PP: 71.2% [58.9%, 82.1%]; I2 = 90.91%), and subpleural distribution of lesions (PP: 57.2% [39.0%, 74.3%]; I2 = 93.08%). Multivariate meta-regression revealed a positive association between prevalence of air bronchograms and average age of the population (p=0.013). Bilateral ground glass opacification, a subpleural distribution of lesions, and involvement of the left lower lobe were the most notable chest CT findings in COVID-19 patients.

Modeling Evaporation of Water Droplets as Applied to Survival of Airborne Viruses

Many viruses, such as coronaviruses, tend to spread airborne inside water microdroplets Evaporation of the microdroplets may result in a reduction of their contagiousness However, the evaporation of small droplets is a complex process involving mass and heat transfer, diffusion, convection and solar radiation absorption Virological studies indicate that airborne virus survival is very sensitive to air humidity and temperature We employ a model of droplet evaporation with the account for the Knudsen layer This model suggests that evaporation is sensitive to both temperature and the relative humidity (RH) of the ambient air We also discuss various mechanisms such as the effect of solar irradiation, the dynamic relaxation of moving droplets in ambient air and the gravitational sedimentation of the droplets The maximum estimate for the spectral radiative flux in the case of cloudless sky showed that the radiation contribution to evaporation of single water droplets is insignificant We conclude that at small and even at moderately high levels of RH, microdroplets evaporate within dozens of seconds with the convective heat flux from the air being the dominant mechanism in every case The numerical results obtained in the paper are in good qualitative agreement with both the published laboratory experiments and seasonal nature of many viral infections Sophisticated experimental techniques may be needed for in situ observation of interaction of viruses with organic particles and living cells within microdroplets The novel controlled droplet cluster technology is suggested as a promising candidate for such experimental methodology

Guidelines for primary health care-based telemental health in a low-to middle-income country: the case of Lebanon

Significant efforts have been conducted to improve access to Mental Health Services (MHS) and reduce the burden of Mental Health Disorders (MHD) in Low-to Middle-Income Countries (LMIC). However, important challenges to accessing MHS still exist and limit improvements. Telemental Health (TMH), a modality that delivers remote MHS provides an ideal solution to complement existing efforts; however, there are limited reports on its implementation in developing countries such as Lebanon. This study presents the first roadmap for TMH applicability in Lebanon, with a focus on the Primary Health Care (PHC) setting, which has international relevance. We review existing guidelines and contextualise them to the Lebanese setting by addressing essential components for implementation. In specific, we shed light on 6 aspects: (1) patient population, (2) technological guidelines, (3) clinical guidelines, (4) administrative guidelines, (5) workforce, and (6) monitoring and evaluation. In addition, we acknowledge the important role of governmental efforts in setting the infrastructural and regulatory aspects for TMH practice. We provide guidance for public health professionals, government officials, and clinicians looking to adopt TMH practice in Lebanon or other countries with similar development and cultural landscapes.

Macrophage activation syndrome in children with Kawasaki disease: diagnostic and therapeutic approaches

BACKGROUND: Macrophage activation syndrome (MAS) is a rare, life-threatening complication of Kawasaki disease (KD). Early recognition and treatment of MAS are very important, but sometimes it is difficult to distinguish MAS from a severe form of KD. DATA SOURCES: A PubMed search was performed in Clinical Queries using the key terms "macrophage activation syndrome or secondary hemophagocytic lymphohistiocytosis (HLH)" and "Kawasaki disease". RESULTS: KD patients with MAS show high intravenous immunoglobulin (IVIG) resistance and coronary complications. Mortality is also as high as MAS in other diseases. Persistent fever greater than 10 days is highly associated with development of MAS in KD. Splenomegaly is observed in more than two-thirds of KD patients with MAS. Thrombocytopenia is often the earliest laboratory finding of MAS. Hyperferritinemia is highly specific and sensitive for detecting MAS in KD; so, ferritin levels should be checked if there are unexplained clinical exacerbations in KD patients. Given the under-recognition of MAS in KD, it is prudent to consider resistant KD as occult/subclinical MAS. Many KD patients with MAS have good outcomes on immune modulators. However, if KD patients fulfill the HLH-2004 diagnostic criteria, they may undergo longer and more intensive treatment than needed. CONCLUSIONS: The possible existence of MAS should be taken into account when a KD patient shows persistent fever, splenomegaly, thrombocytopenia, hyperferritinemia, or IVIG resistance. The under-diagnosis of MAS in patients with KD is an important issue to be addressed. Therapeutically, however, there is a possibility of over-treatment of MAS in patients with KD.

Revising entrepreneurial action in response to exogenous shocks: Considering the COVID-19 pandemic

With regards to the ongoing impact of the COVID-19 pandemic in the domain of entrepreneurship, we offer research-based evidence and associated insights focused on three perspectives (i.e., business planning, frugality, and emotional support) regarding entrepreneurial action under an exogenous shock. Beyond the initial emergency response that countries around the world have taken, we argue that it is time to revise entrepreneurial action guidance in such a context. Our aim is to highlight ways that entrepreneurs can take action in light of the current COVID-19 pandemic. We position our insights to be relevant to both researchers and practitioners coping with an unprecedented situation that has catastrophic consequences both economically and socially.

COVID-19 as a trigger for global transport infrastructure digitalization

The global transport infrastructure has evolved in recent years, gradually incorporating digital innovations into traditional processes and services However, everywhere the process of digitalization was hindered by the priority and low cost of classic forms of transport services, the absence of strict requirements for compliance with the conditions of contactless movement of products and prevention of the spread of infections According to the authors, the vector for total digitalization was taken after the spread of the SARS-CoV-2 virus The authors analyzed the implementation of digital tools until 2019, assessing the degree of implementation and coverage of digital innovations in the global transport industry Having studied the transport system of Russia, as one of the world's largest systems, in the context of the COVID-19 pandemic, the authors showed how the structure of cargo turnover by the mode of transport has changed and which industries have suffered the most damage Having calculated the forecast of digitalization growth and the dynamics of the share of digitized processes in the global transport infrastructure, the authors have come to the conclusions about the acceleration of the accumulated potential of digitalization of the transport sector in the context of the COVID-19 pandemic © Published under licence by IOP Publishing Ltd

Anaesthetic Management of Patients with COVID-19: A Single Center Initial Experience from Nepal

Anaesthetic management of patients with Corona Virus Disease (COVID-19) posses multiple challenges In the low-income nation like Nepal, factors like suboptimal infrastructure and resource limitations may add on to the existing challenges Proper planning and preparedness can help to overcome the challenges and enhance safety of both the patients undergoing surgery and of the health care workers involved in patient management Keywords: Anaesthetic management;COVID-19;Nepal

[Standardized sputum collection increases sputum sample collection rate for novel coronavirus nucleic acid detection]

OBJECTIVE: To evaluate the effect of standardized health education on the sputum specimen collection rate for nucleic acid detection of coronavirus disease 2019 (COVID-19) METHODS: Two hundred and twenty-seven patients in fever clinics and isolation wards of Sir Run Run Shaw Hospital of Zhejiang University and 307 migrant workers returning to 5 enterprises in Shanghai from February 3 to March 14, 2020 were enrolled in the study Through clarifying the procedures of collecting sputum specimens, making graphic/video health education materials, standardizing the contents and methods of health education, we conducted education to the subjects The subject expectorated spontaneously or with medical assistance For patients, the number of sampling attempts and sputum acquisition times were documented before and after the implementation of the standardized expectoration method;for the returning migrant employees in the enterprises, only the number of collected samples after the implementation of the standardized expectoration method were recorded RESULTS: A total of 378 sputum samples were collected from 227 patients The sputum sampling rates before and after the implementation of health education were 40 9%and 58 4%, respectively (P<0 01) A total of 304 sputum samples were obtained from 307 enterprise returnees, with a sample collection rate of 99 0% CONCLUSIONS: The education for standardized sputum sample collection method can effectively increase the sputum collection rate

A Hybrid Clustering Model for Analyzing COVID-19 National Prevention and Control Strategy

In order to analyze the relationship between the national epidemic strategy response to COVID-19 and the severity of the current epidemic, this paper firstly collects the national strategic data responds to the COVID-19 epidemic situation and the resulting data of COVID-19 in these nations, then use StandardScaler normalization method to pre-process the data, and use K-Means Clustering, Agglomerative Clustering and Density-Based Spatial Clustering of Applications with Noise (DBSCAN) clustering algorithm to perform cluster analysis on the above two types of data, use Silhouette Coefficient index, Calinski Harabasz Score, Davies bouldin score to evaluate the clustering results, and take the clustering results with the best clustering effect to analyze the impact of national epidemic policies on the current epidemic results, finally use cases to prove the effectiveness and feasibility of the model, and provide data support and strategic support for the prevention and control of the epidemic similar to COVID-19 in the future © 2020 IEEE

SARS-CoV-2 and COVID-19: How much do we know?

The recent outbreak of coronavirus disease (COVID-19) globally threatens the public health. COVID-19 is a pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known as the 2019 novel coronavirus (2019-nCoV). Typical symptoms of COVID-19 include fever, cough and fatigue. As a novel disease, there are still many unsolved questions regarding COVID-19. Nevertheless, genetic analysis has demonstrated that the virus is strongly associated with certain SARS-like coronavirus originated from bats. The COVID-19 outbreak started in a seafood wholesale market in Wuhan, China, but the exact origin of the virus is still highly debatable. Since there is currently no registered antiviral drug for the disease, symptomatic treatments have been applied routinely to manage COVID-19 cases. However, various drugs and vaccines have been currently under research. This review aims to consolidate and discuss the likely origins and genetic features of SARS-CoV-2 as well as the recent clinical findings and potential effective treatments of COVID-19. Keywords: COVID-19; SARS-CoV-2; 2019-nCoV; SARS; coronavirus.

Ripresa dell'attività sportiva in seguito a pandemia COVID-19. Come comportarsi?/ [Return to sport after the COVID-19 pandemic. How to behave?]

Italy, and all the world, has recently faced the arduous battle against the spread of a new coronavirus: SARS-CoV-2. This unexpected pandemic dramatically upended all areas of life, leading to a profound change in priorities, both in the medical as well as the social-economic field; and sports is no exception. Not surprisingly, the COVID-19 pandemic also walloped the world of sports. Every aspect of sports has been affected, leading professional and amateur leagues to stop their activities, in order to limit the spread of the virus, a painful but mandatory choice. Even the most popular sports in the world had to deal with the massive global threat of SARS-CoV-2. The Italian Sports Medical Federation (FMSI) has recently drawn up a protocol to be implemented when teams will receive from the authorities the permission to return to competitive activities. The purpose of this paper is to deepen the FMSI indications and allow wider dissemination and understanding.

Ripresa dell'attività sportiva in seguito a pandemia COVID-19. Come comportarsi?/ [Return to sport after the COVID-19 pandemic. How to behave?]

Italy, and all the world, has recently faced the arduous battle against the spread of a new coronavirus: SARS-CoV-2. This unexpected pandemic dramatically upended all areas of life, leading to a profound change in priorities, both in the medical as well as the social-economic field; and sports is no exception. Not surprisingly, the COVID-19 pandemic also walloped the world of sports. Every aspect of sports has been affected, leading professional and amateur leagues to stop their activities, in order to limit the spread of the virus, a painful but mandatory choice. Even the most popular sports in the world had to deal with the massive global threat of SARS-CoV-2. The Italian Sports Medical Federation (FMSI) has recently drawn up a protocol to be implemented when teams will receive from the authorities the permission to return to competitive activities. The purpose of this paper is to deepen the FMSI indications and allow wider dissemination and understanding.

Platform philanthropy, ‘public value’, and the COVID-19 pandemic moment

This commentary examines the COVID-19 pandemic as a moment of strategic advancement for digital platforms. Focusing on the redeployment of Google Maps data for tracking adherence to mobility restrictions, I argue that demonstrating such ‘public value’ uses of Google’s vast geolocation and behavioral data forms part of a larger effort to strengthen their economic and political position in the face of two existential threats—declining advertising revenues and platform regulation.

Estimating the burden of United States workers exposed to infection or disease: A key factor in containing risk of COVID-19 infection

INTRODUCTION: With the global spread of COVID-19, there is a compelling public health interest in quantifying who is at increased risk of contracting disease. Occupational characteristics, such as interfacing with the public and being in close quarters with other workers, not only put workers at high risk for disease, but also make them a nexus of disease transmission to the community. This can further be exacerbated through presenteeism, the term used to describe the act of coming to work despite being symptomatic for disease. Quantifying the number of workers who are frequently exposed to infection and disease in the workplace, and understanding which occupational groups they represent, can help to prompt public health risk response and management for COVID-19 in the workplace, and subsequent infectious disease outbreaks. METHODS: To estimate the number of United States workers frequently exposed to infection and disease in the workplace, national employment data (by Standard Occupational Classification) maintained by the Bureau of Labor Statistics (BLS) was merged with a BLS O*NET survey measure reporting how frequently workers in each occupation are exposed to infection or disease at work. This allowed us to estimate the number of United States workers, across all occupations, exposed to disease or infection at work more than once a month. RESULTS: Based on our analyses, approximately 10% (14.4 M) of United States workers are employed in occupations where exposure to disease or infection occurs at least once per week. Approximately 18.4% (26.7 M) of all United States workers are employed in occupations where exposure to disease or infection occurs at least once per month. While the majority of exposed workers are employed in healthcare sectors, other occupational sectors also have high proportions of exposed workers. These include protective service occupations (e.g. police officers, correctional officers, firefighters), office and administrative support occupations (e.g. couriers and messengers, patient service representatives), education occupations (e.g. preschool and daycare teachers), community and social services occupations (community health workers, social workers, counselors), and even construction and extraction occupations (e.g. plumbers, septic tank installers, elevator repair). CONCLUSIONS: The large number of persons employed in occupations with frequent exposure to infection and disease underscore the importance of all workplaces developing risk response plans for COVID-19. Given the proportion of the United States workforce exposed to disease or infection at work, this analysis also serves as an important reminder that the workplace is a key locus for public health interventions, which could protect both workers and the communities they serve.

Association Between Frequent Urination and Prolonged Staying at Home

BACKGROUND: Due to the coronavirus 2019 (COVID-19) pandemic, many activities have stopped and individuals have been forced to stay at home for prolonged periods, which can have a negative impact on overall health and trigger stress and psychological disorders such as depression and anxiety The objective of this study was to highlight 25 cases of unusual frequent urination associated with abnormal sleep and their relation to staying at home for a prolonged period due to the COVID-19 crisis METHODS: This retrospective cross-sectional study included 25 patients who complained of frequent urination (> 3 times/hour) and abnormal sleep during the last 4 months (January-April 2020) These patients were evaluated for all possible differential diagnoses RESULTS: All of the patients had frequent urination > 10 times/day and abnormal sleep but had normal kidney function tests and other investigations None of the patients had been doing any physical activity at home All of the patients said that both sleep and urination frequency improved after leaving home for a while (eg, to visit friends, walk, or play sports) This improvement occurred within 2 nights of leaving the home;however, the majority of patients improved after the first night CONCLUSIONS: "Home staying syndrome" is an undefined syndrome of unusual symptoms of abnormal sleep (altering sleep time and duration) and frequent urination > 3 times/hour This syndrome is associated with staying at home for a long period of time and is easily resolved by doing any activity such as sports or visiting friends While this syndrome is rare, it may be more prevalent now due to the COVID-19 pandemic, which forces people to stay home for infection prevention

Structural Variation of the Turtle Mitochondrial Control Region

The present study describes the most comprehensive comparison of turtle mtD-loop regions to date. The primary structure was compared from DNA sequences accessed from GenBank from 48 species in 13 families of extant turtles, and secondary structures of the mtD-loop region were inferred from thermal stabilities, using the program Mfold, for each superfamiliy of turtles. Both primary and secondary structures were found to be highly variable across the order. The Cryptodira showed conservation in the primary structure at conserved sequence blocks (CSBs), but the Pleurodira displayed limited conservation of primary structural characters, other than the coreTAS, a binding site for the helicase TWINKLE, which was highly conserved in the Central and Right Domains across the order. No secondary structure was associated with a TAS, but an AT-rich fold (secondary structure) near the 3' terminus of the mtD-loop region was detected in all turtle superfamilies. Mapping of character states of structural features of the mtD-loop region revealed that most character states were autapomorphies and inferred a number of homoplasies. The Left Domain of turtles, containing no highly conserved structural elements, likely does not serve a functional role; therefore, the Central Domain in turtles is likely equivalent to the Left Domain of mammals. The AT-rich secondary structural element near the 3' terminus of the mtD-loop region may be conserved across turtles because of a functional role, perhaps containing the Light Strand Promotor, or perhaps interacting with the TWINKLE-coreTAS complex in the Central and Right Domains to regulate mtDNA replication and transcription.

Multiple Epidemic Wave Model of the COVID-19 Pandemic: Modeling Study

BACKGROUND: Intervention measures have been implemented around the world to mitigate the spread of the coronavirus disease (COVID-19) pandemic. Understanding the dynamics of the disease spread and the effectiveness of the interventions is essential in predicting its future evolution. OBJECTIVE: The aim of this study is to simulate the effect of different social distancing interventions and investigate whether their timing and stringency can lead to multiple waves (subepidemics), which can provide a better fit to the wavy behavior observed in the infected population curve in the majority of countries. METHODS: We have designed and run agent-based simulations and a multiple wave model to fit the infected population data for many countries. We have also developed a novel Pandemic Response Index to provide a quantitative and objective way of ranking countries according to their COVID-19 response performance. RESULTS: We have analyzed data from 18 countries based on the multiple wave (subepidemics) hypothesis and present the relevant parameters. Multiple waves have been identified and were found to describe the data better. The effectiveness of intervention measures can be inferred by the peak intensities of the waves. Countries imposing fast and stringent interventions exhibit multiple waves with declining peak intensities. This result strongly corroborated with agent-based simulations outcomes. We also provided an estimate of how much lower the number of infections could have been if early and strict intervention measures had been taken to stop the spread at the first wave, as actually happened for a handful of countries. A novel index, the Pandemic Response Index, was constructed, and based on the model's results, an index value was assigned to each country, quantifying in an objective manner the country's response to the pandemic. CONCLUSIONS: Our results support the hypothesis that the COVID-19 pandemic can be successfully modeled as a series of epidemic waves (subepidemics) and that it is possible to infer to what extent the imposition of early intervention measures can slow the spread of the disease.

Multiple Epidemic Wave Model of the COVID-19 Pandemic: Modeling Study

BACKGROUND: Intervention measures have been implemented around the world to mitigate the spread of the coronavirus disease (COVID-19) pandemic. Understanding the dynamics of the disease spread and the effectiveness of the interventions is essential in predicting its future evolution. OBJECTIVE: The aim of this study is to simulate the effect of different social distancing interventions and investigate whether their timing and stringency can lead to multiple waves (subepidemics), which can provide a better fit to the wavy behavior observed in the infected population curve in the majority of countries. METHODS: We have designed and run agent-based simulations and a multiple wave model to fit the infected population data for many countries. We have also developed a novel Pandemic Response Index to provide a quantitative and objective way of ranking countries according to their COVID-19 response performance. RESULTS: We have analyzed data from 18 countries based on the multiple wave (subepidemics) hypothesis and present the relevant parameters. Multiple waves have been identified and were found to describe the data better. The effectiveness of intervention measures can be inferred by the peak intensities of the waves. Countries imposing fast and stringent interventions exhibit multiple waves with declining peak intensities. This result strongly corroborated with agent-based simulations outcomes. We also provided an estimate of how much lower the number of infections could have been if early and strict intervention measures had been taken to stop the spread at the first wave, as actually happened for a handful of countries. A novel index, the Pandemic Response Index, was constructed, and based on the model's results, an index value was assigned to each country, quantifying in an objective manner the country's response to the pandemic. CONCLUSIONS: Our results support the hypothesis that the COVID-19 pandemic can be successfully modeled as a series of epidemic waves (subepidemics) and that it is possible to infer to what extent the imposition of early intervention measures can slow the spread of the disease.

Cobalt-60 and electron beam irradiation induced lipid oxidation on largemouth bass (Micropterus salmoides)

BACKGROUND: Irradiation can cause lipid oxidation of fish. This study aimed to examine the effect of radiation (method, dose, and dose rate) on the acid value (AV), peroxide value (PV), thiobarbituric acid reactive substances (TBARS) content, and fatty acid profile of fresh and freeze-dried largemouth bass fleshes. RESULTS: The AV, PV and TBARS presented dose dependent increase in fish meat for both cobalt-60 (60 Co) and electron beam (EB) irradiation. With a 6 kGy of radiation, all measured indices in 60 Co group were significantly higher than those in EB group (P<0.05 or P<0.01). With a 3 kGy of radiation, the AV, PV and TBARS in 200 Gy/min dose rate group were significantly lower than those in 2 Gy/min and 80 Gy/min groups (P<0.05). After 60 Co irradiation, the AV, PV and TBARS in most of fresh samples were significantly higher than those in freeze-dried samples (P<0.01). And 60 Co radiation decreased the unsaturated fatty acid (UFA) content in fresh samples and increased the UFA content in freeze-dried samples. Our study indicated that 60 Co irradiation, particularly at a low dose rate, accelerated lipid oxidation in fish meat. A large amount of muscle moisture enhances the amount of UFA loss in fish meat during 60 Co irradiation. CONCLUSION: Low dose (3 kGy) of EB irradiation, high dose rate (200 Gy/min) of 60 Co irradiation or freeze-drying treatment can alleviate the lipid oxidation of largemouth bass meat. This article is protected by copyright. All rights reserved.

LATENT//Missing: On Missing Values, Narrative Power, and Data Politics in Discourse of COVID-19

April is National Minority Health Month in the United States. The first week of April is National Public Health Week. This year, both occasions passed as the COVID-19 pandemic unfolded and, in the process, rendered remarkably clear the magnitude of the United States' collective shortcomings in advancing population health equity-particularly as related to dominant narratives of health and data politics. Drawing from critical theory, I use essay to contextualize present COVID-19 discourse and poetry to situate this discourse within a broader historical arc of the United States' racist, classist, and homophobic proclivities in times of public health crises. I use the combination of essay/poem as creative praxis to analyze and reflect on our present moment in relation to public health pasts and to raise questions about public health research, education, and data futures-offering a critical commentary on the intersections of infectious diseases, structural inequality (e.g., racism), data politics, and public health violence.

Assessing the potential impact on health of the UK's future relationship agreement with the EU: analysis of the negotiating positions

While policy attention is understandably diverted to COVID-19, the end of the UK's post-Brexit 'transition period' remains 31 December 2020. All forms of future EU-UK relationship are worse for health than EU membership, but analysis of the negotiating texts shows some forms are better than others. The likely outcomes involve major negative effects for NHS staffing, funding for health and social care, and capital financing for the NHS; and for UK global leadership and influence. We expect minor negative effects for cross border healthcare (except in Northern Ireland); research collaboration; and data sharing, such as the Early Warning and Response System for health threats. Despite political narratives, the legal texts show that the UK seeks de facto continuity in selected key areas for pharmaceuticals, medical devices, and equipment [including personal protective equipment (PPE)], especially clinical trials, pharmacovigilance, and batch-testing. The UK will be excluded from economies of scale of EU membership, e.g. joint procurement programmes as used recently for PPE. Above all, there is a major risk of reaching an agreement with significant adverse effects for health, without meaningful oversight by or input from the UK Parliament, or other health policy stakeholders.

Impact of the COVID-19 pandemic in patient admission to a high-complexity cancer center in Southern Brasil

OBJECTIVE: The aim of our study was to investigate whether there has been a reduction in patient admission to a high-complexity cancer care center in Brasil during the COVID-19 pandemic, similar to what was reported in Europe. METHODS: We reviewed the cancer tracking database of the largest cancer center in southern Brasil and performed statistical tests to compare first-time appointments from the onset of the outbreak until the end of June to those of the equivalent period in 2019. RESULTS: We observed a dramatic reduction (-42%) in first-time appointments during the pandemic compared to the same period in the previous year (P <0.001). This reduction was observed among all medical specialties (P <0.001). CONCLUSION: The onset of COVID-19 was correlated with a reduction in admission to a high-complexity cancer care center in Brasil. Since a delay in diagnosis and treatment may influence prognosis, it is important that cancer centers and public health strategies reinforce care for non-COVID-19 patients to prevent potentially unnecessary deaths.

Research on Coastal Economic Development Trend in Hengqin New District of China against the Epidemic

With the rapid spread of COVID-19 epidemic, Hengqin New District of China, as a place with high population mobility in coastal areas, is under tremendous pressure to fight the epidemic Supported by the statistical survey data of relevant government departments, this paper makes an in-depth analysis of the development of enterprises in the coastal areas in Hengqin New District of China in respect of cash flow difficulty, insufficient service supply It is recommended that the Chinese government continues to deepen and expand opening up, supports the development of small and medium-sized enterprises in coastal areas, as well as speeds up the economic layout of the "Maritime Silk Road" in Hengqin New District of China while preventing and controlling the epidemic Enterprises in coastal regions of Hengqin New District of China should actively integrate into the coastal economic layout to improve their core competitiveness, according to their own development direction

Production of Modified Vaccinia Ankara Virus by Intensified Cell Cultures: A Comparison of Platform Technologies for Viral Vector Production

Modified Vaccinia Ankara (MVA) virus is a promising vector for vaccination against various challenging pathogens or the treatment of some types of cancers, requiring a high amount of virions per dose for vaccination and gene therapy. Upstream process intensification combining perfusion technologies, the avian suspension cell line AGE1.CR.pIX and the virus strain MVA-CR19 is an option to obtain very high MVA yields. Here the authors compare different options for cell retention in perfusion mode using conventional stirred-tank bioreactors. Furthermore, the authors study hollow-fiber bioreactors and an orbital-shaken bioreactor in perfusion mode, both available for single-use. Productivity for the virus strain MVA-CR19 is compared to results from batch and continuous production reported in literature. The results demonstrate that cell retention devices are only required to maximize cell concentration but not for continuous harvesting. Using a stirred-tank bioreactor, a perfusion strategy with working volume expansion after virus infection results in the highest yields. Overall, infectious MVA virus titers of 2.1-16.5 × 109 virions/mL are achieved in these intensified processes. Taken together, the study shows a novel perspective on high-yield MVA virus production in conventional bioreactor systems linked to various cell retention devices and addresses options for process intensification including fully single-use perfusion platforms.

Media trust and infection mitigating behaviours during the COVID-19 pandemic in the USA

INTRODUCTION: The COVID-19 pandemic is an unprecedented public health crisis It is becoming increasingly clear that people's behavioural responses in the USA during this fast-changing pandemic are associated with their preferred media sources The polarisation of US media has been reflected in politically motivated messaging around the coronavirus by some media outlets, such as Fox News This resulted in different messaging around the risks of infection and behavioural changes necessary to mitigate that risk This study determined if COVID-related behaviours differed according to trust in left-leaning or right-leaning media and how differences changed over the first several months of the pandemic METHODS: Using the nationally representative Understanding America Study COVID-19 panel, we examine preventive and risky behaviours related to infection from COVID-19 over the period from 10 March to 9 June for people with trust in different media sources: one left-leaning, CNN and another right-leaning, Fox News People's media preferences are categorised into three groups: (1) those who trust CNN more than Fox News;(2) those who have equal or no preferences and (3) those who trust Fox News more than CNN RESULTS: Results showed that compared with those who trust CNN more than Fox news, people who trust Fox News more than CNN engaged in fewer preventive behaviours and more risky behaviours related to COVID-19 Out of five preventive and five risky behaviours examined, people who trust Fox News more than CNN practised an average of 3 41 preventive behaviours and 1 25 risky behaviours, while those who trust CNN more than Fox News engaged in an average of 3 85 preventive and 0 94 risky behaviours, from late March to June The difference between these two groups widened in the month of May (p≤0 01), even after controlling for access to professional information and overall diversity of information sources CONCLUSIONS: Our findings indicate that behavioural responses were divided along media bias lines In such a highly partisan environment, false information can be easily disseminated, and health messaging, which is one of the few effective ways to slowdown the spread of the virus in the absence of a vaccine, is being damaged by politically biased and economically focused narratives During a public health crisis, media should reduce their partisan stance on health information, and the health messaging from neutral and professional sources based on scientific findings should be better promoted

Evaluating How Smartphone Contact Tracing Technology Can Reduce the Spread of Infectious Diseases: The Case of COVID-19

Detecting and controlling the diffusion of infectious diseases such as COVID-19 is crucial to managing epidemics. One common measure taken to contain or reduce diffusion is to detect infected individuals and trace their prior contacts so as to then selectively isolate any individuals likely to have been infected. These prior contacts can be traced using mobile devices such as smartphones or smartwatches, which can continuously collect the location and contacts of their owners by using their embedded localisation and communications technologies, such as GPS, Cellular networks, Wi-Fi, and Bluetooth. This paper evaluates the effectiveness of these technologies and determines the impact of contact tracing precision on the spread and control of infectious diseases. To this end, we have created an epidemic model that we used to evaluate the efficiency and cost (number of people quarantined) of the measures to be taken, depending on the smartphone contact tracing technologies used. Our results show that in order to be effective for the COVID-19 disease, the contact tracing technology must be precise, contacts must be traced quickly, and a significant percentage of the population must use the smartphone contact tracing application. These strict requirements make smartphone-based contact tracing rather ineffective at containing the spread of the infection during the first outbreak of the virus. However, considering a second wave, where a portion of the population will have gained immunity, or in combination with some other more lenient measures, smartphone-based contact tracing could be extremely useful.

Development of a personal passive air sampler for estimating exposure to effective chlorine while using chlorine-based disinfectants

With an increasing use of indoor disinfectants such as chlorine (Cl2 ) and hypochlorous acid, a convenient sampler for estimating exposure to oxidants, such as effective chlorine, is necessary. Here, we developed a personal passive air sampler (PPAS) composed of a redox dye, o-dianisidine, in a polydimethylsiloxane (PDMS) sheet. o-Dianisidine readily reacts with gaseous oxidants generated by bleach usage, and its color changes as the reaction progresses; hence, personal exposure to effective chlorine could be easily detected by the naked eye, while cumulative exposure could be determined by measuring concentrations of o-dianisidine reacting with it. The PPAS was calibrated, and a sampling rate of 0.00253 m3 /h was obtained using a small test chamber. The PPAS was tested with the help of ten volunteers whose personal exposure to Cl2 -equivalent gas was estimated after bathrooms were cleaned using spray and liquid-type household disinfection products, and the accumulated exposure-gas concentrations ranged from 69 to 408 ppbv and 148 to 435 ppbv, respectively. These PPAS-derived exposure concentrations were approximately two orders lower than those estimated using ConsExpo, suggesting a significant overestimation by prevailing screening models, possibly due to the ignorance of transformation reactions.

Superspreaders and lockdown timing explain the power-law dynamics of COVID-19

Infectious disease outbreaks are expected to grow exponentially in time when left unchecked Containment measures such as lockdown and social distancing can drastically alter the growth dynamics of the outbreak This is the case for the 2019-2020 COVID-19 outbreak, which is characterized by a power-law growth Strikingly however, the power-law exponent is different across countries Here I illustrate the relationship between these two extreme scenarios, exponential and power-law growth, based on the impact of superspreaders and lockdown strategies to contain the outbreak The theory predicts a relationship between the power- law exponent and the time interval between the first case and lockdown that is validated by the observed COVID-19 data across different countries © 2020 American Physical Society

mSphere of Influence: That's Racist-COVID-19, Biological Determinism, and the Limits of Hypotheses

Kishana Taylor works in the field of virology In this mSphere of Influence article, she reflects on the personal impact of "Racial health disparities and COVID-19 - caution and context" by Merlin Chowkwanyun and Adolph L Reed, Jr (N Engl J Med 383:201-203, 2020, https://doi org/10 1056/NEJMp2012910) and "A hypothesis is a liability" by Itai Yanai and Martin Lercher (Genome Biol 21:231, 2020, https://doi org/10 1186/s13059-020-02133-w) and how it became part of the mission for Black In Microbiology Week

Strengthening health systems resilience: Key concepts and strategies

Health system resilience is key to coping with catastrophic events, such as the economic crisis and the coronavirus (COVID-19) pandemic, but there is much confusion about what resilience means, how to strengthen it and how to assess it For operational and assessment purposes, and to foster a more consistent understanding and use of the key concepts, we adopt the following definitions of health system resilience and shock: Health system resilience is the ability to prepare for, manage (absorb, adapt and transform) and learn from shocks Shock is a sudden and extreme change which impacts on a health system, and is thus different from the predictable and enduring health system stresses, such as population ageing A shock cycle has four stages: Stage 1: Preparedness;Stage 2: Shock onset and alert;Stage 3: Shock impact and management;and Stage 4: Recovery and learning Based on the existing literature and emerging evidence from the ongoing COVID-19 pandemic, we identify strategies for enhancing resilience and map them on to the key health systems functions: Governance: effective and participatory leadership with strong vision and communication;coordination of activities across government and key stakeholders;an organizational learning culture that is responsive to crises;effective information systems and flows;and surveillance enabling timely detection of shocks and their impact Financing: ensuring sufficient monetary resources in the system and flexibility to reallocate and inject extra funds;ensuring stability of health system funding through countercyclical health financing mechanisms and reserves;purchasing flexibility and reallocation of funding to meet changing needs;and comprehensive health coverage Resources: appropriate level and distribution of human and physical resources;ability to increase capacity to cope with a sudden surge in demand;and motivated and well-supported workforce Service delivery: alternative and flexible approaches to deliver care Assessing how each function is placed in terms of the strategies above can allow a country to identify the potential sources of vulnerability and plan for further action (to enhance resilience or the capacity to respond) Resilience can also be assessed after the crisis, providing an evaluation of the handling of the crisis Assessment of health system resilience is crisis- and context-specific It is important to employ a range of both quantitative and qualitative metrics that allow evaluation of particular aspects of health system resilience in order to provide a meaningful overall assessment Analysing experiences of other countries provides useful lessons for policy-makers implementing resilience-enhancing strategies It is particularly important to learn in the aftermath of the shock and make the link between recovering from the shock to preparedness for future shocks, which is an area often neglected once the health system returns to post-shock 'normality'

The Appointment in Samarra: A New Use for Some Old Jokes

The coronavirus epidemic is not just a biological phenomenon which affects humans: it is also a moment of a profound global and ecological crisis that includes many human and nonhuman actors. To confront the crisis, a radical philosophical change is needed, which penetrates to natural, economic, and cultural processes. The amassing of dictatorial powers of state apparatuses evoked by the pandemic highlights their basic impotence and the fact that the system as we know it cannot continue in its existing liberal-permissive form. While the final outcome is uncertain what is most probable is that a new barbarian capitalism will prevail: many old and weak will be sacrificed and let to die, workers will have to accept much lower standards of living, digital control of our lives will remain a permanent feature, and class distinctions will become much more than now a matter of life and death.

Understanding the epidemic course in order to improve epidemic forecasting

Abstract The epidemic course of the severe acute respiratory syndrome (SARS) has been differently divided according to its transmission pattern and the infection and mortality status, and such efforts for the coronavirus disease 2019 (COVID-19) have been lacking Does every epidemic have a unique epidemic course? Can we coordinate two arbitrary courses into an integrated course, which could better reflect a common real-world progression pattern of the epidemics? To what degree can such arbitrary divisions help to predict the future trends of the COVID-19 pandemic and the future epidemics? The advanced spatial and digital technologies provide a new perspective to understand the course of epidemics, especially pandemics, and a new toolkit to predict the course of future epidemics on the basis of big data In the data-driven era we are in right now, data should be integrated and inform us what the epidemic transmits like at the present moment, what it will transmit like at the next moment, and which interventions would be most cost-effective to curb the epidemic Both national and international legislations are needed to facilitate the integration of relevant policies of data sharing and confidentiality protection into the current pandemic preparedness guidelines

COVID-19 communication in India

The aim of the article was to examine transparency and timeliness in information were laid down as essential principles in scientific communication of COVID-19 pandemic in India

RNA Drugs and RNA Targets for Small Molecules: Principles, Progress, and Challenges

RNA-based therapies, including RNA molecules as drugs and RNA-targeted small molecules, offer unique opportunities to expand the range of therapeutic targets. Various forms of RNAs may be used to selectively act on proteins, transcripts, and genes that cannot be targeted by conventional small molecules or proteins. Although development of RNA drugs faces unparalleled challenges, many strategies have been developed to improve RNA metabolic stability and intracellular delivery. A number of RNA drugs have been approved for medical use, including aptamers (e.g., pegaptanib) that mechanistically act on protein target and small interfering RNAs (e.g., patisiran and givosiran) and antisense oligonucleotides (e.g., inotersen and golodirsen) that directly interfere with RNA targets. Furthermore, guide RNAs are essential components of novel gene editing modalities, and mRNA therapeutics are under development for protein replacement therapy or vaccination, including those against unprecedented severe acute respiratory syndrome coronavirus pandemic. Moreover, functional RNAs or RNA motifs are highly structured to form binding pockets or clefts that are accessible by small molecules. Many natural, semisynthetic, or synthetic antibiotics (e.g., aminoglycosides, tetracyclines, macrolides, oxazolidinones, and phenicols) can directly bind to ribosomal RNAs to achieve the inhibition of bacterial infections. Therefore, there is growing interest in developing RNA-targeted small-molecule drugs amenable to oral administration, and some (e.g., risdiplam and branaplam) have entered clinical trials. Here, we review the pharmacology of novel RNA drugs and RNA-targeted small-molecule medications, with a focus on recent progresses and strategies. Challenges in the development of novel druggable RNA entities and identification of viable RNA targets and selective small-molecule binders are discussed. SIGNIFICANCE STATEMENT: With the understanding of RNA functions and critical roles in diseases, as well as the development of RNA-related technologies, there is growing interest in developing novel RNA-based therapeutics. This comprehensive review presents pharmacology of both RNA drugs and RNA-targeted small-molecule medications, focusing on novel mechanisms of action, the most recent progress, and existing challenges.

Solidarity in times of crisis

The 2019 COVID-19 pandemic has amplified inequalities and human rights challenges;in some states, COVID-19 policies have been introduced that further curtail human rights Although some limits may be justified in the time of a public health emergency, other rights are vital to secure precisely because of pandemic conditions Following a discussion of the concept of political solidarity, we examine how COVID-19 has underscored democratic "deficits" and human rights failures within the United States and India Emergency "stay-at-home" orders and social distancing measures make political dissent challenging, yet this extreme moment has created opportunities for solidarity, initially in restrained ways via the internet or local forms of collective support and protest, and later through mass mobilizations to end racial injustice (in the United States) Our assessment of the challenges and promises of solidarist action in two of the largest democracies offers reasons for guarded optimism

SARS-CoV-2: Mechanism of infection and emerging technologies for future prospects

The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally to over 200 countries with more than 23 million confirmed cases and at least 800,000 fatalities as of 23 August 2020. Declared a pandemic on March 11 by World Health Organization, the disease caused by SARS-CoV-2 infection, called coronavirus disease 2019 (COVID-19), has become a global public health crisis that challenged all national healthcare systems. This review summarized the current knowledge about virologic and pathogenic characteristics of SARS-CoV-2 with emphasis on potential immunomodulatory mechanism and drug development. With multiple emerging technologies and cross-disciplinary approaches proving to be crucial in our global response against COVID-19, the application of PROteolysis TArgeting Chimeras strategy, CRISPR-Cas9 gene editing technology, and Single-Nucleotide-Specific Programmable Riboregulators technology in developing antiviral drugs and detecting infectious diseases are proposed here. We also discussed the available but still limited epidemiology of COVID-19 as well as the ongoing efforts on vaccine development. In brief, we conducted an in-depth analysis of the pathogenesis of SARS-CoV-2 and reviewed the therapeutic options for COVID-19. We also proposed key research directions in the future that may help uncover more underlying molecular mechanisms governing the pathology of COVID-19.

Emergency Surgery and Trauma CareDuring COVID-19 Pandemic. Recommendations of the Spanish Association of Surgeons

New coronavirus SARS-CoV-2 infection (coronavirus disease 2019 [COVID-19]) has determined the necessity of reorganization in many centers all over the world Spain, as an epicenter of the disease, has been forced to assume health policy changes in all the territory However, and from the beginning of the pandemic, every center attending surgical urgencies had to guarantee the continuous coverage adopting correct measures to maintain the excellence of quality of care This document resumes general guidelines for emergency surgery and trauma care, obtained from the available bibliography and evaluated by a subgroup of professionals designated from the general group of investigators Cirugia-AEC-COVID-19 from the Spanish Association of Surgeons, directed to minimize professional exposure, to contemplate pandemic implications over different urgent perioperative scenarios and to adjust decision making to the occupational pressure caused by COVID-19 patients

Emergency Surgery and Trauma Care During COVID-19 Pandemic. Recommendations of the Spanish Association of Surgeons

New coronavirus SARS-CoV-2 infection (coronavirus disease 2019 [COVID-19]) has determined the necessity of reorganization in many centers all over the world Spain, as an epicenter of the disease, has been forced to assume health policy changes in all the territory However, and from the beginning of the pandemic, every center attending surgical urgencies had to guarantee the continuous coverage adopting correct measures to maintain the excellence of quality of care This document resumes general guidelines for emergency surgery and trauma care, obtained from the available bibliography and evaluated by a subgroup of professionals designated from the general group of investigators Cirugia-AEC-COVID-19 from the Spanish Association of Surgeons, directed to minimize professional exposure, to contemplate pandemic implications over different urgent perioperative scenarios and to adjust decision making to the occupational pressure caused by COVID-19 patients

Correction to Lancet Infect Dis 2020 published online March 12. https://doi.org/10.1016/S1473-3099(20)30174-2 (The Lancet Infectious Diseases, (S1473309920301742), (10.1016/S1473-3099(20)30174-2))

Han H, Luo Q, Mo F, Long, L, Zheng W SARS-CoV-2 RNA more readily detected in induced sputum than in throat swabs of convalescent COVID-19 patients Lancet Infect Dis 2020;published online March 12 https://doi org/10 1016/S1473-3099(20)30174-2-In this Correspondence, the email address for the corresponding author should have been huanqinhan@126 com This correction has been made to the online version as of March 18, 2020 and will be made to the printed version Copyright © 2020 Elsevier Ltd

Clinical Management of Lung Cancer Patients during the Outbreak of 2019 Novel Coronavirus Disease (COVID-19)

Since late December 2019, an outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly nationwide With the spread of COVID-19, the routine clinical diagnosis and treatment for lung cancer patients has been disturbed Due to the systemic immunosuppressive of lung cancer patients caused by the malignancy and anticancer treatments, lung cancer patients are more susceptible to infection than healthy individuals Furthermore, patients with cancer had poorer prognosis from infection Lung cancer patients should be the priority group for COVID-19 prevention The protection provisions and control measures aiming to protect lung cancer patients from COVID-19 have been increasingly concerned During the COVID-19 outbreak period, it should be carefully differentiated for fever and respiratory symptoms for lung cancer patients receiving anti-tumor treatment, in order to evaluate the risk of COVID-19 Moreover, it is necessary to carry out meticulous and individualized clinical management for lung cancer patients to effectively protect the patients from COVID-19

[Clinical Management of Lung Cancer Patients during the Outbreak of 2019 Novel Coronavirus Disease (COVID-19)]

Since late December 2019, an outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly nationwide. With the spread of COVID-19, the routine clinical diagnosis and treatment for lung cancer patients has been disturbed. Due to the systemic immunosuppressive of lung cancer patients caused by the malignancy and anticancer treatments, lung cancer patients are more susceptible to infection than healthy individuals. Furthermore, patients with cancer had poorer prognosis from infection. Lung cancer patients should be the priority group for COVID-19 prevention. The protection provisions and control measures aiming to protect lung cancer patients from COVID-19 have been increasingly concerned. During the COVID-19 outbreak period, it should be carefully differentiated for fever and respiratory symptoms for lung cancer patients receiving anti-tumor treatment, in order to evaluate the risk of COVID-19. Moreover, it is necessary to carry out meticulous and individualized clinical management for lung cancer patients to effectively protect the patients from COVID-19.

Clinical findings of patients with coronavirus disease 2019 in Jiangsu province, China: A retrospective, multi-center study

Limited data are available for clinical characteristics of patients with coronavirus disease 2019 (COVID-19) outside Wuhan. This study aimed to describe the clinical characteristics of COVID-19 and identify the risk factors for severe illness of COVID-19 in Jiangsu province, China. Clinical data of hospitalized COVID-19 patients were retrospectively collected in 8 hospitals from 8 cities of Jiangsu province, China. Clinical findings of COVID-19 patients were described and risk factors for severe illness of COVID-19 were analyzed. By Feb 10, 2020, 202 hospitalized patients with COVID-19 were enrolled. The median age of patients was 44.0 years (interquartile range, 33.0-54.0). 55 (27.2%) patients had comorbidities. At the onset of illness, the common symptoms were fever (156 [77.2%]) and cough (120 [59.4%]). 66 (32.7%) patients had lymphopenia. 193 (95.5%) patients had abnormal radiological findings. 11 (5.4%) patients were admitted to the intensive care unit and none of the patients died. 23 (11.4%) patients had severe illness. Severe illness of COVID-19 was independently associated with body mass index (BMI) &#8805; 28 kg/m2 (odds ratio [OR], 9.219; 95% confidence interval [CI], 2.731 to 31.126; P<0.001) and a known history of type 2 diabetes (OR, 4.326; 95% CI, 1.059 to 17.668; P = 0.041). In this case series in Jiangsu Province, COVID-19 patients had less severe symptoms and had better outcomes than the initial COVID-19 patients in Wuhan. The BMI &#8805; 28 kg/m2 and a known history of type 2 diabetes were independent risk factors of severe illness in patients with COVID-19.

Temporal Trends of Patients Undergoing Transcatheter Aortic Valve Implantation 2011-2019

Background: The technology and indications for transcatheter aortic valve implantation (TAVI) have been continuously evolving for over a decade We evaluated temporal trends in patient selection and clinical outcomes in our regional TAVI cohort Method: Patients who underwent TAVI between October 2011 and December 2019 in the Auckland Region were included Patient characteristics, procedural details and clinical outcomes were obtained from electronic records Results: A total of 461 patients were studied (54 9% female, mean age 79 5±8 4 years) TAVI was performed for severe aortic stenosis in the majority of patients (84 6%), while off-label indications were severe aortic regurgitation (8 7%) and mixed aortic valve disease (6 7%) Valve-in-valve TAVI was performed in 43 patients (9 3%), at a median of 13 years after previous aortic valve replacement The mean EuroSCORE II was 5 5±4 4%, and there has been a shift over time to treating patients with lower risk New York Heart Association Functional Classes III and IV were present in 170 (36 9%) and 22 (4 8%) patients respectively Based on 30-day mortality risk, patients were stratified into 3 groups;210 (46%) had low-risk (EuroSCORE II 9%, 30-day mortality 4 6%, p=0 058) Transfemoral TAVI was performed in 411 patients (89 4%), and tended towards lower 30-day mortality when compared to non-transfemoral TAVI (1 2% vs 4 1%, p=0 12) Conclusion: Temporal trends in our TAVI cohort include increased utilisation in lower risk patients, off-label indications, and treatment of bioprosthetic valve failure 30-day mortality in our cohort is low, especially in transfemoral TAVI

Peripheral facial nerve palsy associated with COVID-19

COVID-19 pandemic revealed several neurological syndromes related to this infection We describe the clinical, laboratory, and radiological features of eight patients with COVID-19 who developed peripheral facial palsy during infection In three patients, facial palsy was the first symptom Nerve damage resulted in mild dysfunction in five patients and moderate in three SARS-Cov-2 was not detected in CSF by PCR in any of the samples Seven out of eight patients were treated with steroids and all patients have complete or partial recovery of the symptoms Peripheral facial palsy should be added to the spectrum of neurological manifestations associated with COVID-19

Review of Big Data Analytics, Artificial Intelligence and Nature-Inspired Computing Models towards Accurate Detection of COVID-19 Pandemic Cases and Contact Tracing

The emergence of the 2019 novel coronavirus (COVID-19) which was declared a pandemic has spread to 210 countries worldwide. It has had a significant impact on health systems and economic, educational and social facets of contemporary society. As the rate of transmission increases, various collaborative approaches among stakeholders to develop innovative means of screening, detecting and diagnosing COVID-19's cases among human beings at a commensurate rate have evolved. Further, the utility of computing models associated with the fourth industrial revolution technologies in achieving the desired feat has been highlighted. However, there is a gap in terms of the accuracy of detection and prediction of COVID-19 cases and tracing contacts of infected persons. This paper presents a review of computing models that can be adopted to enhance the performance of detecting and predicting the COVID-19 pandemic cases. We focus on big data, artificial intelligence (AI) and nature-inspired computing (NIC) models that can be adopted in the current pandemic. The review suggested that artificial intelligence models have been used for the case detection of COVID-19. Similarly, big data platforms have also been applied for tracing contacts. However, the nature-inspired computing (NIC) models that have demonstrated good performance in feature selection of medical issues are yet to be explored for case detection and tracing of contacts in the current COVID-19 pandemic. This study holds salient implications for practitioners and researchers alike as it elucidates the potentials of NIC in the accurate detection of pandemic cases and optimized contact tracing.

The COVID-19 Pandemic: Anticipating its Effects on Canada's Agricultural Trade

With the deep recession now forecast for the world economy, trade can be expected to fall even more steeply. Agricultural trade will be less significantly affected, being insulated by its relatively low income elasticities of demand. However, a drop in the range of 12 to 20 percent in real trade value should be expected. Canada can be expected to share in this, but, within agricultural exports, cereals will be least affected. This minimal expected impact to cereals stems from the risk of wheat export bans by Russia and Kazakhstan, due to the resulting increase in wheat prices. Livestock, pulses, and horticulture can be expected to face a larger decline in trade prospects and revenues. An equally large threat to falling incomes in our trade partners is their policy responses, particularly the potential increase in import restrictions. These may take the form of more costly inspections, tightened SPS and food safety regulations, and protectionist measures from competing domestic producers. This article is protected by copyright. All rights reserved.

An empirical model on the dynamics of Covid-19 spread in human population

We propose a mathematical model to analyze the time evolution of the total number of infected population with Covid-19 disease at a region in the ongoing pandemic. Using the available data of Covid-19 infected population on various countries we formulate a model which can successfully track the time evolution from early days to the saturation period in a given wave of this infectious disease. It involves a set of effective parameters which can be extracted from the available data. Using those parameters the future trajectories of the disease spread can also be projected. A set of differential equations is also proposed whose solutions are these time evolution trajectories. Using such a formalism we project the future time evolution trajectories of infection spread for a number of countries where the Covid-19 infection is still rapidly rising.

Mining the Characteristics of COVID-19 Patients in China: Analysis of Social Media Posts

BACKGROUND: In December 2019, pneumonia cases of unknown origin were reported in Wuhan City, Hubei Province, China. Identified as the coronavirus disease (COVID-19), the number of cases grew rapidly by human-to-human transmission in Wuhan. Social media, especially Sina Weibo (a major Chinese microblogging social media site), has become an important platform for the public to obtain information and seek help. OBJECTIVE: This study aims to analyze the characteristics of suspected or laboratory-confirmed COVID-19 patients who asked for help on Sina Weibo. METHODS: We conducted data mining on Sina Weibo and extracted the data of 485 patients who presented with clinical symptoms and imaging descriptions of suspected or laboratory-confirmed cases of COVID-19. In total, 9878 posts seeking help on Sina Weibo from February 3 to 20, 2020 were analyzed. We used a descriptive research methodology to describe the distribution and other epidemiological characteristics of patients with suspected or laboratory-confirmed SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The distance between patients' home and the nearest designated hospital was calculated using the geographic information system ArcGIS. RESULTS: All patients included in this study who sought help on Sina Weibo lived in Wuhan, with a median age of 63.0 years (IQR 55.0-71.0). Fever (408/485, 84.12%) was the most common symptom. Ground-glass opacity (237/314, 75.48%) was the most common pattern on chest computed tomography; 39.67% (167/421) of families had suspected and/or laboratory-confirmed family members; 36.58% (154/421) of families had 1 or 2 suspected and/or laboratory-confirmed members; and 70.52% (232/329) of patients needed to rely on their relatives for help. The median time from illness onset to real-time reverse transcription-polymerase chain reaction (RT-PCR) testing was 8 days (IQR 5.0-10.0), and the median time from illness onset to online help was 10 days (IQR 6.0-12.0). Of 481 patients, 32.22% (n=155) lived more than 3 kilometers away from the nearest designated hospital. CONCLUSIONS: Our findings show that patients seeking help on Sina Weibo lived in Wuhan and most were elderly. Most patients had fever symptoms, and ground-glass opacities were noted in chest computed tomography. The onset of the disease was characterized by family clustering and most families lived far from the designated hospital. Therefore, we recommend the following: (1) the most stringent centralized medical observation measures should be taken to avoid transmission in family clusters; and (2) social media can help these patients get early attention during Wuhan's lockdown. These findings can help the government and the health department identify high-risk patients and accelerate emergency responses following public demands for help.

Mining the Characteristics of COVID-19 Patients in China: Analysis of Social Media Posts

BACKGROUND: In December 2019, pneumonia cases of unknown origin were reported in Wuhan City, Hubei Province, China. Identified as the coronavirus disease (COVID-19), the number of cases grew rapidly by human-to-human transmission in Wuhan. Social media, especially Sina Weibo (a major Chinese microblogging social media site), has become an important platform for the public to obtain information and seek help. OBJECTIVE: This study aims to analyze the characteristics of suspected or laboratory-confirmed COVID-19 patients who asked for help on Sina Weibo. METHODS: We conducted data mining on Sina Weibo and extracted the data of 485 patients who presented with clinical symptoms and imaging descriptions of suspected or laboratory-confirmed cases of COVID-19. In total, 9878 posts seeking help on Sina Weibo from February 3 to 20, 2020 were analyzed. We used a descriptive research methodology to describe the distribution and other epidemiological characteristics of patients with suspected or laboratory-confirmed SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The distance between patients' home and the nearest designated hospital was calculated using the geographic information system ArcGIS. RESULTS: All patients included in this study who sought help on Sina Weibo lived in Wuhan, with a median age of 63.0 years (IQR 55.0-71.0). Fever (408/485, 84.12%) was the most common symptom. Ground-glass opacity (237/314, 75.48%) was the most common pattern on chest computed tomography; 39.67% (167/421) of families had suspected and/or laboratory-confirmed family members; 36.58% (154/421) of families had 1 or 2 suspected and/or laboratory-confirmed members; and 70.52% (232/329) of patients needed to rely on their relatives for help. The median time from illness onset to real-time reverse transcription-polymerase chain reaction (RT-PCR) testing was 8 days (IQR 5.0-10.0), and the median time from illness onset to online help was 10 days (IQR 6.0-12.0). Of 481 patients, 32.22% (n=155) lived more than 3 kilometers away from the nearest designated hospital. CONCLUSIONS: Our findings show that patients seeking help on Sina Weibo lived in Wuhan and most were elderly. Most patients had fever symptoms, and ground-glass opacities were noted in chest computed tomography. The onset of the disease was characterized by family clustering and most families lived far from the designated hospital. Therefore, we recommend the following: (1) the most stringent centralized medical observation measures should be taken to avoid transmission in family clusters; and (2) social media can help these patients get early attention during Wuhan's lockdown. These findings can help the government and the health department identify high-risk patients and accelerate emergency responses following public demands for help.

Mining the Characteristics of COVID-19 Patients in China: Analysis of Social Media Posts

BACKGROUND: In December 2019, pneumonia cases of unknown origin were reported in Wuhan City, Hubei Province, China. Identified as the coronavirus disease (COVID-19), the number of cases grew rapidly by human-to-human transmission in Wuhan. Social media, especially Sina Weibo (a major Chinese microblogging social media site), has become an important platform for the public to obtain information and seek help. OBJECTIVE: This study aims to analyze the characteristics of suspected or laboratory-confirmed COVID-19 patients who asked for help on Sina Weibo. METHODS: We conducted data mining on Sina Weibo and extracted the data of 485 patients who presented with clinical symptoms and imaging descriptions of suspected or laboratory-confirmed cases of COVID-19. In total, 9878 posts seeking help on Sina Weibo from February 3 to 20, 2020 were analyzed. We used a descriptive research methodology to describe the distribution and other epidemiological characteristics of patients with suspected or laboratory-confirmed SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection. The distance between patients' home and the nearest designated hospital was calculated using the geographic information system ArcGIS. RESULTS: All patients included in this study who sought help on Sina Weibo lived in Wuhan, with a median age of 63.0 years (IQR 55.0-71.0). Fever (408/485, 84.12%) was the most common symptom. Ground-glass opacity (237/314, 75.48%) was the most common pattern on chest computed tomography; 39.67% (167/421) of families had suspected and/or laboratory-confirmed family members; 36.58% (154/421) of families had 1 or 2 suspected and/or laboratory-confirmed members; and 70.52% (232/329) of patients needed to rely on their relatives for help. The median time from illness onset to real-time reverse transcription-polymerase chain reaction (RT-PCR) testing was 8 days (IQR 5.0-10.0), and the median time from illness onset to online help was 10 days (IQR 6.0-12.0). Of 481 patients, 32.22% (n=155) lived more than 3 kilometers away from the nearest designated hospital. CONCLUSIONS: Our findings show that patients seeking help on Sina Weibo lived in Wuhan and most were elderly. Most patients had fever symptoms, and ground-glass opacities were noted in chest computed tomography. The onset of the disease was characterized by family clustering and most families lived far from the designated hospital. Therefore, we recommend the following: (1) the most stringent centralized medical observation measures should be taken to avoid transmission in family clusters; and (2) social media can help these patients get early attention during Wuhan's lockdown. These findings can help the government and the health department identify high-risk patients and accelerate emergency responses following public demands for help.

Neprilysin expression and functions in development, ageing and disease

Neprilysin (NEP) is an integral membrane-bound metallopeptidase with a wide spectrum of substrates and physiological functions. It plays an important role in proteolytic processes in the kidney, cardiovascular regulation, immune response, cell proliferation, foetal development etc. It is an important neuropeptidase and amyloid-degrading enzyme which makes NEP a therapeutic target in Alzheimer's disease (AD). Moreover, it plays a preventive role in development of cancer, obesity and type-2 diabetes. Recently a role of NEP in COVID-19 pathogenesis has also been suggested. Despite intensive research into NEP structure and functions in different organisms, changes in its expression and regulation during brain development and ageing, especially in age-related pathologies, is still not fully understood. This prevents development of pharmacological treatments from various diseases in which NEP is implicated although recently a dual-acting drug sacubitril-valsartan (LCZ696) combining a NEP inhibitor and angiotensin receptor blocker has been approved for treatment of heart failure. Also, various natural compounds capable of upregulating NEP expression, including green tea (EGCG), have been proposed as a preventive medicine in prostate cancer and AD. This review summarizes the existing literature and our own research on the expression and activity of NEP in normal brain development, ageing and under pathological conditions.

Construction of 5G all-wireless network and information system for cabin hospitals

The epidemic of coronavirus disease 2019 (COVID-19) broke out in Wuhan, China, in early 2020. In an effort to curb the spread of the epidemic, the government has requisitioned a variety of venues and plant buildings and built more than 20 cabin hospitals to receive patients with mild symptoms within 48 hours. Under this circumstance, we worked out a 5G all-wireless solution to divide the overall network system of the cabin hospital into multiple network units by function. While ensuring good signal coverage of the local unit, each network unit was independently connected to the host hospital's data center over a virtual private network (VPN) tunnel built on the 5G wireless network. Our successful experience with the application of this 5G + VPN all-wireless network system well points to the bright prospect of 5G wireless network. In addition, the 5G + VPN solution can also be used for multihospital network interconnection and rapid network recovery during the failure of wired network.

Gastrointestinal Coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention and management

The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019 Some authors reported evidences that patients with SARS-CoV-2 infection could have a direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common Area covered: In this article, we reviewed current published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, presumptive biological mechanism of GI infection, prognosis, clinical management and public health related concerns on the possible risk of oral-fecal transmission Expert opinion: Different clues point to a direct virus infection and replication in mucosal cells of the gastrointestinal tract In vitro studies showed that SARS-CoV-2 could enters into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme 2 membrane receptor These findings, coupled with identification of viral RNA found in stools of patients, clearly suggest that a direct involvement of gastrointestinal tract is very likely This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral fecal route for transmission, additionally or alternatively to the main respiratory route

Privacy Digital Contact Tracing May Protect Privacy, But It Is Unlikely to Stop the Pandemic

It is difficult to imagine a timelier topic for this inaugural Communications Privacy column than the privacy issues associated with COVID-19 apps Against the backdrop of protests around the world opposing racism and police killings of Black people, we have a newly found understanding of the need for protection from surveillance, while also feeling the urgency of shutting down the spread of a deadly virus While many computer scientists are looking to technology for privacy-protective ways to track COVID-19 exposure, Privacy-enhancing technologies (PETs) may prove ineffective without more widely available COVID-19 tests, human-centered design, and complementary laws and policies Digital contact tracing and exp sure notification might be ideal app cations for PETs

Leaf-consuming behavior in the big fruit-eating bat, Artibeus lituratus (Olfers, 1818) (Chiroptera: Phyllostomidae), in an urban area of Southeastern Brazil/ Comportamento do consumo de folhas no morcego frugívoro Artibeus lituratus (Olfers, 1818) (Chiroptera: Phyllostomidae) em uma área urbana do sudeste brasileiro

The feeding behavior of Artibeus lituratus on leaves of Senna macranthera in an urban area of Uberlandia, Minas Gerais, Brazil, is described, with the first record of folivory by bats on this tree species. Between April and June 1999, direct observations were conducted on the approaching behavior of the bats to bite a leaf, number of bats visiting, time and duration of visits, and intervals between visits. The visits began between 21:00 and 21:15, and finished by 00:00. Each tree was visited simultaneously by up to three bats. Visits lasted on average 8 minutes, with intervals about 20 to 25 minutes. Depending on the position of the leaves, two approaching strategies were used by the bats. Many leaves still connected to tree branches exhibited several bite marks, suggesting that the bats consumed small fragments of leaves and that a leaf could receive more than one visit. Discarded leaf pellets were found beneath a day roost, indicating the use of the liquid portion of the leaves. Aspects of foraging schedule and seasonality of leaf consumption by bats are discussed.

Preparedness and Preventive Behaviors for a Pandemic Disaster Caused by COVID-19 in Serbia

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The disease was first detected in Wuhan, the capital of China's Hubei province, in December 2019 and has since spread globally, especially to Europe and North America, resulting in the ongoing global coronavirus pandemic disaster of 2019-2020. Although most cases have mild symptoms, there is some progression to viral pneumonia and multi-organ failure and death. More than 4.6 million cases have been registered across 216 countries and territories as of 19 April 2020, resulting in more than 311,000 deaths. Risk to communities with continued widespread disease transmission depends on characteristics of the virus, including how well it spreads between people; the severity of resulting illness; and the medical or other measures available to control the impact of the virus (for example, vaccines or medications that can treat the illness) and the relative success of these. In the absence of vaccines or medications, non-pharmaceutical interventions were the most important response strategy based on community interventions such as person-to-person distancing, mask-wearing, isolation and good personal hygiene (hand-washing)-all of which have been demonstrated can reduce the impact of this seemingly unstoppable globally spreading natural disaster. This paper presents the results of quantitative research regarding the level of citizen preparedness for disasters caused by coronavirus disease (COVID-19) in Serbia. The survey was conducted using a questionnaire that was requested and then collected online among 975 respondents during disaster in April 2020. The questionnaire examined citizens' basic socio-economic and demographic characteristics, their knowledge, preparedness, risk perception and preventive measures taken individually and as a community to prevent the death and widespread transmission of novel coronavirus disease 2019 in the Republic of Serbia. Based on the findings that there are major differences in the public's perception of risks posed by communicable disease threats such as presented by COVID-19, emergency management agencies should use these differences to develop targeted strategies to enhance community and national preparedness by promoting behavioral change and improving risk management decision-making.

Arterial thrombotic complications in COVID-19 patients

The coronavirus disease 2019 (COVID-19), a viral respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been described to predispose to thrombotic disease in both the venous and arterial circulations. We report four cases of an acute arterial occlusion in COVID-19 patients and literature review on the occurrence of arterial thrombosis in patients with COVID-19. Our findings demonstrate that physicians should be vigilant for signs of thrombotic complications in both hospitalized and new COVID-19 patients.

Feline Niemann-Pick Disease With a Novel Mutation of SMPD1 Gene

A 4-month-old female mixed-breed cat showed gait disturbance and eventual dysstasia with intention tremor and died at 14 months of age. Postmortem histological analysis revealed degeneration of neuronal cells, alveolar epithelial cells, hepatocytes, and renal tubular epithelial cells. Infiltration of macrophages was observed in the nervous system and visceral organs. The cytoplasm of neuronal cells was filled with Luxol fast blue (LFB)-negative and periodic acid-Schiff (PAS)-negative granules, and the cytoplasm of macrophages was LFB-positive and PAS-negative. Ultrastructurally, concentric deposits were observed in the brain and visceral organs. Genetic and biochemical analysis revealed a nonsense mutation (c.1017G>A) in the SMPD1 gene, a decrease of SMPD1 mRNA expression, and reduced acid sphingomyelinase immunoreactivity. Therefore, this cat was diagnosed as having Niemann-Pick disease with a mutation in the SMPD1 gene, a syndrome analogous to human Niemann-Pick disease type A.

Acute respiratory distress syndrome (ARDS) caused by the novel coronavirus disease (COVID-19): a practical comprehensive literature review

INTRODUCTION: The exponential growth of SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on most health systems around the world. The complications derived from the novel coronavirus disease (COVID-19) vary due to comorbidities, sex and age, with more than 50% of the patients requiring some level of intensive care developing acute respiratory distress syndrome (ARDS). The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological, and radiological presentation as well as the current treatment strategies. AREAS COVERED: Various complications caused by SARS-CoV-2 infection have been identified, the most lethal being the acute respiratory distress syndrome, caused most likely by the presence of severe immune cell response and the concomitant alveolus inflammation. The new treatment strategies are updated, and the analysis of the physiopathology is included in this review. EXPERT OPINION: ARDS is one of the most frequent complications in patients with COVID-19. Information regarding the etiology and physiopathology are still unfolding and for the prevention and amelioration, good clinical management, adequate ventilatory support and the use of systemic corticoids seem to be the most efficient way to reduce mortality and to reduce hospital lengths.

Turning the Tide: Natural Products and Natural-Product-Inspired Chemicals as Potential Counters to SARS-CoV-2 Infection

The novel and highly pathogenic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has become a continued focus of global attention due to the serious threat it poses to public health. There are no specific drugs available to combat SARS-CoV-2 infection. Natural products (carolacton, homoharringtonine, emetine, and cepharanthine) and natural product-inspired small molecules (ivermectin, GS-5734, EIDD-2801, and ebselen) are potential anti-SARS-CoV-2 agents that have attracted significant attention due to their broad-spectrum antiviral activities. Here, we review the research on potential landmark anti-SARS-CoV-2 agents, systematically discussing the importance of natural products and natural-product-inspired small molecules in the research and development of safe and effective antiviral agents.

The psychological impact of fertility treatment suspensions during the COVID-19 pandemic

PURPOSE: To examine the psychological impact of fertility treatment suspensions resulting from the COVID-19 pandemic and to clarify psychosocial predictors of better or worse mental health. METHODS: 92 women from Canada and the United States (ages 20-45 years) whose fertility treatments had been cancelled were recruited via social media. Participants completed a battery of questionnaires assessing depressive symptoms, perceived mental health impact, and change in quality of life related to treatment suspensions. Potential predictors of psychological outcomes were also examined, including several personality traits, aspects of social support, illness cognitions, and coping strategies. RESULTS: 52% of respondents endorsed clinical levels of depressive symptoms. On a 7-point scale, participants endorsed a significant decline in overall quality of life (M(SD) = -1.3(1.3), p < .0001) as well as a significant decline in mental health related to treatment suspensions on a scale from -5 to +5 (M(SD) = -2.1(2.1), p < .001). Several psychosocial variables were found to positively influence these outcomes: lower levels of defensive pessimism (r = -.25, p < .05), greater infertility acceptance (r = .51, p < .0001), better quality social support (r = .31, p < .01), more social support seeking (r = .35, p < .001) and less avoidance of infertility reminders (r = -.23, p = .029). CONCLUSION: Fertility treatment suspensions have had a considerable negative impact on women's mental health and quality of life. However, these findings point to several protective psychosocial factors that can be fostered in the future to help women cope.

Alternative Strategies for Evaluating General Surgery Residency Applicants and an Interview Limit for MATCH 2021: An Impending Necessity

: The COVID-19 pandemic has posed unique challenges for evaluating general surgery residency applicants to MATCH 2021. In the absence of away rotations, programs are likely to afford greater importance to objective data to stratify the applicant pool and medical students are likely to experience difficulty in thoroughly assessing each program. Virtual rotations, meet-and-greet events conducted before the application submission deadline, personality testing prior to extending interviews, standardized letters of recommendation, and skills testing can serve as valuable adjuncts for determining the best applicant-program fit. Finally, an interview limit which sets the bar for the maximum number of accepted interviews per applicant per specialty can offer a level playing field in the absence of time and cost limitations associated with travel.

Optimization of the intravenous infusion workflow in the isolation ward for patients with coronavirus disease 2019

Objective: This study aimed to evaluate the effect of optimization of the intravenous infusion workflow in isolation wards for patients with coronavirus disease 2019. Methods: The infusion management group optimized the intravenous infusion workflow based on Hamer's Process Reengineering Theory and applied it to the treatment of patients with coronavirus disease 2019. The work efficiency, patients' satisfaction and economic indicators before and after optimization were compared. Results: After the infusion workflow was optimized, average times for preparation drugs and intravenous admixture, and patients' waiting time decreased from 4.84 min, 4.03 min, and 34.33 min to 3.50 min, 2.60 min, and 30.87 min, respectively, patients' satisfaction increased from 66.7% to 93.3%, and the cost of personal protective equipment (PPE) decreased from 46.67 sets and 186.6 CNY per day to 36.17 sets and 144.6 CNY, with statistical significance. Conclusion: The optimization of the intravenous infusion workflow can effectively decrease the cost of PPE while improving the efficiency of infusion and patients' satisfaction.

Population migration, confirmed COVID-19 cases, pandemic prevention, and control: evidence and experiences from China

Aim: The virulence of the novel coronavirus disease (COVID-19) has facilitated its rapid transition towards becoming a pandemic. Hence, this study aims to investigate the association between population migration and the number of confirmed COVID-19 cases in China while investigating its measures for pandemic prevention and control. Subject and methods: A susceptible-exposed-infected-recovered-dormancy (SEIRD) model for the spread of COVID-19 in China was created to theoretically simulate the relationship between the populations migrating from Wuhan and the number of confirmed cases. Data from Baidu's real-time dynamic pandemic monitoring system were elicited to empirically examine the theoretical inferences. Results: Populations migrating from Wuhan to other cities increased the initial number of latently infected cases in these cities, raising the number of confirmed cases. Hence, implementing social distancing between the susceptible and infected populations could effectively lower the number of infected cases. Using data from Baidu's real-time dynamic pandemic monitoring system, the empirical results revealed that an increase of 1000 persons migrating from Wuhan raised the number of confirmed cases by 4.82 persons. Conclusion: This study confirmed the positive association between population migration and the number of confirmed COVID-19 cases. Based on the theoretical and empirical analysis, China's pandemic prevention and control measures are discussed.

SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19

Background & Aims: Liver enzyme abnormalities are common in patients with coronavirus disease 2019 (COVID-19). Whether or not severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to liver damage per se remains unknown. Herein, we reported the clinical characteristics and liver pathological manifestations of COVID-19 patients with liver enzyme abnormalities. Methods: We analyzed 156 patients diagnosed with COVID-19 from 2 designated centers in China and compared clinical features between patients with or without elevated aminotransferases. Postmortem liver biopsies were obtained from 2 cases who had elevated aminotransferases. We investigated the patterns of liver impairment by electron microscopy, immunohistochemistry, TUNEL assay and pathological studies. Results: Sixty-four out of 156 (41.0%) patients with COVID-19 had elevated aminotransferases. The median levels of alanine aminotransferase were 50 U/L vs. 19 U/L, respectively, aspartate aminotransferase were 45.5 U/L vs. 24 U/L, respectively in abnormal and normal aminotransferase groups. Liver enzyme abnormalities were associated with disease severity, as well as a series of laboratory tests including higher alveolar-arterial oxygen partial pressure difference, higher gamma-glutamyltransferase, lower albumin, decreased CD4+ T cells and B lymphocytes. Ultrastructural examination identified typical coronavirus particles, characterized by spike structures, in the cytoplasm of hepatocytes in 2 COVID-19 cases. SARS-CoV-2-infected hepatocytes displayed conspicuous mitochondrial swelling, endoplasmic reticulum dilatation and glycogen granule decrease. Histologically, massive hepatic apoptosis and some binuclear hepatocytes were observed. Taken together, both ultrastructural and histological evidence indicated a typical lesion of viral infection. Immunohistochemical results showed scarce CD4+ and CD8+ lymphocytes. No obvious eosinophil infiltration, cholestasis, fibrin deposition, granuloma, massive central necrosis, or interface hepatitis were observed. Conclusions: SARS-CoV-2 infection in the liver directly contributes to hepatic impairment in patients with COVID-19. Hence, a surveillance of viral clearance in liver and long-term outcome of COVID-19 is required. Lay summary: Liver enzyme abnormalities are common in patients with coronavirus disease 2019 (COVID-19). We reported the clinical characteristics and liver pathological manifestations of COVID-19 patients with elevated liver enzymes. Our findings suggested that SARS-CoV-2 infection of the liver is a crucial factor contributing to hepatic impairment in patients with COVID-19.

SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19

BACKGROUND: Liver enzyme abnormality is common in patients with coronavirus disease 2019 (COVID-19). Whether or not SARS-CoV-2 infection can lead to liver damage per se remains unknown. Here we reported the clinical characteristics and liver pathological manifestations of COVID-19 patients with liver enzyme abnormality. METHODS: We received 156 patients diagnosed of COVID-19 from two designated centers in China, and compared clinical features between patients with elevated aminotransferase or not. Postmortem liver biopsies were obtained from two cases who had elevated aminotransferase. We investigated the patterns of liver impairment by electron microscopy, immunohistochemistry, TUNEL assay, and pathological studies. RESULTS: 64 of 156 (41.0%) COVID-19 patients had elevated aminotransferase. The median levels of ALT were 50 U/L vs. 19 U/L, respectively, AST were 45.5 U/L vs. 24 U/L, respectively in abnormal and normal aminotransferase groups. The liver enzyme abnormality was associated with disease severity, as well as a series of laboratory tests including higher A-aDO2, higher GGT, lower albumin, decreased CD4+ T cells and B lymphocytes. Ultrastructural examination identified typical coronavirus particles characterized by spike structure in cytoplasm of hepatocytes in two COVID-19 cases. SARS-CoV-2 infected hepatocytes displayed conspicuous mitochondrial swelling, endoplasmic reticulum dilatation, and glycogen granule decrease. Histologically, massive hepatic apoptosis and a certain binuclear hepatocytes were observed. Taken together, both ultrastructural and histological evidence indicated a typical lesion of viral infection. Immunohistochemical results showed scanty CD4+ and CD8+ lymphocytes. No obvious eosinophil infiltration, cholestasis, fibrin deposition, granuloma, massive central necrosis, or interface hepatitis were observed. CONCLUSIONS: SARS-CoV-2 infection in liver is a crucial cause of hepatic impairment in COVID-19 patients. Hence, a surveillance of viral clearance in liver and long outcome of COVID-19 is required.

Tracing Weibo (2009–2019): The commercial dissolution of public communication and changing politics

This paper delineates the historical evolution of Weibo as a social media platform (2009–2019). Rather than focusing on individual case event, we showcase how Weibo is enveloped by and also mutually shapes the push-and-pull forces of the platform’s commodification, political control and the Chinese internet ecology writ large. We argue that under these three forces, Weibo transformed from an online space for public discussions to a platform for marketing and advertising, and entertainment uses.

Tracheostomy During the COVID-19 Pandemic: Comparison of International Perioperative Care Protocols and Practices in 26 Countries

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has led to a global surge in critically ill patients requiring invasive mechanical ventilation, some of whom may benefit from tracheostomy. Decisions on if, when, and how to perform tracheostomy in patients with COVID-19 have major implications for patients, clinicians, and hospitals. We investigated the tracheostomy protocols and practices that institutions around the world have put into place in response to the COVID-19 pandemic. DATA SOURCES: Protocols for tracheostomy in patients with severe acute respiratory syndrome coronavirus 2 infection from individual institutions (n = 59) were obtained from the United States and 25 other countries, including data from several low- and middle-income countries, 23 published or society-endorsed protocols, and 36 institutional protocols. REVIEW METHODS: The comparative document analysis involved cross-sectional review of institutional protocols and practices. Data sources were analyzed for timing of tracheostomy, contraindications, preoperative testing, personal protective equipment (PPE), surgical technique, and postoperative management. CONCLUSIONS: Timing of tracheostomy varied from 3 to >21 days, with over 90% of protocols recommending 14 days of intubation prior to tracheostomy. Most protocols advocate delaying tracheostomy until COVID-19 testing was negative. All protocols involved use of N95 or higher PPE. Both open and percutaneous techniques were reported. Timing of tracheostomy changes ranged from 5 to >30 days postoperatively, sometimes contingent on negative COVID-19 test results. IMPLICATIONS FOR PRACTICE: Wide variation exists in tracheostomy protocols, reflecting geographical variation, different resource constraints, and limited data to drive evidence-based care standards. Findings presented herein may provide reference points and a framework for evolving care standards.

Health-care workers with COVID-19 living in Mexico City: clinical characterization and related outcomes

BACKGROUND: Health-care workers (HCWs) could be at increased occupational risk for SARS-CoV-2 infection. Information regarding prevalence and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence of SARS-CoV-2, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. METHODS: We explored data collected by the National Epidemiological Surveillance System in Mexico City. All cases underwent real-time RT-PCR test. We explored outcomes related to severe COVID-19 in HCWs and the diagnostic performance of symptoms to detect SARS-CoV-2 infection in HCWs. RESULTS: As of July 5 th, 2020, 35,095 HCWs were tested for SARS-CoV-2 and 11,226 were confirmed (31.9%). Overall, 4,322 were nurses (38.5%), 3,324 physicians (29.6%), 131 dentists (1.16%) and 3,449 laboratory personnel and other HCWs (30.8%). After follow-up, 1,009 HCWs required hospitalization (9.00%), 203 developed severe outcomes (1.81%), and 93 required mechanical-ventilatory support (0.82%). Lethality was recorded in 226 (2.01%) cases. Symptoms associated with SARS-CoV-2 positivity were fever, cough, malaise, shivering, myalgias at evaluation but neither had significant predictive value. We also identified 341 asymptomatic SARS-CoV-2 infections (3.04%). Older HCWs with chronic non-communicable diseases, pregnancy, and severe respiratory symptoms were associated with higher risk for adverse outcomes. Physicians had higher risk for hospitalization and for severe outcomes compared with nurses and other HCWs. CONCLUSIONS: We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. No symptomatology can accurately discern HCWs with SARS-CoV-2 infection. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes and reduce infection risk.

Warp Speed for COVID-19 Vaccines: Why are Children Stuck in Neutral?

While adult clinical trials of COVID-19 vaccines have moved quickly into Phase 3 clinical trials, clinical trials have not started in children in the US. The direct COVID-19 impact upon children is greater than that observed for a number of other pathogens for which we now have effective pediatric vaccines. Additionally, the role of children in SARS-CoV-2 transmission has clearly been underappreciated. Carefully conducted Phase II clinical trials can adequately address potential COVID-19 vaccine safety concerns. Delaying Phase II vaccine clinical trials in children will delay our recovery from COVID-19 and unnecessarily prolong its impact upon children's education, health and emotional well-being, and equitable access to opportunities for development and social success. Given the potential direct and indirect benefits of pediatric vaccination, implementation of Phase II clinical trials for COVID-19 vaccines should begin now.

Dependence of new environmental nano organic semiconductor nickel-(II)-tetraphenyl-21H,23H-porphyrin films on substrate type for energy storage applications

Characterization of organic nickel-(II)-tetraphenyl-21H,23H-porphyrin films as a function of substrate type was performed for energy storage applications and consequently environmental enhancement. Nickel-(II)-tetraphenyl-21H,23H-porphyrin films show an amorphous phase. They have a crystallite size of 8-11 nm. Strain caused a shift of different humps' positions. The measured transmittance has high values within the range of 85-91%, and the absorption coefficient values were included within the high-absorption region. Both optical gap and fundamental gap, refractive index, carrier-concentration-to-effective-mass ratio and lattice dielectric constant were calculated, and they were found to be increased, except refractive index and lattice dielectric constant. The obtained data indicated that nickel-(II)-tetraphenyl-21H,23H-porphyrin films are a candidate for energy storage applications.

Quarantine decision due to coronavirus pandemic

These days the world is facing Coronavirus disease (COVID-19) pandemic. More or less, governments decide to quarantine some of the cities. However, it would be a hard decision to decide which cities should be on the list of quarantine due to the social, psychological and financial costs. This short letter is proposing a systematic methodology to solve this decision making challenge in public health administration.

Sparse HP Filter: Finding Kinks in the COVID-19 Contact Rate

In this paper, we estimate the time-varying COVID-19 contact rate of a Susceptible-Infected-Recovered (SIR) model. Our measurement of the contact rate is constructed using data on actively infected, recovered and deceased cases. We propose a new trend filtering method that is a variant of the Hodrick-Prescott (HP) filter, constrained by the number of possible kinks. We term it the $\textit{sparse HP filter}$ and apply it to daily data from five countries: Canada, China, South Korea, the UK and the US. Our new method yields the kinks that are well aligned with actual events in each country. We find that the sparse HP filter provides a fewer kinks than the $\ell_1$ trend filter, while both methods fitting data equally well. Theoretically, we establish risk consistency of both the sparse HP and $\ell_1$ trend filters. Ultimately, we propose to use time-varying $\textit{contact growth rates}$ to document and monitor outbreaks of COVID-19.

Sparse HP filter: Finding kinks in the COVID-19 contact rate

In this paper, we estimate the time-varying COVID-19 contact rate of a Susceptible-Infected-Recovered (SIR) model. Our measurement of the contact rate is constructed using data on actively infected, recovered and deceased cases. We propose a new trend filtering method that is a variant of the Hodrick-Prescott (HP) filter, constrained by the number of possible kinks. We term it the sparse HP filter and apply it to daily data from five countries: Canada, China, South Korea, the UK and the US. Our new method yields the kinks that are well aligned with actual events in each country. We find that the sparse HP filter provides a fewer kinks than the ℓ 1 trend filter, while both methods fitting data equally well. Theoretically, we establish risk consistency of both the sparse HP and ℓ 1 trend filters. Ultimately, we propose to use time-varying contact growth rates to document and monitor outbreaks of COVID-19.

Synthetic cannabinoids induce acute lung inflammation via cannabinoid receptor 1 activation

Synthetic cannabinoids (SCs) induce a pro-inflammatory condition by activating cannabinoid receptor 1 (CB1R) in the lungs of mice, which raises a potential therapeutic use of CB1R antagonists in SC-induced lung disease resulting in hospitalisation https://bit.ly/31bWw4Q.

Institution of a Novel Process for N95 Respirator Disinfection with Vaporized Hydrogen Peroxide in the Setting of the COVID-19 Pandemic at a Large Academic Medical Center

Personal protective equipment (PPE) has been an invaluable yet limited resource when it comes to protecting healthcare workers against infection during the 2019 coronavirus (COVID-19) pandemic. In the US, N95 respirator supply chains are severely strained and conservation strategies are needed. A multidisciplinary team at the Washington University School of Medicine, Barnes Jewish Hospital, and BJC Healthcare was formed to implement a program to disinfect N95 respirators. The process described extends the life of N95 respirators using vaporized hydrogen peroxide (VHP) disinfection and allows healthcare workers to retain their own N95 respirator across a large metropolitan healthcare system.

Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft）

Autopsy is of great significance to the elucidation of the pathological changes, pathogenesis and cause of death of corona virus disease 2019 （COVID-19） and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak Based on related laws and regulations, such as Law of the People's Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） has been developed This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff

Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft

Abstract: Autopsy is of great significance to the elucidation of the pathological changes, pathogeneses and causes of death of corona virus disease 2019 （COVID-19） and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak. Based on related laws and regulations, such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） has been developed. This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on. This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff.

Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft）

Autopsy is of great significance to the elucidation of the pathological changes, pathogenesis and cause of death of corona virus disease 2019 （COVID-19） and can provide theoretical basis for more scientific and accurate prevention and control of the outbreak Based on related laws and regulations, such as Law of the People's Republic of China on Prevention and Control of Infectious Diseases, the clinical manifestations and epidemiological characteristics of COVID-19, and the related guidelines on the prevention and control of the outbreak, combined with the practical work of forensic pathology examination, the Guide to the Forensic Pathology Practice on Death Cases Related to Corona Virus Disease 2019 （COVID-19） （Trial Draft） has been developed This guide includes information on the background investigation of the cases, autopsy room requirements, personal prevention and protections, external examinations, autopsy, auxiliary examinations, and so on This guide can be used as a reference by forensic and pathological examination institutions, as well as examination staff

Nosocomial COVID-19 infection: examining the risk of mortality. The COPE-Nosocomial Study (COVID in Older PEople)

BACKGROUND: Hospital admissions for non-coronavirus disease 2019 (COVID-19) pathology have decreased significantly. It is believed that this may be due to public anxiety about acquiring COVID-19 infection in hospital and the subsequent risk of mortality. AIM: To identify patients who acquire COVID-19 in hospital (nosocomial COVID-19 infection (NC)) and their risk of mortality compared to those with community-acquired COVID-19 (CAC) infection. METHODS: The COPE-Nosocomial Study was an observational cohort study. The primary outcome was the time to all-cause mortality (estimated with an adjusted hazard ratio (aHR)), and secondary outcomes were day 7 mortality and the time-to-discharge. A mixed-effects multivariable Cox's proportional hazards model was used, adjusted for demographics and comorbidities. FINDINGS: The study included 1564 patients from 10 hospital sites throughout the UK, and one in Italy, and collected outcomes on patients admitted up to April 28th, 2020. In all, 12.5% of COVID-19 infections were acquired in hospital; 425 (27.2%) patients with COVID died. The median survival time in NC patients was 14 days compared with 10 days in CAC patients. In the primary analysis, NC infection was associated with lower mortality rate (aHR: 0.71; 95% confidence interval (CI): 0.51-0.98). Secondary outcomes found no difference in day 7 mortality (adjusted odds ratio: 0.79; 95% CI: 0.47-1.31), but NC patients required longer time in hospital during convalescence (aHR: 0.49, 95% CI: 0.37-0.66). CONCLUSION: The minority of COVID-19 cases were the result of NC transmission. No COVID-19 infection comes without risk, but patients with NC had a lower risk of mortality compared to CAC infection; however, caution should be taken when interpreting this finding.

Face masks and respirators in the fight against the COVID-19 pandemic: An overview of the standards and testing methods

The COVID-19 outbreak has resulted in a shortage of personal protective equipment (PPE) throughout the world. This shortage has resulted in an increase in production of PPE to meet the demand, and as a result, several substandard equipment has entered the market. With face masks and respirators now beginning to see widespread use throughout the world, the standards and test with which they are required to undertake have become points of interest. The filtration efficiency of the masks is a key testing element that examines its ability to filter particles, bacteria and viruses; this examines the penetration efficiency percentage of each with lower results being preferable. Masks are also subjected to NaCl testing method, which allows a range of particle sizes to be examined and their penetration to be observed. The masks must also show considerable resistance to fluids and flames, to prevent the penetration of liquids and to be non-flammable. Various PPE testing protocols such as biological, chemical, fluid and flame resistances, protective ensemble, facepiece fit testing, NIOSH NaCl method and impact protection have been discussed. In addition, various tests involving bacterial and viral filtration efficiencies are also discussed. Differential pressure is examined to ascertain the comfort, airflow and breathability of the masks, whilst fit testing is examined to ensure a correct fit of the mask.

Automatic COVID-19 Lung Infected Region Segmentation and Measurement Using CT-Scans Images

History shows that the infectious disease (COVID-19) can stun the world quickly, causing massive losses to health, resulting in a profound impact on the lives of billions of people, from both a safety and an economic perspective, for controlling the COVID-19 pandemic. The best strategy is to provide early intervention to stop the spread of the disease. In general, Computer Tomography (CT) is used to detect tumors in pneumonia, lungs, tuberculosis, emphysema, or other pleura (the membrane covering the lungs) diseases. Disadvantages of CT imaging system are: inferior soft tissue contrast compared to MRI as it is X-ray-based Radiation exposure. Lung CT image segmentation is a necessary initial step for lung image analysis. The main challenges of segmentation algorithms exaggerated due to intensity in-homogeneity, presence of artifacts, and closeness in the gray level of different soft tissue. The goal of this paper is to design and evaluate an automatic tool for automatic COVID-19 Lung Infection segmentation and measurement using chest CT images. The extensive computer simulations show better efficiency and flexibility of this end-to-end learning approach on CT image segmentation with image enhancement comparing to the state of the art segmentation approaches, namely GraphCut, Medical Image Segmentation (MIS), and Watershed. Experiments performed on COVID-CT-Dataset containing (275) CT scans that are positive for COVID-19 and new data acquired from the EL-BAYANE center for Radiology and Medical Imaging. The means of statistical measures obtained using the accuracy, sensitivity, F-measure, precision, MCC, Dice, Jacquard, and specificity are 0.98 , 0.73 , 0.71 , 0.73 , 0.71 , 0.71 , 0.57 , 0.99 respectively; which is better than methods mentioned above. The achieved results prove that the proposed approach is more robust, accurate, and straightforward.