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Potential Application of Whole Body Vibration Exercise For Improving The Clinical Conditions of COVID-19 Infected Individuals: A Narrative Review From the World Association of Vibration Exercise Experts (WAVex) Panel

COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.

SARS-CoV-2 antibody signatures robustly predict diverse antiviral functions relevant for convalescent plasma therapy

Convalescent plasma has emerged as a promising COVID-19 treatment However, the humoral factors that contribute to efficacy are poorly understood This study functionally and phenotypically profiled plasma from eligible convalescent donors In addition to viral neutralization, convalescent plasma contained antibodies capable of mediating such Fc-dependent functions as complement activation, phagocytosis and antibody-dependent cellular cytotoxicity against SARS-CoV-2 These activities expand the antiviral functions associated with convalescent plasma and together with neutralization efficacy, could be accurately and robustly from antibody phenotypes These results suggest that high-throughput profiling could be used to screen donors and plasma may provide benefits beyond neutralization

Reduction of Coronavirus Burden With Mass Azithromycin Distribution

We evaluated the potential antiviral effects of azithromycin on the nasopharyngeal virome of Nigerien children who had received multiple rounds of mass drug administration. We found that the respiratory burden of non-severe acute respiratory syndrome coronaviruses was decreased with azithromycin distributions. Clinical Trials Registration. NCT02047981.

Erratum: Strategies to deal with the COVID-19 pandemic. Braz Oral Res. 2020;34:e068

[This corrects the article doi: 10.1590/1807-3107bor-2020.vol34.0068].

Drug re-purposing from SARS-CoV led the identification of potential candidate drug target and alternate drug molecules against SARS-CoV-2

Background: SARS-CoV-2 causes COVID19 disease where there are no suitable drugs available. Objective: The objective of the work is to repurpose the drugs prescribed for SARS-CoV as the drugs for the control of SARS-CoV-2. Methods: In this work, we have used homology searches and docking methods for understanding the mechanism of the drugs prescribed for the control of SARS-CoV on SARS-CoV-2. Results: In our analysis, we found that the drugs Benzyl (2-Oxopropyl)carbamate, 2-[(2,4-Dichloro-5-methyl phenyl)sulfonyl]-1,3-dinitro-5-(trifluoromethyl)benzene, S-[5-(Trifluoromethyl)-4H-1,2,4-triazol-3-YL] 5-(phenylethynyl)furan-2-carbothioate, 4-(Dimethylamino)benzoic acid, which are capable of inhibition of the activity of 3CL Proand prevent the progression of SARS-CoV. Conclusion: In this letter, we describe the findings of the protein ligand interactions between 3CL Proof SARS-CoV, SARS-CoV-2 with Benzyl (2-oxopropyl) carbamate.

Endothelial cell contributions to COVID-19

Understanding of the clinical, histological and molecular features of the novel coronavirus 2019 (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)) has remained elusive Coronavirus disease 2019 (COVID-19) caused by this virus has unusual clinical presentation with regard to other related coronaviruses Recent reports suggest that SARS-CoV-2, unlike other related viruses, infects and replicates within endothelial cells, which may explain a significant portion of the observed clinical pathology Likewise, mounting evidence associates vascular and endothelial cell dysfunction with increased mortality This review focuses on understanding how endothelial cell pathology is caused by SARS-CoV-2 at the molecular and cellular levels and how these events relate to COVID-19 A detailed examination of current knowledge regarding canonical inflammatory reaction pathways as well as alteration of endothelial cell-derived exosomes and transdifferentiation by SARS-CoV-2 is included in this assessment Additionally, given an understanding of endothelial contributions to COVID-19, potential therapeutic aims are discussed, particularly as would affect endothelial function and pathology

Endothelial Cell Contributions to COVID-19

Understanding of the clinical, histological and molecular features of the novel coronavirus 2019 (Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)) has remained elusive Coronavirus disease 2019 (COVID-19) caused by this virus has unusual clinical presentation with regard to other related coronaviruses Recent reports suggest that SARS-CoV-2, unlike other related viruses, infects and replicates within endothelial cells, which may explain a significant portion of the observed clinical pathology Likewise, mounting evidence associates vascular and endothelial cell dysfunction with increased mortality This review focuses on understanding how endothelial cell pathology is caused by SARS-CoV-2 at the molecular and cellular levels and how these events relate to COVID-19 A detailed examination of current knowledge regarding canonical inflammatory reaction pathways as well as alteration of endothelial cell-derived exosomes and transdifferentiation by SARS-CoV-2 is included in this assessment Additionally, given an understanding of endothelial contributions to COVID-19, potential therapeutic aims are discussed, particularly as would affect endothelial function and pathology

Discovering associations in COVID-19 related research papers

A COVID-19 pandemic has already proven itself to be a global challenge. It proves how vulnerable humanity can be. It has also mobilized researchers from different sciences and different countries in the search for a way to fight this potentially fatal disease. In line with this, our study analyses the abstracts of papers related to COVID-19 and coronavirus-related-research using association rule text mining in order to find the most interestingness words, on the one hand, and relationships between them on the other. Then, a method, called information cartography, was applied for extracting structured knowledge from a huge amount of association rules. On the basis of these methods, the purpose of our study was to show how researchers have responded in similar epidemic/pandemic situations throughout history.

Effectiveness of laptop-based versus smartphone-based videoconferencing interaction on loneliness, depression and social support in nursing home residents: A secondary data analysis

INTRODUCTION: The worldwide coronavirus disease 2019 pandemic re-emphasises the importance of Internet videoconferencing in supporting interactions between nursing home residents and their family and friends. However, there is a scarcity of comparative studies on how modalities of conferencing programs impact health outcomes. The purpose of this study was to compare laptop-based with smartphone-based videoconferencing programs on nursing home residents' perceptions of loneliness, depressive symptoms and social support. METHODS: This retrospective secondary analysis used data from two previous studies on the effectiveness of videoconferencing programs (laptop-based and smartphone-based) to improve outcomes of loneliness, depressive symptoms and social support (type and source) among nursing home residents. Generalised estimating equations compared differences from baseline measures with measures at 1 and 3 months between the two groups with and without adjusting for the effects of confounding variables. RESULTS: With the exception of age, there were no differences in demographics between participants in the laptop and smartphone groups. Neither changes from baseline in mean scores for loneliness nor depressive symptoms differed between groups. However, changes in mean scores from baseline between groups were significantly greater in the smartphone-based group compared with the laptop-based group for three types of social support: informational and appraisal at 1 and 3 months; and emotional at 3 months. Changes from baseline in mean scores for social support from friends (at 1 and 3 months) and other sources (at 3 months) were also significantly greater for the smartphone group compared with the laptop group. DISCUSSION: The two modalities of videoconferencing did not differ in effects on depressive symptoms or loneliness. However, smartphones had a greater effect on the type and source of social support compared with laptops. Whether the small screen of a smartphone reduces users' anxiety and allows them to talk more on screen is worth studying.

Effectiveness of laptop-based versus smartphone-based videoconferencing interaction on loneliness, depression and social support in nursing home residents: A secondary data analysis

INTRODUCTION: The worldwide coronavirus disease 2019 pandemic re-emphasises the importance of Internet videoconferencing in supporting interactions between nursing home residents and their family and friends. However, there is a scarcity of comparative studies on how modalities of conferencing programs impact health outcomes. The purpose of this study was to compare laptop-based with smartphone-based videoconferencing programs on nursing home residents' perceptions of loneliness, depressive symptoms and social support. METHODS: This retrospective secondary analysis used data from two previous studies on the effectiveness of videoconferencing programs (laptop-based and smartphone-based) to improve outcomes of loneliness, depressive symptoms and social support (type and source) among nursing home residents. Generalised estimating equations compared differences from baseline measures with measures at 1 and 3 months between the two groups with and without adjusting for the effects of confounding variables. RESULTS: With the exception of age, there were no differences in demographics between participants in the laptop and smartphone groups. Neither changes from baseline in mean scores for loneliness nor depressive symptoms differed between groups. However, changes in mean scores from baseline between groups were significantly greater in the smartphone-based group compared with the laptop-based group for three types of social support: informational and appraisal at 1 and 3 months; and emotional at 3 months. Changes from baseline in mean scores for social support from friends (at 1 and 3 months) and other sources (at 3 months) were also significantly greater for the smartphone group compared with the laptop group. DISCUSSION: The two modalities of videoconferencing did not differ in effects on depressive symptoms or loneliness. However, smartphones had a greater effect on the type and source of social support compared with laptops. Whether the small screen of a smartphone reduces users' anxiety and allows them to talk more on screen is worth studying.

COVID-19 and Cancer: A Clear Change Not Only in Daily Clinical Practice But Also in Clinical Research Management

the outbreak of the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) pandemic has literally engulfed the health systems of many countries around the world. Particular attention was paid to the possible relationship between cancer and coronavirus disease-19 (COVID-19) and to the fact that cancer patients are more susceptible to SARS-CoV-2 infection than the general population1-4 ; however this increase ranged from 0.4%1 to 2%3 in cancer patients, again compared to the general population. This article is protected by copyright. All rights reserved.

Covid-19 (Sars-Cov-2 Infection) Information for Patients with Predialytic Chronic Kidney Disease

Patients with Chronic Kidney Disease are among those individuals at increased risk for developing more serious forms of Covid-19. This increased risk starts in the pre-dialysis phase of the disease. Providing useful information for these patients, in language that facilitates the understanding of the disease, can help nephrologists and other healthcare professionals to establish a more effective communication with these patients and help minimize contagion and the risks of serious illness in this population.

Herbal medicine for treatment of children diagnosed with COVID-19: A review of guidelines

This review aimed to summarize and analyze the pattern identification (PI), herbal formulae, and composition of herbs provided by recent guidelines for the treatment of pediatric COVID-19. Seven data sources were reviewed until March 25, 2020. We analyzed the herbal formulae included in the guidelines and performed a network analysis to identify the frequency of herbs recommended in the herbal formulae. All 3 guidelines were provincial guidelines from China. Our results showed that there were 4 stages, 12 PIs, and 13 herbal formulae recommended by the provincial guidelines. These herbal formulae included a total of 56 herbs. Based on our network analysis, Scutellariae Radix was paired with Artemisiae Annuae Herba in one cluster. In another cluster, Armeniacae Semen was paired with Coicis Semen and Ephedrae Herba was paired with Gypsum Fibrosum. This review serves as a reference for the use of traditional medicine in the treatment of pediatric COVID-19.

On Neighbourhood Zagreb index of product graphs

There is powerful relation between the chemical behaviour of chemical compounds and their molecular structures. Topological indices defined on these chemical molecular structures are capable to predict physical properties, chemical reactivity and biological activity. In this article, a new topological index named as Neighbourhood Zagreb index $(M_N)$ is presented. Here the chemical importance of this newly introduced index is studied and some explicit results for this index of different product graphs such as Cartesian, Tensor and Wreath product is derived. Some of these results are applied to obtain the Neighbourhood Zagreb index of several chemically important graphs and nano-structures.

Proximal tubular-targeted overexpression of the Cyp4a12-20-HETE synthase promotes salt-sensitive hypertension in male mice

20-Hydroxyeicosatetraenoic acid (20-HETE) has been linked to blood pressure (BP) regulation via actions on the renal microvasculature and tubules. We assessed tubular 20-HETE contribution to hypertension by generating transgenic mice overexpressing the CYP4A12-20-HETE synthase (PT-4a12 mice) under the control of the proximal tubule (PT)-specific promoter, phosphoenolpyruvate carboxykinase (PEPCK). 20-HETE levels in the kidney cortex of male (967±210 vs. 249±69 pg/mg protein), but not female (121±15 vs. 92±11 pg/mg protein) PT-4a12 mice, showed a 2.5-fold increase compared to WT. Renal cortical Cyp4a12 mRNA and CYP4A12 protein in male, but not female PT-4a12 mice increased by 2-3-fold compared to WT. Male PT-4a12 mice displayed elevated BP (142±1 vs. 111±4 mmHg, p<0.0001), whereas BP in females PT-4a12 mice was not significantly different from WT (118±2 vs. 117±2 mmHg; p=0.98). In male PT-4a12 mice, BP decreased when transitioned from a control salt (0.4%) to a low-salt diet (0.075%) from 135±4 to 120±6 mmHg (p<0.01) and increased to 153±5 mmHg (p<0.05) when placed on a high-salt diet (4%). Female PT-4a12 mice did not show changes in BP on either low- or high-salt diet. In conclusion, the expression of Cyp4a12 driven by the PEPCK promoter is sex-specific probably due to its X-linkage. The salt-sensitive hypertension seen in PT-4a12 male mice suggests a potential anti-natriuretic activity of 20-HETE that needs to be further explored.

Antibiotic treatment for COVID-19 complications could fuel resistant bacteria

In her regular job, Priya Nori runs Montefiore Medical Center’s antibiotic stewardship program, and spends most of her time ensuring that the Bronx-based hospital doesn’t overuse the drugs and allow bacteria resistant to them to thrive But like many physicians, Nori is now spending all of her time helping treat COVID-19 patients at her New York City hospital, which like other medical centers in the pandemic hot spot, is crowded with 50% more patients than normal As part of that care, she and other doctors are administering many more antibiotics than normal, which is a recipe for the rapid rise or spread of resistant bacteria, especially given the crowded conditions

Immuno-epidemiology and pathophysiology of coronavirus disease 2019 (COVID-19)

Occasional zoonotic viral attacks on immunologically naive populations result in massive death tolls that are capable of threatening human survival. Currently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infectious agent that causes coronavirus disease (COVID-19), has spread from its epicenter in Wuhan China to all parts of the globe. Real-time mapping of new infections across the globe has revealed that variable transmission patterns and pathogenicity are associated with differences in SARS-CoV-2 lineages, clades, and strains. Thus, we reviewed how changes in the SARS-CoV-2 genome and its structural architecture affect viral replication, immune evasion, and transmission within different human populations. We also looked at which immune dominant regions of SARS-CoV-2 and other coronaviruses are recognized by Major Histocompatibility Complex (MHC)/Human Leukocyte Antigens (HLA) genes and how this could impact on subsequent disease pathogenesis. Efforts were also placed on understanding immunological changes that occur when exposed individuals either remain asymptomatic or fail to control the virus and later develop systemic complications. Published autopsy studies that reveal alterations in the lung immune microenvironment, morphological, and pathological changes are also explored within the context of the review. Understanding the true correlates of protection and determining how constant virus evolution impacts on host-pathogen interactions could help identify which populations are at high risk and later inform future vaccine and therapeutic interventions.

Repercussions of the COVID-19 pandemic on the well-being and training of medical clerks: a pan-Canadian survey

BACKGROUND: The COVID-19 pandemic has been an unprecedented and potentially stressful event that inserted itself into the 2019-2020 Canadian medical curriculum. However, its impact on stress and subsequent professional pathways is not well understood. This study aims to assess the impact of the COVID-19 pandemic on the mental well-being, training, and career choices of Canadian medical clerks within the first three months of the pandemic. It also aims to assess their use of university support systems and their appreciation of potential solutions to common academic stressors. METHODS: An electronic survey composed of four sections: demographics, stressors experienced during the pandemic, World Health Organization (WHO) well-being index, and stress management and resources was distributed to Canadian clerks. RESULTS: Clerks from 10 of the 17 Canadian medical faculties participated in this study (n = 627). Forty-five percent of clerks reported higher levels of stress than usual; 22% reconsidered their residency choice; and 19% reconsidered medicine as a career. The factors that were most stressful among clerks were: the means of return to rotations; decreased opportunities to be productive in view of residency match; and taking the national licensing exam after the beginning of residency. The mean WHO well-being index was 14.8/25 ± 4.5, indicating a poor level of well-being among a considerable proportion of students. Clerks who reconsidered their residency choice or medicine as a career had lower mean WHO well-being indices. Most clerks agreed with the following suggested solutions: training sessions on the clinical management of COVID-19 cases; being allowed to submit fewer reference letters when applying to residency; and having protected time to study for their licensing exam during residency. Overall, clerks were less concerned with being infected during their rotations than with the impact of the pandemic on their future career and residency match. CONCLUSION: The COVID-19 pandemic had a considerable impact on the medical curriculum and well-being of clerks. A number of student-identified solutions were proposed to reduce stress. The implementation of these solutions throughout the Canadian medical training system should be considered.

The landscape of disinformation on health crisis communication during the COVID-19 pandemic in Ukraine: hybrid warfare tactics, fake media news and review of evidence

The COVID-19 pandemic has impacted the world in ways not seen since the 1918-1920 Spanish Flu Disinformation campaigns targeting health crisis communication during this pandemic seek to cripple the medical response to the novel coronavirus and instrumentalize the pandemic for political purposes Propaganda from Russia and other factions is increasingly infiltrating public and social media in Ukraine Still, scientific literature has only a limited amount of evidence of hybrid attacks and disinformation campaigns focusing on COVID-19 in Ukraine We conducted a review to retrospectively examine reports of disinformation surrounding health crisis communication in Ukraine during the COVID-19 response Based on the themes that emerged in the literature, our recommendations are twofold: 1) increase transparency with verified health crisis messaging and, 2) address the leadership gap in reliable regional information about COVID-19 resources and support in Ukraine

Impact of Social Determinants of Health on the Emerging COVID-19 Pandemic in the United States

A novel coronavirus (2019-nCoV) caused a global pandemic in the months following the first four cases reported in Wuhan, China, on December 29, 2019 The elderly, immunocompromised, and those with preexisting conditions-such as asthma, cardiovascular disease (CVD), hypertension, chronic kidney disease (CKD), or obesity-experience higher risk of becoming severely ill if infected with the virus Systemic social inequality and discrepancies in socioeconomic status (SES) contribute to higher incidence of asthma, CVD, hypertension, CKD, and obesity in segments of the general population Such preexisting conditions bring heightened risk of complications for individuals who contract the coronavirus disease (COVID-19) from the virus (2019-nCoV)-also known as "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) In order to help vulnerable groups during times of a health emergency, focus must be placed at the root of the problem Studying the social determinants of health (SDOH), and how they impact disadvantaged populations during times of crisis, will help governments to better manage health emergencies so that every individual has equal opportunity to staying healthy This review summarizes the impact of social determinants of health (SDOH) during the COVID-19 pandemic

Porcine Epidemic Diarrhea Virus (PEDV) ORF3 Enhances Viral Proliferation by Inhibiting Apoptosis of Infected Cells

The genomes of coronaviruses carry accessory genes known to be associated with viral virulence. The single accessory gene of porcine epidemic diarrhea virus (PEDV), ORF3, is dispensable for virus replication in vitro, while viral mutants carrying ORF3 truncations exhibit an attenuated phenotype of which the underlying mechanism is unknown. Here, we studied the effect of ORF3 deletion on the proliferation of PEDV in Vero cells. To this end, four recombinant porcine epidemic diarrhea viruses (PEDVs) were rescued using targeted RNA recombination, three carrying the full-length ORF3 gene from different PEDV strains, and one from which the ORF3 gene had been deleted entirely. Our results showed that PEDVs with intact or naturally truncated ORF3 replicated to significantly higher titers than PEDV without an ORF3. Further characterization revealed that the extent of apoptosis induced by PEDV infection was significantly lower with the viruses carrying an intact or C-terminally truncated ORF3 than with the virus lacking ORF3, indicating that the ORF3 protein as well as its truncated form interfered with the apoptosis process. Collectively, we conclude that PEDV ORF3 protein promotes virus proliferation by inhibiting cell apoptosis caused by virus infection. Our findings provide important insight into the role of ORF3 protein in the pathogenicity of PEDV.

Personality Heterogeneity in Adolescents With Disruptive Behavior Disorders1

We first confirmed adolescents diagnosed with disruptive behavior disorders (oppositional defiant, conduct disorder; n = 158) had lower constraint and higher negative emotionality, and greater psychiatric comorbidity and psychosocial dysfunction, relative to adolescents without (n = 755), in a population-based sample enriched for externalizing psychopathology (mean age = 17.90 years; 52% female). We then explored whether different personality types, defined by patterns of personality identified via latent profile analysis, were differently associated with clinical features in adolescents with a disruptive behavior disorder diagnosis. Four distinct personality types ("disinhibited," "high distress," "low distress," "positive") were meaningfully different from one another. Results highlight personality heterogeneity as a means of identifying individuals at greatest risk for the most deleterious forms of externalizing psychopathology.

Synthetic generation of DSC-MRI-derived relative CBV maps from DCE MRI of brain tumors

PURPOSE: Perfusion MRI with gadolinium-based contrast agents is useful for diagnosis and treatment response evaluation of brain tumors. Dynamic susceptibility contrast (DSC) MRI and dynamic contrast enhanced (DCE) MRI are two gadolinium-based contrast agent perfusion imaging techniques that provide complementary information about the tumor vasculature. However, each requires a separate administration of a gadolinium-based contrast agent. The purpose of this retrospective study was to determine the feasibility of synthesizing relative cerebral blood volume (rCBV) maps, as computed from DSC MRI, from DCE MRI of brain tumors. METHODS: One hundred nine brain-tumor patients underwent both DCE and DSC MRI. Relative CBV maps were computed from the DSC MRI, and blood plasma volume fraction maps were computed from the DCE MRIs. Conditional generative adversarial networks were developed to synthesize rCBV maps from the DCE MRIs. Tumor-to-white matter ratios were calculated from real rCBV, synthetic rCBV, and plasma volume fraction maps and compared using correlation analysis. Real and synthetic rCBV in white and gray matter regions were also compared. RESULTS: Pearson correlation analysis showed that both the tumor rCBV and tumor-to-white matter ratios in the synthetic and real rCBV maps were strongly correlated (&#961; = 0.87, P < .05 and &#961; = 0.86, P < .05, respectively). Tumor plasma volume fraction and real rCBV were not strongly correlated (&#961; = 0.47). Bland-Altman analysis showed a mean difference between the synthetic and real rCBV tumor-to-white matter ratios of 0.20 with a 95% confidence interval of ±0.47. CONCLUSION: Realistic rCBV maps can be synthesized from DCE MRI and contain quantitative information, enabling robust brain-tumor perfusion imaging of DSC and DCE parameters with a single gadolinium-based contrast agent administration.

Predicting the angiotensin converting enzyme 2 (ACE2) utilizing capability as the receptor of SARS-CoV-2

SARS-CoV-2, the newly identified human coronavirus causing severe pneumonia pandemic, was probably originated from Chinese horseshoe bats. However, direct transmission of the virus from bats to humans is unlikely due to lack of direct contact, implying the existence of unknown intermediate hosts. Angiotensin converting enzyme 2 (ACE2) is the receptor of SARS-CoV-2, but only ACE2s of certain species can be utilized by SARS-CoV-2. Here, we evaluated and ranked the receptor-utilizing capability of ACE2s from various species by phylogenetic clustering and sequence alignment with the currently known ACE2s utilized by SARS-CoV-2. As a result, we predicted that SARS-CoV-2 tends to utilize ACE2s of various mammals, except murines, and some birds, such as pigeon. This prediction may help to screen the intermediate hosts of SARS-CoV-2.

Predicting the angiotensin converting enzyme 2 (ACE2) utilizing capability as the receptor of SARS-CoV-2

SARS-CoV-2, the newly identified human coronavirus causing severe pneumonia pandemic, was probably originated from Chinese horseshoe bats. However, direct transmission of the virus from bats to humans is unlikely due to lack of direct contact, implying the existence of unknown intermediate hosts. Angiotensin converting enzyme 2 (ACE2) is the receptor of SARS-CoV-2, but only ACE2s of certain species can be utilized by SARS-CoV-2. Here, we evaluated and ranked the receptor-utilizing capability of ACE2s from various species by phylogenetic clustering and sequence alignment with the currently known ACE2s utilized by SARS-CoV-2. As a result, we predicted that SARS-CoV-2 tends to utilize ACE2s of various mammals, except murines, and some birds, such as pigeon. This prediction may help to screen the intermediate hosts of SARS-CoV-2.

Pharmacological options for the treatment of chronic migraine pain

Migraine is a debilitating neurological condition with symptoms typically consisting of unilateral and pulsating headache, sensitivity to sensory stimuli, nausea, and vomiting. The World Health Organization (WHO) reports that migraine is the third most prevalent medical disorder and second most disabling neurological condition in the world. There are several options for preventive migraine treatments that include, but are not limited to, anticonvulsants, antidepressants, beta blockers, calcium channel blockers, botulinum toxins, NSAIDs, riboflavin, and magnesium. Patients may also benefit from adjunct nonpharmacological options in the comprehensive prevention of migraines, such as cognitive behavior therapy, relaxation therapies, biofeedback, lifestyle guidance, and education. Preventative therapies are an essential component of the overall approach to the pharmacological treatment of migraine. Comparative studies of newer therapies are needed to help patients receive the best treatment option for chronic migraine pain.

A Web Application for Adrenal Incidentaloma Identification, Tracking, and Management Using Machine Learning

BACKGROUND: Incidental radiographic findings, such as adrenal nodules, are commonly identified in imaging studies and documented in radiology reports. However, patients with such findings frequently do not receive appropriate follow-up, partially due to the lack of tools for the management of such findings and the time required to maintain up-to-date lists. Natural language processing (NLP) is capable of extracting information from free-text clinical documents and could provide the basis for software solutions that do not require changes to clinical workflows. OBJECTIVES: In this manuscript we present (1) a machine learning algorithm we trained to identify radiology reports documenting the presence of a newly discovered adrenal incidentaloma, and (2) the web application and results database we developed to manage these clinical findings. METHODS: We manually annotated a training corpus of 4,090 radiology reports from across our institution with a binary label indicating whether or not a report contains a newly discovered adrenal incidentaloma. We trained a convolutional neural network to perform this text classification task. Over the NLP backbone we built a web application that allows users to coordinate clinical management of adrenal incidentalomas in real time. RESULTS: The annotated dataset included 404 positive (9.9%) and 3,686 (90.1%) negative reports. Our model achieved a sensitivity of 92.9% (95% confidence interval: 80.9-97.5%), a positive predictive value of 83.0% (69.9-91.1)%, a specificity of 97.8% (95.8-98.9)%, and an F1 score of 87.6%. We developed a front-end web application based on the model's output. CONCLUSION: Developing an NLP-enabled custom web application for tracking and management of high-risk adrenal incidentalomas is feasible in a resource constrained, safety net hospital. Such applications can be used by an institution's quality department or its primary care providers and can easily be generalized to other types of clinical findings.

Molecular and serological characterization of SARS-CoV-2 infection among COVID-19 patients

BACKGROUND: SARS-CoV-2 is a novel coronavirus and the cause of COVID-19. More than 80% of COVID-19 patients exhibit mild or moderate symptoms. In this study, we investigated the dynamics of viral load and antibodies against SARS-CoV-2 in a longitudinal cohort of COVID-19 patients with severe and mild/moderate diseases. METHODS: Demographic and clinical information were obtained. Serial samples of blood, nasal and pharyngeal and anal swabs were collected at different time points post-onset. SARS-CoV-2 RNA and anti-SARS-CoV-2 antibodies were measured by qRT-PCR and immunoassays, respectively. RESULTS: Respiratory SARS-CoV-2 RNA was detectable in 58.0% (58/100) COVID-19 patients upon admission and lasted for a median of 13 days post-onset. In addition, 5.9% (1/17) and 20.2% (19/94) of the blood and anal swab specimens were positive for SARS-CoV-2 RNA, respectively. Anal viral RNA was more frequently detected in the patients who were positive for viral RNA in the respiratory samples upon admission. Specific anti-SARS-CoV-2 antibody developed within two weeks after onset, reached peak approximately 17 days post-onset and then maintained at relatively high level up to 50 days we analyzed in most patients. However, the levels of antibodies were variable among the patients. High titers of antibodies appeared to be associated with the severity of the disease. Furthermore, viral proteins from different sources showed significant difference of serological sensitivity especially during the first week post-onset. CONCLUSIONS: Our results indicate rapid clearance or self-elimination of viral RNA in about half of the COVID-19 patients upon admission. Viral RNA shedding of SARS-CoV-2 occurred in multiple tissues including the respiratory system, blood, and intestine. Variable levels of specific anti-SARS-CoV-2 antibody may be associated with disease severity. These findings have shed light on viral kinetics and antibody response in COVID-19 patients and provide scientific evidence for infection control and patient management.

Willingness to Participate in a COVID-19 Vaccine Trial Among Young Adults in China

Background: With the demand for rapid COVID-19 vaccine development and evaluation, this paper aimed to describe the prevalence and correlates of willingness to

Automated Detection of COVID-19 from CT Scans Using Convolutional Neural Networks

COVID-19 is an infectious disease that causes respiratory problems similar to those caused by SARS-CoV (2003). Currently, swab samples are being used for its diagnosis. The most common testing method used is the RT-PCR method, which has high specificity but variable sensitivity. AI-based detection has the capability to overcome this drawback. In this paper, we propose a prospective method wherein we use chest CT scans to diagnose the patients for COVID-19 pneumonia. We use a set of open-source images, available as individual CT slices, and full CT scans from a private Indian Hospital to train our model. We build a 2D segmentation model using the U-Net architecture, which gives the output by marking out the region of infection. Our model achieves a sensitivity of 96.428% (95% CI: 88%-100%) and a specificity of 88.39% (95% CI: 82%-94%). Additionally, we derive a logic for converting our slice-level predictions to scan-level, which helps us reduce the false positives.

Impact of Lockdown on Ambient Air Quality in COVID-19 Affected Hotspot Cities of India: Need to Readdress Air Pollution Mitigation Policies

The present study investigates the effect of lockdown on ambient air quality of 16 Indian cities constituting the major hotspots for COVID-19 cases. The COVID-19 lockdown resulted in cleaner air in India. Significant reduction of nearly 62%, 52% and 69% are observed in PM 10, PM 2.5and NO 2levels as compared to preceding years. However, there is no significant effect of lockdown on other gaseous pollutants (SO 2and O 3). The lockdown in India was found to be an effective way to restrict the virus spread rate and measure control ambient air pollutant levels.

Numerical analysis of paclitaxel-eluting coronary stents: Mechanics and drug release properties

Since theoretical models provide data that cannot be otherwise gathered, numerical methods applied to medical devices analysis have emerged as fundamental tool in preclinical development. Large efforts were done to study mechanical and drug-eluting properties in stents but often the coating modelling is neglected. This work presents a finite element framework to calculate mechanical loads and drug distribution in three commercial drug-eluting stents (Palmaz-Schatz, Palmaz Genesis and Multi Link Vision), to check coatings strength and drug distribution maps in biological tissues. The promising copolymer poly(methylmethacrylate-co-n-butylmethacrylate), loaded with paclitaxel, is analyzed. Results demonstrated that the coating undergoes localized plastic phenomena, and calculated stresses are lower than the ultimate stress, ensuring coating integrity. Computed drug concentration depends on stent geometry and its values are in all cases lower than the toxicity level for this drug.

Recent biotechnological tools for diagnosis of corona virus disease: A review

Recently, a corona virus disease (COVID-19) caused by a novel corona virus (sevier acute respiratory syndrome corona virus 2; SARS-CoV-2), rapidly spread throughout the world. It has been resulted an unprecedented public health crisis and has become a global threat. WHO declared it as a pandemic due to rapid transmission and severity of the disease. According to WHO, as of 22nd of August 2020, the disease spread over 213 countries of the world having 22,812,491 confirmed cases and 795,132 deaths recorded worldwide. In the absence of suitable antiviral drugs and vaccines, the current pandemic has created an urgent need for accurate diagnostic tools that would be helpful for early detection of the patients. Many tests including classical and high-throughput techniques have developed and obtained U.S. Food and drug administration (FDA) approval. However, efforts are being made to develop new diagnostic tools for detection of the disease. Several molecular diagnostic tests such as real-time-polymerase chain reaction, real-time isothermal loop-mediated amplification (RT-LAMP), full genome analysis by next-generation sequencing, clustered regularly interspaced short palindromic repeats technique and microarray-based assays along with other techniques such as computed tomography scan, biomarkers, biosensor, nanotechnology, serological test, enzyme-linked immunosorbent assay (ELISA), isolation of viral strain in cell culture are currently available for diagnosis of COVID-19 infection. This review provides a brief overview of promising high-throughput techniques currently used for detection of SARS-CoV-2, along with their scope and limitations that may be used for effective control of the disease.

Cognitive disorders associated with hospitalization of COVID-19: Results from an observational cohort study

INTRODUCTION: Our understanding of risk factors for COVID­19, including pre-existing medical conditions and genetic variations, is limited. To what extent the pre-existing clinical condition and genetic background have implications for COVID-19 still needs to be explored. METHODS: Our study included 389,620 participants of European descent from the UK Biobank, of whom 3,884 received the COVID-19 test and 1,091 were tested positive for COVID-19. We examined the association of COVID-19 status with an extensive list of 974 medical conditions and 30 blood biomarkers. Additionally, we tested the association of genetic variants in two key genes related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2), with COVID-19 or any other phenotypes. RESULTS: The most significant risk factors for COVID-19 include Alzheimer's disease (OR = 2.29, 95% CI: 1.25-4.16), dementia (OR = 2.16, 95% CI: 1.36-3.42), and the overall category of delirium, dementia, amnestic and other cognitive disorders (OR = 1.90, 95% CI: 1.24-2.90). Evidence suggesting associations of genetic variants in SARS-CoV-2 infection-related genes with COVID-19 (rs7282236, OR = 1.33, 95% CI: 1.14-1.54, p = 2.31 × 10-4) and other phenotypes, such as an immune deficiency (p = 5.65 × 10-5) and prostate cancer (p = 1.1 × 10-5), was obtained. CONCLUSIONS: Our unbiased and extensive search identified pre-existing Alzheimer's disease and dementia as top risk factors for hospital admission due to COVID-19, highlighting the importance of providing special protective care for patients with cognitive disorders during this pandemic. We also obtained evidence suggesting a direct association of genetic variants with COVID-19.

An Epochal Moment? The COVID-19 Pandemic and China’s International Order Building

This article considers the potential for the COVID-19 pandemic to represent an epochal moment in international politics, one which China can use as a window to maximize its international order-building efforts. It is argued that China’s putative international order-building efforts to date have faltered, in part, due to an inability to create meaningful friendships with prominent international powers. However, the COVID-19 pandemic allows China to play a key humanitarian role in heavily afflicted countries and, through this, perhaps an opportunity to forge more meaningful friendships. It is argued that China is trying to attach its concept of friendship to its humanitarian assistance while also stepping into the clear international leadership void that exists at the moment. This is not without faults or missteps, but the lasting impact could be significant for international politics and the global order.

Covid-19 Respiratory Mechanics Feasibility in Homeless Quarantine

SESSION TITLE: Global Case Report Posters SESSION TYPE: Global Case Reports PRESENTED ON: October 18-21, 2020 INTRODUCTION: In Covid-19 patients hospitalized in Wuhan, 20-41% developed lung disease including ARDS with a mortality rate of almost 50% 1 Traditional methods of monitoring lung infection such as CT scan, Ultrasound, and X-ray are infeasible at scale, especially due to the risks of cross-contamination Forced Oscillation Technique (FOT) may provide a quick, inexpensive, and simple way (logistics and minimal patient effort) to monitor COVID-19 patients at home or point-of-care settings FOT measures lung mechanics with tidal, rested breathing, and does not require patient training FOT measures respiratory impedance, a combination of resistance (openness of the airways) and reactance (elasticity of the airways) at different frequencies (denoting small vs large airways) Assessment of lung mechanics has been shown as a predictor for ARDS and acute lung injury (ALI) and may be crucial for early intervention for COVID-19 patients2-3 Characterization as Symptomatic, Exposed, Infectious, and Recovered is insufficient for patients discharged to home or holding facilities and inadequately gathers information to describe the course, risk of deterioration, and lung recovery Pulse oximetry alone is insufficient in the face of the "happy hypoxic" CASE PRESENTATION: Homeless patients are followed by Public Health and quarantined at a motel for monitoring We used a portable FOT device, PulmoScan (Cognita Labs, USA), to measure respiratory mechanical impedance of COVID-19 patients and assess the feasibility for monitoring at home or point-of-care settings COVID-19 patients (male, age 45-55) were recruited from a homeless shelter at Oxnard, CA, USA, for daily lung function monitoring using PulmoScan A single device was used to monitor multiple patients during daily testing routines by taking adequate precautions, personal protection equipment, and anti-viral, anti-bacterial filters were used The parameters were resistances and reactances at frequencies 5-30Hz (R5-R30, X5-X30), small airway resistance (R5-R20), resonant frequency (fres), and area under reactance (AX) DISCUSSION: Both patients were asymptomatic throughout the duration of the study However, the respiratory impedance was consistently higher in the first 5 days compared to the last 5 days of recovery On average, the following parameters were higher- R5(patient 1 by 16%, patient 2 by 17%), R10 (12%,10%), R15 (12%,9%), R20 (10%,9%), R25 (8%,9%), R30 (6%,9%), R5-R20 (291%,138%), AX (37%,54%), and fres (18%,21%), and the following were lower- X5 (17%,32%), X10 (41%,72%), X15 (80%,102%), X20 (36%,57%), X25 (16%,33%) and X30 (10%,24%) on the first 5 days compared to the last 5 days CONCLUSIONS: Monitoring COVID-19 patients using FOT is feasible in the point-of-care setting for daily tracking The changes in lung mechanics measured through FOT shows early promise as a method for tracking lung deterioration Reference #1: Wu, C , Chen, X , Cai, Y , Zhou, X , Xu, S , Huang, H , … & Song, J (2020) Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China JAMA Internal Medicine Reference #2: Chen, L , Chen, G Q , Shore, K , Shklar, O , Martins, C , Devenyi, B , … & Tuma, M (2017) Implementing a bedside assessment of respiratory mechanics in patients with acute respiratory distress syndrome Critical Care, 21(1), 84 ? Reference #3: Kostic, P , Zannin, E , Olerud, M A , Pompilio, P P , Hedenstierna, G , Pedotti, A , … & Dellaca, R L (2011) Positive end-expiratory pressure optimization with forced oscillation technique reduces ventilator induced lung injury: a controlled experimental study in pigs with saline lavage lung injury Critical Care, 15(3), R126 DISCLOSURES: Owner/Founder relationship with Cognita Labs Please note: $1-$1000 Added 05/31/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Removed 06/01/2020 by Rajoshi Biswas, source=W b Response Owner/Founder relationship with Cognita Labs Please note: &gt;$100000 Added 06/01/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Removed 06/01/2020 by Rajoshi Biswas, source=Web Response Owner/Founder relationship with Cognita Labs Please note: &gt;$100000 Added 06/01/2020 by Rajoshi Biswas, source=Web Response, value=Ownership interest Advisory Committee Member relationship with ABMRCC Please note: $1-$1000 Added 03/31/2020 by Chris Landon, source=Web Response, value=Consulting fee Employee relationship with Cognita Labs LLC Please note: $20001 - $100000 Added 06/12/2020 by Ronak Patel, source=Admin input, value=Salary No relevant relationships by Eva Reeder, source=Web Response

Exploring group theory and topology for analyzing the structure of biology

The concepts of population and species play a fundamental role in biology. The existence and precise definition of higher-order hierarchies, such as division into species, is open to debate among biologists. First, we seek to show a fractal structure of species. We are able to define a species as a $p$-Sylow subgroup of a particular community in a single niche, confirmed by topological analysis. We named this model the patch with zeta dominance (PzDom) model. Next, the topological nature of the system is carefully examined and for testing purposes, species density data are used in conjunction with data derived from liquid-chromatography mass spectrometry of proteins. We confirm the induction of hierarchy and time through a one-dimensional probability space with certain topologies. For further clarification of induced fractals including the relation to renormalization in physics, a theoretical development is proposed based on a newly identified fact, namely that scaling parameters for magnetization exactly correspond to imaginary parts of the Riemann zeta function's nontrivial zeros. A master torus and a Lagrangian/Hamiltonian are derived expressing fractal structures as a solution for diminishing divergent terms in renormalization. We will also focus on an application of our developed model. We extend current PzDom model to the so-called exPzDom model to qualify population dynamics as a topological matter as a whole, not focusing on hierarchy. The indicators in the exPzDom model adhere well to the empirical dynamics of SARS-CoV-2 infected people and align appropriately with actual policies instituted by the Japanese government. In our patch with zeta dominance (PzDom) model or its extended version (exPzDom), calculations only require knowledge of the density of individuals over time.

Health Outcome Predictive Evaluation for COVID 19 international registry (HOPE COVID-19), rationale and design

The disease produced by the new coronavirus known as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), named COVID-19 (Coronavirus Disease-2019) has recently been classified as a pandemic by the World Health Organization (WHO). However, scarce clinical data is available and generally limited to the Chinese population due to the first cases were identified in Wuhan (Hubei, China).This article describes the rationale and design of the HOPE COVID-19 (Health Outcome Predictive Evaluation for COVID 19) registry (ClinicalTrials.gov Identifier: NCT04334291). With an ambispective cohort design, eligible patients are those discharged, deceased or alive, from any hospital center with a confirmed diagnosis or a COVID-19 high suspicion. With a current recruitment of more than 7000 cases, in 46 hospitals in 8 countries, since it is not possible to estimate the sample size based on literature reports, the investigators will try to get the maximum numbers of patients possible. The study primary objective is all cause mortality and aims to characterize the clinical profile of patients infected in order to develop a prognostic clinical score allowing, rapid logistic decision making. As secondary objectives, the analysis of other clinical events, the risk-adjusted influence of treatments and previous comorbidities of patients infected with the disease will be performed.The results of HOPE COVID-19 will contribute to a better understanding of this condition. We aim to describe the management of this condition as well as the outcomes in relation to the therapy chosen, in order to gain insight into improving patient care in the coming months. Clinical Trial registration: ClinicalTrials.gov. Unique identifier: NCT04334291.

Characteristics and Outcomes of COVID-19 Patients with Respiratory Failure Admitted to a "Pandemic Ready" Intensive Care Unit - Lessons from Singapore

Introduction: Singapore was one of the first countries affected by the coronavirus disease 2019 (COVED-19) pandemic but has been able to prevent its healthcare system and intensive care units (ICU) from being overwhelmed We describe the clinical features, management and outcomes of COVID-19 patients with respiratory failure admitted to our ICU Materials and Methods: A case series of COVID-19 patients admitted to our ICU for respiratory failure from 7 February, with data censoring at 30 June 2020, was performed from a review of medical records Results: Twenty-two COVID-19 patients were admitted to our ICU for respiratory failure The median age was 54 5 years (IQR 30-45 5), 72 7% were male and had at least one comorbidity The Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores were 2 5 (IQR 1 25-7) and 10 (8 25-12) respectively Thirteen patients required invasive mechanical ventilation (IMV) and had a median PaO2/FiO2 ratio of 194 mmHg (IQR 173-213) after intubation The 28-day survival was 100%, with 2 patients demising subsequently The overall ICU mortality rate was 9 1% at the time of data censoring In IMV survivors, length of IMV and ICU stay were 11 days (IQR 9-17 75) and 16 days (IQR 12-32) respectively Conclusion: Low COVID-19 ICU mortality was observed in our "pandemic-ready" ICU This was achieved by having adequate surge capacity to facilitate early ICU admission and IMV, lung protective ventilation, and slow weaning Being able to maintain clinical standards and evidence-based practices without having to resort to rationing contributed to better outcomes

The effects of nicotine and cannabis co-use during adolescence and young adulthood on white matter cerebral blood flow estimates

RATIONALE: Co-use of cannabis and nicotine is common among adolescents/young adults and is associated with poorer psychological and physical outcomes, compared with single substance use. Little is known about the impact of co-use on the developing brain. OBJECTIVES: Preliminary investigation of the effects of nicotine on white matter (WM) cerebral blood flow (CBF) in adolescents/young adults and its potential moderation by cannabis use. METHODS: Adolescent/young adult (16-22 years old) nicotine and tobacco product users (NTP; N = 37) and non-nicotine users (non-NTP; N = 26) underwent a neuroimaging session comprised of anatomical, optimized pseudo-continuous arterial spin labeling, and diffusion tensor imaging scans. Groups were compared on whole-brain WM CBF estimates and their relation to past-year cannabis use. Follow-up analyses assessed correlations between identified CBF clusters and corresponding fractional anisotropy (FA) values. RESULTS: Group by cannabis effects were observed in five clusters (voxel-wise alpha < 0.001, cluster-wise alpha < 0.05; &#8805; 11 contiguous voxels): non-NTP exhibited positive correlations between CBF and cannabis use in all clusters, whereas no significant relationships were observed for NTP. Greater CBF extracted from one cluster (including portions of right superior longitudinal fasciculus) was associated with reduced FA for non-NTP group only. CONCLUSIONS: This is the first investigation of WM health as indexed by CBF, and its association with FA, in adolescents/young adults with nicotine and/or cannabis use. Results suggest that cannabis use by itself may be related to increased CBF in WM fiber tracts demonstrating poorer structural intergrity, yet the occurrence of even infrequent NTP use (greater than once per month) appears to diminish this relationship.

Far Apart and Close Together: Fritz Haber and Chaim Weizmann

Fritz Haber (1868?1934) and Chaim Weizmann (1874?1952) were both prominent German-speaking Jewish chemists with rather divergent views on Jewish assimilation and Zionism that only converged upon the rise of the Nazis to power in Germany While Haber converted to Protestantism and followed the calling of a German patriot during World War One and the turmoil of the Weimar Republic, Weizmann became the leader of the Zionist movement whose efforts led to the founding of Jewish academic institutions in British Mandate Palestine and eventually to the creation of the State of Israel Weizmann won the support of the British political establishment for the Zionist cause through his invaluable services to the British military as a chemist during World War One Guided by the timeline of their encounters as well as their mutual correspondence, we trace the ever-closer relationship between these two towering figures of the 20th century Had it not been for his ill health, Haber would have likely assumed a leading position at what is today the Weizmann Institute of Science in Rehovot as well as played a direct role in shaping other academic institutions, including The Hebrew University of Jerusalem, in the future State of Israel

Weapons for when bigotry claimse science as its ally

Countering the myth that human physical appearance has any predictable relationship with genetics, Rutherford shows that differences in skin colour occur across a wide geography that has little relationship to common ideas of race (Anti-Black violence continues to keep these codes in effect, as evidenced by a 2015 viral video showing a Black teenage girl being viciously attacked by police in McKinney, Texas, for attempting to use a community swimming pool with her friends ) As for the myth of racial correlation with IQ, Rutherford stresses the importance of environmental factors in driving variable measures across populations To topple the edifice of structural racism that produces 'excess' death in the context of COVID-19 and of life generally will take urgent social, political and economic action, from court rooms to clinics, lecture halls to voting booths

Spatio-temporal simulation of the novel coronavirus (COVID-19) outbreak using the agent-based modeling approach (case study: Urmia, Iran)

The ongoing outbreak of the COVID-19 as the current global concern threatens lives of many people around the world. COVID-19 is highly contagious so that it has infected more than 1,848,439 people until April 14, 2020 and killed more than 117,217 people. The main aim of this study is to develop an agent-based model (ABM) that simulates the spatio-temporal outbreak of COVID-19. The main innovation of this research is investigating the impacts of various strategies of school and educational center closures, heeding social distancing, and office closures on controlling the COVID-19 outbreak in Urmia city, Iran. In this research, the outbreak of COVID-19 disease was simulated with the help of ABM so that all agents considered in the ABM along with their attributes and behaviors as well as the environment of the ABM were described. Besides, the transmission of COVID-19 between human agents was simulated based on the SEIRD model, and finally, all control strategies applied in Urmia city along with corresponding actions of each control strategy were implemented in the ABM. The results of the ABM indicated that school and educational center closures in Urmia city, reduced the number of infected people by 4.96% each week on average and 49.61% in total from February 21 until May 10. Heeding social distancing by 30% and 70% of people of Urmia city from March 27, led to decrease the number of infected people by 5.24% and 10.07% each week, on average and 31.46% and 60.44% in total, respectively, and if 30% and 70% of civil servants of Urmia city did not go to work, the number of infected people would be decreased by 3.30% and 5.25% each week, on average and 32.98% and 52.48% in total from February 21 until May 10, respectively. As a result of this research, heeding social distancing by the majority of people is recommended for Urmia city in the current situation. The main advantages of disease modeling are to investigate how the disease is likely to evolve amongst the population of society and also assess the impacts of control strategies on controlling the outbreak of disease.

Antibody kinetics in primary- and secondary-care physicians with mild to moderate SARS-CoV-2 infection

Three hundred and ninety-seven primary- and secondary-care physicians were tested for the presence of IgG (and IgA) antibodies against SARS-coronavirus-2 with a commercially available ELISA. In 19 of 20 individuals with PCR-proven infection and only mild to moderate symptoms not requiring hospitalization positive IgG levels occurred within two to three weeks. Among the remaining 377 persons without clear-cut evidence of infection, unequivocally positive IgG antibodies were found in only one, showing a surprisingly low prevalence (0.3%, 95% CI: 0.01-1.5) in physicians with likely contacts with infected patients in a region highly affected by the pandemic (Tyrol, Austria).

Analysis of Emergency Department Visits and Hospital Activity during Influenza Season, COVID-19 Epidemic, and Lockdown Periods in View of Managing a Future Disaster Risk: A Multicenter Observational Study

ED-visits and through-ED admissions to medical/surgical wards (MSW) and intensive care unit (ICU) during influenza, COVID-19 and lockdown periods were evaluated in a four-hospital prospective observational study from November 2018 to March 2020. ED visit characteristics and main diagnostic categories were assessed. Analysis of 368,262 ED-visits highlighted a significantly increasing trend in ED-visits during influenza followed by a significantly decreasing trend after lockdown. For MSW-admissions, a pattern of growth during influenza was followed by a fall that began during COVID-19 pandemic and intensified during the lockdown. For ICU-admissions, a significant rise during the COVID-19 pandemic was followed by diminution during the lockdown period. During lockdown, significantly diminishing trends were shown for all diagnostic categories (between -40.8% and -73.6%), except influenza-like illness/COVID cases (+31.6%), Pulmonary embolism/deep vein thrombosis (+33.5%) and frequent users (+188.0%). The present study confirms an increase in demand during the influenza epidemic and during the initial phase of the COVID-19 epidemic, but a drop in activity during the lockdown, mainly related to non-COVID conditions. Syndromic surveillance of ILI cases in ED is a tool for monitoring influenza and COVID-19, and it can predict ED activity and the need for MSW and ICU beds.

SARS-CoV-2 infection presenting as colitis with chest and abdomen CT findings

Most of reported symptoms of SARS-CoV-2 infection are related to the respiratory system Extra pulmonary manifestations of this novel virus infection are being increasingly reported in the literature, with increased attention on the gastrointestinal symptoms which might be the only presenting symptoms in some patients These GI symptoms are nonspecific and little reported cases in the literature of confirmed gastrointestinal manifestations of SARS-CoV-2 infection by imaging Colitis related to SARS-CoV-2 is even less reported in the literature We present a case of SARS-CoV-2 infection of a 40-year-old lady who presented with GI manifestations and features of colitis of the caecum and ascending colon on CT scan The patient did not have respiratory symptoms but had incidental lung changes in the visualized lung bases These features were completely resolved as evident clinically and on follow-up CT scan after only 2 weeks, with only supportive care for SARS-CoV-2 infection GI symptoms, in general, are very common presenting complain for many patients visiting the emergency department;hence, early recognition and high index of clinical suspicion for SARS-CoV-2 infection with the presence of supporting laboratory and imaging findings are to be considered for early protective measures to be undertaken to help in reducing the spread of this virus;in particular, in the middle of global pandemic of this virus and the fact that GI symptoms could be the only presenting symptoms without any respiratory symptoms More studies and further invasive investigations in patients with features of colitis in imaging are needed to further understand the pathogenesis and its relation to SARS-CoV-2 infection

Non-pharmaceutical Interventions for Pandemic COVID-19: A Cross-Sectional Investigation of US General Public Beliefs, Attitudes, and Actions

Non-pharmaceutical interventions (NPIs) represent the primary mitigation strategy for the COVID-19 pandemic. Despite this, many government agencies and members of the general public may be resistant to NPI adoption. We sought to understand public attitudes and beliefs regarding various NPIs and self-reported adoption of NPIs, and to explore associations between NPI performance and the baseline characteristics of respondents. We performed a cross-sectional age-, sex-, and race- stratified survey of the general US population. Of the 1,005 respondents, 37% (95% CI 34.0, 39.9) felt that NPIs were inconvenient, while only 0.9% (95% CI 0.3, 1.5) of respondents believed that NPIs would not reduce their personal risk of illness. Respondents were most uncertain regarding the efficacy of mask and eye protection use, with 30.6 and 22.1%, respectively, unsure whether their use would slow disease spread. On univariate logistic regression analyses, NPI adherence was associated with a belief that NPIs would reduce personal risk of developing COVID-19 [OR 3.06, 95% CI [1.25, 7.48], p = 0.014] and with a belief that NPIs were not difficult to perform [OR 1.79, 95% CI [1.38, 2.31], p &lt; 0.0001]. Respondents were compliant with straightforward, familiar, and heavily-encouraged NPI recommendations such as hand-washing; more onerous approaches, such as avoiding face touching, disinfecting surfaces, and wearing masks or goggles, were performed less frequently. NPI non-adherence is associated with both outcome expectations (belief that NPIs are effective) and process expectations (belief that NPIs are not overly inconvenient); these findings have important implications for designing public health outreach efforts, where the feasibility, as well as the effectiveness, of NPIs should be stressed.

How does China’s stock market react to the announcement of the COVID-19 pandemic lockdown?

In this paper, we study how China’s stock market reacts to the sudden outbreak of COVID-19 in 2020, particularly to the announcement of the pandemic lockdown. In general, we observe reversals both at the industry level and at the firm level due to investors’ overreactions to the pandemic lockdown. For industry- and firm-level stocks with positive cumulative abnormal returns (CARs) in the event window when Wuhan was locked down, the reversals are stronger. Thus, the reversal effects are mostly driven by industries and stocks that positively overreact to COVID-19 than do others. Further investigation shows that overreactions are stronger for stocks with lower institutional ownership, which means that retail investors react more strongly to COVID-19. Among stocks with positive CARs in the event window, those with higher idiosyncratic volatilities and lower book-to-market ratios tend to have worse performance after one month.

COVID-19 in persons with chronic myeloid leukaemia

We studied by questionnaire 530 subjects with chronic myeloid leukaemia (CML) in Hubei Province during the recent SARS-CoV-2 epidemic. Five developed confirmed (N = 4) or probable COVID-19 (N = 1). Prevalence of COVID-19 in our subjects, 0.9% (95% Confidence Interval, 0.1, 1.8%) was ninefold higher than 0.1% (0, 0.12%) reported in normals but lower than 10% (6, 17%) reported in hospitalised persons with other haematological cancers or normal health-care providers, 7% (4, 12%). Co-variates associated with an increased risk of developing COVID-19 amongst persons with CML were exposure to someone infected with SARS-CoV-2 (P = 0.037), no complete haematologic response (P = 0.003) and co-morbidity(ies) (P = 0.024). There was also an increased risk of developing COVID-19 in subjects in advanced phase CML (P = 0.004) even when they achieved a complete cytogenetic response or major molecular response at the time of exposure to SARS-CoV-2. 1 of 21 subjects receiving 3rd generation tyrosine kinase-inhibitor (TKI) developed COVID-19 versus 3 of 346 subjects receiving imatinib versus 0 of 162 subjects receiving 2nd generation TKIs (P = 0.096). Other co-variates such as age and TKI-therapy duration were not significantly associated with an increased risk of developing COVID-19. Persons with these risk factors may benefit from increased surveillance of SARS-CoV-2 infection and possible protective isolation.

Tolerability and toxicity of pegaspargase in adults 40 years and older with acute lymphoblastic leukemia

Pegaspargase is a modified version of asparaginase with prolonged asparagine depletion. It appears to be safe in adults <40 years old, but has a unique spectrum of toxicities, the risks of which appear to increase with age. The primary objective of this study was to evaluate pegaspargase tolerability and toxicity as assessed by evaluation of incidence and severity of adverse events. Secondary objectives included characterization of the reasons underlying pegaspargase discontinuation, when applicable. Grade 3/4 asparaginase-related toxicities with &#8805;10% incidence included: hyperbilirubinemia, hyperglycemia, hypertriglyceridemia, hypoalbuminemia, hypofibrinogenemia, and transaminitis. 63% of patients (38 of 60) received all intended doses of pegaspargase, with the most common reasons for discontinuation noted as hypersensitivity (12%), hyperbilirubinemia/transaminitis (8%), and hematopoietic transplantation in complete remission (10%). This study suggests that while hepatotoxicity and other known adverse effects are common, with careful monitoring, pegaspargase can safely be administered to adults with ALL age &#8805;40 years old.

Time to get thrifty

Hyperconsumption is one of the things that got us into this mess But we have to avoid the temptation to rely on it to get us out again, writes Graham Lawton

Insights into antiviral mechanisms of remdesivir, lopinavir/ritonavir and chloroquine/hydroxychloroquine affecting the new SARS-CoV-2

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia with an unusual outbreak in Wuhan, China, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is currently no licensed antiviral treatment available to prevent human CoV infection. The widespread clinical use and existing knowledge on antiviral mechanisms of remdesivir, lopinavir/ritonavir and chloroquine/hydroxychloroquine in the treatment of previous epidemic diseases, namely, severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), may be helpful in the combat with novel SARS-CoV-2 infection. Recent clinical evidence didn't confirm the beneficial role of lopinavir/ritonavir and chloroquine/hydroxychloroquine for COVID-19 patients and their use was reassessed. We provide an overview of the current evidence into the mechanisms of action of these available drugs which are repurposed for treatment of the new virus. Available data identifies remdesivir as an adenosine analogue that can target the RNA-dependent RNA polymerase and block viral RNA synthesis. It has been a promising antiviral drug against a wide array of RNA viruses. 3CLpro is a major CoV protease that cleaves the large replicase polyproteins during viral replication and can be targeted by the protease inhibitor lopinavir/ritonavir but the clinical effects are controversial. Chloroquine/Hydroxychloroquine could impair the replication of SARSCoV-2 by multiple mechanisms and their immunomodulatory properties could ameliorate clinical manifestations that are mediated by immune reactions of the host although its beneficial effects are under question and need to be proven at the clinical level. Existing in vitro and in vivo evidence delineate the molecular mechanisms of these drugs in CoV-infected cells. Numerous studies demonstrated the ability of remdesivir to inhibit SARS-CoV-2 replication but future research would be needed to understand the exact mode of action of lopinavir/ritonavir and chloroquine/hydroxychloroquine in SARS-CoV-2 infected cells and to use this knowledge in the treatment of the current COVID-19.

Isolation and Propagation of Coronaviruses in Embryonated Eggs

The embryonated egg is a complex structure comprised of an embryo and its supporting membranes (chorioallantoic, amniotic, and yolk). The developing embryo and its membranes provide a diversity of cell types that allow for the successful replication of a wide variety of different viruses. Within the family Coronaviridae the embryonated egg has been used as a host system primarily for two avian coronaviruses within the genus Gammacoronavirus, infectious bronchitis virus (IBV) and turkey coronavirus (TCoV). IBV replicates well in the embryonated chicken egg, regardless of inoculation route; however, the allantoic route is favored as the virus replicates well in epithelium lining the chorioallantoic membrane, with high virus titers found in these membranes and associated allantoic fluids. TCoV replicates only in epithelium lining the embryo intestines and bursa of Fabricius; thus, amniotic inoculation is required for isolation and propagation of this virus. Embryonated eggs also provide a potential host system for detection, propagation, and characterization of other, novel coronaviruses.

Lessons Learned for Orthopaedic Care Within the NYC COVID Epicenter Utilizing the USNS Comfort

Although elective surgeries and in-person office visits were greatly reduced during the COVID-19 crisis, orthopaedic surgeons continue to play a critical role in caring for both orthopaedic and non-orthopaedic problems during this pandemic. Orthopaedic departments provide the ability to off-load emergency departments of orthopaedic issues, redeploy staff to areas of need across the hospital system, and provide direct care to COVID-19 patients. The following will discuss the experience of a large academic orthopaedic surgery department within the epicenter of the COVID-19 pandemic with respect to redeployment of human capital, unique resources such as the USNS Comfort, as well as our recommended strategy for handling future disaster situations. LEVEL OF EVIDENCE:: Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.

Lessons Learned for Orthopaedic Care Within the NYC COVID Epicenter Utilizing the USNS Comfort

Although elective surgeries and in-person office visits were greatly reduced during the COVID-19 crisis, orthopaedic surgeons continue to play a critical role in caring for both orthopaedic and non-orthopaedic problems during this pandemic. Orthopaedic departments provide the ability to off-load emergency departments of orthopaedic issues, redeploy staff to areas of need across the hospital system, and provide direct care to COVID-19 patients. The following will discuss the experience of a large academic orthopaedic surgery department within the epicenter of the COVID-19 pandemic with respect to redeployment of human capital, unique resources such as the USNS Comfort, as well as our recommended strategy for handling future disaster situations. LEVEL OF EVIDENCE:: Prognostic Level V. See Instructions for Authors for a complete description of levels of evidence.

Lessons Learned for Orthopaedic Care Within the NYC COVID Epicenter Using the United States Naval Ship Comfort

Although elective surgeries and in-person office visits were greatly reduced during the COVID-19 crisis, orthopaedic surgeons continue to play a critical role in caring for both orthopaedic and nonorthopaedic problems during this pandemic. Orthopaedic departments provide the ability to off-load emergency departments of orthopaedic issues, redeploy staff to areas of need across the hospital system, and provide direct care to COVID-19 patients. The following will discuss the experience of a large academic orthopaedic surgery department within the epicenter of the COVID-19 pandemic with respect to redeployment of human capital and unique resources such as the United States Naval Ship Comfort as well as our recommended strategy for handling future disaster situations.

Event-Driven Learning of Systematic Behaviours in Stock Markets

It is reported that financial news, especially financial events expressed in news, provide information to investors' long/short decisions and influence the movements of stock markets. Motivated by this, we leverage financial event streams to train a classification neural network that detects latent event-stock linkages and stock markets' systematic behaviours in the U.S. stock market. Our proposed pipeline includes (1) a combined event extraction method that utilizes Open Information Extraction and neural co-reference resolution, (2) a BERT/ALBERT enhanced representation of events, and (3) an extended hierarchical attention network that includes attentions on event, news and temporal levels. Our pipeline achieves significantly better accuracies and higher simulated annualized returns than state-of-the-art models when being applied to predicting Standard\&Poor 500, Dow Jones, Nasdaq indices and 10 individual stocks.

Museum Opening Delayed

Mid-April was to have been the grand opening of the James Madison University Mineral Museum in Harrisonburg, Virginia However, the celebration was postponed because of the coronavirus

Exploration of turn-positive RT-PCR results and factors related to treatment outcome in COVID-19: A retrospective cohort study

The cause of some patients with negative RT-PCR results experienced turn-positive after treatment remains unclear. In addition, understanding the correlation between changes in clinical data in the course of COVID-19 and treatment outcomes is of great importance in determining the prognosis of COVID-19. To perform cause analysis of RT-PCR turn-positive and the effective screening factors related to treatment outcome in COVID-19. Clinical data, including clinical manifestations, laboratory tests, radiography results, treatment methods and outcomes, were retrospectively collected and analyzed from January to March 2020 in Renmin Hospitals of Wuhan University. 116 COVID-19 patients (40 in recurrent group, 29 in recovered group and 47 in unrecovered group) were recruited. In the recurrent group, white blood cell, Neutrophils, prothrombin time, activated partial thromboplastin time, CD3, CD4, CD8, ratio of CD4/CD8, IgG and C4 complement were of significant difference among the baseline, negative and turn-positive time points. CD19 and CT scan results were found notable difference between recurrent group and recovered group. Odds from CD3, CD4, CD8, CD19, IgM, C3 complement, C4 complement and CT scan results validated associations with clinical outcomes of COVID-19. The so-called recurrence in some COVID-19 patients may be due to the false-negative of nucleic acid test results from nasopharyngeal swabs. Levels of CD3, CD4, CD8, CD19, IgM, C3 complement, C4 complement and CT results were significantly correlated with the outcome of COVID-19. The cellular immunity test could be beneficial to further screen the reliability of RT-PCR test on the basis of CT images.

SARS-CoV-2 Evolutionary Adaptation toward Host Entry and Recognition of Receptor O-Acetyl Sialylation in Virus-Host Interaction

The recently emerged SARS-CoV-2 is the cause of the global health crisis of the coronavirus disease 2019 (COVID-19) pandemic. No evidence is yet available for CoV infection into hosts upon zoonotic disease outbreak, although the CoV epidemy resembles influenza viruses, which use sialic acid (SA). Currently, information on SARS-CoV-2 and its receptors is limited. O-acetylated SAs interact with the lectin-like spike glycoprotein of SARS CoV-2 for the initial attachment of viruses to enter into the host cells. SARS-CoV-2 hemagglutinin-esterase (HE) acts as the classical glycan-binding lectin and receptor-degrading enzyme. Most ß-CoVs recognize 9-O-acetyl-SAs but switched to recognizing the 4-O-acetyl-SA form during evolution of CoVs. Type I HE is specific for the 9-O-Ac-SAs and type II HE is specific for 4-O-Ac-SAs. The SA-binding shift proceeds through quasi-synchronous adaptations of the SA-recognition sites of the lectin and esterase domains. The molecular switching of HE acquisition of 4-O-acetyl binding from 9-O-acetyl SA binding is caused by protein-carbohydrate interaction (PCI) or lectin-carbohydrate interaction (LCI). The HE gene was transmitted to a ß-CoV lineage A progenitor by horizontal gene transfer from a 9-O-Ac-SA-specific HEF, as in influenza virus C/D. HE acquisition, and expansion takes place by cross-species transmission over HE evolution. This reflects viral evolutionary adaptation to host SA-containing glycans. Therefore, CoV HE receptor switching precedes virus evolution driven by the SA-glycan diversity of the hosts. The PCI or LCI stereochemistry potentiates the SA-ligand switch by a simple conformational shift of the lectin and esterase domains. Therefore, examination of new emerging viruses can lead to better understanding of virus evolution toward transitional host tropism. A clear example of HE gene transfer is found in the BCoV HE, which prefers 7,9-di-O-Ac-SAs, which is also known to be a target of the bovine torovirus HE. A more exciting case of such a switching event occurs in the murine CoVs, with the example of the ß-CoV lineage A type binding with two different subtypes of the typical 9-O-Ac-SA (type I) and the exclusive 4-O-Ac-SA (type II) attachment factors. The protein structure data for type II HE also imply the virus switching to binding 4-O acetyl SA from 9-O acetyl SA. Principles of the protein-glycan interaction and PCI stereochemistry potentiate the SA-ligand switch via simple conformational shifts of the lectin and esterase domains. Thus, our understanding of natural adaptation can be specified to how carbohydrate/glycan-recognizing proteins/molecules contribute to virus evolution toward host tropism. Under the current circumstances where reliable antiviral therapeutics or vaccination tools are lacking, several trials are underway to examine viral agents. As expected, structural and non-structural proteins of SARS-CoV-2 are currently being targeted for viral therapeutic designation and development. However, the modern global society needs SARS-CoV-2 preventive and therapeutic drugs for infected patients. In this review, the structure and sialobiology of SARS-CoV-2 are discussed in order to encourage and activate public research on glycan-specific interaction-based drug creation in the near future.

Characterization of community-wide transmission of SARS-CoV-2 in congregate living settings and local public health-coordinated response during the initial phase of the COVID-19 pandemic

BACKGROUND: Clusters of COVID-19 cases amplify the pandemic and are critical targets for intervention, but comprehensive cluster-level data are not collected systematically by federal or most state public health entities. This analysis characterizes COVID-19 clusters among vulnerable populations housed in congregate living settings across an entire community and describes early mitigation efforts. METHODS: The Cuyahoga County Board of Health identified and interviewed COVID-19 cases and exposed contacts, assessing possible connections to congregate living facilities within its jurisdiction from March 7, 2020, to May 15, 2020, during the first phase of the pandemic, while state of Ohio stay-at-home orders were in effect. A multi-disciplinary team-based response network was mobilized to support active case finding and develop facility-focused containment strategies. RESULTS: We identified a cascade of 45 COVID-19 clusters across community facilities (corrections, nursing, assisted living, intermediate care, extended treatment, shelters, group homes). Attack rates were highest within small facilities (P < .01) and large facilities requiring extensive support to implement effective containment measures. For 25 clusters, we identified an index case who frequently (88%) was a healthcare worker. Engagement of clinical, community, and government partners through public health coordination efforts created opportunities to rapidly develop and coordinate effective response strategies to support the facilities facing the dawning impact of the pandemic. CONCLUSIONS: Active cluster investigations can uncover the dynamics of community transmission affecting both residents of congregate settings and their caregivers and help to target efforts toward populations with ongoing challenges in access to detection and control resources.

Containment of COVID-19 in Ethiopia and implications for tuberculosis care and research

BACKGROUND: The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB. MAIN TEXT: Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the 'PM Abiy-Jack Ma initiative', which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention. CONCLUSIONS: Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.

Erratum: Cytotoxic and Antimicrobial Efficacy of Silver Nanoparticles Synthesized Using a Traditional Phytoproduct, Asafoetida Gum [Corrigendum]

[This corrects the article DOI: 10.2147/IJN.S258319.].

Best practice in cardiac anesthesia during the COVID-19 pandemic: Practical recommendations

The COVID-19 outbreak has influenced the entire health care system, including cardiac surgery. In this review, the authors reveal practical aspects that are important during the COVID-19 pandemic with regards to the safe delivery of cardiac anesthesia. Timing for operations of the cardio-vascular system may be well programmed in most cases. Hence, the level of priorities must be defined for any single patient. The postponement of surgery may be convenient for most cases, if it is made in the best interest of the patient. The preanesthetic evaluation should be attentive of the respiratory history of the patient. Cardiac anesthesia always implies some respiratory monitoring; hence the existing clinical situation of the patient's respiratory system should be clear. In case of emergency surgery, the patient should be treated as if they potentially have or are at risk for the virus. In the case of a COVID-19 confirmed or suspected patient, attention must be made to preserve operating room and team integrity. The machineries are to be draped with plastic to simplify the disinfection after the operation. Perioperative management of suspected or confirmed COVID-19 patients must strictly follow the most relevant international guidelines. This review article has synthesized the common aspects present in the most important of these.

Best practice in cardiac anesthesia during the COVID-19 pandemic: Practical recommendations

The COVID-19 outbreak has influenced the entire health care system, including cardiac surgery. In this review, the authors reveal practical aspects that are important during the COVID-19 pandemic with regards to the safe delivery of cardiac anesthesia. Timing for operations of the cardio-vascular system may be well programmed in most cases. Hence, the level of priorities must be defined for any single patient. The postponement of surgery may be convenient for most cases, if it is made in the best interest of the patient. The preanesthetic evaluation should be attentive of the respiratory history of the patient. Cardiac anesthesia always implies some respiratory monitoring; hence the existing clinical situation of the patient's respiratory system should be clear. In case of emergency surgery, the patient should be treated as if they potentially have or are at risk for the virus. In the case of a COVID-19 confirmed or suspected patient, attention must be made to preserve operating room and team integrity. The machineries are to be draped with plastic to simplify the disinfection after the operation. Perioperative management of suspected or confirmed COVID-19 patients must strictly follow the most relevant international guidelines. This review article has synthesized the common aspects present in the most important of these.

Clinical management of psoriasis patients during the COVID-19 pandemic

Psoriasis is a systemic immune-mediated inflammatory disease that requires consistent treatment and follow-up. Given that COVID-19 will persist in the coming years, dermatologists need to adjust their practices accordingly to care for their patients, particularly psoriasis patients managed with systemic therapies. We provide guidelines for optimizing care for psoriasis patients, including considerations for medication management, lifestyle adjustments, and utilization of telemedicine.

Avaliação Da Adoção Das Medidas De Precauções Padrão Em Categorias Específicas De Profissionais De Saúde

Uma pesquisa em profissionais da área da saúde que provavelmente tem intensa e freqüente exposição a sangue e outros fluídos orgânicos (anestesiologistas) foi conduzida para avaliar a freqüência de relatos de exposição ocupacional a sangue e/ou outros fluídos orgânicos e o conhecimento e aderência destes profissionais as medidas de precauções padrão. De todos os profissionais entrevistados, 62,8% relataram acidentes ocupacionais com sangue e/ou outros fluídos orgânicos, seja através de lesão percutânea e/ou contato em membrana mucosa, todos relataram conhecimento acerca das medidas de precauções padrão e a maioria referirou a adoção de tais medidas e vacinação contra hepatite B. No entanto, observou-se na prática desses profissionais uma pobre aderência às medidas de precaução, principalmente, em relação ao uso de máscaras, óculos protetores e lavagem das mãos. Esse estudo enfatiza a importância do desenvolvimento de novas estratégias para o treinamento em precauções padrão.

Disparities In Outcomes Among COVID-19 Patients In A Large Health Care System In California

As the novel coronavirus disease (COVID-19) pandemic spreads throughout the United States, evidence is mounting that racial and ethnic minorities and socioeconomically disadvantaged groups are bearing a disproportionate burden of illness and death. We conducted a retrospective cohort analysis of COVID-19 patients at Sutter Health, a large integrated health system in northern California, to measure potential disparities. We used Sutter's integrated electronic health record to identify adults with suspected and confirmed COVID-19, and we used multivariable logistic regression to assess risk of hospitalization, adjusting for known risk factors, such as race/ethnicity, sex, age, health, and socioeconomic variables. We analyzed 1,052 confirmed cases of COVID-19 from the period January 1-April 8, 2020. Among our findings, we observed that compared with non-Hispanic white patients, non-Hispanic African American patients had 2.7 times the odds of hospitalization, after adjustment for age, sex, comorbidities, and income. We explore possible explanations for this, including societal factors that either result in barriers to timely access to care or create circumstances in which patients view delaying care as the most sensible option. Our study provides real-world evidence of racial and ethnic disparities in the presentation of COVID-19.

Physical activity in a pandemic: A new treatment target for psychological therapy

The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing activity levels should be prioritized as a treatment target, especially when the barriers to exercise are greater than ever. Promoting physical activity has not traditionally been the remit of psychologists. Yet psychological theory and therapeutic techniques can be readily applied to address physical inactivity. We present theoretical perspectives and therapy techniques relating to (1) beliefs about physical activity, (2) motivation to be physically active, and (3) the sense of reward achieved through being physically active. We outline strategies to initiate and maintain physical activity during the COVID-19 pandemic, thereby benefitting mental and physical health. COVID-19 is demanding rapid and substantial change across the whole health care system. Psychological therapists can respond creatively by addressing physical activity, a treatable clinical target which delivers both mental and physical health benefits. PRACTITIONER POINTS: Physical activity is essential for our mental and physical health. Yet COVID-19 presents novel barriers to physical activity. Psychological theory and techniques to address beliefs, motivation, and reward can be applied to increase physical activity during COVID-19. Physical activity is an important clinical target to sustain and improve mental health, especially in the current pandemic.

Physical activity in a pandemic: A new treatment target for psychological therapy

The COVID-19 pandemic and its management are placing significant new strains on people's well-being, particularly those with pre-existing mental health conditions. Physical activity has been shown to improve mental as well as physical health. Increasing activity levels should be prioritized as a treatment target, especially when the barriers to exercise are greater than ever. Promoting physical activity has not traditionally been the remit of psychologists. Yet psychological theory and therapeutic techniques can be readily applied to address physical inactivity. We present theoretical perspectives and therapy techniques relating to (1) beliefs about physical activity, (2) motivation to be physically active, and (3) the sense of reward achieved through being physically active. We outline strategies to initiate and maintain physical activity during the COVID-19 pandemic, thereby benefitting mental and physical health. COVID-19 is demanding rapid and substantial change across the whole health care system. Psychological therapists can respond creatively by addressing physical activity, a treatable clinical target which delivers both mental and physical health benefits. PRACTITIONER POINTS: Physical activity is essential for our mental and physical health. Yet COVID-19 presents novel barriers to physical activity. Psychological theory and techniques to address beliefs, motivation, and reward can be applied to increase physical activity during COVID-19. Physical activity is an important clinical target to sustain and improve mental health, especially in the current pandemic.

Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign

OBJECTIVES: The outbreak of 2019 coronavirus disease (COVID-19) pandemic in Wuhan, China, has subsided after a hard hit by the disease and subsequent city lockdown. Information on the number of people involved in Wuhan is still inadequate. This study aimed to describe the screening results of 61,437 community members in Wuchang District, Wuhan. METHODS: In mid-May 2020, Wuhan launched a population-scale city-wide SARS-CoV-2 testing campaign, which aimed to perform nucleic acid and viral antibody testing for citizens in Wuhan. Here we show the screening results of cluster sampled 61,437 residents in Wuchang District, Wuhan, China. RESULTS: A total of 1470 (2.39%, 95% CI: 2.27-2.52) individuals were detected positive for at least one antiviral antibody. Among the positive individuals, 324 (0.53%, 95% CI: 0.47-0.59) and 1200 (1.95%, 95% CI: 1.85-2.07) were positive for immunoglobulin IgM and IgG, respectively, and 54 (0.08%, 95% CI: 0.07-0.12) were positive for both antibodies. The positive rate of female carriers of antibodies were higher than those of male counterparts (male-to-female ratio of 0.75), especially in elderly citizens (ratio of 0.18 in 90+ age subgroup), indicating a sexual discrepancy in seroprevalence. In addition, viral nucleic acid detection using real-time PCR had showed 8 (0.013%, 95% CI: 0.006-0.026) asymptomatic virus carriers. CONCLUSIONS: The seroprevalence of SARS-CoV-2 in Wuhan was low. Most of Wuhan residents are still susceptible to this virus. Precautions, such as wearing mask, frequent hand hygiene, and proper social distance, are necessary before an effective vaccine or antiviral treatments are available.

Human and financial cost of COVID-19

This paper analyzes the human and financial costs of the COVID-19 pandemic on 92 countries. We compare country-by-country equity market dynamics to cumulative COVID-19 case and death counts and new case trajectories. First, we examine the multivariate time series of cumulative cases and deaths, particularly regarding their changing structure over time. We reveal similarities between the case and death time series, and key dates that the structure of the time series changed. Next, we classify new case time series, demonstrate five characteristic classes of trajectories, and quantify discrepancy between them with respect to the behavior of waves of the disease. Finally, we show there is no relationship between countries' equity market performance and their success in managing COVID-19. Each country's equity index has been unresponsive to the domestic or global state of the pandemic. Instead, these indices have been highly uniform, with most movement in March.

Exploring the impact of COVID-19 pandemic lockdown on informal settlements in Tshwane Gauteng Province, South Africa

Informal settlements remain a public health problem as they lack basic infrastructure. Furthermore, it is challenging to enforce public health regulations and protocols to prevent the spread of infection during a pandemic. This paper was set out to explore the impact of lockdown during COVID-19 among people living in informal settlements. An exploratory qualitative design was utilised. Purposive sampling was used to select research participants. In-depth one-to-one interviews were held involving 30 research participants through a WhatsApp online telephone platform. A thematic approach underpinned by the four stages of data analysis in interpretive phenomenological analysis was utilised to analyse the data. The study found that during the the research participants were affected by lack of space to practice social distancing, over-burdened infrastructure, lack of savings, loss of income and shortage of food, hunger and diseases, anxiety and depression and poor access to education. There is a need to prioritise the needs of informal settlers and endeavour to establish permanent homes. Health promotion and communication initiatives and pandemic awareness programmes are needed to mitigate the impact of lockdown during a pandemic in informal settlements.

An Assessment of Physicochemical characteristics of Awotan dumpsite in Ibadan, South western Nigeria

Gaseous emission, particulate emission, biological molecules and other harmful substances discharge into the atmosphere from dumpsite environment. The carbon dioxide (CO2) and methane (CH4) content of the gaseous emission from different platforms and offsets of the Awotan dump site were measured. P Sense CO2 Meter AZ 7755 was used to measure the level of carbon dioxide gas, temperature and relative humidity. K60 Gas detector was used to measure the level of methane (CH4) gas and Pm 2.5. Thermo-scientific MIE pDR 1500 PM monitor was used to measure the particulate matter on the dumpsite. The CO2 levels (697±28.84 - 502±2.19) were above the minimum permissible levels of ASHRAE of 400ppm for all platforms at the dumpsite. CH4 levels range (73.33±3.32 - 18.33±4.27) was above the methane explosive limits (MEL) of 15% for all Platforms, however the level at 25m and 50m offsets (14.83±4.11 - 13.83±2.48) was below the MEL for 75m and 100m offsets. PM2.5 levels were lower in the morning and peaked in the afternoon at Platform 5, 6 and 9 locations with values of 62.76±6.03, 63.9±11.37 and 32.06±3.89 respectively which is not within the WHO minimum permissible limit of 25µg/m3. There was a significant positive correlation between CO2 and CH4 (r=0.7558, p=0.028) but no significant correlation between CO2 and other meteorological parameters (temperature and humidity) (r=-0.1309, p=0.67and r=0.09644, p=0.754). The carbon dioxide and methane content of the gaseous emission from the Awotan dump site are potential health hazard, hence the need for an engineering design that will reduce the quantum of the emission thereby reducing the hazard.

Personalized therapy approach for hospitalized patients with COVID-19

Hospitalized patients with COVID-19 experiencing respiratory symptoms have different complications (inflammatory, co-infection and thrombotic) that are identifiable by analytics patterns. Personalized treatment decisions decreased early mortality (OR 0.144, CI 0.03-0.686; p=0.015). Increasing age (OR 1.06; p=0.038) and therapeutic effort limitation (OR 9.684; p<0.001) were associated with higher mortality.

Efeitos da fratura de corpo da mandíbula no crescimento da maxila e da mandíbula: estudo experimental em ratos jovens

Objective: The purpose of this study was to observe the effects of experimental fracture of the mandibular body on the growth of maxilla and mandible, by using one-month-old rats. Methods: These were distributed into two groups: experimental, which underwent a fracture of the right mandibular body, and sham-operated, which underwent the surgical access only. The animals were sacrificed at three months of age and, after dissection, the mandible was disarticulated. The skull was submitted to axial radiograph and the hemimandibles to a lateral radiograph. With these, cephalometric mensurations were made through a computer system, and the obtained values submitted to statistical analyses. Results: The length of the maxilla, as well as the height and length of the mandible presented significant difference with decrease to the right side, in the experimental group. In the sham-operated group there was significant difference with decrease to length of posterior part of the maxilla and to height and length of the mandible on the right side. The experimental group when compared to the sham-operated group was significantly lesser in all the mensurations of maxilla and mandible to both sides, except in mandibular length. Conclusion: It was concluded that fracture of the mandibular body, as well as the surgical access, had negative effects on growth of maxilla and mandible.

The Aging of γδ T Cells

In the coming decades, many developed countries in the world are expecting the "greying" of their populations. This phenomenon poses unprecedented challenges to healthcare systems. Aging is one of the most important risk factors for infections and a myriad of diseases such as cancer, cardiovascular and neurodegenerative diseases. A common denominator that is implicated in these diseases is the immune system. The immune system consists of the innate and adaptive arms that complement each other to provide the host with a holistic defense system. While the diverse interactions between multiple arms of the immune system are necessary for its function, this complexity is amplified in the aging immune system as each immune cell type is affected differently-resulting in a conundrum that is especially difficult to target. Furthermore, certain cell types, such as γδ T cells, do not fit categorically into the arms of innate or adaptive immunity. In this review, we will first introduce the human γδ T cell family and its ligands before discussing parallels in mice. By covering the ontogeny and homeostasis of γδ T cells during their lifespan, we will better capture their evolution and responses to age-related stressors. Finally, we will identify knowledge gaps within these topics that can advance our understanding of the relationship between γδ T cells and aging, as well as age-related diseases such as cancer.

Cardiorenal tissues express SARS-CoV-2 entry genes and basigin (BSG/CD147) increases with age in endothelial cells

Vascular/cardiovascular inflammation and thrombosis occur in severe COVID-19. Advancing age is the most significant risk factor for severe COVID-19. Using transcriptomic databases, we found: (i) cardiovascular tissues/endothelial cells express putative genes for SARS-CoV-2 infection including ACE2 and BSG, (ii) SARS-CoV-2 receptor pathways, ACE2TMPRSS2 and BSG/PPIB(A) polarise to lung/epithelium and vessel/endothelium respectively, (iii) expression of host genes are relatively stable with age and (iv) notable exceptions are ACE2 which decreases with age in some tissues and BSG which increases with age in endothelial cells, suggesting that BSG expression in the vasculature may explain the heightened risk of severe disease with age.

Les enzymes de la replication/transcription chez les coronavirus

The discovery of a new coronavirus (CoV) as the causative agent of the severe acute respiratory syndrome (SARS) pandemic outbreak in 2003 has stimulated a number of studies on the molecular biology of SARS-CoV and related viruses This research has provided significant new insight into functions and activities of the CoV replication-transcription complex, a multi-protein complex that directs coordinated processes of both continuous and discontinuous RNA synthesis to replicate and transcribe the large CoV genome, a single-stranded, positive-sense RNA of ~30 kilobases In this review, we summarize current understanding of the expression and functions of key replicative enzymes, such as RNA polymerases, ribonucleases, methyltransferases and other replicase gene encoded proteins involved in genome expression, virus-host interactions and other processes Collectively, these recent studies reveal fascinating details of a huge enzymatic machinery unique in the RNA virus world

Maintaining robust HIV and tuberculosis services in the COVID-19 era: A public health dilemma in Zimbabwe

Coronavirus disease 2019 (COVID-19) has challenged health systems worldwide. In Zimbabwe, the COVID-19 response has seen the diversion of human capital, equipment, and other resources that were meant for the HIV and tuberculosis (TB) programmes. In a country with one of the worst HIV and TB burdens globally, the authors discuss this public health dilemma of sustained HIV and TB services in the context of a new threat - COVID-19.

Maintaining robust HIV and tuberculosis services in the COVID-19 era: A public health dilemma in Zimbabwe

Coronavirus disease 2019 (COVID-19) has challenged health systems worldwide. In Zimbabwe, the COVID-19 response has seen the diversion of human capital, equipment, and other resources that were meant for the HIV and tuberculosis (TB) programmes. In a country with one of the worst HIV and TB burdens globally, the authors discuss this public health dilemma of sustained HIV and TB services in the context of a new threat - COVID-19.

What we know about COVID-19 and its treatment

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) which is the human coronavirus and a member of the Coronaviridae family leads to fatal pneumonia cases Severe acute respiratory syndrome corona virus 2 attaches to the cells in the human body through binding to the angiotensin converting enzyme 2 (ACE2) receptor with the spike (S) protein Firstly, SARS-CoV-2 arised in China in late 2019 and was reported to the World Health Organization (WHO) The World Health Organization named the disease caused by this virus as corona virus disease (COVID)-19 SARS-CoV-2 which has human-to-human transmission through droplets, direct contact and aerosol routes have affected more than 10 million people and caused more than 500 thousand deaths Clinical symptoms of COVID-19 are fever, dry cough, sore throat, respiratory distress, lung damage, and diarrhea In severe cases, mechanical ventilation is required and multiple organ damage is encountered COVID-19 is diagnosed with real-time polymerase chain reaction (PCR) technique which is applied to saliva and swab samples taken from the nose or nasal cavity Lung damage is detected by computerized tomography (CT) COVID-19 develops more severely in patients with comorbidities such as hypertension, diabetes and cancer While vaccine and drug development studies are continuing all over the world, available antiviral drugs such as umifenovir, remdesivir, favipiravir are also tested against SARS-CoV-2 Moreover, the plasma donated from the recovered patients are tested for COVID-19 treatment Additionally, treating the inflammatory conditions developing due to COVID-19 and applying antimicrobial drugs against co-infections are among the current approaches

Sequencing Therapies for Metastatic Renal Cell Carcinoma

In an era of several therapeutic options available, optimal treatment sequencing is crucial to providing patients the most effective therapy and promoting quality of life. In clear cell renal cell carcinoma, a combination approach with an immunotherapy backbone, such as nivolumab/ipilimumab or axitinib/pembrolizumab, has a key role in the first-line setting. Safety and activity data support the transition to single-agent targeted therapies in the second-line setting. Nivolumab monotherapy possesses clinical and mechanistic rationale as a second-line therapeutic option for patients treated with targeted therapies in the first-line setting. Gene expression models are being generated from large prospective clinical trial data sets.

Inequities in access to education: Lessons from the COVID-19 pandemic

The COVID-19 pandemic has brought attention to the stark inequities in public education worldwide, with the United Nations sharing these statistics: Schools closed in 191 countries, affecting 1 5 billion students and 63 million primary and secondary school teachers Half of students did not have access to a computer, and 40% did not have internet access A total of 56 million children live in areas that are not served by mobile networks ? for example, in sub-Saharan Africa In the United States, about 7 million school-aged children are in homes without home internet service

Statistical and Network-Based Analysis of Italian COVID-19 Data: Communities Detection and Temporal Evolution

The coronavirus disease (COVID-19) outbreak started in Wuhan, China, and it has rapidly spread across the world. Italy is one of the European countries most affected by COVID-19, and it has registered high COVID-19 death rates and the death toll. In this article, we analyzed different Italian COVID-19 data at the regional level for the period 24 February to 29 March 2020. The analysis pipeline includes the following steps. After individuating groups of similar or dissimilar regions with respect to the ten types of available COVID-19 data using statistical test, we built several similarity matrices. Then, we mapped those similarity matrices into networks where nodes represent Italian regions and edges represent similarity relationships (edge length is inversely proportional to similarity). Then, network-based analysis was performed mainly discovering communities of regions that show similar behavior. In particular, network-based analysis was performed by running several community detection algorithms on those networks and by underlying communities of regions that show similar behavior. The network-based analysis of Italian COVID-19 data is able to elegantly show how regions form communities, i.e., how they join and leave them, along time and how community consistency changes along time and with respect to the different available data.

Report of four pregnant women getting COVID-19 in Ilam, Iran: Case Series

Background: Today, COVID-19 has become the most important health burdenall over the world.Pregnant women are determined as one of the high-risk groups. COVID-19 infection in this group may result in huge damages. This study aimed to report COVID-19 infection in four pregnant women in Ilam, Iran. Findings: In the present study, four pregnant women infected with COVID-19 were reported. They were first positive for real-time PCR and then their CT scan werepositive, main clinical parameters of these patients were presented. All of these patients were hospitalized and all of them were treated successfully. Conclusion: This study showed although pregnant women were at higher risk of COVID-19 infection, they were treated successfully. This study also reported that receiving the necessary care and treatment atthe hospital for pregnant women can be a good experience.

Dengue and COVID-19: similarities and differences

RESUMEN Dengue y COVID-19 son dos enfermedades que amenazan a poblaciones enteras en la Región de Las Américas y coexisten en Cuba Tienen semejanzas y diferencias que obligan a los médicos tratantes a hacer el diagnóstico diferencial entre ambas pues cada una puede ser causa de muerte El objetivo del presente trabajo es contribuir al diagnóstico correcto de cada enfermo y su mejor atención Se revisaron los conceptos actuales sobre etiología y patogenia de ambas, así como su cuadro clínico, cuidado y prevención Tanto dengue como COVID-19 tienen un periodo febril y otro crítico, ambas son infecciones sistémicas y sus síntomas iniciales pueden ser parecidos entre sí y no ser los mismos del cuadro típico o característico posterior, particularmente en la edad pediátrica El dengue define su curso en una semana y la enfermedad por el nuevo coronavirus tiene al menos tres semanas para su restablecimiento o evolución fatal Cada semejanza y diferencia entre ambas fue objeto de análisis considerando los criterios nacionales e internacionales más actualizados haciendo énfasis en la mejor manera de tratar cada paciente para evitar complicaciones y muerte ABSTRACT Dengue and COVID-19 are two diseases that threaten many populations in the region of the Americas and which co-exist in Cuba They both have similarities and differences which force doctors in charge to do a differential diagnosis among both diseases because each can be a cause of death The objective of this work is contributing to the correct diagnosis of each patient and their better care There was a review of the current concepts on etiology and pathogenesis of both diseases, as well as their clinical profile, care and prevention Dengue as COVID-19 has a fever period and a critical one, both are systemic infections and their initial symptoms can be similar and might not be the same of the subsequent typical clinical picture, particularly in pediatric ages Dengue defines its evolution in one week and the disease caused by the new coronavirus needs at least three weeks for its recovery or fatal evolution Each similarity and difference among each disease was analyzed taking into account the most updated national and international criteria higlighting the best way to treat each patient avoiding complications and deads

Dengue and covid-19: Similarities and differences

Dengue and COVID-19 are two diseases that threaten many populations in the region of the Americas and which co-exist in Cuba They both have similarities and differences which force doctors in charge to do a differential diagnosis among both diseases because each can be a cause of death The objective of this work is contributing to the correct diagnosis of each patient and their better care There was a review of the current concepts on etiology and pathogenesis of both diseases, as well as their clinical profile, care and prevention Dengue as COVID-19 has a fever period and a critical one, both are systemic infections and their initial symptoms can be similar and might not be the same of the subsequent typical clinical picture, particularly in pediatric ages Dengue defines its evolution in one week and the disease caused by the new coronavirus needs at least three weeks for its recovery or fatal evolution Each similarity and difference among each disease was analyzed taking into account the most updated national and international criteria higlighting the best way to treat each patient avoiding complications and deads © 2020, Editorial Ciencias Medicas All rights reserved

Optimization of atomic density-fitting basis functions for molecular two-electron integral approximations

A general procedure for the optimization of atomic density-fitting basis functions is designed with the balance between accuracy and numerical stability in mind. Given one-electron wavefunctions and energies, weights are assigned to the product densities, modeling their contribution to the exchange and second-order correlation energy, and a simple weighted error measure is minimized. Generally contracted Gaussian auxiliary basis sets are optimized to match the wavefunction basis sets [D. N. Laikov, Theor. Chem. Acc. 138, 40 (2019)] for all 102 elements in a scalar-relativistic approximation [D. N. Laikov, J. Chem. Phys. 150, 061103 (2019)].

Pneumatosis Intestinalis in COVID-19: Case Series

Objective: To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) who developed pneumatosis intestinalis (PI) Methods: This case series was conducted in intensive care units at two large tertiary care centers within the Northwell Health System, located in New York State Patients were included if they were identified as having confirmed COVID-19 as well as pneumatosis intestinalis from March 16, 2020 to July 31, 2020 Patient demographics, clinical characteristics, vasopressor use, anticoagulation use, opiate use, paralytic use, COVID-19 treatment regimen, serum lactate, arterial pH, serum bicarbonate, subsequent intervention, and outcomes during hospitalization were collected Results: A total of nine patients were identified Average serum lactate was 4 33 mmol/L at time of diagnosis Portal venous gas (56%) and bowel dilation (56%) were common radiographic findings Subsequent morbidity (increased vasopressor requirements - 67%, acute kidney injury - 67%, increased oxygen requirements - 44%) and mortality (78%) were high PI occurred despite a majority of patients being on anticoagulation (78%) Interleukin-6 (IL-6) inhibitors were commonly administered (56%) prior to development of PI Conclusion: Pneumatosis intestinalis in COVID-19 is clinically significant, with high morbidity and mortality, and is also likely underdiagnosed

Chembio DPP COVID-19 IgM/IgG Serological Testing: Laboratory Validation, Guidelines, and Recommendations

BACKGROUND: On January 30, 2020, WHO declared COVID-19 a pandemic. In this article we describe our experience at Richmond University Medical Center with Chembio serological IgM, IgG testing. METHODS: In this prospective cohort study of patients and hospital employees, we utilized Chembio COVID-19 IgM/IgG serological testing in addition to Cepheid RT-PCR analysis. RESULTS: We evaluated the performance of Chembio serological test for IgM and IgG as an employee screening tool in a community hospital setting. The total number of currently asymptomatic employees screened was 1,866 from the Richmond University Medical Center. The non-exposed group included 1,253 (67.1%) employees with no significant clinical history and non-reactive IgM and IgG antibodies. The convalescent group included 255 (13.7%) of the employees with elevation of IgG only, 18 (1%) employees with past history of positive PCR and COVID-19 who currently have non-reactive IgM and IgG antibodies or demonstrate elevated IgG only, followed by 3 employees (< 1%) with no past clinical history who demonstrated reactive IgM and IgG antibodies and negative follow up by PCR. The reported 14.9% exposure/convalescent rate is lower than the reported 20% by the Department of Health and Governor Andrew Cuomo and may represent a better utilization of personal protective equipment, better hand washing techniques, and better disinfection procedures combined with strict social distancing. CONCLUSIONS: Chembio's performance is satisfactory; however, hospitals must design their own policies addressing: who needs to be screened and who will interpret the results as well as constructing management algorithms for employees with no previous history and current double positive antibodies.

Nowcasting of COVID-19 confirmed cases: Foundations, trends, and challenges

The coronavirus disease 2019 (COVID-19) has become a public health emergency of international concern affecting more than 200 countries and territories worldwide. As of September 30, 2020, it has caused a pandemic outbreak with more than 33 million confirmed infections and more than 1 million reported deaths worldwide. Several statistical, machine learning, and hybrid models have previously tried to forecast COVID-19 confirmed cases for profoundly affected countries. Due to extreme uncertainty and nonstationarity in the time series data, forecasting of COVID-19 confirmed cases has become a very challenging job. For univariate time series forecasting, there are various statistical and machine learning models available in the literature. But, epidemic forecasting has a dubious track record. Its failures became more prominent due to insufficient data input, flaws in modeling assumptions, high sensitivity of estimates, lack of incorporation of epidemiological features, inadequate past evidence on effects of available interventions, lack of transparency, errors, lack of determinacy, and lack of expertise in crucial disciplines. This chapter focuses on assessing different short-term forecasting models that can forecast the daily COVID-19 cases for various countries. In the form of an empirical study on forecasting accuracy, this chapter provides evidence to show that there is no universal method available that can accurately forecast pandemic data. Still, forecasters' predictions are useful for the effective allocation of healthcare resources and will act as an early-warning system for government policymakers.

Breastfeeding during the novel coronavirus (COVID-19) pandemic: guidelines and challenges

COVID-19 pandemic has raised questions on pregnant women and newborns' management. Guidelines, issued by most international agencies and national bodies, recommend rooming-in and direct breastfeeding. In the early days of this pandemic, breastfeeding practices have been challenged by fear among both parents and healthcare workers occasionally resulting in mother-newborn separation. We herein review current breastfeeding guidelines and discuss remaining questions and challenges. As we are facing the second wave of this pandemic, more information is gathered, especially regarding possible virus transmissibility through breastfeeding, enabling more definite instructions about breastfeeding practices.

Anxiety and depression symptoms of medical staff under COVID-19 epidemic in China

BACKGROUND: It is well known that unexpected pandemic has led to an increase in mental health problems among a variety of populations. METHODS: In this study, an online non-probability sample survey was used to anonymously investigate the anxiety and depression symptoms among medical staff under the COVID-19 outbreak. The questionnaire included Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Factors associated with anxiety and depression symptoms were estimated by logistic regression analysis. RESULTS: A total of 1090 medical staff were investigated in this study. The estimated self-reported rates of anxiety symptoms, depression symptoms and both of the two were 13.3%, 18.4% and 23.9% respectively. Factors associated with self-reported anxiety symptoms include married status (OR=2.3, 95%CI: 1.2, 4.4), not living alone (OR=0.4, 95%CI: 0.2, 0.7), never confiding their troubles to others (OR=2.2, 95%CI: 1.4, 3.5) and higher stress (OR=14.4, 95%CI: 7.8, 26.4). Factors associated with self-reported depression symptoms include not living alone (OR=0.4, 95%CI: 0.3, 0.7), sometimes/often getting care from neighbours (OR=0.6, 95%CI: 0.4, 0.9), never confiding their troubles to others (OR=2.0, 95%CI: 1.3, 3.0) and higher stress (OR=9.7, 95%CI: 6.2, 15.2). LIMITATIONS: The study was a non-probability sample survey. Besides, scales used in this study can only identify mental health states. CONCLUSIONS: Under outbreak of COVID-19, self-reported rates of anxiety symptoms and depression symptoms were high in investigated medical staff. Psychological interventions for those at high risk with common mental problems should be integrated into the work plan to fight against the epidemic.

Lung ultrasound as diagnostic tool for SARS-CoV-2 infection

The aim of this study was to explore the role of lung ultrasound (LUS) in the diagnosis of SARS-CoV-2 infection and to verify its utility in the prediction of lung disease's severity and outcome. Fifty-three consecutive patients presenting to the Emergency Department of Santa Maria delle Grazie Hospital with high suspicion of SARS-CoV-2 infection underwent diagnostic test for SARS-CoV-2 on samples obtained from nasopharyngeal swab as well as complete proper diagnostic work-up that included clinical evaluation, laboratory tests, blood gas analyses, chest CT and LUS. A semiquantitative analysis of B-lines distribution was performed to calculate the LUS score. Patients were divided into two groups according to the results of both SARS-CoV-2 diagnostic test and other exams (Group A = pneumonia due to SARS-CoV2 infection vs Group B = no SARS-CoV2 infection and another definite diagnosis). LUS showed an excellent accuracy in predicting the diagnosis of SARS-CoV-2 infection (area under the ROC curve of 0.92 with a sensibility of 73% and a specificity of 89% a the cut-off of 12.5). LUS score was more impaired in SARS-CoV-2 patients (18.1 ± 6.0 vs 7.6 ± 5.9, p < 0.00001) and it is significantly negatively correlated with PF ratio values (r = - 0.719, p < 0.0001). An intrahospital mortality rate of 46% was found; patients with adverse outcome had significant higher value of LUS, PF, LDH, and APACHE II score. None of these parameters was predictive of mortality. LUS is a useful tool for the early detection of SARS-CoV-2 infection and for the evaluation of the disease severity, but does not predict mortality. Further studies with repeated evaluations of LUS score are needed to further explore the role of LUS in the assessment of severity in SARS-CoV-2 disease and in the monitoring of the response to treatments.

Single center trends in acute coronary syndrome volume and outcomes during the COVID-19 pandemic

Background: The coronavirus disease 2019 (COVID-19) pandemic has greatly affected healthcare delivery across the world. In this report, we aim to further characterize the changes in cardiac catheterization at our institution, specifically in the setting of acute coronary syndrome (ACS). Methods: We performed a retrospective analysis of patients undergoing cardiac catheterization between December 23, 2019 and April 12, 2020 at our institution. All patients with cardiac catheterizations for ACS, ST-elevation myocardial infarction (STEMI) activation, and out-of-hospital cardiac arrest (OHCA) were analyzed. Cardiac catheterization volume, as well as clinical and procedural characteristics of patients undergoing cardiac catheterization, was compared before and during the COVID-19 pandemic. Results: Patients presenting with ACS and OHCA were similar in terms of demographics and comorbidities during both time periods. The mean monthly volume for ACS cases dropped by 26% during the pandemic, which was consistent among both unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) and STEMI cases. OHCA volume decreased significantly as well (five cases per month before to zero cases during the pandemic, P = 0.01). Among patients with STEMI, initial markers of cardiac injury, door-to-balloon time, and all-cause mortality were similar in both time periods. Conclusions: With the start of the COVID-19 pandemic, there was a reduction in cardiac catheterization volume across the spectrum of ACS at our institution, which was consistent with reports from other centers across the globe. Patients with STEMI during the initial phase of the COVID-19 pandemic did not seem to have delays in presentation or significant differences in all-cause mortality at our institution.

Antibacterial Drug Development: A New Approach Is Needed for the Field to Survive and Thrive

It is often said that the marketplace for new antibiotics is broken This notion is supported by the observation that many recently-approved antibiotics to treat drug-resistant bacteria have failed commercially in a spectacular fashion Today, companies with peak market-cap values in excess of USD 500 million to 1 billion prior to product launch regularly sell for pennies on the dollar a few years after market introduction It is possible, however, that the market is not as broken as we perceive That is, in the collective mind of the clinician, recently-approved antibiotics may be too-poorly differentiated to justify their broad use and inordinate cost relative to those already existing Perhaps we in the antibacterial drug development field must change our way of thinking if we are to survive and thrive Rather than reflexively developing new &beta;-lactam-&beta;-lactamase inhibitor combinations for every new enzyme that evades our current inhibitors, we should focus discovery and development efforts on agents that revolutionize how we potentiate antibiotics To this end, there has been renewed interest in phage therapies, virulence inhibitors, bacterial growth rate modulators, monoclonal antibodies, and other approaches to augment antibiotic effects Herein, we suggest that the unmet medical need is less about adding poorly-differentiated antibiotics to our armamentarium and more about the need for innovation in how we augment antibiotic regimen effects

Regulation of arachidonic acid oxidation and metabolism by lipid electrophiles

Arachidonic acid (AA) is a precursor of enzymatic and non-enzymatic oxidized products such as prostaglandins, thromboxanes, leukotrienes, lipoxins, and isoprostanes. These products may exert signaling or damaging roles during physiological and pathological conditions, some of them being markers of oxidative stress linked to inflammation. Recent data support the concept that cyclooxygenases (COX), lipoxygenases (LOX), and cytochrome P450 (CYP450) followed by cytosolic and microsomal dehydrogenases can convert AA to lipid-derived electrophiles (LDE). Lipid-derived electrophiles are fatty acid derivatives bearing an electron-withdrawing group that can react with nucleophiles at proteins, DNA, and small antioxidant molecules exerting potent signaling properties. This review aims to describe the formation, sources, and electrophilic anti-inflammatory actions of key mammalian LDE.

A cytokine super cyclone in COVID-19 patients with risk factors: the therapeutic potential of BCG immunization

The seventh human coronavirus SARS-CoV2 belongs to the cluster of extremely pathogenic coronaviruses including SARS-CoV and MERS-CoV, which can cause fatal lower respiratory tract infection. Likewise, SARS-CoV2 infection can be fatal as the disease advances to pneumonia, followed by acute respiratory distress syndrome (ARDS). The development of lethal clinical symptons is associated with an exaggerated production of inflammatory cytokines, referred to as the cytokine storm, is a consequence of a hyperactivated immune response aginst the infection. In this article, we discuss the pathogenic consequences of the cytokine storm and its relationship with COVID-19 associated risk factors. The increased pro-inflammatory immune status in patients with risk factors (diabetes, hypertension, cardiovascular disease, COPD) exacerbates the Cytokine-storm of COVID-19 into a 'Cytokine Super Cyclone'. We also evaluate the antiviral immune responses provided by BCG vaccination and the potential role of 'trained immunity' in early protection against SARS-CoV2.

A cytokine super cyclone in COVID-19 patients with risk factors: the therapeutic potential of BCG immunization

The seventh human coronavirus SARS-CoV2 belongs to the cluster of extremely pathogenic coronaviruses including SARS-CoV and MERS-CoV, which can cause fatal lower respiratory tract infection. Likewise, SARS-CoV2 infection can be fatal as the disease advances to pneumonia, followed by acute respiratory distress syndrome (ARDS). The development of lethal clinical symptons is associated with an exaggerated production of inflammatory cytokines, referred to as the cytokine storm, is a consequence of a hyperactivated immune response aginst the infection. In this article, we discuss the pathogenic consequences of the cytokine storm and its relationship with COVID-19 associated risk factors. The increased pro-inflammatory immune status in patients with risk factors (diabetes, hypertension, cardiovascular disease, COPD) exacerbates the Cytokine-storm of COVID-19 into a 'Cytokine Super Cyclone'. We also evaluate the antiviral immune responses provided by BCG vaccination and the potential role of 'trained immunity' in early protection against SARS-CoV2.