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Risk factors for being a victim of online grooming in adolescents/ Factores de riesgo de ser víctima de online grooming en adolescentes

BACKGROUND: The risk of child grooming has spread exponentially with the massive access of adolescents to social networks and the internet. The aim of the study was to examine the personal factors (body self-esteem and disinhibition) and erotic-sexual factors (sexual initiation strategies and erotic-pornographic sexting) that predict grooming. METHOD: The sample was comprised of 1,200 adolescents aged between 12 and 16 years (M = 14.54, SD = 1.17; 50.83% girls). A cross-sectional design with self-report data was used and structural equation modeling (SEM) with mediation analysis was performed. RESULTS: The results indicated two paths explaining child grooming: 1) physical attractiveness and disinhibition are indirectly associated with grooming through erotic sexting and direct sexual initiation strategies; both of which partially mediate this relationship; 2) disinhibited behavior has an indirect impact on grooming; pornographic sexting and coercive strategies acting as mediators. The semi-partial mediation model explains 54% of the variance of grooming. CONCLUSIONS: These findings highlight the urgent need to implement prevention programs considering these attitudes and behaviors that function as precursors of victimization and the risk of falling into pedophile networks

Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

During the COVID-19 pandemic, the antimicrobial stewardship module in our electronic medical record was reconfigured for the management of COVID-19 patients. This change allowed our subspecialist providers to review charts quickly to optimize potential therapy and management during the patient surge.

Repurposing antimicrobial stewardship tools in the electronic medical record for the management of COVID-19 patients

During the COVID-19 pandemic, the antimicrobial stewardship module in our electronic medical record was reconfigured for the management of COVID-19 patients. This change allowed our subspecialist providers to review charts quickly to optimize potential therapy and management during the patient surge.

Transmission of SARS-CoV-2 Involving Residents Receiving Dialysis in a Nursing Home - Maryland, April 2020

SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), can spread rapidly in nursing homes once it is introduced (1,2). To prevent outbreaks, more data are needed to identify sources of introduction and means of transmission within nursing homes. Nursing home residents who receive hemodialysis (dialysis) might be at higher risk for SARS-CoV-2 infections because of their frequent exposures outside the nursing home to both community dialysis patients and staff members at dialysis centers (3). Investigation of a COVID-19 outbreak in a Maryland nursing home (facility A) identified a higher prevalence of infection among residents undergoing dialysis (47%; 15 of 32) than among those not receiving dialysis (16%; 22 of 138) (p<0.001). Among residents with COVID-19, the 30-day hospitalization rate among those receiving dialysis (53%) was higher than that among residents not receiving dialysis (18%) (p = 0.03); the proportion of dialysis patients who died was 40% compared with those who did not receive dialysis (27%) (p = 0.42).Careful consideration of infection control practices throughout the dialysis process (e.g., transportation, time spent in waiting areas, spacing of machines, and cohorting), clear communication between nursing homes and dialysis centers, and coordination of testing practices between these sites are critical to preventing COVID-19 outbreaks in this medically vulnerable population.

Right Heart Strain on Presenting 12-Lead Electrocardiogram Predicts Critical Illness in COVID-19

Background Cardiovascular comorbidities and complications, including right ventricular dysfunction, are common and are associated with worse outcomes in patients with COVID-19 The data on the clinical utility of 12-lead electrocardiograms (ECG) to aid with prognosis is limited Objectives We aim to assess the association of new right heart strain patterns on presenting 12-lead electrocardiogram (RHS-ECG) with outcomes in patients hospitalized with COVID-19 Methods We retrospectively evaluated records from 480 patients who were consecutively admitted with COVID-19 ECGs obtained at the time of presentation in the emergency department (ED) were considered as index ECGs RHS-ECG was defined by any new right axis deviation, S1Q3T3 pattern, or ST depressions with T-wave inversions in leads V1-3 or II, III, aVF Multivariable logistic regression was performed to assess whether RHS-ECG is independently associated with our primary outcomes Results ECGs from the ED were available for 314 patients who were included in the analysis Most patients were in sinus rhythm, with sinus tachycardia being the most frequent dysrhythmia RHS-ECG findings were present in 40 (11%) patients RHS-ECG was significantly associated with the incidence of adverse outcomes and an independent predictor of mortality (adjOR, 15 2 (95% [CI, 5 1-45 2];P&lt;0 001), the need for mechanical ventilation (adjOR, 8 8 [95% CI, 3 4-23 2];P&lt;0 001), and their composite (adjOR, 12 1 [95% CI, 4 3-33 9];P&lt;0 001) Conclusions RHS-ECG was associated with mechanical ventilation and mortality in patients admitted with COVID-19 Special attention should be taken in patients admitted with new signs of RHS on presenting ECG

Suicide and the Elderly During the COVID-19 Pandemic: An Overview of Different Suicide Theories

Objective: To expand knowledge during the coronavirus disease 2019 (COVID-19) pandemic with regard to suicide prevention among the elderly population by providing recommendations for interview strategies using 3 suicide theories. Methods: Two hypothetical geriatric suicide cases (1 low lethality and 1 high lethality) are presented and categorized according to 3 suicide theories: interpersonal theory of suicide, three-step theory of suicide, and hopelessness theory of depression. Results: In crisis intervention, the clinician's interview must match the intrinsic belief of the suicide attempter to enable engagement and rapport. Use of different aspects of the 3 suicide theories can be useful but are dependent on the emergent nature of the attempt. Conclusion: The need for identification and treatment of those with mental health issues, especially among the elderly population, and collaborative multidiscipline management teams is increasing during the current global pandemic. Specific interview strategies are needed when engaging with elderly suicidal patients. Suicide prevention in elderly patients is worthy of strong public attention.

Efficacy and safety of triazavirin therapy for coronavirus disease 2019: A pilot randomized controlled trial

No therapeutics have been proven effective yet for the treatment of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To assess the efficacy and safety of Triazavirin therapy for COVID-19, we conducted a randomized, double-blinded controlled trial involving hospitalized adult patients with COVID-19. Participants were enrolled from ten sites, and were randomized into two arms of the study with a ratio of 1:1. Patients were treated with Triazavirin 250 mg versus a placebo three or four times a day for 7 d. The primary outcome was set as the time to clinical improvement, defined as normalization of body temperature, respiratory rate, oxygen saturation, cough, and absorption of pulmonary infection by chest computed tomography (CT) until 28 d after randomization. Secondary outcomes included individual components of the primary outcome, the mean time and proportion of inflammatory absorption in the lung, and the conversion rate to a repeated negative SARS-CoV-2 nucleic acid test of throat swab sampling. Concomitant therapeutic treatments, adverse events, and serious adverse events were recorded. Our study was halted after the recruitment of 52 patients, since the number of new infections in the participating hospitals decreased greatly. We randomized 52 patients for treatment with Triazavirin (n = 26) or a placebo (n = 26). We found no differences in the time to clinical improvement (median, 7 d vs. 12 d; risk ratio (RR), 2.0; 95% confidence interval (CI), 0.7-5.6; p = 0.2), with clinical improvement occurring in ten patients in the Triazavirin group and six patients in the placebo group (38.5% vs. 23.1%, RR, 2.1; 95% CI, 0.6-7.0; p = 0.2). All components of the primary outcome normalized within 28 d, with the exception of absorption of pulmonary infection (Triazavirin 50.0%, placebo 26.1%). Patients in the Triazavirin group used less frequent concomitant therapies for respiratory, cardiac, renal, hepatic, or coagulation supports. Although no statistically significant evidence was found to indicate that Triazavirin benefits COVID-19 patients, our observations indicated possible benefits from its use to treat COVID-19 due to its antiviral effects. Further study is required for confirmation.

COVID-19 drive-through testing survey: Measuring the burden on healthcare workers

Objective: To survey individuals who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at 1 of 4 Trinity Health of New England drive-through testing centers to assess their demographic information, hospitalization rate, preexisting conditions, possible routes of exposures, duration of symptoms, and subsequent household infections of healthcare workers (HCWs) when compared to non-HCWs. Methods: Data were collected via a telephone survey using a standardized script. Between March 1, 2020 and June 17, 2020, 28,903 people were tested at 4 Connecticut drive-through testing centers. Individuals who tested positive between March 16 and April 21, 2020 were randomly contacted. Of those individuals, 100 people agreed to complete the survey. Bivariate analysis and logistic regression were performed. Results: HCWs comprised 46% of the 100 survey respondents during the study period. Similarly, HCWs comprised 42.1% of all individuals who tested positive and listed an employer between March 1 and June 17, 2020. HCWs reported a longer duration of symptoms (17.39 vs 13.44 days) and were more likely to report work as their route of exposure (80.4% vs 27.8%) than non-HCWs. Conclusions: HCWs may face a disproportionate risk of contracting COVID-19 and self-report a longer duration of symptoms than the general public. The data suggest a need for an increased recovery time away from work than is currently recommended by the Centers for Disease Control and Prevention, as well as an increase in infection precautions for HCWs.

The immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2: Vaccine design strategies

The worldwide outbreak of SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 as a novel human coronavirus, was the worrying news at the beginning of 2020 Since its emergence complicated more than 870,000 individuals and led to more than 43,000 deaths worldwide Considering to the potential threat of a pandemic and transmission severity of it, there is an urgent need to evaluate and realize this new virus’s structure and behavior and the immunopathology of this disease to find potential therapeutic protocols and to design and develop effective vaccines This disease is able to agitate the response of the immune system in the infected patients, so ARDS, as a common consequence of immunopathological events for infections with Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2, could be the main reason for death Here, we summarized the immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2 and therapeutic and prophylactic strategies with a focus on vaccine development and its challenges

Autonomously Replicating RNAs of Bungowannah Pestivirus: ERNS Is Not Essential for the Generation of Infectious Particles

Autonomously replicating subgenomic Bungowannah virus (BuPV) RNAs (BuPV replicons) with deletions of the genome regions encoding the structural proteins C, ERNS, E1, and E2 were constructed on the basis of an infectious cDNA clone of BuPV. Nanoluciferase (Nluc) insertion was used to compare the replication efficiencies of all constructs after electroporation of in vitro-transcribed RNA from the different clones. Deletion of C, E1, E2, or the complete structural protein genome region (C-ERNS-E1-E2) prevented the production of infectious progeny virus, whereas deletion of ERNS still allowed the generation of infectious particles. However, those &#916;ERNS viral particles were defective in virus assembly and/or egress and could not be further propagated for more than three additional passages in porcine SK-6 cells. These "defective-in-third-cycle" BuPV &#916;ERNS mutants were subsequently used to express the classical swine fever virus envelope protein E2, the N-terminal domain of the Schmallenberg virus Gc protein, and the receptor binding domain of the Middle East respiratory syndrome coronavirus spike protein. The constructs could be efficiently complemented and further passaged in SK-6 cells constitutively expressing the BuPV ERNS protein. Importantly, BuPVs are able to infect a wide variety of target cell lines, allowing expression in a very wide host spectrum. Therefore, we suggest that packaged BuPV &#916;ERNS replicon particles have potential as broad-spectrum viral vectors.IMPORTANCE The proteins NPRO and ERNS are unique for the genus Pestivirus, but only NPRO has been demonstrated to be nonessential for in vitro growth. While this was also speculated for ERNS, it has always been previously shown that pestivirus replicons with deletions of the structural proteins ERNS, E1, or E2 did not produce any infectious progeny virus in susceptible host cells. Here, we demonstrated for the first time that BuPV ERNS is dispensable for the generation of infectious virus particles but still important for efficient passaging. The ERNS-defective BuPV particles showed clearly limited growth in cell culture but were capable of several rounds of infection, expression of foreign genes, and highly efficient trans-complementation to rescue virus replicon particles (VRPs). The noncytopathic characteristics and the absence of preexisting immunity to BuPV in human populations and livestock also provide a significant benefit for a possible use, e.g., as a vector vaccine platform.

Autonomously Replicating RNAs of Bungowannah Pestivirus: ERNS Is Not Essential for the Generation of Infectious Particles

Autonomously replicating subgenomic Bungowannah virus (BuPV) RNAs (BuPV replicons) with deletions of the genome regions encoding the structural proteins C, ERNS, E1, and E2 were constructed on the basis of an infectious cDNA clone of BuPV. Nanoluciferase (Nluc) insertion was used to compare the replication efficiencies of all constructs after electroporation of in vitro-transcribed RNA from the different clones. Deletion of C, E1, E2, or the complete structural protein genome region (C-ERNS-E1-E2) prevented the production of infectious progeny virus, whereas deletion of ERNS still allowed the generation of infectious particles. However, those &#916;ERNS viral particles were defective in virus assembly and/or egress and could not be further propagated for more than three additional passages in porcine SK-6 cells. These "defective-in-third-cycle" BuPV &#916;ERNS mutants were subsequently used to express the classical swine fever virus envelope protein E2, the N-terminal domain of the Schmallenberg virus Gc protein, and the receptor binding domain of the Middle East respiratory syndrome coronavirus spike protein. The constructs could be efficiently complemented and further passaged in SK-6 cells constitutively expressing the BuPV ERNS protein. Importantly, BuPVs are able to infect a wide variety of target cell lines, allowing expression in a very wide host spectrum. Therefore, we suggest that packaged BuPV &#916;ERNS replicon particles have potential as broad-spectrum viral vectors.IMPORTANCE The proteins NPRO and ERNS are unique for the genus Pestivirus, but only NPRO has been demonstrated to be nonessential for in vitro growth. While this was also speculated for ERNS, it has always been previously shown that pestivirus replicons with deletions of the structural proteins ERNS, E1, or E2 did not produce any infectious progeny virus in susceptible host cells. Here, we demonstrated for the first time that BuPV ERNS is dispensable for the generation of infectious virus particles but still important for efficient passaging. The ERNS-defective BuPV particles showed clearly limited growth in cell culture but were capable of several rounds of infection, expression of foreign genes, and highly efficient trans-complementation to rescue virus replicon particles (VRPs). The noncytopathic characteristics and the absence of preexisting immunity to BuPV in human populations and livestock also provide a significant benefit for a possible use, e.g., as a vector vaccine platform.

Signal amplification by reversible exchange for COVID-19 antiviral drug candidates

Several drug candidates have been proposed and tested as the latest clinical treatment for coronavirus pneumonia (COVID-19). Chloroquine, hydroxychloroquine, ritonavir/lopinavir, and favipiravir are under trials for the treatment of this disease. The hyperpolarization technique has the ability to further provide a better understanding of the roles of these drugs at the molecular scale and in different applications in the field of nuclear magnetic resonance/magnetic resonance imaging. This technique may provide new opportunities in diagnosis and research of COVID-19. Signal amplification by reversible exchange-based hyperpolarization studies on large-sized drug candidates were carried out. We observed hyperpolarized proton signals from whole structures, due to the unprecedented long-distance polarization transfer by para-hydrogen. We also found that the optimal magnetic field for the maximum polarization transfer yield was dependent on the molecular structure. We can expect further research on the hyperpolarization of other important large molecules, isotope labeling, as well as polarization transfer on nuclei with a long spin relaxation time. A clinical perspective of these features on drug molecules can broaden the application of hyperpolarization techniques for therapeutic studies.

JAK1 Inhibition Blocks Lethal Immune Hypersensitivity in a Mouse Model of Down Syndrome

Individuals with Down syndrome (DS; trisomy 21) display hyperactivation of interferon (IFN) signaling and chronic inflammation, which could potentially be explained by the extra copy of four IFN receptor (IFNR) genes encoded on chromosome 21. However, the clinical effects of IFN hyperactivity in DS remain undefined. Here, we report that a commonly used mouse model of DS overexpresses IFNR genes and shows hypersensitivity to IFN ligands in diverse immune cell types. When treated repeatedly with a TLR3 agonist to induce chronic inflammation, these animals overexpress key IFN-stimulated genes, induce cytokine production, exhibit liver pathology, and undergo rapid weight loss. Importantly, the lethal immune hypersensitivity and cytokine production and the ensuing pathology are ameliorated by JAK1 inhibition. These results indicate that individuals with DS may experience harmful hyperinflammation upon IFN-inducing immune stimuli, as observed during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, pointing to JAK1 inhibition as a strategy to restore immune homeostasis in DS.

Epidemilogy of moderate-to-severe psoriasis: a comparison between psoriasis patients treated with biological agents, conventional systemic drugs and topical agents

INTRODUCTION: Understanding how different comorbidities and epidemiological factors are related to psoriasis severity can help us estimating patients' clinical outcome. AIM: Establish possible prognostic factors of severe psoriasis. METHODS: Three groups of patients were included: 118 were on topical therapy, 83 used conventional systemic drugs and 112 were treated with biological agents. Based of the fact that patients on topical therapy have a lower grade of disease severity than patients treated systemically, we compared a variety of comorbidities and epidemiological parameters between the three groups. RESULTS: Patients treated more aggressively have an increased risk of cardiovascular disease (p = 0.044), suffer more from depression (p = 0.020), hyperuricemia (p = 0.031) and nonspecific non-infectious liver disease (p = 0.005). Male gender (p < 0.001), increased height (p < 0.001), early age of disease onset (p < 0.001), viral upper respiratory infections (p = 0.049) and periods of hormonal changes (p = 0.045) are associated with these therapies. CONCLUSION: Psoriasis severity is directly related to an increased risk of cardiovascular disease, depression, hyperuricemia and nonspecific non-infectious liver disease. Male gender, increased height, early age of disease onset, viral upper respiratory infections and periods of hormonal changes seem to be prognostic of higher degrees of psoriasis severity. We are pioneering the use of increased height and puberty, menopause/andropause as independent prognostic factors of psoriasis severity.

Willingness to participate in genome testing: a survey of public attitudes from Qatar

Genomics has the potential to revolutionize medical approaches to disease prevention, diagnosis, and treatment, but it does not come without challenges. The success of a national population-based genome program, like the Qatar Genome Program (QGP), depends on the willingness of citizens to donate samples and take up genomic testing services. This study explores public attitudes of the Qatari population toward genetic testing and toward participating in the QGP. A representative sample of 837 adult Qataris was surveyed in May 2016. Approximately 71% of respondents surveyed reported that they were willing to participate in the activities of the QGP. Willingness to participate was significantly associated with basic literacy in genetics, a family history of genetic diseases, and previous experience with genetic testing through premarital screening. Respondents cited the desire to know more about their health status as the principle motivation for participating, while lack of time and information were reported as the most important barriers. With QGP plans to ramp up the scale of its national operation toward more integration into clinical care settings, it is critical to understand public attitudes and their determinants. The results demonstrate public support but also identify the need for more education and individual counseling that not only provide information on the process, challenges, and benefits of genomic testing, but that also address concerns about information security.

Clinical Characteristics and Outcomes of Patients Hospitalized for COVID-19 in Africa: Early Insights from the Democratic Republic of the Congo

Little is known about the clinical features and outcomes of SARS-CoV-2 infection in Africa We conducted a retrospective cohort study of patients hospitalized for COVID-19 between March 10, 2020 and July 31, 2020 at seven hospitals in Kinshasa, Democratic Republic of the Congo (DRC) Outcomes included clinical improvement within 30 days (primary) and in-hospital mortality (secondary) Of 766 confirmed COVID-19 cases, 500 (65 6%) were male, with a median (interquartile range [IQR]) age of 46 (34-58) years One hundred ninety-one (25%) patients had severe/critical disease requiring admission in the intensive care unit (ICU) Six hundred twenty patients (80 9%) improved and were discharged within 30 days of admission Overall in-hospital mortality was 13 2% (95% CI: 10 9-15 8), and almost 50% among those in the ICU Independent risk factors for death were age &lt; 20 years (adjusted hazard ratio [aHR] = 6 62, 95% CI: 1 85-23 64), 40-59 years (aHR = 4 45, 95% CI: 1 83-10 79), and ≥ 60 years (aHR = 13 63, 95% CI: 5 70-32 60) compared with those aged 20-39 years, with obesity (aHR = 2 30, 95% CI: 1 24-4 27), and with chronic kidney disease (aHR = 5 33, 95% CI: 1 85-15 35) In marginal structural model analysis, there was no statistically significant difference in odds of clinical improvement (adjusted odds ratio [aOR] = 1 53, 95% CI: 0 88-2 67, P = 0 132) nor risk of death (aOR = 0 65, 95% CI: 0 35-1 20) when comparing the use of chloroquine/azithromycin versus other treatments In this DRC study, the high mortality among patients aged &lt; 20 years and with severe/critical disease is of great concern, and requires further research for confirmation and targeted interventions

Does the $\ell_1$-norm Learn a Sparse Graph under Laplacian Constrained Graphical Models?

We consider the problem of learning a sparse graph under Laplacian constrained Gaussian graphical models. This problem can be formulated as a penalized maximum likelihood estimation of the precision matrix under Laplacian structural constraints. Like in the classical graphical lasso problem, recent works made use of the $\ell_1$-norm regularization with the goal of promoting sparsity in Laplacian structural precision matrix estimation. However, we find that the widely used $\ell_1$-norm is not effective in imposing a sparse solution in this problem. Through empirical evidence, we observe that the number of nonzero graph weights grows with the increase of the regularization parameter. From a theoretical perspective, we prove that a large regularization parameter will surprisingly lead to a fully connected graph. To address this issue, we propose a nonconvex estimation method by solving a sequence of weighted $\ell_1$-norm penalized sub-problems and prove that the statistical error of the proposed estimator matches the minimax lower bound. To solve each sub-problem, we develop a projected gradient descent algorithm that enjoys a linear convergence rate. Numerical experiments involving synthetic and real-world data sets from the recent COVID-19 pandemic and financial stock markets demonstrate the effectiveness of the proposed method. An open source $\mathsf{R}$ package containing the code for all the experiments is available at https://github.com/mirca/sparseGraph.

Influence of nano-hydroxyapatite coating implants on gene expression of osteogenic markers and micro-CT parameters. An in vivo study in diabetic rats

This study evaluated the response of a nano-hydroxyapatite coating implant through gene expression analysis (runt-related transcription factor 2 (Runx2), alkaline phosphatase (Alp), osteopontin (Opn), osteocalcin (Oc), receptor activator of nuclear factor-kappa B (Rank), receptor activator of nuclear factor-kappa B ligand (Rank-L), and osteoprotegerin (Opg)). Three-dimensional evaluation (percent bone volume (BV/TV); percent intersection surface (BIC); bone surface/volume ratio (BS/BV); and total porosity (To.Po)) were also analyzed. Mini implants were surgically placed in tibias of both healthy and diabetic rats. The animals were euthanized at 7 and 30 days. Evaluating all factors the relative expression of Rank showed that NANO surface presented the best results at 7 days (diabetic rats). Furthermore the levels of Runx2, Alp, Oc, and Opn suggest an increase in osteoblasts proliferation, especially in early stages of osseointegration. %BIC in healthy and diabetic (7 days) depicted statistically significant differences for NANO group. BV/TV, BS/BV and To.Po demonstrated higher values for NANO group in all evaluated time point and irrespective of systemic condition, but BS/BV 30 days (healthy rat) and 7 and 30 days (diabetic rat). Microtomographic and gene expression analyses have shown the benefits of nano-hydroxyapatite coated implants in promoting new bone formation in diabetic rats.

The Rise of Majorities and Emerging Existential Threats to India and China

China and India are comparable in size, complexity, and their relatively recent State-building histories Commencing in 1947 and 1949 respectively, the relatively recent foundations of India and China highlighted a ‘unity in diversity’ message The significance of this lay as much in ideology as in a pragmatism that was both central and relatively successful in bringing what could be argued as many civilizations into singular modern States While the messages about diversity have always been contested in some quarters by rival ethno-nationalists, they remained significant in laying the foundations for a strong ‘national’ identity To the majority populations, Hindu in India and Han in China this called for restraint to any triumphalism or chauvinism;to the minorities, they called for unshakeable loyalty in return for full citizenship rights In both cases, these messages were backed by constructive affirmative action measures that, irrespective of their efficacy, served to emphasize the ‘unity in diversity’ message, sowing a degree of fealty towards the State over what may have been more prominent and compelling ethno-religious or ethno-linguistic cleavages In recent years, however, this message has been significantly altered, as political majoritarianism has begun to oust legally or administratively determined minority protections This article seeks to offer an assessment of the potential impact on this phenomenon on each country, arguing that it has contributed to instability, sowing seeds for the rise of opposing sub-national identities that the founding parents of each State actively sought to counter in their statecraft

Doing nothing does something: Embodiment and data in the COVID-19 pandemic

The COVID-19 pandemic redefines how we think about the body, physiologically and socially But what does it mean to have and to be a body in the COVID-19 pandemic? The COVID-19 pandemic offers data scholars the unique opportunity, and perhaps obligation, to revisit and reinvent the fundamental concepts of our mediated experiences The article critiques the data double, a longstanding concept in critical data and media studies, as incompatible with the current public health and social distancing imperative The data double, instead, is now the presupposition of a new data entity, which will emerge out of a current data shimmer: a long-sustaining transition that blurs the older boundaries of bodies and the social, and establishes new ethical boundaries around the (in)activity and (im)mobility of doing nothing to do something The data double faces a unique dynamic in the COVID-19 pandemic between boredom and exhaustion Following the currently simple rule to stay home presents data scholars the opportunity to revisit the meaning of data as something given, a shimmering embodied relationship with data that contributes to the common good in a global health crisis

Dialysis, COVID-19, Poverty, and Race in Greater Chicago: An Ecological Analysis

Rationale & Objective: Persons with end-stage kidney disease receiving in-center maintenance hemodialysis may be at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and severe outcomes with coronavirus disease 2019 (COVID-19). The objective of this study was to examine the correlation of SARS-CoV-2 positivity rate per capita and COVID-19-associated deaths with number of dialysis stations and demographics of residents within zip codes in Cook County, IL. Study Design: Ecological analysis. Setting & Participants: Data for SARS-CoV-2 test results and COVID-19-associated deaths during January 21 to June 15, 2020, among the 5,232,412 residents living within the 163 zip codes in Cook County, IL, were merged with demographic and income data from the US Census Bureau. The total number of positive test results in this population was 84,353 and total number of deaths was 4,007. Assessments: Number of dialysis stations and stations per capita within a zip code were calculated. SARS-CoV-2-positive test results per capita were calculated as number of positive test results divided by the zip code population. COVID-19-associated deaths per capita were calculated as COVID-19 deaths among residents for a given zip code divided by the zip code population. Analytic Approach: Spearman rank correlation coefficients were calculated to examine the correlation of SARS-CoV-2-positive tests per capita and COVID-19-associated deaths per capita with dialysis stations, demographics, and household poverty. To account for multiple testing, statistical significance was considered as P < 0.005. Results: Among the 163 Cook County zip codes, there were 2,501 dialysis stations. Positive test results per capita were significantly associated with number of dialysis stations (r = 0.25; 95% CI, 0.19 to 0.29; P < 0.005) but not with dialysis stations per capita (r = 0.02; 95% CI, -0.03 to 0.08; P = 0.7). Positive test results per capita also correlated significantly with number of households living in poverty (r = 0.57; 95% CI, 0.53-0.6; P < 0.005) and percentage of residents reporting Black race (r = 0.28; 95% CI, 0.23-0.33; P < 0.005) and Hispanic ethnicity (r = 0.68; 95% CI, 0.65-0.7; P < 0.001;). COVID-19-associated deaths per capita correlated significantly with the percentage of residents reporting Black race (r = 0.24; 95% CI, 0.19-0.29; P < 0.005) and with percentage of households living in poverty (r = 0.34; 95% CI, 0.29-0.38; P < 0.005). The association between the number of COVID-19-associated deaths per capita and total number of dialysis stations (r = 0.20; 95% CI, 0.14-0.25; P = 0.01) did not achieve a priori significance, whereas the association with dialysis stations per capita (r = 0.12; 95% CI, 0.07-0.17; P = 0.01) was not significant. Limitations: Analysis is at the zip code level and not at the person level. Conclusions: The number of dialysis stations within a zip code correlates with the SARS-CoV-2 positivity rate per capita in Cook County, IL, and this correlation may be driven by population density and the demographics of the residents. These findings highlight the high risk of SARS-CoV-2 exposure for patients with end-stage kidney disease living in poor urban areas.

Dual Substance Use of Electronic Cigarettes and Alcohol

Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, particularly in younger populations Given the long history of the comorbidity of alcohol and nicotine use, the rising prevalence of ECs raises the question as to their role in the consumption of alcohol Of the numerous models of ECs available, JUUL is the most popular This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for standardization among studies In summary, EC users are more likely to participate in hazardous drinking and are at higher risk for alcohol use disorder (AUD) We surmise the pathogenic damage of dual use may exhibit an additive effect, particularly in pathogen clearance from the lungs, increased inflammation and decreased immune response, physical damage to epithelial cells, and exacerbation of chronic obstructive pulmonary disease (COPD)-like illnesses A better understanding of pathogenic damages is critical to understand the risks placed on dual users when exposed to respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) © Copyright © 2020 Wetzel and Wyatt

Impact of spirituality on resilience and coping during the COVID-19 crisis: A mixed-method approach investigating the impact on women

Spirituality has been known to have a positive correlation to resilience during disasters. This study investigated the impact of spirituality on resilience during our current pandemic. A mixed-method approach was used to analyze correlations between spirituality and resilience of women. Correlations were noted to be statistically significant with Pearson's correlation of -.450 at 0.001, CD-RISC (M = 77.94), and DSES (M = 39.74). Thematic analysis of six open-ended questions provide depth to quantitative findings supporting the positive influence of spirituality on resilience, hope, optimism, peace, and comfort suggesting that spirituality may be an important dimension as this pandemic continues to unfold across the globe.

Covid-19 and the European Convention on Human Rights

This paper examines the implications for compliance with obligations under the ECHR of the responses that have been adopted by Council of Europe member States as a result of the threat posed by the spread or Coronavirus and the risk of succumbing to Covid-19 Although some member States have submitted derogations under Article in respect of a state of emergency declared by them, this has not been the response of others even where an emergency has been declared After considering the possible obligation to act as a result of the threat posed by Covid-19, the paper considers the extent to which existing case law suggests at least some measures being taken would not need a derogation to be compatible with obligations under the Convention on account of the need to protect the spread of the virus It considers in this connection restrictions on the right to liberty and freedom of movement, entry to and departure from a country, private and family life, public and private gatherings, information and expression, weddings and funerals and property, as well as the implications of testing and treatment and of compulsion to work and the importance to maintain the functioning of courts It emphasises the need for all restrictions to have a legal basis whether or not there is a derogation and that the duration of restrictions will be an important factor in considering both their proportionality and the need for a derogation В статье рассматриваются последствия мер, принимаемых государствами - участниками Совета Европы в связи с угрозой, создаваемой распространением коронавируса, и риском стать жертвой Covid-19, для соблюдения обязательств, взятых ими на себя при присоединении к Европейской Конвенции по правам человека Хотя некоторые государства-участники, объявив чрезвычайное положение, заявили об отступлениях от обязательств в соответствии со статьёй 15 Конвенции, другие этого не сделали, хотя чрезвычайное положение ими было также объявлено После анализа обязательства действовать, которое может возникнуть у государства в результате угрозы, создаваемой Covid-19, в статье рассматривается степень, в которой существующая практика Европейского Суда позволяет считать хотя бы некоторые принимаемые меры совместимыми с обязательствами согласно Конвенции без объявления об отступлении от обязательств, поскольку они диктуются необходимостью защиты от распространения вируса В этой связи в статье рассматриваются ограничения права на свободу передвижения, въезда в страну и выезда из неё, уважение частной и семейной жизни, проведение публичных и частных собраний, информацию и выражение мнений, проведение свадеб и похорон, право собственности, а также последствия тестирования и лечения, принуждения к работе, и важность поддержания функционирования судов В статье подчёркивается необходимость того, чтобы все ограничения имели правовую основу независимо от того, подано ли заявление об отступлении от обязательств, и что продолжительность ограничений будет являться важным фактором при рассмотрении как их пропорциональности, так и необходимости отступления от обязательств

Food safety issues related to wildlife have not been taken seriously from SARS to COVID-19

17 years after the outbreak of SARS, the 2019-nCoV broke out in December 2019. It's an unprecedented huge challenge and disaster for people all over the world. According to Web of Science database, The author found that 95,724 virology papers have been published in the past 17 years, 68,632 of which are supported by fund (71.7%). Meanwhile, 50,567 papers related to food safety have been published in the past 17 years, 28,165 of which are supported by fund (55.7%%). It seems that people's safety and global stability are greatly guaranteed. However, whether SARS or 2019-nCoV, scientists were targeting wildlife, the author found that only 515 studies on food safety related to wildlife have been published worldwide in the past 17 years. After SARS, the whole world did not pay enough attention to food safety related to wildlife.

Using lung ultrasound changes to evaluate the response of recruitment maneuver in a patient recovering from coronavirus disease 2019 with acute respiratory distress syndrome

Lung ultrasound (LUS) is widely used in intensive care units because it provides timely information noninvasively. The use of LUS is recommended to minimize transfers in critically ill patients with coronavirus disease 2019 (COVID-19) during the pandemic. The clinical efficacies of bedside chest X-ray (CXR) and LUS have not been compared in these patients. Herein, we demonstrated serial LUS changes in a 75-year-old woman recovering from COVID-19 with acute respiratory distress syndrome (ARDS) in need of veno-venous extracorporeal membrane oxygenation support. LUS initially revealed extensive consolidation in the bilateral lower lung (BLL) fields with coalescent B-lines. While the patient recovered from ARDS, the findings gradually changed to discrete B-lines and small pleural consolidations. The LUS findings were more sensitive than those of the CXR in detecting re-expansion of the lungs by showing B-lines instead of consolidations in the BLL fields immediately after recruitment maneuver (RM). Compared with physiological parameters, LUS findings provided more precise information about the parts of the lungs that had been recruited by RM. Therefore, we encourage intensivists to extend their use of LUS in critically ill patients with COVID-19 and ARDS to acquire real-time information for a quick response and minimize the risk of viral transmission.

Growing up in economic hardship: The relationship between childhood social assistance recipiency and early adulthood obstacles

Despite the vast body of literature investigating the effects of childhood economic conditions, few studies have investigated the significance of the timing and extent of economic hardship experienced during childhood This study utilised the 1987 Finnish Birth Cohort, which includes all 59,476 children born in Finland in 1987, to explore the impact of the timing of childhood economic hardship on subsequent well-being, with a special emphasis on gender differences during three developmental stages We examined the relationship between the timing and extent of childhood economic hardship and the following four subsequent adolescence and early adulthood outcomes: the cohort members? criminal convictions, early school leaving, psychiatric diagnoses, and social assistance (SA) recipiency in adulthood We found a strong association between heavy receipt of SA during secondary school and the cohort members? early adulthood receipt of SA Furthermore, early childhood economic hardship seemed to be especially detrimental for girls

COVID-19 Status, Symptom Burden, and Characteristics of Dialysis Patients Residing in Areas of Community Transmission: Research Letter

Background: Routine testing of hemodialysis patients for COVID-19 (outside of those identified as “at risk” based on regional practice) is not universally recommended However, there is variability in the clinical presentation of COVID-19;patients may experience symptoms that do not meet regional criteria for testing and some patients with active infection may be asymptomatic To avoid missing individuals who are infected, consideration could be made for regular screening, particularly among those residing in areas with evidence of community spread Objective: To describe the clinical characteristics, symptom burden, and COVID-19 status in a cross-section of hemodialysis patients residing in areas with evidence of community spread Design: Cross-sectional study Setting: Three hemodialysis units in a large tertiary care facility in Nova Scotia, Canada Patients: In-center hemodialysis patients who resided in areas with evidence of community transmission at the time of the study Methods: All dialysis patients (irrespective of whether or not they resided in areas with community spread) completed a standard “at-risk” questionnaire for COVID-19 based on (1) 2 or more of new or worsening cough, fever greater than 38°C, sore throat, headache, runny nose/new or acute respiratory illness consistent with infection or (2) any one of close contact with a known/suspected case, travel outside of the province or residence in a facility with an outbreak prior to entry into the dialysis unit at each treatment Patients residing in areas with evidence of community spread were swabbed for SARS-CoV-2 over a 1-week period (May 1-7, 2020) using a combined oropharyngeal/nares swab irrespective of whether or not they were identified as “at-risk ” Measurements: Baseline characteristics of patients were acquired using electronic records In addition to the “at-risk” questionnaire, patients answered “yes” or “no” to any of the following symptoms at the time of the swab (sneeze, fatigue, myalgia, nausea/vomiting, diarrhea, malaise, abdominal pain, loss of taste, and loss of smell) Results: Of the 334 patients receiving dialysis at the time of the study, 133 resided in areas with evidence of community transmission and 104 consented for the study No patients met our regional criteria for being “at-risk” and no patients reported cough, sore throat or fever at the time of swab Many other symptoms were noted, including sneezing (24%), fatigue (16%), myalgias (11%), nausea/vomiting (11%), loss of taste (4%), and loss of smell (4%) Overall, 100% of swabs performed for this study were negative for SARS-CoV-2 Limitations: Single-center study, and the daily new case rate was exceedingly low (4-14) at the time of the study, emphasizing that the findings are not generalizable to areas of higher prevalence of SARS-CoV-2 Conclusions: In this study of hemodialysis patients residing in areas with community spread who otherwise did not meet symptom criteria for being “at-risk,” we did not identify any individual who tested positive for SARS-CoV-2 Future studies are needed to examine the utility of routine testing for COVID-19 (outside of those who are “at-risk”) in areas of higher disease prevalence Trial Registration: Not applicable as this is not a clinical trial

Venous Thromboembolism in Hospitalized COVID-19 Patients

BACKGROUND: Venous thromboembolism (VTE) is increasingly reported in seriously ill patients with COVID-19 infection Incidence of VTE has been reported before and results varied widely in study cohorts AREA OF UNCERTAINTY: Incidence of major VTE (segmental pulmonary embolism and above and proximal deep vein thrombosis) which is a contributor to mortality and morbidity is not known Also, data is unclear on the optimal anticoagulation regimen to prevent VTE DATA SOURCES: Multiple databases including PubMed were searched until May 12, 2020, to include studies reporting VTE in hospitalized COVID-19 adult patients MOOSE guidelines were followed in selection, and 11 studies were included We conducted a systematic review and meta-analysis to quantitatively assess the VTE burden in hospitalized COVID-19 patients and potential benefits of therapeutic dosing of anticoagulation compared with prophylaxis dosing for VTE prevention THERAPEUTIC ADVANCES: Many societies and experts recommend routine prophylactic anticoagulation with heparin for VTE prevention in hospitalized COVID-19 patients In this meta-analysis, the pooled rate of major VTE was 12 5% in hospitalized patients and 17 2% in intensive care unit patients When therapeutic anticoagulation dosing was compared with prophylactic anticoagulation, the pooled odds ratio of VTE was 0 33 (95% confidence interval 0 14-0 75;P = 0 008, I = 0%) suggesting statistical significance with therapeutic dosing of anticoagulation for primary prevention of VTE in all hospitalized patients However, this should be interpreted with caution as the bleeding events and safety profile could not be ascertained because of lack of adequate information We recommend applying this finding to hospitalized COVID 19 patients only after carefully weighing individual bleeding risks and benefits CONCLUSION: Major VTE events, especially pulmonary embolism, seem to be high in COVID-19 patients admitted to the intensive care unit Therapeutic anticoagulation dosing seems to significantly benefit the odds of preventing any VTE when compared with prophylactic dosing in all hospitalized patients

Resilience of Spanish forests to recent droughts and climate change

A widespread increase in forest cover is underway in northern Mediterranean forests because of land abandonment and decreased wood demand, but the resilience of these successional forests to climate change remains unresolved. Here we use 18-year time series of canopy greenness derived from satellite imagery (NDVI) to evaluate the impacts of climate change on Spain's forests. Specifically, we analyzed how NDVI was influenced by the climatic water balance (i.e. Standardized Precipitation-Evapotranspiration Index, SPEI), using monthly time-series extracted from 3,100 pixels of forest, categorized into ten forest types. The forests increased in leaf area index by 0.01 per year on average (from 1.7 in 2000 to 1.9 in 2017) but there was enormous variation among years related to climatic water balance. Forest types varied in response to drought events: those dominated by drought-avoiding species showed strong covariance between greenness and SPEI, while those dominated by drought-tolerant species showed weak covariance. Native forests usually recovered more than 80% of greenness within the 18 months and the remainder within 5 years, but plantations of Eucalyptus were less resilient. Management to increase the resilience of forests-a key goal of forestry in the Mediterranean region-appears to have had a positive effect: canopy greenness within protected forests was more resilient to drought than within non-protected forests. In conclusion, many of Spain's successional forests have been resilient to drought over the past 18 years, from the perspective of space. Future studies will need to combine remote sensing with field-based analyses of physiological tolerances and mortality processes to understand how Mediterranean forests will respond to the rapid climate change predicted for this region in the coming decades.

Correlation of feline coronavirus shedding in faeces with serum coronavirus antibody titre

Feline coronavirus (FCoV) infection is very common in multi-cat households It has been proposed that cats with higher antibody titres are more likely to shed FCoV in their faeces Aim of the study was to determine a possible correlation between FCoV serum antibody titres and faecal FCoV shedding Four faecal samples from 72 cats originating from 18 German catteries were examined for FCoV by quantitative reverse transcriptase polymerase chain reaction (RT-PCR) Serum antibody titres were determined by immunofluorescence assay There was a weak positive correlation between height of antibody titre and mean faecal virus load (Spearman r = 0 3394;P = 0 0035) Antibody titres were significantly higher if cats shed FCoV more frequently (Kruskal Wallis test P = 0 0042) Twenty-two cats were RT-PCRnegative in all four faecal samples Those cats had significantly lower antibody titres than cats shedding continuously (in all four samples) (Dunn's test;P 0 05) When analysing FCoV-shedding cats (shedding at least once), cats that were FCoV RT-PCR-positive continuously in all four samples had significantly higher antibody titres (Mann-Whitney U test P = 0 0026) and significantly higher mean faecal virus loads (Mann-Whitney U test P = 0 0383) than cats that were FCoV RT-PCRpositive in only one, two, or three samples Eight cats had no detectable antibodies but were shedding FCoV Height of antibody titre was correlated to faecal virus load Chronic FCoV shedders had higher antibody titres and shed more virus This knowledge can be of importance for the management of FCoV infection in multi-cat environments However, measurement of serum antibodies cannot replace faecal RT-PCR

COVID-19: Impact of obesity and diabetes on disease severity

The coronavirus disease 2019 (COVID-19) pandemic is straining the healthcare system, particularly for patients with severe outcomes requiring admittance to the intensive care unit (ICU). This study investigated the potential associations of obesity and diabetes with COVID-19 severe outcomes, assessed as ICU admittance. Medical history, demographic and patient characteristics of a retrospective cohort (1158 patients) hospitalized with COVID-19 were analysed at a single centre in Kuwait. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance. Of 1158 hospitalized patients, 271 had diabetes, 236 had hypertension and 104 required admittance into the ICU. From patients with available measurements, 157 had body mass index (BMI) &#8805;25 kg/m2 . Univariate analysis showed that overweight, obesity class I and morbid obesity were associated with ICU admittance. Patients with diabetes were more likely to be admitted to the ICU. Two models for multivariate regression analysis assessed either BMI or diabetes on ICU outcomes. In the BMI model, class I and morbid obesities were associated with ICU admittance. In the diabetes model, diabetes was associated with increased ICU admittance, whereas hypertension had a protective effect on ICU admittance. In our cohort, overweight, obesity and diabetes in patients with COVID-19 were associated with ICU admittance, increasing the risk of poor outcomes.

COVID-19: Impact of obesity and diabetes on disease severity

The coronavirus disease 2019 (COVID-19) pandemic is straining the healthcare system, particularly for patients with severe outcomes requiring admittance to the intensive care unit (ICU). This study investigated the potential associations of obesity and diabetes with COVID-19 severe outcomes, assessed as ICU admittance. Medical history, demographic and patient characteristics of a retrospective cohort (1158 patients) hospitalized with COVID-19 were analysed at a single centre in Kuwait. Univariate and multivariate analyses were performed to explore the associations between different variables and ICU admittance. Of 1158 hospitalized patients, 271 had diabetes, 236 had hypertension and 104 required admittance into the ICU. From patients with available measurements, 157 had body mass index (BMI) &#8805;25 kg/m2 . Univariate analysis showed that overweight, obesity class I and morbid obesity were associated with ICU admittance. Patients with diabetes were more likely to be admitted to the ICU. Two models for multivariate regression analysis assessed either BMI or diabetes on ICU outcomes. In the BMI model, class I and morbid obesities were associated with ICU admittance. In the diabetes model, diabetes was associated with increased ICU admittance, whereas hypertension had a protective effect on ICU admittance. In our cohort, overweight, obesity and diabetes in patients with COVID-19 were associated with ICU admittance, increasing the risk of poor outcomes.

Psychiatric emergency care during Coronavirus 2019 (COVID 19) pandemic lockdown: results from a Department of Mental Health and Addiction of northern Italy

BACKGROUND: The current COVID-19 pandemic and the consequent containment measures are leading to increasing mental health issues both in psychiatric patients and general population. OBJECTIVE: We aimed to compare the number and characteristics of emergency psychiatric consultations during the phase 1 of lockdown with respect to the same period in 2019 in a Department of Mental Health and Addiction (DMHA) located in Lombardy region. METHODS: We conducted a cross-sectional study including subjects consecutively admitted to two psychiatric emergency rooms of DMHA in Monza, Lombardy, Italy. Sociodemographic data, clinical characteristics, referred symptoms, diagnosis and information on patients' illness course following the emergency consultations were collected. No subjects were excluded for the purposes of the study. RESULTS: Between February 21st and May 3rd 2020, there was a marked reduction in the number of psychiatric emergency consultations, if compared to the same period of 2019. Subjects who were living in psychiatric residential treatment facilities, had cannabis addiction and a diagnosis of obsessive-compulsive disorder were significantly more likely to present to emergency psychiatric consultations during lockdown. CONCLUSIONS: COVID-19 epidemic may have a negative impact on more vulnerable individuals. Strategies to enhance relapse prevention and the use of alternative approaches as e-health technologies should be promoted.

Computational biophysical characterization of the SARS-CoV-2 spike protein binding with the ACE2 receptor and implications for infectivity

SARS-CoV-2 is a novel highly virulent pathogen which gains entry to human cells by binding with the cell surface receptor – angiotensin converting enzyme (ACE2) We computationally contrasted the binding interactions between human ACE2 and coronavirus spike protein receptor binding domain (RBD) of the 2002 epidemic-causing SARS-CoV-1, SARS-CoV-2, and bat coronavirus RaTG13 using the Rosetta energy function We find that the RBD of the spike protein of SARS-CoV-2 is highly optimized to achieve very strong binding with human ACE2 (hACE2) which is consistent with its enhanced infectivity SARS-CoV-2 forms the most stable complex with hACE2 compared to SARS-CoV-1 (23% less stable) or RaTG13 (11% less stable) Notably, we calculate that the SARS-CoV-2 RBD lowers the binding strength of angiotensin 2 receptor type I (ATR1) which is the native binding partner of ACE2 by 44 2% Strong binding is mediated through strong electrostatic attachments with every fourth residue on the N-terminus alpha-helix (starting from Ser19 to Asn53) as the turn of the helix makes these residues solvent accessible By contrasting the spike protein SARS-CoV-2 Rosetta binding energy with ACE2 of different livestock and pet species we find strongest binding with bat ACE2 followed by human, feline, equine, canine and finally chicken This is consistent with the hypothesis that bats are the viral origin and reservoir species These results offer a computational explanation for the increased infection susceptibility by SARS-CoV-2 and allude to therapeutic modalities by identifying and rank-ordering the ACE2 residues involved in binding with the virus

Surgical treatment of diabetic foot ulcers during the COVID-19 pandemic in China

Diabetic foot ulcers are among the most serious complications of diabetes. If left untreated, these ulcers can lead to severe infection and gangrene; in some instances, they may result in death. Thus, timely treatment of diabetic foot ulcers is extremely important. However, timely patient treatment during the COVID-19 pandemic is particularly challenging, because of the higher volume of patients and the need to ensure safety of medical personnel. This article describes a proposed strategy for diagnosis and treatment of diabetic foot ulcers, based on experiences with infection and control strategies during the COVID-19 pandemic in China.

Silent myocardial dysfunction in vitamin D deficiency

Introduction: Vitamin D (VD) deficiency is a common disease that occurs in all stages of life. A growing number of studies call attention to the relationship between VD deficiency and cardiovascular disease. The aim of this study was to investigate the effect of VD on subclinical left ventricular (LV) function in diabetic and non-diabetic patients with no significant coronary artery disease. Material and methods: We recruited 140 patients (80 diabetics and 60 non-diabetics) with symptoms of stable ischemic heart disease who underwent coronary angiography and who had no significant coronary artery disease in our clinic. The 25(OH)D3 levels were measured and patients who had 25-(OH)D3 levels below 20 ng/dl were defined as the VD deficient group. In addition to conventional echocardiographic parameters, tissue Doppler echocardiography was used for LV diastolic functions and 2D speckle tracking strain echocardiography (2D STE) for evaluating the longitudinal deformation indices of the LV myocardium. Results: In all groups, LV global longitudinal strain (GLS) was significantly impaired in patients with VD deficiency (p < 0.001) compared to patients without VD deficiency. LV global longitudinal strain rate (GLSR) was significantly impaired in patients with VD deficiency (p = 0.003). The GLS was negatively associated with 25-(OH)D3 in the VD deficiency group (r = -0.52623, p < 0.001). Conversely, GLS was positively associated with 25-(OH)D3 levels in the normal VD group (r = 0.28, p = 0.048). Conclusions: VD deficiency is associated with impaired myocardial GLS. The present study demonstrated that VD deficiency may be the cause of subclinical myocardial dysfunction in patients with or without diabetes mellitus and no history of significant coronary artery disease.

The After Diagnosis Head and Neck cancer-specific Patient Concerns Inventory (HaNC-AD) as a pre-treatment preparation aid during the COVID-19 pandemic

The coronavirus disease 2019 pandemic has resulted in new challenges for clinicians, head and neck cancer (HNC) patients and carers. There is evidence that the current crisis is affecting the management of HNC patients. Most healthcare systems have introduced remote consultations to decrease the risk of coronavirus infection to patients, carers and clinicians. At present, HNC patients may be anxious and due to logistical issues, may not be adequately prepared for their treatment. To ensure that patients have a thorough understanding of their treatment and expected outcome during the current COVID-19 crisis there may be merit in the use of the HaNC-AD PCI.

Non-Bacterial Thrombotic Endocarditis: A Presentation of COVID-19

The SARS-CoV-2 virus is a newly emergent pathogen first identified in Wuhan, China, and responsible for the COVID-19 global pandemic. In this case report we describe a manifestation of non-bacterial thrombotic endocarditis with continuous peripheral embolization in a COVID-19-positive patient. The patient responded well to high-dose LMWH treatment with cessation of the embolic process. LEARNING POINTS: Raising awareness of possible complications of COVID-19.To highlight the importance of the careful consideration of and dosage of anticoagulation in non-bacterial thrombotic endocarditis.

Therapeutic versus prophylactic anticoagulation for severe COVID-19: A randomized phase II clinical trial (HESACOVID)

INTRODUCTION: Coronavirus disease 2019 (COVID-19) causes a hypercoagulable state. Several autopsy studies have found microthrombi in pulmonary circulation. METHODS: In this randomized, open-label, phase II study, we randomized COVID-19 patients requiring mechanical ventilation to receive either therapeutic enoxaparin or the standard anticoagulant thromboprophylaxis. We evaluated the gas exchange over time through the ratio of partial pressure of arterial oxygen (PaO2) to the fraction of inspired oxygen (FiO2) at baseline, 7, and 14 days after randomization, the time until successful liberation from mechanical ventilation, and the ventilator-free days. RESULTS: Ten patients were assigned to the therapeutic enoxaparin and ten patients to prophylactic anticoagulation. There was a statistically significant increase in the PaO2/FiO2 ratio over time in the therapeutic group (163 [95% confidence interval - CI 133-193] at baseline, 209 [95% CI 171-247] after 7 days, and 261 [95% CI 230-293] after 14 days), p = 0.0004. In contrast, we did not observe this improvement over time in the prophylactic group (184 [95% CI 146-222] at baseline, 168 [95% CI 142-195] after 7 days, and 195 [95% CI 128-262] after 14 days), p = 0.487. Patients of the therapeutic group had a higher ratio of successful liberation from mechanical ventilation (hazard ratio: 4.0 [95% CI 1.035-15.053]), p = 0.031 and more ventilator-free days (15 days [interquartile range IQR 6-16] versus 0 days [IQR 0-11]), p = 0.028 when compared to the prophylactic group. CONCLUSION: Therapeutic enoxaparin improves gas exchange and decreases the need for mechanical ventilation in severe COVID-19. TRIAL REGISTRATION: REBEC RBR-949z6v.

Natural and human environment interactively drive spread pattern of COVID-19: a city-level modeling study in China

A novel Coronavirus COVID-19 has caused high morbidity and mortality in China and worldwide A few studies have explored the impact of climate change or human activity on the disease incidence in China or a city The integrated study concerning environment impact on the emerging disease is rarely reported Therefore, based on the two-stage modeling study, we investigate the effect of both natural and human environment on COVID-19 incidence at a city level Besides, the interactive effect of different factors on COVID-19 incidence is analyzed using Geodetector;the impact of effective factors and interaction terms on COVID-19 is simulated with Geographically Weighted Regression (GWR) models The results find that mean temperature (MeanT), Destination proportion in population flow from Wuhan (WH), Migration scale (MS), and WH*MeanT, are generally promoting for COVID-19 incidence before Wuhan’s shutdown (T1);the WH and MeanT play a determinant role in the disease spread in T1 The effect of environment on COVID-19 incidence after Wuhan’s shutdown (T2) includes more factors (including relative humidity, precipitation, travel intensity within a city (TC), and their interactive terms) than T1, and their effect shows distinct spatial heterogeneity Interestingly, the dividing line of positive-negative effect of MeanT and Pre on COVID-19 incidence is 8 5°C and 1mm, respectively In T2, WH has weak impact, but the MS has the strongest effect The COVID-19 incidence in T2 without quarantine is also modeled using the developed GWR model, and the modeled incidence shows an obvious increase for 75 6% cities compared with reported incidence in T2 especially for some mega cities This evidences national quarantine and traffic control take determinant role in controlling the disease spread The study indicates that both natural environment and human factors integratedly affect the spread pattern of COVID-19 in China

Public Opinion, Crisis, and Vulnerable Populations: The Case of Title IX and COVID-19

A central function of democratic institutions is to protect vulnerable populations. The stability and success of these institutions depends, in part, on popular support. Times of crisis can introduce novel dynamics that alter popular support for protective institutions, particularly among those who do not benefit from those protections. We explore this possibility in the context of Title IX's gender equality requirements and infrastructure to address sexual harassment in college sports. We conduct a large survey of college student-athletes to study their attitudes on these issues in response to the COVID-19 pandemic and concomitant financial challenges affecting college sports. We find that male student-athletes and those with sexist attitudes exhibit alarmingly low levels of support for ensuring the maintenance of equality and sexual harassment policy under Title IX during the COVID-19 crisis and eventual recovery. The results accentuate the vulnerability of certain populations during crises and the importance of maintaining strong institutional policy support during such times.

The Epidemiology of Fractures and Muskulo-Skeletal Traumas During COVID-19 Lockdown: A Detailed Survey of 17.591 Patients in a Wide Italian Metropolitan Area

Introduction: On 9 March 2020 the Italian Government declared a national lockdown to curb the spread of Covid-19 The aim of our study was to analyze the effects of such intervention on the traumatological emergency service, with particular emphasis on variations in trauma incidence and patients’ characteristics Materials and Methods: An observational analysis was performed Medical records were collected from 3 different trauma centers within a wide metropolitan area, and compared between 2 time periods: the full Italian lockdown period and the same period from the past year The study population included all patients who were admitted to the Emergency Department (ED) For those who accessed for orthopedic reasons, the analyzed variables included the date of ED admission, age, gender, after visit discharge or hospitalization, place where the injury occurred, traumatic mechanism, diagnosis, relationship with sport activity, and time from injury/symptoms debut to ED access Results: A total of 17591 ED accesses and 3163 ED trauma visits were identified During the lockdown, ED trauma visits decreased by -59 8%, but required patient’s hospitalization significantly more frequently The rate of ED trauma admissions in the elderlies significantly increased, together with the proportion of fragility fractures such as hip fractures Road accident traumas (-79 6%) and sport-related injuries (-96 2%) significantly dropped Admissions for less-severe reasons such as atraumatic musculoskeletal pain significantly decreased (-81 6%) Conclusions: The lockdown reduced the pressure on the Health System in at least 2 ways: directly, by curbing viral transmission and indirectly, by more than halving the ED trauma visits Nonetheless, we observed an increased proportion of traumas in older patients, requiring hospitalizations, while the rate of less-severe cases decreased This analysis may raise awareness of the effects of a lockdown on trauma services and may be helpful for those ones around the world who are now facing the emergency

A dual-ion battery has two sides: the effect of ion-pairs

There is mutual interference between the positive and negative electrodes in a dual-ion battery. In Li4Ti5O12/graphite batteries, strong ion-pairs between Li+ and anions may have a detrimental effect on intercalation at both sides: Li+ into Li4Ti5O12, and anions into graphite.

Optimal Control and Numerical Optimization Applied to Epidemiological Models

The relationship between epidemiology, mathematical modeling and computational tools allows to build and test theories on the development and battling of a disease. This PhD thesis is motivated by the study of epidemiological models applied to infectious diseases in an Optimal Control perspective, giving particular relevance to Dengue. Dengue is a subtropical and tropical disease transmitted by mosquitoes, that affects about 100 million people per year and is considered by the World Health Organization a major concern for public health. The mathematical models developed and tested in this work, are based on ordinary differential equations that describe the dynamics underlying the disease, including the interaction between humans and mosquitoes. An analytical study is made related to equilibrium points, their stability and basic reproduction number. The spreading of Dengue can be attenuated through measures to control the transmission vector, such as the use of specific insecticides and educational campaigns. Since the development of a potential vaccine has been a recent global bet, models based on the simulation of a hypothetical vaccination process in a population are proposed. Based on Optimal Control theory, we have analyzed the optimal strategies for using these controls, and respective impact on the reduction/eradication of the disease during an outbreak in the population, considering a bioeconomic approach. The formulated problems are numerically solved using direct and indirect methods. The first discretize the problem turning it into a nonlinear optimization problem. Indirect methods use the Pontryagin Maximum Principle as a necessary condition to find the optimal curve for the respective control. In these two strategies several numerical software packages are used.

A predictive model for COVID-19 spreading

As the novel coronavirus disease 2019 (COVID-19) has become a Public Health Emergency of International Concern, it is greatly significant to accurately predict the disease's incoming trend Herein, we performed a stage-rolling Susceptible-Exposed-Infectious-Recovered (SEIR) model to measure the evolution of the basic reproduction number of COVID-19, based on the number of confirmed infections announced by the National Health Commission of the People's Republic of China We assumed that the infected number under the spreading of infectious diseases will generally experience two different stages In the first stage, due to the public's ignorance of the severity and harmfulness of the disease, the infected population grows exponentially and the process of disease transmission can be considered as the classic SEIR model with a constant basic reproduction number Consequently, with limited awareness of the epidemic situation, there is a lack of effective preventive measures to control disease transmission In the second stage, various control measures and medical resources are introduced in succession by the government, as well as the public gradually takes effective preventions (e g keep social distance and wear masks) based on the knowledge of the disease transmission Collectively, the infected population grows much slower than the first stage We performed a stage-rolling SEIR model, in which the basic reproduction number changes every day Based on this model, the number of daily basic reproduction is estimated from the daily new infection number We found that the daily basic reproduction number is expected to decline continually until it is less than 1, which means the eradication of the disease Leveraging the evolution of the basic reproduction number, we extrapolate the incoming daily basic reproduction number, based on which we further predict the incoming trend of COVID-19 spreading in terms of the daily infection number Our predictive model estimates that at the end of the epidemic, the total number of infections in China is nearly 14000 except for Hubei Province, and 32000 except for Wuhan city We also found that in most parts of China, the number of newly confirmed infections increases linearly rather than exponentially before the day of "Wuhan travel restrictions", implying that the prevention and containing the infected people from Wuhan at the eve of the Spring Festival has been effective from the beginning

Stem Cells Therapy as a Possible Therapeutic Option in Treating COVID-19 Patients

An unfortunate emergence of a new virus SARS-CoV-2, causing a disease known as COVID-19, has spread all around the globe and has caused a pandemic. It primarily affects the respiratory tract and lungs in some cases causing severe organ damage and pneumonia due to overwhelming immune responses. Clinical reports show that the most commons symptoms are fever, dry cough, and shortness of breath, along with several other symptoms. It is thought that an immense cytokine dysregulation in COVID-19 patients is caused following the virus infection. Notably, if patients present with pre-existing specific comorbidities like diabetes or high blood pressure, rates of COVID-19 induced complications and deaths are escalated. Mesenchymal stem cell (MSC) therapy has been shown to alleviate pneumonia and acute respiratory syndrome (ARDS) symptoms, through their immunomodulatory activities in COVID-19 patients. Although more research studies and clinical trial results are needed to elucidate the exact mechanism by which MSCs provide relief to COVID-19 infected patients. Results from clinical trials are encouraging as patients treated with MSCs, regain lung functions and have restored levels of cytokines and trophic factors underscoring the fact that stem cell therapy can be, at least, a complementary therapy to alleviate sufferings in COVID-19 patients. This review discusses the possible therapeutic uses of MSCs for treating COVID-19. Graphical Abstract.

Development of a reliable and flexible supply chain network design model: a genetic algorithm based approach

Enhancing the proactive strategic capabilities to withstand the most unfavourable circumstances is always appreciated as a long-term policy rather than incident-based responses. The present research is positioned on this fundamental notion of supply chain risk management with a particular focus on strategic capabilities like reliability and flexibility that often conflict with cost. Accordingly, the authors propose a multi-objective mathematical model for designing a four-echelon supply chain that optimises cost, reliability, and volume flexibility. Interestingly, this research is the maiden effort to optimise the supply chain with these trifold objectives and herein lies the novelty as well as the challenges. Consequently, a genetic algorithm based approach is utilised as the solution methodology. To demonstrate the effectiveness of the proposed method, the small problem instances and the four-echelon problems have also been validated through exact methods and simulated annealing algorithm, respectively. A case study on a footwear supply chain involving three echelons is also presented to showcase the industrial applicability and adaptability of the proposed model. A fuzzy TOPSIS method has been adopted in the case study to incorporate the expert opinion for assigning priorities to the objectives. Supply chain professionals can leverage this methodology to establish a risk resistant supply chain.

Klp2 and Ase1 synergize to maintain meiotic spindle stability during metaphase I

The spindle apparatus segregates bi-oriented sister chromatids during mitosis but mono-oriented homologous chromosomes during meiosis I. It has remained unclear if similar molecular mechanisms operate to regulate spindle dynamics during mitosis and meiosis I. Here, we employed live-cell microscopy to compare the spindle dynamics of mitosis and meiosis I in fission yeast cells and demonstrated that the conserved kinesin-14 motor Klp2 plays a specific role in maintaining metaphase spindle length during meiosis I, but not during mitosis. Moreover, the maintenance of metaphase spindle stability during meiosis I requires the synergism between Klp2 and the conserved microtubule crosslinker Ase1 as the absence of both proteins causes exacerbated defects in metaphase spindle stability. The synergism is not necessary for regulating mitotic spindle dynamics. Hence, our work reveals a new molecular mechanism underlying meiotic spindle dynamics and provides insights into understanding differential regulation of meiotic and mitotic events.

Coronavirus (COVID 19) Infection in Pregnancy

Coronavirus illness 2019 (COVID-19) is an airways infection caused by the new coronavirus (SARS-CoV-2) which has been quickly disseminated all over the world, affecting to the general population including women in pregnancy time As being a recent infection, the evidence that supports the best practices for the management of the infection during pregnancy is limited, and most of the questions have not been completely solved yet This publication offers general guidelines focused on decision-making people, managers, and health&#039;s teams related to pregnant women attention and newborn babies during COVID-19 pandemic Its purpose is to promote useful interventions to prevent new infections as well as prompt and adequate attention to avoid serious complications or deaths, trying to be adapted to the different contexts in which attention to expectant mothers is provided Guidelines are set within a well-scientific evidence and available recommendations up to date Resumen La enfermedad por coronavirus 2019 (COVID-19) es una infección de las vías respiratorias causada por un nuevo virus (SARS-CoV-2) que se ha diseminado rápidamente en el mundo, afectando a la población general, incluida la población de mujeres cursando un embarazo Por ser una infección de aparición reciente, la información que soporta las mejores prácticas para el manejo de la infección durante la gestación es escasa y muchas de las preguntas no están completamente resueltas Esta publicación brinda lineamientos generales orientados a tomadores de decisión, gerentes y equipos de salud en relación con el cuidado de mujeres gestantes y recién nacidos durante la pandemia por COVID 19 Su finalidad es promover intervenciones beneficiosas para prevenir nuevos contagios, y la atención oportuna y adecuada de la gestante para evitar complicaciones graves y/o muertes, adecuándose a los distintos contextos en los que se proporciona atención médica Los lineamientos se enmarcan en la mejor información científica y las recomendaciones disponibles hasta la fecha

Coronavirus (COVID 19) Infection in Pregnancy

Coronavirus illness 2019 (COVID-19) is an airways infection caused by the new coronavirus (SARS-CoV-2) which has been quickly disseminated all over the world, affecting to the general population including women in pregnancy time. As being a recent infection, the evidence that supports the best practices for the management of the infection during pregnancy is limited, and most of the questions have not been completely solved yet. This publication offers general guidelines focused on decision-making people, managers, and health's teams related to pregnant women attention and newborn babies during COVID-19 pandemic. Its purpose is to promote useful interventions to prevent new infections as well as prompt and adequate attention to avoid serious complications or deaths, trying to be adapted to the different contexts in which attention to expectant mothers is provided. Guidelines are set within a well-scientific evidence and available recommendations up to date.

Empleo de la salud móvil en Cuba para el enfrentamiento a la COVID-19

Desde que en el mes de marzo de 2020 aparecieron los primeros casos de la COVID-19 en Cuba se implementó una estrategia de trabajo intersectorial, concebida meses antes, conducida por el Ministerio de Salud Pública, el Sistema de la Defensa Civil y el Gobierno, para contener el riesgo de contagio y diseminación del nuevo coronavirus en el territorio nacional, así como minimizar los efectos negativos de una epidemia en el país Esta estrategia contempla el fortalecimiento de la vigilancia epidemiológica, la organización de la atención médica en las unidades asistenciales, la capacitación de todo el personal de salud pública para el diagnóstico y atención a la COVID-19 y la protección del personal cubano que trabaja con los casos positivos Para su cumplimiento se implementan medidas que conllevan, entre otras soluciones, al distanciamiento social, por lo que resulta necesario desempeñar, cuando sea posible, el estudio y el trabajo a distancia De ahí que las tecnologías de la información y las comunicaciones resulten imprescindibles para la ejecución de estos procedimientos, a los que se les han incorporado acciones que están relacionadas directamente con la salud electrónica en general y en particular la salud móvil Por eso es objetivo del presente artículo exponer las experiencias relacionadas con la salud móvil en el enfrentamiento a la COVID-19 (AU) From March, 2020 when the first cases of COVID-19 appeared in Cuba, it was implemented an intersectoral work strategy that was conceived some months earlier and directed by the Ministry of Public Health, the Civil Defense System and the Government to contain the risk of contagion and spreading of the new coronavirus in the national territory;as well as to minimize the negative effects of a pandemic in the country This strategy includes the strengthening of epidemiologic surveillance, the organization of medical care in healthcare facilities, the training of all the public health&#039;s personnel for diagnosing and care of COVID19 patients, and the protection of the personnel working with positive cases For its compliance, there are implemented measures that entail, among other solutions, social distancing which implies when possible remote study and work It is then when the information and communication technologies become essential for the implementation of these procedures which are linked to actions directly related with electronic health, in general, and particularly with mobile health Thus, it is the aim of this article to show the experiences related to mobile health in the confrontation to COVID-19 in Cuba, because its use has turned into an ally to face the current sanitary contingency caused by this disease, while it helps in (AU)

A systematic review and participant-level meta-analysis found little association of retinal microvascular caliber and reduced kidney function

Previously, variation in retinal vascular caliber has been reported in association with chronic kidney disease (CKD) but findings remain inconsistent. To help clarify this we conducted individual participant data meta-analysis and aggregate data meta-analysis on summary estimates to evaluate cross-sectional associations between retinal vascular caliber and CKD. A systematic review was performed using Medline and EMBASE for articles published until October 2018. The aggregate analysis used a two-stage approach combining summary estimates from eleven studies (44,803 patients) while the individual participant analysis used a one-stage approach combining raw data from nine studies (33,222 patients). CKD stages 3-5 was defined as an estimated glomerular filtration rate under 60 mL/min/1.73m2. Retinal arteriolar and venular caliber (central retinal arteriolar and venular equivalent) were assessed from retinal photographs using computer-assisted methods. Logistic regression estimated relative risk of CKD stages 3-5 associated with a 20 µm decrease (approximately one standard deviation) in central retinal arteriolar and venular equivalent. Prevalence of CKD stages 3-5 was 11.2 % of 33,222 and 11.3 % of 44,803 patients in the individual participant and aggregate data analysis, respectively. No significant associations were detected in adjusted analyses between central retinal arteriolar and venular equivalent and CKD stages 3-5 in the aggregate analysis for central retinal arteriolar relative risk (0.98, 95% confidence interval 0.94-1.03); venular equivalent (0.99, 0.95- 1.04) or individual participant central retinal arteriolar (0.99, 0.95-1.04) or venular equivalent (1.01, 0.97-1.05). Thus, meta-analysis provided little evidence to suggest that cross sectional direct measurements of retinal vascular caliber was associated with CKD stages 3-5 in the general population. Hence, meta-analyses of longitudinal studies evaluating the association between retinal parameters and CKD stages 3-5 may be warranted.

Widespread Pandemic, Wide-Ranging Response: Student-Led Virtual Telemedicine and Digital Community-Based Healthcare Provision in A University Healthcare Centre in Response to Coronavirus Quarantine Measures

Introduction: Isolation and border control measures, with home quarantine measures, are essential to stem the spread of the newly emergent novel Covid-19 Such measures are doomed to fail if reliant on traditional isolation methods, which entail small numbers of overworked healthcare staff screening and surveilling large numbers of well individuals who are potential false positives Innovative method employed by Hospital UMS to overcome these logistics difficulties Methods: A total of 440 returning China students to UMS were planned for home quarantine measures for 14 days In the intervening 14 days, groups of ten quarantined individuals were assigned to 1 Mandarin-speaking medical student liaison officer (LO) LOs performed assessment toolkit for 14 consecutive days virtually via WhatsApp and WeChat and reported back to NCOV central command if any symptoms ensued Results: 45 China students have been put on home quarantine Two (2) students with symptoms were monitored virtually till resolution of symptoms Also, five (5) students with uncontactable phone numbers required tracking down, using various methods eg: retrieval from close contacts through wide-bore virtual search No cases so far have been positive for NCOV or have required referral to tertiary hospitals Qualitatively, such methods are a vital public health intervention, as task shifting happens to semi-professionals Hospital UMS first trial of two cherished founding principles: community-based rather than healthcare-facility center healthcare delivery, and judicious use of digital health communications, applications, and rudimentary telemedicine Conclusion: Student-led virtual telemedicine and digital health delivery has potential in public health crises like NCOV, freeing frontline healthcare staff to devote energies to their specialties of screening and treatment Integration of video and biometrics to incorporate true telemedicine, allowing individuals to be "hospitalized" in a community setting in situations of low risk [ABSTRACT FROM AUTHOR] Copyright of Malaysian Journal of Medicine & Health Sciences is the property of Universiti Putra Malaysia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

Etude transversale de la prevalence de l'hyposmie et de l'hypogueusie chez 390 patients atteints de COVID-19 hospitalises ou non

Declaration de liens d'interets: Les auteurs declarent ne pas avoir de liens d'interets Copyright © 2020

Competitive pricing of substitute products under supply disruption

There has been an increased interest in optimizing pricing and sourcing decisions under supplier competition with supply disruptions. In this paper, we conduct an analytical game-theoretical study to examine the effects of supply capacity disruption timing on pricing decisions for substitute products in a two-supplier one-retailer supply chain setting. We investigate whether the timing of a disruption may significantly impact the optimal pricing strategy of the retailer. We derive the optimal pricing strategy and ordering levels with both disruption timing and product substitution. By exploring both the Nash and Stackelberg games, we find that the order quantity with the disrupted supplier depends on price leadership and it tends to increase when the non-disrupted supplier is the leader. Moreover, the equilibrium market retail prices are higher under higher levels of disruption for the Nash game, compared to the Stackelberg game. We also uncover that the non-disrupted supplier can always charge the highest wholesale price if a disruption occurs before orders are received. This highlights the critical role of order timing. The insights can help operations managers to proper design risk mitigation ordering strategies and re-design the supply contracts in the presence of product substitution under supply disruptions.

Survey of Hearing Health During the COVID-19 Pandemic: Implications for Service Delivery

Purpose This study aimed to explore older adults' perceptions of their hearing health during the stay-at-home order issued during the COVID-19 pandemic. Method A 24-item survey was completed by 150 community-dwelling older adults in the United States. Participants were asked about their self-reported hearing status, use of hearing aids and difficulty wearing masks while wearing hearing aids, relative importance of their hearing health, priority of their hearing health during the COVID-19 pandemic, difficulty communicating with masks, and utilization of telepractice services. Results The majority of participants did not wear hearing aids despite reporting that they had at least a little trouble hearing. Most participants reported that their hearing health was important and indicated that they were likely to visit their audiologist for an in-person or virtual visit during the pandemic. Conclusion Audiologists should consider telepractice or remote service delivery options during and after the COVID-19 pandemic to meet the needs of their patients.

Mental distress among U.S. adults during the COVID-19 pandemic

OBJECTIVE: This study aims to document the impact of the COVID-19 pandemic on mental health METHOD: We compared a nationally representative online sample of 2,032 U S adults in late April 2020 to 19,330 U S adult internet users who participated in the 2018 National Health Interview Survey (NHIS) using the Kessler-6 scale of mental distress in the last 30 days RESULTS: Compared to the 2018 NHIS sample, U S adults in April 2020 were eight times more likely to fit criteria for serious mental distress (27 7% vs 3 4%) and three times more likely to fit criteria for moderate or serious mental distress (70 4% vs 22 0%) Differences between the 2018 and 2020 samples appeared across all demographic groups, with larger differences among younger adults and those with children in the household CONCLUSIONS: These considerable levels of mental distress may portend substantial increases in diagnosed mental disorders and in their associated morbidity and mortality

Analysis of the Healthcare MERS-CoV Outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 Using a SEIR Ward Transmission Model

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic coronavirus that has a tendency to cause significant healthcare outbreaks among patients with serious comorbidities. We analyzed hospital data from the MERS-CoV outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 using the susceptible-exposed-infectious-recovered (SEIR) ward transmission model. The SEIR compartmental model considers several areas within the hospital where transmission occurred. We use a system of ordinary differential equations that incorporates the following units: emergency department (ED), out-patient clinic, intensive care unit, and hospital wards, where each area has its own carrying capacity and distinguishes the transmission by three individuals in the hospital: patients, health care workers (HCW), or mobile health care workers. The emergency department, as parameterized has a large influence over the epidemic size for both patients and health care workers. Trend of the basic reproduction number (R0), which reached a maximum of 1.39 at the peak of the epidemic and declined to 0.92 towards the end, shows that until added hospital controls are introduced, the outbreak would continue with sustained transmission between wards. Transmission rates where highest in the ED, and mobile HCWs were responsible for large part of the outbreak.

Breastfed 13 month-old infant of a mother with COVID-19 pneumonia: a case report

BACKGROUND: In China, mothers with confirmed or suspected COVID-19 pneumonia are recommended to stop breastfeeding. However, the evidence to support this guidance is lacking. There have been relatively few cases reported about direct breastfeeding an infant by a mother with SARS-CoV-2 pneumonia. Therefore, it is necessary to assess the safety of breastfeeding and the possible protective effects of breast milk on infants. CASE PRESENTATION: This report analyzes the case of a mother who continued breastfeeding her 13 month-old child when both were diagnosed with confirmed COVID-19 pneumonia. We describe the clinical presentation, diagnosis, treatment, and outcome. The presence of SARS-CoV-2 nucleic acid was determined in maternal serum, breast milk, nasopharyngeal (NP) swabs and feces, and in infant serum, NP swabs and feces. IgM and IgG antibodies against SARS-CoV-2 were assessed in maternal serum and breast milk and in infant serum. SARS-CoV-2 nucleic acid was not detected in the breast milk, and antibodies against SARS-CoV-2 were detected in the mother's serum and milk. CONCLUSIONS: The present case further confirms that the possibility of mother-to-child transmission about SARS-CoV-2 via breast milk alone was very small, and breast milk is safe for direct feeding of infants.

The social life of COVID-19: Early insights from social media monitoring data collected in Poland

Research has revealed that social media data may be promising in many health threats and help to understand how people respond to them. As the outbreak of a novel coronavirus disease (COVID-19) is a global pandemic, a real-time social media monitoring is needed to know the scale of this phenomenon. We have reported the frequency, reach and impact of online mentions about the COVID-19 illness taken from social media platforms: Facebook, Instagram, Twitter, blogs, forums, and news portals to highlight and better understand the scope of coronavirus discussion in Poland. We used SentiOne social listening tool to gather the data and perform the monitoring between 24 February 2020 to 25 March 2020. We found a total of 1,415,750 mentions related to COVID-19 which gives the average 47,192 mentions per day. 95.36% (1,350,059) of mentions were people's updates and expressions, 4.64% (65,691) mentions were articles from news portals and social media. Males have dominated the online conversation about COVID-19 (65.32% vs 34.68% females). At the same time, women were more likely to discuss the topic on social media platforms such as: Facebook, Twitter, and Instagram. We concluded with theoretical and practical implications.

COVID 19 pandemic: Social aspects and safe behaviours

Coronavirus, a recently discovered virus is responsible for the causation of Coronavirus disease (COVID-19) which is an infectious disease The population at a higher risk of developing an advanced disease are elderly people, cardiac patients, diabetics, malignancy, and chronic respiratory illness Prevention of the disease is best practiced by being informed about the disease, the symptoms, the virus, and its transmission The mode of transmission of the COVID-19 virus is basically through saliva or nasal discharge of an infected patient when the patient coughs or sneezes © 2020 by Advance Scientific Research

Behandling med 4-aminokinoliner vid covid-19 kan ge allvarliga biverkningar./ [Potential harms associated with 4-aminoquinoline treatment]

Hydroxychloroquine and chloroquine are currently being evaluated as treatment against COVID-19. These drugs are associated with some potential harms, including QTc-interval prolongation, hypoglycaemia, severe skin reactions and psychiatric effects. Use of hydroxychloroquine or chloroquine should be reserved to current indications or clinical trials, as recommended by several governmental medical products agencies.

Efficacy and tolerability of DPP4 inhibitor, teneligliptin, on autonomic and peripheral neuropathy in type 2 diabetes: an open label, pilot study

BACKGROUND: Diabetic neuropathy increases risk of cardiovascular disease, peripheral artery disease, foot amputation and overall mortality. Not only hyperglycaemia induced nerve damage is harder to repair using currently approved medications, but also, the use of these agents is often limited by the extent of pain relief provided and side effects. METHODOLOGY: In this prospective, open-label, pilot study, 20 type-2 diabetes mellitus patients (male/female=13/7, mean age- 56.1±8.04 years), meeting inclusion/exclusion criteria, were treated with dipeptidyl peptidase-4 (DPP-4) inhibitor, Teneligliptin, 20mg once a day for three months. Efficacy parameters: Sudomotor function (Sudoscan score); parasympathetic dysfunction assessed using Ewing's criteria i.e. heart rate response to -standing (HRS), -valsalva (HRV) and -deep breath (HRD); sympathetic dysfunction assessed as blood pressure response to -standing (BPS) and -handgrip (BPH); ankle brachial index (ABI), vibration perception threshold (VPT), C-reactive protein, glycemic profile and health related quality of life (HRQoL); and, tolerability parameters: complete blood count, liver function tests, serum creatinine, thyroid stimulating hormone, QT- interval and serum vitamin B12 levels, were measured. RESULTS: There was no statistical difference in BMI, SBP, DBP, HRD, BPH and all safety parameters. After 12 weeks treatment, there was improvement in HRS (p<0.01) and HRV (p<0.01), but not in HRD (p=0.12). BPS was significantly lowered (p <0.01), but not the BPH (p =0.06). Sudoscan score was increased, while VPT was significantly decreased (both p<0.01). CONCLUSION: Teneligliptin not only improves the glycemic status but also improves sudomotor function, peripheral and autonomic neuropathy, and reduces vascular inflammation in type 2 diabetes.

Gastrointestinal and hepatic manifestations of Corona Virus Disease-19 and their relationship to severe clinical course: A systematic review and meta-analysis

BACKGROUND: Many case series on Corona Virus Disease (COVID-19) have reported gastrointestinal (GI) and hepatic manifestations in a proportion of cases; however, the data is conflicting. The relationship of GI and hepatic involvement with severe clinical course of COVID-19 has also not been explored. OBJECTIVES: The main objectives were to determine the frequency of GI and hepatic manifestations of COVID-19 and to explore their relationship with severe clinical course. METHODS: We searched PubMed for studies published between January 1, 2020, and March 25, 2020, with data on GI and hepatic manifestations in adult patients with COVID-19. These data were compared between patients with severe and good clinical course using the random-effects model and odds ratio (OR) as the effect size. If the heterogeneity among studies was high, sensitivity analysis was performed for each outcome. RESULTS: We included 62 studies (8301 patients) in the systematic review and 26 studies (4676 patients) in the meta-analysis. Diarrhea was the most common GI symptom (9%), followed by nausea/vomiting (5%) and abdominal pain (4%). Transaminases were abnormal in approximately 25%, bilirubin in 9%, prothrombin time (PT) in 7%, and low albumin in 60%. Up to 20% patients developed severe clinical course, and GI and hepatic factors associated with severe clinical course were as follows: diarrhea (OR 2), high aspartate aminotransferase (OR 1.4), high alanine aminotransferase (OR 1.6), high bilirubin (OR 2.4), low albumin (OR 3.4), and high PT (OR 3). CONCLUSIONS: GI and hepatic involvement should be sought in patients with COVID-19 since it portends severe clinical course. The pathogenesis of GI and hepatic involvement needs to be explored in future studies.

COVID-19: the older adult and the importance of vitamin D sufficiency

In December 2019, in Wuhan, China, the novel coronavirus ‘severe acute respiratory syndrome 2’ (SARS-CoV-2) was discovered as the cause of a pneumonia-like illness and subsequently named coronavirus disease 2019 (COVID-19) COVID-19 spread and is now a global pandemic With few exceptions, countries in the Northern hemisphere have higher mortality rates from COVID-19 This may be due to an increased prevalence of older people in Northern Europe at higher risk of having cardio-pulmonary and metabolic comorbidities as well as hypovitaminosis D With increasing age, immunosenescence and ‘inflammaging’ lead to impaired and maladaptive immune responses to SARS-CoV-2 infections, contributing to the enhanced prevalence of severe COVID-19 in older patients The association of ageing with increased vitamin D deficiency, which is associated with cardiovascular risk factors and disease and worse prognosis in COVID-19 infection, is discussed Considerable experimental evidence demonstrates the immuno-modulatory properties of vitamin D, in particular, its role in regulating and suppressing the inflammatory cytokine response to viral respiratory infections links the importance of vitamin D sufficiency as a potential protective factor in COVID-19 There is an urgent need for prospective randomised studies to examine whether hypovitaminosis D correlates with severity of COVID-19 disease and the actual benefit of repletion Moreover, given what has been described as a ‘pandemic of vitamin D deficiency’, especially in Europe, and in the context of the SARS-CoV-2 contagion, the authors support the call for public health doctors and physicians, with support from Governments, to prioritise and strengthen recommendations on vitamin D intake and supplementation

Chaperna: linking the ancient RNA and protein worlds

As a mental framework for the transition of self-replicating biological forms, the RNA world concept stipulates a dual function of RNAs as genetic substance and catalyst. The chaperoning function is found intrinsic to ribozymes involved in protein synthesis and tRNA maturation, enriching the primordial RNA world with proteins of biological relevance. The ribozyme-resident protein folding activity, even before the advent of protein-based molecular chaperone, must have expedited the transition of the RNA world into the present protein theatre.

COVID-19: ensuring our medical equipment can meet the challenge

To predict the spread of coronavirus disease globally and consequently prepare the hospital facilities with the required technology is a challenge. The availability of essential medical equipment to support patients affected by Covid-19 is globally limited. Areas covered This perspective gives a technical view of the pandemic focusing on the main actions taken by regulatory agencies to cope with the shortage of devices. The risk/benefit assessment and the main infection control policies in the clinical practices are also looked at. Expert opinion Regulatory agencies have amended their medical devices directives to address the pandemic, but each in a different way. In this exceptional situation scientist and technology experts in collaboration with medical specialists should work together to re-assess the risk analysis on medical equipment management and their use and re-use in this context with the aim to improve global health care Every effort must be made to provide the necessary devices at least with the minimum acceptable performances for Covid-19 patients while maintaining a high standard of safety for users. The aim of the present manuscript is to highlight the technical challenges in order to prevent, through targeted actions, operating standards from falling below the standards of care due to a lack of medical devices. Abbreviations AKI: acute Kidney Injury; ARGMD: Australian Regulatory Guidelines for Medical Devices; Covid-19: Coronavirus disease; FDA: Food and Drug Administration; ECMO: Extracorporeal Membrane Oxygenation; EU: European Union; ICU: Intensive Care Unit; WHO: World Health Organization; MHRA: Medicines and Healthcare products Regulatory Agency; MDR: Medical Device Regulation; SARI: Severe Acute Respiratory Infection.

The value of intra-operative electrographic biomarkers for tailoring during epilepsy surgery: from group-level to patient-level analysis

Signal analysis biomarkers, in an intra-operative setting, may be complementary tools to guide and tailor the resection in drug-resistant focal epilepsy patients. Effective assessment of biomarker performances are needed to evaluate their clinical usefulness and translation. We defined a realistic ground-truth scenario and compared the effectiveness of different biomarkers alone and combined to localize epileptogenic tissue during surgery. We investigated the performances of univariate, bivariate and multivariate signal biomarkers applied to 1 min inter-ictal intra-operative electrocorticography to discriminate between epileptogenic and non-epileptogenic locations in 47 drug-resistant people with epilepsy (temporal and extra-temporal) who had been seizure-free one year after the operation. The best result using a single biomarker was obtained using the phase-amplitude coupling measure for which the epileptogenic tissue was localized in 17 out of 47 patients. Combining the whole set of biomarkers provided an improvement of the performances: 27 out of 47 patients. Repeating the analysis only on the temporal-lobe resections we detected the epileptogenic tissue in 29 out of 30 combining all the biomarkers. We suggest that the assessment of biomarker performances on a ground-truth scenario is required to have a proper estimate on how biomarkers translate into clinical use. Phase-amplitude coupling seems the best performing single biomarker and combining biomarkers improves localization of epileptogenic tissue. Performance achieved is not adequate as a tool in the operation theater yet, but it can improve the understanding of pathophysiological process.

Benford's Law and COVID-19 reporting

Trust in the reported data of contagious diseases in real time is important for policy makers. Media and politicians have cast doubt on Chinese reported data on COVID-19 cases. We find Chinese confirmed infections match the distribution expected in Benford's Law and are similar to that seen in the U.S. and Italy. We identify a more likely candidate for problems in the policy making process: Poor multilateral data sharing on testing and sampling.

Preventive Measures for COVID-19 in Dental Treatments

OBJECTIVE: COVID-19 has spread to most countries around the world, infecting millions of people and resulting in the pandemic. This presents great challenges for dental professionals. It is necessary to explore preventive measures for COVID-19 in dental treatments. METHODS: In this paper, we outline several measures designed to prevent COVID-19 in dental treatments, such as three-level pre-examination triage and two-body temperature tests, three-level protection for medical personnel, gargle before oral treatment, implement the four-hand operation, suctioning saliva during oral treatment, use a rubber dam, strict enforcement of hand hygiene. These measures include recommendations for medical staff and give practical advice for managing treatment. RESULTS: The epidemic has been brought under control and routine oral examination and treatments have gradually been resumed from March 9, 2020, in Hunan province, China. From January 24, 2020, to March 8, 2020, a total of 4,272 patients received oral therapy during the COVID-19 epidemic in our hospital. We followed these guidelines during the COVID-19 epidemic and none of the clinical dental staff, other workers, or patients were infected with COVID-19. CONCLUSIONS: These preventive measures for COVID-19 in dental treatments can be used as a reference for oral clinics and stomatological hospitals.

To Do, This:On Physician Training During COVID-19

I want to do this. I’m called to do this. I’m scared to do this. I learned how to do this. I’ll prove I can do this. Will you let me do this?. No one warned me about this. My family hates that I do this. I got sick from doing this.

Research Progress in the Convalescent Plasma Therapy of Virus Infection

康复者恢复期血浆可治疗多种病毒性感染疾病 本文通过总结既往康复者恢复期血浆在治疗病毒性传播疾病中的研究进展,分析其在新型冠状病毒肺炎治疗中的潜在价值 总结了康复者恢复期血浆在募集、血浆处理、抗体效价检测中的技术进展及其在禽流感病毒、MERS-CoV、SARS-CoV、EBOV、SARS-CoV-2等病毒性感染的临床治疗效果以及血浆输注相关不良反应等 康复者恢复期血浆在多数病例报道及回顾性分析结果 提示其可以降低疾病死亡率,可作为新型冠状病毒肺炎感染潜在的治疗方法

Crisis change management during COVID-19 in the elective orthopaedic hospital: Easing the trauma burden of acute hospitals

INTRODUCTION: With the emergence of the 2019 novel coronavirus and its resulting pandemic status in March 2020 all routine elective orthopaedic surgery was cancelled in our institution. The developing picture in Italy, of acute hospitals becoming overwhelmed with treating patients suffering with severe and life-threatening symptoms from the disease, prompted the orthopaedic surgeons to formulate a plan to transfer trauma patients requiring surgery to the elective hospital to unburden the acute hospital system. METHODS: Under the threat of this pandemic; protocols and algorithms were established for referral, acceptance and care of trauma patients from acute hospitals in the region. Each day, as new guidance on COVID-19 emerged, our process and algorithms were adjusted to reflect pertinent change. RESULTS: The screening of all patients referred, worked well in keeping our hospital "COVID-free" with respect to patients undergoing operations. An upward trend in cases referred reflected the decreased capacity in the acute hospitals due to rising cases of COVID-19 within the hospital network. During the first 7 weeks of the pandemic 308 operations were performed, (31.1% upper limb, 33.4% lower limb, 4.1% spine, 14.1% urgent elective, 17.4% plastic surgery cases). Regular review and audit of the activity in the hospital as well as communication with the referring teams enabled appropriate planning to accommodate the increase in case-mix as the need arose. DISCUSSION: This paper details the steps that were taken in planning for such a change in management specific to the orthopaedic surgery setting and the lessons learnt during this process. The success of the development of this pathway was facilitated by clear communication channels, flexibility to adapt to changing process and feedback from all stakeholders. The implementation of this pathway allowed the unburdening of acute hospitals dealing with the pandemic that was steadily reducing access to operating theatres and anaesthetic resources.

Preliminary Design of a Smart Wristband Disinfectant to Help in Covid-19 Fight

This concept paper describes a device consisting of a disinfectant wristband for the hands of the wearer and objects that the wearer intends to touch This wristband can be powered automatically by the movement of the user&rsquo;s hand or by solar cells or, if necessary, by a power outlet It disinfects the surface of the hands and the objects in front of them using an ultraviolet (UV) lamp Control and monitoring can be carried out automatically or manually, which guarantees complete and effective disinfection The electronic control system, which is fully integrated into the UV emitter head, regulates the intensity and duration of the UV radiation and also manages the electrical energy In addition, the wristband can be fitted with an optional watch to improve its decoration and ergonomics The device in question has a compact, elegant, and practical shape This hand sanitizing wristband can be an effective tool in the fight against the current COVID-19 pandemic and, in general, help to address the health challenges related to hygiene and disease prevention

Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China

Importance: While the outbreak of coronavirus disease 2019 (COVID-19) has resulted in more than 100 000 infected individuals in China and worldwide, there are few reports on the association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with ocular abnormalities. Understanding ocular manifestations of patients with COVID-19 by ophthalmologists and others may facilitate the diagnosis and prevention of transmission of the disease. Objective: To investigate ocular manifestations and viral prevalence in the conjunctiva of patients with COVID-19. Design, Setting, and Participants: In this case series, patients with COVID-19 treated from February 9 to 15, 2020, at a hospital center in Hubei province, China, were retrospectively reviewed for ocular manifestations. During the period of treatment, the ocular signs and symptoms as well as results of blood tests and reverse transcriptase-polymerase chain reaction (RT-PCR) from nasopharyngeal and conjunctival swabs for SARS-CoV-2 were noted and analyzed. Main Outcomes and Measures: Ocular signs and symptoms as well as results of blood tests and RT-PCR for SARS-CoV-2. Results: Of the 38 included patients with clinically confirmed COVID-19, 25 (65.8%) were male, and the mean (SD) age was 65.8 (16.6) years. Among them, 28 patients (73.7%) had positive findings for COVID-19 on RT-PCR from nasopharyngeal swabs, and of these, 2 patients (5.2%) yielded positive findings for SARS-CoV-2 in their conjunctival as well as nasopharyngeal specimens. A total of 12 of 38 patients (31.6%; 95% CI, 17.5-48.7) had ocular manifestations consistent with conjunctivitis, including conjunctival hyperemia, chemosis, epiphora, or increased secretions. By univariate analysis, patients with ocular symptoms were more likely to have higher white blood cell and neutrophil counts and higher levels of procalcitonin, C-reactive protein, and lactate dehydrogenase than patients without ocular symptoms. In addition, 11 of 12 patients with ocular abnormalities (91.7%; 95% CI, 61.5-99.8) had positive results for SARS-CoV-2 on RT-PCR from nasopharyngeal swabs. Of these, 2 (16.7%) had positive results for SARS-CoV-2 on RT-PCR from both conjunctival and nasopharyngeal swabs. Conclusions and Relevance: In this study, one-third of patients with COVID-19 had ocular abnormalities, which frequently occurred in patients with more severe COVID-19. Although there is a low prevalence of SARS-CoV-2 in tears, it is possible to transmit via the eyes.

Rethinking of Health Management Discipline Enlightened by COVID‑19/ 新型冠状病毒肺炎对健康管理学科建设带来的启示

新型冠状病毒肺炎的暴发，给我国公共卫生和临床医学带来了巨大挑战。面对新型冠状病毒的反复威胁及其潜在次生危害，建立体系完整、紧密协作的健康管理服务体系迫在眉睫。健康管理学科需更加专注于健康、亚健康、疾病各类人群的全方位健康管理，着眼健康危险因素的评估和干预，采用人工智能与互联网技术对慢性非传染性疾病与突发急性传染病采取精准、高效的防治措施，实现健康管理防、治、管工作的整体融合发展，实现健康管理在后疫情时代新的“三个转变”，从而保障人民健康，提高全民健康水平，确保社会稳定发展。

Noncanonical Functions of Antibodies

The typical functions of antibodies are based on linking the process of antigen recognition with initiation of innate immune reactions. With the introduction of modern research technologies and the use of sophisticated model systems, recent years have witnessed the discovery of a number of noncanonical functions of antibodies. These functions encompass either untypical strategies for neutralization of pathogens or exertion of activities that are characteristic for other proteins (cytokines, chaperones, or enzymes). Here, we provide an overview of the noncanonical functions of antibodies and discuss their mechanisms and implications in immune regulation and defense. A better comprehension of these functions will enrich our knowledge of the adaptive immune response and shall inspire the development of novel therapeutics.

Risk of COVID-19 infection in MS and neuromyelitis optica spectrum disorders

OBJECTIVE: Disease-modifying drugs (DMDs) may alter the immune status and thus increase the susceptibility to coronavirus disease 2019 (COVID-19) in patients with MS or neuromyelitis optica spectrum disorders (NMOSD). However, evidence supporting this notion is currently lacking. In this study, we conducted a survey on the risk of COVID-19 in patients with MS and NMOSD. METHODS: The survey was conducted through the Chinese Medical Network for Neuroinflammation. Patients in 10 MS centers from 8 cities including Wuhan were included. Information about MS and NMOSD disease duration and the usage of DMDs were collected. Data of suspected cases of COVID-19 were obtained from hospital visits, questionnaires, and patient self-reporting. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was confirmed through clinical evaluation by a panel of experts in conjunction with chest CT and viral RNA detection. RESULTS: Eight hundred eighty-two of 1,804 (48.89%) patients with MS and 2,129 of 3,060 (69.58%) patients with NMOSD were receiving DMDs. There were no alterations in the patients' DMD regimen during January 15, 2020, to March 15, 2020, the 3-month period. None of the patients with MS treated with DMDs had COVID-19. However, 2 patients with relapsing NMOSD were diagnosed with COVID-19-related pneumonia. After treatment, both patients recovered from pneumonia and neither patient experienced new attacks due to predisposing SARS-CoV-2 infection in the following 2 months. CONCLUSIONS: No increased risk of COVID-19 infection was observed in patients with MS or NMOSD, irrespective of whether these patients received DMDs. A battery of stringent preventive measures adopted by neurologists to reduce COVID-19 infection in these patients may have contributed to low risk of COVID-19 infection.

Risk of COVID-19 infection in MS and neuromyelitis optica spectrum disorders

OBJECTIVE: Disease-modifying drugs (DMDs) may alter the immune status and thus increase the susceptibility to coronavirus disease 2019 (COVID-19) in patients with MS or neuromyelitis optica spectrum disorders (NMOSD). However, evidence supporting this notion is currently lacking. In this study, we conducted a survey on the risk of COVID-19 in patients with MS and NMOSD. METHODS: The survey was conducted through the Chinese Medical Network for Neuroinflammation. Patients in 10 MS centers from 8 cities including Wuhan were included. Information about MS and NMOSD disease duration and the usage of DMDs were collected. Data of suspected cases of COVID-19 were obtained from hospital visits, questionnaires, and patient self-reporting. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was confirmed through clinical evaluation by a panel of experts in conjunction with chest CT and viral RNA detection. RESULTS: Eight hundred eighty-two of 1,804 (48.89%) patients with MS and 2,129 of 3,060 (69.58%) patients with NMOSD were receiving DMDs. There were no alterations in the patients' DMD regimen during January 15, 2020, to March 15, 2020, the 3-month period. None of the patients with MS treated with DMDs had COVID-19. However, 2 patients with relapsing NMOSD were diagnosed with COVID-19-related pneumonia. After treatment, both patients recovered from pneumonia and neither patient experienced new attacks due to predisposing SARS-CoV-2 infection in the following 2 months. CONCLUSIONS: No increased risk of COVID-19 infection was observed in patients with MS or NMOSD, irrespective of whether these patients received DMDs. A battery of stringent preventive measures adopted by neurologists to reduce COVID-19 infection in these patients may have contributed to low risk of COVID-19 infection.

COVID-19 in Vietnam: A lesson of pre-preparation

BACKGROUND: Vietnam was slowing the spread of COVID-19 to 200 cases by the end of March. From perspective of a relatively vulnerable healthcare systems, timely interventions were implemented to different stage of pandemic progress to limit the spread. METHOD: The authors compiled literature on different public health measures in Vietnam in compared to the progression of COVID-19 from January to March 2020. RESULTS: Three stages of pandemic progression of COVID-19 were recorded in Vietnam. At 213 confirmed cases under treatment and isolation, a range of interventions were enforced including intensive and expansive contact, mass testing, isolation, and sterilization. Many were in place before any case were reported. CONCLUSION: Preparation were key for Vietnam's healthcare system in the ever-changing landscape of COVID-19 pandemic.

Atypical Manifestation of COVID-19-Induced Myocarditis

We present a case of a 39-year-old male who presented with chest pain without fever or respiratory symptoms Troponins were elevated and electrocardiogram (ECG) was inconclusive for ST-elevation myocardial infarction (STEMI) Angiography revealed normal coronaries and the patient was found to be coronavirus disease 2019 (COVID-19) positive;he was diagnosed with COVID-19 myocarditis With the global pandemic, more cases are emerging regarding myocardial injury induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus Although COVID-19 manifests primarily as respiratory disease, few cases of cardiac injury without respiratory involvement or febrile illness have been reported This case illustrates that COVID-19 can present atypically and affect an isolated non-respiratory organ system

Evidence of a"current-mediated"turbulent regime in space and astrophysical plasmas

How the turbulent energy cascade develops below the magnetohydrodynamic scales in space and astrophysical plasmas is a major open question. Here, we measure the power spectrum of magnetic fluctuations in Parker Solar Probe's observations close to the Sun and in state-of-the-art numerical simulations of plasma turbulence. Both reveal a power-law behavior with a slope compatible with $-11/3$ at scales smaller than the ion characteristic scales, steeper than what is typically observed in the solar wind and in the Earth's magnetosheath. We explain such behavior by developing a simple two-fluid model which does not require any kinetic processes nor electron-inertia effects. This is characterized by a significant contribution of the ion kinetic energy to the total turbulent energy cascade at sub-ion scales, although the dynamics is driven by the magnetic field through the current density. We expect that this regime may be relevant for a broad class of low-beta plasmas, e.g. the solar corona, non-relativistic magnetized jets and disks, and laboratory plasmas.

Successful containment of Covid-19 outbreak in a large maternity and perinatal center while continuing clinical service

With increasing number of SARS-CoV-2 infections and COVID-19 patients to be taken care of by the health system, more and more health workers become affected by the disease. It has been reported that right from the beginning of the outbreak in Lombardy up to 20% of the doctors and nurses became infected. Under these circumstances, the regular operation of health institutions already suffering from a shortage of staff becomes difficult. This has led to complete or partial shutdowns of hospitals, either due to a lack of uninfected personnel or because of uncontrollable chains of infection endangering patients. In one of the largest university perinatal center in Bavaria with more than 3000 births per year, an outbreak of COVID-19 occurred in March 2020, affecting 36 staff members, including doctors, nurses, and midwives. Here, we describe the outbreak and present the measures contributing to the successful containment of the outbreak within three weeks. At the same time, clinical services could be maintained, however, not without deployment of personnel exposed to employees infected with SARS-CoV-2. Apart from massive testing of personnel in pre-defined phases and increased hygiene measures, including a general obligation to wear surgical face masks, we identified the need to monitor cases of illness across all groups of employees, to ensure social distancing within personnel and to evaluate contacts of clinical personnel outside of the hospital environment, in order to be able to interpret chains of infections and to disrupt them. Overall, only a bundle of measures is needed to contain such an outbreak.

Preparedness and Response to Pediatric COVID-19 in European Emergency Departments: A Survey of the REPEM and PERUKI Networks

Study objective: We aim to describe the variability and identify gaps in preparedness and response to the coronavirus disease 2019 pandemic in European emergency departments (EDs) caring for children. Methods: A cross-sectional point-prevalence survey was developed and disseminated through the pediatric emergency medicine research networks for Europe (Research in European Pediatric Emergency Medicine) and the United Kingdom and Ireland (Paediatric Emergency Research in the United Kingdom and Ireland). We aimed to include 10 EDs for countries with greater than 20 million inhabitants and 5 EDs for less populated countries, unless the number of eligible EDs was less than 5. ED directors or their delegates completed the survey between March 20 and 21 to report practice at that time. We used descriptive statistics to analyze data. Results: Overall, 102 centers from 18 countries (86% response rate) completed the survey: 34% did not have an ED contingency plan for pandemics and 36% had never had simulations for such events. Wide variation on personal protective equipment (PPE) items was shown for recommended PPE use at pretriage and for patient assessment, with 62% of centers experiencing shortage in one or more PPE items, most frequently FFP2 and N95 masks. Only 17% of EDs had negative-pressure isolation rooms. Coronavirus disease 2019-positive ED staff was reported in 25% of centers. Conclusion: We found variation and identified gaps in preparedness and response to the coronavirus disease 2019 epidemic across European referral EDs for children. A lack in early availability of a documented contingency plan, provision of simulation training, appropriate use of PPE, and appropriate isolation facilities emerged as gaps that should be optimized to improve preparedness and inform responses to future pandemics.

Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic

Since February 21, 2020, SARS-CoV-2 has spread exponentially worldwide. Neonatal patients needing intensive care are considered a vulnerable population. To report the results of a policy based on multi-timepoint surveillance for SARS-CoV-2 of all neonates admitted to the neonatal intensive care unit (NICU), their parents, and all healthcare providers in a part of Italy with a high prevalence of the infection. Observational study conducted from 21 February to 21 April 2020. Intervention consisted of (a) parental triage on arrival at the neonatal ward; (b) universal testing with nasopharyngeal swabs and blood testing for SARS-CoV-2 IgM and IgG antibodies; (c) use of continuous personal protective equipment at the NICU by parents and staff. A total of 6726 triage procedures were performed on 114 parents, and 954 nasopharyngeal swabs were collected from 226 individuals. Five (2.2%) asymptomatic individuals (2 parents and 3 healthcare providers) tested positive on nasopharyngeal swabs and were kept isolated for 14 days. Of 75 admitted newborn, no one tested positive on nasopharyngeal swabs or antibody tests. Three parents presented with fever or flu-like symptoms at triage; they tested negative on swabs.Conclusion: With universal screening of neonates, parents, and staff, there were no cases of SARS-CoV-2 infection among the neonates admitted to a NICU in an area with a high incidence of SARS-CoV-2. Our experience could be usefully compared with other strategies with a view to developing future evidence-based guidelines for managing high-risk neonates in case of new epidemics. What is Known: • The novel coronavirus named SARS-CoV-2 has since spread worldwide at a remarkable rate, with more than 2.5 million confirmed cases. • Pediatric population may be less affected from COVID-19 than adult population but infants and newborn babies seem to be more vulnerable to SARS-CoV-2 infection. What is New: • Using an approach based on triage; testing with nasopharyngeal swabs and serology; and use of personal protective equipment, there were no cases of SARS-CoV-2 infection among neonates in a NICU in a high incidence of SARS-CoV-2 area. • Positive and asymptomatic individuals were identified and isolated early allowing the containment of infection's spread among healthcare providers and parents.

Digital technology applications for contact tracing: the new promise for COVID-19 and beyond?

Among the most critical strategies in the fight against the Corona Virus Disease (COVID-19) is the rapid tracing and notification of potentially infected persons. Several nations have implemented mobile software applications ("apps") to alert persons exposed to the coronavirus. The expected advantages of this new technology over the traditional method of contact tracing include speed, specificity, and mass reach. Beyond its use for mitigating and containing COVID-19, digital technology can complement or even augment the traditional approach to global health program implementation. However, as with any new system, strong regulatory frameworks are necessary to ensure that individual information is not used for surveillance purposes, and user privacy will be maintained. Having safeguarded this, perhaps the global health community will witness the beginning of a new era of implementing mass health programs through the medium of digital technology.

Managing Burns During COVID-19 Outbreak

The coronavirus disease pandemic has affected our practice as healthcare professionals. As burn surgeons, we are obliged to provide the best possible care to our patients. However, due to the risk of viral transmission, the goal should be to provide safe care to our patients as well as ensure the safety of the whole team providing burn care. The burn patients are usually debilitated and require a prolonged hospital stay and multiple operative procedures which put them and everyone involved in their care at increased risk of coronavirus infections and transmission. This warrants special caution to the burn team while managing such patients. In this review, we aim to highlight the key considerations for burn care teams while dealing with burn patients during the COVID-19 pandemic.

Managing burns during COVID-19 outbreak

The coronavirus disease pandemic has affected our practice as healthcare professionals (HCP). As burn surgeons, we are obliged to provide the best possible care to our patients. However, due to the risk of viral transmission, the goal should be to provide safe care to our patients as well as ensure the safety of the whole team providing burn care. The burn patients are usually debilitated and require a prolonged hospital stay and multiple operative procedures which puts them and everyone involved in their care at increased risk of coronavirus infections and transmission. This warrants special caution to the burn team while managing such patients. In this review, we aim to highlight the key considerations for burn care teams while dealing with burn patients during the COVID-19 pandemic.

Considerations in Developing Medical Countermeasures Against Chemical Ocular Toxicity

The Chemical Countermeasures Research Program (CCRP) was established in 2006 by the National Institute of Allergy and Infectious Diseases (NIAID/NIH) on behalf of the National Institutes of Health Office of the Director (NIH OD). It is a trans-NIH initiative to expedite the discovery and early development of medical countermeasures (MCMs) that can reduce mortality and serious morbidity during and after large consequence public health emergency involving the deliberate or accidental large-scale release of highly toxic chemicals (HTCs).

Virtual Interviews May Fall Short for Pediatric Surgery Fellowships: Lessons Learned From COVID-19/SARS-CoV-2

BACKGROUND: As a result of the coronavirus disease 2019 pandemic, many Pediatric Surgery Fellowship programs were forced to convert their normal in-person interviews into virtual interviews. This study sought to determine the perceived value of virtual interviews for Pediatric Surgery Fellowship. METHODS: An anonymous survey was distributed to the applicants and faculty at a university-affiliated, free-standing children's hospital with a Pediatric Surgery fellowship program that conducted one of three interview days using a virtual format. RESULTS: All applicants who responded to the survey had at least one interview that was converted to a virtual interview. Faculty (75%) and applicants (87.5%) preferred in-person interviews over virtual interviews; most applicants (57%) did not feel they got to know the program as well with the virtual format. Applicants and faculty felt that virtual interviews could potentially be used as a screening tool in the future (7/10 Likert) but did not recommend they be used as a complete replacement for in-person interviews (3.5-5/10 Likert). Applicants were more likely than faculty to report that interview type influenced their final rank list (5 versus 3/10 Likert). CONCLUSIONS: Faculty and applicants preferred in-person interviews and did not recommend that virtual interviews replace in-person interviews. As the coronavirus disease 2019 pandemic continues, more virtual interviews will be necessary, and innovations may be necessary to ensure an optimal interview process. TYPE OF STUDY: Survey. LEVEL OF EVIDENCE: N/A.

COVID-19: Pandemic Risk, Resilience and Possibilities for Aging Research

The COVID-19 global crisis is reshaping Canadian society in unexpected and profound ways. The significantly higher morbidity and mortality risks by age suggest that this is largely a "gero-pandemic," which has thrust the field of aging onto center stage. This editorial emphasizes that vulnerable older adults are also those most affected by COVID-19 in terms of infection risk, negative health effects, and the potential deleterious outcomes on a range of social, psychological, and economic contexts - from ageism to social isolation. We also contend that the pathogenic analysis of this pandemic needs to be balanced with a salutogenic approach that examines the positive adaptation of people, systems and society, termed COVID-19 resilience. This begs the question: how and why do some older adults and communities adapt and thrive better than others? This examination will lead to the identification and response to research and data gaps, challenges, and innovative opportunities as we plan for a future in which COVID-19 has become another endemic infection in the growing list of emerging and re-emerging pathogens.

Comparison of the Accula SARS-CoV-2 Test with a Laboratory-Developed Assay for Detection of SARS-CoV-2 RNA in Clinical Nasopharyngeal Specimens

Several point-of-care (POC) molecular tests have received emergency use authorization (EUA) from the Food and Drug Administration (FDA) for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The test performance characteristics of the Accula (Mesa Biotech) SARS-CoV-2 POC test need to be evaluated to inform its optimal use. The aim of this study was to assess the test performance of the Accula SARS-CoV-2 test. The performance of the Accula test was assessed by comparing results of 100 nasopharyngeal swab samples previously characterized by the Stanford Health Care EUA laboratory-developed test (SHC-LDT), targeting the envelope (E) gene. Assay concordance was assessed by overall percent agreement, positive percent agreement (PPA), negative percent agreement (NPA), and Cohen's kappa coefficient. Overall percent agreement between the assays was 84.0% (95% confidence interval [CI], 75.3 to 90.6%), PPA was 68.0% (95% CI, 53.3 to 80.5%), and the kappa coefficient was 0.68 (95% CI, 0.54 to 0.82). Sixteen specimens detected by the SHC-LDT were not detected by the Accula test and showed low viral load burden, with a median cycle threshold value of 37.7. NPA was 100% (95% CI, 94.2 to 100%). Compared to the SHC-LDT, the Accula SARS-CoV-2 test showed excellent negative agreement. However, positive agreement was low for samples with low viral load. The false-negative rate of the Accula POC test calls for a more thorough evaluation of POC test performance characteristics in clinical settings and for confirmatory testing in individuals with moderate to high pretest probability of SARS-CoV-2 who test negative on Accula.

Comparison of the Accula SARS-CoV-2 Test with a Laboratory-Developed Assay for Detection of SARS-CoV-2 RNA in Clinical Nasopharyngeal Specimens

Several point-of-care (POC) molecular tests have received emergency use authorization (EUA) from the Food and Drug Administration (FDA) for the diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The test performance characteristics of the Accula (Mesa Biotech) SARS-CoV-2 POC test need to be evaluated to inform its optimal use. The aim of this study was to assess the test performance of the Accula SARS-CoV-2 test. The performance of the Accula test was assessed by comparing results of 100 nasopharyngeal swab samples previously characterized by the Stanford Health Care EUA laboratory-developed test (SHC-LDT), targeting the envelope (E) gene. Assay concordance was assessed by overall percent agreement, positive percent agreement (PPA), negative percent agreement (NPA), and Cohen's kappa coefficient. Overall percent agreement between the assays was 84.0% (95% confidence interval [CI], 75.3 to 90.6%), PPA was 68.0% (95% CI, 53.3 to 80.5%), and the kappa coefficient was 0.68 (95% CI, 0.54 to 0.82). Sixteen specimens detected by the SHC-LDT were not detected by the Accula test and showed low viral load burden, with a median cycle threshold value of 37.7. NPA was 100% (95% CI, 94.2 to 100%). Compared to the SHC-LDT, the Accula SARS-CoV-2 test showed excellent negative agreement. However, positive agreement was low for samples with low viral load. The false-negative rate of the Accula POC test calls for a more thorough evaluation of POC test performance characteristics in clinical settings and for confirmatory testing in individuals with moderate to high pretest probability of SARS-CoV-2 who test negative on Accula.

Using Helping Mothers Survive to Improve Intrapartum Care

Data from the past decade have revealed that neonatal mortality represents a growing burden of the under-5 mortality rate. To further reduce these deaths, the focus must expand to include building capacity of the workforce to provide high-quality obstetric and intrapartum care. Obstetric complications, such as hypertensive disorders and obstructed labor, are significant contributors to neonatal morbidity and mortality. A well-prepared workforce with the necessary knowledge, skills, attitudes, and motivation is required to rapidly detect and manage these complications to save both maternal and newborn lives. Traditional off-site, didactic, and lengthy training approaches have not always yielded the desired results. Helping Mothers Survive training was modeled after Helping Babies Breathe and incorporates further evidence-based methodology to deliver training on-site to the entire team of providers, who continue to practice after training with their peers. Research has revealed that significant gains in health outcomes can be reached by using this approach. In the coronavirus disease 2019 era, we must look to translate the best practices of these training programs into a flexible and sustainable model that can be delivered remotely to maintain quality services to women and their newborns.

Using Helping Mothers Survive to Improve Intrapartum Care

Data from the past decade have revealed that neonatal mortality represents a growing burden of the under-5 mortality rate To further reduce these deaths, the focus must expand to include building capacity of the workforce to provide high-quality obstetric and intrapartum care Obstetric complications, such as hypertensive disorders and obstructed labor, are significant contributors to neonatal morbidity and mortality A well-prepared workforce with the necessary knowledge, skills, attitudes, and motivation is required to rapidly detect and manage these complications to save both maternal and newborn lives Traditional off-site, didactic, and lengthy training approaches have not always yielded the desired results Helping Mothers Survive training was modeled after Helping Babies Breathe and incorporates further evidence-based methodology to deliver training on-site to the entire team of providers, who continue to practice after training with their peers Research has revealed that significant gains in health outcomes can be reached by using this approach In the coronavirus disease 2019 era, we must look to translate the best practices of these training programs into a flexible and sustainable model that can be delivered remotely to maintain quality services to women and their newborns

A Tale of Two Viruses: The Distinct Spike Glycoproteins of Feline Coronaviruses

Feline coronavirus (FCoV) is a complex viral agent that causes a variety of clinical manifestations in cats, commonly known as feline infectious peritonitis (FIP). It is recognized that FCoV can occur in two different serotypes. However, differences in the S protein are much more than serological or antigenic variants, resulting in the effective presence of two distinct viruses. Here, we review the distinct differences in the S proteins of these viruses, which are likely to translate into distinct biological outcomes. We introduce a new concept related to the non-taxonomical classification and differentiation among FCoVs by analyzing and comparing the genetic, structural, and functional characteristics of FCoV and the FCoV S protein among the two serotypes and FCoV biotypes. Based on our analysis, we suggest that our understanding of FIP needs to consider whether the presence of these two distinct viruses has implications in clinical settings.

Duration of viral shedding in asymptomatic or mild cases of novel coronavirus disease 2019 (COVID-19) from a cruise ship: A single-hospital experience in Tokyo, Japan

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is the cause of novel coronavirus disease 2019 (COVID-19), was first reported in Wuhan, China, and now has spread across the world as a global pandemic. The propagation from asymptomatic polymerase chain reaction (PCR)-positive individuals represents a complicating factor in the efforts to control the COVID-19 pandemic. We examined the course of PCR assays and the duration of viral shedding in 23 asymptomatic or mild COVID-19 patients from the cruise ship who were admitted to our hospital. Among these 23 cases, the median duration of viral shedding was 19 days (range, 6-37 days) from initial viral detection. Eight cases (35%) had another positive PCR result after testing negative once. Although the duration of viral shedding was approximately three weeks, the infectivity and transmissibility period from asymptomatic and mild COVID-19 cases is unclear. Further studies are needed to determine how long such asymptomatic and mild COVID-19 cases have infectivity.

International Study of Movement Behaviors in the Early Years (SUNRISE): Results from SUNRISE Sweden's Pilot and COVID-19 Study

The International Study of Movement Behaviors in the Early Years (SUNRISE) was initiated in response to the 2019 WHO guidelines for physical activity, sedentary behavior, and sleep in children aged 0-5 years. This Swedish pilot study aimed to: (i) assess the proportion of preschoolers meeting the guidelines, (ii) evaluate the feasibility of the methods for the SUNRISE study, and (iii) assess how movement behaviors have been affected in preschoolers during the COVID-19 pandemic. Physical activity and sleep (waist-worn ActiGraph); screen time and movement behaviors (parental questionnaire); motor skills (Ages and Stages Questionnaire); and executive functions (3 iPad games) were assessed in 100 Swedish preschoolers (n = 58 boys). There were 19.4% of preschoolers (n = 14) who met the WHO guidelines. The motor skill and executive function assessments were feasible; however, 20% refused to wear the ActiGraph overnight. Additionally, during the pandemic Swedish children's physical activity, time spent outside on weekdays and weekend days, and screen time significantly increased (+53; +124; +68; +30min/day, respectively, all p-values &#8804; 0.001). Methods for the SUNRISE study were feasible in a Swedish context; however, considerations to switch to a wrist-worn accelerometer should be made. Furthermore, children's physical activity increased during the pandemic, which is likely due to how the rules/restrictions were implemented in Sweden.

Are there overlapping clinical features between thoracic radiotherapy side effects and covid-19 pneumonia? radiation pneumonitis outside the radiation ports : three case reports

Respiratory involvement of Covid-19 infection, presenting as a mild flu-like illness to potentially lethal acute respiratory distress syndrome is the main clinical manifestation in adults. Chest imaging shows a pictorial fashion of images due to the severity and stage of the disease, starting from focal nodular or mass-like opacities with air bronchogram to areas of ground glass consolidation or whited out lung. However, at the Covid-19 pandemic time, CT findings could yield confounding reporting in case of cancer patients previously treated with thoracic radiotherapy (tRT) due to atypical radiation pneumonitis occurring outside the radiation ports. Hypersensitivity pneumonitis and radiation induced bronchiolitis obliterans organizing pneumonitis (RT-BOOP) are accounted in this report.