title: COVID-19 Outbreak Perception in Italian Dentists

text: The aim of this study is an evaluation of the Italian dentists' knowledge regarding COVID-19 and their perception of the risks associated with COVID-19, their attitude in resuming their activities, and how they judge the institutional intervention on a health and economic basis. METHODS: This research evaluated Italian dentists from 11 to 18 April 2020, using a questionnaire submitted via Google Forms (Alphabet, Mountain View, CA, USA). It consisted of different investigations about sociodemographic aspects, profession-related characteristics, knowledge about COVID-19 infection transmission modalities, symptoms, and attitude in treating potentially infected patients. Statistical analysis was performed using the Pearson chi2 test and Student t-test. The α-level was fixed at p = 0.05. All data were analyzed with STATA 16 (StataCorp LP, College Station, TX, USA). RESULTS: 1500 dentists (664 men and 836 women) completed the questionnaire. The majority of respondents declared having been trained in infection prevention procedures (64.3%) but not specifically to prevent the spread of COVID-19 (48.7%). A total of 57.2% declared that they were not trained sufficiently to restart working after lockdown, with a significantly higher prevalence (Pearson chi2 test, p < 0.001) among women (62.3%) than men (50.9%). CONCLUSION: Italian dentists were informed correctly on the mode of transmission but partially missed COVID-19 symptoms. Dentists considered the virus infection highly dangerous, and they were not confident in being able to work safely. The lack of precise operating guidelines creates uncertainties on infection control measures and appropriate personal protective equipment (PPE) use. The participants revealed apprehension for their health and the current and future economic situation of their practices.


title: Domain Adaptation in Highly Imbalanced and Overlapping Datasets

text: In many machine learning domains, datasets are characterized by highly imbalanced and overlapping classes. Particularly in the medical domain, a specific list of symptoms can be labeled as one of various different conditions. Some of these conditions may be more prevalent than others by several orders of magnitude. Here we present a novel unsupervised domain adaptation scheme for such datasets. The scheme, based on a specific type of Quantification, is designed to work under both label and conditional shifts. It is demonstrated on datasets generated from electronic health records and provides high quality results for both Quantification and Domain Adaptation in very challenging scenarios. Potential benefits of using this scheme in the current COVID-19 outbreak, for estimation of prevalence and probability of infection are discussed.


Identification of the hyper-variable genomic hotspot for the novel coronavirus SARS-CoV-2


Involving antimicrobial stewardship programs in COVID-19 response efforts: All hands on deck


The need for urogenital tract monitoring in COVID-19


Potential influences of obstructive sleep apnea and obesity on COVID-19 severity


Analysis of dermatology-related search engine trends during the COVID-19 pandemic: implications for patient demand for outpatient services and telehealth


title: Computer-based and paper-and-pencil tests: A study in calculus for STEM majors

text: Computer-based testing is an expanding use of technology offering advantages to teachers and students. We studied Calculus II classes for STEM majors using different testing modes. Three sections with 324 students employed: Paper-and-pencil testing, computer-based testing, and both. Computer tests gave immediate feedback, allowed multiple submissions, and pooling. Paper-and-pencil tests required work and explanation allowing inspection of high cognitive demand tasks. Each test mode used the strength of its method. Students were given the same lecture by the same instructor on the same day and the same homework assignments and due dates. The design is quasi-experimental, but students were not aware of the testing mode at registration. Two basic questions examined were: (1) Do paper-and-pencil and computer-based tests measure knowledge and skill in STEM Calculus II in a consistent manner? (2) How does the knowledge and skill gained by students in a fully computer-based Calculus II class compare to students in a class requiring pencil-and-paper tests and hence some paper-and-pencil work. These results indicate that computer-based tests are as consistent with paper-and-pencil tests as computer-based tests are with themselves. Results are also consistent with classes using paper-and-pencil tests having slightly better outcomes than fully computer-based classes using only computer assessments.


title: Homeopathic Clinical Features of 18 Patients in COVID-19 Outbreaks in Hong Kong

text: BACKGROUND: Hong Kong is geographically located in the province of Guangdong which, after Hubei, has been the region of China second-most affected by the COVID-19 pandemic. Compared to the pathognomonic symptoms of the named disease, homeopathic symptoms are always more helpful for homeopathic prescriptions. AIM: This study reports and summarizes the homeopathic symptoms observed in 18 confirmed/suspected epidemiologically related cases in cluster outbreaks of COVID-19 in Hong Kong in early 2020. METHODS: Homeopathic symptoms from this case series were collected from 18 consecutive patients who, in addition to their concurrent conventional treatment or traditional Chinese medicine, actively sought help from homeopathy as an adjunctive measure for symptomatic relief from COVID-19. Cases were categorized according to outbreak clusters, focusing mainly on the homeopathic symptoms. In the analysis, frequency of all homeopathic medicines, common rubrics in all the cases, common rubrics in each of the top-ranked remedies, and differentiating symptoms for each top-ranked remedy were determined. RESULTS: Homeopathic symptoms of 18 cases, each identified as mild and belonging to one of six separate clusters, are reported. Eighteen common symptoms screened out of 79 selected rubrics constituted two sets of homeopathic symptom pictures: Bryonia alba (n = 4) and Gelsemium sempervirens (n = 12). Eight and seven differentiating features, respectively, were identified for Bryonia alba and Gelsemium sempervirens. CONCLUSION: The common symptoms of 18 mild COVID-19 cases constituted two sets of homeopathic symptom pictures, indicating Bryonia alba or Gelsemium sempervirens; they were indicated in 4 and 12 cases, respectively, out of the 18 in total.


Key Takeaways From the U.S. CDC's 2019 Antibiotic Resistance Threats Report for Frontline Providers


title: An empirical analysis of the Ebola outbreak in West Africa

text: The data for the Ebola outbreak that occurred in 2014-2016 in three countries of West Africa are analysed within a common framework. The analysis is made using the results of an agent based Susceptible-Infected-Removed (SIR) model on a Euclidean network, where nodes at a distance $l$ are connected with probability $P(l) \propto l^{-\delta }$, $\delta$ determining the range of the interaction, in addition to nearest neighbors. The cumulative (total) density of infected population here has the form $R(t) = \frac{a\exp(t/T)}{1+c\exp(t/T)}$, where the parameters depend on $\delta$ and the infection probability $q$. This form is seen to fit well with the data. Using the best fitting parameters, the time at which the peak is reached is estimated and is shown to be consistent with the data. We also show that in the Euclidean model, one can choose $\delta$ and $q$ values which reproduce the data for the three countries qualitatively. These choices are correlated with population density, control schemes and other factors. Comparing the real data and the results from the model one can also estimate the size of the actual population susceptible to the disease. Rescaling the real data a reasonably good quantitative agreement with the simulation results is obtained.


Coronavirus disease 2019 in pregnancy: consider thromboembolic disorders and thromboprophylaxis


COVID-19 resurgence in Iran


Authors' response re: From the frontlines of COVID-19-How prepared are we as obstetricians: a commentary


Making a brochure about coronavirus disease (COVID-19) for children with autism spectrum disorder and their family members


Making brochure of Coronavirus disease (COVID-19) for children with autism spectrum disorder and their family members


docid: xhdyxhbs

title: The Challenges Wrought by COVID-19


title: Vaccines against Coronaviruses: The State of the Art

text: The emerging epidemic caused by the new coronavirus SARS-CoV-2 represents the most important socio-health threat of the 21st century. The high contagiousness of the virus, the strong impact on the health system of the various countries and the absence to date of treatments able to improve the prognosis of the disease make the introduction of a vaccine indispensable, even though there are currently no approved human coronavirus vaccines. The aim of the study is to carry out a review of the medical literature concerning vaccine candidates for the main coronaviruses responsible for human epidemics, including recent advances in the development of a vaccine against COVID-19. This extensive review carried out on the vaccine candidates of the main epidemic coronaviruses of the past has shown that the studies in animal models suggest a high efficacy of potential vaccines in providing protection against viral challenges. Similar human studies have not yet been carried out, as the main trials are aimed at assessing mainly vaccine safety and immunogenicity. Whereas the severe acute respiratory syndrome (SARS-CoV) epidemic ended almost two decades ago and the Middle East respiratory syndrome (MERS-CoV) epidemic is now better controlled, as it is less contagious due to the high lethality of the virus, the current SARS-CoV-2 pandemic represents a problem that is certainly more compelling, which pushes us to accelerate the studies not only for the production of vaccines but also for innovative pharmacological treatments. SARS-CoV-2 vaccines might come too late to affect the first wave of this pandemic, but they might be useful if additional subsequent waves occur or in a post-pandemic perspective in which the virus continues to circulate as a seasonal virus.


Treating multiple sclerosis and neuromyelitis optica spectrum disorder during the COVID-19 pandemic


Re-Opening Schools Safely: The Case for Collaboration, Constructive Disruption of Pre-COVID Expectations, and Creative Solutions


title: The Covid-19 pandemic in Denmark: Big lessons from a small country

text: Denmark, a Scandinavian country of 5.8 million people has weathered the Covid-19 crisis with a relatively low rate of infection and death. Denmark has also become one of the first European countries to partially re-open its society. We offer the perspective that the combination of rapid response from the government, trust and a high level of confidence in government by Danish citizens, and the importance of social heritage contributed to the effective management of the coronavirus crisis.


Could IL-17 represent a new therapeutic target for the treatment and/or management of COVID-19-related respiratory syndrome?


docid: jvpwltbx

title: City-scale dark fiber DAS measurements of infrastructure use during the COVID-19 pandemic

text: Throughout the recent COVID-19 pandemic when government officials around the world ordered citizens to quarantine inside their homes, real-time measurements about the use of roads, hospitals, grocery stores, and other public infrastructure became vital to accurately forecast viral infection rates and inform future government decisions. Although mobile phone locations provide some information about community-level activity, dense distributed geophysical sensing of ground motions across a city are more complete and also natively anonymous. In this paper, we demonstrate how fiber-optic Distributed Acoustic Sensing (DAS) connected to a telecommunication cable beneath Palo Alto, CA captured seismic and geodetic signals produced by vehicles during the COVID-19 pandemic outbreak and subsequent quarantine. We utilize DAS strain measurements of roadbed deformation caused by local cars and trucks in an automatic template matching detection algorithm to count the number of vehicles traveling per day over a two-month period around the timing of the San Francisco Bay Area shelter-in-place order. Using a segment of the optical fiber near a major grocery store on Sand Hill Road we find a 50% decrease in vehicle count immediately following the order, but data from near Stanford Hospital showed a far more subtle change due to on-going hospital activities. We compare the information derived from DAS measurements to other quarantine response metrics and find a strong correlation with the relative changes reported by Google and Apple using mobile phone data.


Burnout in the age of COVID-19


COVID-19 suicidal behavior among couples and suicide pacts: Case study evidence from press reports


[â ¡.Strategy of Treatment for Untreated Transplant-Ineligible Multiple Myeloma]


A Promising Anti-Cytokine-Storm Targeted Therapy for COVID-19: The Artificial-Liver Blood-Purification System


Editorial - Covid-19


title: Exploring Opportunities for Household-Level Chronic Care Management Using Linked Electronic Health Records of Adults and Children: A Retrospective Cohort Study

text: OBJECTIVE: Linking electronic health records (EHR) of pediatric and adult patients living in the same household has the potential to improve chronic care management efficiencies by facilitating the delivery of services to multiple household members at once. However, little is known about relationship between the chronic medical (CM) and behavioral health (CBH) of adults and children living in common households. METHODS: EHR data for children were linked to the EHR data of adults living at the same address during the same time in a retrospective cohort study from 2006 to 2014 to evaluate associations between adult and child CM and CBH conditions within a Boston safety-net primary care patient sample. RESULTS: Of the 13,845 included children, 61.6% lived with at least one adult with ≥ 1 CM or CBH condition. Compared to children living with an adult(s) without a chronic condition, children living with an adult with a CM or CBH condition had a respective 16.2% and 18.1% increased likelihood of having a chronic condition themselves, with multiple adult chronic conditions in adults increasing children's likelihood. CONCLUSIONS FOR PRACTICE: We found a positive association between the chronic diseases of adult and child household members. Given the clustering of child and adult chronic disease within households, using EHR data to support the care management needs of multiple members of households may be a promising approach to improving child and adult health in safety-net settings.


title: Antibody responses to SARS-CoV-2 in patients with COVID-19

text: We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.


title: Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARS-CoV-2 and other acute viral infections: a systematic review and meta-analysis

text: BACKGROUND: Antiviral medications are being given empirically to some patients with coronavirus disease 2019 (COVID-19). To support the development of a COVID-19 management guideline, we conducted a systematic review that addressed the benefits and harms of 7 antiviral treatments for COVID-19. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed and 3 Chinese databases (CNKI, WANFANG and SinoMed) through Apr. 19, medRxiv and Chinaxiv through Apr. 27, and Chongqing VIP through Apr. 30, 2020. We included studies of ribavirin, chloroquine, hydroxychloroquine, umifenovir (arbidol), favipravir, interferon and lopinavir/ritonavir. If direct evidence from COVID-19 studies was not available, we included indirect evidence from studies of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) for efficacy outcomes and other acute respiratory viral infections for safety outcomes. RESULTS: In patients with nonsevere COVID-19 illness, the death rate was extremely low, precluding an important effect on mortality. We found only very low-quality evidence with little or no suggestion of benefit for most treatments and outcomes in both nonsevere and severe COVID-19. An exception was treatment with lopinavir/ritonavir, for which we found low-quality evidence for a decrease in length of stay in the intensive care unit (risk difference 5 d shorter, 95% confidence interval [CI] 0 to 9 d) and hospital stay (risk difference 1 d shorter, 95% CI 0 to 2 d). For safety outcomes, evidence was of low or very low quality, with the exception of treatment with lopinavir/ritonavir for which moderate-quality evidence suggested likely increases in diarrhea, nausea and vomiting. INTERPRETATION: To date, persuasive evidence of important benefit in COVID-19 does not exist for any antiviral treatments, although for each treatment evidence has not excluded important benefit. Additional randomized controlled trials involving patients with COVID-19 will be needed before such treatments can be administered with confidence.


title: Efficacy and safety of antiviral treatment for COVID-19 from evidence in studies of SARSCoV-2 and other acute viral infections: a systematic review and meta-analysis


Author reply to Letters to the Editor "COVID-19 pneumonia in Taiwan"


title: Blood Donor Recruitment in Guangzhou, China, during the 2019 Novel Coronavirus (COVID-19) Epidemic

text: BACKGROUND: The coronavirus disease 2019 (COVID-19) epidemic affected blood collection in Guangzhou, China. STUDY DESIGN AND METHODS: This paper included three studies. The observational study reported the trends of blood collection during the epidemic in Guangzhou, China. The cross-sectional survey investigated factors influencing blood donation during the COVID-19 epidemic, and a self-administered questionnaire was given to 1,584 street whole blood donors (SWBDs) who donated during the epidemic. The randomized controlled trial involved 19,491 SWBDs who donated in 2019 but did not donate during the epidemic. Trial participants were randomly assigned to two intervention groups: group 1 completed Questionnaire 1, which contained precautionary measures in response to COVID-19 and other messages about blood donation during the epidemic; and group 2 completed Questionnaire 2, which did not include this information. A control group did not receive any questionnaire. RESULTS: As measures implemented, the number of blood donors increased accordingly. Both first-time and repeat SWBDs perceived the same level of blood need and donated blood because it would save lives. SWBDs who completed Questionnaire 1 expressed a greater intention to donate during the epidemic. Enabling blood donors to perceive a higher level of blood need and a lower level of COVID-19 infection risk related to blood donation mobilized experienced SWBDs to donate within three weeks. Intention-to-treat analyses and average-treatment-effect-on-the-treated estimations confirmed that Questionnaire 1 could motivate SWBDs to actually donate blood. CONCLUSION: Various measures could ease blood shortage during the COVID-19 epidemic. Administration of Questionnaire 1 could increase blood donations during the epidemic. This article is protected by copyright. All rights reserved.


docid: uaoyounl

title: Genomic variance of the 2019-nCoV coronavirus

text: There is a rising global concern for the recently emerged novel coronavirus (2019-nCoV). Full genomic sequences have been released by the worldwide scientific community in the last few weeks to understand the evolutionary origin and molecular characteristics of this virus. Taking advantage of all the genomic information currently available, we constructed a phylogenetic tree including also representatives of other coronaviridae, such as Bat coronavirus (BCoV) and severe acute respiratory syndrome. We confirm high sequence similarity (>99%) between all sequenced 2019-nCoVs genomes available, with the closest BCoV sequence sharing 96.2% sequence identity, confirming the notion of a zoonotic origin of 2019-nCoV. Despite the low heterogeneity of the 2019-nCoV genomes, we could identify at least two hypervariable genomic hotspots, one of which is responsible for a Serine/Leucine variation in the viral ORF8-encoded protein. Finally, we perform a full proteomic comparison with other coronaviridae, identifying key aminoacidic differences to be considered for antiviral strategies deriving from previous anti-coronavirus approaches.


SARS-Coronavirus-2


How to demystify COVID-19 and reduce social stigma


Temporary Emergency Guidance to STEMI Systems of Care During the COVID-19 Pandemic: AHA's Mission: Lifeline


COVID 19 and its mental health consequences


title: Decision-making on management of ms and nmosd patients during the COVID-19 pandemic: A latin american survey

text: BACKGROUND: The emergence of COVID-19 and its vertiginous spreading speed represents a unique challenge to neurologists managing multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). The need for data on the impact of the virus on these patients grows rapidly. There is an urgent necessity of sharing information to enable evidence-based decision making on the clinical management. There are no data on what physicians are doing on clinical practice in Latin American countries. AIM: to investigate current management opinion of Latin American MS and/or NMOSD expert neurologists based on their experience and recommendations. METHODS: we developed a voluntary web-based survey based on hypothetical situations that these patients may encounter, while taking into account the potential risk of developing severe COVID-19 infection. RESULTS: 60% of the experts had the possibility of monitoring their patients by telemedicine. Most neurologists postpone magnetic resonance. Laboratory blood tests delay is associated with the type of treatment. Platform therapies, dimethyl-fumarate and natalizumab are considered safe options to initiate in naive patients. CONCLUSION: decision-making about MS and NMOSD patients has become even more complex in order to adapt to the COVID-19 pandemic. Risks and benefits should be taken into consideration throughout the patient follow-up.


title: How many infections of COVID-19 there will be in the"Diamond Princess"-Predicted by a virus transmission model based on the simulation of crowd flow

text: Objectives: Simulate the transmission process of COVID-19 in a cruise ship, and then to judge how many infections there will be in the 3711 people in the"Diamond Princess"and analyze measures that could have prevented mass transmission. Methods: Based on the crowd flow model, the virus transmission rule between pedestrians is established, to simulate the spread of the virus caused by the close contact during pedestrians' daily activities on the cruise ship. Measurements and main results: Three types of simulation scenarios are designed, the Basic scenario focus on the process of virus transmission caused by a virus carrier and the effect of the personal protective measure against the virus. The condition that the original virus carriers had disembarked halfway and more and more people strengthen self-protection are considered in the Self-protection scenario, which would comparatively accord with the actual situation of"Diamond princess"cruise. Control scenario are set to simulate the effect of taking recommended or mandatory measures on virus transmission Conclusions: There are 850~1009 persons (with large probability) who have been infected with COVID-19 during the voyage of"Diamond Princess". The crowd infection percentage would be controlled effectively if the recommended or mandatory measures can be taken immediately during the alert phase of COVID-19 outbreaks.


title: Digital Ariadne: Citizen Empowerment for Epidemic Control

text: The COVID-19 crisis represents the most dangerous threat to public health since the H1N1 influenza pandemic of 1918. So far, the disease due to the SARS-CoV-2 virus has been countered with extreme measures at national level that attempt to suppress epidemic growth. However, these approaches require quick adoption and enforcement in order to effectively curb virus spread, and may cause unprecedented socio-economic impact. A viable alternative to mass surveillance and rule enforcement is harnessing collective intelligence by means of citizen empowerment. Mobile applications running on personal devices could significantly support this kind of approach by exploiting context/location awareness and data collection capabilities. In particular, technology-assisted location and contact tracing, if broadly adopted, may help limit the spread of infectious diseases by raising end-user awareness and enabling the adoption of selective quarantine measures. In this paper, we outline general requirements and design principles of personal applications for epidemic containment running on common smartphones, and we present a tool, called 'diAry' or 'digital Ariadne', based on voluntary location and Bluetooth tracking on personal devices, supporting a distributed query system that enables fully anonymous, privacy-preserving contact tracing. We look forward to comments, feedback, and further discussion regarding contact tracing solutions for pandemic containment.


title: Targets of T Cell Responses to SARS-CoV-2 Coronavirus in Humans with COVID-19 Disease and Unexposed Individuals

text: Understanding adaptive immunity to SARS-CoV-2 is important for vaccine development, interpreting coronavirus disease 2019 (COVID-19) pathogenesis, and calibration of pandemic control measures. Using HLA class I and II predicted peptide "megapools," circulating SARS-CoV-2-specific CD8+ and CD4+ T cells were identified in â¼70% and 100% of COVID-19 convalescent patients, respectively. CD4+ T cell responses to spike, the main target of most vaccine efforts, were robust and correlated with the magnitude of the anti-SARS-CoV-2 IgG and IgA titers. The M, spike, and N proteins each accounted for 11%-27% of the total CD4+ response, with additional responses commonly targeting nsp3, nsp4, ORF3a, and ORF8, among others. For CD8+ T cells, spike and M were recognized, with at least eight SARS-CoV-2 ORFs targeted. Importantly, we detected SARS-CoV-2-reactive CD4+ T cells in â¼40%-60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating "common cold" coronaviruses and SARS-CoV-2.


title: The COVID-19 Global Pandemic: Implications for People With Schizophrenia and Related Disorders

text: The coronavirus disease-19 (COVID-19) global pandemic has already had an unprecedented impact on populations around the world, and is anticipated to have a disproportionate burden on people with schizophrenia and related disorders. We discuss the implications of the COVID-19 global pandemic with respect to: (1) increased risk of infection and poor outcomes among people with schizophrenia, (2) anticipated adverse mental health consequences for people with schizophrenia, (3) considerations for mental health service delivery in inpatient and outpatient settings, and (4) potential impact on clinical research in schizophrenia. Recommendations emphasize rapid implementation of measures to both decrease the risk of COVID-19 transmission and maintain continuity of clinical care and research to preserve safety of both people with schizophrenia and the public.


title: A first case of meningitis/encephalitis associated with SARS-Coronavirus-2

text: Novel coronavirus (SARS-Coronavirus-2:SARS-CoV-2) which emerged in Wuhan, China, has spread to multiple countries rapidly. We report the first case of meningitis associated with SARS-CoV-2 who was brought in by ambulance due to a convulsion accompanied by unconsciousness. He had never been to any foreign countries. He felt generalized fatigue and fever (day 1). He saw doctors nearby twice (day 2 and 5) and was prescribed Laninamivir and antipyretic agents, His family visited his home and found that he was unconsciousness and lying on the floor in his vomit. He was immediately transported to this hospital by ambulance (day 9). Under emergency transport, he had transient generalized seizures that lasted about a minute. He had obvious neck stiffness. The specific SARS-CoV-2 RNA was not detected in the nasopharyngeal swab but was detected in a CSF. Anti- HSV 1 and varicella-zoster IgM antibodies were not detected in serum samples. A brain MRI showed hyperintensity along the wall of right lateral ventricle and hyperintense signal changes in the right mesial temporal lobe and hippocampus, suggesting the possibility of SARS-CoV-2 meningitis. This case warns the physicians of patients who have CNS symptoms.


title: Covid-19 and infection in health-care workers: An emerging problem

text: The 2019 coronavirus infection (called SARS-CoV-2) began in Wuhan, spread rapidly throughout the world. In many countries the exponential growth of Covid-19 cases is overwhelming health care systems with overcrowding of hospitals and overflowing Intensive Care Units. While people must stay at home to reduce the spread of this virus health-care workers do the exact opposite. In some countries doctors are working with insufficient protection and are constantly at risk of contracting Covid-19. Health-care workers should be constantly monitored because if they are infected they may spread the virus to colleagues, hospitalized patients and even family members. Increased rates of infection in health-care workers could cause the health-care system to collapse and a further worsening of the pandemic; if there are too few doctors it will be even more difficult to manage.


docid: szdhhsbm

title: Highly efficient nitrate and phosphorus removal and adsorption of tetracycline by precipitation in a chitosan/polyvinyl alcohol immobilized bioreactor

text: Single denitrification using bacteria has been widely investigated, but few studies have focused on the simultaneous removal of nitrate, phosphorus. and tetracycline. Strain L2, an iron-reducing bacteria, was immobilized using chitosan/polyvinyl alcohol to simultaneously remove nitrate and phosphorus. The effects of carbon/nitrogen ratio (1:1, 1.5:1, and 2:1), initial Fe2+ concentration (0, 15, and 30 mg·L-1), and HRT (2, 4, and 6 h) were assessed in bioreactors and optimum conditions were established. Results showed that the nitrate and phosphorus removal efficiency reached 100.00% (2.697 mg·L-1·h-1) and 81.93% (1.533 mg·L-1·h-1) under the conditions of carbon/nitrogen of 2:1, Fe2+ concentration of 30 mg·L-1 and HRT of 6 h. The precipitation of bioreactor, which identified as FeOOH by XRD, had significant adsorption on tetracycline. The results of high-throughput sequencing indicated that strain L2 played a significant role in denitrification. This bioreactor provided effective method for the treatment of polluted water contaminated by nitrate, phosphorus, and tetracycline.


Cancer care during and after the pandemic


title: COVID-19, hipertensión y enfermedad cardiovascular./ [COVID-19 and its relationship with hypertension and cardiovascular disease]

text: The association between hypertension, diabetes, cardio and cerebrovascular disease and severe and fatal COVID-19, described in different countries, is remarkable. Myocardial damage and myocardial dysfunction are postulated as a possible causal nexus. Frequent findings of elevated troponin levels and electrocardiographic anomalies support this concept. On the other hand, hypotheses in favour and against a deleterious effect of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, a usual treatment for cardiovascular disease, have been raised. There is currently no solid evidence and thus properly designed studies on this subject are urgently needed. In this context, patients with cardiovascular disease should especially avoid being exposed to the virus, should not self-medicate and rapidly seek medical advice should they show symptoms of infection.


title: Coronavirus Disease 19 Infection Does Not Result in Acute Kidney Injury: An Analysis of 116 Hospitalized Patients from Wuhan, China

text: BACKGROUND: Whether the patients with coronavirus disease 19 (COVID-19) infected by severe acute respiratory syndrome (SARS)-CoV-2 would commonly develop acute kidney injury (AKI) is an important issue worthy of clinical attention. This study aimed to explore the effects of SARS-CoV-2 infection on renal function through analyzing the clinical data of 116 hospitalized COVID-19-confirmed patients. METHODS: One hundred sixteen COVID-19-confirmed patients enrolled in this study were hospitalized in the Department of Infectious Diseases, Renmin Hospital of Wuhan University from January 14 to February 13, 2020. The recorded information includes demographic data, medical history, contact history, potential comorbidities, symptoms, signs, laboratory test results, chest computer tomography scans, and treatment measures. SARS-CoV-2 RNA in 53 urine sediments of enrolled patients was detected by real-time reverse transcription-polymerase chain reaction. RESULTS: Twelve (10.8%) patients showed mild increase of blood urea nitrogen or creatinine (<26 µmol/L within 48 h), and 8 (7.2%) patients showed trace or 1+ albuminuria in 111 COVID-19-confirmed patients without chronic kidney disease (CKD). All these patients did not meet the diagnostic criteria of AKI. In addition, 5 patients with CKD who were undergone regular continuous renal replacement therapy (CRRT) before admission were confirmed infection of SARS-CoV-2 and diagnosed as COVID-19. In addition to therapy for COVID-19, CRRT was also applied 3 times weekly during hospitalization for these 5 patients with CKD. In the course of treatment, the renal function indicators showed stable state in all 5 patients with CKD, without exacerbation of CKD, and pulmonary inflammation was gradually absorbed. All 5 patients with CKD were survived. Moreover, SARS-CoV-2 RNA in urine sediments was positive only in 3 patients from 48 cases without CKD, and 1 patient had a positive for SARS-CoV-2 open reading frame 1ab from 5 cases with CKD. CONCLUSION: AKI was uncommon in COVID-19. SARS-CoV-2 infection does not result in AKI, or aggravate CKD in the COVID-19 patients.


Ventiladores mecánicos de emergencia para la COVID-19./ Ventiladores mecánicos de emergencia para la COVID-19./ Emergency Mechanical Ventilators for Covid-19


Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey


title: Optional antiviral agents for the 2019 novel coronavirus and the liver injury

text: The most important treatment of anti 2019 novel coronavirus is antiviral and supportive treatment Currently, the anti novel coronavirus drugs in clinical trials include broad-spectrum antiviral drugs (Alpha interferon and Ribavirin), hemagglutinin inhibitors (Arbidol), human immunodeficiency virus protease inhibitors (Lopinavir/Ritonavir and Darunavir/Cobicistat), nucleoside analogues (Favipiravir and Remdesivir) and antimalarial drug (chloroquine), however, some patients suffered from liver damage during the actual usage This article reviews the research on liver damage associated with anti novel coronavirus drugs, aiming at promoting the rational, safe and effective use of anti novel coronavirus drugs


title: First case of convalescent plasma transfusion in a child with COVID-19-associated severe aplastic anemia

text: We present the case of a six-year-old girl with severe COVID-19, in whom SARS-CoV-2 was successfully eliminated after convalescent plasma transfusion. Children show a variable clinical course of COVID-19, from asymptomatic to critical. In our patient, we diagnosed COVID-19-associated aplastic anemia with severe pancytopenia. The correlation between SARS-CoV-2 infection with aplastic anemia remains unclear. At the beginning of the disease, we used antiviral drugs and immune modulators as therapy but without any positive results. After providing a transfusion of convalescent plasma, the elimination of SARS-CoV-2 was observed. We did not observe any adverse events of this treatment. The girl still has a diagnosis of aplastic anemia and requires specialist therapy.


title: Antibody cocktail to SARS-CoV-2 spike protein prevents rapid mutational escape seen with individual antibodies

text: Antibodies targeting the spike protein of SARS-CoV-2 present a promising approach to combat the COVID19 pandemic; however, concerns remain that mutations can yield antibody resistance. We investigate the development of resistance against four antibodies to the spike protein that potently neutralize SARS-CoV-2, individually as well as when combined into cocktails. These antibodies remain effective against spike variants that have arisen in the human population. However, novel spike mutants rapidly appeared following in vitro passaging in the presence of individual antibodies, resulting in loss of neutralization; such escape also occurred with combinations of antibodies binding diverse but overlapping regions of the spike protein. Importantly, escape mutants were not generated following treatment with a non-competing antibody cocktail.


title: Adding crust to BPS Skyrme neutron stars

text: The Skyrme model and its generalisations provide a conceptually appealing field-theory basis for the description of nuclear matter and, after its coupling to gravity, also of neutron stars. In particular, a specific Skyrme submodel, the so-called Bogomol'nyi-Prasad-Sommerfield (BPS) Skyrme model, allows both for an exact field-theoretic and a mean-field treatment of neutron stars, as a consequence of its perfect fluid property. A pure BPS Skyrme model description of neutron stars, however, only describes the neutron star core, by construction. Here we consider different possibilities to extrapolate a BPS Skyrme neutron star at high baryon density to a description valid at lower densities. In the exact field-theoretic case, a simple effective description of the neutron star crust can be used, because the exact BPS Skyrme neutron star solutions formally extend to sufficiently low densities. In the mean-field case, on the other hand, the BPS Skyrme neutron star solutions always remain above the nuclear saturation density and, therefore, must be joined to a different nuclear physics equation of state already for the outer core. We study the resulting neutron stars in both cases, facilitating an even more complete comparison between Skyrmionic neutron stars and neutron stars obtained from other approaches, as well as with observations.


title: Momentum Contrastive Learning for Few-Shot COVID-19 Diagnosis from Chest CT Images

text: The current pandemic, caused by the outbreak of a novel coronavirus (COVID-19) in December 2019, has led to a global emergency that has significantly impacted economies, healthcare systems and personal wellbeing all around the world. Controlling the rapidly evolving disease requires highly sensitive and specific diagnostics. While real-time RT-PCR is the most commonly used, these can take up to 8 hours, and require significant effort from healthcare professionals. As such, there is a critical need for a quick and automatic diagnostic system. Diagnosis from chest CT images is a promising direction. However, current studies are limited by the lack of sufficient training samples, as acquiring annotated CT images is time-consuming. To this end, we propose a new deep learning algorithm for the automated diagnosis of COVID-19, which only requires a few samples for training. Specifically, we use contrastive learning to train an encoder which can capture expressive feature representations on large and publicly available lung datasets and adopt the prototypical network for classification. We validate the efficacy of the proposed model in comparison with other competing methods on two publicly available and annotated COVID-19 CT datasets. Our results demonstrate the superior performance of our model for the accurate diagnosis of COVID-19 based on chest CT images.


title: Characteristics and outcomes of COVID-19 positive patients with diabetes managed as outpatients

text: We analyzed disease outcomes for patients with diabetes and laboratory-confirmed COVID-19 who were managed outpatient and followed by the Emory COVID-19 Virtual Outpatient Management Clinic (ECVOMC). The rate of hospitalization for patients with diabetes was double the overall rate of hospitalization for patients in the ECVOMC.


title: A Patient with COVID-19 Disease in a Referral Hospital in Iran: A Typical Case

text: After the initial Wuhan outbreak in the end of December 2019, many new cases were found in other provinces of China and also many other countries over the world, including South Korea, Italy, Iran, Japan, and 68 other countries. We presented a 61-year-old woman with a history of diabetes mellitus was referred to the emergency department of a referral hospital in Tehran, Iran. The patient presented with fever, chills, and myalgia within three days. Laboratory analysis showed increased levels of erythrocyte sedimentation rate (ESR), and mild leukopenia. SARSCoV-2 PCR test -under Iran Ministry of Health and Medical Education (MoH&ME) guidelines - result was positive and the chest X-ray shows bilateral ground glass opacity. O2 saturation was 87% (without O2 therapy). The patient was hospitalized and treated with Oseltamivir 75 mg every 12 hours, Lopinavir/Ritonavir (Kaletra) 400/100 mg every 12 hours and hydroxychloroquine 400 mg stat. The patient last O2 saturation measured was 93% and had no fever in the 10th day of hospitalization. So she has been discharged from hospital and homeisolated according to Iran Ministry of Health protocol.


title: Using open-source intelligence to detect early signals of COVID-19 in China, Descriptive study

text: BACKGROUND: COVID-19 in China was first reported to the World Health Organization on December 31st 2019. The first cases were officially identified around December 8th 2019. The origin of COVID-19 is not confirmed, but half the early cases were linked to a seafood market in Wuhan. The first two documented cases did not attend the seafood market. News reports, social media and informal sources may contain information about outbreaks prior to formal notification. OBJECTIVE: To identify early signals of pneumonia and/or severe acute respiratory illness (SARI) in China, prior to official recognition of the COVID 19 outbreak in December 2019, using open source data. METHODS: In order to capture early reports we searched an open source epidemic observatory, Epiwatch from 1st October2019 in China, for severe acute respiratory illness (SARI) or pneumonia related illnesses. Google and Chinese search engine Baidu were used. RESULTS: There was an increase in reports following the official notification of COVID 19 to WHO on December 31 2019, and a retracted report on December 26th 2019. A report of severe pneumonia was identified on November 22 2019 in Xiangyang, Index patient was retrospectively identified on 17 November. CONCLUSIONS: The lack of reports of a SARI outbreaks prior to December 31st, with a retracted report on December 26th suggests media censorship, given formal reports that cases began on December 8th. However, the findings also support relatively recent origin of COVID-19 in November 2019. The case reported on November 22nd was transferred to Wuhan approximately 1 incubation period before the first reported cases on December 8th, and should be further investigated, as only half of the early cases had exposure to the seafood market. It has since been reported that another case of COVID 19 has been retrospectively identified in Hubei on November 17th, confirming that the infection was present prior to December.


The impact of health worker gap in Italy on the COVID-19 pandemic. A good time to improve the quality of the Italian National Health System (NHS)?


A Urology Department's Experience at the Epicenter of the COVID-19 Pandemic


The friendly use of chloroquine in the COVID-19 disease: a warning for the G6PD-deficient males and for the unaware carriers of pathogenic alterations of the G6PD gene


title: Remdesivir in COVID-19: A critical review of pharmacology, pre-clinical and clinical studies

text: BACKGROUND & AIMS: Remdesivir is a broad spectrum anti-viral drug that has shown to inhibit SARS-CoV-2, in vitro and in vivo. In absence of any effective treatment for SARS-CoV-2 infection (COVID-19), remdesivir has been tried for a compassionate use in severe COVID-19. Newer randomized controlled studies that have recently become available, showed a mixed result. We aimed to systematically search the literature to understand the pharmacology and clinical effects of remdesivir in patients with COVID-19. METHODS: We systematically searched the PubMed, ClinicalTrial.Org and MedRxiv database up till May 5, 2020 using specific key words such as "Remdesivir" or 'GS-5734â³ AND "COVID-19" or "SARS-CoV-2" and retrieved all the article published in English language, that have reported the pharmacology and the clinical outcomes of remdesivir in patients with COVID-19. RESULTS: Initial compassionate use of remdesivir has shown a fairly good result, but difficult to quantify, in the absence of control arm. While the very first double-blind, placebo-controlled, randomized trial conducted in Wuhan, did not find any significant benefit compared to the control, the preliminary result of another similar multi-country trial has shown a significant faster time to recovery but without any difference in mortality. CONCLUSIONS: Remdesivir has shown a mixed result in patients with COVID-19 with an acceptable side effect. However, jury is still out while awaiting the results from the forthcoming trials.


Urticaria-like lesions in COVID-19 patients are not really urticaria - a case with clinicopathological correlation


title: Ontogenetic development of tetra Astyanax lacustris (Characiformes: Characidae)

text: Ontogenetic development of the tetra Astyanax lacustris was studied under laboratory conditions. Larvae obtained by induced reproduction were maintained individually in tissue-culture plates, at 25°C. Daily observations and morphometric measurements were performed. Larvae hatched with a total length (TL) of 3.02 ± 0.34 mm (average ± standard deviation) without pigmentation and 0.06 ± 0.02 mm³ of yolk reserves. The yolk-sac larval period lasted 26 h post-hatching (hph). During this period, eye pigmentation started, the digestive tract emerged, the anus opened, and the animals began to show steady movements. Inflation of the swimming bladder initiates the preflexion stage, which extended until 230 hph. During this stage, the transition from endogenous to exogenous feeding was observed, with the yolk reserve being completely absorbed after 74 hph (TL: 4.17 ± 0.36 mm). Up to 86 hph it was possible to observe the first food ingested within the digestive tract. This period was followed by the flexion stage, with the folding of the notochord tip and development of the caudal fin (11-13 days post-hatching). Finally, during the last larval developmental stage (postflexion), the segmentation of the fin rays was completed, and the emergence of scales was observed (TL: 5.97 ± 0.65 mm). The larval ontogenetic development of A. lacustris was completed after 22 post-hatching days (dph).(AU)


title: [Anesthesia management in cesarean section for a patient with coronavirus disease 2019]

text: Since the corona virus disease 2019 (COVID-19) affects the cardio-pulmonary function of pregnant women, the anesthetic management in the cesarean section for the patients, as well as the protection for medical staff is significantly different from that in ordinary surgical operation. This paper reports a pregnant woman with COVID-19, for whom a cesarean section was successfully performed in our hospital on February 8, 2020. Anesthetic management, protection of medical staff and psychological intervention for the patients during the operation are discussed. Importance should be attached to the preoperative evaluation of pregnant women with COVID-19 and the implementation of anesthesia plan. For ordinary COVID-19 patients intraspinal anesthesia is preferred in cesarean section, and the influence on respiration and circulation in both maternal and infant should be reduced; while for severe or critically ill patients general anesthesia with endotracheal intubation should be adopted. The safety of medical environment should be ensured, and level-â ¢ standard protection should be taken for anesthetists. Special attention and support should be given to maternal psychology. It is important to give full explanation before operation to reduce anxiety; to relieve the discomfort during operation to reduce tension; to avoid the bad mood of patients due to pain after operation.


title: Special attention to nurses' protection during the COVID-19 epidemic

text: As of March 8, 2020, the novel coronavirus disease 2019 (COVID-19) had caused 80,815 human infections and 3073 deaths in China, including more than 3000 infections among medical staff. Guangdong Second Provincial General Hospital (Guangzhou, Guangdong Province, China), a provincial emergency hospital, has treated more than 35 confirmed cases of COVID-19 and more than 260 suspected cases. Most of nurses' work involves direct contact with patients. As nurses have high vulnerability to COVID-19, it is necessary to establish hospital-specific protocols to reduce the risk of nurses' infection in interactions with COVID-19 patients. Our hospital has maintained a "zero nurse infection" rate while battling SARS in 2003 and during the present COVID-19 epidemic. The following are the key measures implemented in our hospital.


Response to "Lupus anticoagulant is frequent in patients with Covid-19" (JTH-2020-00483)


title: A benchmark study on reliable molecular supervised learning via Bayesian learning

text: Virtual screening aims to find desirable compounds from chemical library by using computational methods. For this purpose with machine learning, model outputs that can be interpreted as predictive probability will be beneficial, in that a high prediction score corresponds to high probability of correctness. In this work, we present a study on the prediction performance and reliability of graph neural networks trained with the recently proposed Bayesian learning algorithms. Our work shows that Bayesian learning algorithms allow well-calibrated predictions for various GNN architectures and classification tasks. Also, we show the implications of reliable predictions on virtual screening, where Bayesian learning may lead to higher success in finding hit compounds.


title: Serum Cytokine and Chemokine profile in Relation to the Severity of Coronavirus disease 2019 (COVID-19) in China

text: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We investigated the serum cytokine and chemokine levels in asymptomatic, mild, moderate, severe and convalescent SARS-CoV-2 infected cases. Proinflammatory cytokine and chemokine production induced by SARS-CoV-2 were observed not only in symptomatic patients but also in asymptomatic cases, and returned to normal after recovery. IL-6, IL-7, IL-10, IL-18, G-CSF, M-CSF, MCP-1, MCP-3, IP-10, MIG, and MIP-1α were found to be associated with the severity of COVID-19. Moreover, a set of cytokine and chemokine profiles were signicfiantly higher in SARS-CoV-2-infected male patients than female cases. The serum levels of MCP-1, G-CSF, and VEGF were weekly and positively correlated with the viral titers. We suggest that combinatorial analysis of serum cytokines and chemokines with clinical classification may contribute to evaluate the severity of COVID-19 and optimize the therapeutic strategies.


Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy: Early Experience and Forecast During an Emergency Response


title: SARS Cov-2 infection in a renal-transplanted patient: A case report

text: The clinical manifestation of COVID-19 can vary from an asymptomatic course to ARDS requiring invasive mechanical ventilation and extracorporeal membrane oxygenation. A kidney transplanted patient infected with SARS CoV-2 infection showed a mild disease despite immune suppression. It is possible that Immunosuppression can "be protective" as the cytokine storm is an important factor in the disease story. Despite the good outcome reported in the present case report, is remains of vital importance the solid organ transplant patients use precautions in order to avoid the infection.


title: Using Social Media for Rapid Information Dissemination in a Pandemic: #PedsICU and Coronavirus Disease 2019

text: OBJECTIVE: To describe the impact of a strategy for international collaboration and rapid information dissemination on Twitter among the pediatric critical care community during a global pandemic. DESIGN: Analysis of #PedsICU and coronavirus disease 2019 Twitter data in the Symplur Signals Database between February 1, 2020, and May 1, 2020. SETTING: Social media platform Twitter. PATIENTS: None. INTERVENTIONS: Promotion of the joint usage of #PedsICU and #COVID19 throughout the international pediatric critical care community in tweets relevant to the coronavirus disease 2019 pandemic and pediatric critical care. MEASUREMENTS AND MAIN RESULTS: We collected data on all tweets containing the hashtag #PedsICU in addition to those containing both #PedsICU and coronavirus disease 2019 hashtags. Tweets including #PedsICU were shared 49,865 times on six continents between February 1, 2020, and May 1, 2020; between February 1 and March 13, only 8% of #PedsICU tweets included a coronavirus disease 2019 hashtag. After a sharp rise during the week of March 14, 2020, coronavirus disease 2019 content has dominated the #PedsICU conversation on Twitter, comprising 69% of both #PedsICU tweets and impressions (p < 0.001). The most commonly used coronavirus disease 2019 hashtag over the study period was #COVID19 (69%). Proportionately, a greater percentage of #PedsICU tweets including the coronavirus disease 2019 hashtag (vs not) had images or videos (45% vs 41%; p < 0.001). In addition, non-physician healthcare providers were the largest group of users (46%) of the combination of #PedsICU and coronavirus disease 2019 hashtags. The most popular tweets shared on Twitter were open-access resources, including links for updated literature, narrative reviews, and educational videos relevant to coronavirus disease 2019 clinical care. Concurrent hashtags and words in tweets containing #PedsICU and coronavirus disease 2019 hashtags spanned several different disciplines and topics in pediatric critical care. CONCLUSION: Twitter has been used widely for real-time information sharing and collaboration among the international pediatric critical care community during the coronavirus disease 2019 pandemic. Targeted use of #PedsICU and #COVID19 for engagement on Twitter is a conduit to combat misinformation and optimize reach to pediatric critical care stakeholders across the globe when rapid dissemination is needed.


title: Immunity-Boosting Spices and the Novel Coronavirus

text: Although there is no reported genetic predisposition in contracting coronavirus disease 2019 (COVID-19), the mortality rate varies among different ethnic groups. Here we determined potential correlation between COVID-19 and spice consumption. The data from 163 countries including total cases, total deaths, and total recovered were analyzed. It was observed that there is a clear interrelated prevalence between the total number of COVID-19 cases per million population tested and the gram of spice supply per capita per day. Nations with lower consumptions of spices per capita showed greater number of COVID-19 cases per million population. This is not surprising as herbs and spices are well-known to boost immunity. Although the precise molecular mechanisms associated with spices and immunity are not completely understood, our findings led us to hypothesize that spice consumption plays a role in our ability to fight COVID-19; however, intensive research is needed to determine the translational value of these findings.


title: Angiotensin-Converting Enzyme 2 as a Versatile Player in the Management of Coronavirus Disease 2019

text: In view of the global coronavirus disease 2019 (COVID-19) pandemic, there are ongoing efforts aimed at predicting potential factors causing clinical exacerbation of COVID-19 and at seeking effective therapies for COVID-19.Recent studies have indicated that severe acute respiratory coronavirus 2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) as a receptor for cellular invasion and subsequent replication.


Investigational Therapies for the Treatment of COVID-19: Updates from Ongoing Clinical Trials


An Emergency Surgery in Severe Case Infected by COVID-19 With Perforated Duodenal Bulb Ulcer


COVID-19, una nueva oportunidad para la educación sanitaria global./ COVID-19, una nueva oportunidad para la educación sanitaria global./ COVID-19, a new opportunity for global health education


The use of Janus kinase inhibitors in the time of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)


COVID-19 and medical education


title: Prosthetic aortic valve endocarditis complicated by COVID-19 and hemorrhage

text: The novel coronavirus, now termed SARS-CoV-2, has caused a significant global impact in the space of 4 months. Almost all elective cardiac surgical operations have been postponed with only urgent and emergency operations being considered in order to maximise resource utilisation. We present a case of a 69-year old lady with an infected prosthetic aortic valve for consideration of urgent inpatient surgery. Despite being asymptomatic and testing negative initially for COVID-19 RT-PCR swab, further investigations with CT revealed suspicious findings. She subsequently tested positive on a repeat swab and unfortunately deteriorated rapidly with complications including gastro-intestinal and intracerebral haemorrhage.


docid: lwizctxz

title: Hernia in the time of COVID-19


Impacts of COVID-19 Pandemic on Gastrointestinal Endoscopy Volume and Diagnosis of Gastric and Colorectal Cancers: A Population-based Study


docid: auzknkbx

title: Ribosomal proteins as a possible tool for blocking SARS-COV 2 virus replication for a potential prospective treatment

text: Coronavirus disease (COVID-19) is caused by SARS-COV2 and has resulted in more than four million cases globally and the death cases exceeded 300,000. Normally, a range of surviving and propagating host factors must be employed for the completion of the infectious process including RPs. Viral protein biosynthesis involves the interaction of numerous RPs with viral mRNA, proteins which are necessary for viruses replication regulation and infection inside the host cells. Most of these interactions are crucial for virus activation and accumulation. However, only small percentage of these proteins is specifically responsible for host cells protection by triggering the immune pathway against virus. This research proposes RPs extracted from bacillus sp. and yeast as new forum for the advancement of antiviral therapy. Hitherto, antiviral therapy with RPs-involving viral infection has not been widely investigated as critical targets. Also, exploring antiviral strategy based on RPs could be a promising guide for more potential therapeutics.


title: Professional autonomy and liability of the resident doctor: Between the hammer and the anvil

text: Within the regime of professional liability of doctors in training, the limits and the medico-legal aspects of their professional duties are not well-defined. The Italian Court of Cassation established in its sentence no. 26311/2019 that resident doctors do not work at hospitals just to receive their professional training. They are, indeed, licensed physicians and therefore bear full responsibility for the acts performed within the compass of their professional activity. The purpose of this article is to briefly define the possible consequences of this judgment.


Doctors' wellbeing: self-care during the covid-19 pandemic


title: Application of the criterion of Li-Wang to a five dimensional epidemic model of COVID-19. Part I

text: The dynamics of many epidemic models for infectious diseases that spread in a single host population demonstrate a threshold phenomenon. If the basic reproduction number R0 is below unity, the disease-free equilibrium P0 is globally stable in the feasible region and the disease always dies out. If R0>1, a unique endemic equilibrium P? is globally asymptotically stable in the interior of the feasible region and the disease will persist at the endemic equilibrium if it is initially present. In this paper (Part I), we reinvestigate the study of the stability or the non stability of a mathematical Covid-19 model constructed by Nita H. Shah, Ankush H. Suthar and Ekta N. Jayswal. We use a criterion of Li-Wang for stability of matrices [Li-Wang] on the second additive compound matrix associated to their model. In second paper (Part II), In order to control the Covid-19 system, i.e., force the trajectories to go to the equilibria we will add some control parameters with uncertain parameters to stabilize the five-dimensional Covid-19 system studied in this paper. Based on compound matrices theory, we apply in [Intissar] again the criterion of Li-Wang to study the stability of equilibrium points of Covid-19 system with uncertain parameters. In this part II, all sophisticated technical calculations including those in part I are given in appendices.


Maternal Fetal Surgery During the COVID-19 Pandemic


Telemedicine and support groups could be used to improve adherence to treatment and health-related quality of life in patients affected by inflammatory skin conditions during the COVID-19 pandemic


title: Artificial Neural Networks Solve Musical Problems With Fourier Phase Spaces

text: How does the brain represent musical properties? Even with our growing understanding of the cognitive neuroscience of music, the answer to this question remains unclear. One method for conceiving possible representations is to use artificial neural networks, which can provide biologically plausible models of cognition. One could train networks to solve musical problems, and then study how these networks encode musical properties. However, researchers rarely examine network structure in detail because networks are difficult to interpret, and because many assume that networks capture informal or subsymbolic properties. Here we report very high correlations between network connection weights and discrete Fourier phase spaces used to represent musical sets. This is remarkable because there is no clear mathematical relationship between network learning rules and discrete Fourier analysis. That networks discover Fourier phase spaces indicates that these spaces have an important role to play outside of formal music theory. Finding phase spaces in networks raises the strong possibility that Fourier components are possible codes for musical cognition.


Lessening COVID-19 healthcare burden in dental practice via rapid serological tests


title: The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID-19 in China: A multicentre cross-sectional survey

text: Since December 2019, the medical staff fighting against COVID-19 frequently reported the device-related pressure injury (DRPI) caused by personal protective equipment (PPE). We conducted a cross-sectional survey online to investigate the prevalence and characteristics of DRPI among medical staff. Univariate and multivariate logistic regression analyses were employed to explore the risk factors associated with DRPI. A total of 4308 participants were collected and 4306 participants were valid from 161 hospitals in China. The overall prevalence of DRPI caused by PPE among medical staff was 30.03% (95% CI 28.69%-31.41%). The prevalence of male was more than that of female (42.25%, 95% CI 37.99-46.51% vs 26.36%, 95% CI 26.93-29.80%, P < .001).The categories were mainly stages 1 and 2, and the common anatomical locations were nose bridge, cheeks, ears, and forehead. Logistic regression analysis revealed that the risk factors were sweating (OR = 43.99, 95% CI 34.46-56.17), male (OR = 1.50, 95% CI 1.12-1.99), level 3 PPE (OR = 1.44, 95% CI 1.14-1.83), and longer wearing time (OR = 1.28, 95% CI 0.97-1.68). The prevalence of DRPI was high among medical staff wearing PPE against COVID-19, and the risk factors were sweating, male, wearing level 3 PPE, and longer wearing time. Comprehensive preventive interventions should be taken.


Impact of the digital divide in the age of COVID-19


title: Predicting COVID-19 Incidence Using Anosmia and Other COVID-19 Symptomatology: Preliminary Analysis Using Google and Twitter

text: OBJECTIVE: To determine the relative correlations of Twitter and Google Search user trends concerning smell loss with daily coronavirus disease 2019 (COVID-19) incidence in the United States, compared to other severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms. To describe the effect of mass media communications on Twitter and Google Search user trends. STUDY DESIGN: Retrospective observational study. SETTING: United States. SUBJECTS AND METHODS: Google Search and "tweet" frequency concerning COVID-19, smell, and nonsmell symptoms of COVID-19 generated between January 1 and April 8, 2020, were collected using Google Trends and Crimson Hexagon, respectively. Spearman coefficients linking each of these user trends to COVID-19 incidence were compared. Correlations obtained after excluding a short timeframe (March 22 to March 24) corresponding to the publication of a widely read lay media publication reporting anosmia as a symptom of infection was performed for comparative analysis. RESULTS: Google searches and tweets concerning all nonsmell symptoms (0.744 and 0.761, respectively) and COVID-19 (0.899 and 0.848) are more strongly correlated with disease incidence than smell loss (0.564 and 0.539). Twitter users tweeting about smell loss during the study period were more likely to be female (52%) than users tweeting about COVID-19 more generally (47%). Tweet and Google Search frequency pertaining to smell loss increased significantly (>2.5 standard deviations) following a widely read media publication linking smell loss and SARS-CoV-2 infection. CONCLUSIONS: Google Search and tweet frequency regarding fever and shortness of breath are more robust indicators of COVID-19 incidence than anosmia. Mass media communications represent important confounders that should be considered in future analyses.


title: Olfactory and Gustatory Outcomes in COVID-19: A Prospective Evaluation in Nonhospitalized Subjects

text: OBJECTIVE: To prospectively assess the rate and timing of recovery of olfactory (OD) and gustatory (GD) dysfunction in patients affected by COVID-19. STUDY DESIGN: Cohort study. SETTING: Population-based evaluation in a COVID-19 high-prevalence region. SUBJECTS AND METHODS: We analyzed the clinical course of OD and GD in a cohort of home-quarantined SARS-CoV-2-positive patients from Northern Italy. Physicians administered a survey-based questionnaire at recruitment (T0). During follow-up, patients responded to online dedicated surveys modulated according to symptoms at T0. RESULTS: A total of 151 patients completed the follow-up survey. OD and/or GD were observed in 83% and 89% of subjects, respectively. Resolution rates of OD and GD at 30 days from onset were 87% and 82%, respectively. Risk factors for late resolution were grade of dysfunction at onset (total vs partial), gender, and presence of nasal congestion. Three (2%) patients previously reporting complete resolution of symptoms complained of subsequent recurrence of OD and/or GD after a mean of 19 days from resolution of the previous episode. CONCLUSION: COVID-19-related OD and GD had high rate of resolution in the first month from onset of symptoms. However, in 10% to 15% of patients, these symptoms showed only partial improvement after this period.


title: Survival of COVID-19 patients requires precise immune regulation: The hypothetical immunoprotective role of nicotinic agonists

text: recent studies have provided novel evidence regarding the effect of nicotine agonists on the prevention or modulation of cytokines storm and reduction of infection. In this study we tried to attempt to address these issues from a therapeutic perspective of nicotine agonists in this manner and we describe one of the most challenging theories of immunotherapy in coronavirus-19 (COVID-19). The analysis of the proposed mechanism goes beyond the physiological consequences of a way to design new strategies to provide anti-inflammatory drugs.


Treatments in the COVID-19 pandemic: an update on clinical trials


title: Chancen und Einsatzmöglichkeiten von Telemedizin in der Hals, Nasen- und Ohrenheilkunde bei der Bekämpfung von SARS-COV-2 : Narratives Review./ [Telemedicine in the fight against SARS-COV-2-opportunities and possible applications in otorhinolaryngology : Narrative review]

text: INTRODUCTION: The COVID-19 pandemic is bringing healthcare systems worldwide to the brink of collapse. One reason for this is the rapidly increasing number of new infections. On the other hand, the high sickness rates of doctors and nurses, particularly in ENT medicine, are aggravating the situation. Telemedicine can be a useful tool to reduce the number of physician-patient contacts. This could break infection chains and minimize the risk of infection for physicians. METHODS: To prepare the review, a selective literature search was conducted at www.pubmed.com using the relevant English technical terms for telemedicine and ENT. In addition, research was conducted at www.news.google.com on current developments of the COVID-19 pandemic with the search terms "telemedicine" and "COVID-19." RESULTS: Telemedicine can be helpful in direct contact with patients as well as in the conciliar support of general practitioners. The available studies show that, on average, more than 50% of medical consultations could be carried out telemedically. Both physicians and patients rate the use of telemedicine positively. Neither image quality nor the handling of the technology are relevant obstacles to a reliable diagnosis. Patients indicated that the telemedical consultation did not last longer than a traditional consultation. Patients also highlighted the faster and better availability of medical care through telemedicine. CONCLUSION: Telemedicine can make a decisive contribution to coping with the current COVID-19 pandemic. Furthermore, the establishment of telemedicine can help us to become better prepared for future pandemics.


Interferon beta-1b for COVID-19


Hematuria Associated With SARS-CoV-2 Infection in a Child


Asthma in children during the COVID-19 pandemic: lessons from lockdown and future directions for management


Sibling Grief #394


title: Shared Ventilation in the Era of COVID-19: A Theoretical Consideration of the Dangers and Potential Solutions

text: BACKGROUND: The use of shared ventilation, or the simultaneous support of multiple patients connected in parallel to a single mechanical ventilator, is receiving considerable interest for addressing the severe shortage of mechanical ventilators available during the novel coronavirus pandemic (COVID-19). In this paper we highlight the potentially disastrous consequences of naïve shared ventilation, in which patients are simply connected in parallel to a ventilator without any regard to their individual ventilatory requirements. We then examine possible approaches for individualization of mechanical ventilation, using modifications to the breathing circuit that may enable tuning of individual tidal volumes and driving pressures during either volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV). METHODS: Breathing circuit modifications included a PEEP valve on each expiratory limb for both VCV and PCV, an adjustable constriction and one-way valve on the inspiratory limb for VCV, and a pressure-relief valve for peak inspiratory pressure reduction on the inspiratory limb for PCV. The ability to regulate individual tidal volumes using these breathing circuit modifications was tested both theoretically in computer simulations as well as experimentally in mechanical test lungs. RESULTS: In both the simulations and experimental measurements, naïve shared ventilation resulted in large imbalances across individual tidal volume delivery, dependent on imbalances across patient mechanical properties. The proposed breathing circuit modifications for shared VCV and shared PCV enabled optimization of tidal volume distributions. Individual tidal volume for one patient during shared VCV was sensitive to changes in the mechanical properties of other patients. By contrast, shared PCV enabled independent control of individual patient-received ventilation. CONCLUSIONS: Of the shared ventilation strategies considered, shared PCV, with the inclusion of in-line pressure-relief valves in the individual inspiratory and expiratory limbs, offers the greatest degree of safety and lowest risk of catastrophic mechanical interactions between multiple patients connected to a single ventilator.


docid: bsqpkjcj

title: COVID-19 Cardiac Injury: Implications for Long-Term Surveillance and Outcomes in Survivors

text: Up to 20-30% of patients hospitalized with coronavirus disease (COVID-19) have evidence of myocardial involvement. Acute cardiac injury in patients hospitalized with COVID-19 is associated with higher morbidity and mortality. There are no data on how acute treatment for COVID-19 may affect convalescent phase or long-term cardiac recovery and function. Myocarditis from other viral pathogens can evolve into overt or subclinical myocardial dysfunction, and sudden death has been described in the convalescent phase of viral myocarditis. This raises concerns for patients recovering from COVID-19. Some patients will have subclinical and possibly overt cardiovascular abnormalities. Patients with ostensibly recovered cardiac function may still be at risk for cardiomyopathy and cardiac arrhythmias. Screening for residual cardiac involvement in the convalescent phase for patients recovered from COVID-19 associated cardiac injury is needed. The type of testing, and therapies for post COVID-19 myocardial dysfunction will need to be determined. Therefore, now is the time to plan for appropriate registries and clinical trials to properly assess these issues and prepare for long-term sequelae of "post-COVID-19 Cardiac Syndrome".


Covid-19: Each discarded face mask is a potential biohazard


Alemtuzumab in multiple sclerosis during the COVID-19 pandemic: A mild uncomplicated infection despite intense immunosuppression


Coronavirus disease 2019 (COVID-19) and decrease in blood donation: experience of Iranian Blood Transfusion Organization (IBTO)


Hematologic Consequences of the Coronavirus Crisis-Focus on Relevant Clues and Complications for the Perioperative Cardiothoracic and Vascular Community


title: The Diagnosis of SARS-CoV2 Pneumonia: A Review of Laboratory and Radiological Testing Results

text: The rapid emergence of COVID-19 (coronavirus disease 2019) has necessitated the implementation of diverse pandemic control strategies throughout the world. In order to effectively control the spread of this disease, it is essential that it be diagnosed at an early stage so that patients can be reliably quarantined such that disease spread will be slowed. At present, the diagnosis of this infectious form of coronavirus pneumonia is largely dependent upon a combination of laboratory testing and imaging analyses of variable diagnostic efficacy. In the present report, we reviewed prior literature pertaining to the diagnosis of different forms of pneumonia caused by coronaviruses (SARS, MERS, and SARS-CoV-2) and assessed two different potential diagnostic approaches. We ultimately found that computed tomography (CT) was associated with a higher rate of diagnostic accuracy than was a real-time quantitative polymerase chain reaction (qPCR)-based approach (P = 0.0041), and chest radiography (P = 0.0100). Even so, it is important that clinicians utilize a combination of laboratory and radiological testing where possible in order to ensure that this virus is reliably and quickly detected such that it may be treated and patients may be isolated in a timely fashion, thereby effectively curbing the further progression of this pandemic. This article is protected by copyright. All rights reserved.


docid: mvxvhtzy

title: The positive effects of covid-19


title: A COVID-19 Epidemiological Model for Community and Policy Maker Use

text: An epidemiological model for COVID-19 was developed and implemented in MATLAB/GNU Octave for use by public health practitioners, policy makers and the general public. The model distinguishes four stages in the disease: infected, sick, seriously sick, and better. The model was preliminarily parameterized based on observations of the spread of the disease. The model is consistent with a mortality rate of 1.5 %. Preliminary simulations with the model indicate that concepts such as"herd immunity"and"flattening the curve"are highly misleading in the context of this virus. Public policies based on these concepts are inadequate to protect the population. Only reducing the R0 of the virus below 1 is an effective strategy for maintaining the death burden of COVID-19 within the normal range of seasonal flu. As R0 values estimated with the model range from 2.82 worldwide outside of China and 3.83 in the Western world in late February - early March 2020, this means social distancing with effectiveness greater than 65 % (worldwide) or 75 % (Western world) are needed to combat the virus successfully.


title: [Clinical application effect of modified nasopharyngeal swab sampling for 2019 novel coronavirus nucleic acid detection]

text: Objective: To study the clinical application effect of modified nasopharyngeal swab sampling for 2019 novel coronavirus nucleic acid detection. Methods: This study covered the period from January 14 to March 1, 2020. From February 24 on, the supine position method and the protective face screen were used to collect nasopharyngeal swabs, before which, the nasopharyngeal swabs were collected by sitting position method. All the patients were diagnosed with suspected/confirmed 2019 novel coronavirus infection, who were admitted from February 19 on, before which, the nasopharyngeal swabs were collected outside the hospital. (1) Thirty-four operators meeting the inclusion criteria of the study were recruited in this retrospective cohort study. They were grouped according to the collection method of nasopharyngeal swabs. Sixteen operators of Wuhan Taikang Tongji Hospital who used the supine position method and the protective face screen were included in supine position method+protective face screen group (15 males and 1 female, aged 34-49 years); 18 operators (12 from the First Affiliated Hospital of Army Medical University (the Third Military Medical University), 1 from Wuhan Jiangxia Mobile Cabin Hospital, 5 from the East District of People's Hospital of Wuhan University) who used the traditional sitting position method were included in sitting position method group (2 males and 16 females, aged 25-49 years). In supine position method+protective face screen group, when collecting sample, the patient lay flat and wore a special protective face screen for nasopharyngeal swab sampling, with neck slightly extending and face turning to the opposite side of the operator about 10°. The self-designed questionnaire was used to investigate the cooperation, the incidence of nausea, coughing, sneezing, and struggling of patients evaluated by the operators, the operation time of single sampling, the fear of operation and the perceived exposure risk of operators of the two groups. (2) Sixty-five patients (22 males and 43 females, aged 25-91 years) admitted to Wuhan Taikang Tongji Hospital who successively received the sitting position method and supine position method+protective face screen for nasopharyngeal swabs sampling and with complete nucleic acid detection results were included. The positive rates of nucleic acid detection by the two sampling methods of nasopharyngeal swabs of the patients were statistically analyzed. (3) Forty-one patients who could express their feelings accurately were selected from the above 65 patients (12 males and 29 females, aged 27-83 years). The comfort of patients in the process of sampling by the two methods was investigated. (4) Thirty-four patients (10 males and 24 females, aged 25-83 years) with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method were selected from the above 65 patients. The positive rate of nucleic acid detection of nasopharyngeal swab of patients by supine position method+protective face screen, i.e. negative to positive rate was statistically analyzed. Data were statistically analyzed with Wilcoxon's sign rank test, t test, and chi-square test. Results: (1) The cooperation score of patients evaluated by the operators in supine position method+protective face screen group was significantly higher than that in sitting position method group (Z=-4.928, P<0.01), the incidence of nausea, choking cough, sneezing, and struggling of patients evaluated by the operators, and the fear of operation score and the perceived exposure risk score of operators were significantly lower than those of sitting position method group (Z=-5.071, -5.046, -4.095, -4.397, -4.174, -5.049, P<0.01), and the operation time of single sampling was significantly longer than that of sitting position method group (t=23.17, P<0.01). (2) The positive rate of nucleic acid detection of nasopharyngeal swabs by supine position method+protective face screen was 60.00% (39/65), which was obviously higher than 41.54% (27/65) by sitting position method (χ(2)=4.432, P<0.05). (3) The comfort score of the 41 patients during nasopharyngeal swabs sampling by supine position method+protective face screen was significantly higher than that by sitting position method (Z=-5.319, P<0.01). (4) Of the 34 patients with two or more consecutive negative results of nucleic acid detection of nasopharyngeal swabs by sitting position method, the rate of negative to positive of nucleic acid detection was 26.47% (9/34) after sampling by supine position method+protective face screen. Conclusions: Compared with the traditional sitting position method, detection of 2019 novel coronavirus nucleic acids of nasopharyngeal swabs collected by supine method combined with protective face screen is worth promoting, because of its better comfort of patients, low exposure risk for operators, in addition to reducing in the false negative result to some extent, which may help reduce false recurrence of discharged patients.


title: Clinical recurrences of COVID-19 symptoms after recovery: viral relapse, reinfection or inflammatory rebound?

text: For the first 3 months of COVID-19 pandemic, COVID-19 was expected to be an immunizing non-relapsing disease. We report a national case series of 11 virologically-confirmed COVID-19 patients having experienced a second clinically- and virologically-confirmed acute COVID-19 episode. According to the clinical history, we discuss either re-infection or reactivation hypothesis. Larger studies including further virological, immunological and epidemiologic data are needed to understand the mechanisms of these recurrences.


Skin damage among health care workers managing coronavirus disease-2019


title: Autoclave Sterilization and Ethanol Treatment of Re-used Surgical Masks and N95 Respirators during COVID-19: Impact on their Performance and Integrity

text: BACKGROUND: An exceptionally high demand for surgical masks and N95 filtering facepiece respirators (FFRs) during the COVID-19 pandemic has considerably exceeded their supply. These disposable devices are generally not approved for routine decontamination and re-use as standard of care while this practice has widely occurred in hospitals. The US Centers for Disease Control and Prevention allowed it "as a crisis capacity strategy." However, limited testing was conducted on the impact of specific decontamination methods on the performance of N95 FFRs and no data was presented for surgical masks. AIM: We evaluated common surgical masks and N95 respirators with respect to the changes in their performance and integrity resulting from autoclave sterilization and a 70% ethanol treatment; these methods are frequently utilized for re-used filtering facepieces in hospitals. METHODS: The filter collection efficiency and pressure drop were determined for unused masks and N95 FFRs, and for those subjected to the treatments in a variety of ways. The collection efficiency was measured for particles of approximately 0.037-3.2 µm to represent aerosolized single viruses, their agglomerates, bacteria and larger particles carriers. FINDINGS: The initial collection efficiency and the filter breathability may be compromised by sterilization in an autoclave and ethanol treatment. The effect depends on a protective device, particle size, breathing flow rate, type of treatment and other factors. Additionally, physical damages were observed in N95 respirators after autoclaving. CONCLUSION: Strategies advocating decontamination and re-use of filtering facepieces in hospitals should be re-assessed considering the data obtained in this study.


title: COVID-19: The Potential Role of Copper and N-acetylcysteine (NAC) in a Combination of Candidate Antiviral Treatments Against SARS-CoV-2

text: BACKGROUND: On March 11, 2020, the World Health Organization (WHO) declared the outbreak of coronavirus disease (COVID-19) a pandemic. Since then, thousands of people have suffered and died, making the need for a treatment of severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) more crucial than ever. MATERIALS AND METHODS: The authors carried out a search in PubMed, ClinicalTrials.gov and New England Journal of Medicine (NEJM) for COVID-19 to provide information on the most promising treatments against SARS-CoV-2. RESULTS: Possible COVID-19 agents with promising efficacy and favorable safety profile were identified. The results support the combination of copper, N-acetylcysteine (NAC), colchicine and nitric oxide (NO) with candidate antiviral agents, remdesivir or EIDD-2801, as a treatment for patients positive for SARS-CoV-2. CONCLUSION: The authors propose to study the effects of the combination of copper, NAC, colchicine, NO and currently used experimental antiviral agents, remdesivir or EIDD-2801, as a potential treatment scheme for SARS-COV-2.


docid: ujurrmlf

title: Nierensonomorphologie bei COVID-19 mit akuter Niereninsuffizienz./ [Renal Monomorphology in COVID-19 with Acute Renal Insufficiency]

text: Renal Monomorphology in COVID-19 with Acute Renal Insufficiency Abstract. A 78-year-old ventilator-dependent COVID-19 patient developed severe renal failure with an estimated glomerular filtration rate of 20 ml/min per 1.73 m2 and nephrotic proteinuria. Sonography showed echo-dense and enlarged kidneys with high resistance indices (>0.8). Echocontrast sonography showed a delayed renal perfusion. In the further course of the disease renal function recovered, kidney size decreased and the renal perfusion normalized. An acute COVID-19-associated interstitial nephritis is postulated.


title: Pediatric Inflammatory Multisystem Syndrome with Central Nervous System Involvement and Hypocomplementemia following Sars-cov-2 Infection

text: Pediatric inflammatory multisystem syndromes associated with Severe Acute Respiratory Syndrome Coronavirus 2 are emerging in recent reports. We describe a patient with critical illness consistent with atypical Kawasaki disease with cardiac dysfunction and abdominal involvement presenting weeks after Severe Acute Respiratory Syndrome Coronavirus 2 infection. Our patient showed unique central nervous system involvement with small vessel vasculitis and profound hypocomplementemia, both not previously reported in case descriptions and may hint at possible disease mechanisms.


Cardiothoracic Education in the Time of COVID-19: How I Teach It


The impact of COVID-19 on acute psychiatric inpatient unit


title: Correction to: COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon

text: The article COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon, written.


title: A Commentary on the Challenges of Telemedicine for Head and Neck Oncologic Patients during COVID-19

text: The COVID-19 pandemic is an unprecedented and historic event that presents unique challenges to patient care to medical providers worldwide. The pandemic and the ensuing rapid changes to medical practice have particularly affected head and neck cancer surgeons and their patients. In an effort to balance the needs of our patients with the risks to patient and staff safety, we have been tasked with finding alternatives to the traditional office visit. In this commentary, we discuss how telemedicine can be incorporated into the head and neck surgery practice, the challenges that we have faced, and the dilemmas with which we have dealt in our efforts to fulfill the ongoing need for care of this unique patient population.


SARS-CoV-2 and gastrointestinal tract: The dark side of the pandemic


title: Thromboelastography Profiles of Critically Ill Patients With Coronavirus Disease 2019

text: OBJECTIVES: The rate of thromboembolic events among patients with coronavirus disease 2019 is high; however, there is no robust method to identify those at greatest risk. We reviewed thromboelastography studies in critically ill patients with coronavirus disease 2019 to characterize their coagulation states. DESIGN: Retrospective. SETTING: Tertiary ICU in New York City. PATIENTS: Sixty-four patients with coronavirus disease 2019 admitted to the ICU with thromboelastography performed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty percent of patients had a clotting index in the hypercoagulable range (clotting index > 3) (median 3.05). Reaction time and K values were below the lower limit of normal in 43.8% of the population consistent with a hypercoagulable profile. The median α angle and maximum amplitude (75.8° and 72.8 mm, respectively) were in the hypercoagulable range. The α angle was above reference range in 70.3% of patients indicative of rapid clot formation. Maximum amplitude, a factor of fibrinogen and platelet count and function, and a measure of clot strength was above reference range in 60.1% of patients. Thirty-one percent had thromboembolic events; thromboelastography parameters did not correlate with events in our cohort. Those with D-dimer values greater than 2,000 were more likely to have shorter reaction times compared with those with D-dimer levels less than or equal to 2,000 (4.8 vs 5.6 min; p = 0.001). CONCLUSIONS: A large proportion of critically ill patients with coronavirus disease 2019 have hypercoagulable thromboelastography profiles with additional derangements related to fibrinogen and platelet function. As the majority of patients have an elevated thromboelastography maximum amplitude, a follow-up study evaluating platelet aggregation would be instructive.


docid: uvjlvtdb

title: Acute cholecystitis during COVID-19 pandemic: a multisocietary position statement

text: Following the spread of the infection from the new SARS-CoV2 coronavirus in March 2020, several surgical societies have released their recommendations to manage the implications of the COVID-19 pandemic for the daily clinical practice. The recommendations on emergency surgery have fueled a debate among surgeons on an international level.We maintain that laparoscopic cholecystectomy remains the treatment of choice for acute cholecystitis, even in the COVID-19 era. Moreover, since laparoscopic cholecystectomy is not more likely to spread the COVID-19 infection than open cholecystectomy, it must be organized in such a way as to be carried out safely even in the present situation, to guarantee the patient with the best outcomes that minimally invasive surgery has shown to have.


title: Accounting for Symptomatic and Asymptomatic in a SEIR-type model of COVID-19

text: A mathematical model was developed describing the dynamic of the COVID-19 virus over a population considering that the infected can either be symptomatic or not. The model was calibrated using data on the confirmed cases and death from several countries like France, Philippines, Italy, Spain, United Kingdom, China, and the USA. First, we derived the basic reproduction number, $\mathcal{R}_0$, and estimated the effective reproduction $\mathcal{R}_{\rm eff}$ for each country. Second, we were interested in the merits of interventions, either by distancing or by treatment. Results revealed that total and partial containment is effective in reducing the transmission. However, its duration may be long to eradicate the disease (104 days for France). By setting the end of intervention as the day when hospital capacity is reached, numerical simulations showed that the duration can be reduced (up to only 39 days for France if the capacity is 1000 patients). Further, results pointed out that the effective reproduction number remains large after containment. Therefore, testing and isolation are necessary to stop the disease.


docid: juigdaib

title: Screening of Chloroquine, Hydroxychloroquine and its derivatives for their binding affinity to multiple SARS-CoV-2 protein drug targets

text: Recently Chloroquine and its derivative Hydroxychloroquine have garnered enormous interest amongst the clinicians and health authorities' world over as a potential treatment to contain COVID-19 pandemic. The present research aims at investigating the therapeutic potential of Chloroquine and its potent derivative Hydroxychloroquine against SARS-CoV-2 viral proteins. At the same time screening was performed for some chemically synthesized derivatives of Chloroquine and compared their binding efficacy with chemically synthesized Chloroquine derivatives through in silico approaches. For the purpose of the study, some essential viral proteins and enzymes were selected that are implicated in SARS-CoV-2 replication and multiplication as putative drug targets. Chloroquine, Hydroxychloroquine, and some of their chemically synthesized derivatives, taken from earlier published studies were selected as drug molecules. We have conducted molecular docking and related studies between Chloroquine and its derivatives and SARS-CoV-2 viral proteins, and the findings show that both Chloroquine and Hydroxychloroquine can bind to specific structural and non-structural proteins implicated in the pathogenesis of SARS-CoV-2 infection with different efficiencies. Our current study also shows that some of the chemically synthesized Chloroquine derivatives can also potentially inhibit various SARS-CoV-2 viral proteins by binding to them and concomitantly effectively disrupting the active site of these proteins. These findings bring into light another possible mechanism of action of Chloroquine and Hydroxychloroquine and also pave the way for further drug repurposing and remodeling.Communicated by Ramaswamy H. Sarma.


title: Prevalence of Flu-like Symptoms and COVID-19 in Healthcare Workers from India

text: Background: The current COVID-19 pandemic is unprecedented. As the numbers expand exponentially, a paucity of data regarding health care workers (HCWs), who are at the forefront of this disaster, exists. Hence we decided to conduct a study amongst the HCWs to determine the prevalence and risk factor stratification. Methods: This was an online questionnaire-based survey of healthcare workers conducted at Max Super Speciality Hospital, Saket, New Delhi, India from 23rd March to 30th April 2020. Data on flu-like symptoms, travel history, posting in high-risk or low risk zones, and prophylactic drugs was collected. Results: Out of the 18000 HCWs who were approached 4403 responded and adequate data of 3667 was available for analysis. 14.7% had flu-like symptoms. 1.8% (20/1113) of the participants tested were positive for the virus. HCWs posted in the high-risk zones had more symptoms than those working in low-risk zones (169/539, 31.4% vs 679/3128, 21.7%), p<0.001; but no difference in COVID-19 positivity rates (p=0.849). Symptomatic HCWs had higher positivity (10/193, 5.2%) than the asymptomatic ones (10/920, 1.1%), p=0.001. HCQ was taken by 755/1113 (67.8%) people and 14 (1.9%) of these reported positive for the virus. Conclusion: This is the first study on healthcare workers from India to the best of our knowledge. Our findings suggest that posting in a high-risk zone with adequate PPE does not pose higher risk to the HCWs. Moreover, HCQ as a prophylactic has no use. ClinicalTrials.gov Identifier: NCT04339608.


CT appearance of severe, laboratory-proven coronavirus disease 2019 (COVID-19) in a Caucasian patient in Berlin, Germany