title: Health Observation App for COVID-19 Symptom Tracking Integrated With Personal Health Records: Proof of Concept and Practical Use Study

text: BACKGROUND: As a counter-cluster measure to prevent the spread of the infectious novel coronavirus disease (COVID-19), an efficient system for health observation outside the hospital is urgently required. Personal health records (PHRs) are suitable for the daily management of physical conditions. Importantly, there are no major differences between the items collected by daily health observation via PHR and the observation of items related to COVID-19. Until now, observations related to COVID-19 have been performed exclusively based on disease-specific items. Therefore, we hypothesize that PHRs would be suitable as a symptom-tracking tool for COVID-19. To this end, we integrated health observation items specific to COVID-19 with an existing PHR-based app. OBJECTIVE: This study is conducted as a proof-of-concept study in a real-world setting to develop a PHR-based COVID-19 symptom-tracking app and to demonstrate the practical use of health observations for COVID-19 using a smartphone or tablet app integrated with PHRs. METHODS: We applied the PHR-based health observation app within an active epidemiological investigation conducted by Wakayama City Public Health Center. At the public health center, a list is made of individuals who have been in close contact with known infected cases (health observers). Email addresses are used by the app when a health observer sends data to the public health center. Each health observer downloads the app and installs it on their smartphone. Self-observed health data are entered daily into the app. These data are then sent via the app by email at a designated time. Localized epidemiological officers can visualize the collected data using a spreadsheet macro and, thus, monitor the health condition of all health observers. RESULTS: We used the app as part of an active epidemiological investigation executed at a public health center. During the investigation, 72 close contacts were discovered. Among them, 57 had adopted the use of the health observation app. Before the introduction of the app, all health observers would have been interviewed by telephone, a slow process that took four epidemiological officers more than 2 hours. After the introduction of the app, a single epidemiological officer can carry out health observations. The app was distributed for free beginning in early March, and by mid-May, it had been used by more than 20,280 users and 400 facilities and organizations across Japan. Currently, health observation of COVID-19 is socially recognized and has become one of the requirements for resuming social activities. CONCLUSIONS: Health observation by PHRs for the purpose of improving health management can also be effectively applied as a measure against large-scale infectious diseases. Individual habits of improving awareness of personal health and the use of PHRs for daily health management are powerful armaments against the rapid spread of infectious diseases. Ultimately, similar actions may help to prevent the spread of COVID-19.


Data Error in Viewpoint on COVID-19 in Italy


docid: bqxdbxqd

title: Blood sampling after COVID-19 - How to organize large scale phlebotomy services in the post SARS CoV-2 era


The progress of 2019 novel coronavirus event in China


Involvement of Cisgender and Transgender Individuals in Studies on the Impact of Hormonal Therapy on COVID-19


Pandemic publishing poses a new COVID-19 challenge


title: Science in crisis

text: Amid the pandemic, a second epidemic of preliminary, unverified and misinterpreted research has broken out, reports Graham Lawton.


title: Estimating the prevalence and risk of COVID-19 among international travelers and evacuees of Wuhan through modeling and case reports

text: Coronavirus disease 2019 (COVID-19) started in Wuhan, China and has spread through other provinces and countries through infected travelers. On January 23rd, 2020, China issued a quarantine and travel ban on Wuhan because travelers from Wuhan were thought to account for the majority of exported COVID-19 cases to other countries. Additionally, countries evacuated their citizens from Wuhan after institution of the travel ban. Together, these two populations account for the vast majority of the "total cases with travel history to China" as designated by the World Health Organization (WHO). The current study aims to assess the prevalence and risk of COVID-19 among international travelers and evacuees of Wuhan. We first used case reports from Japan, Singapore, and Korea to investigate the date of flights of infected travelers. We then used airline traveler data and the number of infected exported cases to correlate the cases with the number of travelers for multiple countries. Our findings suggest that the risk of COVID-19 infection is highest among Wuhan travelers between January 19th and 22nd, 2020, with an approximate infection rate of up to 1.3% among international travelers. We also observed that evacuee infection rates varied heavily between countries and propose that the timing of the evacuation and COVID-19 testing of asymptomatic evacuees played significant roles in the infection rates among evacuees. These findings suggest COVID-19 cases and infectivity are much higher than previous estimates, including numbers from the WHO and the literature, and that some estimates of the infectivity of COVID-19 may need re-assessment.


title: Properties of Coronavirus and SARS-CoV-2

text: were identified beginning with the discovery of SARS-CoV in 2002. With the recent detection of SARS-CoV-2, there are now seven human coronaviruses. Those that cause mild diseases are the 229E, OC43, NL63 and HKU1, and the pathogenic species are SARS-CoV, MERS-CoV and SARS-CoV-2 Coronaviruses (order Nidovirales, family Coronaviridae, and subfamily Orthocoronavirinae) are spherical (125nm diameter), and enveloped with club-shaped spikes on the surface giving the appearance of a solar corona. Within the helically symmetrical nucleocapsid is the large positive sense, single stranded RNA. Of the four coronavirus genera (α,ß,Î³,Î´), human coronaviruses (HCoVs) are classified under α-CoV (HCoV-229E and NL63) and ß-CoV (MERS-CoV, SARS-CoV, HCoVOC43 and HCoV-HKU1). SARS-CoV-2 is a ß-CoV and shows fairly close relatedness with two bat-derived CoV-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. Even so, its genome is similar to that of the typical CoVs. SARS-CoV and MERS-CoV originated in bats, and it appears to be so for SARS-CoV-2 as well. The possibility of an intermediate host facilitating the emergence of the virus in humans has already been shown with civet cats acting as intermediate hosts for SARS-CoVs, and dromedary camels for MERS-CoV. Human-to-human transmission is primarily achieved through close contact of respiratory droplets, direct contact with the infected individuals, or by contact with contaminated objects and surfaces. The coronaviral genome contains four major structural proteins: the spike (S), membrane (M), envelope (E) and the nucleocapsid (N) protein, all of which are encoded within the 3' end of the genome. The S protein mediates attachment of the virus to the host cell surface receptors resulting in fusion and subsequent viral entry. The M protein is the most abundant protein and defines the shape of the viral envelope. The E protein is the smallest of the major structural proteins and participates in viral assembly and budding. The N protein is the only one that binds to the RNA genome and is also involved in viral assembly and budding. Replication of coronaviruses begin with attachment and entry. Attachment of the virus to the host cell is initiated by interactions between the S protein and its specific receptor. Following receptor binding, the virus enters host cell cytosol via cleavage of S protein by a protease enzyme, followed by fusion of the viral and cellular membranes. The next step is the translation of the replicase gene from the virion genomic RNA and then translation and assembly of the viral replicase complexes. Following replication and subgenomic RNA synthesis, encapsidation occurs resulting in the formation of the mature virus. Following assembly, virions are transported to the cell surface in vesicles and released by exocytosis.


title: Caloric restriction reverses left ventricular hypertrophy through the regulation of cardiac iron homeostasis in impaired leptin signaling mice

text: Leptin-deficient and leptin-resistant mice manifest obesity, insulin resistance, and left ventricular hypertrophy (LVH); however, LVH's mechanisms are not fully understood. Cardiac iron dysregulation has been recently implicated in cardiomyopathy. Here we investigated the protective effects of caloric restriction on cardiac remodeling in impaired leptin signaling obese mice. RNA-seq analysis was performed to assess the differential gene expressions in the heart of wild-type and ob/ob mice. In particular, to investigate the roles of caloric restriction on iron homeostasis-related gene expressions, 10-week-old ob/ob and db/db mice were assigned to ad libitum or calorie-restricted diets for 12 weeks. Male ob/ob mice exhibited LVH, cardiac inflammation, and oxidative stress. Using RNA-seq analysis, we identified that an iron uptake-associated gene, transferrin receptor, was upregulated in obese ob/ob mice with LVH. Caloric restriction attenuated myocyte hypertrophy, cardiac inflammation, fibrosis, and oxidative stress in ob/ob and db/db mice. Furthermore, we found that caloric restriction reversed iron homeostasis-related lipocalin 2, divalent metal transporter 1, transferrin receptor, ferritin, ferroportin, and hepcidin expressions in the heart of ob/ob and db/db mice. These findings demonstrate that the cardioprotective effects of caloric restriction result from the cellular regulation of iron homeostasis, thereby decreasing oxidative stress, inflammation, and cardiac remodeling. We suggest that decreasing iron-mediated oxidative stress and inflammation offers new therapeutic approaches for obesity-induced cardiomyopathy.


title: ‘A ticking time bomb’: Scientists worry about coronavirus spread in Africa

text: CAPE TOWN, SOUTH AFRICA—Late on Sunday evening, South African President Cyril Ramaphosa, in a televised address to the nation, declared that COVID-19, the respiratory disease spreading globally, had become a “national disaster ” The declaration allows his government to access special funding and instigate harsh regulations to combat the viral outbreak “Never before in the history of our democracy have we been confronted by such a severe situation,” Ramaphosa said before announcing a raft of measures to curb the virus’ spread, including school closures, travel restrictions, and bans on large gatherings So far, the official numbers seemed to suggest that sub-Saharan Africa, home to more than 1 billion people, had been lucky The interactive map of reported COVID-19 cases run by Johns Hopkins University shows big red blobs almost everywhere—except sub-Saharan Africa


Iran's experience in establishing convalescent care facilities for patients with Covid-19


Can exposure to PM2.5 particles increase the incidence of coronavirus disease 2019 (COVID-19)?


title: Covid-19 epidemic in Italy: evolution, projections and impact of government measures

text: We report on the Covid-19 epidemic in Italy in relation to the extraordinary measures implemented by the Italian Government between the 24th of February and the 12th of March. We analysed the Covid-19 cumulative incidence (CI) using data from the 1st to the 31st of March. We estimated that in Lombardy, the worst hit region in Italy, the observed Covid-19 CI diverged towards values lower than the ones expected in the absence of government measures approximately 7-10 days after the measures implementation. The Covid-19 CI growth rate peaked in Lombardy the 22nd of March and in other regions between the 24th and the 27th of March. The CI growth rate peaked in 87 out of 107 Italian provinces on average 13.6 days after the measures implementation. We projected that the CI growth rate in Lombardy should substantially slow by mid-May 2020. Other regions should follow a similar pattern. Our projections assume that the government measures will remain in place during this period. The evolution of the epidemic in different Italian regions suggests that the earlier the measures were taken in relation to the stage of the epidemic, the lower the total cumulative incidence achieved during this epidemic wave. Our analyses suggest that the government measures slowed and eventually reduced the Covid-19 CI growth where the epidemic had already reached high levels by mid-March (Lombardy, Emilia-Romagna and Veneto) and prevented the rise of the epidemic in regions of central and southern Italy where the epidemic was at an earlier stage in mid-March to reach the high levels already present in northern regions. As several governments indicate that their aim is to "push down" the epidemic curve, the evolution of the epidemic in Italy supports the WHO recommendation that strict containment measures should be introduced as early as possible in the epidemic curve.


docid: xwywuwnt

title: High-profile coronavirus retractions raise concerns about data oversight


Editorial: COVID-19 pandemic: urgent need for action in care homes and senior citizens' homes from a medical-ethics perspective


title: Prevention of exposure and dispersion of COVID-19 using air purifiers: challenges and concerns

text: The outbreak of COVID-19 is now a pandemic. The Korean government has declared the highest infectious-disease alert as a 'red' and the World Health Organization (WHO) has announced the highest level (Phase 6). Control of COVID-19 is an unprecedented worldwide public health problem that governments and individuals must overcome. Recently, infection cluster occurred in a call center located in Seoul. The Ministry of Employment and Labor has decided to support call center companies use the cost of installing partitions, air purifiers, hand sanitizers and masks to prevent droplet and aerosol infections. Air purifiers are expected to be installed on the floor and exhaust stayed on the higher level such as desk or breathing zone of worker. When a worker coughs or releases droplets near a colleague's respiratory system, the droplets can spread throughout the call center space through the air flow. If there is only one infected person, there is a chance that the infection cluster will increase. Installation of air purifiers may cause new problems, so the control to prevent infection should not lead to a new infection. Therefore, using the air purifier to control the COVID-19 should be approached with caution.


title: Prevention of exposure to and spread of COVID-19 using air purifiers: challenges and concerns

text: Coronavirus disease 2019 (COVID-19) is now a pandemic. The Korean government has declared a red alert, which is the highest level of the national infectious disease alert system, and the World Health Organization has similarly declared its highest-level pandemic alert (phase 6). The spread of COVID-19 is an unprecedented worldwide public health problem that governments and individuals must work to overcome. Recently, an infection cluster arose in a call center in Seoul. To support call center companies, the Korean Ministry of Employment and Labor has proposed covering the costs of installing partitions and air purifiers, providing hand sanitizers, and supplying masks to prevent droplet and aerosol infections. Air purifiers are expected to be installed on the floor with the exhaust outlets at a higher level, such as the level of the desks or breathing zones of workers. When a worker coughs or releases droplets near a colleague's respiratory system, the droplets may spread throughout the call center via air flow from air purifier. In this fashion, a single infected person can give rise to an infection cluster. Attempts to prevent infection must not lead to new infections, and the installation of air purifiers may cause new problems. Therefore, using air purifiers to control the spread of COVID-19 should be approached with caution.


Short-term Outcomes in Ambulatory Heart Failure during the COVID-19 Pandemic: Insights from Pulmonary Artery Pressure Monitoring


title: Cyclical lock-down and the economic activity along the pandemic of COVID-19

text: The investigation focuses on an on-off protocol for controlling the COVID-19 widespread. The protocol establishes a working period of 4 days for all the citizens, followed by 8 days of lock-down. We further propose splitting people into smaller groups that undergo the on-off protocol, but shifted in time. This procedure is expected to regularize the overall economic activity. Our results show that either the on-of protocol and the splitting into groups reduces the amount of infected people. However, the latter seems to be better for economic reasons. Our simulations further show that the start-up time is a key issue for the success of the implementation.


title: Characteristics and prognostic factors of disease severity in patients with COVID-19: The Beijing experience

text: COVID-19 has become one of the worst infectious disease outbreaks of recent times, with over 2.1 million cases and 120,000 deaths so far. Our study investigated the demographic, clinical, laboratory and imaging features of 63 patients with COVID-19 in Beijing. Patients were classified into four groups, mild, moderate, severe and critically ill. The mean age of our patients was 47 years of age (range 3-85) and there was a slight male predominance (58.7%). Thirty percent of our patients had severe or critically ill disease, but only 20% of severe and 33% of critically ill patients had been to Wuhan. Fever was the most common presentation (84.1%), but cough was present in only slightly over half of the patients. We found that lymphocyte and eosinophils count were significantly decreased in patients with severe disease (p = 0.001 and p = 0.000, respectively). Eosinopenia was a feature of higher levels of severity. Peripheral CD4+, CD8+ T lymphocytes, and B lymphocytes were significantly decreased in severe and critically ill patients, but there was only a non-statistically significant downward trend in NK cell numbers with severity. Of note is that liver function tests including AST, ALT, GGT and LDH were elevated, and albumin was decreased. The inflammatory markers CRP, ESR and ferritin were elevated in patients with severe disease or worse. IL-6 levels were also higher, indicating that the presence of a hyperimmune inflammatory state portends higher morbidity and mortality. In a binary logistic regression model, C-reactive protein level (OR 1.073, [CI, 1.013-1.136]; p = 0.017), CD8 T lymphocyte counts (OR 0.989, [CI, 0.979-1.000]; p = 0.043), and D-dimer (OR 5.313, [CI, 0.325-86.816]; p = 0.241) were independent predictors of disease severity.


docid: ytqppfwq

title: Persons Evaluated for 2019 Novel Coronavirus - United States, January 2020

text: In December 2019, a cluster of cases of pneumonia emerged in Wuhan City in central China's Hubei Province. Genetic sequencing of isolates obtained from patients with pneumonia identified a novel coronavirus (2019-nCoV) as the etiology (1). As of February 4, 2020, approximately 20,000 confirmed cases had been identified in China and an additional 159 confirmed cases in 23 other countries, including 11 in the United States (2,3). On January 17, CDC and the U.S. Department of Homeland Security's Customs and Border Protection began health screenings at U.S. airports to identify ill travelers returning from Wuhan City (4). CDC activated its Emergency Operations Center on January 21 and formalized a process for inquiries regarding persons suspected of having 2019-nCoV infection (2). As of January 31, 2020, CDC had responded to clinical inquiries from public health officials and health care providers to assist in evaluating approximately 650 persons thought to be at risk for 2019-nCoV infection. Guided by CDC criteria for the evaluation of persons under investigation (PUIs) (5), 210 symptomatic persons were tested for 2019-nCoV; among these persons, 148 (70%) had travel-related risk only, 42 (20%) had close contact with an ill laboratory-confirmed 2019-nCoV patient or PUI, and 18 (9%) had both travel- and contact-related risks. Eleven of these persons had laboratory-confirmed 2019-nCoV infection. Recognizing persons at risk for 2019-nCoV is critical to identifying cases and preventing further transmission. Health care providers should remain vigilant and adhere to recommended infection prevention and control practices when evaluating patients for possible 2019-nCoV infection (6). Providers should consult with their local and state health departments when assessing not only ill travelers from 2019-nCoV-affected countries but also ill persons who have been in close contact with patients with laboratory-confirmed 2019-nCoV infection in the United States.


title: Keeping Journal Club Relevant in a Pandemic: The 'Rapid Fire' 5-Minute Format

text: There has been an explosion of data published in a short period of time about COVID-19. It can be difficult for learners to stay on top of the latest information while also critically appraising each new piece of information. As a result, there can be a lack of local consensus on how to best manage these patients as new data continually becomes available.


Keeping journal club relevant in the COVID-19 pandemic: The 'Rapid Fire' 5-minute format


title: Dashboard of sentiment in Austrian social media during COVID-19

text: To track online emotional expressions of the Austrian population close to real-time during the COVID-19 pandemic, we build a self-updating monitor of emotion dynamics using digital traces from three different data sources. This enables decision makers and the interested public to assess issues such as the attitude towards counter-measures taken during the pandemic and the possible emergence of a (mental) health crisis early on. We use web scraping and API access to retrieve data from the news platform derstandard.at, Twitter and a chat platform for students. We document the technical details of our workflow in order to provide materials for other researchers interested in building a similar tool for different contexts. Automated text analysis allows us to highlight changes of language use during COVID-19 in comparison to a neutral baseline. We use special word clouds to visualize that overall difference. Longitudinally, our time series show spikes in anxiety that can be linked to several events and media reporting. Additionally, we find a marked decrease in anger. The changes last for remarkably long periods of time (up to 12 weeks). We discuss these and more patterns and connect them to the emergence of collective emotions. The interactive dashboard showcasing our data is available online under http://www.mpellert.at/covid19_monitor_austria/. Our work has attracted media attention and is part of an web archive of resources on COVID-19 collected by the Austrian National Library.


Putting resiliency of a health system to the test: COVID-19 in Taiwan


title: COVID-19 vaccine development and the way forward

text: The whole globe is reeling under the COVID-19 pandemic now. With the scale and severity of infection, number of deaths and lack of any definite therapeutic armamentarium, the vaccine development has been accelerated at a never-before pace. A wide variety of vaccine technologies and platforms are being attempted. Out of the over 108 efforts, 100 are in preclinical and eight in Phase 1 or 2 trial stage. While the availability of newer technologies has facilitated development, there are several challenges on the way including limited understanding of the pathophysiology, targeting humoral or mucosal immunity, lack of suitable animal model, poor success of human severe acute respiratory syndrome/Middle East Respiratory Syndrome vaccines, limited efficacy of influenza vaccines, and immune exaggeration with animal coronavirus vaccines. With the current scenario with political, funding, research, and regulatory supports, if everything sails through smoothly, the successful vaccine is expected in 12-18 months. Modestly efficacious vaccine may be also a good achievement.


title: Point-of-Care Lung Ultrasound Findings in Patients with COVID-19 Pneumonia

text: Patients with novel coronavirus disease (COVID-19) typically present with bilateral multilobar ground-glass opacification with a peripheral distribution. The utility of point-of-care ultrasound has been suggested, but detailed descriptions of lung ultrasound findings are not available. We evaluated lung ultrasound findings in 10 patients admitted to the internal medicine ward with COVID-19. All of the patients had characteristic glass rockets with or without the Birolleau variant (white lung). Thick irregular pleural lines and confluent B lines were also present in all of the patients. Five of the 10 patients had small subpleural consolidations. Point-of-care lung ultrasound has multiple advantages, including lack of radiation exposure and repeatability. Also, lung ultrasound has been shown to be more sensitive than a chest radiograph in detecting alveolar-interstitial syndrome. The utilization of lung ultrasound may also reduce exposure of healthcare workers to severe acute respiratory syndrome-coronavirus-2 and may mitigate the shortage of personal protective equipment. Further studies are needed to evaluate the utility of lung ultrasound in the diagnosis and management of COVID-19.


docid: dafuxkbf

title: Recovery from the coronavirus disease-2019 (COVID-19) in two patients with coexisted (HIV) infection


title: Credit migration: Generating generators

text: Markovian credit migration models are a reasonably standard tool nowadays, but there are fundamental difficulties with calibrating them. We show how these are resolved using a simplified form of matrix generator and explain why risk-neutral calibration cannot be done without volatility information. We also show how to use elementary ideas from differential geometry to make general inferences about calibration stability.


title: Network Pharmacology-Based Exploration of Synergistic Mechanism of Guanxin II Formula (II) for Coronary Heart Disease

text: OBJECTIVE: To study the pharmacological mechanism of Guanxin II formula (II) for treatment of coronary heart disease (CHD). METHODS: A network pharmacology-based method was utilized. First candidate compounds, targets of GX II were collected using PharmMapper, BATMAN-TCM, DrugBank and SwissTargetPrediction, and targets on CHD were mined from GeneCards, DisGenet, DrugBank and GEO. Afterwards, the big hub compounds and targets were chosen in the candidate compounds-direct therapeutic targets on the CHD (C-T) network and the direct therapeutic targets on the CHD (T-D) network. Furthermore, the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis were performed to identify the enriched terms. Finally, a molecular docking simulation strategy was adopted to verify the binding capacity between the big hub compounds and big hub targets on CHD. RESULTS: First, 114 candidate compounds were selected with the following criteria: OBâ©¾30%, DLâ©¾0.18, and HL â©¾4 h. Then, 1,035 targets of GX II were gathered, while 928 targets on CHD were collected. Afterwards, 196 common targets of compound targets and therapeutic targets on CHD were defined as direct therapeutic targets acting on CHD. In addition, the contribution index (CI) in the C-T network was calculated, and 4 centrality properties, including degree, betweenness, closeness and coreness, in the T-D network, 4 big hub compounds, and 6 big hub targets were eventually chosen. Furthermore, the GO and KEGG analysis indicated that GX II acted on CHD by regulating the reactive oxygen species metabolism, steroid metabolism, lipid metabolism, inflammatory response, proliferation, differentiation and apoptosis. The docking results manifested excellent binding capacity between the 4 big hub compounds and 6 big hub targets on CHD. CONCLUSION: This network pharmacology-based exploration revealed that GX II might prevent and inhibit the primary pathological processes of CHD.


Urosepsis Increases the Risk of Pulmonary Embolism in Patients Affected by SARS-CoV-2


title: Economic stress, emotional contagion and safety outcomes: A cross-country study

text: BACKGROUND: Economic instability produced by financial crises can increase employment-related (i.e., job insecurity) and income-related (i.e., financial stress) economic stress. While the detrimental impact of job insecurity on safety outcomes has been extensively investigated, no study has examined the concurrent role of financial stress let alone their emotion-related predictors. OBJECTIVE: The present cross-country research sought to identify the simultaneous effects of affective job insecurity and financial stress in predicting employee safety injuries and accidents under-reporting, and to examine the extent to which emotional contagion of positive/negative emotions at work contribute to the level of experienced economic stress. METHODS: We performed multi-group measurement and structural invariance analyses. RESULTS: Data from employees in the U.S. (Nâ=â498) and Italy (Nâ=â366) suggest that financial stress is the primary mediator between emotional contagion and poor safety outcomes. Moreover, greater anger-contagion predicted higher levels of financial strain and job insecurity whereas greater joy-contagion predicted reduced economic stress. CONCLUSIONS: Our findings support the relevance of considering the concurrent role of income-and employment-related stressors as predictors of safety-related outcomes. Theoretical and practical implications for safety are discussed in light of the globally increasing emotional pressure and concerns of income- and employment-related economic stress in today's workplace, particularly given the recent pandemic spread of Corona virus disease (COVID-19).


title: Development and characterization of 20 polymorphic microsatellite markers for the white-bellied pangolin Phataginus tricuspis (Mammalia, Pholidota)

text: Pangolins, or scaly anteaters, have recently been flagshiped as one of the most illegally traded mammals, and as a corollary, as potential intermediate hosts at the origin of the COVID-19 pandemic. In order to improve the traceability of their trade, we developed 20 polymorphic microsatellite loci for the white-bellied pangolin (Phataginus tricuspis), the species most frequently found on African bushmeat markets. We genotyped 24 white-bellied pangolins from the Douala market, Cameroon, originating from the Ebo forest c. 75 km north-east of Douala. The number of alleles per locus ranged from 4 to 12 (mean = 6.95), and mean observed and expected heterozygosities were 0.592 (0.208-0.875) and 0.671 (0.469-0.836), respectively. Genetic diversity was higher than that cross-estimated from microsatellite loci developed for other species of pangolins. Two loci deviated from Hardy-Weinberg equilibrium and two loci showed linkage disequilibrium. Genetic variance (PCoA) was increased with the addition of 13 pangolins of unknown origin, possibly suggesting that the Douala market is fed from differentiated source populations of white-bellied pangolins. Each of the 37 individuals had a unique multilocus genotype. The unbiased probability of identity (uPI) and the probability of identity among siblings (PIsibs) were both very low (uPI = 8.443 e-21; PIsibs = 1.011 e-07). Only five microsatellite loci were needed to reach the conservative value of PIsibs < 0.01, overall indicating a powerful discriminating power of our combined loci. These 20 newly developed microsatellite loci might prove useful in tracing the local-to-global trade of the white-bellied pangolin, and will hopefully contribute to the DNA-assisted implementation of future conservation strategies at reasonable costs.


Use of Chloroquine and Hydroxychloroquine in COVID-19 and Cardiovascular Implications: Understanding Safety Discrepancies to Improve Interpretation and Design of Clinical Trials


title: COVID-19-Associated Miller Fisher Syndrome: MRI Findings

text: Miller Fisher syndrome, also known as Miller Fisher variant of Guillain-Barré syndrome, is an acute peripheral neuropathy that can develop after exposure to various viral, bacterial, and fungal pathogens. It is characterized by a triad of ophthalmoplegia, ataxia, and areflexia. Miller Fisher syndrome has recently been described in the clinical setting of the novel coronavirus disease 2019 (COVID-19) without accompanying imaging. In this case, we report the first presumptive case of COVID-19-associated Miller Fisher syndrome with MR imaging findings.


COVID-19: Defining an invisible enemy within healthcare and the community


title: Coagulopathy of Coronavirus Disease 2019

text: OBJECTIVES: Recent studies have reported a high prevalence of thrombotic events in coronavirus disease 2019. However, the significance of thromboembolic complications has not been widely appreciated. The purpose of this review is to provide current knowledge of this serious problem. DESIGN: Narrative review. DATA SOURCES: Online search of published medical literature through PubMed using the term "COVID-19," "SARS," "acute respiratory distress syndrome," "coronavirus," "coagulopathy," "thrombus," and "anticoagulants." STUDY SELECTION AND DATA EXTRACTION: Articles were chosen for inclusion based on their relevance to coagulopathy and thrombosis in coronavirus disease 2019, and anticoagulant therapy. Reference lists were reviewed to identify additional relevant articles. DATA SYNTHESIS: Coronavirus disease 2019 is associated with a strikingly high prevalence of coagulopathy and venous thromboembolism that may contribute to respiratory deterioration. Monitoring coagulation variables is important, as abnormal coagulation tests are related to adverse outcomes and may necessitate adjuvant antithrombotic interventions. In the initial phase of the infection, D-dimer and fibrinogen levels are increased, while activated partial prothrombin time, prothrombin time, and platelet counts are often relatively normal. Increased D-dimer levels three times the upper limit of normal may trigger screening for venous thromboembolism. In all hospitalized patients, thromboprophylaxis using low-molecular-weight heparin is currently recommended. The etiology of the procoagulant responses is complex and thought to be a result of specific interactions between host defense mechanisms and the coagulation system. Although the coagulopathy is reminiscent of disseminated intravascular coagulation and thrombotic microangiopathy, it has features that are markedly distinct from these entities. CONCLUSIONS: Severe acute respiratory syndrome coronavirus 2/coronavirus disease 2019 frequently induces hypercoagulability with both microangiopathy and local thrombus formation, and a systemic coagulation defect that leads to large vessel thrombosis and major thromboembolic complications, including pulmonary embolism in critically ill hospitalized patients. D-dimers and fibrinogen levels should be monitored, and all hospitalized patients should undergo thromboembolism prophylaxis with an increase in therapeutic anticoagulation in certain clinical situations.


Implementing Emergency Gynecologic Surgery Guidelines during COVID-19


title: Feasibility of a 5G-based robot-assisted remote ultrasound system for cardiopulmonary assessment of COVID-19 patients

text: BACKGROUND: Traditional methods for cardiopulmonary assessment of Coronavirus Disease 2019 (COVID-19) patients pose risks to, both, patients and examiners. This necessitates a remote examination of such patients without sacrificing information quality. RESEARCH QUESTION: Assess the feasibility of a 5G-based robot-assisted remote ultrasound system in examining COVID-19 patients and establish an examination protocol for telerobotic ultrasound scanning. STUDY DESIGN AND METHODS: Twenty-three COVID-19 patients were included and divided into two groups. Twelve were non-severe cases, and 11 were severe cases. All patients underwent a 5G-based robot-assisted remote ultrasound system examination of the lungs and heart following an established protocol. Distribution characteristics and morphology of the lung and surrounding tissue lesions, left ventricular ejection fraction (LVEF), ventricular area ratio, pericardial effusion, and examination-related complications were recorded. Bilateral lung lesions were evaluated by lung ultrasound score (LUS). RESULTS: The remote ultrasound system successfully and safely performed cardiopulmonary examinations of all patients. Peripheral lung lesions were clearly evaluated. Severe cases had significantly more diseased regions [median (interquartile range), 6.0 (2.0-11.0) vs. 1.0 (0.0-2.8)] and higher LUSs [12.0 (4.0-24.0) vs. 2.0 (0.0-4.0)] than non-severe cases (both, P < 0.05 ). One non-severe case (8.3%, 95%CI, 1.5% to 35.4%) and three severe cases (27.3%, 95%CI, 9.7% to 56.6%) were complicated by pleural effusions. Four severe cases (36.4%, 95%CI, 15.2% to 64.6%) were complicated by pericardial effusions (vs 0% of non-severe cases, P < 0.05). No patients had significant examination-related complications. INTERPRETATION: 5G-based robot-assisted remote ultrasound system is feasible, and effectively obtains ultrasound characteristics for cardiopulmonary assessment of COVID-19 patients. By following established protocols and considering medical history, clinical manifestations, and laboratory markers, it might help to evaluate the severity of COVID-19 remotely.


title: Response to "Comments on "Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human" and "Codon bias analysis alone is uninformative for identifying host(s) of new virus"

text: We have recently reported for the first time that SARS-CoV-2 maybe a bat-originated coronavirus with a recombination occurred within the spike (S) protein gene based on phylogenetic and simplot analyses1 . These two conclusions are supported by findings recently reported by others and are well accepted in the field of SARS-CoV-2 research2-4 . This article is protected by copyright. All rights reserved.


'Shielded' anaesthetists and intensivists during the COVID-19 pandemic: a reply


title: SARS-CoV-2 receptor ACE2 gene expression in small intestine correlates with age

text: Gastrointestinal symptoms are common in COVID-19 patients, especially in younger patients. Our hypothesis was that intestinal SARS-CoV-2 receptor ACE2 expression depends on patients' age. We examined duodenal biopsies from 43 healthy human adults. ACE2 gene expression was directly correlated with age (Spearman's r = 0.317, p = 0.039). With each year, duodenal ACE2 expression increased by 0.083 RU. The higher intestinal ACE2 mRNA expression in older patients may impact on their susceptibility to develop intestinal symptoms.


docid: nvlgshlx

title: Science Education in the Era of a Pandemic: How Can History, Philosophy and Sociology of Science Contribute to Education for Understanding and Solving the Covid-19 Crisis?


Gastrointestinal: Bowel ischemia in a suspected coronavirus disease (COVID-19) patient


Examining the need for eye protection for coronavirus disease 2019 (COVID-19) prevention in the community


title: Telehealth as a Bright Spot of the COVID-19 Pandemic: Recommendations From the Virtual Frontlines ("Frontweb")

text: The coronavirus disease (COVID-19) pandemic has accelerated the telehealth tipping point in the practice of family medicine and primary care in the United States, making telehealth not just a novel approach to care but also a necessary one for public health safety. Social distancing requirements and stay-at-home orders have shifted patient care from face-to-face consultations in primary care offices to virtual care from clinicians' homes or offices, moving to a new frontline, which we call the "frontweb." Our telehealth workgroup employed the Clinical Transformation in Technology implementation framework to accelerate telehealth expansion and to develop a consensus document for clinician recommendations in providing remote virtual care during the pandemic. In a few weeks, telehealth went from under 5% of patient visits to almost 93%, while maintaining high levels of patient satisfaction. In this paper, we share clinician recommendations and guidance gleaned from this transition to the frontweb and offer a systematic approach for ensuring "webside" success.


Europe's response to COVID-19 in March and April 2020 - A letter to the editor on "World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)" (Int J Surg 2020;76:71-6)


New device and technique to protect intubation operators against COVID-19


title: Spinal cord injury after the use of ecstasy in a young male

text: INTRODUCTION: Ecstasy is a commonly used party drug and is the second most popular drug after marijuana among youngsters. Serious health hazards have been described including cardiac diseases, neurological complications, multi-organ failure, and even death. Spinal cord injury/dysfunction (SCI/D) is rarely described as a result of ecstasy ingestion. CASE PRESENTATION: We present a case of a 19-year-old male patient who was admitted to our rehabilitation center, after developing a T11 AIS B SCI/D following recreational use of ecstasy. DISCUSSION: In our case magnetic resonance imaging was inconclusive due to artifacts caused by metallic rods used for surgical scoliosis treatment in the past. This individual received no surgical or pharmacological treatments; however, it is questionable whether any specific treatments would have been beneficial. Ecstasy ingestion leads to a serotonin surge and induces microvascular changes. Neurovascular hemorrhage, subarachnoid hemorrhage, de novo aneurysm formation, and subsequent rupture can occur. 5-hydroxytryptamine, which comes from serotonergic terminals, is a very potent vasoconstrictive amine and can thus lead to prolonged vasoconstriction and ischemia. It is most likely that the SCI/D in our case is the result of an ischemic event following the vasoconstrictive effects of ecstasy ingestion. It is important to stress the possible consequences of recreational ecstasy usage and in unexplained SCI/D, one should consider the possibility of drug-related causes.


title: Investigating SARS-CoV-2 surface and air contamination in an acute healthcare setting during the peak of the COVID-19 pandemic in London

text: BACKGROUND: Evaluation of SARS-CoV-2 surface and air contamination during the COVID-19 pandemic in London. METHODS: We performed this prospective cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from seven clinical areas, occupied by patients with COVID-19, and a public area of the hospital. Three or four 1.0 m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected by RT-qPCR and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined. RESULTS: Viral RNA was detected on 114/218 (52.3%) of surfaces and 14/31 (38.7%) air samples but no virus was cultured. The proportion of surface samples contaminated with viral RNA varied by item sampled and by clinical area. Viral RNA was detected on surfaces and in air in public areas of the hospital but was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67/105 (63.8%) vs. 29/64 (45.3%) (odds ratio 0.5, 95% confidence interval 0.2-0.9, p=0.025, Chi squared test)). The high PCR Ct value for all samples (>30) indicated that the virus would not be culturable. CONCLUSIONS: Our findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19, and the need for effective use of PPE, physical distancing, and hand/surface hygiene.


title: COVID-19: a review

text: The enduring epidemic outbreak which started in Wuhan city of China, in December 2019 caused by the 2019 novel coronavirus (COVID- 19) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created a dangerous and deadly Public Health disaster of International apprehension, with cases confirmed in several countries. This novel community health trouble is frightening the universe with clinical, psychological, emotional, collapse of health system and economical slowdown in each and every part of the world infecting nearly 200 countries. A highly virulent and pathogenic COVID-19 viral infection with incubation period ranging from two to fourteen days, transmitted by breathing of infected droplets or contact with infected droplets, belongs to the genus Coronavirus with its high mutation rate in the Coronaviridae. The likely probable primary reservoir could be bats, because genomic analysis discovered that SARSCoV-2 is phylogenetically interrelated to SARS-like bat viruses. The transitional resource of origin and transfer to humans is not known, however, the rapidly developing pandemic has confirmed human to human transfer. Approximately 1,016,128 reported cases, 211,615 recovered cases and 53,069 deaths of COVID-2019 have been reported to date (April 2, 2020). The symptoms vary from asymptomatic, low grade pyrexia, dry cough, sore throat, breathlessness, tiredness, body aches, fatigue, myalgia, nausea, vomiting, diarrhea, to severe consolidation and pneumonia, acute respiratory distress syndrome (ARDS) and multiple organ dysfunction leading to death with case fatality rate ranging from 2 to 3%.


title: Coronavirus disease 2019 and prevalence of chronic liver disease: A meta-analysis

text: At present, there is scarce information regarding the global prevalence of chronic liver disease in individuals with coronavirus disease 2019 (COVID-19) disease, which is becoming a global pandemic. The aim of this study was to assess the overall prevalence of chronic liver disease among patients with COVID-19 disease by meta-analysing data in observational studies and to investigate the relationship between liver damage and COVID-19 disease. We included 11 observational studies for a total of 2034 adult individuals (median age 49 years [IQR 45-54], 57.2% men). The overall prevalence of chronic liver disease at baseline was 3% (95% CI 2%-4%; I2 = 29.1%). Individuals with severe COVID-19 disease had relevant alterations of liver enzymes and coagulative profile, probably due to the innate immune response against the virus. Further studies are needed to better investigate the causes of liver injury in patients with COVID-19 disease and the effect of treatment for COVID-19 on the liver.


title: Potential transmission of SARS-CoV-2 on a flight from Singapore to Hanghzou, China: An epidemiological investigation

text: BACKGROUND: Between January 24, 2020 and February 15, 2020, an outbreak of COVID-19 occurred among 335 passengers on a flight from Singapore to Hangzhou in China. This study aimed to investigate the source of the outbreak and assess the risk of transmission of COVID-19 during the flight. METHOD: Using a standardized questionnaire, we collected information on the travelers' demographic characteristics and illness before, during, and after the flight. We also collected data on factors potentially associated with COVID-19 transmission during the flight. RESULTS: A total of 16 COVID-19 patients were diagnosed among all passengers; the overall attack rate was 4.8%. The attack rate among passengers who had departed from Wuhan was significantly higher than that among those who had departed from other places. One passenger without an epidemiological history of exposure before boarding developed COVID-19. During the flight, he was seated near four infected passengers from Wuhan for approximately an hour and did not wear his facemask correctly during the flight. CONCLUSIONS: COVID-19 transmission may have occurred during the flight. However, the majority of the cases in the flight-associated outbreak could not be attributed to transmission on the flight but were associated with exposure to the virus in Wuhan or to infected members in a single tour group.


[Forhøjet D-dimer og karakteristiske billeddiagnostiske fund hos patient med COVID-19]


COVID-19 as a trigger of acute chest syndrome in a pregnant woman with sickle cell anemia


title: The profile of peripheral blood lymphocyte subsets and serum cytokines in children with 2019 novel coronavirus pneumonia

text: OBJECTIVES: The study was aimed at investigating the characteristics of peripheral blood lymphocyte subsets and serum cytokines in children with 2019 novel coronavirus (2019-nCoV) pneumonia. METHODS: Children with 2019-nCoV pneumonia or with respiratory syncytial virus (RSV) pneumonia were included. Data including lymphocyte subsets and serum cytokines were collected and analyzed. RESULTS: 56 patients were included in the study, 40 children with 2019-nCoV pneumonia and 16 children with RSV pneumonia. Compared with children with RSV pneumonia, patients with 2019-nCoV pneumonia had higher count of CD3+8+ lymphocyte, higher percentages of CD3+, CD3+8+ lymphocytes and a lower percentage of CD19+ lymphocyte. The serum IL-10 level was significantly higher in children with RSV pneumonia. One 2019-nCoV pneumonia child who was with an obvious increase of IL-10 developed severe pneumonia. CONCLUSIONS: Immune response played a very important role in the development of 2019-nCoV pneumonia. The effective CD8+ T cell response might influence the severity of 2019-nCoV pneumonia. The adaptable change in IL-10 level might contribute to the relatively mild pneumonia symptoms in children with 2019-nCoV pneumonia and bacterial co-infection might be a risk factor of severe 2019-nCoV pneumonia.


COVID-19 pandemic: perspectives on an unfolding crisis


title: Uso do ozônio no tratamento da endometritis em éguas: relato de casos/ Use of ozone therapy as treatment of endometritis in mares: case report/ Utilizacion de ozono en el tratamiento de endometritis en yeguas: reporte de casos

text: A endometrite persistente é uma das principais causas de subfertilidade nas éguas, interferindo negativamente na reprodução equina. Muitas vezes, a endometrite ocorre como consequência de uma falha nos mecanismos de defesa uterina, gerando problemas na eliminação de antígenos e produtos inflamatórios presentes no ambiente uterino. A ozonioterapia é uma das terapias existentes para o tratamento desta doença, e seu uso tem aumentado em medicina veterinária. O presente estudo avaliou oito éguas em período cíclico, com endometrite persistente. Um tratamento com ozônio intrauterino persistiu por dois dias. A partir dos dados obtidos no presente estudo, a terapia com ozônio parece ser uma técnica efetiva e promissora na reprodução equina, atuando de maneira efetiva em infecções bacterianas uterinas e condições inflamatórias.(AU)


title: Awake vs. asleep motor mapping for glioma resection: a systematic review and meta-analysis

text: BACKGROUND: Intraoperative stimulation (IS) mapping has become the preferred standard treatment for eloquent tumors as it permits a more accurate identification of functional areas, allowing surgeons to achieve higher extents of resection (EOR) and decrease postoperative morbidity. For lesions adjacent to the perirolandic area and descending motor tracts, mapping can be done with both awake craniotomy (AC) and under general anesthesia (GA). OBJECTIVE: We aimed to determine which anesthetic protocol-AC vs. GA-provides better patient outcomes by comparing EOR and postoperative morbidity for surgeries using IS mapping in gliomas located near or in motor areas of the brain. METHODS: A systematic literature search was carried out to identify relevant studies from 1983 to 2019. Seven databases were screened. A total of 2351 glioma patients from 17 studies were analyzed. RESULTS: A random-effects meta-analysis revealed a trend towards a higher mean EOR in AC [90.1% (95% C.I. 85.8-93.8)] than with GA [81.7% (95% C.I. 72.4-89.7)] (p = 0.06). Neurological deficits were divided by timing and severity for analysis. There was no significant difference in early neurological deficits [20.9% (95% C.I. 4.1-45.0) vs. 25.4% (95% C.I. 13.6-39.2)] (p = 0.74), late neurological deficits [17.1% (95% C.I. 0.0-50.0) vs. 3.8% (95% C.I. 1.1-7.6)] (p = 0.06), or in non-severe [28.4% (95% C.I. 0.0-88.5) vs. 20.1% (95% C.I. 7.1-32.2)] (p = 0.72), and severe morbidity [2.6% (95% C.I. 0.0-15.5) vs. 4.5% (95% C.I. 1.1-9.6)] (p = 0.89) between patients who underwent AC versus GA, respectively. CONCLUSION: Mapping during resection of gliomas located in or near the perirolandic area and descending motor tracts can be safely carried out with both AC and GA.


title: Coagulopathy in COVID-19

text: The COVID-19 pandemic has become an urgent issue in every country. Based on recent reports, the most severely ill patients present with coagulopathy, and disseminated intravascular coagulation (DIC)-like massive intravascular clot formation is frequently seen in this cohort. Therefore, coagulation tests may be considered useful to discriminate severe cases of COVID-19. The clinical presentation of COVID-19-associated coagulopathy is organ dysfunction primarily, while hemorrhagic events are less frequent. Changes in hemostatic biomarkers represented by increase in D-dimer and fibrin/fibrinogen degradation products indicate the essence of coagulopathy is massive fibrin formation. In comparison with bacterial-sepsis-associated coagulopathy/DIC, prolongation of prothrombin time, and activated partial thromboplastin time, and decrease in antithrombin activity is less frequent and thrombocytopenia is relatively uncommon in COVID-19. The mechanisms of the coagulopathy are not fully elucidated, however. It is speculated that the dysregulated immune responses orchestrated by inflammatory cytokines, lymphocyte cell-death, hypoxia, and endothelial damage are involved. Bleeding tendency is uncommon, but the incidence of thrombosis in COVID-19 and the adequacy of current recommendations regarding standard venous thromboembolic dosing are uncertain.


Covid-19: Review of ethnic disparities is labelled "whitewash" for lack of recommendations


Especial COVID-19


Mental health of people living with dementia in care homes during COVID-19 pandemic


title: Clinical Decision Making in Older Adults with Covid-19 in Developing Countries: Looking beyond Chronological Age

text: Background: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic. Older adults have been found as a vulnerable group for developing severe forms of disease and increased mortality. Objective: The objective of the study was to propose a pathway to assist the decision-making process for hospital resource allocation for older adults with COVID-19 using simple geriatric assessment-based tools. Methods: We reviewed the available literature at this point of the COVID-19 outbreak, focusing in older adult care to extract key recommendations for those health-care professionals who will be treating older adults in the hospital emergency ward (HEW) in developing countries during the COVID-19 pandemic. Results: We listed a series of easy recommendations for non-geriatrician doctors in the HEW and suggested simple tools for hospital resource allocation during critical care evaluation of older adults with COVID-19 in low- and middle-income countries. Conclusions: Age must not be used as the sole criterion for resource allocation among older adults with COVID-19. Simple and efficient tools are available to identify components of the comprehensive geriatric assessment, which could be useful to predict outcomes and provide high-quality care that would fit the particular needs of older adults in resource-limited settings amidst this global pandemic.


Covid-19: NICE advises against using NSAIDs for fever in patients with suspected cases


Utilizing tocilizumab for the treatment of cytokine release syndrome in COVID-19


Anticardiolipin antibodies and COVID-19-A case report from America


title: Experiencia COVID-19 en un sanatorio privado de Buenos Aires durante el primer mes de la pandemia: 26 casos./ [COVID-19 experience in a private institution in Buenos Aires during the first month of the pandemic: 26 cases]

text: The first case of coronavirus (COVID-19) infection in Argentina was reported in Buenos Aires on March 3rd, 2020, in a patient who arrived from Milan. The aim of this study is to describe the clinical characteristics and course of illness of patients infected with Covid-19 that were hospitalized in a private clinical setting during March 2020. Sixty three patients suspected of COVID-19 infection, were admitted to our hospital during March 2020. Twenty six of these subjects were diagnosed positive by the RT-PCR for SARS Cov-2 in a nasopharyngeal swab specimen. We recorded data about epidemiological characteristics, clinical signs and symptoms, in addition to comorbidities, laboratory and radiological studies were done. The median age was 40 years (SD ± 15 years); there was an equal number of men and women; all the patients but one were coming from abroad; the most common symptom was fever (24/26 cases) and lymphopenia (n = 8). We found that there were patients in whom fever disappeared within the first 72h (n = 17) and another group in which the fever lasted six or more days (n = 7). One patient out of 26 died. The population of our study was young and almost all were imported cases, in alinement with the stage of the epidemic at the time when the study was conducted. We observed that there were two patterns in the fever curve but the persistence of it did not lead to a worse prognosis. Larger population studies are required in order to confirm these clinical findings.


COVID-19-Future of dentistry


title: Biochanin A, the Most Potent of 16 Isoflavones, Induces Relaxation of the Coronary Artery Through the Calcium Channel and cGMP-dependent Pathway

text: The dietary intake of flavonoids seems to be inversely related to cardiovascular mortality. The consumption of isoflavonoids is increasing in the general population, especially due to the use of food supplements and a variety of isoflavonoid-rich foods. However, detailed studies on the vascular influence of individual pure isoflavonoids are mostly missing. For this study, 16 isoflavonoids were initially screened for their vasorelaxant properties on rat aortas. The 2 most potent of them, biochanin A and glycitein, were further tested for the mechanism of action on porcine coronary arteries. They both induced an endothelium independent vascular relaxation, with EC50 below 6 and 17 µM, respectively. Biochanin A, but not glycitein, was able to block the vasoconstriction caused by KCl, CaCl2, serotonin, and U46619 in a dose-dependent manner. Another series of experiments suggested that the major mechanism of action of biochanin A was the inhibition of L-type calcium channels. Moreover, biochanin A in relatively small concentrations (2â-â4 µM) interfered with the cGMP, but not cAMP, pathway in isolated coronary arteries. These results indicate that some isoflavonoids, in particular biochanin A, are able to have vasodilatory effects in micromolar concentrations, which is of potential clinical interest for the management of cardiovascular pathologies.


COVID-19 and Autism Research: Perspectives from Around the Globe


The Evolving COVID-19 Pandemic: An Update


The Potential Dangers of Artificial Intelligence for Radiology and Radiologists


title: Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics

text: The objective of this Personal View is to compare transmissibility, hospitalisation, and mortality rates for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with those of other epidemic coronaviruses, such as severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), and pandemic influenza viruses. The basic reproductive rate (R0) for SARS-CoV-2 is estimated to be 2·5 (range 1·8-3·6) compared with 2·0-3·0 for SARS-CoV and the 1918 influenza pandemic, 0·9 for MERS-CoV, and 1·5 for the 2009 influenza pandemic. SARS-CoV-2 causes mild or asymptomatic disease in most cases; however, severe to critical illness occurs in a small proportion of infected individuals, with the highest rate seen in people older than 70 years. The measured case fatality rate varies between countries, probably because of differences in testing strategies. Population-based mortality estimates vary widely across Europe, ranging from zero to high. Numbers from the first affected region in Italy, Lombardy, show an all age mortality rate of 154 per 100â000 population. Differences are most likely due to varying demographic structures, among other factors. However, this new virus has a focal dissemination; therefore, some areas have a higher disease burden and are affected more than others for reasons that are still not understood. Nevertheless, early introduction of strict physical distancing and hygiene measures have proven effective in sharply reducing R0 and associated mortality and could in part explain the geographical differences.


title: A Formal Critique of the Value of the Colombian P\'aramo

text: This article presents conceptual and methodological frameworks to prioritise interventions on the Colombian P\'aramo. The mode of analysis that our work takes up is that of questioning value and related categories as definite empirically perceived phenomena. We contend that the valuation of ecosystem services -- even in its post-normal forms -- and the ecosystem services framework not only fail to examine value-based categories, but reproduce the problematic aspects of value-based social relations, which ultimately bear on the ecological issues affecting the P\'aramo. Upon this premise we set out to formalise a (computational) dialogical scenario where arguments stating distinct, and often contradictory, actions delineate possible forms of appropriating the P\'aramo, while motivating the examination of their defining sociality.


Lockdown diary of an ophthalmologist: Nineteen tips for unlocking your life during the ongoing COVID-19 pandemic


title: Environmental concern regarding the effect of humidity and temperature on 2019-nCoV survival: fact or fiction

text: The new coronavirus, called 2019-nCoV, is a new type of virus that was first identified in Wuhan, China, in December 2019. Environmental conditions necessary for survival and spread of 2019-nCoV are somewhat transparent but unlike animal coronaviruses. We are poorly aware of their survival in environment and precise factors of their transmission. Countries located in east and west of globe did not have a significant impact on prevalence of disease among communities, and on the other hand, north and south have provided a model for relative prediction of disease outbreaks. The 2019-nCoV can survive for up to 9 days at 25 °C, and if this temperature rises to 30 °C, its lifespan will be shorter. The 2019-nCoV is sensitive to humidity, and lifespan of viruses in 50% humidity is longer than that of 30%. Also, temperature and humidity are important factors influencing the COVID-19 mortality rate and may facilitate 2019-nCoV transmission. Thus, considering the available and recent evidence, it seems that low temperatures, as well as dry and unventilated air, may affect stability and transmissibility of 2019-nCoV.


Remdesivir and Potential Interactions With Psychotropic Medications: A COVID-19 Perspective


Exposure and seroconversion to severe acute respiratory syndrome coronavirus 2 among obstetrical healthcare providers following a contained outbreak


BES announce new COVID-19 research grant


title: Airborne transmission of severe acute respiratory syndrome coronavirus-2 to healthcare workers: a narrative review

text: Healthcare workers are at risk of infection during the severe acute respiratory syndrome coronavirus-2 pandemic. International guidance suggests direct droplet transmission is likely and airborne transmission occurs only with aerosol-generating procedures. Recommendations determining infection control measures to ensure healthcare worker safety follow these presumptions. Three mechanisms have been described for the production of smaller sized respiratory particles ('aerosols') that, if inhaled, can deposit in the distal airways. These include: laryngeal activity such as talking and coughing; high velocity gas flow; and cyclical opening and closure of terminal airways. Sneezing and coughing are effective aerosol generators, but all forms of expiration produce particles across a range of sizes. The 5-µm diameter threshold used to differentiate droplet from airborne is an over-simplification of multiple complex, poorly understood biological and physical variables. The evidence defining aerosol-generating procedures comes largely from low-quality case and cohort studies where the exact mode of transmission is unknown as aerosol production was never quantified. We propose that transmission is associated with time in proximity to severe acute respiratory syndrome coronavirus-1 patients with respiratory symptoms, rather than the procedures per se. There is no proven relation between any aerosol-generating procedure with airborne viral content with the exception of bronchoscopy and suctioning. The mechanism for severe acute respiratory syndrome coronavirus-2 transmission is unknown but the evidence suggestive of airborne spread is growing. We speculate that infected patients who cough, have high work of breathing, increased closing capacity and altered respiratory tract lining fluid will be significant producers of pathogenic aerosols. We suggest several aerosol-generating procedures may in fact result in less pathogen aerosolisation than a dyspnoeic and coughing patient. Healthcare workers should appraise the current evidence regarding transmission and apply this to the local infection prevalence. Measures to mitigate airborne transmission should be employed at times of risk. However, the mechanisms and risk factors for transmission are largely unconfirmed. Whilst awaiting robust evidence, a precautionary approach should be considered to assure healthcare worker safety.


docid: gnonmisd

title: Risk of SARS-CoV-2 infection among contacts of individuals with COVID-19 in Hangzhou, China

text: OBJECTIVES: This study determined the rate of secondary infection among contacts of individuals with confirmed coronavirus disease 2019 (COVID-19) in Hangzhou according to the type of contacts, the intensity of contacts, and their relationship with the index patient. STUDY DESIGN: This is a retrospective cohort study. METHODS: The analysis used the data of 2994 contacts of 144 individuals with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The contacts were categorized according to the information source, type of contact, location, intensity of contact, and relationship with the index patient. RESULTS: The incidence of infection differed significantly according to contact type. Of the contacts, 186 (6.2%) developed symptoms, and 71 (2.4%) had confirmed SARS-CoV-2 infection. The main symptoms were cough and fever. Compared with those who had brief contact with the index case, those who had dined with the index case had 2.6 times higher risk of acquiring infection; those who had shared transport with, had visited, or had contact with the index case in a medical institution had 3.6 times higher risk of acquiring infection; and household contacts had 41.7 times higher risk of acquiring infection. Family members had 31.6 times higher risk of acquiring infection than healthcare providers or other patients exposed to an index case. CONCLUSIONS: The form and frequency of contact are the main factors affecting the risk of infection among contacts of individuals with COVID-19. Centralized isolation and observation of close contacts of individuals with confirmed SARS-CoV-2 infection, in addition to population-based control measures, can reduce the risk of secondary infections and curb the spread of the infection.


Severe Acute Respiratory Syndrome Coronavirus-2 Cardiovascular Complications: Implications for Cardiothoracic Anesthesiology


title: Multidisciplinary guidance for safe tracheostomy care during the COVID-19 pandemic: the NHS National Patient Safety Improvement Programme (NatPatSIP)

text: The COVID-19 pandemic is causing a significant increase in the number of patients requiring relatively prolonged invasive mechanical ventilation and an associated surge in patients who need a tracheostomy to facilitate weaning from respiratory support. In parallel, there has been a global increase in guidance from professional bodies representing staff who care for patients with tracheostomies at different points in their acute hospital journey, rehabilitation and recovery. Of concern are the risks to healthcare staff of infection arising from tracheostomy insertion and caring for patients with a tracheostomy. Hospitals are also facing extraordinary demands on critical care services such that many patients who require a tracheostomy will be managed outside established intensive care or head and neck units and cared for by staff with little tracheostomy experience. These concerns led NHS England and NHS Improvement to expedite the National Patient Safety Improvement Programme's 'Safe Tracheostomy Care' workstream as part of the NHS COVID-19 response. Supporting this workstream, UK stakeholder organisations involved in tracheostomy care were invited to develop consensus guidance based on: expert opinion; the best available published literature; and existing multidisciplinary guidelines. Topics with direct relevance for frontline staff were identified. This consensus guidance includes: infectivity of patients with respect to tracheostomy indications and timing; aerosol-generating procedures and risks to staff; insertion procedures; and management following tracheostomy.


Why Italian ENT physicians should be aware of SARS-CoV-2


Artificial intelligence in diagnosis and management of COVID-19 in dermatology


COVID-19-related information sources and psychological well-being: An online survey study in Taiwan


title: Successful treatment of COVID-19 using extracorporeal membrane oxygenation, a case report

text: Since the end of 2019, COVID-19 has been prevalent in Wuhan, China, and has been rapidly spreading to mainland China. Currently, more than 80,000 people have been infected, of which over 10,000 were severely ill and had characteristics of dyspnea and hypoxemia about one week after onset. Severe patients had rapidly progressed to acute respiratory distress syndrome (ARDS), causing multiple organ failures and even death, with a mortality rate of nearly 4.3%. The treatment of severe COVID-19 patients has been rarely reported. This study reported a successful example of a severe COVID-19 patient with extracorporeal membrane oxygenation (ECMO) technology in our hospital. This experience revealed that the early application of ECMO can dramatically promote the recovery of severe COVID-19 patients.


title: [Transmission routes of 2019-novel coronavirus (2019-nCoV)]

text: Since the outbreak of COVID-19 in Wuhan, China, at the end of 2019, it has demonstrated China's ability to identify unknown pathogens. At present, reports showed that the main transmission routes are respiratory droplets and indirect contact, other vertical transmission routes have yet to be confirmed. This review discusses the possible transmission routes of 2019-novel coronavirus (2019-nCoV), based on currently research, the main transmission routes are respiratory droplets and indirect contact, fecal-oral might bepossible, while aerosol, tear (conjunctival) and mother-to-fetus still have yet to be confirmed, providing a reference basis for 2019-nCoV prevention and control and public protection.


COVID-19 patients exhibit less pronounced immune suppression compared with bacterial septic shock patients


title: [Discovery of intervention effect of Chinese herbal formulas on COVID-19 pulmonary fibrosis treated by VEGFR and FGFR inhibitors]

text: Since February 2020, a large number of patients infected with new coronavirus has been cured and discharged with the controlling of epidemic. Pulmonary fibrosis, which may be one of the sequela caused by COVID-19, not only brings dyspnea and deterioration of lung function, but also affects patients' life because of its high mortality and poor prognosis. Vascular endothelial growth factor receptor(VEGFR) and fibroblast growth factor receptor(FGFR) can inhibit the proliferation, activation and migration of fibroblasts by regulating the signal transduction pathway involved in the process of pulmonary fibrosis. Chinese herbal formulas pose a good therapeutic effect on pulmonary fibrosis. Present study explores the intervention effect on pulmonary fibrosis of traditional Chinese medicine(TCM) by screening the potential inhibitors of VEGFR and FGFR. The docking models of VEGFR and FGFR were established to obtain the potential active ingredients which were filtered by the docking score. According to 2 prescriptions in the Protocol for the diagnosis and treatment of coronavirus disease 2019(7th edition)and 9 prescriptions in Traditional Chinese medicine prescriptions for treating blight, 959 and 1 047 potential ingredients were obtained as the inhibitors of VEGFR and FGFR respectively with the screening thres-hold set as eighty percent of the docking score of the initial ligands. The potential herbs were then filtered by the components with a hit rate higher than 30%, such as Scutellariae Radix, Adenophorae Radix, Pinelliae Rhizoma, Coicis Semen, etc. To discuss the rule of TCM in the treatment of pulmonary fibrosis, the networks of TCM-channel tropism and TCM-efficacy of the potential herbs was constructed. The potential herbs for treating pulmonary fibrosis mostly belong to lung(degree=14) and spleen(degree value=8), and the efficacy is focused on reinforcing deficiency(degree=9). Qiyin Prescription and Buzhong Yiqi Decoction contain the largest number of the potential herbs. The main symptom of COVID-19 is damp-heat stagnating in the lung, which always causes impairment of body fluid and Qi. Clinical observation shows that patients in the recovery period are mostly at the status that the remaining virus toxicity is not exhausted while the vital Qi have not recovered. The results of this study are expected to provide references for clinical medication in preventing and treating pulmonary fibrosis caused by COVID-19.


docid: hxdwodoq

title: Coronavirus lockdown effect on type 1 diabetes management οn children wearing insulin pump equipped with continuous glucose monitoring system

text: AIMS: On the 10th of March, Greece imposed the closure of schools and universities and a full lockdown a few days later in order to counter the spread of the coronavirus outbreak. Our aim was to monitor the effect of the coronavirus lockdown in diabetes management in children with Type 1 Diabetes Mellitus (T1DM) wearing insulin pump equipped with continuous glucose monitoring system. METHODS: In 34 children with T1DM on Medtronic 640G insulin pump equipped with the Enlite Sensor uploaded CareLink data were categorized in 2 three-week periods before and after the 10th of March. RESULTS: Mean time in range (TIR) did not significantly differ between the two periods. However, a significantly higher Coefficient of Variation (CV) indicating an increased glucose variability in the pre-lockdown period was observed (39.52% versus 37.40%, p=0.011). Blood glucose readings were significantly fewer during the lockdown period (7.91 versus 7.41, p=0.001). No significant difference was recorded regarding the total daily dose of insulin and the reported carbohydrates consumed. However, the meal schedule has changed dramatically as the percentage of breakfast consumed before 10.00 a.m. has fallen from 80.67 % to 41.46 % (p<0.001) during the lockdown. Correspondingly, the percentage of dinner consumption before 10.00 p.m. significantly fell during the lockdown period (60.22 % versus 53.78 %, p=0.019). CONCLUSIONS: Glycemic control during the coronavirus lockdown can be adequately achieved and be comparable to the pre-lockdown period in children with type 1 diabetes mellitus wearing insulin pump equipped with sensor.


COVID-19 mimicking dengue fever with the initial manifestation of retro-orbital pain - A Rare Case


How Indigenous people are coping with COVID-19


title: Broad-Spectrum Host-Based Antivirals Targeting the Interferon and Lipogenesis Pathways as Potential Treatment Options for the Pandemic Coronavirus Disease 2019 (COVID-19)

text: The ongoing Coronavirus Disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) signals an urgent need for an expansion in treatment options. In this study, we investigated the anti-SARS-CoV-2 activities of 22 antiviral agents with known broad-spectrum antiviral activities against coronaviruses and/or other viruses. They were first evaluated in our primary screening in VeroE6 cells and then the most potent anti-SARS-CoV-2 antiviral agents were further evaluated using viral antigen expression, viral load reduction, and plaque reduction assays. In addition to remdesivir, lopinavir, and chloroquine, our primary screening additionally identified types I and II recombinant interferons, 25-hydroxycholesterol, and AM580 as the most potent anti-SARS-CoV-2 agents among the 22 antiviral agents. Betaferon (interferon-ß1b) exhibited the most potent anti-SARS-CoV-2 activity in viral antigen expression, viral load reduction, and plaque reduction assays among the recombinant interferons. The lipogenesis modulators 25-hydroxycholesterol and AM580 exhibited EC50 at low micromolar levels and selectivity indices of >10.0. Combinational use of these host-based antiviral agents with virus-based antivirals to target different processes of the SARS-CoV-2 replication cycle should be evaluated in animal models and/or clinical trials.


Comorbid Medical Conditions in Young Athletes: Considerations for Preparticipation Guidance During the COVID-19 Pandemic


Glycemic control of type 2 diabetic patients with coronavirus disease during hospitalization: a proposal for early insulin therapy


title: COVID-19: What have we learnt, and plan for the future

text: Coronavirus disease (COVID-19) has spread like wildfire and affected almost every stratum of society. It has brought humans together and taught us to have compassion and collaboration among individuals, governments and organisations. Adequate protection of healthcare workers who are at the frontline must be taken care of. Good hygiene and social distancing go a long way in controlling an epidemic. We must strive towards building more balanced and sustainable models and healthcare systems in the future as we try to successfully emerge from this outbreak.


title: Social and psychological consequences of the COVID-19 pandemic in African-American communities: Lessons from Michigan

text: The mental health consequences of the COVID-19 pandemic are particularly relevant in African-American communities because African-Americans have been disproportionately impacted by the disease, yet they are traditionally less engaged in mental health treatment compared with other racial groups. Using the state of Michigan as an example, we describe the social and psychological consequences of the pandemic on African-American communities in the United States, highlighting community members' concerns about contracting the disease, fears of racial bias in testing and treatment, experiences of sustained grief and loss, and retraumatization of already-traumatized communities. Furthermore, we describe the multilevel, community-wide approaches that have been used thus far to mitigate adverse mental health outcomes within our local African-American communities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Concerns for low-resource countries, with under-prepared intensive care units, facing the COVID-19 pandemic

text: BACKGROUND: Low-resource countries with fragile healthcare systems lack trained healthcare professionals and specialized resources for COVID-19 patient hospitalization, including mechanical ventilators. Additional socio-economic complications such as civil war and financial crisis in Libya and other low-resource countries further complicate healthcare delivery. METHODS: A cross-sectional survey evaluating hospital and intensive care unit's capacity and readiness was performed from 16 leading Libyan hospitals in March 2020. In addition, a survey was conducted among 400 doctors who worked in these hospitals to evaluate the status of personal protective equipment. RESULTS: Out of 16 hospitals, the highest hospital capacity was 1000 in-patient beds, while the lowest was 25 beds with a median of 200 (IQR 52-417, range 25-1000) hospital beds. However, a median of only eight (IQR 6-14, range 3-37) available functioning ICU beds were reported in these hospitals. Only 9 (IQR 4.5-14, range 2-20) mechanical ventilators were reported and none of the hospitals had a reverse transcription-polymerase chain reaction machine for COVID-19 testing. Moreover, they relied on one of two central laboratories located in major cities. Our PPE survey revealed that 56.7% hospitals lacked PPE and 53% of healthcare workers reported that they did not receive proper PPE training. In addition, 70% reported that they were buying the PPE themselves as hospitals did not provide them. CONCLUSION: This study provides an alarming overview of the unpreparedness of Libyan hospitals for detecting and treating patients with COVID-19 and limiting the spread of the pandemic.


title: A crisis within the crisis: The mental health situation of refugees in the world during the 2019 coronavirus (2019-nCoV) outbreak

text: BACKGROUND: 68.5 million people around the world have been forced to leave their houses. Refugees have mainly to face their adaption in a host country, which involves bureaucracy, different culture, poverty, and racism. The already fragile situation of refugees becomes worrying and challenged in the face of the new coronavirus (COVID-19) epidemic. Therefore, we aimed to describe the factors that can worsen the mental health of refugees. METHOD: The studies were identified in well-known international journals found in three electronic databases: PubMed, Scopus, and Embase. The data were cross-checked with information from the main international newspapers. RESULTS: According to the literature, the difficulties faced by refugees with the COVID-19 pandemic are potentiated by the pandemic state. There are several risk factors common to coronavirus and psychiatric illnesses as overcrowding, disruption of sewage disposal, poor standards of hygiene, poor nutrition, negligible sanitation, lack of access to shelter, health care, public services, and safety. These associated with fear and uncertainty create a closed ground for psychological sickness and COVID-19 infection. CONCLUSIONS: There should be not only a social mobilization to contain the virus, but also a collective effort on behalf of the most vulnerable populations.


Staying Active in Isolation: Telerehabilitation for Individuals With the Severe Acute Respiratory Syndrome Coronavirus 2 Infection


title: American Association of Hip and Knee Surgeons Advocacy Efforts in Response to the SARS-CoV-2 Pandemic

text: As soon as it became clear that our economy was going to be paralyzed by the SARS-CoV-2 pandemic, the American Association of Hip and Knee Surgeons leadership acted swiftly to ensure that our members were going to be eligible for the anticipated federal economic stimulus. The cessation of elective surgery, enacted in mid-March and necessary to stop the spread of the SARS-CoV-2 virus, would surely challenge the solvency of many of our members' practices. Although our advocacy efforts discussed further have helped, clearly more relief is needed. Fortunately, our mitigation efforts have led to a "flattening of the curve" and discussions have begun on when, where, and how to safely start elective surgery again.


Plausibility of therapeutic effects of Rho kinase inhibitors against Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19)


title: Inpatient Dermatology Consultations during Covid 19 Pandemic in a Tertiary Referral Center

text: Since the COVID-19 infection first appeared in December 2019, patient profile of outpatient and inpatient clinics have changed. Various cutaneous findings associated with COVID-19 have been reported in the literature. The main objective of this study was to describe and analyze the profile of the consultations requested from dermatology department during the COVID pandemic. Retrospective, cohort study In this study we observed the dermatology consultations of the hospitalized patients over a period of 2 months, corresponding to the peak of COVID outbreak in a tertiary care hospital in Turkey. We reviewed the inpatient dermatology consult database retrospectively. Both pediatric and adult dermatology inpatient consultations were evaluated. A total of 166 inpatient dermatology consultations were requested from dermatology department during March-May, 2020. The mean age of the patients was 53,12 (1-89) years. Almost 32,5% (n = 54) of dermatology consultations were requested from the COVID wards and the COVID intensive care unit. The second most common consultations were requested from internal medicine departments (n = 46, 27,7%). The most common indications for the consultations were cutaneous infections (36%), followed by inflammatory disorders (32%), and urticaria (11%). Dermatology consultations have an essential role on the management of hospitalized patients, especially at that pandemic time. Careful dermatological examination improves diagnostic accuracy in skin disorders and skin manifestations of COVID-19 infection that provides an early diagnosis and treatment, helps to improve the quality of the patient care and management. This article is protected by copyright. All rights reserved.


title: A Case of Novel Coronavirus Disease 19 in a Chronic Hemodialysis Patient Presenting with Gastroenteritis and Developing Severe Pulmonary Disease

text: Novel coronavirus disease 2019 (COVID-19) is a highly infectious, rapidly spreading viral disease with an alarming case fatality rate up to 5%. The risk factors for severe presentations are concentrated in patients with chronic kidney disease, particularly patients with end-stage renal disease (ESRD) who are dialysis dependent. We report the first US case of a 56-year-old nondiabetic male with ESRD secondary to IgA nephropathy undergoing thrice-weekly maintenance hemodialysis for 3 years, who developed COVID-19 infection. He has hypertension controlled with angiotensin receptor blocker losartan 100 mg/day and coronary artery disease status-post stent placement. During the first 5 days of his febrile disease, he presented to an urgent care, 3 emergency rooms, 1 cardiology clinic, and 2 dialysis centers in California and Utah. During this interval, he reported nausea, vomiting, diarrhea, and low-grade fevers but was not suspected of COVID-19 infection until he developed respiratory symptoms and was admitted to the hospital. Imaging studies upon admission were consistent with bilateral interstitial pneumonia. He was placed in droplet-eye precautions while awaiting COVID-19 test results. Within the first 24 h, he deteriorated quickly and developed acute respiratory distress syndrome (ARDS), requiring intubation and increasing respiratory support. Losartan was withheld due to hypotension and septic shock. COVID-19 was reported positive on hospital day 3. He remained in critical condition being treated with hydroxychloroquine and tocilizumab in addition to the standard medical management for septic shock and ARDS. Our case is unique in its atypical initial presentation and highlights the importance of early testing.


title: Mapping the Landscape of Artificial Intelligence Applications against COVID-19

text: COVID-19, the disease caused by the SARS-CoV-2 virus, has been declared a pandemic by the World Health Organization, with over 2.5 million confirmed cases as of April 23, 2020. In this review, we present an overview of recent studies using Machine Learning and, more broadly, Artificial Intelligence, to tackle many aspects of the COVID-19 crisis at different scales including molecular, clinical, and societal applications. We also review datasets, tools, and resources needed to facilitate AI research. Finally, we discuss strategic considerations related to the operational implementation of projects, multidisciplinary partnerships, and open science. We highlight the need for international cooperation to maximize the potential of AI in this and future pandemics.


Reproductive health paradigms in times of COVID-19


text: For the past several months, we have witnessed one of the greatest global health challenges experienced by humankind. This unprecedented COVID-19 viral pandemic, characterized by its enigmatic nature and bewildering spread, respects no borders and has nearly paralyzed healthcare systems throughout the world. Indeed, in the absence of specific, proven medical interventions, healthcare systems have been overwhelmed, thus limiting their ability to treat patients with non-emergent medical conditions and those awaiting elective procedures. Although it is beyond the scope of this editorial to discuss what constitutes a necessary or elective procedure, this radical change in medical practice has had an enormous impact on discontinuation of fertility care services, especially the assisted reproductive technologies (ART). It is eminently clear that reducing or discontinuing elective procedures and essential ART treatments was crucial not only to enable hospitals and medical facilities to manage (or to treat) the explosive rise in SARS-CoV-2 patients, but also to reduce disease transmission vis-à-vis various mitigating strategies-especially individual isolation and social distancing, strategies utilized effectively in China and Italy.


title: COVID-19 lockdown measures reveal human impact on water transparency in the Venice Lagoon

text: The lagoon of Venice has always been affected by the regional geomorphological evolution, anthropogenic stressors and global changes. Different morphological settings and variable biogeophysical conditions characterize this continuously evolving system that rapidly responds to the anthropic impacts. When the lockdown measures were enforced in Italy to control the spread of the SARS-CoV-2 infection on March 10th 2020, the ordinary urban water traffic around Venice, one of the major pressures in the lagoon, came to a halt. This provided a unique opportunity to analyse the environmental effects of restrictions to mobility on water transparency. Pseudo true-colour composites Sentinel-2 satellite imagery proved useful for qualitative visual interpretation, showing the reduction of the vessel traffic and their wakes from the periods before and during the SARS-CoV-2 outbreak. A quantitative analysis of suspended matter patterns, based on satellite-derived turbidity, in the absence of traffic perturbations, allowed to focus on natural processes and the residual stress from human activities that continued throughout the lockdown. We conclude that the high water transparency can be considered as a transient condition determined by a combination of natural seasonal factors and the effects of COVID-19 restrictions.


title: A Data-Driven Travel Mode Share Estimation Framework based on Mobile Device Location Data

text: Mobile device location data (MDLD) contains abundant travel behavior information to support travel demand analysis. Compared to traditional travel surveys, MDLD has larger spatiotemporal coverage of population and its mobility. However, ground truth information such as trip origins and destinations, travel modes, and trip purposes are not included by default. Such important attributes must be imputed to maximize the usefulness of the data. This paper tends to study the capability of MDLD on estimating travel mode share at aggregated levels. A data-driven framework is proposed to extract travel behavior information from the MDLD. The proposed framework first identifies trip ends with a modified Spatiotemporal Density-based Spatial Clustering of Applications with Noise (ST-DBSCAN) algorithm. Then three types of features are extracted for each trip to impute travel modes using machine learning models. A labeled MDLD dataset with ground truth information is used to train the proposed models, resulting in 95% accuracy in identifying trip ends and 93% accuracy in imputing five travel modes (drive, rail, bus, bike and walk) with a Random Forest (RF) classifier. The proposed framework is then applied to two large-scale MDLD datasets, covering the Baltimore-Washington metropolitan area and the United States, respectively. The estimated trip distance, trip time, trip rate distribution, and travel mode share are compared against travel surveys at different geographies. The results suggest that the proposed framework can be readily applied in different states and metropolitan regions with low cost in order to study multimodal travel demand, understand mobility trends, and support decision making.


Perspectives from a webinar: COVID-19 and sexual and reproductive health and rights


title: Clinical and histological characterization of late appearance maculopapular eruptions in association with the coronavirus disease 2019. A case series of seven patients

text: Since the first report of cutaneous manifestations of the coronavirus disease 2019 (COVID-19) by Recalcati et al1 , there has been described five clinical patterns including pseudo-chilblain lesions, vesicular eruptions, urticarial lesions, livedo and necrosis and maculopapular eruptions2 . Several clinical reports have been published recently describing these clinical patterns although there is still a lack of information regarding histopathology of maculopapular eruptions. We designed a retrospective study of patients attended in our department over the course of three weeks. We collected clinical data and pictures, and performed a biopsy when possible.


Bacterial and fungal colonization of the respiratory tract in COVID-19 patients should not be neglected


CT of Coronavirus Disease (COVID-19) Pneumonia: A Reference Standard Is Needed


title: Cardiac effects and toxicity of chloroquine: a short update

text: There is currently increased interest in the use of the antimalarial drugs chloroquine and hydroxychloroquine for the treatment of other diseases, including cancer and viral infections such as coronavirus disease 2019 (COVID-19). However, the risk of cardiotoxic effects tends to limit their use. In this review, the effects of these drugs on the electrical and mechanical activities of the heart as well as on remodelling of cardiac tissue are presented and the underlying molecular and cellular mechanisms are discussed. The drugs can have proarrhythmic as well as antiarrhythmic actions resulting from their inhibition of ion channels, including voltage-dependent Na+ and Ca2+ channels, background and voltage-dependent K+ channels, and pacemaker channels. The drugs also exert a vagolytic effect due at least in part to a muscarinic receptor antagonist action. They also interfere with normal autophagy flux, an effect that could aggravate ischaemia/reperfusion injury or post-infarct remodelling. Most of the toxic effects occur at high concentrations, following prolonged drug administration or in the context of drug associations.


Angiotensin II administration to COVID-19 patients is not advisable


Considering the potential for an increase in chronic pain following the COVID-19 pandemic


Considering the potential for an increase in chronic pain after the COVID-19 pandemic


title: In-hospital cardiac arrest outcomes among patients with COVID-19 pneumonia in Wuhan, China

text: OBJECTIVE: To describe the characteristics and outcomes of patients with severe COVID-19 and in-hospital cardiac arrest (IHCA) in Wuhan, China. METHODS: The outcomes of patients with severe COVID-19 pneumonia after IHCA over a 40-day period were retrospectively evaluated. Between January 15 and February 25, 2020, data for all cardiopulmonary resuscitation (CPR) attempts for IHCA that occurred in a tertiary teaching hospital in Wuhan, China were collected according to the Utstein style. The primary outcome was restoration of spontaneous circulation (ROSC), and the secondary outcomes were 30-day survival, and neurological outcome. RESULTS: Data from 136 patients showed 119 (87.5%) patients had a respiratory cause for their cardiac arrest, and 113 (83.1%) were resuscitated in a general ward. The initial rhythm was asystole in 89.7%, pulseless electrical activity (PEA) in 4.4%, and shockable in 5.9%. Most patients with IHCA were monitored (93.4%) and in most resuscitation (89%) was initiated <1â¯min. The average length of hospital stay was 7 days and the time from illness onset to hospital admission was 10 days. The most frequent comorbidity was hypertension (30.2%), and the most frequent symptom was shortness of breath (75%). Of the patients receiving CPR, ROSC was achieved in 18 (13.2%) patients, 4 (2.9%) patients survived for at least 30 days, and one patient achieved a favourable neurological outcome at 30 days. Cardiac arrest location and initial rhythm were associated with better outcomes. CONCLUSION: Survival of patients with severe COVID-19 pneumonia who had an in-hospital cardiac arrest was poor in Wuhan.


The Outbreak of COVID-19 and Diabetes in Korea: "We Will Find a Way as We Have Always Done"


Being Rational About Health: The Pandemic's Long-Term Silver Lining?


Governments cannot just 'follow the science' on COVID-19