docid: aioqogaw

title: Presence of endogenous viral elements negatively correlates with FeLV susceptibility in puma and domestic cat cells

text: While feline leukemia virus (FeLV) has been shown to infect felid species other than the endemic domestic cat host, differences in FeLV susceptibility among species has not been evaluated. Previous reports have noted a negative correlation between enFeLV copy number and exogenous FeLV infection outcomes in domestic cats. Since felids outside the genus Felis do not harbor enFeLV genomes, we hypothesized absence of enFeLV results in more severe disease consequences in felid species lacking these genomic elements. We infected primary fibroblasts isolated from domestic cats (Felis catus) and pumas (Puma concolor) with FeLV and quantitated proviral and viral antigen loads. Domestic cat enFeLV env and LTR copy numbers were determined for each individual and compared to FeLV viral outcomes. FeLV proviral and antigen levels were also measured in 6 naturally infected domestic cats and 11 naturally infected Florida panthers (P. concolor coryi). We demonstrated that puma fibroblasts are more permissive to FeLV than domestic cat cells, and domestic cat FeLV restriction was highly related to enFeLV LTR copy number. Terminal tissues from FeLV-infected Florida panthers and domestic cats had similar exFeLV proviral copy numbers, but Florida panther tissues have higher FeLV antigen loads. Our work indicates enFeLV LTR elements negatively regulate exogenous FeLV replication. Further, Puma concolor lacking enFeLV are more permissive to FeLV infection than domestic cats, suggesting endogenization can play a beneficial role in mitigating exogenous retroviral infections. Conversely, presence of endogenous retroelements may relate to new host susceptibility during viral spillover events. Importance Feline leukemia virus (FeLV) can infect a variety of felid species. Only the primary domestic cat host and related small cat species harbor a related endogenous virus in their genomes. Previous studies noted a negative association between the endogenous virus copy number and exogenous virus infection in domestic cats. This report shows that puma cells, which lack endogenous FeLV, produce more virus more rapidly than domestic cat fibroblasts following cell culture challenge. We document a strong association between domestic cat cell susceptibility and FeLV long terminal repeat (LTR) copy number, similar to observations in natural FeLV infections. Viral replication does not, however, correlate with FeLV env copy number, suggesting this effect is specific to FeLV LTR elements. This discovery indicates a protective capacity of the endogenous virus against the exogenous form, either via direct interference or indirectly via gene regulation, and may suggest evolutionary outcomes of retroviral endogenization.


title: Benchmarking the CoVID-19 pandemic across countries and states in the U.S.A. under heterogeneous testing

text: Public health officials need to make urgent decisions to reduce the potential impact of the CoVID-19 pandemic. Benchmarking based on the increase in total cases or case fatality rates is one way of comparing performance across countries or territories (such as states in the USA), and could inform policy decisions about COVID-19 mitigation strategies. But comparing cases and fatality across territories is challenging due to heterogeneity in testing and health systems. We show two complementary ways of benchmarking across countries or US states. First, we used multivariate regressions to estimate the test-elasticity-of-COVID-19-case-incidence. We found a 10% increase in testing yielded ~9% (95% CI:4.2-13.4%; p<0.001) increase in reported cases across countries, and ~2% (95%CI:0.1-3.4%; p=0.03) increase across US states during the week ending April 10th, 2020. We found comparable negative elasticities for fatality rates (across countries: beta;=-0.77, 95%CI:-1.40- -0.14; p=0.02; US states: beta;=-0.15, 95%CI:-0.30-0.01; p=0.06). Our results were robust to various model specifications. Second, we decomposed the growth in cases into test growth and positive test ratio (PTR) growth to intuitively visualize the components of case growth. We hope these results can help support evidence-based decisions by public health officials as more consistent data hopefully becomes available.


title: Computational Analysis of Dynamic Allostery and Control in the SARS-CoV-2 Main Protease

text: The dynamics and thermodynamics of the homodimer main protease protein SARS-CoV-2 are analysed at the level of Elastic Network Models (ENM). Correlated motions display a rich and heterogeneous dynamical structure, including allosterically correlated motions between the active sites in the two domains. Exhaustive 1-point and 2-point mutation maps, and their effect on binding free energies and allosteric free energies confirm the susceptibility identified in recent candidate inhibitor assays, but also suggest several new candidate regions for control and inhibition of the protease function, which may assist the development of current fragment binding screens.


title: Direct Wire-Tension Measurement Based Bowing Correction in Hot Wire Cutting of Polystyrene

text: Abstract The accuracy of parts produced by hot wire cutting of expanded polystyrene (EPS) is severely affected by bowing of the wire. The degree of bowing depends on the current supplied and the feed rate of the hot wire. Bowing occurs when the current is insufficient to melt the foam ahead of the wire and the mechanical interaction between the foam and the wire increases. This causes an increase in the tension in the wire and this is directly measured using a load cell arrangement. Based on this direct wire tension measurement a real time closed-loop feedback mechanism is implemented which regulates the current to maintain a constant wire tension and eliminates the bowing of the hot wire during the cutting process. For a particular feed rate the feedback mechanism precisely fine tunes the current supplied to the wire such that there is no mechanical drag force between the foam and the wire. The sensitivity of the feedback mechanism is high and responds to very minute contact between the foam and the wire and nominally regulates the current variation in the hot wire, hence, maintaining a constant kerf width throughout the cut. This mechanism allows to significantly improve the accuracy of the EPS part even in complex 3D cutting paths.


title: Sustaining Social Distancing Policies to Prevent a Dangerous Second Peak of COVID-19 Outbreak

text: Governments around the world have enacted strict social distancing policies in order to slow the spread of COVID-19. The next step is figuring out when to relax these restrictions and to what degree. Our results predict potentially disastrous implications of ending these policies too soon, based on projections made from a Susceptible-Exposed-Infectious-Removed (SEIR) epidemic model. Even when infection rates appear to be slowing down or decreasing, prematurely returning to "business as usual" produces a severe second peak far worse than the first. Furthermore, such a second peak is made more likely when very severe restrictions are initially enacted. Only an appropriately measured and committed set of restrictions can appropriately control COVID-19 outbreak levels.


title: Temporal relationship between outbound traffic from Wuhan and the 2019 coronavirus disease (COVID-19) incidence in China

text: Background: The city of Wuhan is the epicenter of the 2019 coronavirus disease (COVID-19) outbreak and a central Chinese hub for transportation and industry. Mass migration prior to the Chinese New Year may have accelerated the spread of COVID-19 across China. This analysis investigated the temporal relationship between daily outbound traffic from Wuhan and the incidence of COVID-19 in 31 Chinese provinces during January-February 2020. Methods: We collected incidence of confirmed COVID-19 cases from National and Provincial Health Committee reports from January 10 to February 29, 2020. Volume of outbound traffic from Wuhan to other provinces was measured by Baidu Migration Index, a widely used metric that tracks migration based on cellphone location. We used cross-correlation function and autoregressive integrated moving average (ARIMA) model to examine time-lagged association between traffic volume and COVID-19 incidence by province. Contributors to the provincial variation in the temporal associations were investigated. Additionally, we estimated the reduction in cumulative incidence of COVID-19 cases following the travel ban for Wuhan. Results: Cross-correlation function analyses suggested that the volume of outbound traffic from Wuhan was positively associated with COVID-19 incidence in all provinces, with correlation coefficients between 0.22-0.78 (all P<0.05). Approximately 42% of provinces showed <1 week of lag between traffic volume and COVID-19 incidence, 39% with 1 week, and 19% with 2-3 weeks. Migration had more prolonged impacts in provinces closer to Wuhan and with more passenger influx from Wuhan, but affected economically advantaged provinces to a lesser extent. We further estimated that the travel ban may have prevented approximately 19,768 COVID-19 cases (95% CI: 13,589, 25,946) outside of Wuhan by February 29, 2020. Conclusions: Outflowing migration from Wuhan facilitated the COVID-19 transmission to other parts of China with varying time-lagged effects dependent on provincial characteristics. The travel ban led to a significant reduction in COVID-19 outside of Wuhan.


title: Evaluation of K18-hACE2 mice as a model of SARS-CoV-2 infection

text: Murine models of SARS-CoV-2 infection are critical for elucidating the biological pathways underlying COVID-19 disease. Because human ACE2 is the receptor for SARS-CoV-2, mice expressing the human ACE2 gene have shown promise as a potential model for COVID-19. Five mice from the transgenic mouse strain K18-hACE2 were intranasally inoculated with SARS-CoV-2 Hong Kong/VM20001061/2020. Mice were followed twice daily for five days and scored for weight loss and clinical symptoms. Infected mice did not exhibit any signs of infection until day four, when weight loss, but no other obvious clinical symptoms were observed. By day five all infected mice had lost around 10% of their original body weight, but exhibited variable clinical symptoms. All infected mice showed high viral titers in the lungs as well as altered lung histology associated with proteinaceous debris in the alveolar space, interstitial inflammatory cell infiltration and alveolar septal thickening. Overall, these results show that symptomatic SARS-CoV-2 infection can be established in the K18-hACE2 transgenic background and should be a useful mouse model for COVID-19 disease.


title: Pandemic related Health literacy - A Systematic Review of literature in COVID-19, SARS and MERS pandemics

text: Background: Health literacy plays an essential role in ones ability to acquire and understand critical medical information in the COVID-19 infodemic and other pandemics. Purpose: To summarize the assessment, levels and determinants of pandemic related health literacy and its associated clinical outcomes. Data sources: Medline, Embase, PsychINFO, CINAHL, arXiv, bioRxiv, medRxiv, and Social Science Research Network. The start date was unrestricted and current as of 22 April 2020. Study selection Studies which evaluated health literacy related to novel coronavirus disease 2019 (COVID-19), Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) Data extraction Data on the characteristics of study designs, instruments, participants and level of health literacy were collected. Items used in instruments were grouped under the themes of knowledge, attitudes and practices. Determinants of health literacy were grouped into five domains (socio-demographic, medical, psychological/psychiatric, health systems related and others). Data synthesis: Of 2,065 articles screened, 70 articles were included. 21, 17 and 32 studies evaluated health literacy related to COVID-19, SARS and MERS, respectively. The rates of low pandemic health literacy ranged from 4.3 to 57.9% among medical-related populations and 4.0% to 82.5% among non-medical populations. Knowledge about symptoms and transmission of infection; worry about infection and, practices related to mask usage and hand hygiene was most frequently evaluated. Socio-demographic determinants of health literacy were most studied, where higher education level, older age and female gender were associated with better health literacy. No studies evaluated outcomes associated with health literacy. Limitations Non-English articles were excluded. Conclusion: The level of pandemic related health literacy is sub-optimal. Healthcare administrators need to be aware of health literacy determinants when formulating policies in pandemics.


title: Tourist as vector: Viral mobilities of COVID-19

text: Tourist mobilities helped COVID-19 become a global pandemic. This commentary argues that mobilities perspectives are vital to understanding the impacts of COVID-19 on global tourism. It assists scholars and policy-makers in two ways: by demonstrating how tourism is implicated in political issues heightened by the pandemic, and by advancing research on low carbon tourist mobilities.


title: Psychiatric advice during Covid-19 pandemic for patients with multiple sclerosis

text: The new pandemic coronavirus disease 2019 (COVID-19) that is caused by a new strain of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), has become an issue for governments and health care providers such as specialists including psychiatrists worldwide (1). Treatment strategies and vaccination for this disease are yet to be explored. Therefore, at this time, the best-proposed health measure to break the chain of transmission is social distancing or, in some instances, quarantine. In a recent systematic review published in Lancet, Brooks et al. (2) evaluated the psychological impacts of quarantine during the 2003 SARS outbreak and the 2014 Ebola outbreak. Accordingly, most of the reviewed studies reported adverse psychological effects, including post-traumatic stress symptoms, confusion, and anger (2). Delays in psychological interventions in such situations can lead to psychological damage to individuals who are involved (3). However, people with a pre-existing mental health problem such as anxiety or depressive disorder would be more vulnerable to experience adverse psychological effects of quarantine and social distancing.


title: COVID-19 spreading: a model

text: This communication describes a recursive mathematical model of the spreading COVID-19 infection, which allows estimating the effectiveness of quarantine measures. The model was used to analyze the situation in eight countries and to find the viral transmissibility, which made it possible to give a brief prediction of the COVID-19 spreading.


title: Transmission and control strategies for porcine reproductive and respiratory syndrome virus

text: In the monitoring of porcine reproductive and respiratory syndrome virus (PRRSv), knowledge about between-farm transmission dynamics is still lacking. Our objective was to assess the relative contribution of between-farm PRRSv transmission routes through a mechanistic epidemiological model calibrated with PRRSv occurrence, identify risk areas, and estimate the impact of immunization strategies in the disease spread. We developed a mathematical model of PRRSv transmission accounting for spatial proximity, pig movements, and re-breaks in sow farms, parametrized on data collected routinely by commercial pig farms. We then used the model to simulate the weekly frequency of cases and built risk maps, and compared with the observed cases. We simulated the implementation of two immunization strategies (preventive and reactive) to mitigate the between-farm transmission. Our results indicated for sow and GDU farms’ local spread on average was above 60%, while for nurseries between-farm movements represented 83% of transmissions and in finisher farms it was distributed almost 50% local and 50% between-farm movement, the model allowed reproduce the weekly frequency of observed cases and the risk maps built allowed the identification of observed cases in the space. The increase in vaccine efficacy was the most important parameter to mitigate between-farm transmission. Also, the implementation of immunization by a preventive and reactive strategy combined had the better result to mitigate between-farm transmission than implement these strategies individually. These immunization strategies had a better performance with the use of rigorous protocols, such as immunization as soon as the farm receives a shipment or increase the detection coverage in all production types, as well as reduce time of disease detection. This model can be used by the pork producers to improve surveillance activities, enhancing the capacities to early detect circulation not only of endemic disease but also foreign animal diseases (FADs).


title: A Modelling Study for Designing a Multi-layered Surveillance Approach to Detect the Potential Resurgence of SARS-CoV-2

text: Background: Countries achieving control of COVID-19 after an initial outbreak will continue to face the risk of SARS-CoV-2 resurgence. This study explores surveillance strategies for COVID-19 containment based on polymerase chain reaction tests. Methods: Using a dynamic SEIR-type model to simulate the initial dynamics of a COVID-19 introduction, we investigate COVID-19 surveillance strategies among healthcare workers, hospital patients, and community members. We estimate surveillance sensitivity as the probability of COVID-19 detection using a hypergeometric sampling process. We identify test allocation strategies that maximise the probability of COVID-19 detection across different testing capacities. We use Beijing, China as a case study. Findings: Surveillance subgroups are more sensitive in detecting COVID-19 transmission when they are defined by more COVID-19 specific symptoms. In this study, fever clinics have the highest surveillance sensitivity, followed by respiratory departments. With a daily testing rate of 0.07/1000 residents, via exclusively testing at fever clinic and respiratory departments, there would have been 598 [95% eCI: 35, 2154] and 1373 [95% eCI: 47, 5230] cases in the population by the time of first case detection, respectively. Outbreak detection can occur earlier by including non-syndromic subgroups, such as younger adults in the community, as more testing capacity becomes available. Interpretation: A multi-layer approach that considers both the surveillance sensitivity and administrative constraints can help identify the optimal allocation of testing resources and thus inform COVID-19 surveillance strategies. Funding: Bill & Melinda Gates Foundation, National Institute of Health Research (UK), National Institute of Health (US), the Royal Society, and Wellcome Trust.


title: Role of pharmacist during the COVID-19 pandemic: a scoping review

text: Abstract Background Since the start of the new Coronavirus (COVID-19) outbreak in December 2019, pharmacists worldwide are playing a key role adopting innovative strategies to minimize the adverse impact of the pandemic. Objectives To identify and describe core services provided by the pharmacist during the COVID-19 pandemic. Methods A literature search was performed in MEDLINE, Embase, Scopus, and LILACS for studies published between December 1st, 2019 and May 20th, 2020 without language restriction. Studies that reported services provided by pharmacists during the COVID-19 pandemic were included. Two independent authors performed study selection and data extraction with a consensus process. The pharmacist's intervention identified in the included studies were described based on key domains in the DEPICT v.2. Results A total of 1,189 records were identified, of which 11 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n=4) and China (n=4). The most common type of publication were letters (n=4) describing the workplace of the pharmacist in hospitals (n=8). These findings showed the different roles of pharmacists during the COVID-19 pandemic, such as disease prevention and infection control, adequate storage and drug supply, patient care and support for healthcare professionals. Pharmacists' interventions were mostly conducted for healthcare professionals and patients (n=7), through one-to-one contact (n=11), telephone (n=6) or video conference (n=5). The pharmacists' main responsibility was to provide drug information for healthcare professionals (n=7) as well as patient counseling (n=8). Conclusions A reasonable number of studies that described the role of the pharmacists during the COVID-19 pandemic were found. All studies reported actions taken by pharmacists, although without providing a satisfactory description. Thus, future research with more detailed description as well as an evaluation of the impact of pharmacist intervention is needed in order to guide future actions in this and-or other pandemic. Keywords: COVID-19; pharmacists; pharmaceutical services; review


title: Monitoring trends and differences in COVID-19 case fatality rates using decomposition methods: Contributions of age structure and age-specific fatality

text: The population-level case fatality rate (CFR) associated with COVID-19 varies substantially, both across countries and within countries over time. We analyze the contribution of two key determinants of the variation in the observed CFR: the age-structure of diagnosed infection cases and age-specific case-fatality rates. We use data on diagnosed COVID-19 cases and death counts attributable to COVID-19 by age for China, France, Germany, Italy, South Korea, Spain, and the United States. We calculate the CFR for each country at the latest data point and for Italy also over time. We use demographic decomposition to break the difference between CFRs into unique contributions arising from the age-structure of confirmed cases and the age-specific case-fatality. CFRs vary from 0.7% in Germany and 1.6% in South Korea to 8.6% in Spain and 10.6% in Italy. The age-structure of detected cases can explain a substantial proportion of cross-country variation in the CFR. For example, 57% of Spain's difference with respect to South Korea is explained by the observed cases being older. In Italy, the CFR increased from 4.2% to 10.6% between March 9 and March 29, 2020, and more than 95% of the change was due to increasing age-specific case fatality rates. The importance of the age-structure of infected cases likely reflects several factors, including different testing regimes and differences in transmission trajectories; while increasing age-specific case fatality rates indicate the worsening health outcomes of those infected with COVID-19. Our findings lend support to recommendations for data to be disaggregated by age, and potentially other variables, to facilitate a better understanding of population-level differences in CFRs. They also show the need for well designed seroprevalence studies to ascertain the extent to which differences in testing regimes drive differences in the age-structure of detected cases.


title: Reaching collective immunity for COVID-19: an estimate with a heterogeneous model based on the data for Italy

text: Background. At the current stage of COVID-19 pandemic, forecasts become particularly important regarding the possibility that the total incidence could reach the level where the disease stops spreading because a considerable portion of the population has become immune and collective immunity could be reached. Such forecasts are valuable because the currently undertaken restrictive measures prevent mass morbidity but do not result in the development of a robust collective immunity. Thus, in the absence of efficient vaccines and medical treatments, lifting restrictive measures carries the risk that a second wave of the epidemic could occur. Methods. We developed a heterogeneous model of COVID-19 dynamics. The model accounted for the differences in the infection risk across subpopulations, particularly the age-depended susceptibility to the disease. Based on this model, an equation for the minimal number of infections was calculated as a condition for the epidemic to start declining. The basic reproductive number of 2.5 was used for the disease spread without restrictions. The model was applied to COVID-19 data from Italy. Findings. We found that the heterogeneous model of epidemic dynamics yielded a lower proportion, compared to a homogeneous model, for the minimal incidence needed for the epidemic to stop. When applied to the data for Italy, the model yielded a more optimistic assessment of the minimum total incidence needed to reach collective immunity: 43% versus 60% estimated with a homogeneous model. Interpretation. Because of the high heterogeneity of COVID-19 infection risk across the different age groups, with a higher susceptibility for the elderly, homogeneous models overestimate the level of collective immunity needed for the disease to stop spreading. This inaccuracy can be corrected by the homogeneous model introduced here. To improve the estimate even further additional factors should be considered that contribute to heterogeneity, including social and professional activity, gender and individual resistance to the pathogen.


docid: nlavfnpt

title: COVID-19 infection induces readily detectable morphological and inflammation-related phenotypic changes in peripheral blood monocytes, the severity of which correlate with patient outcome

text: Background: Excessive monocyte/macrophage activation with the development of a cytokine storm and subsequent acute lung injury, leading to acute respiratory distress syndrome (ARDS) is a feared consequence of infection with COVID-19. The ability to recognize and potentially intervene early in those patients at greatest risk of developing this complication could be of great clinical utility. Methods: We performed detailed flow cytometric analysis of peripheral blood samples from 28 COVID-19 patients treated at Xian No.8 Hospital and the First Affiliated Hospital of Xian Jiaotong University in early 2020 in an attempt to identify factors that could help predict severity of disease and patient outcome. Findings: While we did not detect significant differences in the number of monocytes between patients with COVID-19 and normal healthy individuals,we did identify significant morphological and functional differences, which are more pronounced in patients requiring prolonged hospitalization and ICU admission. Patients with COVID-19 have larger than normal monocytes, easily identified on forward scatter, side scatter analysis by routine flow cytometry,with the presence of a distinct population of monocytes with high forward scatter (FSC-high). On more detailed analysis, these FSC-high monocytes are CD11b+, CD14+, CD16+, CD68+, CD80+, CD163+, CD206+ and secrete IL-6, IL-10 and TNF-alpha, consistent with an inflammatory phenotype. Conclusions: The detection and serial monitoring of this subset of inflammatory monocytes using flow cytometry could be of great help in guiding the prognostication and treatment of patients with COVID-19 and merits further evaluation.


title: Citizen science data enhance spatio-temporal extent and resolution of animal population studies

text: Informed management and conservation decisions for animal populations often require data at sufficient geographic, temporal, and demographic resolutions for precise and unbiased estimates of parameters including population size and demographic rates. Recently developed integrated population models estimate such parameters by unifying population presence-absence and demographic data, and we demonstrate how citizen science offers a cost-efficient mechanism to collect such data. We describe the early results of iSeeMammals, a citizen science project that collects opportunistic data on the black bear population in New York State by enlisting volunteers to collect data through observations, hikes, and trail cameras. In 10 months, iSeeMammals increased the spatio-temporal extent of data collection by approximately fourfold and reduced cost by 83% compared to systematic sampling. In combination with other datasets in integrated population model frameworks, large, spatiotemporally extensive datasets from citizen science projects like iSeeMammals can help improve inferences about population-level structure and dynamics.


title: Analysis and suggestions for the preview and triage screening of children with suspected COVID-19 outside the epidemic area of Hubei Province

text: Background: Since December 2019, a number of patients infected with COVID-19 (SARS-CoV-2) have been identified in Wuhan, Hubei, China. As the epidemic has spread, similar cases have also been found in other parts of mainland China and abroad. The main reason for this spread is the highly contagious nature of the virus and the fact that children can also become infected during its incubation period. This has made the virus a substantial challenge for the outpatient triage staff of children's hospitals outside the epidemic area of the Hubei Province. It is very important for the preview and triage personnel to accurately grasp the epidemiology of the virus and identify children's symptoms in the fever clinic. Methods: We performed an analysis of our early preview and triage of suspected COVID-19 in 36 children presenting at fever clinics. Two specialists either excluded suspected cases or referred cases to the isolation ward for new nucleic acid testing. Results: All 14 children who were transferred to the isolation ward had a fever, and 71.43% of them had a cough. Their nucleic acid testing results were negative. The suspected cases and excluded suspected cases had similar epidemiology history as well as complete blood count results. With reference to the diagnostic criteria in existing pediatric guidelines, we have further improved the triage screening questionnaire for children with fever in our hospital. Conclusions: According to the situation in our city and hospital, an evaluation questionnaire that is suitable for use with children in our hospital has been formulated to achieve the goals of early detection, isolation, diagnosis, and treatment. We provided an important basis for the next step in developing accurate preview and triage screening standards and appropriate guidelines for pediatric patients.


title: Modeling the Effects of Non-PharmaceuticalInterventions on COVID-19 Spread in Kenya

text: Mathematical modeling of non-pharmaceutical interventions (NPIs) of COVID-19 in Kenya is presented. An SEIR compartment model is considered with additional compartments of hospitalized population whose condition is severe or critical and also the fatalities compartment. The basic reproduction number (R_0) is computed by next generation matrix approach and later expressed as a time-dependent function so as to incorporate the NPIs into the model. The resulting system of ordinary differential equations (ODEs) are solved using fourth-order and fifth-order Runge-Kutta methods. Different intervention scenarios are considered and results show that, implementation of closure of education insitutions, curfew and partial lockdown yield predicted delayed peaks of the overall infections, severe cases and fatalities and subsequently containement of the pandemic in the country.


title: The impact of viral transport media on PCR assay results for the detection of nucleic acid from SARS-CoV-2 and other viruses

text: During the 2020 SARS-Cov-2 pandemic, there has been an acute shortage of viral transport medium. Many different products have been used to meet the demands of large-scale diagnostic and surveillance testing. The stability of SARS-Cov-2 RNA was assessed in several commercially produced transport media and an in-house solution. Coronavirus RNA was rapidly destroyed in the commercial transport media though the deleterious effects on intact virus were limited. Similar results were obtained for a Type A influenza virus. There was reduced detection of both virus and nucleic acid when a herpesvirus sample and purified DNA were tested. Collectively these data showed that the commercial viral transport media contained nucleases or similar substances and may seriously compromise diagnostic and epidemiological investigations. Recommendations to include foetal bovine serum as a source of protein to enhance the stabilising properties of viral transport media are contraindicated. Almost all commercial batches of foetal bovine serum contain pestiviruses and at times other bovine viruses. In addition to the potential for there to be nucleases in the transport medium, the presence of these viruses and other extraneous nucleic acid in samples may compromise the interpretation of sequence data. The inclusion of foetal bovine serum presents a biosecurity risk for the movement of animal pathogens and renders these transport media unsuitable for animal disease diagnostic applications. While these transport media may be suitable for virus culture purposes, there could be misleading results if used for nucleic acid-based tests. Therefore, these products should be evaluated to ensure fitness for purpose.


title: Geospatially Referenced Demographic Agent-Based Modeling of SARS-CoV-2-Infection (COVID-19) Dynamics and Mitigation Effects in a Real-world Community

text: Re-opening societies and economies across the globe following the initial wave of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic requires scientifically-guided decision processes and policy development. Public health authorities now consider it highly likely that transmission of SARS-CoV-2 and COVID-19 will follow a pattern of seasonal circulation globally. To guide mitigation strategies and tactics in a location-specific manner, accurate simulation of prolonged or intermittent patterns of social/physical distancing is required in order to prevent healthcare systems and communities from collapsing. It is equally important to capture the stochastic appearance of individual transmission events. Traditional epidemiological/statistical models cannot make predictions in a geospatial temporal manner based on human individuals in a community. Thus, the challenge is to conduct spatio-temporal simulations of transmission chains with real-world geospatial and georeferenced information of the dynamics of the disease and the effect of different mitigation strategies such as isolation of infected individuals or location closures. Here, we present a stochastic, geospatially referenced and demography-specific agent-based model with agents representing human beings and include information on age, household composition, daily occupation and schedule, risk factors, and other relevant properties. Physical encounters between humans are modeled in a time-dependent georeferenced network of the population. The model (GERDA-1) can predict infection dynamics under normal conditions and test the effect of different mitigation scenarios such as school closures, reduced social contacts as well as closure or reopening of public/work spaces. Specifically, it also includes the fate and influence of health care workers and their access to protective gear. Key predictions so far entail: (i) the effect of specific groups on the spreading, specifically that children in school contribute substantially to distribution. (ii) the result of reopening society depends crucially on how strict the measures have been during lock-down. (iii) the outcome of reopening is a stochastic process - in the majority of cases, we must expect a second wave, in some cases not. To the best of our best knowledge, the GERDA-1 model is the first model able to predict a bimodal behavior of SARS-Cov-2 infection dynamics. Given the criticality of the global situation, informing the scientific community, decision makers and the general public seems prudent. Therefore, we here provide a pre-print of the GERDA-1 model together with a first set of predictions and analyses as work in progress.


title: Forecasting COVID-19 impact in India using pandemic waves Nonlinear Growth Models

text: The ongoing pandemic of the coronavirus disease 2019 (COVID-19) started in China and devastated a vast majority of countries. In India, COVID-19 cases are steadily increasing since January 30, 2020, and the government-imposed lockdown across the country to curtail community transmission. COVID-19 forecasts have played an important role in capturing the probability of infection and the basic reproduction rate. In this study, we predicted some trajectories of trajectories associated with COVID-19 in the coming days in India using an Auto-regression integrated moving average model (ARIMA) and Richards model. By the end of April 2020, the incidence of new cases is predicted to be 5200 (95% CI: 4650 to 6002) through the ARIMA model versus be 6378 (95% CI: 4904 to 7851) Richard model. We estimated that there would be a total of 197 (95% CI: 118 to 277) deaths and drop down in the recovery rates will reach around 501 (95% CI: 245 to 758) by the end of April 2020. These estimates can help to strengthen the implementation of strategies to increase the health system capacity and enactment of social distancing measures all over India.


title: Allocating Scarce Resources and Triaging Patients during the COVID-19 Pandemic

text: Abstract The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that healthcare systems have faced or will face difficult decisions about triage, allocation and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation (DNAR) and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.


title: Transmissibility of 2019 Novel Coronavirus: zoonotic vs. human to human transmission, China, 2019-2020

text: Objectives: The novel coronavirus (2019-nCoV) originating from Wuhan has rapidly spread throughout China. While the origin of the outbreak remains uncertain, accumulating evidence links a wet market in Wuhan for the early spread of 2019-nCoV. Similarly, the influence of the marketplace on the early transmission dynamics is yet to be investigated. Methods: Using the daily series of COVID-19 incidenceincluding contact history with the market, we have conducted quantitative modeling analyses to estimate the reproduction numbers (R) for the market-to-human and human-to-human transmission together with the reporting probability and the early effects of public health interventions. Results: Our mean R estimates for China in 2019-2020 are estimated at 0.37 (95%CrI: 0.02-1.78) for market-to-human transmission, and 3.87 (95%CrI: 3.18-4.78) for human-to-human transmission, respectively. Moreover we estimated that the reporting rate cases stemming from market-to-human transmission was 3-31 fold higher than that for cases stemming from human-to-human transmission, suggesting that contact history with the wet market played a key role in identifying COVID-19 cases. Conclusions: Our findings suggest that the proportions of asymptomatic and subclinical patients constitute a substantial component of the epidemic's magnitude. Findings suggest that the development of rapid diagnostic tests could help bring the epidemic more rapidly under control.


title: PREDICTING THE EVOLUTION OF COVID-19 IN PORTUGAL USING AN ADAPTED SIR MODEL PREVIOUSLY USED IN SOUTH KOREA FOR THE MERS OUTBREAK

text: Since original reports in Wuhan, China, the new coronavirus covid-19 has spread very quickly worldwide, leading the World Health Organization (WHO) to declare a state of pandemic. Moreover, as of the 13th of March 2020, the WHO has announced that the European continent is now the main centre of the pandemic. Many European governments have already implemented harsh measures to attempt to contain the spread of the virus. In Portugal, there are, as of the 20th of March 2020, 1020 confirmed cases. One of the questions many policy makers, and governments are asking themselves is how the spread is going to evolve in time. A timely idea of the amount of cases that will exist in a near future can allow governments and policy makers to act accordingly. In this study, I applied an adapted SIR model previously used in South Korea to model the MERS outbreak, which is also caused by a coronavirus, to estimate the evolution of the curve of active cases in the case of the Portuguese situation. As some of the parameters were unknown, and the data for Portugal is still scarce, given that the outbreak started later (first case on the 2nd of March) I used Italian data (first reported case in Italy on the 31st of January) to predict them. I then construct two or three different scenarios for the evolution of covid-19 in Portugal, considering both the effectiveness of the mitigation measurements implemented by the government, and the self-protective measures taken by the population, as explained in the South Korean model. In the out of control scenario, the number of active cases could reach as much as ~40,000 people by the beginning of April. If measures are appropriately taken this number can be reduced to about 800 cases. In case that some measures are taken, but their implementation is not done appropriately, the active cases could reach circa 7,000 people. The actual figures probably lie between the interval (~800-7,000) and the peak will be reached between 9th and the 20nd of April 2020. Without control and self-protective measures, this model predicts that the figures of active cases of SARS-covid-2 would reach a staggering ~40,000 people It shows the importance of control and self-protecting measure to bring down the number of affected people by following the recommendations of the WHO and health authorities. With the appropriate measures, this number can be brought down to ~800-7,000 people. Hopefully that will be the case not just in Portugal, but in the rest of the World.


title: Bayesian analysis of tests with unknown specificity and sensitivity

text: When testing for a rare disease, prevalence estimates can be highly sensitive to uncertainty in the specificity and sensitivity of the test. Bayesian inference is a natural way to propagate these uncertainties, with hierarchical modeling capturing variation in these parameters across experiments. Another concern is the people in the sample not being representative of the general population. Statistical adjustment cannot without strong assumptions correct for selection bias in an opt-in sample, but multilevel regression and poststratification can at least adjust for known differences between sample and population. We demonstrate these models with code in R and Stan and discuss their application to a controversial recent study of COVID-19 antibodies in a sample of people from the Stanford University area. Wide posterior intervals make it impossible to evaluate the quantitative claims of that study regarding the number of unreported infections. For future studies, the methods described here should facilitate more accurate estimates of disease prevalence from imperfect tests performed on non-representative samples.


title: Bronchoscopy in critically ill COVID-19 Patients: microbiological profile and factors related to nosocomial respiratory infection

text: Background: Nosocomial co-infections are a cause of morbidity and mortality in Intensive Care Units (ICU). Objectives: Our aim was to describe bronchoscopy findings and analyse co-infection through bronchial aspirate (BA) samples in patients with COVID-19 pneumonia requiring ICU admission. Methods: We conducted a retrospective observational study, analysing the BA samples collected from intubated patients with COVID-19 to diagnose nosocomial respiratory infection. Results: One-hundred and fifty-five consecutive BA samples were collected from 75 patients. Of them, 90 (58%) were positive cultures for different microorganisms, 11 (7.1%) were polymicrobial, and 37 (23.7%) contained resistant microorganisms. There was a statistically significant association between increased days of orotracheal intubation (OTI) and positive BA (18.9 days versus 10.9 days, p<0.01), polymicrobial infection (22.11 versus 13.54, p<0.01) and isolation of resistant microorganisms (18.88 versus 10.94, p<0.01). In 88% of the cases a change in antibiotic treatment was made. Conclusion: Nosocomial respiratory infection in intubated COVID-19 patients seems to be higher than in non-epidemic periods. The longer the intubation period, the greater the probability of co-infection, isolation of resistant microorganisms and polymicrobial infection. Microbiological sampling through BA is an essential tool to manage these patients appropriately


title: What do we know about SARS-CoV-2 transmission? A systematic review and meta-analysis of the secondary attack rate, serial interval, and asymptomatic infection

text: Background Current SARS-CoV-2 containment measures rely on the capacity to control person-to-person viral transmission. Effective prioritization of these measures can be determined by understanding SARS-CoV-2 transmission dynamics. We conducted a systematic review and meta-analyses of three parameters: (i) secondary attack rate (SAR) in various settings, (ii) clinical onset serial interval (SI), and (iii) the proportion of asymptomatic infection. Methods and Findings We searched PubMed, medRxiv, and bioRxiv databases between January 1, 2020, and May 15, 2020, for articles describing SARS-CoV-2 attack rate, SI, and asymptomatic infection. Studies were included if they presented original data for estimating point estimates and 95% confidence intervals of the three parameters. Random effects models were constructed to pool SAR, mean SI, and asymptomatic proportion. Risk ratios were used to examine differences in transmission risk by setting, type of contact, and symptom status of the index case. Publication and related bias were assessed by funnel plots and Egger's meta-regression test for small-study effects. Our search strategy for SAR, SI, and asymptomatic infection identified 459, 572, and 1624 studies respectively. Of these, 20 studies met the inclusion criteria for SAR, 18 studies for SI, and 66 studies for asymptomatic infection. We estimated the pooled household SAR at 15.4% (95% CI: 12.2%, 18.7%) compared to 4.0% (95% CI: 2.8%, 5.2%) in non-household settings. We observed variation across settings; however, the small number of studies limited power to detect associations and sources of heterogeneity. SAR of symptomatic index cases is significantly higher than cases that were symptom-free at diagnosis (RR 2.55, 95% CI: 1.47, 4.45). Adults appear to be more susceptible to transmission than children (RR 1.40, 95% CI: 1.00, 1.96). The pooled mean SI is estimated at 4.87 days (95% CI: 3.98, 5.77). The pooled proportion of cases who had no symptoms at diagnosis is 25.9% (95% CI: 18.8%, 33.1%). Conclusions Based our pooled estimates, 10 infected symptomatic persons living with 100 contacts would result in 15 additional cases in <5 days. To be effective, quarantine of contacts should occur within 3 days of symptom onset. If testing and tracing relies on symptoms, one-quarter of cases would be missed. As such, while aggressive contact tracing strategies may be appropriate early in an outbreak, as it progresses, control measures should transition to account for SAR variability across settings. Targeted strategies focusing on high-density enclosed settings may be effective without overly restricting social movement.


title: Different adiposity measures across sex, age, ethnicity, and COVID-19

text: We examined the link between several adiposity measures - BMI, fat mass, body fat percentage, fat mass index, waist and waist to hip ratio) taken at baseline visits over a decade ago to risk for COVID-19 positive tests that occurred in hospital in the UK biobank. Overall, 793 participants tested positive in a hospital setting out of 380,976 participants. Poisson models with penalised thin plate splines were run relating exposures of interest to positive tests in hospital, adjusting for confounding factors. Each measure of adiposity was associated strongly with positive in-hospital test, in a broadly linear fashion, despite the model allowing for non-linear associations. There was a stronger gradient of risk across BMI (Pinteraction=0.09) and fat-mass index (Pinteraction=0.048) in men compared with women. Compared to a referent of 21 kg/m2, men with BMI of 30 kg/m2 (RR 2.08 95% CI 1.84-2.36) and 35 kg/m2 (RR 2.80, 95% CI 2.36-3.31) were at higher risk; corresponding RRs for women were 1.36 (95% CI 1.49-1.63) and 1.86 (95% CI 1.59-2.17). The associations between BMI and COVID-19 were largely consistent by age group and ethnicity. These data add further support for linear links between excess body fat and more severe COVID-19 outcomes across differing groups.


title: Knowledge, attitude, practice and perception regarding COVID-19 among students in Bangladesh: Survey in Rajshahi University

text: Background: The number of infection and death by COVID-19 has been rapidly increasing since December 2019 in all over the world. Until now, there is no specific treatment or vaccine for this disease; WHO suggests only some protective measures like maintaining social distance, staying home, washing hands with soap or sanitizer, wearing mask etc. The objective of this study was to survey knowledge, attitude, practice and perception regarding COVID-19 among students in Rajshahi University, Bangladesh. Methods: We collected data from 305 students of Rajshahi University for this cross-sectional study using mixed sampling from March 11 to March 19, 2020. Frequency distribution, Mann-Whitney and Kruskal-Wallis tests were used in this study. Results: Out of 305 participants, 224 (73.4%) and 81 (26.6%) were male and female students respectively. The study revealed that Rajshahi university students had average knowledge on symptoms, protective way and transmission of COVID-19. Female students were more knowledgeable than male. More than one third of the students had negative attitude to avoiding public transport and going out to public places with friends and family. The practice of students during our data collection period and in future was not satisfactory. More than one third of students were not keen to stay at home and avoid going to crowded places. The perception towards COVID-19 was not good; they had no idea whether the outbreak would affect their daily routine, study and financial matters, study field work and restrict leisure time of meeting family and relatives. Conclusions: We found that general knowledge, attitude, practice and perception of the university students regarding COVID-19 were not satisfactory. This indicated that the situation was worse among common people. In Bangladesh, the number of healthcare providers is insufficient. University students can be employed as potential workforce to create awareness among mass people on prevention of COVID-19.


title: Anisotropic osmosis filtering for shadow removal in images

text: We present an anisotropic extension of the isotropic osmosis model that has been introduced by Weickert et al.~(Weickert, 2013) for visual computing applications, and we adapt it specifically to shadow removal applications. We show that in the integrable setting, linear anisotropic osmosis minimises an energy that involves a suitable quadratic form which models local directional structures. In our shadow removal applications we estimate the local structure via a modified tensor voting approach (Moreno, 2012) and use this information within an anisotropic diffusion inpainting that resembles edge-enhancing anisotropic diffusion inpainting (Weickert, 2006, Gali\'c, 2008). Our numerical scheme combines the nonnegativity preserving stencil of Fehrenbach and Mirebeau (Fehrenbach, 2014) with an exact time stepping based on highly accurate polynomial approximations of the matrix exponential. The resulting anisotropic model is tested on several synthetic and natural images corrupted by constant shadows. We show that it outperforms isotropic osmosis, since it does not suffer from blurring artefacts at the shadow boundaries.


title: Covid-19 Outbreak In Italy: Are We Ready for the Psychosocial and the Economic Crisis? Baseline Findings From the PsyCovid Study

text: The Covid-19 pandemic is burning all over the world. National healthcare systems are facing the contagion with incredible strength, but concern regarding the psychosocial and economic effects is growing quickly. The PsyCovid Study assessed the influence of psychosocial variables on individual differences from the perceived impact of the Covid-19 outbreak on the issues of health and economy in the Italian population. Italian volunteers from different regions completed an online anonymous survey. The main outcomes were the perceived impact of the Covid-19 outbreak on health and the economy. A two-way MANOVA evaluated differences in the main outcomes, with geographical area (northern, central, and southern regions) and professional status (healthcare workers or not) as factors. We then tested the relationship linking psychosocial variables (i.e. perceived distress and social isolation, empathy, and coping style) to the main outcomes through two different mediation models. 1163 responders completed the survey (835 females; mean age: 42 ± 13.5 y.o.; age range: 18-81 y.o.) between March 14 and 21, 2020. Healthcare workers and people living in northern Italy reported a significantly worse outbreak impact on health, but not on the economy. In the whole sample, distress and loneliness were key variables influencing the perceived impact of the Covid-19 outbreak on health, while empathy and coping style affected the perceived impact on the economy. The Covid-19 pandemic is a worldwide emergency in terms of psychological, social, and economic consequences. Our data suggests that in the Italian population, actual differences in individual perception of the Covid-19 outbreak severity for health are dramatically modulated by psychosocial frailty (i.e., distress and loneliness). At the same time, problem-oriented coping strategies and enhanced empathic abilities increase people's awareness of the severity of the impact of the Covid-19 emergency on economics. There is an immediate need for consensus guidelines and healthcare policies to support interventions aimed to manage psychosocial distress and increase population resilience towards the imminent crisis.


title: Combination of Ruxolitinib and Eculizumab for Treatment of Severe SARS-CoV-2-Related Acute Respiratory Distress Syndrome: A Controlled Study

text: To date, there are no specific therapeutic strategies for treatment of COVID-19. Based on the hypothesis that complement and coagulation cascades are activated by viral infection, and might trigger an acute respiratory distress syndrome (ARDS), we report clinical outcomes of 17 consecutive cases of SARS-CoV-2-related ARDS treated (N = 7) with the novel combination of ruxolitinib, a JAK1/2 inhibitor, 10 mg/twice daily for 14 days and eculizumab, an anti-C5a complement monoclonal antibody, 900 mg IV/weekly for a maximum of three weeks, or with the best available therapy (N = 10). Patients treated with the combination showed significant improvements in respiratory symptoms and radiographic pulmonary lesions and decrease in circulating D-dimer levels compared to the best available therapy group. Our results support the use of combined ruxolitinib and eculizumab for treatment of severe SARS-CoV-2-related ARDS by simultaneously turning off abnormal innate and adaptive immune responses.


docid: uekujxpl

title: Coronavirus disease-19 and rheumatological disorders: A narrative review

text: The global spread of coronavirus disease-19 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2, which originated from Wuhan, China, is likely to have an impact on the rheumatological practices due to a dilemma in both continuing and initiating immunosuppressive medications. We reviewed the risk stratification of patients with rheumatological disorders, the safety of various anti-rheumatological drugs, and the role of multiple drugs used by the rheumatologists in managing COVID-19. The score-based risk stratification is helpful in therapeutic decision-making such as self-isolation, continuation, or initiation of immunosuppressive therapy. Most of the immunosuppressive therapies need not be discontinued unless there is an overwhelming infection. The treatment interruption should not be made in fear, and there should be shared decision-making in consultation with the patient. The proposed role of different anti-rheumatic drugs such as hydroxychloroquine and tocilizumab in COVID-19 based on some initial uncontrolled trials and case reports will become clearer when the results of various ongoing well-planned studies become available.


title: A Simple Mathematical Model for Estimating the Inflection Points of COVID-19 Outbreaks

text: Background: Exponential-like infection growths leading to peaks (which could be the inflection points or turning points) are usually the hallmarks of infectious disease outbreaks including coronaviruses. To predict the inflection points, i.e., inflection time (Tmax) & maximal infection number (Imax) of the novel coronavirus (COVID-19), we adopted a trial and error strategy and explored a series of approaches from simple logistic modeling (that has an asymptomatic line) to sophisticated tipping point detection techniques for detecting phase transitions but failed to obtain satisfactory results. Method: Inspired by its success in diversity-time relationship (DTR), we apply the PLEC (power law with exponential cutoff) model for detecting the inflection points of COVID-19 outbreaks. The model was previously used to extend the classic species-time relationship (STR) for general DTR (Ma 2018), and it has two secondary parameters (computed from its 3 parameters including power law scaling parameter w, taper-off parameter d to overwhelm virtually exponential growth ultimately, and a parameter c related to initial infections): one that was originally used for estimating the potential or dark biodiversity is proposed to estimate the maximal infection number (Imax) and another is proposed to determine the corresponding inflection time point (Tmax). Results: We successfully estimated the inflection points [Imax, Tmax] for most provinces (≈ 85%) in China with error rates <5% in both Imax and Tmax. We also discussed the constraints and limitations of the proposed approach, including (i) sensitive to disruptive jumps, (ii) requiring sufficiently long datasets, and (iii) limited to unimodal outbreaks.


Reflections on COVID‐19 in Sydney, Australia


title: Experience with Hydroxychloroquine and Azithromycin in the COVID-19 Pandemic: Implications for QT Interval Monitoring

text: Background: Despite a paucity of clinical evidence, hydroxychloroquine and azithromycin are being administered widely to patients with verified or suspected COVID-19. Both drugs may increase risk of lethal arrhythmias associated with QT interval prolongation. Methods: We performed a case series of COVID-19 positive/suspected patients admitted between 2/1/2020 and 4/4/2020 who were treated with azithromycin, hydroxychloroquine or a combination. We evaluated baseline and post-medication QT interval (QTc, Bazett) using 12-lead ECGs. Critical QTc prolongation was defined as: a) maximum QTc [≥]500 ms (if QRS <120 ms) or QTc [≥]550 (if QRS [≥]120 ms) and b) increased QTc of [≥]60 ms. Tisdale score and Elixhauser comorbidity index were calculated. Results: Of 490 COVID-19 positive/suspected patients, 314 (64%) received either/both drugs, and 98 (73 COVID-19 positive, 25 suspected) met study criteria (age 62{+/-}17 yrs, 61% male). Azithromycin was prescribed in 28%, hydroxychloroquine in 10%, and both in 62%. Baseline mean QTc was 448{+/-}29 ms and increased to 459{+/-}36ms (p=0.005) with medications. Significant prolongation was observed only in men (18{+/-}43 ms vs -0.2{+/-}28 ms in women, p=0.02). 12% of patients reached critical QTc prolongation. In a multivariable logistic regression, age, sex, Tisdale score, Elixhauser score, and baseline QTc were not associated with critical QTc prolongation (p>0.14). Changes in QTc were highest with the combination compared to either drug, with many-fold greater prolongation with the combination vs. azithromycin alone (17{+/-}39 vs. 0.5{+/-}40 ms, p=0.07). No patients manifested torsades de pointes. Conclusions: Overall, 12% of patients manifested critical QTc interval prolongation, and traditional risk indices failed to flag these patients. With the drug combination, QTc prolongation was several-fold higher compared to azithromycin alone. The balance between uncertain benefit and potential risk when treating COVID-19 patients with these drugs should be carefully assessed prior to use.


title: Evaluation of antibody testing for SARS-Cov-2 using ELISA and lateral flow immunoassays

text: Background: The SARS-CoV-2 pandemic caused >1 million infections during January-March 2020. There is an urgent need for robust antibody detection approaches to support diagnostics, vaccine development, safe individual release from quarantine and population lock-down exit strategies. The early promise of lateral flow immunoassay (LFIA) devices has been questioned following concerns about sensitivity and specificity. Methods: We used a panel of plasma samples designated SARS-CoV-2 positive (from SARS-CoV-2 RT-PCR-positive individuals; n=40) and negative (samples banked in the UK prior to December-2019 (n=142)). We tested plasma for SARS-Cov-2 IgM and IgG antibodies by ELISA and using nine different commercially available LFIA devices. Results: ELISA detected SARS-CoV-2 IgM or IgG in 34/40 individuals with an RT-PCR-confirmed diagnosis of SARS-CoV-2 infection (sensitivity 85%, 95%CI 70-94%), vs 0/50 pre-pandemic controls (specificity 100% [95%CI 93-100%]). IgG levels were detected in 31/31 RT-PCR-positive individuals tested ≥10 days after symptom onset (sensitivity 100%, 95%CI 89-100%). IgG titres rose during the 3 weeks post symptom onset and began to fall by 8 weeks, but remained above the detection threshold. Point estimates for the sensitivity of LFIA devices ranged from 55-70% versus RT-PCR and 65-85% versus ELISA, with specificity 95-100% and 93-100% respectively. Within the limits of the study size, the performance of most LFIA devices was similar. Conclusions: The performance of current LFIA devices is inadequate for most individual patient applications. ELISA can be calibrated to be specific for detecting and quantifying SARS-CoV-2 IgM and IgG and is highly sensitive for IgG from 10 days following symptoms onset.


title: Burnout among healthcare professionals during COVID-19 pandemic: a cross-sectional study

text: Background: The unpredictable nature of the new COVID-19 pandemic and the already alarming incidence of healthcare workers being affected can have a significant impact on the psychological well-being of the staff. Objective: To describe the prevalence of burnout among healthcare professionals and the associated factors. Design: Cross-sectional survey. Setting: Eight university affiliated hospitals in the capital city of Tehran, Iran. Participants: All healthcare workers at the study sites who had been taking care of COVID-19 patients. Measurements: Age, gender, marital status, having children, hospital, job category, experience, and work load, as well as the level of burnout in each subscale. Results: 326 persons (53.0%) experienced high levels of burnout. The average score in emotional exhaustion, depersonalization and lack of personal accomplishment was 26.6, 10.2, and 27.3, respectively. The level of burnout in the three subscales varied based on the personal as well as work related factors and gender was the only variable that was associated with high levels of all three domains. Limitations: There was no control group and thus we cannot claim a causal relationship between COVID-19 and the observed level of burnout. Not all confounding factors might have been accounted for. Conclusions: Burnout is prevalent among healthcare workers caring for COVID-19 patients. Age, gender, job category, and site of practice contribute to the level of burnout that the staff experience.


title: A Lung Transcriptomic Analysis for Exploring Host Response in COVID-19

text: Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) rose without precedent for Wuhan, China, in December 2019 It is a kind of exceptionally pathogenic human coronavirus (HCoV) which causes zoonotic sicknesses and represents a significant risk to general wellbeing Recognizing the hidden biology and pathogenesis of this novel coronavirus is extremely critical to comprehend as well as boosting the treatment of this deadly pandemic The point of this study is to recognize key genes which show significant expression in the SARS-CoV-2 infected lungs as compared to healthy ones Our analysis uncovered 149 gene-signatures that show substantial up-regulation in COVID-19 lungs Out of these, top ten dysregulated genes STAP1, CASP5, FDCSP, CARD17, ST20, AKR1B10, CLC, KCNJ2-AS1, RNASE2 and FLG are found to be significant based on various crucial statistical factors and may end up being acceptable helpful drug targets


docid: xwwomnqu

title: An epidemiologic profile of COVID-19 patients in Vietnam

text: Background and Aim. There is a paucity of data on the COVID-19 pandemic in Vietnam. In this paper, we sought to provide an epidemiologic description of patients who were infected with SARS-Cov-2 in Vietnam. Methods. Data were abstracted from the wikipedia's COVID-19 information resource and Johns Hopkins University Dashboard. Demographic data and treatment status were obtained for each patient in each day. The coverage period was from 23/1/2020 to 10/4/2020. Descriptive analyses of incident cases were stratified by gender and age group. The estimation of the reproduction ratio was done with a bootstrap method using the R statistical environment. Results. During the coverage period, Vietnam has recorded 257 cases of COVID-19. Approximately 54% of the cases were women. The median age of patients was 30 years (range: 3 months to 88 years), with 78% of patients aged 49 or younger. About 66% (n = 171) of patients were overseas tourists (20%) and Vietnamese students or workers returning from overseas (46%). Approximately 57% (n = 144) of patients have been recovered and discharged from hospitals. There have been no mortality. The reproduction ratio was estimated to range between 0.95 and 1.24. Conclusion. These data indicate that a majority of COVID-19 patients in Vietnam was imported cases in overseas tourists and young students and workers who had returned from overseas.


title: Sick Bats Stay Home Alone: Social distancing during the acute phase response in Egyptian fruit bats (Rousettus aegyptiacus)

text: Along with its many advantages, social roosting imposes a major risk of pathogen transmission. How social animals, and especially free-ranging mammals, reduce this risk is poorly documented. We used lipopolysaccharide injection to imitate bacterial sickness in both a captive and a free-ranging colony of an extremely social mammal – the Egyptian fruit bat. We monitored behavioral and physiological responses using an arsenal of methods, including on-board GPS and acceleration, video, temperature and weight measurements, and blood samples. Sick-like bats exhibited an increased immune response, as well as classical illness symptoms including fever, weight loss, anorexia, and lethargy. Notably, they also isolated themselves from the group by leaving the social cluster and avoiding contact. Free-ranging individuals ceased foraging outdoors for at least two nights. Together, these sickness behaviors demonstrate a strong, integrative immune response which protects both individuals and their group members from transmission of pathogens.


title: Modeling COVID-19 for lifting non-pharmaceutical interventions

text: As a result of the COVID-19 worldwide pandemic, the United States instituted various non-pharmaceutical interventions (NPIs) in an effort to the slow the spread of the disease. Although necessary for public safety, these NPIs can also have deleterious effects on the economy of a nation. State and federal leaders need tools that provide insight into which combination of NPIs will have the greatest impact on slowing the disease and at what point in time it is reasonably safe to start lifting these restrictions to everyday life. In the present work, we outline a modeling process that incorporates the parameters of the disease, the effects of NPIs, and the characteristics of individual communities to offer insight into when and to what degree certain NPIs should be instituted or lifted based on the progression of a given outbreak of COVID-19.


title: Impact of non-pharmaceutical interventions against COVID-19 in Europe: a quasi-experimental study

text: The current epidemic of COVID-19 is unparalleled in recent history as are the social distancing interventions that have led to a significant halt on the economic and social life of so many countries. However, there is very little empirical evidence about which social distancing measures have the most impact. We report a quasi-experimental study of the impact of various interventions for control of the outbreak. Data on case numbers and deaths were taken from the daily published figures by the European Centre for Disease Control and dates of initiation of various control strategies from the Institute of Health Metrics and Evaluation website and published sources. Our primary analyses were modelled in R using Bayesian generalised additive mixed models (GAMM). We found that closure of education facilities, prohibiting mass gatherings and closure of some non-essential businesses were associated with reduced incidence whereas stay at home orders, closure of all non-businesses and requiring the wearing of facemasks or coverings in public was not associated with any independent additional impact. Our results could help inform strategies for coming out of lockdown.


title: Encephalopathy as the Sentinel Sign of a Cortical Stroke in a Patient Infected With Coronavirus Disease-19 (COVID-19)

text: The novel coronavirus has challenged medical systems worldwide to provide optimal medical care in the setting of limited resources. Although we are uncovering many facets of its disease spectrum, with rapidly emerging data, there is still limited knowledge of the sequelae of this infection, making treatment guidelines incomplete and resulting in serious unpredictable outcomes in patients at seemingly low risk, especially ones afflicted by neurological consequences. We present a case of a cortical stroke in a 31-year-old coronavirus disease-19 (COVID-19) positive female with otherwise no stroke risk factors. We noted a correlation between cytokine release, encephalopathy, and the onset of stroke symptoms. Patients with marked pro-thrombotic and inflammatory markers may benefit from closer neurological monitoring and thromboprophylaxis at therapeutic doses. The establishment of acute care pathways to manage critically ill patients with neurological consequences may reverse the suboptimal outcome trends seen during the pandemic.


title: Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy

text: Coronavirus disease 2019 (COVID-19) is a pandemic. Neurological complications of COVID-19 have not been reported. Encephalopathy has not been described as a presenting symptom or complication of COVID-19. We report a case of a 74-year-old patient who traveled from Europe to the United States and presented with encephalopathy and COVID-19.


title: High resolution CT findings and clinical features of COVID-19 in Guangzhou/ 广州地区新型冠状病毒肺炎的高分辨率CT表现与临床特点

text: Objective: To investigate the initial high resolution CT (HRCT) manifestations and clinical features of imported COVID-19 in Guangzhou. Methods: A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years,then their clinical features and HRCT characteristics were analyzed. Results: The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases). The first time HRCT showed that 24 cases with COVID-19 were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung. Conclusion: The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of COVID-19 patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner.


title: Neoadjuvant endocrine therapy for luminal breast cancer treatment: a first-choice alternative in times of crisis such as the COVID-19 pandemic

text: The epidemiological emergency caused by CoV-2 (COVID-19) has changed priorities in breast cancer management. In those places where the pandemic has had the greatest effect, it is of paramount importance for most patients to be at home, reducing or postponing their attendance at clinics, as well as avoiding surgeries. In this scenario, neoadjuvant endocrine treatment could be an appropriate alternative treatment for hormone receptor positive breast cancer (luminal-like tumours) in order to minimise hospital admissions and to delay elective surgeries. Accordingly, we present a simple protocol that can be applied to most cases of luminal-like breast cancer and is appropriate for the majority of secondary or tertiary medical centres, or even primary care.


title: Challenges in control of Covid-19: short doubling time and long delay to effect of interventions

text: Early assessments of the spreading rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but more reliable inferences can now be made. Here, we estimate from European data that COVID-19 cases are expected to double initially every three days, until social distancing interventions slow this growth, and that the impact of such measures is typically only seen nine days - i.e. three doubling times - after their implementation. We argue that such temporal patterns are more critical than precise estimates of the basic reproduction number for initiating interventions. This observation has particular implications for the low-and middle-income countries currently in the early stages of their local epidemics.


title: Epidemiological and clinical characteristics of the early phase of the COVID-19 epidemic in Brazil

text: Background: The first case of COVID-19 was detected in Brazil on February 25, 2020. We report the epidemiological, demographic, and clinical findings for confirmed COVID-19 cases during the first month of the epidemic in Brazil. Methods: Individual-level and aggregated COVID-19 data were analysed to investigate demographic profiles, socioeconomic drivers and age-sex structure of COVID-19 tested cases. Basic reproduction numbers (R0) were investigated for Sao Paulo and Rio de Janeiro. Multivariate logistic regression analyses were used to identify symptoms associated with confirmed cases and risk factors associated with hospitalization. Laboratory diagnosis for eight respiratory viruses were obtained for 2,429 cases. Findings: By March 25, 1,468 confirmed cases were notified in Brazil, of whom 10% (147 of 1,468) were hospitalised. Of the cases acquired locally (77.8%), two thirds (66.9% of 5,746) were confirmed in private laboratories. Overall, positive association between higher per capita income and COVID-19 diagnosis was identified. The median age of detected cases was 39 years (IQR 30-53). The median R0 was 2.9 for Sao Paulo and Rio de Janeiro. Cardiovascular disease/hypertension were associated with hospitalization. Co-circulation of six respiratory viruses, including influenza A and B and human rhinovirus was detected in low levels. Interpretation: Socioeconomic disparity determines access to SARS-CoV-2 testing in Brazil. The lower median age of infection and hospitalization compared to other countries is expected due to a younger population structure. Enhanced surveillance of respiratory pathogens across socioeconomic statuses is essential to better understand and halt SARS-CoV-2 transmission.


title: Pharmacy Patronage: Identifying the Roles of Nepalese Pharmacists in Tacking COVID-19

text: Coronavirus disease (COVID-19) pandemic is one of the dire issues currently worldwide With increasing death tolls every day and with new information regarding disease every minute, it is very important to disseminate the updated and reliable information to the public Along with other health care professionals, the pharmacists' role is crucial in preventing the spread and management of the disease The involvement of pharmacists from clinical trials, drug evaluation to providing pharmaceutical care and other basic pharmacy services in the frontline in this health emergency is undeniable This commentary focuses on the role of pharmacists in different settings of the health care system and the degree of recognition of the work in Nepal


title: Community vulnerability to epidemics in Nepal: A high-resolution spatial assessment amidst COVID-19 pandemic

text: The coronavirus disease 19 (COVID-19), the biggest health problem at present, does not have uniform transmission and severity among the countries and communities therein. Knowledge of community vulnerability to the disease would facilitate interventions aimed at transmission control by the efficient deployment of available limited resources. Therefore, we assessed spatial variations and heterogeneity of disease vulnerability among the population in 753 municipal units of Nepal. We collected geospatial indicators representing the domain of socioeconomic inequalities, population dynamics, heterogeneity in the accessibility and the information related to an underlying health condition which potentially affect the severity of COVID-19 transmission. Those indicators were assembled to create three vulnerability indices using Geographic Information System (GIS); Social Vulnerability Index (SVI), Epidemiological Vulnerability Index (EVI) and a composite of the two- Social and Epidemiological Vulnerability Index (SEVI). The indicators were scaled to a common measurement scale and spatially overlaid via equally weighted arithmetic mean. The indices were classified into five level of risk and the municipal units and the population within vulnerabilities classes were quantified and visualized in the map. The index output indicated high vulnerability to epidemics in megacities like Kathmandu, Pokhara, Bharatpur, etc.; developing cities especially in the Province No 2; and, municipal units of Karnali and Sudoorpashchim provinces. Additionally, some other municipalities such as Dhulikhel, Beshishahar, Tansen etc. which have a higher prevalence of pulmonary and cardiovascular disorders are highly vulnerable. The SVI indicated that 174 municipal units and 41.5% population is highly vulnerable. The EVI identified 55 municipal units and 40.7% of the total population of the country highly vulnerable to COVID-19. The SEVI accounted that disease vulnerability is high in 105 municipal units and 40% population of Nepal. The vulnerability indices created are means for different tiers of the existing government in federal system of Nepal for prioritization and improved planning for disease intervention especially in highly vulnerable municipal units where the COVID-19 transmission could have high severity.


title: De-Escalation by Reversing the Escalation with a Stronger Synergistic Package of Contact Tracing, Quarantine, Isolation and Personal Protection: Feasibility of Preventing a COVID-19 Rebound in Ontario, Canada, as a Case Study

text: Since the beginning of the COVID-19 pandemic, most Canadian provinces have gone through four distinct phases of social distancing and enhanced testing. A transmission dynamics model fitted to the cumulative case time series data permits us to estimate the effectiveness of interventions implemented in terms of the contact rate, probability of transmission per contact, proportion of isolated contacts, and detection rate. This allows us to calculate the control reproduction number during different phases (which gradually decreased to less than one). From this, we derive the necessary conditions in terms of enhanced social distancing, personal protection, contact tracing, quarantine/isolation strength at each escalation phase for the disease control to avoid a rebound. From this, we quantify the conditions needed to prevent epidemic rebound during de-escalation by simply reversing the escalation process.


title: Estimating weekly excess mortality at subnational level in Italy during the COVID-19 pandemic

text: Background Excess mortality from all-cause has been estimated at national level for different countries, to provide a picture of the total burden of the COVID-19 pandemic. Nevertheless, there have been no attempts at modelling it at high spatial resolution, needed to understand geographical differences in the mortality patterns, to evaluate temporal lags and to plan for future waves of the pandemic. Methods This is the first subnational study on excess mortality during the COVID-19 pandemic in Italy, the third most-hit country. We considered municipality level and estimated all-cause mortality weekly trends based on the first four months of 2016 -- 2019. We specified a Bayesian hierarchical model allowing for spatial heterogeneity as well as for non-linear smooth spatio-temporal terms. We predicted the weekly mortality rates at municipality level for 2020 based on the modelled spatio-temporal trends (i.e.~in the absence of the pandemic) and estimated the excess mortality and the uncertainty surrounding it. Results We found strong evidence of excess mortality for Northern Italy, with higher mortality rates than expected from the end of February in Lombardia, with total excess deaths of 23,946 (23,013 -- 24,786), and the beginning of March for North East and North West with total excess deaths of 8,033 (7,061 -- 9,044) and 1,588 (404 -- 2,700) respectively. We found marked geographical differences, with percent excess of up to 88.9% (81.9% -- 95.2%) at the peak of the pandemic, in the city of Bergamo (Lombardia).


title: Clinical outcomes of 402 patients with COVID-2019 from a single center in Wuhan, China

text: The SARS-CoV-2 outbreak is causing widespread infections and significant mortality. Previous studies describing clinical characteristics of the disease contained small cohorts from individual centers or larger series consisting of mixed cases from different hospitals. We report analyses of mortality and disease severity among 402 patients from a single hospital. The cohort included 297 patients with confirmed and 105 with suspected diagnosis. The latter group met the criteria for clinical diagnosis but nucleic acid tests results were initially interpreted as suspicious. Data were compared between genders and among different age groups. The overall case fatality is 5.2%. However, patients 70 years of age or older suffered a significantly higher mortality (17.8%), associated with more patients having severe or critical illness (57.5%). Patients 50 years of age or older had a mortality of 8.0%, and those younger than 50 years, 1.2%. Male patients had a mortality of 7.6% versus 2.9% in females.


title: Discussing Privacy and Surveillance on Twitter: A Case Study of COVID-19

text: Technology is uniquely positioned to help us analyze large amounts of information to provide valuable insight during widespread public health concerns, like the ongoing COVID-19 pandemic. In fact, information technology companies like Apple and Google have recently launched tools for contact tracing-the ability to process location data to determine the people who have been in contact with a possible patient, in order to contain the spread of the virus. While China and Singapore have successfully led the effort, more and more countries are now implementing such surveillance systems, raising potential privacy concerns about this long term surveillance. For example, it is not clear what happens to the information post-pandemic because people are more likely to share their information during a global crisis without governments having to elaborate on their data policies. Digital Ethnography on Twitter, which has over 330 million users worldwide, with a majority in the United States where the pandemic has the worst effects provides a unique opportunity to learn about real-time opinions of the general public about current affairs in a rather naturalistic setting. Consequently, it might be useful to highlight the privacy concerns of users, should they exist, through analysis of Twitter data and information sharing policies during unprecedented public health outbreaks. This will allow governments to protect their citizens both during and after health emergencies.


title: Extended Storage of SARS-CoV2 Nasopharyngeal Swabs Does Not Negatively Impact Results of Molecular-Based Testing

text: With the global outbreak of the novel coronavirus disease 2019, the demand for testing rapidly increased and quickly exceeded the testing capacities for many laboratories. Clinical tests which receive CE and FDA authorizations cannot always be tested thoroughly in a real-world environment. Here we demonstrate the long-term stability of nasopharyngeal swab specimens for SARS-CoV-2 molecular testing across three assays recently approved by the U.S. FDA under Emergency Use Authorization. This study demonstrates that nasopharyngeal swab specimens can be stored under refrigeration or even ambient conditions for 21 days without clinically impacting the results of the real-time RT-PCR testing.


title: Frequency Energy Analysis in Detecting Rolling Bearing Faults

text: Abstract Component failure analysis is sometimes difficult to directly detect due to the complexity of an operating system configuration. Raw time series data is not enough in some cases to understand the type of fault or how it is progressing. The conversion of data from the time domain to the frequency domain assists researchers in making a more discernible difference for detecting failures, but depending on the manufacturing equipment type and complexity, there is still a possibility for inaccurate results. This research explores a method of classifying rolling bearing faults utilizing the total energy gathered from the Power Spectral Density (PSD) of a Fast Fourier Transform (FFT). Using a spectrogram over an entire process cycle, the PSD is swept through time and the total energy is computed and plotted over the periodic machine cycle. Comparing with a baseline set of data, classification patterns emerge, giving an indication of the type of fault, when a fault begins and how the fault progresses. There is a separable difference in each type of fault and a measurable change in the distribution of accumulated damage over time. A roller bearing is used as a validating component, due to the known types of faults and their classifications. Traditional methods are used for comparison and the method verified using experimental and industrial applications. Future application is justified for more complex and not so well-understood systems.


title: Thrombocytopenia in the Course of COVID-19 Infection

text: We report three cases of severe thrombocytopenia during COVID-19 infection associated with either cutaneous purpura or mucosal bleeding. The initial investigations ruled out other causes of thrombocytopenia. Two of the patients were treated with intravenous immunoglobulins and eltrombopag, while the third recovered spontaneously. A good clinical and biological response was achieved in all patients leading to hospital discharge. LEARNING POINTS: Immune thrombocytopenia should be considered in COVID-19-infected patients presenting with thrombocytopenia. Coronavirus-related thrombocytopenia can be severe and life-threatening. Despite the severity of coronavirus-related immune thrombocytopenia, recovery may be spontaneous or achieved following immunoglobulin or platelet growth factor administration.


Nationwide system to centralize decisions around extracorporeal membranous oxygenation use for severe COVID‐19 pneumonia in Japan


title: Validation and performance of a quantitative IgG assay for the screening of SARS-CoV-2 antibodies

text: The current COVID-19 epidemic imposed an unpreceded challenge to the scientific community in terms of treatment, epidemiology, diagnosis, social interaction, fiscal policies and many other areas. The development of accurate and reliable diagnostic tools (high specificity and sensitivity) is crucial in the current period, the near future and in the long term. These assays should provide guidance to identify immune presumptive protected persons, potential plasma, and/or B cell donors and vaccine development among others. Also, such assays will be contributory in supporting prospective and retrospective studies to identify the prevalence and incidence of COVID-19 and to characterize the dynamics of the immune response. As of today, only thirteen serological assays have received the Emergency Use Authorization (EUA) by the U.S. Federal Drug Administration (FDA). In this work we describe the development and validation of a quantitative IgG enzyme-linked immunoassay (ELISA) using the recombinant SARS-CoV-2 Spike Protein S1 domain, containing the receptor-binding domain (RBD), showing 98% sensitivity and 98.9% specificity. The assay showed to be useful to test for SARS-CoV-2 IgG antibodies in plasma samples from COVID-19-recovered subjects as potential donors for plasmapheresis. This assay is currently under review by the Federal Drug Administration for an Emergency Use Authorization request (Submission Number EUA201115).


title: Evaluation of Rural Public Libraries to Address Telemedicine Inequities

text: Introduction: In the United States, access to home-based telemedicine is inequitably distributed due to the limited reach of fixed broadband in rural areas. Public libraries typically offer patrons free access to broadband. Libraries, particularly those in rural regions, need to be evaluated as a site for patients to connect to a health care provider over a video visit. The purpose of this research was to evaluate the technological readiness of public libraries to provide telemedicine support and to determine differences in readiness between rural and urban public libraries. Methods: We distributed a survey to members of the Virginia Library Association to evaluate technological readiness of Virginia public libraries to support telemedicine use in their facilities. The survey evaluated availability and speed of fixed broadband internet access, physical equipment, and private space for each library. Results: Respondents from 39 libraries completed the survey, approximately one-third of which were in rural or small urban areas. All respondents reported fixed broadband, at least four computers, and available staff to assist who technology in their libraries. Eighty-five percent of surveyed libraries reported sufficient broadband speed and a private room available to patrons. There were no significant differences between rural and urban status for any of the library characteristics. Discussion: Public libraries in Virginia are technologically ready to support patrons connecting to health care providers over telemedicine. Systematic guidelines for library-practice collaborations are needed to support implementation across geographic and socioeconomically diverse areas.


title: Dental considerations after the outbreak of 2019 novel coronavirus disease: A review of literature

text: In late December 2019, a new type of coronavirus, called novel coronavirus disease 2019 (COVID-19), caused a major outbreak of severe pneumonia in Wuhan (Huanan seafood market) and then, across China. As of 31 March 2020, COVID-19 has spread in 200 countries, including Iran, and imposed serious health-related threats to the public worldwide. Fever, dry (non-productive) cough, myalgia, and pneumonia seem to be the symptoms of COVID-19 disease. To date, and despite various studies and investigations, except for chloroquine and hydroxychloroquine, which have recently been temporarily approved by FDA, no other vaccines and/or antiviral agents have been clinically endorsed for the treatment of COVID-19 disease. Nevertheless, prevention of the disease and control of the infection is deemed a top priority for the general public. Owing to the characteristics of different dental treatments and settings, the risk of virus transmission can be considered high between patients and dental practitioners. Therefore, the need for strict and tough effective infection control protocols in dental practice is of great importance, namely for the dental centers in the potentially affected areas with COVID-19. This study, based on relevant evidence, aimed to review the basic knowledge of COVID-19 and address the recommended protocols of infection control for the dental practitioners and treatments in hypothetically stricken areas.


title: Development and Multicenter Performance Evaluation of The First Fully Automated SARS-CoV-2 IgM and IgG Immunoassays

text: BACKGROUND: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread globally. The laboratory diagnosis of SARS-CoV-2 infection has relied on nucleic acid tests. However, there are many limitations of nucleic acid tests, including low throughput and high rates of false negatives. More sensitive and accurate tests to effectively identify infected patients are needed. METHODS: This study has developed fully automated chemiluminescent immunoassays (CLIA) to determine IgM and IgG antibodies to SARS-CoV-2 in human serum. The assay performance has been evaluated at 10 hospitals. Clinical specificity was evaluated by measuring 972 hospitalized patients with diseases other than COVID-19, and 586 donors of a normal population. Clinical sensitivity was assessed on 503 confirmed cases of SARS-CoV-2 by RT-PCR and 52 suspected cases. RESULTS: The assays demonstrated satisfied assay precision with coefficient of variation (CV) of less than 4.45%. Inactivation of specimen does not affect assay measurement. SARS-CoV-2 IgM shows clinical specificity of 97.33% and 99.49% for hospitalized patients and normal population respectively. SARS-CoV-2 IgG shows clinical specificity of 97.43% and 99.15% for the hospitalized patients and the normal population respectively. SARS-CoV-2 IgM and IgG show clinical sensitivity of 85.88% and 96.62% respectively for confirmed SARS-Cov-2 infection with RT-PCR, of 73.08% and 86.54% respectively for suspected cases. CONCLUSIONS: we have developed fully automated immunoassays for detecting SARS-CoV-2 IgM and IgG antibodies in human serum. The assays demonstrated high clinical specificity and sensitivity, and add great value to nucleic acid testing in fighting against the global pandemic of the SARS-CoV-2 infection.


title: The Epidemiological Implications of Incarceration Dynamics in Jails for Community, Corrections Officer, and Incarcerated Population Risks from COVID-19

text: COVID-19 challenges the daily function of nearly every institution of society. It is the duty of any society to be responsive to such challenges by relying on the best tools and logic available to analyze the costs and benefits of any mitigative action. We here provide a mathematical model to explore the epidemiological consequences of allowing standard intake and unaltered within-jail operational dynamics to be maintained during the ongoing COVID-19 pandemic, and contrast this with proposed interventions to reduce the burden of negative health outcomes. In this way, we provide estimates of the infection risks, and likely loss of life, that arise from current incarceration practices. We provide estimates for in-custody deaths and show how the within-jail dynamics lead to spill-over risks, not only affecting the incarcerated people, but increasing the exposure, infection, and death rates for both corrections officers with whom they interact within the jail system, and the broader community beyond the justice system. We show that, given a typical jail-community dynamic, operating in a business as usual way will result in significant and rapid loss of life. Large scale reductions in arrest and speeding of releases are likely to save the lives of incarcerated people, staff and the community at large.