title: The CoRisk-Index: A data-mining approach to identify industry-specific risk assessments related to COVID-19 in real-time

text: While the coronavirus spreads, governments are attempting to reduce contagion rates at the expense of negative economic effects. Market expectations plummeted, foreshadowing the risk of a global economic crisis and mass unemployment. Governments provide huge financial aid programmes to mitigate the economic shocks. To achieve higher effectiveness with such policy measures, it is key to identify the industries that are most in need of support. In this study, we introduce a data-mining approach to measure industry-specific risks related to COVID-19. We examine company risk reports filed to the U.S. Securities and Exchange Commission (SEC). This alternative data set can complement more traditional economic indicators in times of the fast-evolving crisis as it allows for a real-time analysis of risk assessments. Preliminary findings suggest that the companies' awareness towards corona-related business risks is ahead of the overall stock market developments. Our approach allows to distinguish the industries by their risk awareness towards COVID-19. Based on natural language processing, we identify corona-related risk topics and their perceived relevance for different industries. The preliminary findings are summarised as an up-to-date online index. The CoRisk-Index tracks the industry-specific risk assessments related to the crisis, as it spreads through the economy. The tracking tool is updated weekly. It could provide relevant empirical data to inform models on the economic effects of the crisis. Such complementary empirical information could ultimately help policymakers to effectively target financial support in order to mitigate the economic shocks of the crisis.


Home quarantine for Taiwanese travelers entering Taiwan


Impact of COVID-19 lockdown on adherence to continuous positive airway pressure (CPAP) by obstructive sleep apnoea patients


90Y Radioembolization: Telemedicine During COVID-19 Outbreak, Opportunity for Prime Time


Strengthening ICU health security for a coronavirus epidemic


docid: vwzdijgg

title: Molecular analysis of several in-house rRT-PCR protocols for SARS-CoV-2 detection in the context of genetic variability of the virus in Colombia

text: The COVID-19 pandemic caused by SARS-CoV-2 is a public health problem unprecedented in the recent history of humanity. Different in-house real-time RT-PCR (rRT-PCR) methods for SARS-CoV-2 diagnosis and the appearance of genomes with mutations in primer regions have been reported. Hence, whole-genome data from locally-circulating SARS-CoV-2 strains contribute to the knowledge of its global variability and the development and fine tuning of diagnostic protocols. To describe the genetic variability of Colombian SARS-CoV-2 genomes in hybridization regions of oligonucleotides of the main in-house methods for SARS-CoV-2 detection, RNA samples with confirmed SARS-CoV-2 molecular diagnosis were processed through next-generation sequencing. Primers/probes sequences from 13 target regions for SARS-CoV-2 detection suggested by 7 institutions and consolidated by WHO during the early stage of the pandemic were aligned with Muscle tool to assess the genetic variability potentially affecting their performance. Finally, the corresponding codon positions at the 3' end of each primer, the open reading frame inspection was identified for each gene/protein product. Complete SARS-CoV-2 genomes were obtained from 30 COVID-19 cases, representative of the current epidemiology in the country. Mismatches between at least one Colombian sequence and five oligonucleotides targeting the RdRP and N genes were observed. The 3' end of 4 primers aligned to the third codon position, showed high risk of nucleotide substitution and potential mismatches at this critical position. Genetic variability was detected in Colombian SARS-CoV-2 sequences in some of the primer/probe regions for in-house rRT-PCR diagnostic tests available at WHO COVID-19 technical guidelines; its impact on the performance and rates of false-negative results should be experimentally evaluated. The genomic surveillance of SARS-CoV-2 is highly recommended for the early identification of mutations in critical regions and to issue recommendations on specific diagnostic tests to ensure the coverage of locally-circulating genetic variants.


title: Boning up: amino-bisphophonates as immunostimulants and endosomal disruptors of dendritic cell in SARS-CoV-2 infection

text: Amino-bisphosphonates such as zoledronic acid (ZA) can possibly ameliorate or prevent severe COVID-19 disease by at least three distinct mechanisms: (1) as immunostimulants which could boost Î³Î´ T cell expansion, important in the acute response in the lung; (2) as DC modulators, limiting their ability to only partially activate T cells; and (3) as prenylation inhibitors of small GTPases in the endosomal pathway of the DC to prevent expulsion of lysosomes containing SARS-CoV-2 virions. Use of ZA or other amino-bisphosphonates as modulators of COVID-19 disease should be considered.


title: Is the Collapse of the Respiratory Center in the Brain Responsible for Respiratory Breakdown in COVID-19 Patients?

text: Following the identification of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, we are now again facing a global highly pathogenic novel coronavirus (SARS-CoV-2) epidemic. Although the lungs are one of the most critically affected organs, several other organs, including the brain may also get infected. Here, we have highlighted that SARS-CoV-2 might infect the central nervous system (CNS) through the olfactory bulb. From the olfactory bulb, SARS-CoV-2 may target the deeper parts of the brain including the thalamus and brainstem by trans-synaptic transfer described for many other viral diseases. Following this, the virus might infect the respiratory center of brain, which could be accountable for the respiratory breakdown of COVID-19 patients. Therefore, it is important to screen the COVID-19 patients for neurological symptoms as well as possibility of the collapse of the respiratory center in the brainstem should be investigated in depth.


COVID-19 exacerbating inequalities in the US


title: Test, test, test for COVID-19 antibodies: the importance of sensitivity, specificity and predictive powers

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests of varying specificity and sensitivity are now available. For informing individuals whether they have had coronavirus disease 2019 (COVID-19), they need to be very accurate. For measuring population prevalence of past infection, the numbers of false positives and negatives need to be roughly equal. With a series of worked examples for a notional population of 100,000 people, we show that even test systems with a high specificity can yield a large number of false positive results, especially where the population prevalence is low. For example, at a true population prevalence of 5%, using a test with 99% sensitivity and specificity, 16% of positive results will be false and thus 950 people will be incorrectly informed they have had the infection. Further confirmatory testing may be needed. Giving false reassurance on which personal or societal decisions might be based could be harmful for individuals, undermine public confidence and foster further outbreaks.


title: Preparing for the Next Wave of COVID-19: Resilience in the Face of a Spreading Pandemic

text: COVID-19 painfully demonstrates how little resilience our societies have to novel viruses. Societies, decision makers, and scientists lack (1) a comprehensive understanding of the complexity of viral outbreaks and their impact on society; (2) intervention portfolios; and (3) a global crisis and resilience policy, all of which are required to develop appropriate measures and to improve societal resilience. We highlight COVID-19 immunity as one key benchmark in preparation for the next wave of the pandemic. Specifically, using network scenarios, we demonstrate the substantial advantage of reintegrating health care workers with acquired COVID-19 immunity in epidemic hotspots, which would not only enable their safe contribution to the health care system but also drastically contain further spread.


Sleep Health Service in China During the COVID-19 Outbreak


title: [Suggestions for disinfection of ophthalmic examination equipment and protection of ophthalmologist against 2019 novel coronavirus infection]

text: At present, the prevention and treatment of 2019 Novel Coronavirus (2019-nCoV) in China has reached a critical stage. It is extremely important to disinfect ophthalmic examination instruments and protect ophthalmic medical care during the epidemic period to reduce cross-infection in clinical practice and reduce the infection risk of ophthalmic medical staff. (Chin J Ophthalmol, 2020, 56: 0001).


Clinicopathological characteristics of 8697 patients with COVID-19 in China: meta-analysis


Commentary: Rethinking surgical protocols in the COVID-19 era


Mental health of older adults during the COVID-19 pandemic: lessons from history to guide our future


title: Twitter discussions and emotions about COVID-19 pandemic: a machine learning approach

text: The objective of the study is to examine coronavirus disease (COVID-19) related discussions, concerns, and sentiments that emerged from tweets posted by Twitter users. We analyze 4 million Twitter messages related to the COVID-19 pandemic using a list of 25 hashtags such as"coronavirus,""COVID-19,""quarantine"from March 1 to April 21 in 2020. We use a machine learning approach, Latent Dirichlet Allocation (LDA), to identify popular unigram, bigrams, salient topics and themes, and sentiments in the collected Tweets. Popular unigrams include"virus,""lockdown,"and"quarantine."Popular bigrams include"COVID-19,""stay home,""corona virus,""social distancing,"and"new cases."We identify 13 discussion topics and categorize them into five different themes, such as"public health measures to slow the spread of COVID-19,""social stigma associated with COVID-19,""coronavirus news cases and deaths,""COVID-19 in the United States,"and"coronavirus cases in the rest of the world". Across all identified topics, the dominant sentiments for the spread of coronavirus are anticipation that measures that can be taken, followed by a mixed feeling of trust, anger, and fear for different topics. The public reveals a significant feeling of fear when they discuss the coronavirus new cases and deaths than other topics. The study shows that Twitter data and machine learning approaches can be leveraged for infodemiology study by studying the evolving public discussions and sentiments during the COVID-19. Real-time monitoring and assessment of the Twitter discussion and concerns can be promising for public health emergency responses and planning. Already emerged pandemic fear, stigma, and mental health concerns may continue to influence public trust when there occurs a second wave of COVID-19 or a new surge of the imminent pandemic.


title: Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China

text: Coronavirus disease 2019 (COVID-19) is a respiratory disorder caused by the highly contagious severe acute respiratory syndrome coronavirus 2. The immunopathological characteristics of patients with COVID-19, either systemic or local, have not been thoroughly studied. In the present study, we analysed both the changes in the number of various immune cell types as well as cytokines important for immune reactions and inflammation. Our data indicate that patients with severe COVID-19 exhibited an overall decline of lymphocytes including CD4+ and CD8+ T cells, B cells and natural killer cells. The number of immunosuppressive regulatory T cells was moderately increased in patients with mild COVID-19. Interleukin-6 (IL-6), IL-10 and C-reactive protein were remarkably up-regulated in patients with severe COVID-19. In conclusion, our study shows that the comprehensive decrease of lymphocytes, and the elevation of IL-6, IL-10 and C-reactive protein are reliable indicators of severe COVID-19.


title: Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses

text: A direct approach to limit airborne viral transmissions is to inactivate them within a short time of their production. Germicidal ultraviolet light, typically at 254 nm, is effective in this context but, used directly, can be a health hazard to skin and eyes. By contrast, far-UVC light (207-222 nm) efficiently kills pathogens potentially without harm to exposed human tissues. We previously demonstrated that 222-nm far-UVC light efficiently kills airborne influenza virus and we extend those studies to explore far-UVC efficacy against airborne human coronaviruses alpha HCoV-229E and beta HCoV-OC43. Low doses of 1.7 and 1.2 mJ/cm2 inactivated 99.9% of aerosolized coronavirus 229E and OC43, respectively. As all human coronaviruses have similar genomic sizes, far-UVC light would be expected to show similar inactivation efficiency against other human coronaviruses including SARS-CoV-2. Based on the beta-HCoV-OC43 results, continuous far-UVC exposure in occupied public locations at the current regulatory exposure limit (~3 mJ/cm2/hour) would result in ~90% viral inactivation in ~8 minutes, 95% in ~11 minutes, 99% in ~16 minutes and 99.9% inactivation in ~25 minutes. Thus while staying within current regulatory dose limits, low-dose-rate far-UVC exposure can potentially safely provide a major reduction in the ambient level of airborne coronaviruses in occupied public locations.


COVID-19 Presents High Risk to Older Persons


Challenges to dementia care during COVID-19: Innovations in remote delivery of group Cognitive Stimulation Therapy


Preliminary detection of lung hypoperfusion in discharged Covid-19 patients during recovery


title: Successful recovery of COVID-19 pneumonia in a patient from Colombia after receiving chloroquine and clarithromycin

text: BACKGROUND: COVID-19 pandemics is a challenge for public health and infectious diseases clinicians, especially for the therapeutical approach that is not yet adequately defined. Amid this situation, investigational agents are being used, including chloroquine. We report here the clinical features and therapeutic course of the first reported patient with confirmed COVID-19 pneumonia that recovered in Colombia, after the use of chloroquine and clarithromycin. CASE PRESENTATION: A 34-year-old male, returning from Spain, presented with complaints of fever, and cough, and class-II obesity, being hospitalized. The respiratory viruses and bacteria tested by FilmArray® PCR were negative. Two days later, clarithromycin was started because the patient was suspected as community-acquired pneumonia. At the third day, the rRT-PCR confirmed the SARS-CoV-2 infection. A day later, chloroquine was started because of that. His chest computed tomography was performed and showed bilateral multifocal ground-glass opacities with consolidation, which suggested viral pneumonia as a differential diagnosis. Progressively his clinical condition improved and at day 9, patient rRT-PCR for SARS-CoV-2 became negative. The patient was discharged and isolated at home per 14 days. CONCLUSIONS: Our patient improved significantly. This and other COVID-19 cases are urgently demanding results from clinical trials that support evidence-based therapeutical approaches to this pandemic and the clinical management of patients, especially those at critical care.


title: Low prevalence of arrhythmias in clinically stable COVID-19 patients

text: BACKGROUND: No studies investigated the prevalence of arrhythmias among clinically-stable patients affected by COVID-19 infection. METHODS: We assessed prevalence, type, and burden of arrhythmias, by a single-day snapshot in seven non-intensive COVID Units at a third-level center. RESULTS: We enrolled 132 inhospital patients (mean age 65±14y; 66% males) newly diagnosed with COVID-19 infection. Arrhythmic episodes were detected in 12 patients (9%). In detail, 8 had atrial fibrillation, and 4 self-limiting supraventricular tachyarrhythmias. There were no cases of ventricular arrhythmias or new-onset atrioventricular blocks. In addition, we report no patients with QTc interval >450 ms. CONCLUSIONS: Our single-day snapshot survey suggests that the prevalence of arrhythmias among clinically stable COVID-19 patients is low. In particular, no life-threatening arrhythmic events occurred.


title: Neurological Impact of Coronavirus Disease of 2019: Practical Considerations for the Neuroscience Community

text: BACKGROUND: The coronavirus disease of 2019 (COVID-19), which is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently been designated a pandemic by the World Health Organization, affecting 2.7 million individuals globally as of April 25, 2020, with more than 187,000 deaths. An increasing body of evidence has supported central nervous system involvement. METHODS: We conducted a review of the reported data for studies concerning COVID-19 pathophysiology, neurological manifestations, and neuroscience provider recommendations and guidelines. RESULTS: Central nervous system manifestations range from vague nonfocal complaints to severe neurological impairment associated with encephalitis. It is unclear whether the neurological dysfunction results from direct viral injury or systemic disease. The virus could affect brainstem pathways that lead to indirect respiratory dysfunction, in addition to direct pulmonary injury. Necessary adaptations in patient management, triage, and diagnosis are evolving in light of the ongoing scientific and clinical findings. CONCLUSIONS: The present review has consolidated the current body of data regarding the neurological impact of coronaviruses, discussed the reported neurological manifestations of COVID-19, and highlighted the recommendations for patient management. Specific recommendations pertaining to clinical practice for neurologists and neurosurgeons have also been provided.


docid: xbtkyzfa

title: COVID-19 and the Future of Long-Term Care: The Urgency of Enhanced Federal Financing

text: The economic threat posed by responses to COVID 19 endangers financing for long-term care across the states that is already inadequate and inequitable. Increasing the federal share of Medicaid spending as unemployment rises would mitigate fiscal pressure on states and preserve public services. But unlike the demand for Medicaid's health care protections, which rises when economic activity declines, the demand for long-term care protections will grow even in a healthy economy as the population ages. Enhanced federal support is urgent not only to cope with the virus today but also to meet the long-term care needs of the nation's aging population in the years to come. Long-term care financing policy should be modified to either adjust federal matching funds by the age of each state's population, or fully federalize the funding of LTC expenses of Medicaid beneficiaries who are also eligible for Medicare.


title: Challenges and Opportunities for the Biotechnology Research Community during the Coronavirus Pandemic

text: The coronavirus disease 2019 (COVID-19) pandemic has presented some significant challenges to the scientific community. However, this has also offered opportunities for the pursuit of new scientific activities, and in particular for the field of biotechnology.


Pool size selection when testing for SARS-CoV-2


Flattening the curve on Covid-19


SARS-CoV-2 infection and air pollutants: Correlation or causation?


Digitalized Adaptation of Oncology Trials during and after COVID-19


title: Pediatric SARS, H1N1, MERS, EVALI, and Now Coronavirus Disease (COVID-19) Pneumonia: What Radiologists Need to Know

text: OBJECTIVE. The purpose of this article is to review new pediatric lung disorders-including disorders that have occurred in recent years years such as severe acute respiratory syndrome (SARS), swine-origin influenza A (H1N1), Middle East respiratory syndrome (MERS), e-cigarette or vaping product use-associated lung injury (EVALI), and coronavirus disease (COVID-19) pneumonia-to enhance understanding of the characteristic imaging findings. CONCLUSION. Although the clinical symptoms of SARS, H1N1, MERS, EVALI, and COVID-19 pneumonia in pediatric patients may be nonspecific, some characteristic imaging findings have emerged or are currently emerging. It is essential for radiologists to have a clear understanding of the characteristic imaging appearances of these lung disorders in pediatric patients to ensure optimal patient care.


title: Biomarkers associated with COVID-19 disease progression

text: The coronavirus disease 2019 (COVID-19) pandemic is a scientific, medical, and social challenge. The complexity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is centered on the unpredictable clinical course of the disease that can rapidly develop, causing severe and deadly complications. The identification of effective laboratory biomarkers able to classify patients based on their risk is imperative in being able to guarantee prompt treatment. The analysis of recently published studies highlights the role of systemic vasculitis and cytokine mediated coagulation disorders as the principal actors of multi organ failure in patients with severe COVID-19 complications. The following biomarkers have been identified: hematological (lymphocyte count, neutrophil count, neutrophil-lymphocyte ratio (NLR)), inflammatory (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT)), immunological (interleukin (IL)-6 and biochemical (D-dimer, troponin, creatine kinase (CK), aspartate aminotransferase (AST)), especially those related to coagulation cascades in disseminated intravascular coagulation (DIC) and acute respiratory distress syndrome (ARDS). New laboratory biomarkers could be identified through the accurate analysis of multicentric case series; in particular, homocysteine and angiotensin II could play a significant role.


title: Intentional Hydroxychloroquine Overdose Treated with High-Dose Diazepam: an Increasing Concern in the COVID-19 Pandemic

text: INTRODUCTION: Recent attention on the possible use of hydroxychloroquine and chloroquine to treat COVID-19 disease has potentially triggered a number of overdoses from hydroxychloroquine. Toxicity from hydroxychloroquine manifests with cardiac conduction abnormalities, seizure activity, and muscle weakness. Recognizing this toxidrome and unique management of this toxicity is important in the COVID-19 pandemic. CASE REPORT: A 27-year-old man with a history of rheumatoid arthritis presented to the emergency department 7 hours after an intentional overdose of hydroxychloroquine. Initial presentation demonstrated proximal muscle weakness. The patient was found to have a QRS complex of 134 ms and QTc of 710 ms. He was treated with early orotracheal intubation and intravenous diazepam boluses. Due to difficulties formulating continuous diazepam infusions, we opted to utilize an intermitted intravenous bolus strategy that achieved similar effects that a continuous infusion would. The patient recovered without residual side effects. DISCUSSION: Hydroxychloroquine toxicity is rare but projected to increase in frequency given its selection as a potential modality to treat COVID-19 disease. It is important for clinicians to recognize the unique effects of hydroxychloroquine poisoning and initiate appropriate emergency maneuvers to improve the outcomes in these patients.


Understanding the Singapore COVID-19 Experience: Implications for Hospital Medicine


What Do We Know About Remdesivir Drug Interactions?


Working together to contain and manage COVID-19


title: Health Risks Associated with 5G Exposure: A View from the Communications Engineering Perspective

text: The deployment of 5G wireless communication services requires the installation of 5G next-generation Node-B Base Stations (gNBs) over the territory and the wide adoption of 5G User Equipment (UE). In this context, the population is concerned about the potential health risks associated with the Radio Frequency (RF) emissions from 5G equipment, with several communities actively working toward stopping the 5G deployment. To face these concerns, in this work, we analyze the health risks associated with 5G exposure by adopting a new and comprehensive viewpoint, based on the communications engineering perspective. By exploiting our background, we debunk the alleged health effects of 5G exposure and critically review the latest works that are often referenced to support the health concerns from 5G. We then precisely examine the up-to-date metrics, regulations, and assessment of compliance procedures for 5G exposure, by evaluating the latest guidelines from IEEE, ICNIRP, ITU, IEC, and FCC, as well as the national regulations in more than 220 countries. We also thoroughly analyze the main health risks that are frequently associated with specific 5G features (e.g., MIMO, beamforming, cell densification, adoption of millimeter waves, and connection of millions of devices). Finally, we examine the risk mitigation techniques based on communications engineering that can be implemented to reduce the exposure from 5G gNB and UE. Overall, we argue that the widely perceived health risks that are attributed to 5G are not supported by scientific evidence from communications engineering. In addition, we explain how the solutions to minimize the health risks from 5G are already mature and ready to be implemented. Finally, future works, e.g., aimed at evaluating long-term impacts of 5G exposure, as well as innovative solutions to further reduce the RF emissions, are suggested.


title: Panax quinquefolium saponin Optimizes Energy Homeostasis by Modulating AMPK-Activated Metabolic Pathways in Hypoxia-Reperfusion Induced Cardiomyocytes

text: OBJECTIVE: To investigate the effects and underlying mechanisms of Panax quinquefolium saponin (PQS) on energy deficiency in hypoxia-reperfusion (H/R) induced cardiomyocytes. METHODS: The H/R injury involved hypoxia for 3 h and then reperfusion for 2 h. Cardiomyocytes recruited from neonatal rat ventricular myocytes (NRVMs) were randomly divided into control, H/R, H/R+compound C (C.C), H/R+PQS, and H/R+C. C+PQS groups. BrdU assay, lactase dehydrogenase (LDH) leakage and early apoptosis rate were evaluated to assess cell damages. Contents of high energy phosphate compounds were conducted to detect the energy production. Protein expression levels of adenosine monophosphate-activated protein kinase a (AMPKα), glucose transporter 4 (GLUT4), phosphate fructose kinase 2 (PFK2), fatty acid translocase/cluster of differentiation 36 (FAT/CD36), and acetyl CoA carboxylase 2 (ACC2) in the regulatory pathways were measured by Western blotting. Immunofluorescence staining of GLUT4 and FAT/CD36 was used to observe the mobilization of metabolic transporters. RESULTS: PQS (50 mg/L) pretreatment significantly alleviated H/R-induced inhibition of NRVMs viability, up-regulation of LDH leakage, acceleration of early apoptosis, and reduction of energy production (P<0.05). Compared with the H/R group, up-regulated expression of AMPKα, GLUT4, PFK2, FAT/CD36 and ACC2 were observed, and more GLUT4 and FAT/CD36 expressions were detected on the membrane in the H/R+PQS group (P<0.05). These effects of PQS on H/R-induced NRVMs were eliminated in the H/R+C.C+PQS group (P<0.05). CONCLUSION: PQS has prominent advantages in protecting NRVMs from H/R-induced cell damages and energy metabolic disorders, by activation of AMPKα-mediated GLUT4-PFK2 and FAT/CD36-ACC2 pathways.


A tale of two pandemics: How will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another?


Hemoptysis as an Initial Presentation of COVID-19 - An Observation


Covid-19 and exacerbation of psoriasis


Extracorporeal Life Support Organization COVID-19 Interim Guidelines


title: Response: D-dimer triage for COVID-19

text: We thank Dr Al-Najar and colleagues for their letter(1). Our Research Letter(2) from work completed early April 2020 is intended to rapidly communicate our finding of 93% 28-day survival (95% CI, 92-95%) for a normal D-dimer on admission and 98% survival (95% CI, 96-99%) for a normal D-dimer two days later. Because we reported on 749 patients, those estimates had high precision. We chose death as a hard relevant outcome, rather than severity. 100% of patients had gold-standard PCR RNA positivity.


title: Internalized Stigma among Bedouin and Jews with Mental Illness: Comparing Self-Esteem, Hope, and Quality of Life

text: The aim of this study was to assess the differences in internalized-stigma, self-esteem, hope, and quality of life in individuals with mental illness from two diverse cultures (Bedouins and Jews) and to examine the relationships between self-stigma and self-esteem, hope, and quality of life in participants from both cultures. Two hundred participants with mental illness in Israel were assessed on the Internalized Stigma of Mental Illness (ISMI) scale. The Arab Bedouin participants tended to internalize stigma to a greater extent than the Jewish participants. Overall, there was a significant negative correlation between self-stigma, self-esteem, and hope and between alienation and quality of life in both groups although the correlation was stronger among the Arab Bedouin participants. By contrast, the associations between self-stigma and quality of life were only significant for two of the self-stigma dimensions (alienation and discrimination) among the Jewish participants. These results contribute to a better understanding of the role internalized stigma may play in the life of people with mental illness from diverse cultures. They may help design culturally appropriate intervention programs for people with mental illness.


title: Imprints of pandemic lockdown on subsurface water quality in the coastal industrial city of Tuticorin, South India: A revival perspective

text: Globally, the incidences of environmental improvements owing to seizing the anthropogenic activities during the lockdown have been reported through news articles and photographs, yet a formal scholarly study has been lacking to substantiate the imprints of lockdown. We hereby present the imprints of lockdown on water quality (both chemical and biological) parameters during the nationwide lockdown (COVID-19 epidemic) in India between 25th March to 30th May 2020. The present study describes the changes in chemical and biological water quality parameters based on twenty-two groundwater samples from the coastal industrial city of Tuticorin in Southern India, taken before (10 and 11th February 2020) and during the lockdown (19 and 20th April 2020) periods. The physico-chemical parameters compared are pH, total dissolved solids (TDS) and electrical conductivity (EC), nitrate (NO3), fluoride (F), chromium (Cr), iron (Fe), copper (Cu), zinc (Zn), cadmium (Cd), lead (Pb), arsenic (As), and selenium (Se), and the bacterial parameters are total coliforms, fecal coliforms, E. coli, and fecal streptococci. Among the metals, the significant reductions in Se (42%), As (51%), Fe (60%) and Pb (50%) were noticed probably owing to no or very less wastewater discharges from metal-based industries, seafood-based industries and thermal power plants during the lockdown. Reduction in NO3 (56%), total coliform (52%) and fecal coliforms (48%) indicated less organic sewage from the fishing industries. Contents of Cr, Cu, Zn and Cd, however, remained similar and fluoride did not show any change, probably as they were sourced from rock-water interactions. Similarly, we did not observe alterations in E. coli and fecal streptococci due to no significant change in domestic sewage production during the lockdown. The multivariate analyses aptly illustrated this and the principal component analyses helped to identify the sources that controlled water qualities of the lockdown compared to the pre-lockdown period. Our observation implies that groundwater is definitely under active interaction with surface waters and thus a quick revival could be observed following the seizing of anthropogenic activities.


title: Histopathology and genetic susceptibility in COVID-19 pneumonia

text: BACKGROUND: The clinical features of COVID-19 pneumonia range from a mild illness to patients with a very severe illness with acute hypoxemic respiratory failure requiring ventilation and Intensive Care Unit admission. AIMS: To provide a brief overview of the existing evidence for such differences in host response and outcome, and generate hypotheses for divergent patterns and avenues for future research, by highlighting similarities and differences in histopathological appearance between COVID-19 and influenza as well as previous coronavirus outbreaks, and by discussing predisposition through genetics and underlying disease. MATERIALS AND METHOD: We assessed the available early literature for histopathological patterns of COVID-19 pneumonia and underlying risk factors. RESULT: The histopathological spectrum of COVID-19 pneumonia includes variable patterns of epithelial damage, vascular complications, fibrosis and inflammation. Risk factors for a fatal disease include older age, respiratory disease, diabetes mellitus, obesity and hypertension. DISCUSSION: While some risk factors and their potential role in COVID-19 pneumonia are increasingly recognized, little is known about the mechanisms behind episodes of sudden deterioration or the infrequent idiosyncratic clinical demise in otherwise healthy and young subjects. CONCLUSION: The answer to many of the remaining questions regarding COVID-19 pneumonia pathogenesis may in time be provided by genotyping as well careful clinical, serological, radiological and histopathological phenotyping.


Covid-19: GPs call for appraisals and CQC inspections to be suspended


title: Just the Facts: What are the roles of oxygen escalation and noninvasive ventilation in COVID-19?

text: A 37-year-old female presents with cough, fever, dyspnea, and myalgias for five days after recent contact with a family member with confirmed 2019 coronavirus disease (COVID-19). Her vital signs include T 38.3° C, HR 108, BP 118/70 mm Hg, RR 26 breaths per minute, and oxygen saturation 67% on room air. She is not in respiratory distress currently and is protecting her airway. Her chest X-ray reveals bilateral airspace opacities. You plan to immediately intervene and address her hypoxia.


How COVID-19 pandemic changed our communication with families: losing nonverbal cues


Is Africa prepared for tackling the COVID-19 (SARS-CoV-2) epidemic. Lessons from past outbreaks, ongoing pan-African public health efforts, and implications for the future


Meticulous surgical technique cannot be replaced by cholangiography


title: Laboratory data analysis of novel coronavirus (COVID-19) screening in 2510 patients

text: BACKGROUND: Novel coronavirus (COVID-19) is highly infectious and requires early detection, isolation, and treatment. We tried to find some useful information by analyzing the covid-19 screening data, so as to provide help for clinical practice. METHOD: We collected nucleic acid and hematology data from 2510 patients for COVID-19 infection for retrospective analysis. RESULT: COVID-19 and influenza A and B infection rates were 1.3%, 3%, and 3%, respectively. COVID-19 nucleic acid was detected in stool but not in tear samples from 8 positive patients. Among the 32 patients with COVID-19, 15 (47%) and 16 (50%) patients showed decreased lymphocyte count and lymphocyte ratio, 21(66%) and 24(75%) patients showed decreased eosinophil count and eosinophil ratio, and 18 (56%) patients showed increased C-reactive protein. Ten hematological indicators significantly differed in the blood of patients with COVID-19 and those with influenza A and B (P < 0.05). Eighteen hematological indicators significantly differed between patients with COVID-19 and negative patients (P < 0.05). CONCLUSION: The positive rate of influenza A and B infection was higher than that of COVID-19. When pharyngeal swab collection may cause infection, fecal samples can be examined. Evaluation of pharyngeal swab and fecal samples can improve the positive rate of nucleic acid detection. The COVID-19 can cause some hematological indices changes.


Pediatric coronavirus disease-2019: How to assess chest disease?


docid: ynlsubzn

title: SARS-CoV-2 infection in children in Parma

text: not available.


title: Nicht-invasive Beurteilung von pulmonalen Läsionen bei Patienten mit Coronavirus-Erkrankung (COVID-19) durch Ultraschall direkt am Krankenbett./ A Clinical Study of Noninvasive Assessment of Lung Lesions in Patients with Coronavirus Disease-19 (COVID-19) by Bedside Ultrasound

text: PURPOSE: This study was conducted to explore the clinical value of noninvasive assessment of bedside ultrasound in the diagnosis of lung lesions of Coronavirus Disease-19. METHODS: In this retrospective study, 30 patients with Coronavirus Disease-19 admitted to our hospital from January 18 to February 5, 2020, were selected as the research subjects. All cases were examined by lung ultrasound and CT. Lung lesions were reviewed by blinded observers, with imaging scores being used to analyze the ultrasound findings of lung lesions in patients with Coronavirus Disease-19 and with chest CT being used as the reference standard. The clinical value of ultrasound in the noninvasive assessment of lung lesions was evaluated. RESULTS: Lung ultrasound signs in patients with Coronavirus Disease-19 were mainly manifested as interstitial pulmonary edema (90.0â%, 27/30) and pulmonary consolidations (20.0â%, 6/30). The lung lesions were mainly distributed in the subpleural and peripheral pulmonary zones. The lower lobe and the dorsal region had a greater tendency to be involved. There was moderate agreement (Kappaâ=â0.529) between the noninvasive assessment of bedside ultrasound for lung lesions in patients with Coronavirus Disease-19 and CT. The ultrasound scores to evaluate mild, moderate and severe lung lesions exhibited sensitivity of 68.8â% (11/16), 77.8â% (7/9), 100.0â% (2/2), specificity of 85.7â% (12/14), 76.2â% (16/21), 92.9â% (26/28), and diagnostic accuracy of 76.7â% (23/30), 76.7â% (23/30), 93.3â% (28/30), respectively. The follow-up dynamic ultrasound examination showed that the condition of all patients worsened gradually, with the ultrasound scores of lung lesions increasing to varying degrees. CONCLUSION: Though the diagnostic efficacy of bedside ultrasound is relatively low for mild to moderate patients, it is high for severe patients. Bedside ultrasound has important clinical significance for noninvasive assessment and dynamic observation of lung lesions in patients with Coronavirus Disease-19, which is worth further consideration.


More on Covid-19 in Immune-Mediated Inflammatory Diseases


title: E-Quarantine: A Smart Health System for Monitoring Coronavirus Patients for Remotely Quarantine

text: Coronavirus becomes officially a global pandemic due to the speed spreading off in various countries. An increasing number of infected with this disease causes the Inability problem to fully care in hospitals and afflict many doctors and nurses inside the hospitals. This paper proposes a smart health system that monitors the patients holding the Coronavirus remotely. Due to protect the lives of the health services members (like physicians and nurses) from infection. This smart system observes the people with this disease based on putting many sensors to record many features of their patients in every second. These parameters include measuring the patient's temperature, respiratory rate, pulse rate, blood pressure, and time. The proposed system saves lives and improves making decisions in dangerous cases. It proposes using artificial intelligence and Internet-of-things to make remotely quarantine and develop decisions in various situations. It provides monitoring patients remotely and guarantees giving patients medicines and getting complete health care without anyone getting sick with this disease. It targets two people's slides the most serious medical conditions and infection and the lowest serious medical conditions in their houses. Observing in hospitals for the most serious medical cases that cause infection in thousands of healthcare members so there is a big need to uses it. Other less serious patients slide, this system enables physicians to monitor patients and get the healthcare from patient's houses to save places for the critical cases in hospitals.


title: Ioflupane 123I (DAT scan) SPECT identifies dopamine receptor dysfunction early in the disease course in progressive apraxia of speech

text: OBJECTIVE: To describe 123I-FP-CIT (DAT scan) SPECT findings in progressive apraxia of speech (PAOS) patients and to compare those findings with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). BACKGROUND: PAOS is a neurodegenerative syndrome in which patients present with apraxia of speech, a motor speech disorder affecting programming and planning of speech. Patients with PAOS predictably develop Parkinsonism. DAT scan is a neuroimaging tool that assesses the integrity of presynaptic dopamine transporters in striatum and is usually abnormal in PSP and CBS. METHODS: As part of an NIH-funded grant, we performed a DAT scan on 17 PAOS patients early in the disease course. DaTQUANT software was used to quantify uptake in the left and right caudate and anterior/posterior putamen, with striatum to background ratios (SBRs). The PAOS cohort was compared to 15 PSP and 8 CBS patients. RESULTS: Five PAOS patients (29%) showed abnormalities in at least one striatal region on DAT scan. When the five PAOS patients with abnormal DAT were compared to the PSP and CBS patients, the only difference observed was lower uptake in the posterior putamen in PSP (p = 0.03). There were no differences is putamen/caudate ratio or in symmetry of uptake, across all groups. There was also no difference in MDS-UPDRS-III scores between PAOS patients with and without abnormal DAT scans (p = 0.56). CONCLUSIONS: Abnormal DAT scan is observed early in the disease course in approximately 30% of PAOS patients, with striatal abnormalities similar to those in PSP and CBS.


title: COVID-19 and Acute Lupus Pneumonitis: Diagnostic and Treatment Dilemma

text: In this article, we present a case of a young female patient with previously diagnosed lupus pneumonitis, now with a flare and new superimposed COVID-19 infection that was treated with intravenous steroids. On computed tomography scans, she had extensive interstitial lung fibrosis in addition to a positive COVID-19 polymerase chain reaction test requiring 6 L of oxygen via nasal cannula on admission. After administration of methylprednisolone, the patient improved and was weaned off her oxygen requirements and was discharged home.


title: Notes From the Field: Vape Shop Business Operations Compliance in the Wake of COVID-19

text: The novel 2019 Coronavirus Disease (COVID-19) pandemic has led to the closing of all but essential businesses in California. However, several nonessential businesses have remained open in Southern California despite the mandated "stay at home" order issued by the governor. As part of an ongoing vape shop project involving 88 participating shops, this study investigated the number of vape shops that remained open amidst the coronavirus outbreak and related mandates. Examination of shop social media websites and telephone calls to shops revealed that 61.4% (n = 54) have remained open, particularly within Korean/Asian and Hispanic/Latino ethnic locations (32 of the 54 shops). Importantly, walk-in service was much higher within Hispanic/Latino locations compared to African American, Korean/Asian, or non-Hispanic White neighborhoods (p = 0.03). It is not known if shops that stayed open were in direct violation of the order, didn't know all the details of the order, or found a loophole in the order and believed that they were an essential business. Better communication between the vape shop industry and public health officials during this pandemic is needed.


Handling of allergen immunotherapy in the COVID-19 pandemic: An ARIA-EAACI statement


How Simulations May Help Us to Understand the Dynamics of COVID-19 Spread. - Visualizing Non-Intuitive Behaviours of a Pandemic (pansim.uni-jena.de)


Inflammatory Bowel Disease Management During the Coronavirus-19 Outbreak: A Survey From the European Crohn's and Colitis Organization


title: Acute Type A Aortic Dissection during COVID-19 Outbreak

text: As of April 7, 2020, approximately 1,300,000 cases and 80,000 deaths related to coronavirus disease 2019 (COVID-19) have been reported in > 180 countries/territories. Healthcare infrastructures and resources, particularly as it relates to the care of the most critically ill patients, are currently being strained globally. In this context, however, there has been little clinical guidance or information regarding life-threatening conditions requiring emergency surgery that cannot be delayed. We herein present a case of acute type A aortic dissection with COVID-19 in order to highlight the clinical implications of a true emergent procedure during the COVID-19 outbreak.


Reply to: "Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak"


title: Effects of intrauterine exposure to 2,3',4,4',5-pentachlorobiphenyl on the reproductive system and sperm epigenetic imprinting of male offspring

text: Polychlorinated biphenyls (PCBs) are a class of persistent organic environmental pollutants with a total of 209 homologs. The homolog 2,3',4,4',5-pentachlorobiphenyl (PCB118) is one of the most important dioxin-like PCBs and is highly toxic. PCB118 can accumulate in human tissues, serum and breast milk, which leads to direct exposure of the fetus during development. In the present study, pregnant mice were exposed to 0, 20 and 100 µg/kg/day of PCB118 during the stage of fetal primordial germ cell migration. Compared with the control group, we found morphological alterations of the seminiferous tubules and a higher sperm deformity rate in the male offspring in the treatment groups. Furthermore, the methylation patterns in the treatment groups of the imprinted genes H19 and Gtl2 in the sperm were altered in the male offspring. We also characterized the disturbance of the expression levels of DNA methyltransferase 1 (Dnmt1), Dnmt3a, Dnmt3b, Dnmt3l, and Uhrf1. The results indicated that intrauterine exposure to low doses of PCB118 could significantly damage the reproductive health of the male offspring. Therefore, attention should be paid to the adverse effects of PCB118 exposure during pregnancy on the reproductive system of male offspring.


Vicissitudes in oncological care during COVID19


title: Drugs supply and pharmaceutical care management practices at a designated hospital during the COVID-19 epidemic

text: The coronavirus disease-19 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus that was first detected at the end of December 2019. The epidemic has affected various regions of China in different degrees. As the situations evolve, the COVID-19 had been confirmed in many countries, and made a assessment that it can be characterized as a pandemic by the World Health Organization on March 11, 2020. Drugs are the main treatment of COVID-19 patients. Pharmaceutical service offers drug safety ensurance for COVID-19 patients. According to COVID-19 prevention and control policy and requirements, combined with series of diagnosis and treatment plans, pharmacists in the first provincial-level COVID-19 diagnosis and treatment unit in Jilin Province in Northeast China have established the management practices of drug supply and pharmaceutical care from four aspects: personnel, drugs supply management, off-label drug use management and pharmaceutical care. During the outbreak, the pharmaceutical department of THJU completed its assigned workload to ensure drug supply. So far, no nosocomial infections and medication errors have occurred, which has stabilized the mood of the staff and boosted the pharmacists' confidence in fighting the epidemic. For the treatment of COVID-19, pharmacists conducted adverse reaction monitoring and participated in the multidisciplinary consultation of COVID-19. Up to now, the COVID-19 patients admitted to THJU have not shown any new serious adverse reactions and been cured finally. The hospital pharmacy department timely adjusted the work mode, and the formed management practices is a powerful guarantee for the prevention and control of the COVID-19 epidemic. This paper summarized the details and practices of drug supply and pharmaceutical services management to provide experience for the people who involving in COVID-19 prevention and contain in other abroad epidemic areas.


docid: zkaognoz

title: Abdominal Aortic Thrombosis Complicating COVID-19 Pneumonia


title: Analysis of CT features of 15 Children with 2019 novel coronavirus infection/ 中华儿科杂志

text: Objective@#To explore imaging characteristics of children with 2019 novel coronavirus (2019-nCoV) infection.@*Methods@#A retrospective analysis was performed on clinical data and chest CT images of 15 children diagnosed with 2019-nCoV. They were admitted to the third people’s Hospital of Shenzhen from January 16 to February 6, 2020. The distribution and morphology of pulmonary lesions on chest CT images were analyzed.@*Results@#Among the 15 children, there were 5 males and 10 females, aged from 4 to 14 years old. Five of the 15 children were febrile and 10 were asymptomatic on first visit. The first nasal or pharyngeal swab samples in all the 15 cases were positive for 2019-nCoV nucleic acid. For their first chest CT images, 6 patients had no lesions, while 9 patients had pulmonary inflammation lesions. Seven cases of small nodular ground glass opacities and 2 cases of speckled ground glass opacities were found. After 3 to 5 days of treatment, 2019-nCoV nucleic acid in a second respiratory sample turned negative in 6 cases. Among them, chest CT images showed less lesions in 2 cases, no lesion in 3 cases, and no improvement in 1 case. Other 9 cases were still positive in a second nucleic acid test. Six patients showed similar chest CT inflammation, while 3 patients had new lesions, which were all small nodular ground glass opacities.@*Conclusions@#The early chest CT images of children with 2019-nCoV infection are mostly small nodular ground glass opacities. The clinical symptoms of children with 2019-nCoV infection are nonspecific. Dynamic reexamination of chest CT and nucleic acid are important.


title: [Analysis of CT features of 15 Children with 2019 novel coronavirus infection]

text: Objective: To explore imaging characteristics of children with 2019 novel coronavirus (2019-nCoV) infection. Methods: A retrospective analysis was performed on clinical data and chest CT images of 15 children diagnosed with 2019-nCoV. They were admitted to the third people's Hospital of Shenzhen from January 16 to February 6, 2020. The distribution and morphology of pulmonary lesions on chest CT images were analyzed. Results: Among the 15 children, there were 5 males and 10 females, aged from 4 to 14 years old. Five of the 15 children were febrile and 10 were asymptomatic on first visit. The first nasal or pharyngeal swab samples in all the 15 cases were positive for 2019-nCoV nucleic acid. For their first chest CT images, 6 patients had no lesions, while 9 patients had pulmonary inflammation lesions. Seven cases of small nodular ground glass opacities and 2 cases of speckled ground glass opacities were found. After 3 to 5 days of treatment, 2019-nCoV nucleic acid in a second respiratory sample turned negative in 6 cases. Among them, chest CT images showed less lesions in 2 cases, no lesion in 3 cases, and no improvement in 1 case. Other 9 cases were still positive in a second nucleic acid test. Six patients showed similar chest CT inflammation, while 3 patients had new lesions, which were all small nodular ground glass opacities. Conclusions: The early chest CT images of children with 2019-nCoV infection are mostly small nodular ground glass opacities. The clinical symptoms of children with 2019-nCoV infection are nonspecific. Dynamic reexamination of chest CT and nucleic acid are important.


"Flattening the Curve" of COVID-19 pandemic in Orthopaedics and Trauma: the Greek perspective


It is not the time for science fiction


COVID-19: delay, mitigate, and communicate


Letter to the Editor: SARS-CoV-2 and Traumatic Cervical Acute Spinal Cord Injury: An Appraisal


Sars-Cov-2 interference in HEME production: is it the time for an early predictive biomarker?


COVID-19 Awakens a New Focus on Surge Capacity Blood Glucose Testing and the Critical Role of Telehealth in Self-Management


Non-epileptic seizures in autonomic dysfunction as the initial symptom of COVID-19


COVID-19: Reducing the risk of infection might increase the risk of intimate partner violence


Good things come in threes (and sometimes fours): Update on renin-angiotensin-aldosterone system inhibitors and COVID-19


Public health in the eye of the storm: what can we learn from the COVID-19 pandemic experience to strengthen public health services in Europe?


title: Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease

text: BACKGROUND: Since early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia. METHODS: Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher's exact test. Logistic regression analysis was performed to explore the risk factors for disease progression. RESULTS: Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, Uâ=â4.932, Pâ=â0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χâ=â9.291, Pâ=â0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, Uâ=â2.057, Pâ=â0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χâ=â5.611, Pâ=â0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, Uâ=â4.030, Pâ=â0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, Uâ=â1.315, Pâ=â0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62â±â6.60 vs. 41.27â±â4.55âg/L, Uâ=â2.843, Pâ=â0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χâ=â16.01, Pâ=â0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; Pâ=â0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; Pâ=â0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, Pâ=â0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; Pâ=â0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; Pâ=â0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, Pâ=â0.028) were risk factors for disease progression. CONCLUSIONS: Several factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature at admission, respiratory failure, albumin, and C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.


How to prioritize urological surgeries during epidemics: Lessons learned from the Toronto SARS outbreak in 2003


title: COVID-19: Role of Ambulatory Surgery Facilities in This Global Pandemic

text: Coronavirus disease 2019 (COVID-19) has now become a global pandemic. This has led the United States to declare a national emergency and resulted in a ban on all elective diagnostic and therapeutic procedures as well as elective surgery in inpatient and outpatient settings. Ambulatory surgery facilities (ASF) that perform only elective procedures are thus likely to be closed. However, these facilities may be able to assist acute care hospitals as essential (urgent and emergent) surgeries and diagnostic and therapeutic procedures will still need to be performed. The aim of this article is to explore the potential contribution of ASFs in the current health care crisis. It is important to understand that COVID-19-related information is continually evolving, and thus, the discussion provided here is subject to change.


COVID-19 and healthcare systems: What should we do next?


title: Intermittent yet coordinated regional strategies can alleviate the COVID-19 epidemic: a network model of the Italian case

text: The COVID-19 epidemic that emerged in Wuhan China at the end of 2019 hit Italy particularly hard, yielding the implementation of strict national lockdown rules (Phase 1). There is now a hot ongoing debate in Italy and abroad on what the best strategy is to restart a country to exit a national lockdown (Phase 2). Previous studies have focused on modelling possible restarting scenarios at the national level, overlooking the fact that Italy, as other nations around the world, is divided in administrative regions who can independently oversee their own share of the Italian National Health Service. In this study, we show that regionalism, and heterogeneity between regions, is essential to understand the spread of the epidemic and, more importantly, to design effective post Lock-Down strategies to control the disease. To achieve this, we model Italy as a network of regions and parameterize the model of each region on real data spanning almost two months from the initial outbreak. Using the model, we confirm the effectiveness at the regional level of the national lockdown strategy implemented so far by the Italian government to mitigate the spread of the disease and show its efficacy at the regional level. We also propose that differentiated, albeit coordinated, regional interventions can be effective in Phase 2 to restart the country and avoid future recurrence of the epidemic, while avoiding saturation of the regional health systems and mitigating impact on costs. Our study and methodology can be easily extended to other levels of granularity (provinces or counties in the same region or states in other federal countries, etc.) to support policy- and decision-makers.


title: Swine acute diarrhea syndrome coronavirus-induced apoptosis is caspase- and cyclophilin D- dependent

text: Swine acute diarrhea syndrome coronavirus (SADS-CoV), a newly discovered enteric coronavirus, is the aetiological agent that causes severe clinical diarrhea and intestinal pathological damage in piglets. To understand the effect of SADS-CoV on host cells, we characterized the apoptotic pathways and elucidated mechanisms underlying the process of apoptotic cell death after SADS-CoV infection. SADS-CoV-infected cells showed evidence of apoptosis in vitro and in vivo. The use of a pan-caspase inhibitor resulted in the inhibition of SADS-CoV-induced apoptosis and reduction in SADS-CoV replication, suggestive of the association of a caspase-dependent pathway. Furthermore, SADS-CoV infection activated the initiators caspase-8 and -9 and upregulated FasL and Bid cleavage, demonstrating a crosstalk between the extrinsic and intrinsic pathways. However, the proapoptotic proteins Bax and Cytochrome c (Cyt c) relocalized to the mitochondria and cytoplasm, respectively, after infection by SADS-CoV. Moreover, Vero E6 and IPI-2I cells treated with cyclosporin A (CsA), an inhibitor of mitochondrial permeability transition pore (MPTP) opening, were completely protected from SADS-CoV-induced apoptosis and viral replication, suggesting the involvement of cyclophilin D (CypD) in these processes. Altogether, our results indicate that caspase-dependent FasL (extrinsic)- and mitochondria (intrinsic)- mediated apoptotic pathways play a central role in SADS-CoV-induced apoptosis that facilitates viral replication. In summary, these findings demonstrate mechanisms by which SADS-CoV induces apoptosis and improve our understanding of SADS-CoV pathogenesis.


title: Structural basis of receptor recognition by SARS-CoV-2

text: A novel severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2) recently emerged and is rapidly spreading in humans, causing COVID-191,2. A key to tackling this pandemic is to understand the receptor recognition mechanism of the virus, which regulates its infectivity, pathogenesis and host range. SARS-CoV-2 and SARS-CoV recognize the same receptor-angiotensin-converting enzyme 2 (ACE2)-in humans3,4. Here we determined the crystal structure of the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2 (engineered to facilitate crystallization) in complex with ACE2. In comparison with the SARS-CoV RBD, an ACE2-binding ridge in SARS-CoV-2 RBD has a more compact conformation; moreover, several residue changes in the SARS-CoV-2 RBD stabilize two virus-binding hotspots at the RBD-ACE2 interface. These structural features of SARS-CoV-2 RBD increase its ACE2-binding affinity. Additionally, we show that RaTG13, a bat coronavirus that is closely related to SARS-CoV-2, also uses human ACE2 as its receptor. The differences among SARS-CoV-2, SARS-CoV and RaTG13 in ACE2 recognition shed light on the potential animal-to-human transmission of SARS-CoV-2. This study provides guidance for intervention strategies that target receptor recognition by SARS-CoV-2.


title: Correction: Preventive Behaviors Conveyed on YouTube to Mitigate Transmission of COVID-19: Cross-Sectional Study

text: [This corrects the article DOI: 10.2196/18807.].


title: Incorporating Issues of Elderly Loneliness into the Coronavirus Disease-2019 Public Health Response

text: As the systems that people depend on are increasingly strained by the coronavirus disease-2019 (COVID-19) outbreak, public health impacts are manifesting in different ways beyond morbidity and mortality for elderly populations. Loneliness is already a chief public health concern that is being made worse by COVID-19. Agencies should recognize the prevalence of loneliness among elderly populations and the impacts that their interventions have on loneliness. This letter describes several ways that loneliness can be addressed to build resilience for elderly populations as part of the public health response to COVID-19.


title: A Rapid Systematic Review of Clinical Trials Utilizing Chloroquine and Hydroxychloroquine as a Treatment for COVID-19

text: OBJECTIVES: The emergence of SARS-CoV-2 has presented clinicians with a difficult therapeutic dilemma. With supportive care as the current mainstay of treatment, the fatality rate of COVID-19 is 6.9%. There are currently several trials assessing the efficacy of different antivirals as treatment. Of these, chloroquine (CQ) and its derivative hydroxychloroquine (HCQ) have garnered the most attention. METHODS: In this study, the literature currently available on CQ and HCQ as treatment of COVID-19 was surveyed using EMBASE, PubMed, Cochrane Library, MedRxiv, and one clinical trial registry. Upon gathering published and preprint trials, risk of bias was assessed using Cochrane Risk of Bias Tool 2.0. RESULTS: There are currently seven completed clinical trials and 29 registered clinical trials focusing on HCQ or CQ as a therapeutic avenue for COVID-19. Of these, five of seven trials have shown favorable outcomes for patients using CQ or HCQ and two of seven have shown no change compared to control. However, all seven trials carried varying degrees of bias and poor study design. CONCLUSION: There are currently not enough data available to support the routine use of HCQ and CQ as therapies for COVID-19. Pending further results from more extensive studies with more stringent study parameters, clinicians should defer from routine use of HCQ and CQ. There are several clinical trials currently under way with results expected soon.


MSMA Recommends "Shelter-In-Place" to Missouri Governor to Curb COVID-19


title: Déjà Vu or Jamais Vu? How the Severe Acute Respiratory Syndrome Experience Influenced a Singapore Radiology Department's Response to the Coronavirus Disease (COVID-19) Epidemic

text: OBJECTIVE. This article shares the ground operational perspective of how a tertiary hospital radiology department in Singapore is responding to the coronavirus disease (COVID-19) epidemic. This same department was also deeply impacted by the severe acute respiratory syndrome (SARS) outbreak in 2003. CONCLUSION. Though similar to SARS, the COVID-19 outbreak has several differences. We share how lessons from 2003 are applied and modified in our ongoing operational response to this evolving novel pathogen.


title: Adapting Vascular Surgery Practice to the Current COVID-19 Era at a Tertiary Academic Center in Madrid

text: BACKGROUND: The epidemic potential of coronavirus infection is now a reality. Since the first case detected in late 2019 in China, a fast worldwide expansion confirms it. The vascular patient is at a higher risk of developing a severe form of the disease because of its nature associating several comorbid states, and thus, some vascular surgery communities from many countries have tried to stratify patients into those requiring care during these uncertain times. METHODS: This is an observational study describing the current daily vascular surgery practice at one tertiary academic hospital in Madrid region, Spain-one of the most affected regions worldwide due to the COVID-19 outbreak. We analyzed our surgical practice since March 14th when the lockdown was declared up to date, May 14th (2 months). Procedural surgical practice, organizational issues, early outcomes, and all the troubles encountered during this new situation are described. RESULTS: Our department is composed of 10 vascular surgeons and 4 trainees. Surgical practice has been reduced to only urgent care, totaling 50 repairs on 45 patients during the period. Five surgeries were performed on 3 COVID-19-positive patients. Sixty percent were due to critical limb ischemia, 45% of them performed by complete endovascular approach, whereas less than 10% of repairs were aorta related. We were allocated to use a total of 5 surgical rooms in different locations, none our usual, as it was converted into an ICU room while performing 50% of those repairs with unusual nursery staff. CONCLUSIONS: The COVID-19 outbreak has dramatically changed our organization and practice in favor of urgent or semiurgent surgical care alone. The lack of in-hospital/ICU beds and changing nursery staff changed the whole availability organization at our hospital and was a key factor in surgical decision-making in some cases.


Wuhan: Back to the Future and the Return of Coronaviruses


title: Design of multi-epitope vaccine candidate against SARS-CoV-2: a in-silico study

text: The best therapeutic strategy to find an effective vaccine against SARS-CoV-2 is to explore the target structural protein. In the present study, a novel multi-epitope vaccine is designed using in silico tools that potentially trigger both CD4 and CD8 T-cell immune responses against the novel Coronavirus. The vaccine candidate was designed using B and T-cell epitopes that can act as an immunogen and elicits immune response in the host system. NCBI was used for the retrieval of surface spike glycoprotein, of novel corona virus (SARS-CoV-2) strains. VaxiJen server screens the most important immunogen of all the proteins and IEDB server gives the prediction and analysis of B and T cell epitopes. Final vaccine construct was designed in silico composed of 425 amino acids including the 50S ribosomal protein adjuvant and the construct was computationally validated in terms of antigenicity, allergenicity and stability on considering all critical parameters into consideration. The results subjected to the modeling and docking studies of vaccine were validated. Molecular docking study revealed the protein-protein binding interactions between the vaccine construct and TLR-3 immune receptor. The MD simulations confirmed stability of the binding pose. The immune simulation results showed significant response for immune cells. The findings of the study confirmed that the final vaccine construct of chimeric peptide could able to enhance the immune response against nCoV-19.


title: Potential use of Turmeric in COVID-19

text: Turmeric (Curcuma longa L.) is an integral part of Asian culture which has been used in traditional medicine systems like Ayurveda, Unani and Siddha owing to its wide array of medicinal properties since centuries. Curcumin, the predominant curcumoid in turmeric, influences multiple signaling pathways and been found to possess anti-inflammatory, anti-oxidant, antimicrobial, hypoglycemic, wound healing, chemopreventive, chemosensitising and radiosensitising properties.1 To enhance the bioavailability of curcumin, newer technologies such as adjuvant, nanoparticles, liposomes, micelles and phospholipid complexes are evaluated in the process of drug development. It is documented to be most efficacious in high doses at around 6-7 gm per day which is well tolerated orally.1 It has been widely used as a common household remedy for cough, sore throat and respiratory ailments in Asia.


Structural racism remains a primary public health risk amidst COVID and beyond in the United Kingdom


title: Impact de la pandémie de COVID-19 sur l'activité chirurgicale au sein des services d'urologie de l'Assistance Publique  Hôpitaux de Paris./ [Impact of the COVID-19 pandemic on surgical activity within academic urological departments in Paris]

text: INTRODUCTION: As a result of the COVID-19 pandemic in France, all non-emergency surgical activity has been cancelled since March 12, 2020. In order to anticipate the reinstatement of delayed interventions, surgical activity reduction analysis is essential. The objective of this study was to evaluate the reduction of urological surgery in adult during the COVID-19 pandemic compared to 2019. MATERIAL: The data regarding urological procedures realized in the 8 academic urological departments of Parisians centres (AP-HP) were compared over two similar periods (14-29 March 2019 and 12-27 March 2020) using the centralized surgical planning software shared by these centres. Procedure title, type of surgery and outpatient ratio were collected. The interventions were sorted into 16 major families of urological interventions. RESULTS: Overall, a 55% decrease was observed concerning urological procedures over the same period between 2019 and 2020 (995 and 444 procedures respectively). Oncology activity and emergencies decreased by 31% and 44%. The number of kidney transplantations decreased from 39 to 3 (-92%). Functional, andrological and genital surgical procedures were the most impacted among the non-oncological procedures (-85%, -81% and -71%, respectively). Approximatively, 1033 hours of surgery have been delayed during this 16-day period. CONCLUSION: Lockdown and postponement of non-urgent scheduled urological procedures decisions has led to a drastic decrease in surgical activity in AP-HP. Isolated kidney transplantation has been stopped (national statement). Urologists must anticipate for lockdown exit in order to catch-up delayed surgeries. LEVEL OF EVIDENCE: 3.


docid: jrlfdssk

title: Critical importance of early introduction of prevention measures for SARS-CoV-2 infection in endoscopy units


Pandemics, panic and prevention: Stages in the life of COVID-19 pandemic


SARS-CoV-2 (COVID-19) Vaccine Development and Production: An Ethical Way Forward


text: The world awaits a SARS-CoV-2 virus (i.e., COVID-19 disease) vaccine to keep the populace healthy, fully reopen their economies, and return their social and healthcare systems to "normal." Vaccine safety and efficacy requires meticulous testing and oversight; this paper describes how despite grandiose public statements, the current vaccine development, testing, and production methods may prove to be ethically dubious, medically dangerous, and socially volatile. The basic moral concern is the potential danger to the health of human test subjects and, eventually, many vaccine recipients. This is further complicated by economic and political pressures to reduce government oversight on rushed vaccine testing and production, nationalistic distribution goals, and failure to plan for the widespread immunization needed to produce global herd immunity. As this paper asserts, the public must be better informed to assess promises about the novel vaccines being produced and to tolerate delays and uncertainty.


A vaccine is not too far for COVID-19


title: Mechanical Ventilator Milano (MVM): A Novel Mechanical Ventilator Designed for Mass Scale Production in Response to the COVID-19 Pandemic

text: Presented here is the design of the Mechanical Ventilator Milano (MVM), a novel mechanical ventilator designed for rapid mass production in response to the COVID-19 pandemic to address the urgent shortage of intensive therapy ventilators in many countries, and the growing difficulty in procuring these devices through normal supply chains across borders. This ventilator is an electro-mechanical equivalent of the old and reliable Manley Ventilator, and is able to operate in both pressure-controlled and pressure-supported ventilation modes. MVM is optimized for the COVID-19 emergency, thanks to the collaboration with medical doctors in the front line. MVM is designed for large-scale production in a short amount of time and at a limited cost, as it relays on off-the-shelf components, readily available worldwide. Operation of the MVM requires only a source of compressed oxygen (or compressed medical air) and electrical power. Initial tests of a prototype device with a breathing simulator are also presented. Further tests and developments are underway. At this stage the MVM is not yet a certified medical device but certification is in progress.


Experiences of practicing surgical neuro-oncology during the COVID-19 pandemic


title: Managing uncertainty during a global pandemic: An international business perspective

text: Despite the perennial need to understand and manage uncertainty in international business, there is no comprehensive framework that incorporates different types of uncertainty, their antecedents and outcomes, and the different coping strategies used by managers and their outcomes. This makes it difficult for international business managers to understand the types of uncertainty in their businesses and develop appropriate strategies to deal with it effectively, especially during times such as the ongoing Covid-19 pandemic. This paper uses an extensive review of the international business literature to address the above research gap by identifying the different types of uncertainty, their antecedents and outcomes, the coping strategies used to mitigate their impact, and the consequences of these actions. The authors also use examples from the current Covid-19 crisis to assess the firms' responses and their consequences. The paper concludes with some implications for international business managers and directions for future research.


Our darkest hours (being neurosurgeons during the COVID-19 war)


title: Adapting to a new normal? 5 key operational principles for a radiology service facing the COVID-19 pandemic

text: KEY POINTS: â¢ Radiology services encountering the coronavirus disease-19 pandemic will need to modify their daily operational practices. â¢ Leadership, patient risk stratification, adequate manpower, operational workflow clarity, and workplace/social responsibility will help Radiology services safely and sustainably deal with the current disease outbreak.


COVID-19 and psoriasis: Is it time to limit treatment with immunosuppressants? A call for action


title: The paradox of social distancing: Implications for older adults in the context of COVID-19

text: Loneliness and social isolation have tangible effects on mental and physical health, particularly for older adults. Individuals over the age of 60 may be uniquely at risk of experiencing the impact of loneliness. Social distancing, an intervention intended to protect at-risk individuals such as older adults, may in fact introduce further complications to the health and well-being of older adults, who find themselves more isolated secondary to the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: [Recommendations for respiratory rehabilitation of COVID-19 in adult]

text: COVID-19 is a highly infectious respiratory infection disease, which leads to dysfunction of respiratory, physical, and psychological of the patients. pulmonary rehabilitation is an important intervention for clinical patients as well as cure patients. With the deeper cognition of COVID-19 and accumulation of clinical experience, we proposed the recommendations for pulmonary rehabilitation of COVID-19 in adults based on the opinions of front-line clinical experts involved in the management of this epidemic and a review of the relevant literature and evidences: 1. for the inpatients with COVID-19, pulmonary rehabilitation would relieve the symptoms of dyspnea, anxiety, and depression; eventually improve physical function and the quality of life; 2. For severe/critical inpatients, the early performance of pulmonary rehabilitation is not suggested. 3. For isolating patients, the pulmonary rehabilitation guidence should be conducted through education video, instruction manual or remote consultation. 4. Assessment and monitor should be performed throughout the entire pulmonary rehabilitation process.5. Taking proper grading protection following the guideline. These recommendations can serve as a clinical practice guidence and basis for pulmonary rehabilitation of COVID-19.


title: Manejo de la epidemia por coronavirus SARS-CoV-2 (COVID-19) en unidades de hemodiálisis./ Manejo de la epidemia por coronavirus SARS-CoV-2 (COVID-19) en unidades de hemodiálisis./ [Management of the SARS-CoV-2 (COVID-19) coronavirus epidemic in hemodialysis units]

text: The current outbreak of SARS-CoV-2 represents a special risk for renal patients due to their comorbidities and advanced age. The usual performance of hemodialysis treatments in collective rooms increases the risk. The specific information at this time in this regard is very limited. This manuscript includes a proposal for action to prevent infection in the Nephrology Services, and in particular in Hemodialysis Units, with the objective of early identification of patients who meet the definition of a suspected case of infection by SARS-CoV-2 and propose circuits and mechanisms to carry out hemodialysis treatments. They are recommendations in continuous review and can be modified if the epidemiological situation, the diagnostic and therapeutic options so require.


docid: dwqbzcem

title: The experience of prevention measures taken by the psychiatric hospital during the emergence of asymptomatic patients with COVID-19


title: On the utility of cloth facemasks for controlling ejecta during respiratory events

text: The utility of wearing simple cloth face masks is analyzed using computational fluid dynamics simulations. We simulate the aerodynamic flow through the mask and the spatial spread of droplet ejecta resulting from respiratory events such as coughing or sneezing. Without a mask, a turbulent jet forms, and droplets with a broad size distribution are ejected. Large droplets (greater than about 125 {\mu}m in diameter) fall to the ground within about 2 m, while turbulent clouds transport a mist of small aerosolized droplets over significant distances (~ 5 m), consistent with reported experimental findings. A loosely fitted simple cotton cloth mask (with a pore size ~ 4 microns) qualitatively changes the propagation of the high velocity jet, and largely eliminates the turbulent cloud downstream of the mask. About 12\% of the airflow leaks around the sides of a mask, considering a uniform gap of only 1 mm all around, between the face and the mask. The spread of ejecta is also changed, with most large droplets trapped at the mask surface. We present the viral load in the air and deposited around the person, and show that wearing even a simple cloth mask substantially decreases the extent of spatial spread of virus particles when an infected person coughs or sneezes.


title: A Preliminary Investigation on the Statistical Correlations between SARS-CoV-2 Spread and Local Meteorology

text: The statistical correlation between meteorological parameters and the spread of Coronavirus Disease-2019 (COVID-19) was investigated in five provinces of Italy selected according to the number of infected individuals and the different trends of infection in the early stages of the epidemic: Bergamo and Brescia showed some of the highest trends of infections while nearby Cremona and Mantova, showed lower trends. Pesaro-Urbino province was included for further investigation as it was comparably affected by the epidemic despite being the area far from the Po valley. Moving means of the variables were considered to take into account the variability of incubation periods and uncertainties in the epidemiological data. The same analyzes were performed normalizing the number of new daily cases based on the number of checks performed. For each province, the moving mean of adjusted and unadjusted new daily cases were independently plotted versus each meteorological parameter, and linear regressions were determined in the period from 29th of February 2020 to 29th of March 2020. Strong positive correlations were observed between new cases and temperatures within three provinces representing 86.5% of the contagions. Strong negative correlations were observed between the moving means of new cases and relative humidity values for four provinces and more than 90% of the contagions.


title: A preliminary assessment of the impact of COVID-19 on environment - A case study of China

text: The coronavirus disease (COVID-19) is seriously threatening world public health security. Currently, >200 countries and regions have been affected by the epidemic, with the number of infections and deaths still increasing. As an extreme event, the outbreak of COVID-19 has greatly damaged the global economic growth and caused a certain impact on the environment. This paper takes China as a case study, comprehensively evaluating the dynamic impact of COVID-19 on the environment. The analysis results indicate that the outbreak of COVID-19 improves China's air quality in the short term and significantly contributes to global carbon emission reduction. However, in the long run, there is no evidence that this improvement will continue. When China completely lifts the lockdown and resumes large-scale industrial production, its energy use and greenhouse gas (GHG) emissions are likely to exceed the level before the event. Moreover, COVID-19 significantly reduces the concentration of nitrogen dioxide (NO2) in the atmosphere. The decline initially occurred near Wuhan and eventually spread to the whole country. The above phenomenon shows that the decreasing economic activities and traffic restrictions directly lead to the changes of China's energy consumption and further prevent the environment from pollution. The results in this study support the fact that strict quarantine measures can not only protect the public from COVID-19, but also exert a positive impact on the environment. These findings can provide a reference for other countries to assess the influence of COVID-19 on the environment.


Reply to a letter to the editor


title: Ear nose throat-related symptoms with a focus on loss of smell and/or taste in COVID-19 patients

text: PURPOSE: To determine the frequency and severity of general and ear nose throat (ENT)- related symptoms, especially smell and/or loss of sense of taste (STL) in COVID-19 disease, as well as to investigate the recovery process of STL. MATERIALS AND METHODS: Patients with a positive COVID-19 diagnosis were given a questionnaire consisting of general questions (age, sex, date of symptoms, smoking history, concomitant diseases), questions about the most obvious symptom at presentation (one option only), the severity and frequency of symptoms (general and ENT), and STL (recovery time and degree of recovery). RESULTS: The study population consisted of 172 patients, 18-65 years old (mean age, 37.8 ± 12.5 years; 51.2% female; 76.2% nonsmokers). Cough (n = 30, 17.4%) and loss of sense of smell (n = 18, 10.4%) were the most obvious general and ENT symptoms, respectively. Eighty-eight patients (51.2%) reported loss of sense of smell, and 81 patients (47.1%) reported loss of sense of taste. The mean recovery times for loss of sense of smell and loss of sense of taste were 8.02 ± 6.41 and 8.20 ± 7.07 days, respectively. The loss of sense of smell and loss of sense of taste were the unique symptoms in four (4.54%) and one (1.23%) patients, respectively. CONCLUSION: STL is a common symptom in COVID-19 and may be the first and/or only symptom of this disease. In patients presenting with STL complaints, surveillance for possible COVID-19 disease and screening tests will facilitate the struggle against the disease.


docid: dwjimnil

title: Provision of e-learning programmes to replace undergraduate medical students' clinical general practice attachments during COVID-19 stand-down

text: Senior medical students at the University of Auckland, New Zealand spend most of their learning time in clinical attachments. Experiential apprentice-style training is traditionally recognised as an important aspect of obtaining competency. In March 2020 they were stood down from their general practice placements in the context of a national response to the COVID-19 pandemic. Acute conversion of their general practice education from experiential clinical exposure to online and offsite learning was required. This paper describes the steps taken and the underlying theoretical foundations for our expediently developed online course. Our online learning programme has three online components, reflecting the domains of educational environment theory: asynchronous discussion forums; a symposium facilitating social interactions and teacher presence, and a portfolio facilitating personal goal aspects. The latter is underpinned by a multi-theories model of adult learning, built upon the scaffolding framework that supports our entire medical curriculum. Within this theory, we propose a five-stage model of learning. Learning from this experience contributes to the body of knowledge around online education, particularly in meeting the needs of a clinical attachment traditionally grounded in experiential learning. It is hoped that the mechanisms described here might be useful to other educators facing similar challenges.


2019 Novel Coronavirus and Awareness


docid: luapxlyo

title: Atividade antimicrobiana in vitro do extrato etanólico bruto da folha da Hymenaea martiana Hayne frente às Staphylococcus spp. e avaliação de seu potencial como desinfetante em cabras/ In vitro antimicrobial activity of ethanolic extract of Hymenaea martiana Hayne leaf on strains of Staphylococcus spp. and evaluation of its potential as a disinfectant in goats

text: Este estudo objetivou avaliar a ação antimicrobiana e antisséptica do extrato etanólico bruto da folha da Hymenaea martiana (Jatobá). O estudo foi realizado no Laboratório de Microbiologia e Imunologia da UNIVASF, na cidade de Petrolina-PE. Os extratos foram preparados utilizando diferentes diluentes, sendo estes: álcool etílico absoluto e a água destilada. Em seguida, foi empregada a técnica da Concentração Inibitória Mínima (MIC) e da Concentração Bactericida Mínima (CBM). Todos os ensaios foram realizados em triplicata. A CBM média do extrato diluído em etanol foi de 358µg/µL e do extrato diluído em água destilada foi igual a 520,82µg/mL. Não houve diferença (P<0,05) quanto à inibição bacteriana para o extrato diluído em álcool etílico absoluto ou água destilada autoclavada. Ao comparar a atividade do extrato diluído em álcool etílico absoluto e a relação com a presença do gene blaZ, observou-se que os isolados negativos para o gene pesquisado apresentaram uma CBM igual a 412,3µg/mL, e, quando comparadas aos que foram positivos para o gene blaZ, que foi de 308,80µg/mL, contudo sem diferença estatística. Quanto à inibição das bactérias utilizando extrato aquoso, a atividade foi igual para as bactérias com ou sem o gene (520,82µg/mL). Desse modo, tanto o extrato diluído em álcool etílico absoluto quanto em agua destilada autoclavada demonstrou atividade antimicrobiana, sugerindo que ocorreu extração de substâncias bioativas. Em relação ao potencial antisséptico, H. martiana teve ação pareada com o cloro, contudo aquele agiu mais rapidamente, enquanto o cloro agiu de modo ideal uma hora após a aplicação; ambos os resultados destacam que o extrato etanólico bruto das folhas de H. martiana possui potencial de combate à proliferação de bactérias ambientais e infecciosas, surgindo como uma forma de prevenir a mastite.(AU)


Use of the Demographic and Health Survey framework as a population surveillance strategy for COVID-19


title: CSC Expert Consensus on Principles of Clinical Management of Patients With Severe Emergent Cardiovascular Diseases During the COVID-19 Epidemic

text: In response to the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, the Chinese Society of Cardiology (CSC) issued this consensus statement after consulting with 125 medical experts in the fields of cardiovascular disease and infectious disease. The over-arching principles laid out here are the following: 1) Consider the prevention and control of COVID-19 transmission as the highest priority, including self-protection of medical staff; 2) Patient risk assessment of both infection and cardiovascular issues. Where appropriate, preferential use of conservative medical therapeutic approaches to minimize disease spread; 3) At all times, medical practices and interventional procedures should be conducted in accordance with the directives of the infection control department of local hospitals and local health commissions.


Commentary: Compliance with the American Association for Thoracic Surgery guidelines will prevent sternal wound infections and minimize postoperative complications in cardiac surgery patients during the COVID-19 pandemic


docid: bpnmyadq

title: Helping medical educators worldwide to pivot curricula online: pivotmeded.com


The COVID-19 Host Genetics Initiative, a global initiative to elucidate the role of host genetic factors in susceptibility and severity of the SARS-CoV-2 virus pandemic


title: Therapeutic strategies in an outbreak scenario to treat the novel coronavirus originating in Wuhan, China

text: A novel coronavirus (2019-nCoV) originating in Wuhan, China presents a potential respiratory viral pandemic to the world population. Current efforts are focused on containment and quarantine of infected individuals. Ultimately, the outbreak could be controlled with a protective vaccine to prevent 2019-nCoV infection. While vaccine research should be pursued intensely, there exists today no therapy to treat 2019-nCoV upon infection, despite an urgent need to find options to help these patients and preclude potential death. Herein, I review the potential options to treat 2019-nCoV in patients, with an emphasis on the necessity for speed and timeliness in developing new and effective therapies in this outbreak. I consider the options of drug repurposing, developing neutralizing monoclonal antibody therapy, and an oligonucleotide strategy targeting the viral RNA genome, emphasizing the promise and pitfalls of these approaches. Finally, I advocate for the fastest strategy to develop a treatment now, which could be resistant to any mutations the virus may have in the future. The proposal is a biologic that blocks 2019-nCoV entry using a soluble version of the viral receptor, angiotensin-converting enzyme 2 (ACE2), fused to an immunoglobulin Fc domain, providing a neutralizing antibody with maximal breath to avoid any viral escape, while also helping to recruit the immune system to build lasting immunity. The sequence of the ACE2-Fc protein is provided to investigators, allowing its possible use in recombinant protein expression systems to start producing drug today to treat patients under compassionate use, while formal clinical trials are later undertaken. Such a treatment could help infected patients before a protective vaccine is developed and widely available in the coming months to year(s).


Pandemicity, COVID-19 and the limits of public health 'science'


Applying to dermatology residency during the COVID-19 pandemic


Patients with MS treated with immunosuppressive agents: Across the COVID-19 spectrum


title: Biological responses and toxicopathic effects elicited in Solea senegalensis juveniles on exposure to contaminated sediments under laboratory conditions

text: Whole-sediment toxicity assays contribute to elucidating the intricate association between the presence of contaminants in sediments and their toxicopathic effects in benthic fish. In the present study, Solea senegalensis juveniles were exposed under laboratory conditions to contaminated whole-sediments for 7 and 28 days. Sediments were obtained from a low to moderately polluted estuary, a highly polluted harbour and from the mixture of both field-collected sediments. Biometry data were recorded. Liver, brain, gills, and gonads were dissected out and processed to determine markers of oxidative stress, neurotoxicity and lysosomal biomarkers, and histopathology. Analyses of sediment granulometry and chemical profiles indicated different degrees of toxicity and suggested a distinct release of pollutants from each sediment in relation with their physicochemical properties. Interestingly, biological responses were in agreement with contaminant levels reported in source sediments. The most distinct toxicopathic effects were detected upon exposure to the harbour's sediment and particularly on day 28. Overall, enhanced hepatic glutathione-S-transferase activity and lysosomal enlargement were detected in all experimental groups, demonstrating a toxic effect from all sediments whilst catalase inhibition, lysosomal membrane destabilisation, changes in lysosomal content and liver histopathology were most pronounced in soles exposed to the harbour's sediment. The Integrative Biomarker Response index (IBR/n) evidenced that exposure to the three sediments caused an impact of diverse magnitude in sole health (IBR/nHarbour > IBR/nMixture > IBR/nEstuary). The magnitude of biological responses essentially depended on the presence of contaminants in source sediments, which seemed to be altered by the conditions imposed by whole-sediment toxicity assays.


Flexibility and safety in times of coronavirus disease 2019 (COVID-19): Implications for nurses and allied professionals in cardiology


title: Community Acquired Co-infection in COVID-19: A Retrospective Observational Experience

text: Community acquired co-infection in COVID-19 is not well defined. Current literature describes co-infection in 0-40% of COVID-19 patients. In this retrospective report, co-infection was identified in 3.7% of patients and 41% of patients admitted to intensive care (p<0.005). Despite infrequent co-infection, antibiotics were used in 69% of patients.


Should we continue using laparoscopy amid the COVID-19 pandemic?


title: Can COVID-19 in pregnancy cause preeclampsia?

text: In this issue of BJOG, Mendoza and colleagues report in an observational study the occurrence of a preeclampsia-like syndrome in six out of eight pregnant patients with novel coronavirus disease (COVID-19) who were admitted to the Intensive Care Unit (ICU) with severe pneumonia (Mendoza M, et al. BJOG 2020). There were no symptoms of preeclampsia amongst the 34 pregnant women who had mild forms of COVID-19.