title: Smoking-Mediated Upregulation of the Androgen Pathway Leads to Increased SARS-CoV-2 Susceptibility

text: The COVID-19 pandemic is marked by a wide range of clinical disease courses, ranging from asymptomatic to deadly. There have been many studies seeking to explore the correlations between COVID-19 clinical outcomes and various clinical variables, including age, sex, race, underlying medical problems, and social habits. In particular, the relationship between smoking and COVID-19 outcome is controversial, with multiple conflicting reports in the current literature. In this study, we aim to analyze how smoking may affect the SARS-CoV-2 infection rate. We analyzed sequencing data from lung and oral epithelial samples obtained from The Cancer Genome Atlas (TCGA). We found that the receptor and transmembrane protease necessary for SARS-CoV-2 entry into host cells, ACE2 and TMPRSS2, respectively, were upregulated in smoking samples from both lung and oral epithelial tissue. We then explored the mechanistic hypothesis that smoking may upregulate ACE2 expression through the upregulation of the androgen pathway. ACE2 and TMPRSS2 upregulation were both correlated to androgen pathway enrichment and the specific upregulation of central pathway regulatory genes. These data provide a potential model for the increased susceptibility of smoking patients to COVID-19 and encourage further exploration into the androgen and tobacco upregulation of ACE2 to understand the potential clinical ramifications.


title: COVID-19 Presented With Deep Vein Thrombosis: An Unusual Presenting

text: On December 31, 2019, the World Health Organization was informed of a cluster of cases of pneumonia of unknown cause detected in Wuhan City, Hubei Province, China. The pneumonia was caused by a virus called SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2), which was later named coronavirus infectious disease 2019 (COVID-19). The symptoms most commonly reported by patients affected by COVID-19 include fever, dry cough, and shortness of breath. In this report, we present a case of a 57-year-old woman who presented to the clinic's infectious department with swelling, pain, warmth, and redness in the left leg who was treated with therapeutic heparin. There were no typical and distinguished symptoms of COVID-19, and she had no risk factor for deep vein thrombosis. Then chest X-ray revealed bilateral patchy ground-glass opacity, and computed tomography angiography was performed to rule out pulmonary thromboembolism, which showed no evidence of thrombosis. Left lower limb venous color Doppler ultrasound revealed dilatation and thrombosis in the external iliac and left iliac veins up to the level of the bifurcation of the common iliac veins, as well as thrombosis to the superficial and small saphenous veins. Because of ground-glass opacity and lymphopenia, nasal swabs were used for sampling, and SARS-CoV-2 nucleic acid was detected by reverse transcription polymerase chain reaction (RT-PCR). This case aims to arouse the medical staff's awareness of deep vein thrombosis as a clinical symptom of COVID-19 even if the patient has no typical symptoms of COVID-19.


Enfermedad por coronavirus 2019 (COVID-19) en América Latina: papel de la atención primaria en la preparación y respuesta./ [Coronavirus disease 2019 (COVID-19) in Latin America: Role of primary care in preparedness and response]


Rapid distribution of information by SMS-embedded video link to patients during a pandemic


title: Biocompatibility of polyamide 12 intramedullary rod after humeral consolidation in white Plymouth Rock birds/ Biocompatibilidade de haste intramedular bloqueada de poliamida 12 após consolidação óssea umeral em aves Plymouth Rock branca

text: Technological and tissue engineering have enabled available, biologically inert, and low cost materials to be considered as viable alternatives in the surgical treatment of long bone fractures in birds. The aim of this study was to microscopically analyse osteotomized humerus of birds following the insertion of solid laser-sintered polyamide 12 rods in order to detect foreign body reaction and, thus, verify the bioinert property of the material in the bone fracture environment. Polyamide 12 intramedullary rods were inserted into the osteotomized humerus of 10 birds (white Plymouth Rock) and blocked using 2mm diameter cortical screws of varying lengths. The birds were operated at 60 days of age and monitored post-operatively for three months. Animals were euthanized at 150 days old and samples of the operated humerus collected for immunohistochemistry, light and scanning electron microscopy analysis. Results show bone consolidation without rejection of the implant and absence of inflammatory cells. Vascular Endothelial Growth Factor (VEGF) was expressed in the endothelial cells of the blood vessels at the site of the newly formed bone surrounding the implant, indicative of local angiogenesis. There was no bone growth on the surface of the rod; however, the implant did not interfere with the circumjacent bone repair. Thus, the findings of this study corroborate with the literature in characterizing polyamide as a bioinert material and, under the studied conditions, it can be concluded that polyamide 12 intramedullary rod is biocompatible and provides adequate bone consolidation in humeral fractures with no signs of rejection.(AU)


Therapeutic plasma exchange as a rescue therapy in patients with coronavirus disease 2019: a case series


title: Proposal for International Standardization of the Use of Lung Ultrasound for Patients With COVID-19: A Simple, Quantitative, Reproducible Method

text: Growing evidence is showing the usefulness of lung ultrasound in patients with the 2019 new coronavirus disease (COVID-19). Severe acute respiratory syndrome coronavirus 2 has now spread in almost every country in the world. In this study, we share our experience and propose a standardized approach to optimize the use of lung ultrasound in patients with COVID-19. We focus on equipment, procedure, classification, and data sharing.


High COVID-19 virus replication rates, the creation of antigen-antibody immune complexes and indirect haemagglutination resulting in thrombosis


title: The clinical implication of dynamic neutrophil to lymphocyte ratio and D-dimer in COVID-19: A retrospective study in Suzhou China

text: OBJECTIVE: To investigate the clinical features of COVID-19 cases in Suzhou China. Biomarkers were screened out of hematological parameters for risk stratification. METHOD: Confirmed COVID-19 adult patients in Suzhou were included. The patient data was collected, and the results of laboratory examinations were compared between the mild/moderate and severe COVID-19 groups. A ROC was calculated to compare the diagnostic performance of candidate indexes, and dynamic levels of hematological indexes were compared between the two groups. RESULT: 75 patients were enrolled, with a mean age of 46.6â¯±â¯14â¯years, and 45 patients were male. All patients were classified into two groups: the mild/moderate group and the severe group. WBC, neutrophil to lymphocyte ratio (NLR), D-dimer, and fibrinogen levels of the severe group were significantly higher (Pâ¯<â¯0.05) than the mild/moderate, and the lymphocyte was lower. The ROC test showed that the hematological parameters had a larger AUC than that of inflammatory factors. There was a significant difference in lymphocyte and fibrinogen levels between the two groups on day 1 (Pâ¯<â¯0.05). However, NLR of the severe group was higher than the mild/moderate on days 1, 4 and 14 (Pâ¯<â¯0.01), and so was D-dimer on days 1, 7 and 14 (Pâ¯<â¯0.05). CONCLUSION: The common COVID-19 abnormal hematological indexes on admission included hyperfibrinogenemia, lymphopenia, the elevation of D-dimer, and leukopenia, which were significantly different between the mild/moderate and severe COVID-19 groups. Furthermore, the dynamic change of NLR and D-dimer level can distinguish severe COVID-19 cases from the mild/moderate.


Home sleep testing in the era of COVID-19: a community perspective


title: SARS CoV-2 und Influenza A-Ko-Infektion bei einem pädiatrischen Patienten in Deutschland./ Co-infection of SARS CoV-2 and influenza A in a Pediatric Patient in Germany

text: In December 2019 a novel coronavirus was firstly encountered in Wuhan/China with a massive outbreak of fatal pneumonia leading to a pandemic declared by the World Health Organization in March 2020 (WHO Dashboard COVID-19. [WHO web site]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019), affecting mainly elderly adults with underlying co-morbidities. Clinical course in children below the age of 10 years is considered to be mild or even with subclinical signs (Sinha IP, Ha et al. The Lancet Respiratory medicine 2020;27;S2213-2600(20) 30152-1). We describe a 4 month old infant with co-infection of SARS CoV-2 and influenza A virus.


Abdominal fluid samples (negative for SARS-CoV-2) from a critically unwell patient with respiratory COVID-19


docid: hosilgun

title: Mobilization of energetic substrates in the endangered catfish Steindachneridion parahybae (Siluriformes: Pimelodidae): changes in annual reproductive cycle in captivity

text: This study aimed at analyzing the energetic substrate (ES) in the main storage tissues of Steindachneridion parahybae, throughout the reproductive cycle in captivity. Differently from wild, in captivity, feeding is not interrupted during the reproductive period, the females do not spawn spontaneously, and they are sedentary. Adult females were sampled monthly and based on their histology and gonadosomatic index (GSI), ovaries were classified into: previtellogenic (PRV), vitellogenic (VTG), and regression (REG) stages. Ovaries at the VTG stage showed higher protein and lipids levels than at the PRV stage with a positive correlation between these substrates and the GSI. Muscle was the main source of proteins transferred to the ovaries, according to the negative correlation between these organs. Lipids remained unchanged in the liver, which is an important supplier in vitellogenesis, a pattern that probably occurs due to the continuous feeding. Muscular glycogen levels were higher at the VTG and REG than at the PRV stages. Plasma triglycerides were also higher during REG, while glucose levels were more elevated during the VTG stage. These results suggest that with constant food supply, the pattern of deposition of ES in S. parahybae is different from that described for other wild potamodromous species.(AU)


title: Media Exposure and Anxiety during COVID-19: The Mediation Effect of Media Vicarious Traumatization

text: The rapid spread and high death rates of the COVID-19 pandemic resulted in massive panic and anxiety all over the world. People rely heavily on media for information-seeking during the period of social isolation. This study aimed to explore the relationship between media exposure and anxiety, and highlighted the underlying mechanisms mediated by the media vicarious traumatization effect. A total of 1118 Chinese citizens participated in the online survey, who were from 30 provinces in mainland China. Results showed that all four types of media (official media, commercial media, social media, and overseas media) cause vicarious traumatization to their audiences to different degrees. It was also found that the impact of media exposure on anxiety was mediated by media vicarious traumatization: there were full mediation effects for commercial media exposure and overseas media exposure, while there were indirect-only mediation effects for official media exposure and social media exposure. Audiences staying in cities with a relatively severe pandemic were more susceptible to the vicarious traumatization caused by commercial media compared to those staying in Hubei. This study expanded the concept and application of vicarious traumatization to the mediated context, and the findings provided insightful advice to media practitioners in the face of major crisis.


title: Clinical approach to the inflammatory etiology of cardiovascular diseases

text: Inflammation is an obligatory marker of arterial disease, both stemming from the inflammatory activity of cholesterol itself and from well-established molecular mechanisms. Raised progenitor cell recruitment after major events and clonal hematopoiesis related mechanisms have provided an improved understanding of factors regulating inflammatory phenomena. Trials with inflammation antagonists have led to an extensive evaluation of biomarkers such as the high sensitivity C reactive protein (hsCRP), not exerting a causative role, but frequently indicative of the individual cardiovascular (CV) risk. Aim of this review is to provide indication on the anti-inflammatory profile of agents of general use in CV prevention, i.e. affecting lipids, blood pressure, diabetes as well nutraceuticals such as n-3 fatty acids. A crucial issue in the evaluation of the benefit of the anti-inflammatory activity is the frequent discordance between a beneficial activity on a major risk factor and associated changes of hsCRP, as in the case of statins vs PCSK9 antagonists. In hypertension, angiotensin converting enzyme inhibitors exert an optimal anti-inflammatory activity, vs the case of sartans. The remarkable preventive activity of SLGT-2 inhibitors in heart failure is not associated with a clear anti-inflammatory mechanism. Finally, icosapent ethyl has been shown to reduce the CV risk in hypertriglyceridemia, with a 27 % reduction of hsCRP. The inflammation-based approach to arterial disease has considerably gained from an improved understanding of the clinical diagnostic strategy and from a better knowledge on the mode of action of numerous agents, including nutraceuticals.


From the Editor's Desk: JGIM and COVID-19


title: Veno-venous extracorporeal membrane oxygenation for COVID-19-associated pediatric acute respiratory distress syndrome

text: BACKGROUND: The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) coronavirus has emerged as a highly contagious respiratory pathogen causing severe acute lung injury. Extracorporeal membrane oxygenation is a standard tool for the management of life-threatening acute respiratory distress syndrome, but the use of this resource-intensive therapy has come into question due to strained medical systems and limited proven treatments for COVID-19. CASE SUMMARY: A 16-year-old female with obesity presented with fever, myalgias, cough, and tachypnea and was diagnosed with COVID-19. She progressed to severe pediatric acute respiratory distress syndrome requiring intubation on hospital day 4 and cannulation to veno-venous extracorporeal membrane oxygenation on hospital day 6. The patient received remdesivir, steroids, and anakinra. The patient was successfully decannulated on hospital day 12 and was discharged home on hospital day 21. CONCLUSION: We report the use of veno-venous extracorporeal membrane oxygenation as a bridge to lung recovery in a pediatric patient with severe pediatric acute respiratory distress syndrome due to COVID-19.


Correction to Lancet Respir Med 2020; 8: e21


title: First ever case report of co-occurrence of hobnail variant of papillary thyroid carcinoma and intrathyroid parathyroid adenoma in the same thyroid lobe

text: INTRODUCTION: The hobnail variant of papillary thyroid cancer (PTC) is rare. Intrathyroid parathyroid adenoma (ITPA) is also rare. Co-ocurrence of PTC and ITPA in the same thyroid lobe is extremely rare. Likewise, primary hyperparathyroidism with such non-medullary thyroid carcinoma is rare. The specific molecular profile of hobnail PTC (HPTC) is different from the classic, poorly differentiated and anaplastic variants and may contribute to its aggressive behavior. HPTC's genetic profile remains unclear. PRESENTATION OF CASE: A 61-year-old woman presented to our endocrine clinic with generalized aches, bone pain, polyuria, and right neck swelling of a few months' duration. Laboratory findings revealed hypercalcemia and hyperparathyroidism. Ultrasound of the neck showed 4.6â¯cm complex nodule within the right thyroid lobe. Sestamibi scan suggested parathyroid adenoma in the right thyroid lobe. Fine-needle aspiration (FNA) revealed atypical follicular lesion of undetermined significance. She underwent right lobectomy, which normalized the intraoperative intact parathyroid hormone levels. Final pathology with immunohistochemical stains demonstrated HPTC and IPTA (2â¯cm each). Next-generation sequencing investigated the mutation spectrum of HPTC and detected BRAFV600E mutation. CONCLUSIONS: A parathyroid adenoma should not exclude the diagnosis of thyroid carcinoma. Thyroid evaluation is needed for patients with primary hyperparathyroidism to prevent missing concurrent thyroid cancers. Cytomorphologic features to distinguish thyroid from parathyroid cells on FNA cytology must be considered. Immunohistochemical stains are important. BRAFV600E is the most common mutation in HPTC. This is possibly the first reported case of HPTC and ITPA co-occurring within the same thyroid lobe. Studies that define other molecular abnormalities may be useful as therapeutic targets.


title: Targeting potential drivers of COVID-19: Neutrophil extracellular traps

text: Coronavirus disease 2019 (COVID-19) is a novel, viral-induced respiratory disease that in â¼10-15% of patients progresses to acute respiratory distress syndrome (ARDS) triggered by a cytokine storm. In this Perspective, autopsy results and literature are presented supporting the hypothesis that a little known yet powerful function of neutrophils-the ability to form neutrophil extracellular traps (NETs)-may contribute to organ damage and mortality in COVID-19. We show lung infiltration of neutrophils in an autopsy specimen from a patient who succumbed to COVID-19. We discuss prior reports linking aberrant NET formation to pulmonary diseases, thrombosis, mucous secretions in the airways, and cytokine production. If our hypothesis is correct, targeting NETs directly and/or indirectly with existing drugs may reduce the clinical severity of COVID-19.


title: Improving Spatio-Temporal Understanding of Particulate Matter using Low-Cost IoT Sensors

text: Current air pollution monitoring systems are bulky and expensive resulting in a very sparse deployment. In addition, the data from these monitoring stations may not be easily accessible. This paper focuses on studying the dense deployment based air pollution monitoring using IoT enabled low-cost sensor nodes. For this, total nine low-cost IoT nodes monitoring particulate matter (PM), which is one of the most dominant pollutants, are deployed in a small educational campus in Indian city of Hyderabad. Out of these, eight IoT nodes were developed at IIIT-H while one was bought off the shelf. A web based dashboard website is developed to easily monitor the real-time PM values. The data is collected from these nodes for more than five months. Different analyses such as correlation and spatial interpolation are done on the data to understand efficacy of dense deployment in better understanding the spatial variability and time-dependent changes to the local pollution indicators.


title: Evolution of COVID-19 Guidelines for University of Washington Oral and Maxillofacial Surgery Patient Care

text: The emergence of coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 (SC2) virus, in late December 2019 has placed an overwhelming strain on healthcare institutions nationwide. The modern healthcare system has never managed a pandemic of this magnitude, the ramifications of which will undoubtedly lead to lasting changes in policy and protocol development for viral testing guidelines, personal protective equipment (PPE), surgical scheduling, and residency education and training. The State of Washington had the first reported case and death related to COVID-19 in the United States. Oral and maxillofacial surgeons have a unique risk of exposure to SC2 and developing COVID-19 because of our proximity of working in and around the oropharynx and nasopharynx. The present report has summarized the evolution of COVID-19 guidelines in 4 key areas: 1) preoperative SC2 testing; 2) PPE stewardship; 3) surgical scheduling guidelines; and 4) resident education and training for oral and maxillofacial surgery at the University of Washington, Seattle, Washington.


title: Dermatologists and SARS-CoV-2: the impact of the pandemic on daily practice

text: Since the first case of 'pneumonia of unknown aetiology' was diagnosed at the Wuhan Jinyintan Hospital in China on 30 December 2019, what was recognized thereafter as 'severe acute respiratory syndrome coronavirus 2' (SARS-CoV-2) has spread over the four continents, causing the respiratory manifestations of coronavirus disease-19 (COVID-19) and satisfying the epidemiological criteria for a label of 'pandemic'. The ongoing SARS-CoV-2 pandemic is having a huge impact on dermatological practice including the marked reduction of face-to-face consultations in favour of teledermatology, the uncertainties concerning the outcome of COVID-19 infection in patients with common inflammatory disorders such as psoriasis or atopic dermatitis receiving immunosuppressive/immunomodulating systemic therapies; the direct involvement of dermatologists in COVID-19 care for patient assistance and new research needs to be addressed. It is not known yet if skin lesions and derangement of the skin barrier could make it easier for SARS-CoV-2 to transmit via indirect contact; it remains to be defined if specific mucosal or skin lesions are associated with SARS-CoV-2 infection, although some unpublished observations indicate the occurrence of a transient varicelliform exanthema during the early phase of the infection. SARS-CoV-2 is a new pathogen for humans that is highly contagious, can spread quickly, and is capable of causing enormous health, economic and societal impacts in any setting. The consequences may continue long after the pandemic resolves, and new management modalities for dermatology may originate from the COVID-19 disaster. Learning from experience may help to cope with future major societal changes.


Public's early response to the novel coronavirus-infected pneumonia


US Hydroxychloroquine, Chloroquine, and Azithromycin Outpatient Prescription Trends, October 2019 Through March 2020


title: Thymosin alpha 1 (Tα1) reduces the mortality of severe COVID-19 by restoration of lymphocytopenia and reversion of exhausted T cells

text: BACKGROUND: We previously reported that lymphocytopenia and T cell exhaustion is notable in acute COVID19 patients, especially in aged and severe cases. Thymosin alpha 1 (Tα1) had been used in the treatment of viral infections as an immune response modifier for many years. However, clinical benefits and mechanism of Tα1 supplement to COVID-19 are still unclear. METHODS: We retrospectively reviewed the clinical outcomes of 76 severe cases with COVID-19 admitted into two hospitals in Wuhan from December 2019 to March 2020. The thymus output in peripheral blood mononuclear cells (PBMCs) from COVID-19 patients was measured by T cell receptor excision circles (TREC). The levels of T cell exhaustion markers PD-1 and Tim-3 on CD8+ T cells were detected by flow cytometry. RESULTS: Compared with untreated group, Tα1 treatment significantly reduces mortality of severe COVID-19 patients (11.11% vs. 30.00%, p=0.044). Tα1 timely enhances blood T cell numbers in COVID-19 patients with severe lymphocytopenia (the counts of CD8+ T cells or CD4+ T cells in circulation lower than 400/µL or 650/µL, respectively). Under such conditions, Tα1 also successfully restores CD8+ and CD4+ T cell numbers in aged patients. Meanwhile, Tα1 reduces PD-1 and Tim-3 expression on CD8+ T cells from severe COVID-19 patients in comparison with untreated cases. It is of note that restoration of lymphocytopenia and acute exhaustion of T cells are roughly parallel to the rise of TRECs. CONCLUSIONS: Tα1 supplement significantly reduce mortality of severe COVID-19 patients. COVID-19 patients with the counts of CD8+ T cells or CD4+ T cells in circulation lower than 400/µL or 650/µL, respectively, gain more benefits from Tα1. Tα1 reverses T cell exhaustion and recovers immune reconstitution through promoting thymus output during SARS-CoV-2 infection.


title: Covid-19 spread: Reproduction of data and prediction using a SIR model on Euclidean network

text: We study the datafor the cumulative as well as daily number of cases in the Covid-19 outbreak in China. The cumulative data can be fit to an empirical form obtained from a Susceptible-Infected-Removed (SIR) model studied on an Euclidean network previously. Plotting the number of cases against the distance from the epicenter for both China and Italy, we find an approximate power law variation with an exponent $\sim 1.85$ showing strongly that the spatial dependence plays a key role, a factor included in the model. We report here that the SIR model on the Eucledean network can reproduce with a high accuracy the data for China for given parameter values, and can also predict when the epidemic, at least locally, can be expected to be over.


title: Shifting from survival to supporting resilience in children and families in the COVID-19 pandemic: Lessons for informing U.S. mental health priorities

text: This commentary contextualizes potential mental health outcomes for children during and after the COVID-19 pandemic within the risk and resilience literature. Individual, familial, and community-level factors that may increase risk for mental health challenges for children as well as factors associated with positive adaptation in the face of adversity are considered. We highlight the value of considering children's resilience within a systemic perspective by considering family-centered approaches including both short-term and long-term evidence-informed mental health practices. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Genomic footprints of an old affair: SNP data reveal historical hybridization and the subsequent evolution of reproductive barriers in two recently diverged grasshoppers with partly overlapping distributions

text: Secondary contact in close relatives can result in hybridization and the admixture of previously isolated gene pools. However, after an initial period of hybridization, reproductive isolation can evolve through different processes and lead to the interruption of gene flow and the completion of the speciation process. Omocestus minutissimus and O. uhagonii are two closely related grasshoppers with partially overlapping distributions in the Central System mountains of the Iberian Peninsula. To analyse spatial patterns of historical and/or contemporary hybridization between these two taxa and understand how species boundaries are maintained in the region of secondary contact, we sampled sympatric and allopatric populations of the two species and obtained genome-wide SNP data using a restriction site-associated DNA sequencing approach. We used Bayesian clustering analyses to test the hypothesis of contemporary hybridization in sympatric populations and employed a suite of phylogenomic approaches and a coalescent-based simulation framework to evaluate alternative hypothetical scenarios of interspecific gene flow. Our analyses rejected the hypothesis of contemporary hybridization but revealed past introgression in the area where the distributions of the two species overlap. Overall, these results point to a scenario of historical gene flow after secondary contact followed by the evolution of reproductive isolation that currently prevents hybridization among sympatric populations.


Assessing HIV-Related Stigma in Healthcare Settings in the Era of the COVID-19 Pandemic, Pittsburgh, Pennsylvania


COVID-19 in People with Mental Illness: Challenges and Vulnerabilities


title: Transportation inequalities for Markov kernels and their applications

text: We study the relationship between functional inequalities for a Markov kernel on a metric space $X$ and inequalities of transportation distances on the space of probability measures $\mathcal{P}(X)$. Extending results of Luise and Savar\'e on Hellinger--Kantorovich contraction inequalities for the particular case of the heat semigroup on an $RCD(K,\infty)$ metric space, we show that more generally, such contraction inequalities are equivalent to reverse Poincar\'e inequalities. We also adapt the"dynamic dual"formulation of the Hellinger--Kantorovich distance to define a new family of divergences on $\mathcal{P}(X)$ which generalize the R\'enyi divergence, and we show that contraction inequalities for these divergences are equivalent to the reverse logarithmic Sobolev and Wang Harnack inequalities. We discuss applications including results on the convergence of Markov processes to equilibrium, and on quasi-invariance of heat kernel measures in finite and infinite-dimensional groups.


title: Cost-effectiveness Analysis of Antiepidemic Policies and Global Situation Assessment of COVID-19

text: With a two-layer contact-dispersion model and data in China, we analyze the cost-effectiveness of three types of antiepidemic measures for COVID-19: regular epidemiological control, local social interaction control, and inter-city travel restriction. We find that: 1) intercity travel restriction has minimal or even negative effect compared to the other two at the national level; 2) the time of reaching turning point is independent of the current number of cases, and only related to the enforcement stringency of epidemiological control and social interaction control measures; 3) strong enforcement at the early stage is the only opportunity to maximize both antiepidemic effectiveness and cost-effectiveness; 4) mediocre stringency of social interaction measures is the worst choice. Subsequently, we cluster countries/regions into four groups based on their control measures and provide situation assessment and policy suggestions for each group.


Oncological Surgery During the COVID-19 Pandemic: The Need for Deep and Lasting Measures


title: Laboratory findings and a combined multifactorial approach to predict death in critically ill patients with COVID-19: a retrospective study

text: To describe the laboratory findings of cases of death with coronavirus disease 2019 (COVID-19) and to establish a scoring system for predicting death, we conducted this single-centre, retrospective, observational study including 336 adult patients (≥18 years old) with severe or critically ill COVID-19 admitted in two wards of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology in Wuhan, who had definite outcomes (death or discharge) between 1 February 2020 and 13 March 2020. Single variable and multivariable logistic regression analyses were performed to identify mortality-related factors. We combined multiple factors to predict mortality, which was validated by receiver operating characteristic curves. As a result, in a total of 336 patients, 34 (10.1%) patients died during hospitalisation. Through multivariable logistic regression, we found that decreased lymphocyte ratio (Lymr, %) (odds ratio, OR 0.574, P < 0.001), elevated blood urea nitrogen (BUN) (OR 1.513, P = 0.009), and raised D-dimer (DD) (OR 1.334, P = 0.002) at admission were closely related to death. The combined prediction model was developed by these factors with a sensitivity of 100.0% and specificity of 97.2%. In conclusion, decreased Lymr, elevated BUN, and raised DD were found to be in association with death outcomes in critically ill patients with COVID-19. A scoring system was developed to predict the clinical outcome of these patients.


Why pollution is plummeting in some cities - but not others


title: Development of indigenous IgG ELISA for the detection of anti-SARS-CoV-2 IgG

text: Background & objectives: Since the beginning of the year 2020, the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted humankind adversely in almost all spheres of life. The virus belongs to the genus Betacoronavirus of the family Coronaviridae. SARS-CoV-2 causes the disease known as coronavirus disease 2019 (COVID-19) with mild-to-severe respiratory illness. The currently available diagnostic tools for the diagnosis of COVID-19 are mainly based on molecular assays. Real-time reverse transcription-polymerase chain reaction is the only diagnostic method currently recommended by the World Health Organization for COVID-19. With the rapid spread of SARS-CoV-2, it is necessary to utilize other tests, which would determine the burden of the disease as well as the spread of the outbreak. Considering the need for the development of such a screening test, an attempt was made to develop and evaluate an IgG-based ELISA for COVID-19. Methods: A total of 513 blood samples (131 positive, 382 negative for SARS-CoV-2) were collected and tested by microneutralization test (MNT). Antigen stock of SARS-CoV-2 was prepared by propagating the virus in Vero CCL-81 cells. An IgG capture ELISA was developed for serological detection of anti-SARS-CoV-2 IgG in serum samples. The end point cut-off values were determined by using receiver operating characteristic (ROC) curve. Inter-assay variability was determined. Results: The developed ELISA was found to be 92.37 per cent sensitive, 97.9 per cent specific, robust and reproducible. The positive and negative predictive values were 94.44 and 98.14 per cent, respectively. Interpretation & conclusions: This indigenously developed IgG ELISA was found to be sensitive and specific for the detection of anti-SARS-CoV-2 IgG in human serum samples. This assay may be used for determining seroprevalence of SARS-CoV-2 in a population exposed to the virus.


title: Osteoporosis Management in the Era of COVID-19

text: Osteoporosis is a chronic condition that reflects reduced bone strength and an associated increased risk for fracture. As a chronic condition, osteoporosis generally requires sustained medical intervention(s) to limit the risks for additional bone loss, compromise of skeletal integrity, and fracture occurrence. Further complicating this issue is the fact that the abrupt cessation of some therapies can be associated with an increased risk for harm. It is in this context that the COVID-19 pandemic has brought unprecedented disruption to the provision of health care globally, including near universal requirements for social distancing. In this Perspective, we provide evidence, where available, regarding the general care of patients with osteoporosis in the COVID-19 era and provide clinical recommendations based primarily on expert opinion when data are absent. Particular emphasis is placed on the transition from parenteral osteoporosis therapies. It is hoped that these recommendations can be used to safely guide care for patients with osteoporosis until a return to routine clinical care standards is available. © 2020 American Society for Bone and Mineral Research.


title: Balancing Fiscal and Mortality Impact of SARS-CoV-2 Mitigation Measurements

text: An epidemic carries human and fiscal costs. In the case of imported pandemics, the first-best solution is to restrict national borders to identify and isolate infected individuals. However, when that opportunity is not fully seized and there is no preventative intervention available, second-best options must be chosen. In this article we develop a system of differential equations that simulate both the fiscal and human costs associated to different mitigation measurements. After simulating several scenarios, we conclude that herd immunity (or unleashing the pandemic) is the worst policy in terms of both human and fiscal cost. We found that the second-best policy would be a strict policy (e.g. physical distancing with massive testing) established under the first 20 days after the pandemic, that lowers the probability of infection by 80%. In the case of the US, this strict policy would save more than 239 thousands lives and almost $170.8 billion to taxpayers when compared to the herd immunity case.


Letter: Thrombotic Neurovascular Disease in COVID-19 Patients


A Visual Tool for Enhanced Critical Care Bedside Communications during the Coronavirus Pandemic: The Window Wall of Information


Letter to the Editor: "Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection"


Prehospital pulse oximetry: a red flag for early detection of silent hypoxemia in COVID-19 patients


title: Otomorphs (= otocephalans or ostarioclupeomorphs) revisited

text: A morphological revision is presented here on the cohort Otomorpha, a clade currently interpreted as the most primitive among the large supercohort Clupeocephala. Otomorpha is a morphologically heterogeneous group represented by clupei forms , alepocephaliforms, and ostariophysans (gonorynchiforms, cypriniforms, characiforms, siluriforms, and gymnoti forms) that inhabit various marine and freshwater environments worldwide. Otomorphs have a long (ca. 145 Ma) and diverse fossil record. They are the largest fish teleostean clade worldwide, as well as the largest of the Neotropical Region. While molecular studies strongly confirm the monophyly of Otomorpha, most potential morphological synapomorphies of the group become homoplastic largely due to the peculiar morphological character states (either losses or transformations) present in alepocephaliforms. The fusion of haemal arches with their respective vertebral centra anterior to preural centrum 2 stands as an unambiguous synapomorphy of the clade. The ankylosis or fusion of the extrascapular and parietal bones, and silvery areas associated with the gas bladder are also interpreted as synapomorphies, although they are homoplastic characters mainly due to secondary losses or further transformations of the morphological features in the alepocephaliforms.(AU)


title: Telehealth transformation: COVID-19 and the rise of virtual care

text: The novel coronavirus disease-19 (COVID-19) pandemic has altered our economy, society, and healthcare system. While this crisis has presented the U.S. healthcare delivery system with unprecedented challenges, the pandemic has catalyzed rapid adoption of telehealth, or the entire spectrum of activities used to deliver care at a distance. Using examples reported by U.S. healthcare organizations, including ours, we describe the role that telehealth has played in transforming healthcare delivery during the 3 phases of the U.S. COVID-19 pandemic: (1) stay-at-home outpatient care, (2) initial COVID-19 hospital surge, and (3) postpandemic recovery. Within each of these 3 phases, we examine how people, process, and technology work together to support a successful telehealth transformation. Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived.


title: The coronavirus pandemic in Malaysia: A commentary

text: As of mid-May 2020, it has been 5 months since the 1st case of coronavirus was detected in Malaysia. Thus far, 113 deaths have been reported. Several effective measures have been taken by the government under a partial lockdown or movement control order to contain the spread of the virus, which have led to the flattening of the curve. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: SARS-COV-2 infection (coronavirus disease 2019) for the gastrointestinal consultant

text: The current pandemic due to the severe acute respiratory syndrome coronavirus 2 has caused an extreme burden for health care systems globally, and the number of cases is expected to continue to increase, at least in the immediate future. The virus is estimated to have infected more than 1.5 million individuals. The available reports suggest that gastrointestinal (GI) involvement in coronavirus disease 2019 (COVID-19) is common and in some cases the GI symptoms may precede the respiratory symptoms. In addition to direct effects of severe acute respiratory syndrome coronavirus 2, the infected patients remain at risk for the complications commonly managed by gastroenterology and hepatology consultants. The most commonly reported GI manifestation of COVID-19 is diarrhea, which is reported in a third to up to more than half of the patients. Mild to moderate elevation of the liver enzymes are also common, although no case of acute liver failure has been reported so far. Many of the medications used for treatment of COVID-19 can also be associated with GI symptoms or liver injury and can be included in the differential diagnosis in these patients. Although the diagnosis of the infection is currently based on RNA analysis in respiratory samples, the available literature on fecal shedding of this virus suggests that fecal RNA testing might prove to be a useful diagnostic test. It is reasonable to delay all non-urgent endoscopic procedures during the peak of the pandemic and use additional protective equipment such as N95 respirators during endoscopy while most patients can be considered high risk for having been exposed to the virus.


Ectopic Pregnancy During Coronavirus Disease 2019 (COVID-19): To Operate, or Not to Operate


Action Steps Toward a Culture of Moral Resilience in the Face of COVID-19


title: Statement from the North American Society for Cardiovascular Imaging on imaging strategies to reduce the scarcity of healthcare resources during the COVID-19 outbreak

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an evolving global pandemic that is predicted to strain healthcare resources at multiple locations throughout North America and the World. As of April 6, 2020, the apex of infection rates is predicted to occur within 1 to 5 weeks at various locations. Widespread reports of personal protective equipment (PPE) shortages, and healthcare worker exposure to disease have become commonplace. To mitigate this crisis, we are suggesting imaging strategies that aim to use the least PPE, require the smallest number of potential staff exposures, and streamlines utilization of imaging. They are broadly organized by (1) substituting a noninvasive diagnostic test in place of a semi-invasive or invasive diagnostic tests, and (2) consolidating diagnostic imaging.


title: Análise do líquido cérebro-espinhal de três doenças do sistema nervoso central de cães/ Analysis of cerebral-spinal fluid of three central nervous system diseases of dogs

text: Foi realizado um estudo retrospectivo do líquido cérebro-espinhal de cães (LCE), atendidos pelo Serviço de Neurologia do Hospital Veterinário da Instituição, de 2004 a 2015, com o objetivo de analisar os resultados de cães com sinais neurológicos, comparar as alterações encontradas em dois locais de colheita no mesmo paciente e verificar se esse exame auxiliou o clínico em reforçar a suspeita clínica das principais doenças do sistema nervoso central. A pleocitose linfocítica esteve presente em 78,3% (29/37) das amostras de cães com cinomose e em 23,2% (10/43) de cães com DDIV. Houve dissociação albuminocitológica (DAC) em 73% (19/26) das amostras de cães com tumores IC e em 64,3% (9/14) de cães com tumores envolvendo a ME. Em cães com DDIV, houve significância estatística (p<0,05) entre o grau de disfunção neurológica e o total de células nucleadas (TCN) e total de proteínas (TP). Em 29 cães, houve a colheita do LCE da cisterna magna e da cisterna lombar e em 12 (41,4%) os resultados foram diferentes entre as duas amostras colhidas do mesmo cão, onde dois (6,9%) apresentaram alteração na amostra colhida cranial à lesão. Pode-se concluir que a pleocitose linfocítica foi a principal alteração encontrada no LCE de cães com cinomose e DDIV e DAC nas neoplasias, IC e ME, cães acometidos pela DDIV apresentaram sinais neurológicos mais severos conforme o TCN e o TP aumentaram e o LCE sofreu alteração, mesmo colhido cranial ao local da lesão e auxiliou o clínico em reforçar a suspeita clínica, mas não confirmou, as principais doenças neurológicas em cães.(AU)


Safeguard research in the time of COVID-19


Laser Safety Measures for The Treatment of Genital Warts in Hiv+ Patients During The Covid-19 Pandemic


LASER safety measures for the treatment of genital warts in HIV+ patients during the COVID-19 pandemic


title: The need for fast-track, high-quality and low-cost studies about the role of the BCG vaccine in the fight against COVID-19

text: Bacillus Calmette-Guérin (BCG) vaccination is routine and near-universal in many low- and middle-income countries (LMIC). It has been suggested that BCG can have a protective effect on COVID-19 morbidity and mortality. This commentary discusses the limitations of the evidence around BCG and COVID-19. We argue that higher-quality evidence is necessary to understand the protective effect of the BCG vaccine from existing, secondary data, while we await results from clinical trials currently conducted in different settings.


Digital physical therapy in the COVID-19 pandemic


Aerosol-mediated transmission of SARS-Cov-2 or COVID-19 in the cardiac surgical operating room


title: COVID-19 related neuroimaging findings: A signal of thromboembolic complications and a strong prognostic marker of poor patient outcome

text: OBJECTIVE: To investigate the incidence and spectrum of neuroimaging findings and their prognostic role in hospitalized COVID-19 patients in New York City. METHODS: This is a retrospective cohort study of 3218 COVID-19 confirmed patients admitted to a major healthcare system (three hospitals) in New York City between March 1, 2020 and April 13, 2020. Clinical data were extracted from electronic medical records, and particularly data of all neurological symptoms were extracted from the imaging reports. Four neuroradiologists evaluated all neuroimaging studies for acute neuroimaging findings related to COVID-19. RESULTS: 14.1% of admitted COVID-19 patients had neuroimaging and this accounted for only 5.5% of the total imaging studies. Acute stroke was the most common finding on neuro-imaging, seen in 92.5% of patients with positive neuro-imaging studies, and present in 1.1% of hospitalized COVID-19 patients. Patients with acute large ischemic and hemorrhagic stroke had much higher mortality risk adjusted for age, BMI and hypertension compared to those COVID-19 patients without neuroimaging. (Odds Ratio 6.02 by LR; Hazard Ratio 2.28 by CRR). CONCLUSIONS: Our study demonstrates acute stroke is the most common neuroimaging finding among hospitalized COVID-19 patients. Detection of an acute stroke is a strong prognostic marker of poor outcome. Our study also highlights the fact there is limited use of neuroimaging in these patients due to multiple logistical constraints.


title: Orthopaedic Education During the COVID-19 Pandemic

text: The COVID-19 global pandemic presents a challenge to orthopaedic education. Around the world, including in the United States, elective surgeries are being deferred and orthopaedic residents and fellows are being asked to make drastic changes to their daily routines. In the midst of these changes are unique opportunities for resident/fellow growth and development. Educational tools in the form of web-based learning, surgical simulators, and basic competency tests may serve an important role. Challenges are inevitable, but appropriate preparation may help programs ensure continued resident growth, development, and well-being while maintaining high-quality patient care.


A Rashomon Moment? Ocular Involvement and COVID-19


title: The Impact of the COVID-19 Pandemic on Bariatric Surgery: Results from a Worldwide Survey

text: BACKGROUND: The ongoing "coronavirus disease 19" (COVID-19) pandemic has had a strong effect on the delivery of surgical care worldwide. Elective surgeries have been canceled or delayed in order to reallocate resources to the treatment of COVID-19 patients. Currently, the impact of the COVID-19 pandemic on bariatric and metabolic surgical practice remains unclear. METHODS: An internet-based online survey was performed among bariatric surgeons worldwide. The survey was sent to bariatric surgeons via the International Bariatric Club Facebook group and by electronic mail via the International Federation for the Surgery of Obesity and metabolic disorders (IFSO) secretariat to members of the associated national IFSO societies. RESULTS: One hundred sixty-nine (n = 169) bariatric surgeons participated in the survey. The majority of the respondents postponed preoperative upper gastrointestinal tract endoscopies, appointments in the outpatient clinic and bariatric operations. Most surgeons performed video calls for follow-up appointments instead of meeting the patients in the outpatient clinics. Laparoscopy was still the preferred treatment for surgical emergencies, but a trend towards conservative treatment of acute appendicitis and acute cholecystitis was shown. Rapid preoperative COVID-19 testing availability was poor; therefore, routine screening of emergency bariatric cases was not widely provided. A wide variance occurred regarding precautions and personal protection equipment among the participants. CONCLUSION: The COVID-19 pandemic showed a strong impact on bariatric surgical practice regarding surgical and outpatient planning as well as personnel management. Coordinated effort from the national bariatric societies should focus on strict implementation of the current recommendations regarding precaution measures and personal protection equipment. Further studies should evaluate how this impact will evolve in the near future.


title: Que doivent savoir les chirurgiens à propos des troubles digestifs et des anomalies paracliniques induits par le COVID 19?/ [What do surgeons need to know about the digestive disorders and paraclinical abnormalities induced by COVID-19?]

text: The symptoms associated with COVID-19 are mainly characterized by a triad composed of fever, dry cough and dyspnea. However, digestive symptoms have also been reported; at first considered as infrequent, they in fact seem to affect (to some extent) more than half of patients. The symptoms are mainly manifested by anorexia, diarrhea, nausea and/or vomiting and abdominal pain. Even though prognosis is associated with lung injury, digestive symptoms seem significantly more frequent in patients presenting with severe COVID-19 infection. Digestive forms, which may be isolated or which can precede pulmonary symptoms, have indeed been reported, with diarrhea as a leading clinical sign. The main biological abnormalities that can suggest COVID-19 infection at an early stage are lymphopenia, elevated CRP and heightened ASAT transaminases. Thoraco-abdominal scan seems useful as a means of on the one hand ruling out digestive pathology not connected with coronavirus and on the other hand searching for pulmonary images compatible with COVID-19 infection. No data exist on the interest of digestive endoscopy in cases of persistent digestive symptoms. Moreover, the endoscopic surgeons may themselves be at significant risk of contamination. Fecal-oral transmission of the infection is possible, especially insofar as viral shedding in stools seems frequent and of longer duration than at the ENT level, including in patients with negative throat swab and without digestive symptoms. In some doubtful cases, virologic assessment of stool samples can yield definitive diagnosis. In the event of prolonged viral shedding in stools, a patient's persistent contagiousness is conceivable but not conclusively established. Upcoming serology should enable identification of the patients having been infected by the COVID-19 epidemic, particularly among previously undetected pauci-symptomatic members of a health care staff. Resumption of medico-surgical activity should be the object of a dedicated strategy preceding deconfinement.


The Rheumatologist's Role in COVID-19


Supporting People With Diabetes, Through COVID-19 and Beyond


Resuming work gradually in the context of COVID-19: Experience from a tertiary dermatology department in China


title: COVID-19: Dados Atualizados e sua Relação Com o Sistema Cardiovascular./ COVID-19: Dados Atualizados e sua Relação Com o Sistema Cardiovascular./ COVID-19: Updated Data and its Relation to the Cardiovascular System

text: In December 2019, a new human coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) by the World Health Organization, emerged in the city of Wuhan, China. Spreading globally, it is now considered pandemic, with approximately 3 million cases worldwide at the end of April. Its symptoms include fever, cough, and headache, but the main one is shortness of breath. In turn, it is believed that there is a relationship between COVID-19 and damage to the heart muscle, and hypertensive and diabetic patients, for example, seem to have worse prognosis. Therefore, COVID-19 may worsen in individuals with underlying adverse conditions, and a not negligible number of patients hospitalized with this virus had cardiovascular or cerebrovascular diseases. Systemic inflammatory response and immune system disorders during disease progression may be behind this association. In addition, the virus uses angiotensin-converting enzyme (ACE) receptors, more precisely ACE2, to penetrate the cell; therefore, the use of ACE inhibitor drugs and angiotensin receptor blockers could cause an increase in these receptors, thus facilitating the entry of the virus into the cell. There is, however, no scientific evidence to support the interruption of these drugs. Since they are fundamental for certain chronic diseases, the risk and benefit of their withdrawal in this scenario should be carefully weighed. Finally, cardiologists and health professionals should be aware of the risks of infection and protect themselves as much as possible, sleeping properly and avoiding long working hours.


The global food syndemic: The impact of food insecurity, Malnutrition and obesity on the healthspan amid the COVID-19 pandemic


title: COVID-19 and Disruptive Modifications to Cardiac Critical Care Delivery: JACC Review Topic of the Week

text: The COVID-19 pandemic has presented a major unanticipated stress on the workforce, organizational structure, systems of care, and critical resource supplies. To ensure provider safety, to maximize efficiency, and to optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This review draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe, as well as lessons learned from military mass casualty medicine. This review offers pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies (e.g., telemedicine) to enable effective collaboration despite social distancing imperatives.


docid: eryghszk

title: Disruptive Modifications to Cardiac Critical Care Delivery During the Covid-19 Pandemic: An International Perspective

text: The COVID-19 pandemic has presented a major unanticipated stress on our workforce, organizational structure, systems of care, and critical resource supply. In order to ensure provider safety, maximize efficiency, and optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 virus and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This manuscript draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe as well as lessons learned from military mass casualty medicine. We offer pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies such as telemedicine to enable effective collaboration despite social distancing imperatives.


Clinical Characteristics and Results of Semen Tests Among Men With Coronavirus Disease 2019


Lockdown in Italy: personal stories of doing science during the COVID-19 quarantine


title: Discussion on diagnosis and treatment of hepatobiliary malignancies during the outbreak of novel coronavirus pneumonia/ 中华肿瘤杂志

text: From December 2019, the new coronavirus pneumonia (COVID-19) broke out in Wuhan, Hubei, and spread rapidly to the nationwide. On January 20, 2020, the National Health Committee classified COVID-19 pneumonia as one of B class infectious diseases and treated it as class A infectious disease. During the epidemic period, the routine diagnosis and treatment of tumor patients was affected with varying degrees. In this special period, we performed the superiority of the multi-disciplinary team of diagnosis and treatment, achieved accurate diagnosis and treatment of patients with hepatobiliary malignant tumors, provided support for these patients with limited medical resources, and helped them to survive during the epidemic period.On the basis of fully understanding the new coronavirus pneumonia, the treatment strategy should be changed timely during the epidemic, and more appropriate treatment methods should be adopted to minimize the adverse effect of the epidemic on tumor treatment.


title: [Discussion on diagnosis and treatment of hepatobiliary malignancies during the outbreak of COVID-19]

text: Objective: From December 2019, the new coronavirus pneumonia (COVID-19) broke out in Wuhan, Hubei, and spread rapidly to the nationwide. On January 20, 2020, the National Health Committee classified COVID-19 pneumonia as one of B class infectious diseases and treated it as class A infectious disease. During the epidemic period, the routine diagnosis and treatment of tumor patients was affected with varying degrees. In this special period, we performed the superiority of the multi-disciplinary team of diagnosis and treatment, achieved accurate diagnosis and treatment of patients with hepatobiliary malignant tumors, provided support for these patients with limited medical resources, and helped them to survive during the epidemic period.On the basis of fully understanding the new coronavirus pneumonia, the treatment strategy should be changed timely during the epidemic, and more appropriate treatment methods should be adopted to minimize the adverse effect of the epidemic on tumor treatment.


Diagnostik und Therapie schlafbezogener Atmungsstörungen im Zusammenhang mit der Corona-Pandemie./ [Management of Diagnostic Procedures and Treatment of Sleep Related Breathing Disorders in the Context of the Coronavirus Pandemic - German Respiratory Society (DGP)German Sleep Society (DGSM)]


Stereotype threat


COVID-19: Challenges and opportunities for dermatology response


What COVID-19 is taking away from us


title: Prevalence of Depression and Generalized Anxiety Disorder Among Mexican Indigenous Adolescents and Young Adults: Challenges for Healthcare

text: Providing evidence on mental disorders in indigenous adolescents is critical to achieving universal health coverage (UHC). The prevalence of symptoms of depression and generalized anxiety disorder symptoms were estimated for 2082 adolescents aged 14-20 years in Chiapas, Mexico. Mental disorders were assessed using the 9-item Patient-Health Questionnaire and the 7-item Generalized Anxiety Disorder Scale. Among the adolescents evaluated, 35.8% suffered from depression or generalized anxiety disorder. Of those, 6.1% reported a previous diagnosis. 32.1% of adolescents with both mental disorders reported having attempted suicide. Gender, substance use, adverse living experiences and living conditions were correlated to the presence of depression and/or generalized anxiety disorder. It is mandatory for Mexican health authorities to develop effective instruments aiming to screen and diagnose mental health conditions in adolescents, as well as to provide timely treatment in primary health-care units.


Prevalence of putative invasive pulmonary aspergillosis in critically ill patients with COVID-19


title: Inequity in access to personalized medicine in France: Evidences from analysis of geo variations in the access to molecular profiling among advanced non-small-cell lung cancer patients: Results from the IFCT Biomarkers France Study

text: In this article, we studied geographic variation in the use of personalized genetic testing for advanced non-small cell lung cancer (NSCLC) and we evaluated the relationship between genetic testing rates and local socioeconomic and ecological variables. We used data on all advanced NSCLC patients who had a genetic test between April 2012 and April 2013 in France in the frame of the IFCT Biomarqueurs-France study (n = 15814). We computed four established measures of geographic variation of the sex-adjusted rates of genetic testing utilization at the "départment" (the French territory is divided into 94 administrative units called 'départements') level. We also performed a spatial regression model to determine the relationship between département-level sex-adjusted rates of genetic testing utilization and economic and ecological variables. Our results are the following: (i) Overall, 46.87% lung cancer admission patients obtained genetic testing for NSCLC; département-level utilization rates varied over 3.2-fold. Measures of geographic variation indicated a relatively high degree of geographic variation. (ii) there was a statistically significant relationship between genetic testing rates and per capita supply of general practitioners, radiotherapists and surgeons (negative correlation for the latter); lower genetic testing rates were also associated with higher local poverty rates. French policymakers should pursue effort toward deprived areas to obtain equal access to personalized medicine for advanced NSCLC patients.


title: Mechanism of inflammatory response in associated comorbidities in COVID-19

text: BACKGROUND AND AIMS: The outbreak of the new coronavirus, SARS-CoV-2, causes a respiratory disease and individuals with pre-existing cardiometabolic disorders display worse prognosis through the infection course. The aim of this minireview is to present epidemiological data related to metabolic comorbidities in association with the SARS-CoV-2. METHODS: This is a narrative mini-review with Pubmed search until April 23, 2020 using the keywords COVID-19, SARS-CoV-2, treatment of coronavirus and following terms: diabetes mellitus, obesity, arterial hypertension, ACE-inhibitors, cytokine storm, immune response and vitamin D. RESULTS: Studies indicate that obese individuals are more likely to develop infections, and that adipose tissue serves as a pathogen reservoir. In diabetic individuals higher rate of inflammatory processes is seen due to constant glucose recognition by C type lectin receptors. Hypertensive individuals, usually grouped with other conditions, are treated with drugs to reduce blood pressure mostly through ACEi and ARB, that leads to increased ACE2 expression, used by SARS-CoV-2 for human's cell entry. Until now, the studies have shown that individuals with those conditions and affected by COVID-19 present an uncontrolled release of pro-inflammatory cytokines and an unbalanced immune response, leading to the cytokine storm phenomenon. Vitamin D is highlighted as a potential therapeutic target, because in addition to acting on the immune system, it plays an important role in the control of cardiometabolic diseases. CONCLUSION: Currently, since there is no proven and effective antiviral therapy for SARS-CoV-2, the efforts should focus on controlling inflammatory response and reduce the risks of associated complications.


title: Impact of COVID-19 on oral emergency services

text: OBJECTIVE: To retrospectively review the impact of the outbreak of coronavirus disease 2019 (COVID-19) on services in the oral emergency room. MATERIALS AND METHODS: A statistical analysis of epidemiological characteristics and the patients' diagnoses and treatments in the Emergency Department of Peking University Hospital of Stomatology during the outbreak of COVID-19 in 2020 compared with those in 2019 in Beijing, China. RESULTS: There were fewer total visits in 2020 than in 2019 (P = 0.001), and the proportions of patients who were children, adolescents and elderly people were lower in 2020 than in 2019 (P < 0.001). The proportions of patients with acute toothache and infections were higher in 2020 than in 2019, and the proportions of patients with maxillofacial trauma and non-emergencies were lower in 2020 than in 2019 (P < 0.001). Drug treatment for acute pulpitis was used more often in 2020 than in 2019, and endodontic treatment and examination consultations were less common in 2020 than in 2019 (P = 0.022). CONCLUSIONS: The outbreak of COVID-19 affected the patient population and structure of disease types and oral services in the emergency room. The number of visits to the oral emergency room and the proportions of the patients who were children, adolescents and elderly people were reduced, meanwhile the percentage of emergency cases, except trauma, and conservative treatments increased during the outbreak of COVID-19.


title: Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper

text: Due to the exponential growth of the number of subjects affected by coronavirus disease 2019 (COVID-19), the entire Italian health care system had to respond promptly and in a very short time with the need of semi-intensive and intensive care units. Moreover, trained dedicated COVID-19 teams consisting of physicians were coming from different specialties (intensivists or pneumologists and infectiologists), while respiratory therapists and nurses have been recruited to work on and on without rest. However, due to still limited and evolving knowledge of COVID-19, there are few recommendations concerning the need in respiratory rehabilitation and physiotherapy interventions. The presentation of this paper is the result of a consensus promoted by the Italian societies of respiratory health care professionals who contacted pulmonologists directly involved in the treatment and rehabilitation of COVID-19. The aim was to formulate the more proper and common suggestions to be applied in different hospital settings in offering rehabilitative programs and physiotherapy workforce planning for COVID-19 patients. Two main areas of intervention were identified: organization and treatment, which are described in this paper to face the emergency.


COVID-19: its impact on dental schools in Italy, clinical problems in endodontic therapy and general considerations


COVID-19 : la crise peut aussi être source d'occasions et d'optimisme/ COVID-19: a time of crisis, but also of surgical opportunity and optimism


title: Effect of the type of reducing agents of silver ions in interpolyelectrolyte-metal complexes on the structure, morphology and properties of silver-containing nanocomposites

text: The objective of this work is to study the peculiarities of structural organization, morphology, thermomechanical, electrical and antimicrobial properties of nanocomposites based on pectin-polyethyleneimine interpolyelectrolyte complexes and silver nanoparticles in dependence on the type of reducing agent being applied for chemical reduction of silver ions in the interpolyelectrolyte-metal complexes. The average size of Ag nanoparticles is shown to be increased with decreasing of the activity of reducing agent (E0) and equals to 3.8 nm, 4.3 nm, and 15.8 nm, respectively, when engaging sodium borohydride (-1.24 V), hydrazine (-1.15 V) and ascorbic acid (-0.35 V). Moreover, it was found that the crystallite size of Ag nanoparticles also had the smallest value for nanocomposites obtained involving NaBH4 as reducing agent. Ag-containing nanocomposites prepared by reduction of silver ions in interpolyelectrolyte-metal complexes while applying a range of reducing agents are characterized by different electrical properties and polymer matrix' glass transition temperature. The influence of silver nanoparticles' size incorporated in the polymer matrix on the antimicrobial activity of nanocomposites has been established. The inhibition zone diameter of Staphylococcus aureus and Escherichia coli was higher for nanocomposites obtained using sodium borohydride and hydrazine compared to nanocomposites where ascorbic acid was used as the reducing agent.


Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources


title: Drinking to cope with the pandemic: The unique associations of COVID-19-related perceived threat and psychological distress to drinking behaviors in American men and women

text: The 2019 Coronavirus pandemic has brought about significant and unprecedented changes to the modern world, including stay-at-home orders, high rates of unemployment, and more than a hundred thousand deaths across the United States. Derived from the self-medication hypothesis, this research explored how perceived threat and psychological distress related to the COVID-19 pandemic are associated with drinking behavior among an American sample of adults. We also evaluated whether links between COVID-19-related perceived threat and psychological distress with drinking behavior are different for men and women. Participants (N = 754; 50% women) completed an online Qualtrics Panels study between April 17th and 23rd, 2020. Results suggested that psychological distress related to the COVID-19 pandemic was consistently related to alcohol use indices, and moderation results indicated this pattern was significant only among women for number of drinks consumed during the recent heaviest drinking occasion and number of drinks consumed on a typical evening. COVID-related distress' link to frequency of drinking and heavy drinking episodes was not different for men and women. Our results suggest that continued monitoring, particularly among women, should be conducted as this pandemic continues to evolve to identify the long-term public health impacts of drinking to cope with COVID-19 distress.


Empiric Therapies for COVID-19: Destined to Fail by Ignoring the Lessons of History


title: COVID-19 pandemic: Response plan by the Johns Hopkins Aramco Healthcare inpatient pharmacy department

text: The coronavirus disease 2019 (COVID-19) is an ongoing pandemic having caused a major health care crises across the globe.Pharmacy professionals are considered vital in preparation for optimal response to the COVID-19 pandemic. Therefore, in response to the estimated potential impact of COVID-19 on Johns Hopkins Aramco Healthcare (joint venture between Saudi Aramco and Johns Hopkins Medicine International), several initiatives were taken by the hospital's inpatient pharmacy department with focus on infection control, staffing, meeting clinical operational challenges, ethics, increased utilization of automation, and maintenance of employee wellness to prepare for this challenge. The plan implemented by the inpatient pharmacy department was prepared while incorporating information and recommendations from leading pharmacy organizations, ministry of health, institute's experience in battling another similar coronavirus (the Middle East respiratory syndrome-coronavirus) previously, and updated scientific research. The key focus areas include development of an institutionalized COVID-19 protocol, measures to improve infection control when handling and dispensing medications, modified staffing plan, system changes in peri-operative areas, keeping pharmacy professionals updated about new and scientific researches, increased utilization of automation, clinical interventions by pharmacist ensuring appropriate utilization of medications while monitoring for drug-drug interactions, adverse drug event prevention, and preparing for handling drug shortages. By implementing a robust plan, pharmacy professionals continue to show that they are an integral member of inter-professional health care teams.


docid: ttymnesm

title: Participation of more community hospitals in randomized trials of treatments for COVID-19 is needed


Cardiac dysfunction and thrombocytopenia-associated multiple organ failure inflammation phenotype in a severe paediatric case of COVID-19


title: COVID-19 and Laparoscopic Surgery: Scoping Review of Current Literature and Local Expertise

text: BACKGROUND: The current coronavirus disease (COVID-19) pandemic is holding the world in its grip. Epidemiologists have shown that the mortality risks are higher when the health care system is subjected to pressure from COVID-19. It is therefore of great importance to maintain the health of health care providers and prevent contamination. An important group who will be required to treat patients with COVID-19 are health care providers during semiacute surgery. There are concerns that laparoscopic surgery increases the risk of contamination more than open surgery; therefore, balancing the safety of health care providers with the benefit of laparoscopic surgery for the patient is vital. OBJECTIVE: We aimed to provide an overview of potential contamination routes and possible risks for health care providers; we also aimed to propose research questions based on current literature and expert opinions about performing laparoscopic surgery on patients with COVID-19. METHODS: We performed a scoping review, adding five additional questions concerning possible contaminating routes. A systematic search was performed on the PubMed, CINAHL, and Embase databases, adding results from gray literature as well. The search not only included COVID-19 but was extended to virus contamination in general. We excluded society and professional association statements about COVID-19 if they did not add new insights to the available literature. RESULTS: The initial search provided 2007 records, after which 267 full-text papers were considered. Finally, we used 84 papers, of which 14 discussed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Eight papers discussed the added value of performing intubation in a low-pressure operating room, mainly based on the SARS outbreak experience in 2003. Thirteen papers elaborated on the risks of intubation for health care providers and SARS-CoV-2, and 19 papers discussed this situation with other viruses. They conclude that there is significant evidence that intubation and extubation is a high-risk aerosol-producing procedure. No papers were found on the risk of SARS-CoV-2 and surgical smoke, although 25 papers did provide conflicting evidence on the infection risk of human papillomavirus, hepatitis B, polio, and rabies. No papers were found discussing tissue extraction or the deflation risk of the pneumoperitoneum after laparoscopic surgery. CONCLUSIONS: There seems to be consensus in the literature that intubation and extubation are high-risk procedures for health care providers and that maximum protective equipment is needed. On the other hand, minimal evidence is available of the actual risk of contamination of health care providers during laparoscopy itself, nor of operating room pressure, surgical smoke, tissue extraction, or CO2 deflation. However, new studies are being published daily from current experiences, and society statements are continuously updated. There seems to be no reason to abandon laparoscopic surgery in favor of open surgery. However, the risks should not be underestimated, surgery should be performed on patients with COVID-19 only when necessary, and health care providers should use logic and common sense to protect themselves and others by performing surgery in a safe and protected environment.


title: COVID-19 complicated by pulmonary embolism treated with catheter directed thrombectomy

text: COVID-19 is a recently identified illness that is associated with thromboembolic events. We report a case of pulmonary embolism in a patient with COVID-19, treated by catheter directed thrombectomy. A 57 year old patient presented to the emergency center with severe COVID-19 symptoms and developed massive pulmonary embolism. The patient was treated with catheter directed thrombolysis (CDT) and recovered completely. Coagulopathy associated with COVID-19 is present in all severe cases and is a dynamic process. We describe a case of massive/high risk pulmonary embolism, in a patient with COVID-19 receiving full anticoagulation, who was treated by percutaneous intervention. CDT can be an additional therapeutic option in patients with COVID-19 and pulmonary embolism that present with rapid clinical collapse.


title: Knowledge and awareness regarding spread and prevention of COVID-19 among the young adults of Karachi

text: OBJECTIVE: To measure the awareness of COVID-19 infection among the general population following the outbreak in China. METHODS: This descriptive cross-sectional study was carried out during January and February 2020 amongst the general population of Karachi, Pakistan. A pre-tested, self-administered questionnaire was used among 399 young adult participants. The questionnaire was developed keeping in view of the already published study on severe acute respiratory syndrome (SARS) and the available literature on COVID-19. It included sociodemographic information, assessment of knowledge, beliefs regarding coronavirus and the perception of precautionary measures taken by an individual. Chi-square test was used for categorical variables and p<0.05 was used as statistically significant. RESULTS: There were more females 299 (75%) than male participants 100 (25%). The mean age was 20.9 ±2.30 years and 232 (58%) had graduate degrees. There is lack of knowledge and awareness about coronavirus as 226 (56.6%) participants claimed that coronavirus is actually the most dangerous virus in the world, and 171 (43%) did know that the common flu virus is potentially more lethal than coronavirus. Although a large majority of participants correctly identified sources of transmission, measures and precautions to be taken for coronavirus, their knowledge for symptom identification was deficient. The most pursued platform for information for coronavirus was found to be social media, followed by television and print media. CONCLUSIONS: The study highlighted the level of awareness of coronavirus among young adults in Karachi, Pakistan. The study further pointed out the public knowledge gaps for the authorities concerned to help them develop more effective and successful awareness campaigns using preferred channels.


Use of Handheld Transceiver for Hospital Healthcare Workers-Caregiver Communication During the Coronavirus disease 2019 (COVID-19) Outbreak in Pediatric Emergency Department


title: Simple Primary Colour Editing for Consumer Product Images

text: We present a simple primary colour editing method for consumer product images. We show that by using colour correction and colour blending, we can automate the pain-staking colour editing task and save time for consumer colour preference researchers. To improve the colour harmony between the primary colour and its complementary colours, our algorithm also tunes the other colours in the image. Preliminary experiment has shown some promising results compared with a state-of-the-art method and human editing.


New tools aim to tame pandemic paper tsunami


docid: drxrwpnv

title: Working through the COVID-19 outbreak: Rapid review and recommendations for MSK and allied heath personnel

text: The coronavirus (COVID-19) pandemic has caused the world to undergo unprecedented change in a short space of time. This disease has devastated the economy, infringed personal freedom, and has taken a toll on healthcare systems worldwide. This review aims to highlight aspects of this pandemic with a specific emphasis on musculoskeletal work within the secondary care setting.


Inflammatory Bowel Diseases and Biological Treatment in SARS-CoV-2 Era. Why Not?


title: Observed and estimated prevalence of Covid-19 in Italy: Is it possible to estimate the total cases from medical swabs data?

text: During the current Covid-19 pandemic in Italy, official data are collected with medical swabs following a pure convenience criterion which, at least in an early phase, has privileged the exam of patients showing evident symptoms. However, there are evidences of a very high proportion of asymptomatic patients (e. g. Aguilar et al., 2020; Chugthai et al, 2020; Li, et al., 2020; Mizumoto et al., 2020a, 2020b and Yelin et al., 2020). In this situation, in order to estimate the real number of infected (and to estimate the lethality rate), it should be necessary to run a properly designed sample survey through which it would be possible to calculate the probability of inclusion and hence draw sound probabilistic inference. Some researchers proposed estimates of the total prevalence based on various approaches, including epidemiologic models, time series and the analysis of data collected in countries that faced the epidemic in earlier time (Brogi et al., 2020). In this paper, we propose to estimate the prevalence of Covid-19 in Italy by reweighting the available official data published by the Istituto Superiore di Sanit\`a so as to obtain a more representative sample of the Italian population. Reweighting is a procedure commonly used to artificially modify the sample composition so as to obtain a distribution which is more similar to the population (Valliant et al., 2018). In this paper, we will use post-stratification of the official data, in order to derive the weights necessary for reweighting them using age and gender as post-stratification variables thus obtaining more reliable estimation of prevalence and lethality.


Comment on 'Reorganisation of medical oncology departments during the novel coronavirus disease-19 pandemic: A nationwide Italian survey' by Alice Indini et al


title: Relative Abundance of SARS-CoV-2 Entry Genes in the Enterocytes of the Lower Gastrointestinal Tract

text: There is increasing evidence of gastrointestinal (GI) infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We surveyed the co-expression of SARS-CoV-2 entry genes ACE2 and TMPRSS2 throughout the GI tract to assess potential sites of infection. Publicly available and in-house single-cell RNA-sequencing datasets from the GI tract were queried. Enterocytes from the small intestine and colonocytes showed the highest proportions of cells co-expressing ACE2 and TMPRSS2. Therefore, the lower GI tract represents the most likely site of SARS-CoV-2 entry leading to GI infection.


Anesthesiologists and the High Risk of Exposure to COVID-19


Infarto agudo de miocardio con elevación del segmento ST en tiempos de COVID-19: ¿regreso al siglo pasado? Una llamada de atención./ [ST-segment elevation myocardial infarction in times of COVID-19: back to the last century? A call for attention]


title: Experts proposal and frequently asked questions of rapid screening and prevention of novel coronavirus pneumonia in children/ 中华实用儿科临床杂志

text: The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives. Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.


Screening and Severity of Coronavirus Disease 2019 (COVID-19) in Children in Madrid, Spain


TNFα-antagonist use and mucosal inflammation are associated with increased intestinal expression of SARS-CoV-2 host protease TMPRSS2 in patients with inflammatory bowel disease


title: Outrunning Burnout in a GI Fellowship Program During the COVID-19 Pandemic

text: Many GI training programs have needed to adjust to the serious disruption to the training and education of fellows worldwide due to the COVID-19 pandemic. A silent problem that has arisen within programs is the issue of burnout among their trainees. Burnout is common among gastroenterologists, especially in fellows (Keswani et al. in Gastroenterology 147(1):11-14, 2014. https://doi.org/10.1053/j.gastro.2014.05.023, Am J Gastroenterol 106(10):1734-1740, 2011. https://doi.org/10.1038/ajg.2011.148), with negative consequences to patient care and the safety of the trainees if not effectively dealt with. In this article, the author describes several additional factors potentially contributing to the intensifying burnout of the fellows in their home institution during this pandemic. Moreover, he describes specific practical interventions that the hospital and program have taken in order to address these factors.


L'ospedale al tempo del CoViD-19, diario di bordo


Duration of SARS-CoV-2 viral shedding during COVID-19 infection


title: Keeping an eye on COVID-19: Ophthalmic care and triage for general practitioners

text: The ability of general practitioners to triage ophthalmic conditions appropriately is critical in our fight against COVID-19.


title: The coronavirus pandemic and Holocaust survivors in Israel

text: Holocaust survivors in Israel and abroad appear to be especially vulnerable to COVID-19 because of their early life history, advanced age, and associated health conditions. And although some survivors may experience retraumatization because of the pandemic, others appear to be especially resilient. We encourage a strength-based approach when working with survivors to foster resilience and effective coping in this uncertain time. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Update to device-related pressure ulcers: SECURE prevention. COVID-19, face masks and skin damage

text: The 2019 novel coronavirus disease (COVID-19) pandemic has brought the effects of device-related pressure ulcers (DRPU) into sharp focus. With the increased use of personal protective equipment (PPE), including face masks, continuous positive airway pressure (CAPP) masks and other devices, the incidence of DRPUs among health professionals and patients alike has risen starkly. As such, the Journal of Wound Care (JWC) consensus document, Device-related pressure ulcers: SECURE prevention, published in February 2020, is more relevant than ever. To help support patients and frontline health professionals, JWC is republishing the consensus in a digital format, along with a new introductory article outlining the DRPU risks posed by PPE and other medical devices used by patients and health professionals during the pandemic, and how the skin damage can be avoided. The aim is to provide frontline staff with a clear, simple strategy on how to prevent the risk of personal skin damage and/or DRPU during the pandemic, as well as point them in the direction of more indepth guidance on long-term strategies for prevention, for both themselves and patients.


Faced with today's crisis, what would Gandhi do?


Men's health: COVID-19 pandemic highlights need for overdue policy action


title: Clinical outcome of 55 asymptomatic cases at the time of hospital admission infected with SARS-Coronavirus-2 in Shenzhen, China ;The Journal of Infectious Diseases ;Oxford Academic

text: Abstract An epidemic caused by SARS-Coronavirus-2 infection has spread unexpectedly in Wuhan, Hubei Province, China since December 2019 It is rarely reported about asymptomatic cases screened from close contacts We study epidemiological and clinical outcome of 55 asymptomatic carriers who were laboratory-confirmed positive for the SARS-Coronavirus-2 by testing the nucleic acid of the pharyngeal swab samples The evidence showed that asymptomatic carriers occurred more often in middle aged people who had close contact with infected family members The majority of the cases developed to be mild and ordinary COVID-19 during hospital


title: Experimental evidence on photo-assisted O$^-$ ion production from Al$_2$O$_3$ cathode in cesium sputter negative ion source

text: The production of negative ions in cesium sputter ion sources is generally considered to be a pure surface process. It has been recently proposed that ion pair production could explain the higher-than-expected beam currents extracted from these ion sources, therefore opening the door for laser-assisted enhancement of the negative ion yield. We have tested this hypothesis by measuring the effect of various pulsed diode lasers on the O$^-$ beam current produced from Al$_2$O$_3$ cathode of a cesium sputter ion source. It is expected that the ion pair production of O$^-$ requires populating the 5d electronic states of neutral cesium, thus implying that the process should be provoked only with specific wavelengths. Our experimental results provide evidence for the existence of a wavelength-dependent photo-assisted effect but cast doubt on its alleged resonant nature as the prompt enhancement of beam current can be observed with laser wavelengths exceeding a threshold photon energy. The beam current transients observed during the laser pulses suggest that the magnitude and longevity of the beam current enhancement depends on the cesium balance on the cathode surface. We conclude that the photo-assisted negative ion production could be of practical importance as it can more than double the extracted beam current under certain operational settings of the ion source.


Type I IFN immunoprofiling in COVID-19 patients


Fast and economic cardboard cutout use to increase compliance of face mask wear during COVID-19 pandemic


title: The relationship between COVID-19 knowledge levels and anxiety states of midwifery students during the outbreak: A cross-sectional web-based survey

text: PURPOSE: To determine the relationship between the anxiety states and knowledge levels of female midwifery students about COVID-19 during the outbreak. DESIGN AND METHODS: This cross-sectional study carried out with online participation of 972 female midwifery students. FINDINGS: The anxiety levels of the female midwifery students were high among those visiting the hospital during the pandemic and having parents or relatives who had chronic diseases. Female midwifery students had a high level of knowledge regarding COVID-19. PRACTICE IMPLICATIONS: Female midwives of the future will take part in primary health care services in the protection and promotion of health as an important occupational group in the public health system. To determine mental health and psychological needs of them during the outbreak will greatly contribute to the pandemic management process.


title: Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19)

text: In late December 2019, a cluster of cases with 2019 Novel Coronavirus pneumonia (SARS-CoV-2) in Wuhan, China, aroused worldwide concern. Previous studies have reported epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19). The purpose of this brief review is to summarize those published studies as of late February 2020 on the clinical features, symptoms, complications, and treatments of COVID-19 and help provide guidance for frontline medical staff in the clinical management of this outbreak.


title: Donning a New Approach to the Practice of Gastroenterology: Perspectives From the COVID-19 Pandemic Epicenter

text: The COVID-19 pandemic seemingly is peaking now in New York City and has triggered significant changes to the standard management of gastrointestinal diseases. Priorities such as minimizing viral transmission, preserving personal protective equipment, and freeing hospital beds have driven unconventional approaches to managing gastroenterology (GI) patients. Conversion of endoscopy units to COVID units and redeployment of GI fellows and faculty has profoundly changed the profile of most GI services. Meanwhile, consult and procedural volumes have been reduced drastically. In this review, we share our collective experiences regarding how we have changed our practice of medicine in response to the COVID surge. Although we review our management of specific consults and conditions, the overarching theme focuses primarily on noninvasive measures and maximizing medical therapies. Endoscopic procedures have been reserved for those timely interventions that are most likely to be therapeutic. The role of multidisciplinary discussion, although always important, now has become critical. The support of our faculty and trainees remains essential. Local leadership can encourage well-being by frequent team check-ins and by fostering trainee development through remote learning. Advancing a clear vision and a transparent process for how to organize and triage care in the recovery phase will allow for a smooth transition to our new normal.


title: The care of pregnant women during the COVID-19 pandemic - response of a large health system in metropolitan New York

text: The rapid progression of the coronavirus disease 2019 (COVID-19) outbreak presented extraordinary challenges to the US health care system, particularly straining resources in hard hit areas such as the New York metropolitan region. As a result, major changes in the delivery of obstetrical care were urgently needed, while maintaining patient safety on our maternity units. As the largest health system in the region, with 10 hospitals providing obstetrical services, and delivering over 30,000 babies annually, we needed to respond to this crisis in an organized, deliberate fashion. Our hospital footprint for Obstetrics was dramatically reduced to make room for the rapidly increasing numbers of COVID-19 patients, and established guidelines were quickly modified to reduce potential staff and patient exposures. New communication strategies were developed to facilitate maternity care across our hospitals, with significantly limited resources in personnel, equipment, and space. The lessons learned from these unexpected challenges offered an opportunity to reassess the delivery of obstetrical care without compromising quality and safety. These lessons may well prove valuable after the peak of the crisis has passed.


B Cells, Viruses, and the SARS-CoV-2/COVID-19 Pandemic of 2020


Long-term Pulmonary Consequences of Coronavirus Disease 2019 (COVID-19): What We Know and What to Expect


title: Atención Domiciliaria Y Covid-19. Antes, Durante Y Después Del Estado De Alarma./ [home Care and Covid-19. Before, in and after the State of Alarm]

text: In Spain, Home Care as a fundamental tool of Primary Health Care, has had uneven development both before and during the COVID-19 pandemic, although it initially played a relevant role in the control and monitoring of infected people and their families. However, at no time it was used the desirable community perspective and community participation throughout the process as it has been successfully done in other settings. Subsequently, with the closure of health centers, it ceased to be provided in some autonomous communities, when all the attention was transferred to the hospital setting. This exacerbated hospital-centrism, to the detriment of PHC and Home Care, is showing a high contagion in healthcare professionals. The circulation of professionals in the hospitals, where the main focus of infection is concentrated, and from these to their homes is a clear risk factor. In addition, we must not forget that Home Care is of special importance for the care of people with terminal illnesses or very advanced chronic diseases (dementia, COPD ...), although always taking into account recommendations tending to extreme precautions for infection for professionals, family and caregivers. This can be adapted to the pandemic situation by using tools that digital health offers (telephone care, video calls ...). Finally, it would be very interesting that, once the crisis was over, research was carried out that allowed the incorporation of people who have been treated by the health service during the pandemic, through the technique called public participation in research projects.


The role of self-reported olfactory and gustatory dysfunction as a screening criterion for suspected COVID-19


COVID-19 pandemic and the need for objective criteria for ICU admissions


title: Identification of Human Single-Domain Antibodies against SARS-CoV-2

text: The worldwide spread of COVID-19 highlights the need for an efficient approach to rapidly develop therapeutics and prophylactics against SARS-CoV-2. The SARS-CoV-2 spike protein, containing the receptor-binding domain (RBD) and S1 subunit involved in receptor engagement, is a potential therapeutic target. We describe the development of a phage-displayed single-domain antibody library by grafting naive complementarity-determining regions (CDRs) into framework regions of a human germline immunoglobulin heavy chain variable region (IGHV) allele. Panning this library against SARS-CoV-2 RBD and S1 subunit identified fully human single-domain antibodies targeting five distinct epitopes on SARS-CoV-2 RBD with subnanomolar to low nanomolar affinities. Some of these antibodies neutralize SARS-CoV-2 by targeting a cryptic epitope located in the spike trimeric interface. Collectively, this work presents a versatile platform for rapid antibody isolation and identifies promising therapeutic anti-SARS-CoV-2 antibodies as well as the diverse immogneic profile of the spike protein.


Impact of the COVID-19 pandemic on surgical services: early experiences at a nominated COVID-19 centre


Letter to the editor - Is it really COVID-19?


The correlation between SARS-CoV-2 infection and rheumatic disease