title: Zero COVID-19 infection in inflammatory bowel disease patients: Findings from National IBD Registries in Hong Kong and Taiwan

text: INTRODUCTION: It is unsure whether inflammatory bowel disease (IBD) is a risk factor for novel coronavirus infection (COVID-19). METHODS: IBD patients were identified from population-based databases in Hong Kong and Taiwan from 21 January 2020 till 15 April 2020. RESULTS: Total 2,954 and 2,554 IBD patients were identified in Hong Kong and Taiwan, respectively. None had COVID-19. Pooled analysis showed 65.3%, 39.1%, 4.3% and 12.8% IBD patients in Hong Kong and 75.8 %, 51.4 %, 26.1% and 52.3 % in Taiwan were on 5-aminosalicylates, immunomodulators, corticosteroids and biologics, respectively. CONCLUSION: There was no reported cases of COVID-19 infection amongst IBD patients in Hong Kong and Taiwan. IBD patients should continue their usual medications during the COVID-19 pandemic.


title: Zero COVID-19 infection in inflammatory bowel disease patients: Findings from population-based inflammatory bowel disease registries in Hong Kong and Taiwan

text: BACKGROUND AND AIM: It is unsure whether inflammatory bowel disease (IBD) is a risk factor for novel coronavirus infection (COVID-19). METHODS: IBD patients were identified from population-based databases in Hong Kong and Taiwan from January 21, 2020, until April 15, 2020. RESULTS: Total 2954 and 2554 IBD patients were identified in Hong Kong and Taiwan, respectively. None had COVID-19. Pooled analysis showed that 65.3%, 39.1%, 4.3%, and 12.8% IBD patients in Hong Kong and 75.8 %, 51.4 %, 26.1%, and 52.3 % in Taiwan were on 5-aminosalicylates, immunomodulators, corticosteroids, and biologics, respectively. CONCLUSION: There were no reported cases of COVID-19 infection amongst IBD patients in Hong Kong and Taiwan. IBD patients should continue their usual medications during the COVID-19 pandemic.


Telemedicina, telementorización y evaluación telemática en cirugía. ¿Es su momento después de la COVID-19?/ Telemedicina, telementorización y evaluación telemática en cirugía. ¿Es su momento después de la COVID-19?/ Telemedicine, telementoring and telematic evaluation in surgery. Is it your time after COVID-19?


Life after COVID-19: R WE going to help?


Distinguishing between direct and indirect consequences of covid-19


title: Repurposing drugs for COVID-19 based on transcriptional response of host cells to SARS-CoV-2

text: The Coronavirus Disease 2019 (COVID-19) pandemic has infected over 10 million people globally with a relatively high mortality rate. There are many therapeutics undergoing clinical trials, but there is no effective vaccine or therapy for treatment thus far. After affected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), molecular signaling of host cells plays critical roles during the life cycle of SARS-CoV-2. Thus, it is significant to identify the involved molecular signaling pathways within the host cells, and drugs targeting these molecular signaling pathways could be potentially effective for COVID-19 treatment. In this study, we aimed to identify these potential molecular signaling pathways, and repurpose existing drugs as a potentially effective treatment of COVID-19 to facilitate the therapeutic discovery, based on the transcriptional response of host cells. We first identified dysfunctional signaling pathways associated with the infection caused SARS-CoV-2 in human lung epithelial cells through analysis of the altered gene expression profiles. In addition to the signaling pathway analysis, the activated gene ontologies (GOs) and super gene ontologies were identified. Signaling pathways and GOs such as MAPK, JNK, STAT, ERK, JAK-STAT, IRF7-NFkB signaling, and MYD88/CXCR6 immune signaling were particularly identified. Based on the identified signaling pathways and GOs, a set of potentially effective drugs were repurposed by integrating the drug-target and reverse gene expression data resources. The dexamethasone was top-ranked in the prediction, which was the first reported drug to be able to significantly reduce the death rate of COVID-19 patients receiving respiratory support. The results can be helpful to understand the associated molecular signaling pathways within host cells, and facilitate the discovery of effective drugs for COVID-19 treatment.


title: Effectiveness of Testing, Tracing, Social Distancing and Hygiene in Tackling Covid-19 in India: A System Dynamics Model

text: We present a System Dynamics (SD) model of the Covid-19 pandemic spread in India. The detailed age-structured compartment-based model endogenously captures various disease transmission pathways, expanding significantly from the standard SEIR model. The model is customized for India by using the appropriate population pyramid, contact rate matrices, external arrivals (as per actual data), and a few other calibrated fractions based on the reported cases of Covid-19 in India. Also, we have explicitly modeled, using independent time-variant levers, the effects of testing, contact tracing, isolating Covid-positive patients, quarantining, use of mask/better hygiene practices, social distancing through contact rate reductions at distinct zones of home(H), work(W), school(S) and other(O) locations. Simulation results show that, even after an extended lock-down, some non-trivial number of infections (even asymptomatic) will be left and the pandemic will resurface. Only tools that work against the pandemic is high rate of testing of those who show Covid-19 like symptoms, isolating them if they are positive and contact tracing all contacts of positive patients and quarantining them, in combination with use of face masks and personal hygiene. A wide range of combination of effectiveness of contact tracing, isolation, quarantining and personal hygiene measures help minimize the pandemic impact and some imperfections in implementation of one measure can be compensated by better implementation of other measures.


title: Asignación justa de recursos médicos: guía bioética del CSG./ Allocating medical resources fairly: the CSG bioethics guide

text: On April 12, 2020, a bioethics guide for allocating scarce hospital resources during the current Covid-19 pandemic was posted on the website of the Consejo de Salubridad General (CSG) of the Government of Mexico. The guide, entitled Guía bioética para asignación de recursos limitados de medicina crítica en situación de emergencia, was intended as a preliminary document, but the website posting did not describe it as a first step in the process. The publicity resulted in a wide array of comments and criticisms. That first version posted on the CSG website contained an age-based criterion for breaking a tie between two or more medically eligible patients who needed of a ventilator: younger patients would have preference over older ones. The final version of the guide eliminated that criterion and instead, relied on the leading public health principle, "save the most lives", without regard to personal characteristics other than the possibility of benefitting from the scarce medical resources.


title: AI-Driven Tools for Coronavirus Outbreak: Need of Active Learning and Cross-Population Train/Test Models on Multitudinal/Multimodal Data

text: The novel coronavirus (COVID-19) outbreak, which was identified in late 2019, requires special attention because of its future epidemics and possible global threats. Beside clinical procedures and treatments, since Artificial Intelligence (AI) promises a new paradigm for healthcare, several different AI tools that are built upon Machine Learning (ML) algorithms are employed for analyzing data and decision-making processes. This means that AI-driven tools help identify COVID-19 outbreaks as well as forecast their nature of spread across the globe. However, unlike other healthcare issues, for COVID-19, to detect COVID-19, AI-driven tools are expected to have active learning-based cross-population train/test models that employs multitudinal and multimodal data, which is the primary purpose of the paper.


title: Stand by me 2.0. Visits by family members at Covid-19 time

text: BACKGROUND: In the complex health emergency situation of our country, the application of Information Technology tools has a decisive role in supporting health insurance, creating a highly performing and technologically advanced system that reduce distances, suffering of disease and the weight of necessary isolation. The theme of the humanization of care, understood as attention to the person as a whole, is a highly topical issue today. The humanization in the healthcare is intended as the ability to make the places of care and the same medical care practices more open, safer and painless, reconciling hospitality, information and comfort with care paths as much as possible in sharing with the patient and his family. MATERIALS AND METHODS: Pursuing the purposes inherent in the concept of humanization of care and assistance, with the aim of offering Apulian citizens a complementary, but also fundamental, service in clinical-therapeutic assistance to the patient affected by COVID-19, in the hope of improving the quality of care, also in relation to the perception of the user, the Strategic Management of the AOU Policlinico of Bari has launched an experimental project that fits into the context of care quality, a crucial and not negligible issue, despite the extreme difficulties dictated by the ongoing medical emergency. RESULTS: The experimental project proposes an innovative clinical-organizational model which, through Information and Communications Technology (ICT), intends to make the management of COVID-19 patients optimal, safe and better, in all the spheres that jointly define the concept of Health.


title: The pandemic of COVID-19 and its implications for the purity and authenticity of alcohol-based hand sanitizers: The health risks associated with falsified sanitizers and recommendations for regulatory and public health bodies

text: With the beginning of the pandemic of COVID-19 throughout the world, the demand and consumption of hand sanitizers has increased, which had led to a sharp crunch in these products at all levels. This shortage has led to an increase in the prevalence of falsified alcohol-based hand sanitizers, including the illegal addition of methanol to hand sanitizers and the production of hand sanitizers with an alcohol concentration of less than 60%. These findings indicate that regulatory and public health bodies should take an active role in ensuring the safety and quality of antimicrobial products such as alcohol-based hand sanitizers at every stage of the products' lifecycle, including distribution, manufacture and import.


docid: pxikgilo

title: Covid-19 treatment-induced neuropsychiatric adverse effects


BET 2: Hydroxychloroquine in the treatment of COVID-19


Special report: The simulations driving the world's response to COVID-19


Building Informatics Capacity of Local Health Departments to Combat COVID-19: A Call to Action


Doctor-patient communication in surgical practice during the coronavirus (COVID-19) pandemic


title: Can Chinese Medicine Be Used for Prevention of Corona Virus Disease 2019 (COVID-19)? A Review of Historical Classics, Research Evidence and Current Prevention Programs

text: OBJECTIVE: Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies. METHODS: Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases. RESULTS: The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24-0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao). CONCLUSIONS: Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.


Establishment of a safety protocol for the administration of treatments in multiple sclerosis during the SARS-CoV-2 pandemic


Covid-19: Ministers urged to waive £993 visa bill for "stranded" doctors who had exams cancelled


A real-time dashboard of clinical trials for COVID-19


title: SIRNet: Understanding Social Distancing Measures with Hybrid Neural Network Model for COVID-19 Infectious Spread

text: The SARS-CoV-2 infectious outbreak has rapidly spread across the globe and precipitated varying policies to effectuate physical distancing to ameliorate its impact. In this study, we propose a new hybrid machine learning model, SIRNet, for forecasting the spread of the COVID-19 pandemic that couples with the epidemiological models. We use categorized spatiotemporally explicit cellphone mobility data as surrogate markers for physical distancing, along with population weighted density and other local data points. We demonstrate at varying geographical granularity that the spectrum of physical distancing options currently being discussed among policy leaders have epidemiologically significant differences in consequences, ranging from viral extinction to near complete population prevalence. The current mobility inflection points vary across geographical regions. Experimental results from SIRNet establish preliminary bounds on such localized mobility that asymptotically induce containment. The model can support in studying non-pharmacological interventions and approaches that minimize societal collateral damage and control mechanisms for an extended period of time.


CID-19 pulmonary infection in erythrodermic psoriatic patient with oligodendroglioma: safety and compatibility of apremilast with critical intensive care management


title: Potential of Flavonoid-Inspired Phytomedicines against COVID-19

text: Flavonoids are widely used as phytomedicines. Here, we report on flavonoid phytomedicines with potential for development into prophylactics or therapeutics against coronavirus disease 2019 (COVID-19). These flavonoid-based phytomedicines include: caflanone, Equivir, hesperetin, myricetin, and Linebacker. Our in silico studies show that these flavonoid-based molecules can bind with high affinity to the spike protein, helicase, and protease sites on the ACE2 receptor used by the severe acute respiratory syndrome coronavirus 2 to infect cells and cause COVID-19. Meanwhile, in vitro studies show potential of caflanone to inhibit virus entry factors including, ABL-2, cathepsin L, cytokines (IL-1ß, IL-6, IL-8, Mip-1α, TNF-α), and PI4Kiiiß as well as AXL-2, which facilitates mother-to-fetus transmission of coronavirus. The potential for the use of smart drug delivery technologies like nanoparticle drones loaded with these phytomedicines to overcome bioavailability limitations and improve therapeutic efficacy are discussed.


Coronavirus Disease (COVID-19) Detected at the Lung Apices During CT Angiography in Acute Stroke Assessment


Endoscopy staff are concerned about acquiring COVID-19 infection when resuming elective endoscopy


docid: efebiaer

title: Pursuing a Good Death in the Time of COVID-19


Coronavirus disease 2019 outbreak


COVID-19 in Nepal: Lower Than Expected Incidence and Mortality


The South African Response to the Pandemic


title: Antibody Detection and Dynamic Characteristics in Patients with COVID-19

text: BACKGROUND: The corona virus disease 2019 (COVID-19) caused by the corona virus 2 (SARS-CoV-2) has been rapidly spreading nationwide and abroad. A serologic test to identify antibody dynamics and response to SARS-CoV-2 was developed. METHODS: The antibodies against SARS-CoV-2 were detected by an enzyme-linked immunosorbent assay (ELISA) based on the recombinant nucleocapsid protein of SARS-CoV-2 in patients with confirmed or suspected COVID-19 at 3-40 days after symptom onset. The gold standard for COVID-19 diagnosis was nucleic acid testing for SARS-CoV-2 by RT-PCR. The serodiagnostic power of the specific IgM and IgG antibodies against SARS-CoV-2 was investigated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and consistency rate. RESULTS: The seroconversion of specific IgM and IgG antibodies were observed as early as the 4th day after symptom onset. In the confirmed patients with COVID-19, sensitivity, specificity, PPV, NPV, and consistency rate of IgM were 77.3% (51/66), 100%, 100%, 80.0%, and 88.1%, and those of IgG were 83.3.3% (55/66), 95.0%, 94.8%, 83.8%, and 88.9 %. In patients with suspected COVID-19, sensitivity, specificity, PPV, NPV, and consistency rate of IgM were 87.5% (21/24), 100%, 100%, 95.2%, and 96.4%, and those of IgG were 70.8% (17/24), 96.6%, 85.0%, 89.1%, and 88.1%. Both antibodies performed well in serodiagnosis for COVID-19 rely on great specificity. CONCLUSIONS: The antibodies against SARS-CoV-2 can be detected in the middle and later stage of the illness. Antibody detection may play an important role in the diagnosis of COVID-19 as complement approach for viral nucleid acid assays.


title: Personal Protective Equipment (PPE) for Surgeons during COVID-19 Pandemic: A Systematic Review of Availability, Usage, and Rationing

text: BACKGROUND: Surgeons need guidance regarding appropriate personal protective equipment (PPE) during the COVID-19 pandemic based on scientific evidence rather than availability. The aim of this paper is to inform surgeons of appropriate PPE requirements, and to discuss usage, availability, rationing and future solutions. METHODS: A systematic review was undertaken in accordance with the PRISMA guidelines using the MEDLINE, EMBASE, & WHO COVID-19 Databases. Newspaper and internet article sources were identified using NEXIS. The search was complemented by bibliographic secondary linkage. The findings were analysed alongside guidelines from the World Health Organisation (WHO), Public Health England (PHE), the Royal College of Surgeons & Specialty Associations. RESULTS: Of a total 1329 articles identified, 305 were removed (duplicates etc), and finally, 95 studies met the inclusion criteria. Recommendations made by the WHO regarding the use of PPE in the COVID-19 pandemic have evolved alongside emerging evidence. Medical resources including PPE have been rapidly overwhelmed. There is a global effort to overcome this by combining the most effective use of existing PPE in combination with innovative strategies to produce more. Practical advice on all aspects of PPE are detailed in this systematic review. CONCLUSION: Although there is a need to balance limited supplies with staff and patient safety, this should not leave surgeons treating patients with inadequate PPE. This article is protected by copyright. All rights reserved.


docid: hejqgfys

title: Use of in situ simulation to evaluate the operational readiness of a high-consequence infectious disease intensive care unit

text: On 30 January 2020, the World Health Organization (WHO) declared that the outbreak of a coronavirus disease-2019 (COVID-19) was a public health emergency of international concern. The WHO guidance states that patients with (COVID-19) should be managed by staff wearing appropriate personal protective equipment; however, working whilst wearing personal protective equipment is unfamiliar to many healthcare professionals. We ran high-fidelity, in-situ simulation of high-risk procedures on patients with COVID-19 in a negative-pressure side room on our intensive care unit (ICU). Our aim was to identify potential problems, test the robustness of our systems and inform modification of our standard operating procedures for any patients with COVID-19 admitted to our ICU. The simulations revealed several important latent risks and allowed us to put corrective measures in place before the admission of patients with COVID-19. We recommend that staff working in clinical areas expected to receive patients with COVID-19 conduct in-situ simulation in order to detect their own unique risks and aid in the creation of local guidelines of management of patients with COVID-19.


title: A family cluster of severe acute respiratory syndrome coronavirus 2 infections

text: Clinical and epidemiological knowledge of 2019 novel coronavirus disease (COVID-19) is limited. We reported a family cluster of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cases in Beijing, China. This family comprised three laboratory confirmed cases with clinical symptoms. All three patients had close contact with a relative from Wuhan, Hubei Province. Throat swab samples were all positive for SARS-CoV-2 using real-time reverse transcriptase-polymerase chain reaction assays. Chest computerized tomography revealed ground-glass opacities and consolidation. SARS-CoV-2 infections tend to clusters. Physicians should be aware of contact history so that infected patients can be identified promptly and further spreading prevented.


Hospital response to the COVID-19 outbreak: The experience in Shanghai, China


title: Dying with SARS-CoV-2 infection-an autopsy study of the first consecutive 80 cases in Hamburg, Germany

text: Autopsies of deceased with a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can provide important insights into the novel disease and its course. Furthermore, autopsies are essential for the correct statistical recording of the coronavirus disease 2019 (COVID-19) deaths. In the northern German Federal State of Hamburg, all deaths of Hamburg citizens with ante- or postmortem PCR-confirmed SARS-CoV-2 infection have been autopsied since the outbreak of the pandemic in Germany. Our evaluation provides a systematic overview of the first 80 consecutive full autopsies. A proposal for the categorisation of deaths with SARS-CoV-2 infection is presented (category 1: definite COVID-19 death; category 2: probable COVID-19 death; category 3: possible COVID-19 death with an equal alternative cause of death; category 4: SARS-CoV-2 detection with cause of death not associated to COVID-19). In six cases, SARS-CoV-2 infection was diagnosed postmortem by a positive PCR test in a nasopharyngeal or lung tissue swab. In the other 74 cases, SARS-CoV-2 infection had already been known antemortem. The deceased were aged between 52 and 96 years (average 79.2 years, median 82.4 years). In the study cohort, 34 deceased were female (38%) and 46 male (62%). Overall, 38% of the deceased were overweight or obese. All deceased, except for two women, in whom no significant pre-existing conditions were found autoptically, had relevant comorbidities (in descending order of frequency): (1) diseases of the cardiovascular system, (2) lung diseases, (3) central nervous system diseases, (4) kidney diseases, and (5) diabetes mellitus. A total of 76 cases (95%) were classified as COVID-19 deaths, corresponding to categories 1-3. Four deaths (5%) were defined as non-COVID-19 deaths with virus-independent causes of death. In eight cases, pneumonia was combined with a fulminant pulmonary artery embolism. Peripheral pulmonary artery embolisms were found in nine other cases. Overall, deep vein thrombosis has been found in 40% of the cases. This study provides the largest overview of autopsies of SARS-CoV-2-infected patients presented so far.


title: Cardiovascular Implications and Therapeutic Considerations in COVID-19 Infection

text: The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has profoundly impacted all fields of medicine. Infection with SARS-CoV-2 and the resulting coronavirus of 2019 (COVID-19) syndrome has multiorgan effects. The pandemic has united researchers from bench to bedside in attempts to understand the pathophysiology of the disease and define optimal treatment strategies. Cardiovascular disease is highly prevalent and a leading cause of death across gender, race, and ethnic groups. As the pandemic spreads, there is increasing concern about the cardiovascular effects of the viral infection and the interaction of infection with existing cardiovascular disease. Additionally, there are concerns about the cardiac effects of the numerous treatment agents under study. It will be essential for cardiologists to understand the interplay between underlying cardiac comorbidities, acute cardiovascular effects of COVID-19 disease, and adverse effects of new treatments. Here we describe emerging evidence of the epidemiology of SARS-CoV-2 infection and underlying cardiovascular disease, the evidence for direct myocardial injury in SARS-CoV-2 infection, the specific presentations of cardiovascular involvement by SARS-CoV-2, and the cardiac effects of emerging treatments.


Living in a Covid-19 World


Covid-19 and Health at Work


title: Value of leukocytosis and elevated C-reactive protein in predicting severe coronavirus 2019 (COVID-19): A systematic review and meta-analysis

text: BACKGROUND: Since December 2019, coronavirus 2019 (COVID-19) has spread worldwide. Identifying poor prognostic factors is helpful for risk stratification. In this meta-analysis, we investigated the association between severe COVID-19 and a change in white blood cell (WBC) count, an elevation of C-reactive protein (CRP), and fever. Moreover, we aimed to evaluate the diagnostic accuracy of leukocytosis and an elevation of CRP. METHODS: We performed a systematic search of PubMed, EMBASE, Scopus, and the Cochrane Library through April 20th, 2020. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. A sensitivity analysis was conducted according to the study size (>200 or <200) and median age (>55 or <55). Meta-regression analyses were conducted to examine possible sources of heterogeneity. We calculated the diagnostic accuracy of leukocytosis and CRP. RESULTS: Eighteen studies with 3278 patients were selected. Fever, leukocytosis, and elevated CRP were associated with poor outcomes (OR (95% CI) 1.63 (1.06-2.51), 4.51 (2.53-8.04), and 11.97 (4.97-28.8), respectively). Leukopenia was associated with a better prognosis (OR 0.56, 95% CI 0.40-0.78). Sensitivity analyses showed similar tendencies. Meta-regression analysis for leukocytosis indicated that age, dyspnea, and hypertension contributed to heterogeneity. The pooled area under the leukocytosis and CRP curves were 0.70 (0.64-0.76) and 0.89 (0.80-0.99), respectively. CONCLUSION: In patients with COVID-19, fever, leukocytosis, and an elevated CRP were associated with severe outcomes. Leukocytosis and CRP on arrival may predict poor outcomes.


Pandemic Makes Chronic Disease Prevention a Priority


Urticarial vasculitis in COVID-19 infection: a vasculopathy-related symptom?


The Variety of Cardiovascular Presentations of COVID-19


title: Antigenic and immunogenic properties of the canine distemper virus nucleocapsid protein expressed in Escherichia coli employing codon optimized synthetic gene/ Propriedades antigênicas e imunogênicas da proteína do nucleocapsídeo do virus da cinomose canina expressa em Escherichia coli empregando gene sintético com codons otimizados

text: Despite common occurrence and importance of canine distemper disease the majority of tests currently available for diagnosis are hampered by either low sensitivity or specificity. In this study it was evaluated antigenic and immunogenic characteristics of a conserved region of nucleocapsid protein of canine distemper virus (rCDV NP) expressed in Escherichia coli employing a codon optimized synthetic gene. The expression of rCDVNP in Star strain (mean 300μg/mL, purified) was confirmed by SDS-PAGE and Western blot analysis by using His-Tag monoclonal antibodies. Western blot and ELISA, employing positive and negative control dog sera, demonstrated the rCDVNP antigenicity. The rCDVNP was inoculated in hens and immunoglobulin Y (IgY) was purified from the egg yolk. The mean yield of IgY was 28.55mg/mL. IgY reacted with the recombinant protein as demonstrated by Western blot and ELISA assays. In summary, our findings demonstrated that rCDVNP is antigenic since CDV positive dog sera recognized the protein in vitro. Additionally, the rCDVNP proved to be immunogenic in hens being possible to isolate a high concentration of specific IgY antibodies from the egg yolk. Taken together, these results indicate that the rCDVNP along with the specific IgY could be useful tools for development of the canine distemper immunodiagnostic assays.(AU)


title: Domain Extrapolation via Regret Minimization

text: Many real prediction tasks such as molecular property prediction require ability to extrapolate to unseen domains. The success in these tasks typically hinges on finding a good representation. In this paper, we extend invariant risk minimization (IRM) by recasting the simultaneous optimality condition in terms of regret, finding instead a representation that enables the predictor to be optimal against an oracle with hindsight access on held-out environments. The change refocuses the principle on generalization and doesn't collapse even with strong predictors that can perfectly fit all the training data. Our regret minimization (RGM) approach can be further combined with adaptive domain perturbations to handle combinatorially defined environments. We evaluate our method on two real-world applications: molecule property prediction and protein homology detection and show that RGM significantly outperforms previous state-of-the-art domain generalization techniques.


title: Mortality and survival of COVID-19

text: This study aims to identify the risk factors associated with mortality and survival of COVID-19 cases in a state of the Brazilian Northeast. It is a historical cohort with a secondary database of 2070 people that presented flu-like symptoms, sought health assistance in the state and tested positive to COVID-19 until 14 April 2020, only moderate and severe cases were hospitalised. The main outcome was death as a binary variable (yes/no). It also investigated the main factors related to mortality and survival of the disease. Time since the beginning of symptoms until death/end of the survey (14 April 2020) was the time variable of this study. Mortality was analysed by robust Poisson regression, and survival by Kaplan-Meier and Cox regression. From the 2070 people that tested positive to COVID-19, 131 (6.3%) died and 1939 (93.7%) survived, the overall survival probability was 87.7% from the 24th day of infection. Mortality was enhanced by the variables: elderly (HR 3.6; 95% CI 2.3-5.8; P < 0.001), neurological diseases (HR 3.9; 95% CI 1.9-7.8; P < 0.001), pneumopathies (HR 2.6; 95% CI 1.4-4.7; P < 0.001) and cardiovascular diseases (HR 8.9; 95% CI 5.4-14.5; P < 0.001). In conclusion, mortality by COVID-19 in Ceará is similar to countries with a large number of cases of the disease, although deaths occur later. Elderly people and comorbidities presented a greater risk of death.


docid: zxjlzyxq

title: Mortality and survival of COVID-19


Challenges facing the COVID-19 pandemic in Brazil: lessons from short food supply systems


docid: antgdovx

title: Stemming the flow: how much can the Australian smartphone app help to control COVID-19?

text: OBJECTIVES: Our objective is to assess the potential contribution of the Australian Government's mobile smartphone tracing app (COVIDSafe) to the sustained control of coronavirus disease 2019 (COVID-19). STUDY TYPE: Development and analysis of a system dynamics model. METHODS: To define the pandemic context and specify model-building parameters, we searched for literature on COVID-19, its epidemiology in Australia, case finding processes, and factors that might affect community acceptance of the COVIDSafe smartphone app for contact tracing. We then developed a system dynamics model of COVID-19 based on a modified susceptible-exposed-infected-recovered compartmental model structure, using initial pandemic data and published information on virus behaviour to determine parameter values. We applied the model to examine factors influencing the projected trends: the extent of viral testing, community participation in social distancing, and the level of uptake of the COVIDSafe app. RESULTS: Modelling suggests that a second COVID-19 wave will occur if social distancing declines (i.e. if the average number of contacts made by each individual each day increases) and the rate of testing declines. The timing and size of the second wave will depend on the rate of decrease in social distancing and the decline in testing rates. At the app uptake level of approximately 27% (current at 20 May 2020), with a monthly 50% reduction in social distancing (i.e. the average number of contacts per day doubling every 30 days until they reach pre-social distancing rates) and a 5% decline in testing, the app would reduce the projected total number of new cases during April-December 2020 by one-quarter. If uptake reaches the possible maximum of 61%, the reduction could be more than half. CONCLUSIONS: Maintenance of a large-scale testing regimen for COVID-19 and widespread community practice of social distancing are vital. The COVIDSafe smartphone app has the potential to be an important adjunct to testing and social distancing. Depending on the level of community uptake of the app, it could have a significant mitigating effect on a second wave of COVID-19 in Australia.


An independent appraisal and re-analysis of hydroxychloroquine treatment trial for COVID-19


Management of leprosy patients in the era of COVID-19


A survey of psoriasis patients on biologics during COVID-19: a single centre experience


title: Evaluation of eleven rapid tests for detection of antibodies against SARS-CoV-2

text: Objectives SARS-CoV-2, causing COVID-19, has emerged to cause a human pandemic. Detection of SARS-CoV-2 in respiratory samples by using PCR is the standard laboratory diagnostic tool. Our aim was to perform a limited evaluation of the diagnostic performance and user-friendliness of eleven rapid tests for detection of antibodies against SARS-CoV-2. Methods All participants were tested with PCR against SARS-CoV-2 at a clinical microbiology laboratory. Comparing with results from PCR tests, we evaluated the rapid tests' performances in three arms; 1) 20 hospitalized patients with PCR-confirmed COVID-19, 2) 23 recovered outpatients with former PCR-confirmed COVID-19, and 3) 49 participants with suspected COVID-19 presenting at a primary care emergency room. Results All eleven tests detected antibodies in hospitalized COVID-19 patients, though with varying sensitivities. In former outpatients recovered from COVID-19, there were differences between tests in the immunoglobulin type G (IgG) sensitivity, with five tests having a sensitivity below 65%. In participants with suspected COVID-19 infection, the rapid tests had very low sensitivities. Most rapid tests were easy to perform and interpret. Conclusions Rapid tests were not suited as stand-alone tests to detect present infection in a Norwegian primary care emergency room population. All the rapid tests were able to detect SARS-CoV-2 antibodies, although sensitivities varied and were generally higher in the study arm of more severely affected participants. Rapid tests with high IgG sensitivity (and specificity) may be useful for confirmation of past infection. An independent evaluation should be performed in the intended population before introducing a rapid test.


title: Difficulties and strategies of public hospitals in their participation in the prevention and control of novel coronavirus pneumonia/ 中华医院管理杂志

text: Outbreak of the novel coronavirus pneumonia (NC) across the country has seriously threatened people's lives and health, endangering smooth operation of the national economy and social stability. An all-out campaign to save the NCP patients and reduce their mortality is not only one of the key tasks to fight against the epidemic, but also a major responsibility and mission of public hospitals. In view of the field practice of Wuhan Union Hospital in the epicenter, the authorsDescribed the challenges faced by such hospitals in the prevention and control, summarized its experiences and proposed improvement measures, for reference of other public hospitals and relevant authorities.


title: H∞ Scaled Consensus for MASs With Mixed Time Delays and Disturbances via Observer-Based Output Feedback

text: In this article, the H∞ scaled consensus control problem for multiagent systems in the presence of external disturbances and mixed time delays in both input and Lipschitz nonlinearity is investigated. First, a state observer is introduced for each agent based on the output information of the agent. Then, a scaled consensus protocol is proposed via a truncated predictor output-feedback method, which can deal with the input delay. The integral terms with the mixed time delays that are contained in the transformed systems are analyzed by using the Lyapunov-Krasovskii functionals method, and sufficient conditions are obtained to achieve scaled consensus with guaranteed H∞ performance. An iterative procedure is utilized to calculate the linear matrix inequality. By this, the feedback gain and observer gain are then designed. Finally, a simulation example is provided to illustrate the effectiveness of the theoretical results.


title: Reproduction matrix for an epidemic and lockdowns in a city

text: We consider an epidemic spreading in a city which is divided geographically into different districts. We introduce the reproduction matrix $\R=\bigl(R(i,j)\bigr)$ between districts, where $R(i,j)$ is the mean number of individuals in district $j$ infected by an individual from district $i$. We analyse policies of partial lockdowns of the city, that is of a set of districts, based on the study of matrix $\R$, where rows and columns corresponding to districts in lockdown are set to zero. This schema can also be applied to a country divided into regions or other appropriate units, provided the relevant information is available. We conclude by analyzing a matrix~$\R$ which was constructed for the spread of COVID-19 in Santiago, Chile, with the aid of an agent-based simulator for generating surrogate district data.


COVID-19 pandemic and vascular surgery unit


title: Simple, fast and affordable triaging pathway for COVID-19

text: Coronavirus disease 2019 has caused a global pandemic. The majority of patients will experience mild disease, but others will develop a severe respiratory infection that requires hospitalisation. This is causing a significant strain on health services. Patients are presenting at emergency departments with symptoms of dyspnoea, dry cough and fever with varying severity. The appropriate triaging of patients will assist in preventing health services becoming overwhelmed during the pandemic. This is assisted through clinical assessment and various imaging and laboratory investigations, including chest X-ray, blood analysis and identification of viral infection with SARS-CoV-2. Here, a succinct triaging pathway that aims to be fast, reliable and affordable is presented. The hope is that such a pathway will assist health services in appropriately combating the pandemic.


title: Characteristics of disease progress in patients with coronavirus disease 2019 in Wuhan, China

text: Coronavirus disease 2019 (COVID-19) patients were classified into four clinical stages (uncomplicated illness, mild, severe and critical pneumonia) depending on disease severity. We aim to investigate the corresponding clinical, radiological and laboratory characteristics between different clinical stages. A retrospective, single-centre study of 101 confirmed patients with COVID-19 at Renmin Hospital of Wuhan University from 2 January to 28 January 2020 was enrolled; follow-up endpoint was on 8 February 2020. Clinical data were collected and compared during the course of illness. The median age of the 101 patients was 51.0 years and 33.6% were medical staff. Fever (68%), cough (50%) and fatigue (23%) are the most common symptoms. About 26% patients underwent the mechanical ventilation and 98% patients were treated with antibiotics. Thirty-seven per cent patients were cured and 11 died. On admission, the number of patients with uncomplicated illness, mild, severe and critical pneumonia were 2 [2%], 86 [85%], 11 [11%] and 2 [2%]. Forty-four of the 86 mild pneumonia progressed to severe illness within 4 days, with nine patients worsened due to critical pneumonia within 4 days. Two of the 11 severe patients improved to mild condition while three others deteriorated. Significant differences were observed among groups of different clinical stages in numbers of influenced pulmonary segments (6 vs. 12 vs. 17, P < 0.001). A significantly upward trend was witnessed in ground-glass opacities overlapped with striped shadows (33% vs. 42% vs. 55% vs. 80%, P < 0.001), while pure ground-glass opacities gradually decreased as disease progressed (45% vs. 35% vs. 24% vs. 13%, P < 0.001) within 12 days. Lymphocytes, prealbumin and albumin showed a downtrend as disease progressed from mild to severe or critical condition, an uptrend was found in white blood cells, C-reactive protein, neutrophils and lactate dehydrogenase. The proportions of serum amyloid A > 300 mg/l in mild, severe and critical conditions were 18%, 46% and 71%, respectively.


An invited commentary on "The Surgeon and the COVID-19 pandemic"


COVID-19 in Care Home Settings


title: Rationale of a loading dose initiation for hydroxychloroquine treatment in COVID-19 infection in the DisCoVeRy trial

text: Around the world, several dose regimens of hydroxychloroquine have been used for COVID-19 infection treatment, with the objective of identifying a short-term course. Hydroxychloroquine was found to decrease the viral replication in a concentration-dependent manner in vitro and to be more active when added prior to the viral challenge. A loading dose is used to rapidly attain a target drug concentration, which is usually considered as approximately the steady-state concentration. With a loading dose, the minimum effective concentration is reached much more rapidly than when using only the maintenance dose from the start. Thus, we propose a hydroxychloroquine sulphate dose regimen of 400 mg twice daily at Day 1 then 400 mg once daily from Day 2 to Day 10. We aim to evaluate this in the C-20-15 DisCoVeRy trial.


title: Spatio-Temporal Resource Mapping for Intensive Care Units at Regional Level for COVID-19 Emergency in Italy

text: COVID-19 is a worldwide emergency since it has rapidly spread from China to almost all the countries worldwide. Italy has been one of the most affected countries after China. North Italian regions, such as Lombardia and Veneto, had an abnormally large number of cases. COVID-19 patients management requires availability of sufficiently large number of Intensive Care Units (ICUs) beds. Resources shortening is a critical issue when the number of COVID-19 severe cases are higher than the available resources. This is also the case at a regional scale. We analysed Italian data at regional level with the aim to: (i) support health and government decision-makers in gathering rapid and efficient decisions on increasing health structures capacities (in terms of ICU slots) and (ii) define a geographic model to plan emergency and future COVID-19 patients management using reallocating them among health structures. Finally, we retain that the here proposed model can be also used in other countries.


title: Continual BERT: Continual Learning for Adaptive Extractive Summarization of COVID-19 Literature

text: The scientific community continues to publish an overwhelming amount of new research related to COVID-19 on a daily basis, leading to much literature without little to no attention. To aid the community in understanding the rapidly flowing array of COVID-19 literature, we propose a novel BERT architecture that provides a brief yet original summarization of lengthy papers. The model continually learns on new data in online fashion while minimizing catastrophic forgetting, thus fitting to the need of the community. Benchmark and manual examination of its performance show that the model provide a sound summary of new scientific literature.


Could enhanced influenza and pneumococcal vaccination programs help limit the potential damage from SARS-CoV-2 to fragile health systems of southern hemisphere countries this winter?


title: Anticipating and Mitigating the Impact of the COVID-19 Pandemic on Alzheimer's Disease and Related Dementias

text: The COVID-19 pandemic is causing global morbidity and mortality, straining health systems, and disrupting society, putting individuals with Alzheimer's disease and related dementias (ADRD) at risk of significant harm. In this Special Article, we examine the current and expected impact of the pandemic on individuals with ADRD. We discuss and propose mitigation strategies for: the risk of COVID-19 infection and its associated morbidity and mortality for individuals with ADRD; the impact of COVID-19 on the diagnosis and clinical management of ADRD; consequences of societal responses to COVID-19 in different ADRD care settings; the effect of COVID-19 on caregivers and physicians of individuals with ADRD; mental hygiene, trauma, and stigma in the time of COVID-19; and the potential impact of COVID-19 on ADRD research. Amid considerable uncertainty, we may be able to prevent or reduce the harm of the COVID-19 pandemic and its consequences for individuals with ADRD and their caregivers.


Evaluation on different non-pharmaceutical interventions during COVID-19 pandemic: An analysis of 139 countries


Novel Coronavirus and Old Lessons - Preparing the Health System for the Pandemic


title: Neuroimaging and neurologic findings in COVID-19 and other coronavirus infections: A systematic review in 116 patients

text: Various neurologic syndromes have been described in patients with COVID-19 and other coronavirus infections. In this paper, we systematically reviewed the available imaging findings of patients diagnosed with neurological symptoms associated with coronavirus infections. Diverse radiologic results in the context of different neurologic presentations have been demonstrated using CT and MRI. While many patients have normal imaging evaluations, some patients present with intra-axial and extra-axial abnormalities. Stroke (both ischemic and hemorrhagic), encephalomyelitis, meningitis, demyelinating disorders such as acute disseminated encephalomyelitis (ADEM), and encephalopathy have been reported. Familiarity with these radiologic patterns will guide radiologists and referring clinicians to consider coronavirus infections in patients with worsening or progressive neurologic findings, particularly during the current COVID-19 pandemic. As data on this topic is very limited, further research and investigation are required.


docid: ptgjdhxo

title: Dual function of sialic acid in gastrointestinal SARS-CoV-2 infection

text: Recent analysis concerning the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)- angiotensin converting enzyme (ACE) receptor interaction in enterocytes, the definition of gut-lung axis, as well as the molecular basis of sialic acid-related dual recognition concept in gastrointestinal SARS-CoV-2 infection, have brought a new perspective to potential therapeutic targets. In this review evolving research and clinical data on gastrointestinal SARS-CoV-2 infection are discussed in the context of viral fusion and entry mechanisms, focusing on the different triggers used by coronaviruses. Furthermore, it is emphasized that the viral spike protein is prevented from binding gangliosides, which are composed of a glycosphingolipid with one or more sialic acids, in the presence of chloroquine or hydroxychloroquine. In gastrointestinal SARS-CoV-2 infection the efficiency of these repositioned drugs is debated.


title: COVID-19 effect on phototherapy treatment utilization in dermatology

text: Background: At the end of 2019, an innovative coronavirus caused an outbreak of pneumonia cases in Wuhan, a city Hubei Province of China. Despite the direct effect on the routine of all life aspects, there are no clinical guidelines regarding phototherapy treatment during COVID-19 pandemic and as a result, phototherapies units continued to deliver this therapy for patients worldwide.Objective: We wish to explore the phototherapy utilization among dermatologic patients.Methods: We marked all patients that continue to arrive and being treated during COVID-19 pandemic.Results: From March more than 50% of patients stopped arriving to treatments due to the fear of COVID-19 infection.Conclusions: COVID-19 has a major implication on chronic dermatology treatments such as phototherapy.


title: A Comparison of Clinical and Chest CT Findings in Patients With Influenza A (H1N1) Virus Infection and Coronavirus Disease (COVID-19)

text: OBJECTIVE. The purpose of this study was to compare clinical and chest CT findings in patients with influenza A (H1N1) pneumonia and coronavirus disease (COVID-19) pneumonia. MATERIALS AND METHODS. Thirty patients with diagnosed influenza A (H1N1) virus infection (group A) and 30 patients with diagnosed COVID-19 (group B) were retrospectively enrolled in the present study. The clinical characteristics and chest CT findings of the two groups were compared. RESULTS. Fever, cough, expectoration, and dyspnea were the main symptoms in both groups with viral pneumonia, with cough and expectoration more frequently found in group A. Lymphopenia, an elevated C-reactive protein level, and an increased erythrocyte sedimentation rate were common laboratory test findings in the two groups. The median time from symptom onset to CT in group A and group B was 6 and 15 days, respectively, and the median total CT score of the pulmonary lobes involved was 6 and 13, respectively. Linear opacification, crazy-paving sign, vascular enlargement, were more common in group B. In contrast, bronchiectasis and pleural effusion were more common in group A. Other common CT features, including peripheral or peribronchovascular distribution, ground-glass opacities (GGOs), consolidation, subpleural line, air bronchogram, and bronchial distortion, did not show statistical significance. CONCLUSION. On CT, the significant differences between influenza A (H1N1) pneumonia and COVID-19 pneumonia were findings of linear opacification, crazy-paving sign, vascular enlargement, pleural thickening, and pleural effusion, which were more common in patients with COVID-19 pneumonia, and bronchiectasis and pleural effusion, which were more common in patients with influenza A (H1N1) pneumonia. Other imaging findings, including peripheral or peribronchovascular distribution, ground-glass opacities (GGO), consolidation, subpleural line, air bronchogram, and bronchial distortion, were not significantly different between the two patient groups.


title: Brassinosteroids regulate root meristem development by mediating BIN2-UPB1 module in Arabidopsis

text: Plant steroid hormones brassinosteroids (BRs) regulate plant growth and development at many levels. While negative regulatory factors that inhibit development and are counteracted by BRs exist in the root meristem, these factors have not been characterized. The functions of UPB1 transcription factor in BR-regulated root growth have not been established, although its role in regulating root are well documented. Here, we found that BIN2 interacts with and phosphorylates the UPB1 transcription factor consequently promoting UPB1 stability and transcriptional activity. Genetic analysis revealed that UPB1 deficiency could partially recover the short-root phenotype of BR-deficient mutants. Expression of a mutated UPB1S37AS41A protein lacking a conserved BIN2 phosphorylation sites can rescue shorter root phenotype of bin2-1 mutant. In addition, UPB1 was repressed by BES1 at the transcriptional level. The paclobutrazol-resistant protein family (PRE2/3) interacts with UPB1 and inhibits its transcriptional activity to promote root meristem development, and BIN2-mediated phosphorylation of UPB1 suppresses its interaction with PRE2/3, and subsequently impairing root meristem development. Taken together, our data elucidate a molecular mechanism by which BR promotes root growth via inhibiting BIN2-UPB1 module.


Viral dynamics of SARS-CoV-2 in saliva from infected patients


title: COVID-19 is a challenge for dental education-A commentary

text: The COVID-19, which appeared to originate in China in December 2019, has spread worldwide pandemically. In this commentary, authors described this new challenge for dental education using the recent literature and experience gained in the Italian University of Catanzaro.


title: Medidas de contención de la violencia de género durante la pandemia de COVID-19./ [Measures to contain gender-based violence during the COVID-19 pandemic]

text: Crises, emergencies and times of unrest have been linked to increased interpersonal violence, including violence against women. Following the declaration of alarm status and quarantine, different measures have been implemented to mitigate the possible effect of gender violence (Contingency Plan against Gender-Based Violence in Coronavirus Crisis or Royal Decree Law on Emergency Measures). This document reviews the measures adopted so far by the government of Spain, the autonomous governments and the initiatives formulated in different countries. In the absence of concrete economic measures to date, and the scenario of economic uncertainty, we conclude that it is not possible to prevent gender-based violence in a comprehensive way, without considering the increase in unemployment, temporary and instability employment, economic dependency or the overload of household chores and reproductive tasks, among other elements that facilitate it.


title: A combination of four serum miRNAs for screening of lung adenocarcinoma

text: Serum microRNAs (miRNAs), with their noticeable stability and unique expression pattern in patients with various diseases, are robust novel non-invasive biomarkers for cancer detection. The objective of this study was to identify specific serum miRNAs as potential biomarkers for screening lung adenocarcinoma. The study was divided into a screening phase, training phase, and validation phase. The expression of 46 serum miRNAs from lung adenocarcinoma (LUAD) patients and healthy controls (HCs) were examined in the screening phase. The expression of the most dysregulated miRNAs was further verified in training (30 LUAD vs. 30 HCs) and validation (82 LUAD vs. 90 HCs) phases. Seven serum miRNAs (miR-142-5p, miR-203a-5p, miR-409-3p, miR-223-3p, miR-150-5p, miR-486-5p and miR-146a-5p) in LUAD patients were significantly dysregulated compared to those in HCs. Their ability to diagnose lung cancer was also significant, with miR-142-5p (AUC = 0.743), miR-409-3p (AUC = 0.755), miR-223-3p (AUC = 0.828) and miR-146a-5p (AUC = 0.745) being more prominent. The combined use of these four could enhance diagnostic value (AUC = 0.933). Our findings define a distinct miRNA expression profile in the serum of LUAD patients. The four-miRNA panel (miR-142-5p, miR-409-3p, miR-223-3p and 146a-5p) may be considered as a novel, non-invasive biomarker for LUAD early detection.


title: 2020 - the year of the nurse and midwife: a call for action to scale up and strengthen the nursing and midwifery workforce in the Eastern Mediterranean Region

text: The World Health Organization (WHO) has declared 2020 as the Year of the Nurse and the Midwife. World Health Day on 7 April is dedicated to supporting nurses and midwives and highlights the central role of these professions in advancing universal health coverage, achieving health-related sustainable development goals, and the Eastern Mediterranean Region Vision 2023: Health for All by All.This year, we sadly mark World Health Day in the face of the devastating COVID-19 pandemic, which has brought to attention more than ever the crucial and invaluable role of health workers, who are working tirelessly day and night to care for patients and save lives. In fighting COVID-19, not only might they become infected and put their own lives at risk, but they also face distress and burnout because of long working hours. In addition, many health workers have to be away from their homes for prolonged periods, for fear of putting their own families at risk of acquiring the infection. Even before the pandemic, the safety and security of health workers in the Eastern Mediterranean Region has been a significant concern, as more than half of the countries of the Region face acute and protracted crises, and 70- 80% of total recorded attacks on health facilities globally occur in the Eastern Mediterranean Region.


title: Low Rate of COVID-19 pneumonia in Kidney Transplant Recipients - A Battle Between Infection and Immune Response?

text: BACKGROUND: With COVID-19 pandemic, concerns about kidney transplant recipients are rising. However, the incidence, clinical course, outcome, and predictive factors of disease severity are obscured. METHODS: We describe clinical and laboratory manifestations, radiologic findings, clinical course, and finally outcome of kidney transplant recipients with COVID-19 pneumonia. RESULTS: Of 2493 kidney transplant recipients under follow up in our clinic, 19 cases (4 cases diagnosed based on radiologic findings) were admitted. The mean age of patients was 47.6 ± 12.4 years, and the mean time from transplantation was 115.6 ± 70.3 months. Lymphopenia and eosinopenia were 84.2% and 78.9%, respectively. Nine patients did not survive the hospital course. History of acute rejection during the past 12 months, diabetes, higher N/L ratio, lower platelet count, elevated N/L x CRP, higher levels of LDH, positive D-dimer, higher troponin, and prolonged PT were associated with mortality. Among patients with positive COVID-19 test, history of acute rejection, low platelet count, and positive D-dimer were associated with poor outcome. Treatment with cyclosporine was associated with better clinical outcome. CONCLUSIONS: Low rate of admission in transplant recipients specially in the very first years of transplantation might be due to protective effects of immunosuppressive agents against cytokine storm or modification of immunity function. We suggest evaluation of T cells number, function and cytokine profile as a guide to manage COVID-19 mainly in patients with higher risk of mortality.


title: Barrier device prototype for open tracheotomy during COVID-19 pandemic

text: OBJECTIVE: To present a low-cost prototype for a barrier enclosure device which can be used during open surgeries such as tracheotomy. METHODS: We provide detailed description of a novel device called COVID-Box, developed by The Surgical Airway Team for COVID-19 Pandemic, a temporary task force formed by Walter Cantídio University Hospital. Safety guidelines for performing tracheotomies in COVID-19 patients are also stated. RESULTS: Our prototype device provides greater hand mobility than previous barrier devices reported, making it more suitable for airway surgical procedures, such as tracheotomy. The curved shaped format and the customizable access ports provides ergonomics, without compromising safety. CONCLUSION: The COVID-Box appears to be an efficient, reproduceable, low-cost barrier enclosure device that can be used for open tracheotomies in ICU patients during the COVID-19 pandemic.


title: Does zinc supplementation enhance the clinical efficacy of chloroquine/hydroxychloroquine to win today's battle against COVID-19?

text: Currently, drug repurposing is an alternative to novel drug development for the treatment of COVID-19 patients. The antimalarial drug chloroquine (CQ) and its metabolite hydroxychloroquine (HCQ) are currently being tested in several clinical studies as potential candidates to limit SARS-CoV-2-mediated morbidity and mortality. CQ and HCQ (CQ/HCQ) inhibit pH-dependent steps of SARS-CoV-2 replication by increasing pH in intracellular vesicles and interfere with virus particle delivery into host cells. Besides direct antiviral effects, CQ/HCQ specifically target extracellular zinc to intracellular lysosomes where it interferes with RNA-dependent RNA polymerase activity and coronavirus replication. As zinc deficiency frequently occurs in elderly patients and in those with cardiovascular disease, chronic pulmonary disease, or diabetes, we hypothesize that CQ/HCQ plus zinc supplementation may be more effective in reducing COVID-19 morbidity and mortality than CQ or HCQ in monotherapy. Therefore, CQ/HCQ in combination with zinc should be considered as additional study arm for COVID-19 clinical trials.


title: Developing training for uniportal video-assisted thoracic surgery: a commentary

text: OBJECTIVES: Today, thoracic surgeons have many possible pathways to advance their training in video-assisted thoracic surgery (VATS). For uniportal VATS (uVATS) in particular, what are the training options available and does regulating training matter? METHODS: The relevant literature pertaining to uVATS training is reviewed. RESULTS: Current options for surgeons looking to train in uVATS range from videos on the internet, through 'experts' demonstrating live surgery, to symposia and hands-on wet labs being held in all regions of the world. All have merits, and the aspiring VATS surgeon can choose from a range of preceptorship and proctorship modules to suit his/her own training needs. However, issues in the formalizing training in uVATS remains unresolved. Is there an ideal pathway through uVATS training? At what point can a trainee be considered to have 'graduated' to become an expert in uVATS? Who indeed trains the trainer, and certifies the competence of a training centre? CONCLUSIONS: Although a plethora of training options exist, formulation of a robust training curriculum can further bolster the status of uVATS as a sustainable surgical approach that can be delivered with consistent quality.


title: The COVID-19 AAGP Online Trainee Curriculum: Development and Method of Initial Evaluation

text: OBJECTIVE: One effect of the COVID-19 pandemic is the disruption of in-person clinical experiences within geriatric psychiatry residency education. Online resources for trainees are needed to fill resultant gaps. METHODS: The American Association of Geriatric Psychiatry (AAGP) Teaching and Training Committee leadership collaborated with geriatric psychiatry experts to develop a web-based geriatric psychiatry curriculum for psychiatry residents and other learners. In addition, we planned to obtain initial self-report outcomes of the curricular modules. RESULTS: The COVID-19 AAGP Online Trainee Curriculum (aagponline.org/covidcurriculum) consists of approximately 30 video-recorded lectures provided by AAGP member experts. A demographic survey and pre-/postsurvey attached to each module allow us to obtain learner characteristics and feedback on each module. CONCLUSIONS: The Curriculum has the potential to supplement psychiatry residency education during the pandemic and potentially raise the profile of AAGP, with the goal of inspiring interest within geriatric psychiatry. Results of the initial self-report evaluation should be available in 1 year.


Maxillofacial surgery and COVID-19, The Pandemic !!


Managing intravitreal injections in adults in COVID-19 and post-COVID-19 era- Initial experiences


title: Improving supervised prediction of aging-related genes via dynamic network analysis

text: Motivation: This study focuses on supervised prediction of aging-related genes from -omics data. Unlike gene expression methods that capture aging-specific information but study genes in isolation, or protein-protein interaction (PPI) network methods that account for PPIs but the PPIs are context-unspecific, we recently integrated the two data types into an aging-specific PPI subnetwork, which yielded more accurate aging-related gene predictions. However, a dynamic aging-specific subnetwork did improve prediction performance compared to a static aging-specific subnetwork, despite the aging process being dynamic. Results: So, here, we propose computational advances towards improving prediction accuracy from a dynamic aging-specific subnetwork. We develop a supervised learning model that when applied to a dynamic subnetwork yields extremely high prediction performance, with F-score of 91.4%, while the best model on any static subnetwork yields F-score of"only"74.3%. Hence, our predictive model could guide with high confidence the discovery of novel aging-related gene candidates for future wet lab validation. Contact: tmilenko@nd.edu


title: AI Chatbot Design during an Epidemic Like the Novel Coronavirus

text: Since the discovery of the Coronavirus (nCOV-19), it has become a global pandemic. At the same time, it has been a great challenge to hospitals or healthcare staff to manage the flow of the high number of cases. Especially in remote areas, it is becoming more difficult to consult a medical specialist when the immediate hit of the epidemic has occurred. Thus, it becomes obvious that if effectively designed and deployed chatbot can help patients living in remote areas by promoting preventive measures, virus updates, and reducing psychological damage caused by isolation and fear. This study presents the design of a sophisticated artificial intelligence (AI) chatbot for the purpose of diagnostic evaluation and recommending immediate measures when patients are exposed to nCOV-19. In addition, presenting a virtual assistant can also measure the infection severity and connects with registered doctors when symptoms become serious.


Covid-19: skin damage with prolonged wear of FFP3 masks


docid: hqtrfdfr

title: Online Change Point Detection in Molecular Dynamics With Optical Random Features

text: Proteins are made of atoms constantly fluctuating, but can occasionally undergo large-scale changes. Such transitions are of biological interest, linking the structure of a protein to its function with a cell. Atomic-level simulations, such as Molecular Dynamics (MD), are used to study these events. However, molecular dynamics simulations produce time series with multiple observables, while changes often only affect a few of them. Therefore, detecting conformational changes has proven to be challenging for most change-point detection algorithms. In this work, we focus on the identification of such events given many noisy observables. In particular, we show that the No-prior-Knowledge Exponential Weighted Moving Average (NEWMA) algorithm can be used along optical hardware to successfully identify these changes in real-time. Our method does not need to distinguish between the background of a protein and the protein itself. For larger simulations, it is faster than using traditional silicon hardware and has a lower memory footprint. This technique may enhance the sampling of the conformational space of molecules. It may also be used to detect change-points in other sequential data with a large number of features.


title: PeopleTraffic: a common framework for harmonizing privacy and epidemic risks

text: PeopleTraffic is a proposed initiative to develop a real-time, open-data population density mapping tool open to public institutions, private companies and the civil society, providing a common framework for infection spreading prevention. The system is based on a real-time people' locations gathering and mapping system from available 2G, 3G and 4G mobile networks operators, enforcing privacy-by-design through the adoption of an innovative data anonymizing algorithm inspired by quantum information de-localizing processes. Besides being originally targeted to help balancing social distancing regulations during the Phase-2 of the COVID-19 pandemics, PeopleTraffic would be beneficial for any infection spreading prevention event, e.g. supporting policy-makers in strategic decision-making.


title: Attention should be paid to the exposure risk of patients with chronic wounds on the way to hospital during corona virus disease 2019 epidemic prevention and control/ 中华烧伤杂志

text: Statistics show that 76.74% (4 688) of 6 109 patients with chronic wounds are those over 50 years of age; the proportion of patients with underlying diseases in all age groups above 50 years ranges from 78.25% to 100.00%; among the underlying diseases of chronic wound patients, the top four diseases are diabetes mellitus , cardiovascular and cerebrovascular diseases, hypertension, and respiratory diseases. The above underlying diseases and ages of patients are the susceptibility factors of corona virus disease 2019 released by National Health Commission of China. It is an unavoidable fact that patients with chronic wounds have to go to the hospital for treatment prescribed by the physician. At the same time, we found that there were not a few patients who go far afield because of various reasons when go to the hospital for treatment. During the period of epidemic prevention and control, this kind of "go far afield" style of seeking medical treatment may increase the exposure risk during transportation. Accordingly, we convened 36 wound care clinics in different regions in Shanghai to implement the "Five Measures" to encourage patients with chronic wounds to seek medical treatment proximately. The principle of this operation is that when seeking medical treatment, trying our best to reduce as much as possible the transportation distance for patients with chronic wounds to minimize the exposure risk during the epidemic period and eventually support the epidemic prevention and control campaign.


Rethinking race in medical decision making


title: Inferring the effective fraction of the population infected with Covid-19 from the behaviour of Lombardy, Madrid and London relative to the remainder of Italy, Spain and England

text: I use a very simple deterministic model for the spread of Covid-19 in a large population. Using this to compare the relative decay of the number of deaths per day between different regions in Italy, Spain and England, each applying in principle the same social distancing procedures across the whole country, I obtain an estimate of the total fraction of the population which had already become infected by April 10th. In the most heavily affected regions, Lombardy, Madrid and London, this fraction is higher than expected, i.e. $\approx 0.3$. This result can then be converted to a determination of the infection fatality rate $ifr$, which appears to be $ifr \approx 0.0025-0.005$, and even smaller in London, somewhat lower than usually assumed. Alternatively, the result can also be interpreted as an effectively larger fraction of the population than simple counting would suggest if there is a variation in susceptibility to infection with a variance of up to a value of about 2. The implications are very similar for either interpretation or for a combination of effects.


The importance of initial response during outbreaks: A perspective from observations on COVID-19


New-Onset Diabetes in Covid-19


title: Clinical characteristics of 28 patients with novel coronavirus pneumonia/ 中华传染病杂志

text: Objective@#To analysis the clinical characteristics and experiences in diagnosis and treatment of the patients with novel coronavirus pneumonia (NCP).@*Methods@#Clinical data of 28 patients with NCP in Nanning Fourth People's Hospital from January 22 to February 5 in 2020 were collected. The clinical manifestations, epidemiological history, laboratory tests, imaging examinations and treatments of patients were analyzed retrospectively.@*Results@#The 28 patients with confirmed viral pneumonia included 11 males and 17 females, ranging from 11 to 68 years. They all had history of epidemiological exposure and were all positive for 2019-nCoV nucleic acid in throat swabs. There were one mild case, 25 ordinary cases and two severe cases. There were four groups of family clusters. The illness onset ranged from 1 to 12 days after exposure, and the time from the symptom onset to the positive result of the nucleic acid test was 0 to 13 days. The clinical symptoms were mainly fever and cough, which progressed rapidly in a short period of time. Since the onset of illness, the peak values of axillary temperature of the 28 patients were 36.6~39.5 ℃, while five patients had no fever throughout the course of the disease with the peak temperature of ≤37 ℃. There were two patients presented with decreased white blood cell counts, five patients with elevated C reactive protein, six patients with abnormal alanine aminotransferase, three patients with abnormal aspartate aminotransferase,10 patients with elevated creatine kinase, three patients with elevated creatine kinase isoenzyme, four patients with elevated lactate dehydrogenase, and all with normal procalcitonin levels. The chest computed tomography examinations showed that the common features were ground glass shadows (21 cases), blurred edges (18 cases), speckles and patchy shadows (17 cases), thickening and disorder of some lung textures (7 cases), and visible band shadows (7 cases). Pulmonary lesions often progressed rapidly. One 11-year-old child was treated with alpha-interferon alone, and 27 patients were treated with alpha-interferon inhalation plus lopinavir/ritonavir with 4 withdrawal due to adverse reactions. Up to February 12, nine patients had been discharged from the hospital, who were ordinary cases, without death cases.@*Conclusions@#The NCP patients mostly present with fever and cough. Pulmonary lesions often progress rapidly. Respiratory pathogen testing should be conducted as early as possible and repeatedly. Disisolation should be cautious for suspected people who are negative for 2019-nCoV nucleic acid in pharynx swabs.


title: Liver injury is associated with severe coronavirus disease 2019 (COVID-19) infection: A systematic review and meta-analysis of retrospective studies

text: The coronavirus disease 2019 (COVID-19) outbreak is a major threat to human beings. Lung injury has been reported as the major outcome of COVID-19 infection. However, liver damage has also been considered to occur in severe cases. The current meta-analysis of retrospective studies was carried out to summarize available findings on the association between liver injury and severity of COVID-19 infection. Online databases including PubMed, Scopus, Web of Science, and Cochrane Library were searched to detect relevant publications up to 1 April 2020, using relevant keywords. To pool data, a fixed- or random-effects model was used depending on the heterogeneity between studies. Furthermore, publication bias test and sensitivity analysis were also applied. In total, 20 retrospective studies with 3428 COVID-19 infected patients (severe cases, n = 1455; mild cases, n = 1973), were included in this meta-analysis. Higher serum levels of aspartate aminotransferase (weighted mean difference, 8.84 U/L; 95% confidence interval [CI] 5.97 to 11.71; P < 0.001), alanine aminotransferase (weighted mean difference, 7.35 U/L; 95% CI, 4.77 to 9.93; P < 0.001), total bilirubin (weighted mean difference, 2.30 mmol/L; 95% CI, 1.24 to 3.36; P < 0.001), and lower serum levels of albumin (weighted mean difference, -4.24 g/L; 95% CI, -6.20 to -2.28; P < 0.001) were associated with a significant increase in the severity of COVID-19 infection. The incidence of liver injury, as assessed by serum analysis (aspartate aminotransferase, alanine aminotransferase, total bilirubin, and albumin levels), seems to be higher in patients with severe COVID-19 infection.


Oncology Dietitians Sound Alarm in Key Nutrition Needs of Cancer Patients During COVID-19 Pandemic


Psychosis in a patient with anxiety related to COVID-19: A case report


title: White Paper on 6G Drivers and the UN SDGs

text: The commercial launch of 6G communications systems and United Nations Sustainable Development Goals, UN SDGs, are both targeted for 2030. 6G communications is expected to boost global growth and productivity, create new business models and transform many aspects of society. The UN SDGs are a way of framing opportunities and challenges of a desirable future world and cover topics as broad as ending poverty, gender equality, climate change and smart cities. The relationship between these potentially mutually reinforcing forces is currently under-defined. Building on the vision for 6G, a review of megatrends, on-going activities on the relation of mobile communications to the UN SDGs and existing indicators, a novel linkage between 6G and the UN SDGs is proposed via indicators. The white paper has also launched the work of deriving new 6G related indicators to guide the research of 6G systems. The novel linkage is built on the envisaged three-fold role of 6G as a provider of services to help steer and support communities and countries towards reaching the UN SDGs, as an enabler of measuring tool for data collection to help reporting of indicators with hyperlocal granularity, and as a reinforcer of new ecosystems based on 6G technology enablers and 6G network of networks to be developed in line with the UN SDGs that incorporates future mobile communication technologies available in 2030. Related challenges are also identified. An action plan is presented along with prioritized focus areas within the mobile communication sector technology and industry evolution to best support the achievement of the UN SDGs.


title: Simpson's paradox in Covid-19 case fatality rates: a mediation analysis of age-related causal effects

text: We point out an instantiation of Simpson's paradox in Covid-19 case fatality rates (CFRs): comparing data of 44,672 cases from China with early reports from Italy (9th March), we find that CFRs are lower in Italy for every age group, but higher overall. This phenomenon is explained by a stark difference in case demographic between the two countries. Using this as a motivating example, we introduce basic concepts from mediation analysis and show how these can be used to quantify different direct and indirect effects when assuming a coarse-grained causal graph involving country, age, and mortality. As a case study, we then investigate total, direct, and indirect (age-mediated) causal effects between different countries and at different points in time. This allows us to separate age-related effects from others unrelated to age, and thus facilitates a more transparent comparison of CFRs across countries throughout the evolution of the Covid-19 pandemic.


title: Current status of potential therapeutic candidates for the COVID-19 crisis

text: As of April 15, 2020, the ongoing coronavirus disease 2019 (COVID-2019) pandemic has swept through 213 countries and infected more than 1,870,000 individuals, posing an unprecedented threat to international health and the economy. There is currently no specific treatment available for patients with COVID-19 infection. The lessons learned from past management of respiratory viral infections have provided insights into treating COVID-19. Numerous potential therapies, including supportive intervention, immunomodulatory agents, antiviral therapy, and convalescent plasma transfusion, have been tentatively applied in clinical settings. A number of these therapies have provided substantially curative benefits in treating patients with COVID-19 infection. Furthermore, intensive research and clinical trials are underway to assess the efficacy of existing drugs and identify potential therapeutic targets to develop new drugs for treating COVID-19. Herein, we summarize the current potential therapeutic approaches for diseases related to COVID-19 infection and introduce their mechanisms of action, safety, and effectiveness.


docid: ocnxfgny

title: Binding of SARS-CoV-2 and angiotensin-converting enzyme 2: clinical implications


title: Clinical Evaluation of Three Sample-To-Answer Platforms for the Detection of SARS-CoV-2

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has now spread across the globe. As part of the worldwide response, many molecular diagnostic platforms have been granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) to identify SARS-CoV-2 positive patients. Our objective was to evaluate three sample-to-answer molecular diagnostic platforms (Cepheid Xpert® Xpress SARS-CoV-2 [Xpert Xpress], Abbott ID NOW™ COVID-19 [ID NOW], GenMark ePlex® SARS-CoV-2 Test [ePlex]) to determine analytical sensitivity, clinical performance, and workflow for the detection of SARS-CoV-2 in nasopharyngeal swabs from 108 symptomatic patients. We found that the Xpert Xpress had the lowest limit of detection (100% detection at 100 copies/mL), followed by the ePlex (100% detection at 1,000 copies/mL), and the ID NOW (20,000 copies/mL). The Xpert Xpress also had highest positive percent agreement (PPA) when compared to our reference standard (98.3%) followed by the ePlex (91.4%) and ID now (87.7%). All three assays showed 100% negative percent agreement (NPA). In the workflow analysis, the ID NOW produced the most rapid time to result per specimen (â¼17 minutes) as compared to the Xpert Xpress (â¼46 minutes) and the ePlex (â¼1.5 hours), but what the ID NOW gained in rapid results, it lost in analytical and clinical performance. The ePlex had the longest time to results and showed a slight improvement in PPA over the ID NOW. Information about the clinical and analytical performance of these assays, as well as workflow, will be critical in making informed and timely decisions on testing platform.


title: Enclosure with augmented airflow to decrease risk of exposure to aerosolized pathogens including coronavirus during endotracheal intubation. Can the reduction in aerosolized particles be quantified?

text: INTRODUCTION: As the pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) has impacted hospital routines in recent weeks, recommendations to reduce healthcare worker infections are being developed. METHODS: We report preliminary experience with the efficacy of an enclosure with augmented airflow to decrease the risk of exposure to aerosolized pathogens during airway management including endotracheal intubation. A particle generator was used to test the efficacy of the reduction of aerosolized particles by measuring their concentration within the enclosure and in the environment. RESULTS: No reduction in the concentration of aerosolized particles was noted with the enclosure flap open, whether the interior suction was on or off. However, with the enclosure closed and no augmented airflow (suction off), the particle concentration decreased to 1.2% of baseline. The concentration decreased even further, to 0.8% of baseline with the enclosure closed with augmented airflow (suction on). DISCUSSION: Aerosolized particulate contamination in the operating room can be decreased using a clear plastic enclosure with minimal openings and augmented airflow. This may serve to decrease the exposure of healthcare providers to aerosolized pathogens.


title: The psychological impact of quarantine and how to reduce it: rapid review of the evidence

text: The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.


Rapid sequence spinal must be the new norm for an emergency LSCS in this Covid pandemic


Guillain-Barré syndrome as a complication of SARS-CoV-2 infection


title: A cross-sectional survey on the psychological impact of the COVID-19 pandemic on inflammatory bowel disease patients in Saudi Arabia

text: Background/Aims: The coronavirus (COVID-19) pandemic has caused significant disruption to patients with chronic illnesses. We explored the emotional state, perception, and concerns of Saudi patients with inflammatory bowel disease (IBD) during the crisis. Materials and Methods: We conducted a cross-sectional survey from 30 March to 5 April, 2020 using a pre-designed questionnaire distributed through social media platforms to IBD patients. The five-part questionnaire included an assessment of psychological wellbeing using a previously validated Arabic version of the Hospital Anxiety and Depression Scale (HADS), which includes domains for anxiety (HADS-A) and depression (HADS-D). A logistic regression analysis was used to uncover possible associations between patient characteristics and anxiety and depression. Results: The data from 1156 IBD patients were analyzed. Normal, borderline, and HADS-A scores consistent with a diagnosis of anxiety were reported by 423 (36.6%), 174 (15.1%), and 559 (48.4%) patients, respectively. However, 635 (69%) patients had normal scores and 273 (30.1%) had borderline HADS-D scores; no patients reported scores consistent with depression. Based on a multiple logistic regression analysis, patients educated till a high school diploma (OR = 2.57, 95% CI: 0.09-6.05, P = 0.03) and that had indeterminate colitis (OR = 2.23, 95% CI: 1.27-3.89, P = 0.005) were more likely to express anxiety. Conclusions: Many patients expressed symptoms of anxiety, although not depression. Female patients, patients educated till a high school diploma, and those with indeterminate colitis were more likely to have anxiety. IBD patients require greater attention during a pandemic to avoid adverse disease-related outcomes.


title: Computational screening of antagonists against the SARS-CoV-2 (COVID-19) coronavirus by molecular docking

text: In the current spread of novel coronavirus (SARS-CoV-2), antiviral drug discovery is of great importance. AutoDock Vina was used to screen potential drugs by molecular docking with the structural protein and non-structural protein sites of new coronavirus. Ribavirin, a common antiviral drug, remdesivir, chloroquine and luteolin were studied. Honeysuckle is generally believed to have antiviral effects in traditional Chinese medicine. In this study, luteolin (the main flavonoid in honeysuckle) was found to bind with a high affinity to the same sites of the main protease of SARS-CoV-2 as the control molecule. Chloroquine has been proved clinically effective and can bind to the main protease; this may be the antiviral mechanism of this drug. The study was restricted to molecular docking without validation by molecular dynamics simulations. Interactions with the main protease may play a key role in fighting against viruses. Luteolin is a potential antiviral molecule worthy of attention.


Acupuntura aplicada à medicina equina


docid: renssekm

title: Policy Lessons From Early Reactions to the COVID-19 Virus in China

text: The World Health Organization (WHO) declared the COVID-19 virus outbreak to be a Public Health Emergency of International Concern on January 30, 2020. Although the Chinese central government implemented significant measures to control the epidemic from January 20 within China, the crisis had already escalated dramatically.Between December 1, 2019, and January 20, 2020, a total of 51 days passed before the Chinese central government took full control. Several major factors combined to cause what had been in retrospect a clear break in the governmental information chain between December 1 and January 20. The management of this epidemic also illustrated key organizational limitations of the current Chinese health system, in particular provincial-level senior officials' lack of knowledge and awareness of potential public health risks and insufficient emergency medical material storage and logistics arrangements.We review the specific disease control actions that the Chinese central government took between January 20 and January 27, the major reasons why the governmental information chain had broken before January 20, and key structural health system limitations highlighted as the epidemic expanded.


Nature bites back


How the Italian NHS Is Fighting Against the COVID-19 Emergency


docid: bmlgambn

title: Letter to the Editor Re: Coronavirus disease 2019: The harms of exaggerated information and non-evidence-based measures


title: Diabetes as a risk factor for greater COVID-19 severity and in-hospital death: A meta-analysis of observational studies

text: AIMS: To estimate the prevalence of established diabetes and its association with the clinical severity and in-hospital mortality associated with COVID-19. DATA SYNTHESIS: We systematically searched PubMed, Scopus and Web of Science, from 1st January 2020 to 15th May 2020, for observational studies of patients admitted to hospital with COVID-19. Meta-analysis was performed using random-effects modeling. A total of 83 eligible studies with 78,874 hospitalized patients with laboratory-confirmed COVID-19 were included. The pooled prevalence of established diabetes was 14.34% (95% CI 12.62-16.06%). However, the prevalence of diabetes was higher in non-Asian vs. Asian countries (23.34% [95% CI 16.40-30.28] vs. 11.06% [95% CI 9.73-12.39]), and in patients aged ≥60 years vs. those aged <60 years (23.30% [95% CI 19.65-26.94] vs. 8.79% [95% CI 7.56-10.02]). Pre-existing diabetes was associated with an approximate twofold higher risk of having severe/critical COVID-19 illness (n = 22 studies; random-effects odds ratio 2.10, 95% CI 1.71-2.57; I2 = 41.5%) and ~threefold increased risk of in-hospital mortality (n = 15 studies; random-effects odds ratio 2.68, 95% CI 2.09-3.44; I2 = 46.7%). Funnel plots and Egger's tests did not reveal any significant publication bias. CONCLUSIONS: Pre-existing diabetes is significantly associated with greater risk of severe/critical illness and in-hospital mortality in patients admitted to hospital with COVID-19.


docid: jtemyouo

title: Successful implementation of preventive measures leads to low relevance of SARS-CoV-2 in liver transplant patients: Observations from a German outpatient department

text: BACKGROUND: Immunosuppressed liver transplant (LT) patients are considered to be at high risk for any kind of infection. What the outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) means for the transplant cohort is a question that, as of now, cannot easily be answered. Data on prevalence, relevance of the novel virus, and clinical course of the infection in stable LT patients are limited. METHODS: Nasopharyngeal swabs were performed in our outpatient department during the shutdown between March and April 2020 in Germany. RESULTS: The prevalence of SARS-CoV-2 was 3%. Three out of a cohort of 101 LT patients were asymptomatic for respiratory diseases. Respiratory complaints were common and not associated with SARS-CoV-2 infection. The overall monthly mortality rate was 0.22% and did not show alterations during the shutdown in Germany. CONCLUSIONS: If preventive measures are applied, LT patients do not seem to be at a higher risk for SARS-CoV-2 infection. Telemedicine in the outpatient setting may help to maintain distance and to reduce direct patient contact. However, standard of care must be guaranteed for patients with relevant comorbidities in spite of pandemics, because complications may arise from preexisting conditions.


Ultrarapid diagnosis, microscope imaging, genome sequencing, and culture isolation of SARS-CoV-2


Neurointervention for emergent large vessel occlusion during the COVID-19 pandemic


title: Characterizing the spread of CoViD-19

text: Since the beginning of the epidemic, daily reports of CoViD-19 cases, hospitalizations, and deaths from around the world have been publicly available. This paper describes methods to characterize broad features of the spread of the disease, with relatively long periods of constant transmission rates, using a new population modeling framework based on discrete-time difference equations. Comparative parameters are chosen for their weak dependence on model assumptions. Approaches for their point and interval estimation, accounting for additional sources of variance in the case data, are presented. These methods provide a basis to quantitatively assess the impact of changes to social distancing policies using publicly available data. As examples, data from Ontario and German states are analyzed using this framework. German case data show a small increase in transmission rates following the relaxation of lock-down rules on May 6, 2020. By combining case and death data from Germany, the mean and standard deviation of the time from infection to death are estimated.


title: COVID-19 causes record decline in global CO2 emissions

text: The considerable cessation of human activities during the COVID-19 pandemic has affected global energy use and CO2 emissions. Here we show the unprecedented decrease in global fossil CO2 emissions from January to April 2020 was of 7.8% (938 Mt CO2 with a +6.8% of 2-{\sigma} uncertainty) when compared with the period last year. In addition other emerging estimates of COVID impacts based on monthly energy supply or estimated parameters, this study contributes to another step that constructed the near-real-time daily CO2 emission inventories based on activity from power generation (for 29 countries), industry (for 73 countries), road transportation (for 406 cities), aviation and maritime transportation and commercial and residential sectors emissions (for 206 countries). The estimates distinguished the decline of CO2 due to COVID-19 from the daily, weekly and seasonal variations as well as the holiday events. The COVID-related decreases in CO2 emissions in road transportation (340.4 Mt CO2, -15.5%), power (292.5 Mt CO2, -6.4% compared to 2019), industry (136.2 Mt CO2, -4.4%), aviation (92.8 Mt CO2, -28.9%), residential (43.4 Mt CO2, -2.7%), and international shipping (35.9Mt CO2, -15%). Regionally, decreases in China were the largest and earliest (234.5 Mt CO2,-6.9%), followed by Europe (EU-27&UK) (138.3 Mt CO2, -12.0%) and the U.S. (162.4 Mt CO2, -9.5%). The declines of CO2 are consistent with regional nitrogen oxides concentrations observed by satellites and ground-based networks, but the calculated signal of emissions decreases (about 1Gt CO2) will have little impacts (less than 0.13ppm by April 30, 2020) on the overserved global CO2 concertation. However, with observed fast CO2 recovery in China and partial re-opening globally, our findings suggest the longer-term effects on CO2 emissions are unknown and should be carefully monitored using multiple measures.


The clinical feature of silent infections of novel coronavirus infection (COVID-19) in Wenzhou


title: Individualized prediction nomograms for disease progression in mild COVID-19

text: The coronavirus disease 2019 (COVID-19) has evolved into a pandemic rapidly. The majority of COVID-19 patients are with mild syndromes. This study aimed to develop models for predicting disease progression in mild cases. The risk factors for the requirement of oxygen support in mild COVID-19 were explored using multivariate logistic regression. Nomogram as visualization of the models was developed using R software. A total of 344 patients with mild COVID-19 were included in the final analysis, 45 of whom progressed and needed high-flow oxygen therapy or mechanical ventilation after admission. There were 188 (54.7%) males, and the average age of the cohort was 52.9 ± 16.8 years. When the laboratory data were not included in multivariate analysis, diabetes, coronary heart disease, T ≥ 38.5â and sputum were independent risk factors of progressive COVID-19 (Model 1). When the blood routine test was included the CHD, T ≥ 38.5â and neutrophil-to-lymphocyte ratio were found to be independent predictors (Model 2). The area under the receiver operator characteristic curve of model 2 was larger than model 1 (0.872 vs 0.849, P = .023). The negative predictive value of both models was greater than 96%, indicating they could serve as simple tools for ruling out the possibility of disease progression. In conclusion, two models comprised common symptoms (fever and sputum), underlying diseases (diabetes and coronary heart disease) and blood routine test are developed for predicting the future requirement of oxygen support in mild COVID-19 cases.


docid: agnmfkoq

title: US Equity Risk Premiums during the COVID-19 Pandemic

text: We study equity risk premiums in the United States during the COVID-19 pandemic.