title: The emerging use of social media for health-related purposes in low and middle-income countries: A scoping review

text: Abstract Background Social media allows for instant access to, and dissemination of, information around the globe. Access to social media in low- and middle-income countries has increased exponentially in recent years due to technological advances. Despite this growth, the use of social media in low- and middle-income countries is less well-researched than in high-income countries. Objective To identify, explore and summarize the current state of the literature on the use of social media for health in low- and middle-income countries. Methods A scoping review was conducted on literature available to December 2017. Six databases were searched, and grey literature was identified through the Google and Google Scholar search engines. Literature was considered for inclusion if it (1) was published in English, (2) was conducted in or in relation to a low or middle-income country, (3) reported on as least one type of social media or social media use generally for health purposes, and (4) reported on at least one aspect of human health. Content analysis was performed to identify themes. Results Forty articles met the inclusion criteria. Thirty-one were research articles, and nine were review/discussion/descriptive and evaluative reports. Since 2010, when the first article was published, most of the literature has focused on Asian (n = 15) and African (n = 12) countries. Twitter (n = 11) and Facebook (n = 10) were the most frequently discussed individual social media platforms. Four themes were identified: (1) use for health education and influence (sub-themes were health behaviour and health education); (2) use within infectious disease and outbreak situations; (3) use within natural disaster, terrorism, crisis and emergency response situations; and (4) producers and consumers of social media for health (sub-themes were misinformation, organizational challenges, users’ expectations, and challenges of unique sub-populations). Most studies addressed more than one theme. Conclusion Social media has the ability to facilitate disease surveillance, mass communication, health education, knowledge translation, and collaboration amongst health providers in low- and middle-income countries. Misinformation or poorly communicated information can contribute to negative health behaviours and adverse health outcomes amongst consumers, as well as hysteria and chaos. Organizations using social media should provide accurate and readable information. Promotion of credible social media sites by governments, health care professionals and researchers, as well as education on the appropriate use of social media, could help to lessen the effect of misinformation. This is a nascent body of literature and future research should investigate the relative effectiveness of various platforms for different users, other potential uses, and pursue a broader geographical focus.


title: The urgency of utilizing COVID-19 biospecimens for research in the heart of the global pandemic

text: The outbreak of the novel coronavirus disease 2019 (COVID-19) and consequent social distancing practices have disrupted essential clinical research functions worldwide. Ironically, this coincides with an immediate need for research to comprehend the biology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pathology of COVID-19. As the global crisis has already led to over 15,000 deaths out of 175,000 confirmed cases in New York City and Nassau County, NY alone, it is increasingly urgent to collect patient biospecimens linked to active clinical follow up. However, building a COVID-19 biorepository amidst the active pandemic is a complex and delicate task. To help facilitate rapid, robust, and regulated research on this novel virus, we report on the successful model implemented by New York University Langone Health (NYULH) within days of outbreak in the most challenging hot spot of infection globally. Using an amended institutional biobanking protocol, these efforts led to accrual of 11,120 patients presenting for SARS-CoV-2 testing, 4267 (38.4%) of whom tested positive for COVID-19. The recently reported genomic characterization of SARS-CoV-2 in the New York City Region, which is a crucial development in tracing sources of infection and asymptomatic spread of the novel virus, is the first outcome of this effort. While this growing resource actively supports studies of the New York outbreak in real time, a worldwide effort is necessary to build a collective arsenal of research tools to deal with the global crisis now, and to exploit the virus’s biology for translational innovation that outlasts humanity’s current dilemma.


title: COVID-19 in seniors: Findings and lessons from mass screening in a nursing home

text: BACKGROUND/OBJECTIVE: The COVID-19 epidemic is particularly serious in older adults. The symptomatology and epidemic profile remain little known in this population, especially in disabled oldest-old people with chronic diseases living in nursing homes. The objective of the present study was to comprehensively describe symptoms and chronological aspects of the diffusion of the SARS-CoV-2 virus in a nursing home, among both residents and caregivers. DESIGN: Five-week retrospective cohort study. SETTING: A middle-sized nursing home in Maine-et-Loire, west of France. PARTICIPANTS: Eighty-seven frail older residents (87.9 ± 7.2years; 71% female) and 92 staff members (38.3 ± 11.7years; 89% female) were included. MEASUREMENTS: Mass screening for SARS-CoV-2 was performed in both residents and staff. Attack rate, mortality rate, and symptoms among residents and staff infected with SARS-CoV-2 were recorded. RESULTS: The attack rate of COVID-19 was 47% in residents (case fatality rate, 27%), and 24% in staff. Epidemic curves revealed that the epidemic started in residents before spreading to caregivers. Residents exhibited both general and respiratory signs (59% hyperthermia, 49% cough, 42% polypnea) together with geriatric syndromes (15% falls, 10% altered consciousness). The classification tree revealed 100% COVID-19 probability in the following groups: i) residents younger than 90 with dyspnea and falls; ii) residents older than 90 with anorexia; iii) residents older than 90 without anorexia but with altered consciousness. Finally, 41% of staff members diagnosed with COVID-19 were asymptomatic. CONCLUSIONS: The pauci-symptomatic expression of COVID-19 in older residents, together with the high prevalence of asymptomatic forms in caregivers, justifies mass screening in nursing homes, possibly prioritizing residents with suggestive combinations of clinical signs including dyspnea, falls, anorexia and/or altered consciousness.


title: LAVA: An Open-Source Approach To Designing LAMP (Loop-Mediated Isothermal Amplification) DNA Signatures

text: BACKGROUND: We developed an extendable open-source Loop-mediated isothermal AMPlification (LAMP) signature design program called LAVA (LAMP Assay Versatile Analysis). LAVA was created in response to limitations of existing LAMP signature programs. RESULTS: LAVA identifies combinations of six primer regions for basic LAMP signatures, or combinations of eight primer regions for LAMP signatures with loop primers, which can be used as LAMP signatures. The identified primers are conserved among target organism sequences. Primer combinations are optimized based on lengths, melting temperatures, and spacing among primer sites. We compare LAMP signature candidates for Staphylococcus aureus created both by LAVA and by PrimerExplorer. We also include signatures from a sample run targeting all strains of Mycobacterium tuberculosis. CONCLUSIONS: We have designed and demonstrated new software for identifying signature candidates appropriate for LAMP assays. The software is available for download at http://lava-dna.googlecode.com/.


title: Elderly people and responses to COVID-19 in 27 Countries

text: Amongst the most robust consensus related to the COVID-19 disease is that the elderly are by far the most vulnerable population group. Hence, public authorities target older people in order to convince them to comply with preventive measures. However, we still know little about older people’s attitudes and compliance toward these measures. In this research, I aim to improve our understanding of elderly people’s responses to the pandemic using data from 27 countries. Results are surprising and quite troubling. Elderly people’s response is substantially similar to their fellow citizens in their 50’s and 60’s. This research (i) provides the first thorough description of the most vulnerable population’s attitudes and compliance in a comparative perspective (ii) suggest that governments’ strategies toward elderly people are far from successful and (iii) shows that methodologically, we should be more cautious in treating age as having a linear effect on COVID-19 related outcomes.


title: Microorganisms Associated With Pneumonia in Children <5 Years of Age in Developing and Emerging Countries: The GABRIEL Pneumonia Multicenter, Prospective, Case-Control Study

text: BACKGROUND: Pneumonia, the leading infectious cause of child mortality globally, mainly afflicts developing countries. This prospective observational study aimed to assess the microorganisms associated with pneumonia in children aged <5 years in developing and emerging countries. METHODS: A multicenter, case-control study by the GABRIEL (Global Approach to Biological Research, Infectious diseases and Epidemics in Low-income countries) network was conducted between 2010 and 2014 in Cambodia, China, Haiti, India (2 sites), Madagascar, Mali, Mongolia, and Paraguay. Cases were hospitalized children with radiologically confirmed pneumonia; controls were children from the same setting without any features suggestive of pneumonia. Nasopharyngeal swabs were collected from all subjects; 19 viruses and 5 bacteria were identified by reverse-transcription polymerase chain reaction. Associations between microorganisms and pneumonia were quantified by calculating the adjusted population attributable fraction (aPAF) after multivariate logistic regression analysis adjusted for sex, age, time period, other pathogens, and site. RESULTS: Overall, 888 cases and 870 controls were analyzed; ≥1 microorganism was detected in respiratory samples in 93.0% of cases and 74.4% of controls (P < .001). Streptococcus pneumoniae, Mycoplasma pneumoniae, human metapneumovirus, rhinovirus, respiratory syncytial virus (RSV), parainfluenza virus 1, 3, and 4, and influenza virus A and B were independently associated with pneumonia; aPAF was 42.2% (95% confidence interval [CI], 35.5%–48.2%) for S. pneumoniae, 18.2% (95% CI, 17.4%–19.0%) for RSV, and 11.2% (95% CI, 7.5%–14.7%) for rhinovirus. CONCLUSIONS: Streptococcus pneumoniae, RSV, and rhinovirus may be the major microorganisms associated with pneumonia infections in children <5 years of age from developing and emerging countries. Increasing S. pneumoniae vaccination coverage may substantially reduce the burden of pneumonia among children in developing countries.


title: An analysis of the feasibility of short read sequencing

text: Several methods for ultra high-throughput DNA sequencing are currently under investigation. Many of these methods yield very short blocks of sequence information (reads). Here we report on an analysis showing the level of genome sequencing possible as a function of read length. It is shown that re-sequencing and de novo sequencing of the majority of a bacterial genome is possible with read lengths of 20–30 nt, and that reads of 50 nt can provide reconstructed contigs (a contiguous fragment of sequence data) of 1000 nt and greater that cover 80% of human chromosome 1.


title: Human Wharton’s Jelly—Cellular Specificity, Stemness Potency, Animal Models, and Current Application in Human Clinical Trials

text: Stem cell therapies offer a great promise for regenerative and reconstructive medicine, due to their self-renewal and differentiation capacity. Although embryonic stem cells are pluripotent, their utilization involves embryo destruction and is ethically controversial. Therefore, adult tissues that have emerged as an alternative source of stem cells and perinatal tissues, such as the umbilical cord, appear to be particularly attractive. Wharton’s jelly, a gelatinous connective tissue contained in the umbilical cord, is abundant in mesenchymal stem cells (MSCs) that express CD105, CD73, CD90, Oct-4, Sox-2, and Nanog among others, and have the ability to differentiate into osteogenic, adipogenic, chondrogenic, and other lineages. Moreover, Wharton’s jelly-derived MSCs (WJ-MSCs) do not express MHC-II and exhibit immunomodulatory properties, which makes them a good alternative for allogeneic and xenogeneic transplantations in cellular therapies. Therefore, umbilical cord, especially Wharton’s jelly, is a promising source of mesenchymal stem cells.


title: “Epidemiology and aetiology of influenza-like illness among households in metropolitan Vientiane, Lao PDR”: A prospective, community-based cohort study

text: Respiratory diseases are a major contributor to morbidity and mortality in many tropical countries, including Lao PDR. However, little has been published regarding viral or bacterial pathogens that can contribute to influenza-like illness (ILI) in a community setting. We report on the results of a community-based surveillance that prospectively monitored the incidence of ILI and its causative pathogens in Vientiane capital in Lao PDR. A cohort of 995 households, including 4885 study participants, were followed-up between May 2015 and May 2016. Nasopharyngeal swabs, throat swabs, and sputum specimens were collected from ILI cases identified through active case-finding. Real-Time PCR was used to test nasopharyngeal swabs for 21 respiratory pathogens, while throat and sputum samples were subjected to bacterial culture. Generalized linear mixed models were used to assess potential risk factors for associations with ILI. In total, 548 episodes of ILI were reported among 476 (9.7%) of the study participants and 330 (33.2%) of the study households. The adjusted estimated incidence of ILI within the study area was 10.7 (95%CI: 9.4–11.9) episodes per 100 person-years. ILI was significantly associated with age group (p<0.001), sex (p<0.001), and number of bedrooms (p = 0.04) in multivariate analysis. In 548 nasopharyngeal swabs, the most commonly detected potential pathogens were Streptococcus pneumoniae (17.0%), Staphylococcus aureus (11.3%), influenza A (11.1%; mostly subtype H3N2), rhinovirus (7.5%), and influenza B (8.0%). Streptococci were isolated from 42 (8.6%) of 536 throat swabs, most (27) of which were Lancefield Group G. Co-infections were observed in 132 (24.1%) of the 548 ILI episodes. Our study generated valuable data on respiratory disease burden and patterns of etiologies associated with community-acquired acute respiratory illness Laos. Establishment of a surveillance strategy in Laos to monitor trends in the epidemiology and burden of acute respiratory infections is required to minimize their impact on human health.


title: COVID-19: Wer stirbt, wer überlebt?: Coronavirus-Pandemie

text: Gibt es Risikofaktoren für einen schweren bis tödlichen Verlauf der Coronavirus-Krankheit COVID-19? Um dieser Frage nachzugehen, wurden die Daten von fast 200 frühen Patienten aus Wuhan analysiert.


Complicaciones arteriales trombóticas en pacientes hospitalizados con COVID-19


title: Cloning and sequencing of a 8.4-kb region from the 3′-end of a Taiwanese virulent isolate of the coronavirus transmissible gastroenteritis virus

text: Abstract The nucleotide sequence (8396 nucleotides) was determined, from the 3′-end of the putative polymerase gene to the poly(A) tail, for a Taiwanese virulent isolate, TFI, of transmissible gastroenteritis virus (TGEV). The TFI nucleotide sequence had very high identity to the British virulent field isolate FS772/70 (98.3%), the attenuated Purdue 115 (96.7%) and from the S gene to ORF-4 gene region, to the low passaged virulent Miller (98.3%) strains of TGEV. Comparison of the TFI S protein sequence with those determined from other TGEV strains and those of the TGEV variant, porcine respiratory coronavirus, isolated from Europe and North America showed that they had changed very little over a period of 4 decades. The two extra amino acids found to be present in the spike proteins of the virulent FS772/70 and Miller strains when compared to the avirulent Purdue strain were found to be present in the TFI strain. The genomic organisation of the TFI strain was the same as that of the other TGEV viruses.


title: An animal model that reflects human disease: the common marmoset (Callithrix jacchus)

text: The common marmoset is a new world primate belonging to the Callitrichidae family weighing between 350 and 400g. The marmoset has been shown to be an outstanding model for studying aging, reproduction, neuroscience, toxicology, and infectious disease. With regard to their susceptibility to infectious agents, they are exquisite NHP models for viral, protozoan and bacterial agents, as well as prions. The marmoset provides the advantages of a small animal model in high containment coupled with the immunological repertoire of a nonhuman primate and susceptibility to wild type, non-adapted viruses.


title: Rapid detection of wheat yellow mosaic virus by reverse transcription loop-mediated isothermal amplification

text: For the detection of wheat yellow mosaic virus (WYMV), we established a reverse transcription loop-mediated isothermal amplification (RT-LAMP) method. Using Primer Explorer software, four sets of primers were designed and RT-LAMP assay reaction conditions were optimized. The RT-LAMP was performed at different times by four primer sets. Agarose gel analysis showed that WYMV could be detected after 30 min with the primer set III and after 45 min with the other three primer sets, both under the 80-min reaction time. RT-LAMP had the same results with the four primer sets, thus primer set III and 65°C for 80 min reaction were selected for virus detection. There was no significant different when avian myeloblastosis virus (AMV) and moloney murine leukemia virus (M-MLV) RT-LAMP with the four primer sets and M-MLV was chosen due to its relatively cheap price. The result on specificity showed that the assay could amplify WYMV specifically, and the sensitivity comparison showed that the RT-LAMP was 100 times more sensitive than conventional reverse-transcriptase-polymerase chain reaction (RT-PCR). Overall, RT-LAMP was found to be a simple, specific, sensitive, convenient and time-saving method for WYMV detection.


title: Viral Load Dynamics and Clinical Disease Severity in Infants With Respiratory Syncytial Virus Infection

text: BACKGROUND: The association between respiratory syncytial virus (RSV) loads and clinical outcomes in children remains to be defined. In most studies, viral loads (VL) were evaluated in hospitalized children and at a single time-point. We investigated the relationship between VLs and disease severity in both outpatients and inpatients with RSV infection. METHODS: We enrolled previously healthy children with RSV infection. Disease severity was defined by level of care (outpatients vs ward vs pediatric intensive care unit [PICU]), and a clinical disease severity score (CDSS). Nasopharyngeal VLs by polymerase chain reaction and CDSS were measured at enrollment and daily in inpatients. VL decay according to disease severity was analyzed using linear mixed modeling. RESULTS: From February 2015 to March 2017, we enrolled 150 infants: 39 outpatients and 111 inpatients. VLs were higher in outpatients than in age-matched inpatients. Among inpatients, initial VLs were comparable in ward and PICU patients, and preceded the peak CDSS. However, after excluding infants treated with steroids, those hospitalized in the ward had higher VLs than infants requiring PICU care (P < .001). Dynamic analyses showed that VL decay was delayed in PICU patients, especially in those treated with steroids. CONCLUSIONS: Higher VLs at presentation and a faster and consistent VL decline were both associated with less severe RSV disease in children. SUMMARY: Infants with less severe respiratory syncytial virus (RSV) disease had higher viral loads (VL) at presentation, and faster and consistent VL decline. Conversely, VL decay and overall viral exposure were prolonged and higher in infants severe RSV disease receiving steroids.


title: Molecular docking identifies the binding of 3-chloropyridine moieties specifically to the S1 pocket of SARS-CoV Mpro

text: Abstract The 3C-like main proteinase of the severe acute respiratory syndrome (SARS) coronavirus, SARS-CoV Mpro, is widely considered to be a major drug target for the development of anti-SARS treatment. Based on the chemical structure of a lead compound from a previous screening, we have designed and synthesized a number of non-peptidyl inhibitors, some of which have shown significantly improved inhibitory activity against SARS-CoV Mpro with IC50 values of ∼60nM. In the absence of SARS-CoV Mpro crystal structures in complex with these synthetic inhibitors, molecular docking tools have been employed to study possible interactions between these inhibitors and SARS-CoV Mpro. The docking results suggest two major modes for the initial binding of these inhibitors to the active site of SARS-CoV Mpro. They also establish a structural basis for the ‘core design’ of these inhibitors by showing that the 3-chloropyridine functions common to all of the present inhibitors tend to cluster in the S1 specificity pocket. In addition, intrinsic flexibility in the S4 pocket allows for the accommodation of bulky groups such as benzene rings, suggesting that this structural plasticity can be further exploited for optimizing inhibitor–enzyme interactions that should promote a tighter binding mode. Most importantly, our results provide the structural basis for rational design of wide-spectrum antiviral drugs targeting the chymotrypsin-like cysteine proteinases from coronaviruses and picornaviruses.


title: Neonatal infections in Saudi Arabia: Association with cytokine gene polymorphisms

text: In recent years, many studies have reported potential associations between cytokine gene polymorphisms and the development, course, and outcome of sepsis, often with apparently conflicting results. The objective of this study was to investigate single nucleotide polymorphism (SNP) in the interleukin (IL)-1β –31 T/C, IL-6 –174 G/C, tumor necrosis factor α (TNF-α) –308 G/A, and interferon γ (IFN-γ) +874 A/T genes for their possible association with susceptibility to early onset sepsis (EOS) in Saudi newborn infants. A total of 205 newborn infants aged 1-2 days were consecutively enrolled onto the study having met the inclusion criteria (as per the research protocol). DNA was extracted from filter papers using the Chelex-100 method. The cytokines SNP were genotyping using Taqman 5’ nuclease allelic discrimination. For cytokine measurements we used the commercially available Enzyme-Linked Immunosorbent Assay (ELISA) kit. Our results show that the circulating IL-1β, IL-6, TNF-α, and IFN-γ were significantly (p < 0.001) elevated in EOS patients compared to suspected and sepsis-free control groups; and IL-1β –31C, IL-6 –174G, TNF-α –308G, and IFN-γ +874A alleles were associated with EOS in Saudi infants. In conclusion, analysis of cytokines concentrations and SNP for the four tested genes can be used as a predictor of sepsis outcome in newborns.


title: Diagnosis and management of the drug hypersensitivity reactions in Coronavirus disease 19

text: Coronavirus disease 2019 (COVID‐19), a respiratory tract infection caused by a novel human coronavirus, the severe acute respiratory syndrome coronavirus 2, leads to a wide spectrum of clinical manifestations ranging from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Given the huge influence caused by the overwhelming COVID‐19 pandemic affecting over three million people worldwide, a wide spectrum of drugs is considered for the treatment in the concept of repurposing and off‐label use. There is no knowledge about the diagnosis and clinical management of the drug hypersensitivity reactions that can potentially occur during the disease. This review brings togetherall the published information about the diagnosis and management of drug hypersensitivity reactions due to current and candidate off‐label drugs andhighlights relevant recommendations. Furthermore, it gathers all the dermatologic manifestations reported during the disease for guiding the clinicians to establish a better differential diagnosis of drug hypersensitivity reactionsin the course of the disease.


title: Prevalence of Enteropathogens in Dogs Attending 3 Regional Dog Parks in Northern California

text: BACKGROUND: The prevalence and risk factors for infection with enteropathogens in dogs frequenting dog parks have been poorly documented, and infected dogs can pose a potential zoonotic risk for owners. HYPOTHESIS/OBJECTIVES: To determine the prevalence and risk factors of infection with enteropathogens and zoonotic Giardia strains in dogs attending dog parks in Northern California and to compare results of fecal flotation procedures performed at a commercial and university parasitology laboratory. ANIMALS: Three‐hundred dogs attending 3 regional dog parks in Northern California. METHODS: Prospective study. Fresh fecal specimens were collected from all dogs, scored for consistency, and owners completed a questionnaire. Specimens were analyzed by fecal centrifugation flotation, DFA, and PCR for detection of 11 enteropathogens. Giardia genotyping was performed for assemblage determination. RESULTS: Enteropathogens were detected in 114/300 dogs (38%), of which 62 (54%) did not have diarrhea. Frequency of dog park attendance correlated significantly with fecal consistency (P = .0039), but did not correlate with enteropathogen detection. Twenty‐seven dogs (9%) were infected with Giardia, and genotyping revealed nonzoonotic assemblages C and D. The frequency of Giardia detection on fecal flotation was significantly lower at the commercial laboratory versus the university laboratory (P = .013), and PCR for Giardia was negative in 11/27 dogs (41%) that were positive on fecal flotation or DFA. CONCLUSIONS AND CLINICAL IMPORTANCE: Enteropathogens were commonly detected in dogs frequenting dog parks, and infection with Giardia correlated with fecal consistency. PCR detection of Giardia had limited diagnostic utility, and detection of Giardia cysts by microscopic technique can vary among laboratories.


title: Viral Lower Respiratory Tract Infection in the Elderly: A Prospective In-Hospital Study

text: The objective of this prospective study was to evaluate the clinical and laboratory parameters distinguishing viral from nonviral lower respiratory tract infection in elderly patients and to determine the yield of virological diagnostics in elderly patients with lower respiratory tract infection. The study was conducted in a 184-bed geriatric department in a university hospital during 4 winter months. All consecutive elderly persons admitted with a lower respiratory tract infection were included in the study. Clinical and laboratory parameters, a nasopharyngeal swab, and serological results for respiratory viruses were obtained for all participants. Available blood and sputum cultures were analysed. A total of 165 elderly persons (mean age, 82±6.8 years) were hospitalised with a lower respiratory tract infection. Familial flu-like illness (OR, 4.25; 95%CI, 1.4–13), better functionality (OR, 4; 95%CI, 1.3–14.15), and leucocyte count <10(10)/l (OR, 3; 95%CI, 1.3–7.1) were predictive for viral lower respiratory tract infection. Sixty (36.5%) definite diagnoses (positive blood culture, viral culture, or serological test) and seven (4.2%) probable diagnoses (positive sputum culture) were obtained. An early diagnosis (within 72 h) was possible in 38 (23%) and a late diagnosis in 29 (17.6%) participants. A nasopharyngeal swab contributed in 60.5% of the cases to an early diagnosis. Viral culture identified half (22/43) of the lower respiratory tract infections caused by influenza but only one of six lower respiratory tract infections caused by respiratory syncytial virus. In conclusion, a history of flu-like illness in family members and a total leucocyte count within normal limits makes a viral cause more likely in elderly people hospitalised with a lower respiratory tract infection during winter. Viral culture and rapid antigen detection are insensitive in elderly patients hospitalised with a lower respiratory tract infection.


Science, innovation and society: what we need to prepare for the health challenges of the twenty-first century?


PARENTAL ORIGIN OF CHROMOSOME 15 DELETION IN PRADER-WILLI SYNDROME


The challenges of dental care provision in patients with learning disabilities and special requirements during COVID‐19 pandemic


title: Application of next generation sequencing technology on contamination monitoring in microbiology laboratory

text: Abstract The surveillance and prevention of pathogenic microbiological contamination are the most important tasks of biosafety management in the lab. There is an urgent need to establish an effective and unbiased method to evaluate and monitor such contamination. This study aims to investigate the utility of next generation sequencing (NGS) method to detect possible contamination in the microbiology laboratory. Environmental samples were taken at multiple sites at the lab including the inner site of centrifuge rotor, the bench used for molecular biological tests, the benches of biosafety cabinets used for viral culture, clinical sample pre-treatment and nucleic acids extraction, by scrubbing the sites using sterile flocked swabs. The extracted total nucleic acids were used to construct the libraries for deep sequencing according to the protocol of Ion Torrent platform. At least 1G raw data was obtained for each sample. The reads of viruses and bacteria accounted for 0.01 ± 0.02%, and 77.76 ± 12.53% of total reads respectively. The viral sequences were likely to be derived from gene amplification products, the nucleic acids contaminated in fetal bovine serum. Reads from environmental microorganisms were also identified. Our results suggested that NGS method was capable of monitoring the nucleic acids contaminations from different sources in the lab, demonstrating its promising utility in monitoring and assessing the risk of potential laboratory contamination. The risk of contamination from reagents, remnant DNA and environment should be considered in data analysis and results interpretation.


title: Pulmonary Capillary Leak Syndrome following COVID‐19 Virus Infection

text: Pulmonary capillary leak syndrome secondary to influenza SARS‐CoV‐2virus infection was not previously reported. We report 2 cases. The diagnosis of non‐cardiogenic pulmonary edema due to pulmonary capillary leak syndrome SARS‐CoV‐2 virus infection was obtained by a medical committee of 6 physicians. The diagnosis of COVID‐19 infection is confirmed by reverse transcription polymerase chain reaction (RT‐PCR) test. Moreover, in this specific endemic situation, and according to the British Society of Thoracic Imaging expert reference group update, we took account of chest CT‐Scan results in the early detection of COVID‐19 pneumonia. Our 2 patients with a confirmed influenza SARS‐CoV‐2virus infection had respiratory distress with lung crackles on auscultation of one or both lungs and with alveolar pulmonary edema on the chest CT‐Scan. The cardiogenic nature of pulmonary edema was ruled out in both cases by a transthoracic echocardiography showing normal systolic and diastolic functions. Our patients were treated by oxygen via face mask in one case and mechanical ventilation as supportive treatment in the other patient. Hydroxychloroquine (600mg/day), Azithromycine, steroids (dexamethasone 20mg/day), vitamin C (3g/day), Zinc, diuretics and Enoxaparine were equally used for the two patients. Evolution was marked by a good outcome in both of them. In summary, acute respiratory failure is a rare but major complication of COVID‐19 virus infection. It is due to pulmonary capillary leak syndrome. Treatment is based on a good oxygenation, intravenous corticosteroids, diuretics, Azithromycine, vitamin C, and other symptomatic treatments. This article is protected by copyright. All rights reserved.


title: COVID-19: An Early Review of Its Global Impact and Considerations for Parkinson’s Disease Patient Care

text: While many infectious disorders are unknown to most neurologists, COVID-19 is very different. It has impacted neurologists and other health care workers, not only in our professional lives but also through the fear and panic within our own families, colleagues, patients and their families, and even in the wider public. COVID-19 affects all sorts of individuals, but the elderly with underlying chronic conditions are particularly at risk of severe disease, or even death. Parkinson’s disease (PD) shares a common profile as an age-dependent degenerative disorder, frequently associated with comorbidities, particularly cardiovascular diseases, so PD patients will almost certainly fall into the high-risk group. Therefore, the aim of this review is to explore the risk of COVID-19 in PD based on the susceptibility to severe disease, its impact on PD disease severity, potential long-term sequelae, and difficulties of PD management during this outbreak, where neurologists face various challenges on how we can maintain effective care for PD patients without exposing them, or ourselves, to the risk of infection. It is less than six months since the identification of the original COVID-19 case on New Year’s Eve 2019, so it is still too early to fully understand the natural history of COVID-19 and the evidence on COVID-19-related PD is scant. Though the possibilities presented are speculative, they are theory-based, and supported by prior evidence from other neurotrophic viruses closely related to SARS-CoV-2. Neurologists should be on high alert and vigilant for potential acute and chronic complications when encountering PD patients who are suspected of having COVID-19.


title: Evaluation of a Redesigned Personal Protective Equipment Gown

text: BACKGROUND: In healthcare, the goal of personal protective equipment (PPE) is to protect healthcare personnel (HCP) and patients from body fluids and infectious organisms via contact, droplet, or airborne transmission. The critical importance of using PPE properly is highlighted by 2 potentially fatal viral infections, severe acute respiratory syndrome–associated coronavirus and Ebola virus, where HCP became infected while caring for patients due to errors in the use of PPE. However, PPE in dealing with less dangerous, but highly infectious organisms is important as well. This work proposes a framework to test and evaluate PPE with a focus on gown design. METHODS: An observational study identified issues with potential for contamination related to gown use. After redesigning the existing gown, a high-fidelity patient simulator study with 40 HCP as participants evaluated the gown redesign using 2 commonly performed tasks. Variables of interest were nonadherence to procedural standards, use problems with the gown during task performance, and usability and cognitive task load ratings of the standard and redesigned gowns. RESULTS: While no differences were found in terms of nonadherence and use problems between the current and the redesigned gown, differences in usability and task load ratings suggested that the redesigned gown is perceived more favorably by HCP. CONCLUSIONS: This work proposes a framework to guide the evaluation of PPE. The results suggest that the current design of the PPE gown can be improved in usability and user satisfaction. Although our data did not find an increase in adherence to protocol when using the redesigned gown, it is likely that higher usability and lower task load could result in higher adherence over longer periods of use.


title: COVID‐19: Test, Trace and Isolate‐New Epidemiological Data

text: In the absence of an efficient drug treatment or a vaccine, the control of the COVID‐19 pandemic relies on classic infection control measures. Since these means are socially disruptive and come with substantial economic loss for societies, a better knowledge of the epidemiology of the new coronavirus epidemic is crucial to achieve control at a sustainable cost, and within tolerable restrictions of civil rights. This article is protected by copyright. All rights reserved.


title: Factors Associated With Time to Elimination of Porcine Epidemic Diarrhea Virus in Individual Ontario Swine Herds Based on Surveillance Data

text: Porcine epidemic diarrhea virus (PEDV) emerged into Canada in January of 2014. The virus was considered to be of high importance and the number of new cases were tracked using different mechanisms by stakeholders such as veterinary services from the provincial government and the swine industry. In addition to the initial date of infection, veterinary organizations in the swine industry maintained a disease control program (DCP) database that contained the date of declaration of freedom from PEDV in individual herds. Such data allowed for the determination of the duration of PEDV infection in individual herds based on herd type, year and season of diagnosis. Therefore, the objective of this study was to determine time to PEDV elimination in Ontario swine herds infected between 2014 and 2017, on the basis of records from the DCP database; and to identify factors associated with the likelihood of elimination. Duration of time to eliminate PEDV was estimated using Kaplan-Meier survival curves. The final Cox's proportional hazard model included herd type, season and year of diagnosis. The hazard of PEDV elimination for premises that were farrow-to-wean was 3.36 times larger (P-value: 0.044, 95% CI: 1.03, 10.93) than for farrow-to-feeder herds. Herds diagnosed in the summer and fall had hazard ratios of 1.40 (P-value: 0.044, 95% CI: 1.03, 10.93) and 7.32 (P-value: <0.001, 95% CI: 3.12, 17.18), respectively compared to herds diagnosed in the winter months. The hazard ratio for herds diagnosed in 2015 was 0.54 (P-value: 0.015, 95% CI: 0.33, 0.89) compared to herds diagnosed in 2014. Factors associated with time to elimination are likely reflective of the complexity of infection control practices applied in herds with different demographics and population structures, seasonal variability in the pathogen transmissibility, and the availability of resources to manage an emerging production-limiting disease. The median times to elimination were relatively long, which could be due to how it was measured, decisions made at the level of individual herds or delays related to reporting PEDV elimination. Design of control measures for production-limiting diseases at the regional level should take these factors into consideration.


title: Objective evaluation of anosmia and ageusia in COVID‐19 patients: Single‐center experience on 72 cases

text: BACKGROUND: The first European case series are detecting a very high frequency of chemosensitive disorders in COVID‐19 patients, ranging between 19.4% and 88%. METHODS: Olfactory and gustatory function was objectively tested in 72 COVID‐19 patients treated at University Hospital of Sassari. RESULTS: Overall, 73.6% of the patients reported having or having had chemosensitive disorders. Olfactory assessment showed variable degree hyposmia in 60 cases and anosmia in two patients. Gustatory assessment revealed hypogeusia in 33 cases and complete ageusia in one patient. Statistically significant differences in chemosensitive recovery were detected based on age and distance from the onset of clinical manifestations. CONCLUSION: Olfactory and gustatory dysfunctions represent common clinical findings in COVID‐19 patients. Otolaryngologists and head‐neck surgeons must by now keep this diagnostic option in mind when evaluating cases of ageusia and nonspecific anosmia that arose suddenly and are not associated with rhinitis symptoms.


docid: imexhlwn

title: Assessing the Impact of Reduced Travel on Exportation Dynamics of Novel Coronavirus Infection (COVID-19)

text: The impact of the drastic reduction in travel volume within mainland China in January and February 2020 was quantified with respect to reports of novel coronavirus (COVID-19) infections outside China. Data on confirmed cases diagnosed outside China were analyzed using statistical models to estimate the impact of travel reduction on three epidemiological outcome measures: (i) the number of exported cases, (ii) the probability of a major epidemic, and (iii) the time delay to a major epidemic. From 28 January to 7 February 2020, we estimated that 226 exported cases (95% confidence interval: 86,449) were prevented, corresponding to a 70.4% reduction in incidence compared to the counterfactual scenario. The reduced probability of a major epidemic ranged from 7% to 20% in Japan, which resulted in a median time delay to a major epidemic of two days. Depending on the scenario, the estimated delay may be less than one day. As the delay is small, the decision to control travel volume through restrictions on freedom of movement should be balanced between the resulting estimated epidemiological impact and predicted economic fallout.


docid: woohfqze

title: Human enteric coronaviruses


title: Small interfering RNA targeting nonstructural protein1 α (nsp1α) of porcine reproductive and respiratory syndrome virus (PRRSV) can reduce the replication of PRRSV in MARC-145 cells

text: Abstract Porcine reproductive and respiratory syndrome virus (PRRSV) is one of the most economically devastating and pandemic diseases of swine, which is poorly controlled by current methods. The inhibition of specific genes by small interfering RNA (siRNA) has been proven to be a potential therapeutic strategy against viral infection. Previous studies have indicated that the nonstructural protein 1α (nsp1α) of PRRSV may take an important role in virulence of PRRSV. The present work was involved to explore the effect of siRNA targeting nsp1α on the replication of PRRSV in MARC-145 cells, and the results showed that over-expression of nsp1α enhanced the replication of PRRSV and that siRNAs specifically targeting nsp1α significantly inhibited the replication of PRRSV in MARC-145 cells. In conclusion, this work indicated that nsp1α may be a viral pathogenicity factor of PRRSV and that siRNAs specifically targeting nsp1α may be a new strategy to control PRRSV in the future.


title: What is the best drug to treat COVID-19? The need for randomized controlled trials

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently the biggest public health challenge to the biomedical community of the last century Despite multiple public health measures, 1-3 there remains an urgent need for pharmacologic therapies to treat infected patients and minimize mortality, decrease pressures on intensive care units and health systems and optimally they should decrease subsequent transmission At the time of writing, there are no licensed drugs to treat COVID-19 and a search on clinicaltrials gov using ‘COVID-19’ as the input term, yielded 657 studies Drug-based interventions currently fall into categories including off label use which includes repurposed drugs, 4,5 and newer entities but both categories should be given in the context of clinical trials In Wuhan, China, then the epicentre of the pandemic, Cao et al under heroic circumstances, conducted a randomized, controlled, open-label trial involving 199 hospitalized patients with confirmed SARS-CoV-2 infection including as an entry criteria oxygen saturation (SaO2) of 94% or less on air (ChiCTR2000029308) Patients were randomly assigned 1:1 to receive either lopinavir–ritonavir (400 mg and 100 mg, respectively) twice daily for 14 days, or standard care alone The primary end point was the time to clinical improvement, defined as the time from randomization to either an improvement of two points on a seven-category ordinal scale or discharge from the hospital, whichever came first 6 Even though their study showed no benefits with lopinavir–ritonavir treatment beyond standard care, this is exactly the sort of study that best informs our treatment options Following this, we were surprised to see the New England Journal of Medicine publishing a single arm study on 61 patients who received at least one dose of remdesevir, again with similar entry criteria of SaO2 <94% on air 7 Unlike the randomised trial by Cao et al , there was no accompanying editorial, but there was a subsequent an open letter discussing remdesevir studies from the CEO and Chairman of Gilead (https://www gilead com/stories/articles/an-open-letter-from-our-chairman-and-ceo) One presumes that the patients in the remdesevir single arm study, and several included in an earlier Lancet paper, 8 were recruited in perhaps easier conditions than those in Wuhan earlier this year Randomised trials are designed to precisely answer questions regarding toxicity and efficacy beyond standard of care and in the absence of an effective therapy it remains entirely reasonable and ethical at this point to perform a trial versus placebo They are much more informative than single arm studies which result in claims, perhaps borne from hope and/or desperation, that drugs work, 9 and such claims include those from physicians stating very high cure rates Clearly, recruiting patients recently diagnosed will have ‘cure rates’ usually in the high 90s%, unless one focuses on recruiting hospitalised patients and/or the elderly, frail, those with co-morbidities or a high body mass index, to name a few examples A well-known French microbiologist on social media has promoted the use of chloroquine to treat or prevent COVID-19 The FDA has approved it, although at the time of writing they haven’t explained the rationale behind the approval, and as a consequence patients, institutions and the worried public have demanded immediate chloroquine for all The resulting rush on chloroquine has led to severe shortages of the drug, and patients taking regular chloroquine or hydroxychloroquine for lupus or other systemic diseases had to stop their treatment due to a lack of supply This drug has well known often serious toxicities;10 we note one small study was stopped due to potential cardiac complications (https://www nytimes com/2020/04/12/health/chloroquine-coronavirus-trump html) and we suggest it should only be taken in the context of a randomised or other clinical study This is not to suggest single arm studies are not helpful: they inform subsequent trials includi g dosage, duration and appropriate endpoints For example, we have observed11 that use of baricitinib for 10 days is associated with viral rebound in nasopharyngeal swabs in rapidly recovered and discharged patients, and thus have recommended longer use in the large randomised studies in which it is included, and we suggest again that comparisons between different therapies or placebo are likely to yield more informative results than randomised studies comparing 10 days of intravenous remdesevir with 5 days (https://benevolent ai/news/potential-treatment-for-covid-19-identified-by-benevolentai-usingartificial-intelligence-enters-clinical-testing And https://investor lilly com/news-releases/news-release-details/lilly-begins-clinical-testingtherapies-covid-19) With this in mind, we thoroughly congratulate the authors from Guangzhou, China, who successfully randomised 86 individuals with mild-to-moderate COVID-19 in a 2:2:1 design, to either lopinavir/ritonavir, arbidol (a broad spectrum viral infusion inhibitor12) or placebo (NCT04252885) Because they included only mild-to-moderate patients, the pre-defined primary endpoint was the conversion at day 21 of positive-to-negative PCR tests for SARSCoV-2 from nasopharyngeal swabs The real time reverse-transcriptase PCR (RT-PCR) method used was indeed appropriate as it was performed simultaneously on two target genes, ORF1ab and N genes, and positive and negative controls were used at each batch Negative conversion required 2 separate real time RT-PCR tests separated by 24 hours, and the entry criteria for the definition of mild-to-moderate including the absence of pneumonia are entirely appropriate Baseline criteria between the 3 groups were well-matched (a criticism of one of the hydroxychloroquine randomised studies is this was not the case13) and follow up was appropriate Their data helpfully shows there was no difference between any of the groups in the primary endpoint In the continuing search for safe and effective new therapies to treat patients with COVID-19, we require well-conducted ethical studies including prospective, randomised, placebocontrolled clinical studies such as this Although many drugs have predicted in vitro activity against the virus, the proposal that such drugs might provide more benefit than harm is not appropriate with no evidence base supporting efficacy in any patients infected with SARSCoV-2 A preprint reporting results from a randomised trial of the anti-viral favipravir versus arbidol in 240 adults has shown no difference in clinical recovery at 7 days, but cough and pyrexia were improved on favipravir 14 These authors and Li et al should be applauded for their efforts to add a useful randomised trial to the literature, albeit one that is negative It is critical to publish such studies International multicentre trials, such as Discovery (NCT04315948) and Solidarity (EudraCT Number 2020-000982-18), will randomise patients with COVID-19 to receive different drugs in adaptive study designs Such initiatives will provide the best and most relevant data to guide management of patients with COVID-19 Whether antiviral, immunomodulatory or antimalarial drugs could be effective in changing the disease course in patients with either mild or severe COVID-19 remains unknown When patients take these off-label and recover it is not known whether the drug was helpful in the disease course without randomisation Similarly, when patients deteriorate, we do not know if they should be continued or considered clinically ineffective and stopped Assessing viral loads by PCR on nasopharyngeal swabs as performed in the trial here, will help clarify the roles of these medicines going forwards


Letter by Golomb and Hall Regarding Article, “Temporary Emergency Guidance to US Stroke Centers During the COVID-19 Pandemic”


title: Hepatitis A Outbreak in a Residential School

text: Summary: Hepatitis A outbreak in a residential school. C. R. Boughton, R. A. Hawkes, N. I. Lehmann and G. S. Grohmann, Aust. N.Z. J. Med., 1980, 10, pp. 4–6. Outbreaks of hepatitis A occurred sequentially in two wards for children in a residential institution for the mentally retarded in Sydney. Twenty‐six of 47 children were initially susceptible to hepatitis A. In the first ward affected, 77 of 13 susceptible children (85%), and in the second ward, four of 13 susceptible (31%), were infected. Of the 15 showing serological evidence of infection, five (33%) were clinically jaundiced.


title: 10 Emerging and Reemerging Infectious Disease Threats

text: Abstract This chapter describes the potential public health impact of emerging and reemerging disease. Factors contributing to the emergence of diseases include increasing international travel and commerce, changes in human demographics and behavior, advances in technology and industry, microbial adaptation and the breakdown of public health systems. Of emerging diseases, 60% are zoonotic, making the human–animal biome interaction critical. Preparedness for an emerging disease relies on strong biosurveillance systems for early detection. Control measures to prevent transmission must be implemented early. These include: rapid epidemiologic surveillance and investigations to characterize the disease; transmission prevention through containment and control measures; development and deployment of medical countermeasures; and emergency public information and warning. Recovery after the outbreak of an emerging disease can result in a “new normal” with persistent endemic infection in the community.


title: A new threat from an old enemy: Re-emergence of coronavirus (Review)

text: The new outbreak of coronavirus from December 2019 has brought attention to an old viral enemy and has raised concerns as to the ability of current protection measures and the healthcare system to handle such a threat. It has been known since the 1960s that coronaviruses can cause respiratory infections in humans; however, their epidemic potential was understood only during the past two decades. In the present review, we address current knowledge on coronaviruses from a short history to epidemiology, pathogenesis, clinical manifestation of the disease, as well as treatment and prevention strategies. Although a great amount of research and efforts have been made worldwide to prevent further outbreaks of coronavirus-associated disease, the spread and lethality of the 2019 outbreak (COVID-19) is proving to be higher than previous epidemics on account of international travel density and immune naivety of the population. Only strong, joint and coordinated efforts of worldwide healthcare systems, researchers, and pharmaceutical companies and receptive national leaders will succeed in suppressing an outbreak of this scale.


title: The Antimicrobial and Antiviral Applications of Cell-Penetrating Peptides

text: Over the past two decades, cell-penetrating peptides (CPPs) have become increasingly popular both in research and in application. There have been numerous studies on the physiochemical characteristics and behavior of CPPs in various environments; likewise, the mechanisms of entry and delivery capabilities of these peptides have also been extensively researched. Besides the fundamental issues, there is an enormous interest in the delivery capabilities of the peptides as the family of CPPs is a promising and mostly non-toxic delivery vector candidate for numerous medical applications such as gene silencing, transgene delivery, and splice correction. Lately, however, there has been an emerging field of study besides the high-profile gene therapy applications—the use of peptides and CPPs to combat various infections caused by harmful bacteria, fungi, and viruses. In this chapter, we aim to provide a short overview of the history and properties of CPPs which is followed by more thorough descriptions of antimicrobial and antiviral peptides. To achieve this, we analyze the origin of such peptides, give an overview of the mechanisms of action and discuss the various practical applications which are ongoing or have been suggested based on research.


title: Could fighting airborne transmission be the next line of defence against COVID-19 spread?

text: Abstract The World Health Organization declared the infectious spread of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) an epidemic during its initial outbreak in Wuhan (China) and has since declared it a pandemic and, more recently, an endemic infection that may remain in our communities. A vaccine for COVID-19 is expected to take several months, meaning that the spread may continue in future, in the absence of the most effective measures of social distancing and self-isolation. While these measures have worked well under lockdowns, the potential of airborne transmission of COVID-19 under the eased restrictions has not been considered important enough. We discuss the need to acknowledge the airborne spread of COVID-19 inside built spaces under eased movement restrictions and the potential steps that can be taken to control it.


Reaction to Letter from Zhang et al.


title: Bevölkerungsbezogene psychische Gesundheit als Schlüsselfaktor im Umgang mit COVID-19

text: Aim The aim of the article is to point out the important role of prevention and reduction of mental stress in the general population and in sensitive groups in the context of the coronavirus disease 2019 (COVID-19) pandemic. Methods This article includes the analysis and evaluation of studies and recommendations from organizations such as the World Health Organization (WHO) that have examined the psychological consequences of epidemics/pandemics on people and their impact on the further course. Results Fear-related behaviors can adversely affect the course of epidemics. Past outbreaks of infectious diseases (Ebola and Zika virus) have shown that maladaptive behavior, related to increased psychological stress and anxiety, can interfere with the implementation of treatment strategies and actions and can contribute to a further spread. Hereby, strategies for dealing with infectious diseases, that include the suppression of fear, can trigger a vicious circle in which fear and suppression mutually reinforce each other. Conclusion The COVID-19 pandemic poses an immense challenge to governments, health systems and people, with an uncertain outcome, which is associated with a significant burden of mental health in the population. In line with WHO recommendations, national guidelines and preventive measures should include the psychological consequences, the acceptance and normalization of fears and the promotion of resilience in the population in dealing with COVID-19 in order to counteract a further spread.


title: Presence of infectious agents and co-infections in diarrheic dogs determined with a real-time polymerase chain reaction-based panel

text: BACKGROUND: Infectious diarrhea can be caused by bacteria, viruses, or protozoan organisms, or a combination of these. The identification of co-infections in dogs is important to determine the prognosis and to plan strategies for their treatment and prophylaxis. Although many pathogens have been individually detected with real-time polymerase chain reaction (PCR), a comprehensive panel of agents that cause diarrhea in privately owned dogs has not yet been established. The objective of this study was to use a real-time PCR diarrhea panel to survey the frequencies of pathogens and co-infections in owned dogs attended in a veterinary hospital with and without diarrhea, as well the frequency in different countries. Feces samples were tested for canine distemper virus, canine coronavirus, canine parvovirus type 2 (CPV-2), Clostridium perfringens alpha toxin (CPA), Cryptosporidium spp., Giardia spp., and Salmonella spp. using molecular techniques. RESULTS: In total, 104 diarrheic and 43 control dogs that were presented consecutively at a major private veterinary hospital were included in the study. Overall, 71/104 (68.3%) dogs with diarrhea were positive for at least one pathogen: a single infection in 39/71 dogs (54.9%) and co-infections in 32/71 dogs (45.1%), including 21/32 dogs (65.6%) with dual, 5/32 (15.6%) with triple, and 6/32 (18.8%) with quadruple infections. In the control group, 13/43 (30.2%) dogs were positive, all with single infections only. The most prevalent pathogens in the diarrheic dogs were CPA (40/104 dogs, 38.5%), CPV-2 (36/104 dogs, 34.6%), and Giardia spp. (14/104 dogs, 13.5%). CPV-2 was the most prevalent pathogen in the dual co-infections, associated with CPA, Cryptosporidium spp., or Giardia spp. No statistical difference (P = 0.8374) was observed in the duration of diarrhea or the number of deaths (P = 0.5722) in the presence or absence of single or co-infections. CONCLUSIONS: Diarrheic dogs showed a higher prevalence of pathogen infections than the controls. Whereas the healthy dogs had only single infections, about half the diarrheic dogs had co-infections. Therefore, multiple pathogens should be investigated in dogs presenting with diarrhea. The effects of multiple pathogens on the disease outcomes remain unclear because the rate of death and the duration of diarrhea did not seem to be affected by these factors.


title: RNA-based dynamic genetic controllers: development strategies and applications

text: Dynamic regulation of gene expression in response to various molecules is crucial for both basic science and practical applications. RNA is considered an attractive material for creating dynamic genetic controllers because of its specific binding to ligands, structural flexibility, programmability, and small size. Here, we review recent advances in strategies for developing RNA-based dynamic controllers and applications. First, we describe studies that re-engineered natural riboswitches to generate new dynamic controllers. Next, we summarize RNA-based regulatory mechanisms that have been exploited to build novel artificial dynamic controllers. We also discuss computational methods and high-throughput selection approaches for de novo design of dynamic RNA controllers. Finally, we explain applications of dynamic RNA controllers for metabolic engineering and synthetic biology.


docid: mhjmhlay

title: Direct association between pharyngeal viral secretion and host cytokine response in severe pandemic influenza

text: BACKGROUND: Severe disease caused by 2009 pandemic influenza A/H1N1virus is characterized by the presence of hypercytokinemia. The origin of the exacerbated cytokine response is unclear. As observed previously, uncontrolled influenza virus replication could strongly influence cytokine production. The objective of the present study was to evaluate the relationship between host cytokine responses and viral levels in pandemic influenza critically ill patients. METHODS: Twenty three patients admitted to the ICU with primary viral pneumonia were included in this study. A quantitative PCR based method targeting the M1 influenza gene was developed to quantify pharyngeal viral load. In addition, by using a multiplex based assay, we systematically evaluated host cytokine responses to the viral infection at admission to the ICU. Correlation studies between cytokine levels and viral load were done by calculating the Spearman correlation coefficient. RESULTS: Fifteen patients needed of intubation and ventilation, while eight did not need of mechanical ventilation during ICU hospitalization. Viral load in pharyngeal swabs was 300 fold higher in the group of patients with the worst respiratory condition at admission to the ICU. Pharyngeal viral load directly correlated with plasma levels of the pro-inflammatory cytokines IL-6, IL-12p70, IFN-γ, the chemotactic factors MIP-1β, GM-CSF, the angiogenic mediator VEGF and also of the immuno-modulatory cytokine IL-1ra (p < 0.05). Correlation studies demonstrated also the existence of a significant positive association between the levels of these mediators, evidencing that they are simultaneously regulated in response to the virus. CONCLUSIONS: Severe respiratory disease caused by the 2009 pandemic influenza virus is characterized by the existence of a direct association between viral replication and host cytokine response, revealing a potential pathogenic link with the severe disease caused by other influenza subtypes such as H5N1.


docid: rpwgheot

title: Social media panic and COVID-19 in India

text: Social media has played a crucial role in spreading awareness and knowledge about public health; however, it has also been misused for spreading fake news, hatred and creating racism during epidemics and civil unrest. We discuss how social media and societal response to COVID-19 negatively affected its control measures in India and what should be possible corrective measures.


La maldita pandemia: una oportunidad para la Atención Primaria de Salud


title: Randomised controlled trial of rhinothermy for treatment of the common cold: a feasibility study

text: OBJECTIVE: To determine the feasibility of a randomised controlled trial (RCT) of rhinothermy for the common cold. DESIGN: Open label, randomised, controlled feasibility study. SETTING: Single-centre research institute in New Zealand recruiting participants from the community. PARTICIPANTS: 30 adult participants with symptoms of a common cold, presenting within 48 hours of the onset of symptoms. INTERVENTIONS: Participants were randomly assigned 2:1 to receive either 35 L/min of 100% humidified air at 41°C via high flow nasal cannulae, 2 hours per day for up to 5 days (rhinothermy), or vitamin C 250 mg daily for 5 days (control). PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the proportion of screened candidates who were randomised. Secondary outcomes included: proportion of randomised participants who completed the study; modified Jackson scores from randomisation to 10 days after initiation of randomised regimen; time until feeling ‘a lot better’ compared with study entry; time until resolution of symptoms or symptom score at 10 days postrandomisation; proportion of organisms identified by PCR analysis of nasal swabs taken at baseline; the patterns of use of the rhinothermy device; estimated adherence of the control group; and rhinothermy device tolerability. RESULTS: In all 30/79 (38%, 95% CI 27% to 50%) of potential participants screened for eligibility were randomised. Rhinothermy was well tolerated, and all randomised participants completed the study (100%, 95% CI 88% to 100%). The reduction from baseline in the modified Jackson score was greater with rhinothermy compared with control at days 2, 3, 4, 5 and 6, with the maximum difference at day 4 (−6.4, 95% CI −9.4 to −3.3). The substantial clinical benefit threshold for modified Jackson score was a 5-unit change. CONCLUSIONS: This study shows that an RCT of rhinothermy compared with low-dose vitamin C in the treatment of the common cold is feasible. TRIAL REGISTRATION NUMBER: ACTRN12616000470493; Results.


title: Gastrointestinal involvement in COVID-19: a systematic review and meta-analysis

text: BACKGROUND: Patients with COVID-19 usually manifest fever and respiratory symptoms. However, some patients also experience gastrointestinal (GI) symptoms such as diarrhea, vomiting and abdominal pain. In addition, SARS-CoV-2 RNA has been detected in feces of infected patients. Currently there is huge evolving research interest in this potentially lethal disease. We systematically reviewed and meta-analyzed the evidence suggesting involvement of the digestive system in COVID-19. METHODS: PubMed, Medline and Embase databases were searched up to 10 April 2020, using suitable keywords. Individual and pooled prevalence rates with 95% confidence intervals (CI) were calculated using the fixed- or random-effects model as appropriate. Heterogeneity between studies was calculated employing the Cochran Q test and I(2) values, whereas the possibility of publication bias was examined by constructing funnel plots. Additionally, subgroup and sensitivity analyses were performed. RESULTS: In adult COVID-19 patients, the prevalence rates (95%CI) for all GI symptoms, and separately for diarrhea, nausea/vomiting, and abdominal discomfort/pain were 9.8% (6.4-14.7), 10.4% (95%CI 7.7-13.9), 7.7% (95%CI 4.8-12.1), and 6.9% (95%CI 3.9-11.9) respectively. The prevalence rates for children were 9.6% (95%CI 6.3-14.3) for all symptoms, 9.6% (95%CI 6.3-14.3) for diarrhea, and 6.8% (95% CI 4.2-11) for nausea/vomiting. In 30.3% (95%CI 10.5-61.6) of the patients SARS-CoV-2 RNA was detected in feces. CONCLUSIONS: A percentage of patients with COVID-19 will manifest symptoms from the digestive system. The GI tract may be a target organ and potential transmission route of SARS-CoV-2, with important implications for disease management and transmission.


title: The Fox and the Crow. A need to update pest control strategies

text: The recent discovery that cats and mustelids can be infected by SARS-CoV-2 may raise the question of monitoring domestic, feral and wild populations of such animals, as an adjunct to the elimination of COVID-19 in humans. Emergency solutions might consider large scale control of these animals in the wild. However, looking at science recently published on native vertebrate pest control reveals first that usual controls do not succeed in reducing animal numbers and associated damages, second that controlling can be counter-productive in increasing the infectious risks for humans and livestock. The examples of red fox and corvids are detailed in a European context, illustrating the urgent need for an ethical evaluation of ecological and economic costs and benefits of pest control strategies. A complete scientific evaluation process must be implemented and up-dated regularly, to be organized in four major steps, once the aim of the control strategy has been defined: (1) evaluating damages/risks caused by the animals, to be balanced with the ecosystem services they may provide, also in terms of economic costs; (2) unravelling spatial and temporal population dynamics of target animals to identify, if any, optimal control scenarios – which could be done within an adaptive management framework; (3) estimating the economic costs of implementing those optimal control scenarios, to be compared to the economic costs of damages/diseases; (4) finally evaluating how the control strategy reached its aims. A modern fable of the Fox and the Crow should deliver a timely moral for an ethical, ecological and economical appraisal of pest control strategies in Europe.


title: Chilblain‐like lesions in children following suspected COVID‐19 infection

text: During the COVID‐19 pandemic, chilblain‐like lesions have been reported in mildly symptomatic children and adolescents. We present four children investigated for suspected COVID‐19 infection who presented with acral skin findings and mild systemic symptoms. Histology from one case showed signs of vasculitis with evident fibrin thrombus.


title: Laboratory tests and outcome for patients with COVID-19: A systematic review and meta-analysis

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (COVID-19) poses substantial challenges for health care systems. With a vastly expanding amount of publications on COVID-19, clinicians need evidence synthesis to produce guidance for handling patients with COVID-19. In this systematic review and meta-analysis, we examine which routine laboratory tests are associated with severe COVID-19 disease. CONTENT: PubMed (Medline), Scopus, and Web of Science were searched until the 22(nd) of March 2020 for studies on COVID-19. Eligible studies were original articles reporting on laboratory tests and outcome of patients with COVID-19. Data were synthesised and we conducted random effects meta-analysis and estimated mean difference (MD) and standard mean difference at biomarker level for disease severity. Risk of bias and applicability concern was evaluated using the Quality Assessment of Diagnostic Accuracy Studies -2. SUMMARY: 45 studies were included, of which 21 publications were used for the meta-analysis. Studies were heterogeneous, but had low risk of bias and applicability concern in terms of patient selection and reference standard. Severe disease was associated with higher white blood cell count (MD 1.28 x 10(9)/L), neutrophil count (MD 1.49 x 10(9)/L), C-reactive protein (MD 49.2 mg/L), lactate dehydrogenase (MD 196 U/L), D-dimer (SMD 0.58), and aspartate aminotransferase (MD 8.5 U/L), all p < 0.001. Furthermore, low lymphocyte count (MD -0.32 x 10(9)/L), platelet count (MD -22.4 x 10(9)/L), and haemoglobin (MD -4.1 g/L), all p < 0.001, were also associated with severe disease. In conclusion, several routine laboratory tests are associated with disease severity in COVID-19.


title: Predisposing factors, pathogenesis and therapeutic intervention of Kawasaki disease

text: Kawasaki disease (KD) is an acute febrile childhood inflammatory disease, associated with coronary artery abnormalities. The disease is believed to result from an aberrant inflammatory response to an infectious trigger in a genetically predisposed individual. KD is associated with an endothelial cell injury as a consequence of T cell activation and cytotoxic effects of various proinflammatory cytokines. Intravenous immunoglobulin (IVIG) infusion and aspirin are the standard treatment of acute KD. However, 10–20% of patients show resistance to IVIG therapy and present higher risk of coronary vasculitis. The relative roles of second IVIG infusion, corticosteroids, calcineurin inhibitors, interleukin-1 antagonists and anti-tumor necrosis factor agents remain uncertain. In this review, we highlight the predisposing factors, pathogenesis and therapeutic intervention of KD, particularly new therapeutics for IVIG-resistant patients.


SARS Transmission and Commercial Aircraft


Reproductive health in the time of SARS‐CoV‐2


title: Rapid Molecular Tests for Influenza, Respiratory Syncytial Virus, and Other Respiratory Viruses: A Systematic Review of Diagnostic Accuracy and Clinical Impact Studies

text: We systematically reviewed available evidence from Embase, Medline, and the Cochrane Library on diagnostic accuracy and clinical impact of commercially available rapid (results <3 hours) molecular diagnostics for respiratory viruses as compared to conventional molecular tests. Quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies criteria for diagnostic test accuracy (DTA) studies, and the Cochrane Risk of Bias Assessment and Risk of Bias in Nonrandomized Studies of Interventions criteria for randomized and observational impact studies, respectively. Sixty-three DTA reports (56 studies) were meta-analyzed with a pooled sensitivity of 90.9% (95% confidence interval [CI], 88.7%–93.1%) and specificity of 96.1% (95% CI, 94.2%–97.9%) for the detection of either influenza virus (n = 29), respiratory syncytial virus (RSV) (n = 1), influenza virus and RSV (n = 19), or a viral panel including influenza virus and RSV (n = 14). The 15 included impact studies (5 randomized) were very heterogeneous and results were therefore inconclusive. However, we suggest that implementation of rapid diagnostics in hospital care settings should be considered.


docid: juqsjfhd

title: Recomendaciones De La Sociedad Española De Cirugía Cardiovascular Y Endovascular Ante La Pandemia Covid-19

text: Resumen Ante el contexto sanitario de Pandemia por COVID-19, la Sociedad Española de Cirugía Cardiovascular y Endovascular (SECCE) asume la obligación de elaborar y transmitir una serie de Recomendaciones que permitan asegurar una adecuada cobertura sanitaria de la población, al mismo tiempo que se minimice la exposición y el riesgo de contagio tanto de pacientes como de profesionales. Para ello, y dentro del marco global que formulan las instrucciones del Ministerio de Sanidad, Consejería de Sanidad y Direcciones-Gerencia de cada uno de los centros sanitarios, debe organizarse un plan de contingencia de los distintos servicios de Cirugía Cardiovascular. Este plan de contingencia debe mantener el correcto funcionamiento de los servicios de Cirugía Cardiovascular, asegurando el adecuado cumplimiento de las siguientes dimensiones asistenciales: a) La correcta atención de los pacientes urgentes y emergentes. b) La elaboración de una lista de pacientes preferentes y criterios temporales de tratamiento. c) La demora justificada y segura de aquellos pacientes de tratamiento electivo cuya patología y situación clínica lo permitan. d) La aplicación concreta de los programas de ECMO en el contexto COVID-19. Abstract In the actual COVID-19 Pandemic, the Spanish Society of Cardiovascular and Endovascular Surgery (SECCE) assumes the obligation to elaborate special recommendations that ensure an adequate health care of population, while minimizing the exposure and the risk of contagion for both patients and professionals. For that reason, Cardiovascular Surgery Departments need to develop a functional plan of contingency within the global framework formulated by the instructions of the Ministry of Health and hospital authorities. The aim of this strategy is the proper functioning of Cardiovascular Surgery Departments: a) Correct care for urgent and emerging patients. b) The preparation of a list of preferred patients and temporary treatment criteria. c) The justified and safe delay of elective patients if their pathology and clinical situation allow it. d) The concrete application of ECMO programs in the COVID-19 context.


title: Novel picornavirus in domestic rabbits (Oryctolagus cuniculus var. domestica)

text: Abstract Picornaviruses (family Picornaviridae) are small, non-enveloped viruses with positive sense, single-stranded RNA genomes. The numbers of the novel picornavirus species and genera are continuously increasing. Picornaviruses infect numerous vertebrate species from fish to mammals, but have not been identified in a member of the Lagomorpha order (pikas, hares and rabbits). In this study, a novel picornavirus was identified in 16 (28.6%) out of 56 faecal samples collected from clinically healthy rabbits (Oryctolagus cuniculus var. domestica) in two (one commercial and one family farms) of four rabbit farms in Hungary. The 8364 nucleotide (2486 amino acid) long complete genome sequence of strain Rabbit01/2013/HUN (KT325852) has typical picornavirus genome organization with type-V IRES at the 5′UTR, encodes a leader (L) and a single 2AH-box/NC proteins, contains a hepatitis-A-virus-like cis-acting replication element (CRE) in the 2A, but it does not contain the sequence forming a “barbell-like” secondary structure in the 3′UTR. Rabbit01/2013/HUN has 52.9%, 52% and 57.2% amino acid identity to corresponding proteins of species Aichivirus A (genus Kobuvirus): to murine Kobuvirus (JF755427) in P1, to canine Kobuvirus (JN387133) in P2 and to feline Kobuvirus (KF831027) in P3, respectively. The sequence and phylogenetic analysis indicated that Rabbit01/2013/HUN represents a novel picornavirus species possibly in genus Kobuvirus. This is the first report of detection of picornavirus in rabbit. Further study is needed to clarify whether this novel picornavirus plays a part in any diseases in domestic or wild rabbits.


title: Therapy and Long-Term Prophylaxis of Vaccinia Virus Respiratory Infections in Mice with an Adenovirus-Vectored Interferon Alpha (mDEF201)

text: An adenovirus 5 vector encoding for mouse interferon alpha, subtype 5 (mDEF201) was evaluated for efficacy against lethal vaccinia virus (WR strain) respiratory infections in mice. mDEF201 was administered as a single intranasal treatment either prophylactically or therapeutically at doses of 10(6) to 10(8) plaque forming units/mouse. When the prophylactic treatment was given at 56 days prior to infection, it protected 90% of animals from death (100% protection for treatments given between 1–49 days pre-infection), with minimal weight loss occurring during infection. Surviving animals re-challenged with virus 22 days after the primary infection were protected from death, indicating that mDEF201 did not compromise the immune response against the initial infection. Post-exposure therapy was given between 6–24 h after vaccinia virus exposure and protection was afforded by a 10(8) dose of mDEF201 given at 24 h, whereas a 10(7) dose was effective up to 12 h. Comparisons were made of the ability of mDEF201, given either 28 or 1 day prior to infection, to inhibit tissue virus titers and lung infection parameters. Lung, liver, and spleen virus titers were inhibited to nearly the same extent by either treatment, as were lung weights and lung hemorrhage scores (indicators of pneumonitis). Lung virus titers were significantly (>100-fold) lower than in the placebo group, and the other infection parameters in mDEF201 treated mice were nearly at baseline. In contrast, viral titers and lung infection parameters were high in the placebo group on day 5 of the infection. These results demonstrate the long-acting prophylactic and treatment capacity of mDEF201 to combat vaccinia virus infections.


title: General Practitioner satisfaction with a radiographer-led general radiography reporting service at a district general hospital in the UK

text: INTRODUCTION: To evaluate General Practitioner (GP) satisfaction with a radiographer-led general radiography reporting service in a single district general hospital in order to identify areas for improvement. METHODS: A mixed method online survey was created and distributed to all GP surgeries in the catchment area of the hospital with a 6 week response period. RESULTS: Although the majority of GPs are satisfied with the service they receive, there were areas for improvement. Key areas included methods of contacting radiology department with queries, report content/terminology and recommendations for follow-up. CONCLUSIONS: Although the majority of GPs are happy for radiographers to report imaging examinations some resistance was encountered, particularly with regards to chest reporting. Recommendations are made for improvements designed to address these issues. IMPLICATIONS FOR PRACTICE: This article is one of the first in the UK to assess GP satisfaction with general X-ray reporting services. As the majority of GP reporting in the UK is now completed by radiographers, the results will allow reporting teams to tailor their service, in order to improve outcomes for both commissioners and patients.


title: Laboratory and Postmortem Diagnosis of Bovine Respiratory Disease

text: Pathologic and laboratory investigations are essential when identification of the specific cause of bovine respiratory disease is needed. Considerations for planning a diagnostic investigation include the goals of the inquiry, the potential impact of the diagnosis, the plausible causes based on the clinical and epidemiologic appearance, and the relative merits of the available diagnostic strategies. This review uses 4 cases to outline different approaches to laboratory diagnosis. The postmortem examination is described, along with the patterns and gross appearance of lesions, considerations for effective sampling from appropriately selected animals, and reasons for discrepant or negative laboratory test results.


title: Psoralea corylifolia L: Ethnobotanical, biological, and chemical aspects: A review

text: Psoralea corylifolia L. (Leguminosae) is a well‐known traditional medicinal plant used from ancient times for treatment of various ailments. It is widely distributed and an important part of therapeutics in Ayurveda and in Chinese medicines. The aim of this review is to present comprehensive and most up to date report on its ethnobotanical, ethnopharmacological, clinical, phytochemical, and side effects. Studies on the ethnobotanical, ethnopharmacological, clinical, phytochemical, and side effects of P. corylifolia were published until year 2017 and were searched using various scientific databases. The scientific literature searched revealed that these plant species has been extensively investigated in vivo and in vitro for various biological and phytochemical studies. It has cardiotonic, vasodilator, pigmentor, antitumor, antibacterial, cytotoxic, and anti‐helminthic properties and locally used for alopecia, inflammation, leukoderma, leprosy, psoriasis, and eczema. So far, about a hundred bioactive compounds have been isolated from seeds and fruits, and most important compounds identified belongs to coumarins, flavonoids, and meroterpenes groups. This review article summarized the most updated scientific literature on bioactive phytochemical and biological activities of P. corylifolia. This article will be a useful addition to providing information for future research, and more standard clinical trials are needed for the plant to be used as therapeutic agent.


“Building the plane as you fly”: Simulation during the COVID-19 pandemic


title: Anaesthesia and COVID-19: infection control

text: Summary The world is currently facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogen is spread by human-to-human transmission via droplets exposure and contact transfer, causing mild symptoms in the majority of cases, but critical illness, bilateral viral pneumonia, and acute respiratory distress syndrome (ARDS) in a minority. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary public healthcare intervention used. The pace of transmission and global scale of SARS-CoV-2 infections has implications for strategic oversight, resource management, and responsiveness in infection control. This article presents a summary of learning points in epidemiological infection control from the SARS epidemic, alongside a review of evidence connecting current understanding of the virologic and environmental contamination properties of SARS-CoV-2. We present suggestions for how personal protective equipment policies relate to the viral pandemic context and how the risk of transmission by and to anaesthetists, intensivists, and other healthcare workers can be minimised.


Sometimes less is worse: an advise against non-intubated video-assisted thoracoscopy during COVID-19 pandemia


docid: bfftrrss

title: Hospital biopreparedness in the Looming Presence of SARS‐CoV‐2/COVID‐19


title: Chapter Ten The localization and migration of natural killer cells in health and disease

text: Publisher Summary Natural killer (NK) cells comprise a finite lymphocyte lineage with distinctive gene expression patterns. Natural killer (NK) cells develop in the bone marrow (BM) and are not static but populate secondary and primary lymphoid organs. A unique feature of NK cells is their expression of activating and inhibitory receptors, which allow them to respond either when ligands for activating receptors are upregulated or when ligands for inhibitory receptors are downregulated. The unique transcriptome of NK cells renders them capable of protecting the host from a vast array of disease states. Their undisputed importance in host protection is conferred by their ability to eliminate unhealthy cells. However, in order for NK cells to exert their effects, they need to be strategically located at the right places. This chapter provides an overview of the current understanding of the localization of NK cell populations and their ability to migrate in response to homeostatic and pathological conditions. NK cells develop in the BM, which they exit using specific molecular interactions. Exit from the BM is followed by localization to a number of tissues, including secondary lymphoid organs. Within each tissue, NK cells often acquire unique function and phenotype that is regulated by the local microenvironment. Their localization is primarily directed by the action of chemokines and therefore is in tight association with the activation status of the organism. Changes in chemokine expression during disease results in further NK cell mobilization and allows them to protect the host from infection and malignancy. Thus, from their time of production until their end, NK cells travel exhaustively over long distances and visit places that influence their already dynamic life.


title: Determination of sialic acids in immune system cells (coelomocytes) of sea urchin, Paracentrotus lividus, using capillary LC-ESI-MS/MS

text: Abstract Coelomocytes are considered to be immune effectors of sea urchins. Coelomocytes are the freely circulating cells in the body fluid contained in echinoderm coelom and mediate the cellular defence responses to immune challenges by phagocytosis, encapsulation, cytotoxicity and the production of antimicrobial agents. Coelomocytes have the ability to recognize self from non-self. Considering that sialic acids play important roles in immunity, we determined the presence of sialic acid types in coelomocytes of Paracentrotus lividus. Homogenized coelomocytes were kept in 2 M aqueous acetic acid at 80 °C for 3 h to liberate sialic acids. Sialic acids were determined by derivatization with 1,2-diamino-4,5-methylenediaoxy-benzene dihydrochloride (DMB) followed by capillary liquid-chromatography-electrospray ionization/tandem mass spectrometry (CapLC-ESI-MS/MS). Standard sialic acids; Neu5Ac, Neu5Gc, KDN and bovine submaxillary mucin showing a variety of sialic acids were used to confirm sialic acids types. We found ten different types of sialic acids (Neu5Gc, Neu5Ac, Neu5Gc9Ac, Neu5Gc8Ac, Neu5,9Ac2, Neu5,7Ac2, Neu5,8Ac2, Neu5,7,9Ac3, Neu5Gc7,9Ac2, Neu5Gc7Ac) isolated in limited amounts from total coelomocyte population. Neu5Gc type of sialic acids in coelomocytes was the most abundant type sialic acid when compared with other types. This is the first report on the presence of sialic acid types in coelomocytes of P. lividus using CapLC-ESI-MS/MS-Ion Trap system (Capillary Liquid Chromatography-Electrospray Ionization/Tandem Mass Spectrometry).


title: Modified-live PRRSV subtype 1 vaccine UNISTRAIN(®) PRRS provides a partial clinical and virological protection upon challenge with East European subtype 3 PRRSV strain Lena

text: BACKGROUND: Western European porcine reproductive and respiratory syndrome virus (PRRSV) strains cause limited and mild clinical signs whereas more virulent strains are circulating in Eastern Europe. The emergence of such highly virulent strains in Western Europe might result in severe clinical problems and a financial disaster. In this context, the efficacy of the commercial modified-live PRRSV subtype 1 vaccine UNISTRAIN(®) PRRS was tested upon challenge with the East European subtype 3 PRRSV strain Lena. RESULTS: The mean duration of fever was shortened and the number of fever days was significantly lower in vaccinated pigs than in control pigs. Moreover, a lower number of vaccinated animals showed fever, respiratory disorders and conjunctivitis. The mean virus titers in the nasal secretions post challenge (AUC) were significantly lower in the vaccinated group than in the control group. The duration of viremia was slightly shorter (not significantly different) in the vaccinated group as compared to the control group. CONCLUSIONS: Vaccination of pigs with the modified-live vaccine UNISTRAIN(®) PRRS provides a partial clinical and virological protection against the PRRSV subtype 3 strain Lena.


title: Human metapneumovirus - what we know now

text: Human metapneumovirus (HMPV) is a leading cause of acute respiratory infection, particularly in children, immunocompromised patients, and the elderly. HMPV, which is closely related to avian metapneumovirus subtype C, has circulated for at least 65 years, and nearly every child will be infected with HMPV by the age of 5. However, immunity is incomplete, and re-infections occur throughout adult life. Symptoms are similar to those of other respiratory viral infections, ranging from mild (cough, rhinorrhea, and fever) to more severe (bronchiolitis and pneumonia). The preferred method for diagnosis is reverse transcription-polymerase chain reaction as HMPV is difficult to culture. Although there have been many advances made in the past 16 years since its discovery, there are still no US Food and Drug Administration-approved antivirals or vaccines available to treat HMPV. Both small animal and non-human primate models have been established for the study of HMPV. This review will focus on the epidemiology, transmission, and clinical manifestations in humans as well as the animal models of HMPV pathogenesis and host immune response.


title: Infectious disease screening among stem cell transplant donors: An Institutional experience in Saudi Arabia

text: BACKGROUND: Hematopoietic stem cell transplantation (HSCT) involves the infusion of hematopoietic stem cells from a suitable donor to a patient who has undergone chemotherapy. Stem Cell transplantation is used for the treatment for a wide variety of diseases, including leukemia and lymphoma. PURPOSE: This study highlights prevention strategies of infectious diseases among HSCT donors and recipients in our institute as guided by International guidelines. We aim to highlight the strategy for extensive screening of HIV, Hepatitis B and C, CMV infection and syphilis cases in all the stem cell units stored in our facility METHODS: We searched the institutional database to identify cases of infectious diseases among HSC transplants. Extensive donor evaluation was conducted through screening and laboratory infectious disease testing for HIV, Hepatitis B and C, CMV infection and syphilis. RESULTS: Between 1996 and 2014, 263 consecutive adult HSCT were performed. An approximate equal number of autologous and allogeneic HSC collections were undertaken. The median age for autologous donors was 35 years, whereas that of allogeneic donors is 25 years. Of the 263 stem cell donors, we found 18 patients (autologous) and 2 donors (allogeneic) to be infected. We did not find any of the donors infected with HIV by the serology as well as the NAT testing protocol CONCLUSION: Donor screening and testing is the most critical parameter in stem cell transplantation in order to ensure the safety of the product to be transplanted. Modifications in the regulations related to donor screening are aimed at providing safe transplantation and negate the risk of accidental infection of the donor.


title: Medical Anthropology

text: Abstract Medical anthropology is an interdisciplinary subfield of anthropology with a long history of research on environmental health-related issues, especially those pertaining to human health within environments of risk, consequences of ecological degradation, and the way patterns of development and globalization impact environmental (and therefore human) health. In this article, the authors provide an introduction to the scope of medical anthropology research, its relevance to the field of environmental health, and the methods anthropologists use in their analyses. They conclude by elaborating on some of the key conceptual frameworks that guide current research and highlight topical areas in environmental health (broadly defined) where medical anthropology research is warranted.


title: Quarantine Stressing Voluntary Compliance

text: A 1-day table-top exercise in San Diego, California, in December 2004 emphasized voluntary compliance with home quarantine to control an emerging infectious disease outbreak. The exercise heightened local civilian-military collaboration in public health emergency management. Addressing concerns about lost income by residents in quarantine was particularly challenging.


title: Stroke in patients with SARS-CoV-2 infection: case series

text: BACKGROUND: Italy is one of the most affected countries by the coronavirus disease 2019 (COVID-19). The responsible pathogen is named severe acute respiratory syndrome coronavirus (SARS-CoV-2). The clinical spectrum ranges from asymptomatic infection to severe pneumonia, leading to intensive care unit admission. Evidence of cerebrovascular complications associated with SARS-CoV-2 is limited. We herein report six patients who developed acute stroke during COVID-19 infection. METHODS: A retrospective case series of patients diagnosed with COVID-19 using reverse-transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs, who developed clinical and neuroimaging evidence of acute stroke during SARS-CoV-2 infection. RESULTS: Six patients were identified (5 men); median age was 69 years (range 57–82). Stroke subtypes were ischemic (4, 67%) and hemorrhagic (2, 33%). All patients but one had pre-existing vascular risk factors. One patient developed encephalopathy prior to stroke, characterized by focal seizures and behavioral abnormalities. COVID-19-related pneumonia was severe (i.e., requiring critical care support) in 5/6 cases (83%). Liver enzyme alteration and lactate dehydrogenase (LDH) elevation were registered in all cases. Four patients (67%) manifested acute kidney failure prior to stroke. Four patients (67%) had abnormal coagulation tests. The outcome was poor in the majority of the patients: five died (83%) and the remaining one (17%) remained severely neurologically affected (mRS: 4). CONCLUSIONS: Both ischemic and hemorrhagic stroke can complicate the course of COVI-19 infection. In our series, stroke developed mostly in patients with severe pneumonia and multiorgan failure, liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.


title: New insights into the evolutionary features of viral overlapping genes by discriminant analysis

text: Abstract Overlapping genes originate by a mechanism of overprinting, in which nucleotide substitutions in a pre-existing frame induce the expression of a de novo protein from an alternative frame. In this study, I assembled a dataset of 319 viral overlapping genes, which included 82 overlaps whose expression is experimentally known and the respective 237 homologs. Principal component analysis revealed that overlapping genes have a common pattern of nucleotide and amino acid composition. Discriminant analysis separated overlapping from non-overlapping genes with an accuracy of 97%. When applied to overlapping genes with known genealogy, it separated ancestral from de novo frames with an accuracy close to 100%. This high discriminant power was crucial to computationally design variants of de novo viral proteins known to possess selective anticancer toxicity (apoptin) or protection against neurodegeneration (X protein), as well as to detect two new potential overlapping genes in the genome of the new coronavirus SARS-CoV-2.


title: Priming T-cell responses with recombinant measles vaccine vector in a heterologous prime-boost setting in non-human primates

text: Licensed live attenuated virus vaccines capable of expressing transgenes from other pathogens have the potential to reduce the number of childhood immunizations by eliciting robust immunity to multiple pathogens simultaneously. Recombinant attenuated measles virus (rMV) derived from the Edmonston Zagreb vaccine strain was engineered to express simian immunodeficiency virus (SIV) Gag protein for the purpose of evaluating the immunogenicity of rMV as a vaccine vector in rhesus macaques. rMV-Gag immunization alone elicited robust measles-specific humoral and cellular responses, but failed to elicit transgene (Gag)-specific immune responses, following aerosol or intratracheal/intramuscular delivery. However, when administered as a priming vaccine to a heterologous boost with recombinant adenovirus serotype 5 expressing the same transgene, rMV-Gag significantly enhanced Gag-specific T lymphocyte responses following rAd5 immunization. Gag-specific humoral responses were not enhanced, however, which may be due to either the transgene or the vector. Cellular response priming by rMV against the transgene was highly effective even when using a suboptimal dose of rAd5 for the boost. These data demonstrate feasibility of using rMV as a priming component of heterologous prime-boost vaccine regimens for pathogens requiring strong cellular responses.