title: Prevalence and Demographic Correlates of Poor Sleep Quality Among Frontline Health Professionals in Liaoning Province, China During the COVID-19 Outbreak

text: BACKGROUND: Little empirical evidence is known about the sleep quality of frontline health professionals working in isolation units or hospitals during the novel coronavirus disease (COVID-19) outbreak in China. This study thus aimed to examine the prevalence of poor sleep quality and its demographic and correlates among frontline health professionals. METHODS: This is a multicenter, cross-sectional survey conducted in Liaoning province, China. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). RESULTS: A total of 1,931 frontline health professionals were recruited. The prevalence of poor sleep quality was 18.4% (95%CI: 16.6%–20.11%). Multivariate logistic regression analysis found that older age (OR=1.043, 95%CI=1.026–1.061, P < 0.001), being nurse (OR=3.132, 95%CI=1.727–5.681, P < 0.001), and working in outer emergency medical team (OR=1.755, 95%CI=1.029–3.064, P=0.039) were positively associated with poor sleep quality. Participants who were familiar with crisis response knowledge were negatively associated with poor sleep quality (OR=0.70, 95%CI=0.516–0.949, P=0.021). CONCLUSION: The prevalence of poor sleep quality was relatively low among frontline health professionals during the COVID-19 epidemic. Considering the negative impact of poor sleep quality on health professionals’ health outcomes and patient outcomes, regularly screening and timely treatments are warranted to reduce the likelihood of poor sleep quality in health professionals.


title: The NS1 protein of H5N6 feline influenza virus inhibits feline beta interferon response by preventing NF-κB and IRF3 activation

text: Abstract Despite the apparent lack of a feline influenza virus lineage, cats are susceptible to infection by influenza A viruses. Here, we characterized in vitro A/feline/Guangdong/1/2015, an H5N6 avian influenza virus recently isolated from cats. A/feline/Guangdong/1/2015 replicated to high titers and caused CPE in feline kidney cells. We determined that infection with A/feline/Guangdong/1/2015 did not activate the IFN-β promoter, but inhibited it by blocking the activation of NF-κB and IRF3. We also determined that the viral NS1 protein mediated the block, and that the dsRNA binding domain of NS1 was essential to perform this function. In contrast to treatment after infection, cells pretreated with IFN-β suppressed viral replication. Our findings provide an example of an H5N6 influenza virus suppressing IFN production, which might be associated with interspecies transmission of avian influenza viruses to cats.


title: Characteristics of flavonoids as potent MERS‐CoV 3C‐like protease inhibitors

text: Middle East respiratory syndrome‐coronavirus (MERS‐CoV) is a zoonotic virus transmitted between animals and human beings. It causes MERS with high mortality rate. However, no vaccine or specific treatment is currently available. Since antiviral activity of some flavonoids is known, we applied a flavonoid library to probe inhibitory compounds against MERS‐CoV 3C‐like protease (3CLpro). Herbacetin, isobavachalcone, quercetin 3‐β‐d‐glucoside and helichrysetin were found to block the enzymatic activity of MERS‐CoV 3CLpro. The binding of the four flavonoids was also confirmed independently using a tryptophan‐based fluorescence method. The systematic comparison of the binding affinity of flavonoids made it possible to infer their scaffolds and functional groups required to bind with MERS‐CoV 3CLpro. An induced‐fit docking analysis revealed that S1 and S2 sites play a role in interaction with flavonoids. The experimental and computational study showed that flavonol and chalcone are favourite scaffolds to bind with the catalytic site of MERS‐CoV 3CLpro. It was also deduced that some flavonoid derivatives with hydrophobic or carbohydrate attached to their core structures have a good inhibitory effect. Therefore, we suggest that flavonoids with these characteristics can be used as templates to develop potent MERS‐CoV 3CLpro inhibitors.


title: Emerging challenges in the design of selective substrates, inhibitors and activity‐based probes for indistinguishable proteases

text: Proteases are enzymes that hydrolyze the peptide bond of peptide substrates and proteins. Despite significant progress in recent years, one of the greatest challenges in the design and testing of substrates, inhibitors and activity‐based probes for proteolytic enzymes is achieving specificity toward only one enzyme. This specificity is particularly important if the enzyme is present with other enzymes with a similar catalytic mechanism and substrate specificity but completely different functionality. The cross‐reactivity of substrates, inhibitors and activity‐based probes with other enzymes can significantly impair or even prevent investigations of a target protease. In this review, we describe important concepts and the latest challenges, focusing mainly on peptide‐based substrate specificity techniques used to distinguish individual enzymes within major protease families.


STAFF AND PATIENTS’ PROTECTION IN RADIATION ONCOLOGY DEPARTMENTS DURING COVID-19 PANDEMIC


title: South Korea’s COVID-19 Infection Status: From the Perspective of Re-positive Test Results After Viral Clearance Evidenced by Negative Test Results

text: Coronavirus disease (COVID-19) started to occur in South Korea by means of inflow of the virus from abroad, when a case from Wuhan, China, was first confirmed on January 19, 2020. Although South Korea has drastically reduced the number of new confirmed cases and is stabilizing the situation with its exemplary disease prevention policies, there remains a problem. These are cases that had shown negative results to polymerase chain reaction (PCR) (gene amplification) tests as the COVID-19 virus had become undetectable but turned re-positive after a short period. The Central Clinical Committee determined that these re-positive cases after COVID-19 viral clearance are due to the limits of the test method; it is considered that the genetic material of the “dead virus” remaining in a recovered patient’s body is amplified during the test process. Comprehending the above evidence, re-positive cases of COVID-19 are not infectious; the virus is not even reactivated. However, further research is required as we lack research results on this subject. Until we can be sure, social distancing and other such policies should be maintained.


title: Physiological advantages of children against COVID‐19

text: We read the editorial by Dr. Brodin with great interest, which is discussing why COVID-19 appears to be so mild in children(1). The author discussed the potential theories that could explain why children have a lower incidence and milder clinical manifestations than adults. Additionally to the theories mentioned by the author; we would like to emphasize the differences between the child and adult respiratory systems that potentially protect children from severe COVID-19 disease.


title: Analysis of the humoral immune responses among cynomolgus macaque naturally infected with Reston virus during the 1996 outbreak in the Philippines

text: BACKGROUND: Ebolaviruses induce lethal viral hemorrhagic fevers (VHFs) in humans and non-human primates, with the exceptions of Reston virus (RESTV), which is not pathogenic for humans. In human VHF cases, extensive analyses of the humoral immune responses in survivors and non-survivors have shown that the IgG responses to nucleoprotein (NP) and other viral proteins are associated with asymptomatic and survival outcomes, and that the neutralizing antibody responses targeting ebolaviruses glycoprotein (GP(1,2)) are the major indicator of protective immunity. On the other hand, the immune responses in non-human primates, especially naturally infected ones, have not yet been elucidated in detail, and the significance of the antibody responses against NP and GP(1,2) in RESTV-infected cynomolgus macaques is still unclear. In this study, we analyzed the humoral immune responses of cynomolgus macaque by using serum specimens obtained from the RESTV epizootic in 1996 in the Philippines to expand our knowledge on the immune responses in naturally RESTV-infected non-human primates. RESULTS: The antibody responses were analyzed using IgG-ELISA, an indirect immunofluorescent antibody assay (IFA), and a pseudotyped VSV-based neutralizing (NT) assay. Antigen-capture (Ag)-ELISA was also performed to detect viral antigens in the serum specimens. We found that the anti-GP(1,2) responses, but not the anti-NP responses, closely were correlated with the neutralization responses, as well as the clearance of viremia in the sera of the RESTV-infected cynomolgus macaques. Additionally, by analyzing the cytokine/chemokine concentrations of these serum specimens, we found high concentrations of proinflammatory cytokines/chemokines, such as IFNγ, IL8, IL-12, and MIP1α, in the convalescent phase sera. CONCLUSIONS: These results imply that both the antibody response to GP(1,2) and the proinflammatory innate responses play significant roles in the recovery from RESTV infection in cynomolgus macaques.


title: Describing the Chinese HIV Surveillance System and the Influences of Political Structures and Social Stigma

text: China’s public health surveillance system for HIV was established in late 1980s and has evolved significantly during the past three decades. With the gradually changing mode of HIV transmission from sharing of intravenous injecting equipment to sexual exposure and the rapid spread of HIV infection among Chinese homosexual men in recent years, an efficient and comprehensive population-level surveillance system for describing epidemics trends and risk behaviours associated with HIV acquisition are essential for effective public health interventions for HIV. The current review describes the overall strength of the Chinese HIV surveillance system and its structural weaknesses from a political and social perspective. The HIV surveillance system in China has undergone substantial revamping leading to a comprehensive, timely and efficient reporting system. However, large data gaps and lack of quality control and sharing of information obstruct the full performance of the system. This is largely due to fragmented authoritarianism brought about by the underlying political structure. Social stigma and discrimination in health institutes are also key barriers for further improvements of HIV diagnosis and surveillance in China.


title: Detection and molecular characterization of porcine toroviruses in Korea

text: This study examined the prevalence and genetic diversity of the porcine torovirus (PToV) in Korea. Of 295 samples, 19 (6.4%) samples tested positive for PToVs by RT-PCR. A low nucleotide sequence identity of the partial S gene was detected among the Korean PToVs (73.5%) and between the Korean and European PToVs (74.0%). Phylogenetic analysis of the spike and nucleocapsid genes showed that the Korean PToVs form distinct branches with clusters corresponding to the farm of origin, which were separate from the other known foreign PToVs. These findings suggest that genetically diverse Korean PToV strains cause sporadic infections in Korea. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00705-010-0595-2) contains supplementary material, which is available to authorized users.


title: Translational control by viral proteinases

text: Abstract Most RNA viruses have evolved strategies to regulate cellular translation in order to promote preferential expression of the viral genome. Positive strand RNA viruses express large portions, or all of their proteome via translation of large polyproteins that are processed by embedded viral proteinases or host proteinases. Several of these viral proteinases are known to interact with host proteins, particularly with the host translation machinery, and thus, encompass the dual functions of processing of viral polyproteins and exerting translation control. Picornaviruses are perhaps the best characterized in regards to interaction of their proteinases with the host translation machinery and will be emphasized here. However, new findings have shown that similar paradigms exist in other viral systems which will be discussed.


title: The Association of Cardiovascular Diseases and Diabetes Mellitus with COVID-19 (SARS-CoV-2) and Their Possible Mechanisms

text: Coronavirus disease 2019 (COVID-19) has become a global concern and public health issue due to its higher infection and mortality rate; particularly, the risk is very higher among the patients who have cardiovascular diseases (CVD) and/or diabetes mellitus (DM). In this review, we analyzed the recently published literature on CVD and DM associated with COVD-19 infections and highlight their association with potential mechanisms. The findings revealed that without any previous history of CVD, the COVID-19 patients have developed some CVD complications like myocardial injury, cardiomyopathy, and venous thromboembolism after being infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and required for those patients an emergency clinical support to be aware to manage those complications. Though the association between DM and COVID-19-induced severe complications is still unclear, the limited data predict that different markers like interleukin (IL)-1, IL-6, C-reactive protein, and D-dimer linked with the severity of COVID-19 infection in diabetic individuals. Further studies on a large scale are urgently needed to explore the underlying mechanisms between CVD, DM, and COVID-19 for better treatment.


Clinical Course and Physiotherapy Intervention in 9 patients with COVID-19


title: Absage von Impfungen wegen COVID-19

text: Infolge der Coronapandemie könnte es in Deutschland zu Impflücken kommen. Darauf deutet eine Befragung von 1.000 Menschen im Rahmen des COVID-19 Snapshot Monitoring (COSMO) hin, an dem sich u. a. das RKI beteiligt.


title: Human Coronavirus-NL63 infections in Korean children, 2004–2006

text: Abstract Background Human coronavirus-NL63 (HCoV-NL63) has been isolated from children with respiratory tract infections and its prevalence in Korea has not been reported. Objectives This study was designed to investigate the presence and the clinical features of HCoV-NL63 during two winter seasons. Study design During April 2004–April 2006, nasopharyngeal specimens from children hospitalized with acute respiratory disease were tested for common respiratory viruses, including RSV, influenza A, influenza B, parainfluenza viruses, and adenovirus by IFA. hMPV infection was excluded by nested RT-PCR using primers for F-gene. To detect HCoV-NL63, previously described nested PCR assays for 1a and 1b were used. PCR products of the 1a gene for HCoV-NL63 were sequenced. Results Out of 872 nasopharyngeal aspirate from children aged under 16 years, 14 (1.7%) were positive for HCoV-NL63. Most of the patients had croup (64.2%) or bronchiolitis (21.4%). The peak prevalence was found in November (28.5%). Most were collected between November 2004 and February 2005. Conclusions HCoV-NL63 may be one of the causative agents of acute respiratory tract infection, especially croup.


title: Antigenic structure of transmissible gastroenteritis virus nucleoprotein

text: Abstract A group of 11 monoclonal antibodies (MAbs) raised against transmissible gastroenteritis virus (TGEV) was used to study the antigenic structure of the virus nucleoprotein (N). To identify the regions recognized by MAbs, DNA fragments derived from the N-coding region of the TGEV strain FS772/70 were cloned into pUR expression plasmids and the antigenicity of the resulting fusion proteins was analyzed by immunobloting. A major antigenic domain was identified, covering the first 241 amino acid residues of N, within which an epitope (residues 57–117) was also found. A second antigenic domain extended from residues 175 to 360 of the nucleoprotein, within which a subsite was characterized within the region covering residues 241–349. MAb DA3 recognized a linear epitope which mapped within residues 360 and 382 at the carboxy terminus of the nucleoprotein. The binding of the majority of the MAbs (8 out of 11) to large fusions, but not to smaller fragments included in them, suggests a conformational dependence of the MAb binding sites. Our data show that the use of fusions in Western blot experiments is a useful approach to map not only linear epitopes but more complex antigenic structures found in the nucleoprotein of TGEV.


title: Affections de la rétine

text: Résumé Après un rappel des notions d’anatomie, de physiologie et l’énoncé des définitions qu’il est indispensable de connaître pour aborder l’étude de la pathologie rétinienne, les affections suivantes sont présentées dans les différentes espèces de mammifères domestiques (carnivores, équidés, ruminants et porcins) : dysplasie de la rétine (étiologie, pathogénie, symptômes et conduite à tenir sont décrits) ; dégénérescences des couches externes de la rétine d’origine héréditaire (l’étiologie et la pathogénie sont d’abord envisagées, les résultats fournis par l’examen clinique [symptômes fonctionnels, symptômes ophtalmoscopiques] et la conduite à tenir sont ensuite largement développés) ; rétinopathies acquises-choriorétinites (le développement et l’évolution des lésions sont comparables dans une même espèce, quelle qu’en soit l’étiologie ; les causes sont présentées ensuite en montrant les particularités en fonction des espèces : infectieuses et parasitaires, traumatiques, immuno-induites, hypertensives, tumorales ; la conduite à tenir est envisagée de façon synthétique) ; rétinopathies acquises-rétinopathies toxiques (elles sont iatrogènes ou accidentelles) ; rétinopathies acquises-rétinopathies nutritionnelles et métaboliques (les carences en vitamine E chez le chien, en taurine chez le chat, en vitamine A chez les bovins sont successivement envisagées) ; rétinopathies en relation avec d’autres affections oculaires ; syndrome de la rétine silencieuse chez le chien. Abstract After giving an outline of the knowledge required in the study of retinal diseases (anatomy, physiology, definitions), the followings in different mammalian species (dog and cat, horse, food animals) are described (retinal dysplasia: aetiology, pathogenesis, signs and what should be done when dealing with retinal dysplasia; inherited degenerations of external retinal layers (first aetiology and pathogenesis, then results of clinical examination - age of onset, search for visual impairment [midriasis and reflexes, visual behaviour], ophthalmoscopic findings - are described; finally how to detect a form of progressive retinal atrophy is summarized); acquired diseases of the retina (chorioretinis) (in a specy, the onset and the appearance of lesions depending on the stage of the disease are non specific relative to their causes, which are then listed in the different species: infections, parasites, trauma, immune-mediated diseases, systemic hypertension, neoplasia; fundamentals of diagnosis and treatment are finally presented); acquired diseases of the retina-toxic retinopathies: they are either iatrogenic or accidental; acquired diseases of the retina: nutritional and metabolic diseases such as vitamin E deficiency in the dog, taurine deficiency in the cat, vitamin A deficiency in cattle are succinctly studied; sudden acquired retinal degeneration in the dog is lastly described.


title: Beyond tropes: Towards a new image of nursing in the wake of COVID‐19

text: On 21st December 2019 the first cluster of patients with 'pneumonia of an unknown cause', which was subsequently identified as a coronavirus or 'Covid-19', were identified in Wuhan, China. As we now know the virus spread rapidly around the globe and on March 11th the World Health Organization (WHO) declared the virus a pandemic (BFPG, 2020). As we write, 201,315 deaths have been attributed to the virus internationally and there have been 2,844,712 confirmed cases (ECDC, 2020).


title: Manejo Emocional De La Crisis Sanitaria Ante El Coronavirus: Una Revisión Narrativa

text: Abstract Objective: To make a synthesis of the available scientific evidence in the emotional management of the declared health crisis in the face of coronavirus. Methods: A bibliographic search was made, without date limit, in Medline, CINAHL, PsycINFO, Scopus and Web of Science databases using the following keywords: "emotional management"; "health crisis" and "health crisis response". Initially; 73 studies were identified and; after selecting them according to eligibility criteria; 10 were included. Results: The main recommendations based on the available evidence indicate emotional management measures such as offering support groups to professionals, ensuring their social non-discrimination, strengthening their confidence and control capacity through training actions, as well as reinforcing the recognition of nurses by the community. Discussion and conclusions: The accumulated evidence comes from experience with previous outbreaks of SARS-CoV-1 and MERS-CoV. Stress was the most studied aspect, concerning issues such as social stigma, professionalism, intention to care, burnout, ethical conflicts, anxiety, depression or guilt. The emotional management of health crises in the face of the coronavirus requires an individual, collective, social and institutional strategy to reinforce security on all fronts and reduce fear through effective control measures using sufficient and adequate material and human resources.


title: Rhinovirus : des pathogènes sous-estimés chez les patients en période néonatale

text: Résumé Introduction Les récents développements des outils de diagnostic virologique ont permis d’identifier les entérovirus et rhinovirus (E/RV) plus aisément. Leur mise en évidence est très fréquente lors d’atteintes des voies aériennes chez l’enfant et leur causalité démontrée. La morbidité néonatale des infections à E/RV est méconnue, le manque de données épidémiologiques et cliniques empêche l’interprétation de tels résultats virologiques. Les objectifs de cette étude étaient d’évaluer en période néonatale la fréquence d’identification et l’expression clinique corrélée à l’identification d’E/RV. Matériel et méthodes Six années de résultats virologiques issus de prélèvements naso-pharyngés d’enfants à terme âgés de moins de 28jours et prématurés de moins de 28jours d’âge corrigé ont été colligées. Résultats Au cours de la période d’inclusion 4544 enfants ont été hospitalisés, 711 prélèvements ont été effectués dont 31 % ont identifié au moins un virus respiratoire. La fréquence globale d’identification d’E/RV a été de 1,9 % (0,8 % en néonatologie, 13 % en pédiatrie médicale) : 35 enfants en néonatologie (terme moyen : 35 semaines), 52 en pédiatrie médicale (terme moyen : 39 semaines). Les motifs du prélèvement virologique avaient été : une hypo-réactivité persistante (28 %), une température supérieure à 38°C (25 %), un malaise brutal (23 %), une bradycardie (20,5 %) et un changement de teint inexpliqué (20,5 %). L’identification virale positive avait été associée principalement à une symptomatologie respiratoire (rhinite : 74 %, toux : 35 %, désaturation : 32 %, tirage : 31 %) ou digestive (diminution des prises alimentaires : 59 %, régurgitations : 38 %, ballonnement abdominal : 24 %, vomissements en jet : 17 %). Une prise en charge en soin intensif néonatal ou en réanimation pédiatrique avait concerné 23 % de la cohorte. Une oxygénothérapie avait été nécessaire chez 24 % des enfants, une ventilation non invasive chez 11 % et une intubation trachéale chez 5 %. Une antibiothérapie avait été prescrite chez 36 des enfants (41 %) et une co-infection bactérienne avait été authentifiée chez 9 (10 %). Dans le service de néonatologie, une acquisition nosocomiale avait été suspectée chez 50 % des infections E/RV. Conclusion L’atteinte respiratoire haute bénigne par E/RV est classique, les infections néonatales à E/RV semblent pourtant corrélées à une morbidité marquée. Cette fréquence d’identification permet de souligner la sous-estimation de la transmission nosocomiale et l’importance de réévaluer les mesures de prévention dans ces secteurs. Nos résultats sont en faveur de la recherche des virus respiratoires, dont E/RV, lors d’une altération clinique inexpliquée en période néonatale ; une identification virale rapide serait susceptible de raccourcir une antibiothérapie souvent préemptive. Summary Introduction In recent years, developments in virological tools have led to the easy detection of rhinoviruses and enteroviruses (E/RV). Their detection is very frequent in cases of airway involvement in children and their demonstrated causality. But the morbidity of E/RV in the neonatal period is unknown due to lack of epidemiological data. The objective of this study was to evaluate the incidence and clinical characteristics of these infections in hospitalized neonates. Materials and methods We retrospectively analyzed the virology specimens of all neonates hospitalized at the Caen University Hospital between 2006 and 2011. Clinical characteristics were obtained from the charts. Results During the study period, 4544 infants aged less than 28 days were hospitalized: 4159 in the neonatal ward and 385 in the pediatric ward. Among these, 711 virology specimens were available, 31 % of which identified at least one virus. An E/RV was identified in 87 patients (1.9 % of the neonates admitted during the study period): 52 in the pediatric ward (13.5 % of 385), and 35 in the neonatal ward (0.8 % of 4159). The mean gestational age was 39 weeks in the pediatric cohort and 35 weeks in the neonatal cohort. The main indication for virological analysis was persistent drowsiness (28 %), temperature above 38°C (25 %), an apparently life-threatening event (23 %), bradycardia (20.5 %), and pallor (20.5 %). Respiratory symptoms associated with E/RV infection were coryza (74 %), cough (35 %), hypoxemia (32 %), accessory muscle use, and recession (31 %). Digestive symptoms were poor feeding (59 %), regurgitation (38 %), abdominal distension (24 %), and projectile vomiting (17 %). Twenty-three percent of the patients required admission to the neonatal ICU or pediatric ICU. Respiratory treatments included oxygen (24 % of 87 patients), continuous positive airway pressure (11 %), and ventilation (5 %). Antibiotics were prescribed in 41 % of the patients (46), but only 10 % (9) had an identified concomitant bacterial infection. In the neonatal department, nosocomial acquisition was suspected in 50 % of E/RV infections. Conclusion E/RV infections have a significant morbidity in neonates, and nosocomial transmission of the virus is underestimated. We recommend that respiratory viruses, including E/RV, be tested for in any unexplained signs in a neonate. Better identification of viruses might shorten the duration of unnecessary antibiotics.


Please cite this paper as: MacIntyre et al. (2011) A cluster randomized clinical trial comparing fit‐tested and non‐fit‐tested N95 respirators to medical masks to prevent respiratory virus infection in health care workers. Influenza and Other Respiratory Viruses DOI: 10.1111/j.1750‐2659.2010.00198.x. Background We compared the efficacy of medical masks, N95 respirators (fit tested and non fit tested), in health care workers (HCWs). Methods A cluster randomized clinical trial (RCT) of 1441 HCWs in 15 Beijing hospitals was performed during the 2008/2009 winter. Participants wore masks or respirators during the entire work shift for 4 weeks. Outcomes included clinical respiratory illness (CRI), influenza‐like illness (ILI), laboratory‐confirmed respiratory virus infection and influenza. A convenience no‐mask/respirator group of 481 health workers from nine hospitals was compared. Findings The rates of CRI (3·9% versus 6·7%), ILI (0·3% versus 0·6%), laboratory‐confirmed respiratory virus (1·4% versus 2·6%) and influenza (0·3% versus 1%) infection were consistently lower for the N95 group compared to medical masks. By intention‐to‐treat analysis, when P values were adjusted for clustering, non‐fit‐tested N95 respirators were significantly more protective than medical masks against CRI, but no other outcomes were significant. The rates of all outcomes were higher in the convenience no‐mask group compared to the intervention arms. There was no significant difference in outcomes between the N95 arms with and without fit testing. Rates of fit test failure were low. In a post hoc analysis adjusted for potential confounders, N95 masks and hospital level were significant, but medical masks, vaccination, handwashing and high‐risk procedures were not. Interpretation Rates of infection in the medical mask group were double that in the N95 group. A benefit of respirators is suggested but would need to be confirmed by a larger trial, as this study may have been underpowered. The finding on fit testing is specific to the type of respirator used in the study and cannot be generalized to other respirators. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN: ACTRN12609000257268 (http://www.anzctr.org.au).


title: Implementing a One Health approach to emerging infectious disease: reflections on the socio-political, ethical and legal dimensions

text: BACKGROUND: ‘One Health’ represents a call for health researchers and practitioners at the human, animal and environmental interfaces to work together to mitigate the risks of emerging and re-emerging infectious diseases (EIDs). A One Health approach emphasizing inter-disciplinary co-operation is increasingly seen as necessary for effective EID control and prevention. There are, however, socio-political, ethical and legal challenges, which must be met by such a One Health approach. DISCUSSION: Based on the philosophical review and critical analysis of scholarship around the theory and practice of One Health it is clear that EID events are not simply about pathogens jumping species barriers; they are comprised of complex and contingent sets of relations that involve socioeconomic and socio-political drivers and consequences with the latter extending beyond the impact of the disease. Therefore, the effectiveness of policies based on One Health depends on their implementation and alignment with or modification of public values. SUMMARY: Despite its strong motivating rationale, implementing a One Health approach in an integrated and considered manner can be challenging, especially in the face of a perceived crisis. The effective control and prevention of EIDs therefore requires: (i) social science research to improve understanding of how EID threats and responses play out; (ii) the development of an analytic framework that catalogues case experiences with EIDs, reflects their dynamic nature and promotes inter-sectoral collaboration and knowledge synthesis; (iii) genuine public engagement processes that promote transparency, education and capture people’s preferences; (iv) a set of practical principles and values that integrate ethics into decision-making procedures, against which policies and public health responses can be assessed; (v) integration of the analytic framework and the statement of principles and values outlined above; and (vi) a focus on genuine reform rather than rhetoric.


title: Hydroxychloroquine treatment in COVID‐19: a descriptive observational analysis of 30 cases from a single center in Wuhan, China

text: Hydroxychloroquine (HCQ) garnered scientific attention in early February following publication of reports showing in vitro activity of chloroquine (CQ) against COVID‐19. While studies are mixed on this topic, the therapeutic effect of HCQ or CQ still need more valid clinical evidence. In this descriptive observational study, we aimed to discuss the treatment response of HCQ in COVID‐19 infected patients and 30 cases were included. The demographic, treatment, laboratory parameters of C‐reactive protein (CRP) and interleukin‐6 (IL‐6) before and after HCQ therapy and clinical outcome in the 30 COVID‐19 patients were assessed. In order to evaluate the effect of mediation time point, we also divided these cases into two groups, patients began administrated with HCQ within 7 days hospital (defined as early delivery group) and 7 days after hospital (defined as later delivery group). We found that, the elevated IL‐6, a risk factor in severe patients were reduced to normal level after HCQ treatment. More importantly, patients treated with HCQ at the time of early hospital recovered faster than those who treated later or taken as second line choose for their obvious shorter hospitalization time. In summary, early use of HCQ was better than later use and the effect of IL‐6 and CRP level can not be ruled out. This article is protected by copyright. All rights reserved.


title: High diagnostic accuracy of the Sysmex XT‐2000iV delta total nucleated cells on effusions for feline infectious peritonitis

text: BACKGROUND: The ΔWBC (the ratio between DIFF and BASO counts of the Sysmex XT‐2000iV), hereafter defined as ΔTNC (total nucleated cells), is high in effusions due to feline infectious peritonitis (FIP), as cells are entrapped in fibrin clots formed in the BASO reagent. Similar clots form in the Rivalta's test, a method with high diagnostic accuracy for FIP. OBJECTIVES: The objective of this study was to determine the diagnostic accuracy for FIP and the optimal cutoff of ΔTNC. METHODS: After a retrospective search of our database, DIFF and BASO counts, and the ΔTNC from cats with and without FIP were compared to each other. Sensitivity, specificity, and positive and negative likelihood ratios (LR+, LR−) were calculated. A ROC curve was designed to determine the cutoff for best sensitivity and specificity. RESULTS: Effusions from 20 FIP and 31 non‐FIP cats were analyzed. The ΔTNC was higher (P < .001), and BASO and DIFF counts were lower (P < .001 and P < .05) in FIP than in non‐FIP cats. Only 2 FIP cats with atypical effusions had a ΔTNC < 3.0. The cutoff identified by the ROC curve (area under curve: 0.94; P < .001) was 1.7 (Sensitivity = 90.0%; Specificity = 93.53%; LR+ = 13.9; LR− = 0.1). A ΔTNC > 2.5 had 100% specificity. CONCLUSIONS: The ΔTNC has a high diagnostic accuracy for FIP‐related effusions by providing an estimate of precipitable proteins, as the Rivalta's test, in addition to the cell count. As fibrin clots result in false lower BASO counts, the ΔTNC is preferable to the WBC count generated by the BASO channel alone in suspected FIP effusions.


title: Grippe et voyage

text: Résumé Pour le voyageur, il existe un risque de contracter des maladies infectieuses pendant le voyage et de les introduire dans des régions non endémiques au retour. La grippe en fournit un exemple classique. L'incidence de la grippe chez les voyageurs reste mal connue. Nombre d'épidémies de grippe ont cependant été observées dans des groupes particuliers de voyageurs : voyages en groupe, pèlerinages, transports aériens et maritimes. Le troisième âge en voyage sur des bateaux de croisière constitue un groupe particulièrement à risque. La vaccination antigrippale n'est pas recommandée, à ce jour, pour les personnes voyageant à l'étranger en dehors de celles pour lesquelles cette mesure est normalement conseillée. La prévention vaccinale chez le voyageur est rendue difficile par les problèmes de délivrance du vaccin et l'inadéquation des souches vaccinales aux souches circulant dans l'hémisphère opposé. Cette vaccination semble cependant intéressante à titre individuel et collectif (vaccination altruiste) pour limiter la diffusion des souches grippales et le coût économique engendré par cette affection. Abstract There is a risk for the traveler to acquire an exotic disease when traveling and to introduce it in non-endemic areas after returning. Influenza is a good example of such a disease. The incidence of flu in travelers is unknown. However, numerous outbreaks of flu have been reported in groups of travelers: package tours, pilgrims, elderly people, and travel by plane or cruise ships. Nowadays vaccination against flu is not recommended in travelers unless they belong to groups at risk for flu. Nonetheless vaccination against flu is difficult to apply to travelers due to problems in vaccine availability and inadequacy between vaccine strains and strains responsible for ongoing outbreaks in the opposite hemisphere. This vaccination seems important to travelers because flu may impair their vacation. In addition, it is also interesting for the community if it limits the spread of flu worldwide.


Family in the Age of COVID‐19


OBJECTIVE: During the coronavirus pandemic (COVID-19), health care workers are innovating patient care and safety measures. Unfortunately, many of these are not properly tested for efficacy. The objective of this study was to determine the efficacy of the novel COVID-19 Airway Management Isolation Chamber (CAMIC) to contain and evacuate particulate. STUDY DESIGN: Multi-institutional proof-of-concept study. SETTING: Two academic institutions: Walter Reed National Military Medical Center (WRNMMC) and Madigan Army Medical Center (MAMC). SUBJECTS AND METHODS: Smoke, saline nebulizer, and simulated working port models were developed to assess the efficacy of the CAMIC to contain and remove ultrafine particles. Particulate counts were collected at set time intervals inside and outside the system. RESULTS: With the CAMIC on, smoke particulate counts inside the chamber significantly decreased over time: r(18) = −0.88, P < .001, WRNMMC; r(18) = −0.91, P < .001, MAMC. Similarly, saline nebulizer particulate counts inside the chamber significantly decreased over time: r(23) = −0.82, P < .001, WRNMMC; r(23) = −0.70, P < .001, MAMC. In the working port model, particulate counts inside the chamber significantly decreased over time: r(23) = −0.95, P < .001, WRNMMC; r(23) = −0.85, P < .001, MAMC. No significant leak was detected in the smoke, saline nebulizer, or working port model when the CAMIC was turned on. CONCLUSIONS: The CAMIC system appears to provide a barrier that actively removes particles from within the chamber and limits egress. Further studies are necessary to determine clinical applicability. The CAMIC may serve as an adjunct to improve health care worker safety and patient outcomes.


docid: vsinwqnr

title: Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations

text: Summary As coronavirus disease 2019 (COVID-19) spreads across the world, the intensive care unit (ICU) community must prepare for the challenges associated with this pandemic. Streamlining of workflows for rapid diagnosis and isolation, clinical management, and infection prevention will matter not only to patients with COVID-19, but also to health-care workers and other patients who are at risk from nosocomial transmission. Management of acute respiratory failure and haemodynamics is key. ICU practitioners, hospital administrators, governments, and policy makers must prepare for a substantial increase in critical care bed capacity, with a focus not just on infrastructure and supplies, but also on staff management. Critical care triage to allow the rationing of scarce ICU resources might be needed. Researchers must address unanswered questions, including the role of repurposed and experimental therapies. Collaboration at the local, regional, national, and international level offers the best chance of survival for the critically ill.


Endpoints used in phase III randomized controlled trials of treatment options for COVID-19


title: Prevalence of Multi-Resistant Microorganisms and Antibiotic Stewardship among Hospitalized Patients Living in Residential Care Homes in Spain: A Cross-Sectional Study

text: Antimicrobial resistance is a growing global health problem. Patients living in care homes are a vulnerable high-risk population colonized by multidrug-resistant organisms (MDRO). We identified a case series of 116 residents of care homes from a cohort of 540 consecutive patients admitted to the internal medicine service of our hospital. We performed early diagnostic tests of MDRO through anal exudates in our sample. The prevalence of MDRO colonization was 34.5% of residents and 70% of them had not been previously identified in the clinical records. Previous hospitalizations and in-hospital antibiotic administration were significantly associated with the presence of MDRO. Our results emphasize the need to consider care homes in the planning of regional and national infection control measures and for implementing surveillance systems that monitor the spread of antimicrobial resistance in Spain. Systematic early testing upon admission to hospital services with a high prevalence of patients with MDRO colonization (e.g., internal medicine) could contribute to the adoption of adequate prevention measures. Specific educational programs for care home staff should also be implemented to address this increasing problem.


title: The role of lipid rafts in cell entry of human metapneumovirus

text: Human metapneumovirus (hMPV) is a crucial pathogen in children. A cell entry is the first step for infection. Our previous study indicated that there was an endocytosis pathway for hMPV cell entry. Lipid raft is a specific structure at the cell surface and it has been demonstrated to play an important role in endocytosis process of many viruses. In this study, we investigated whether and how lipid raft can take part in the hMPV entry. The confocal microscope was used to detect colocalization of hMPV and lipid raft marker. We demonstrated that colocalizations were increased along with the viral infection and hMPV particles transferred to the perinuclear region with lipid raft. When specific lipid raft inhibitors: methyl‐β cyclodextrin and nystatin were used, hMPV cell entry was inhibited and viral titer decreased dramatically. With the replenishment of exogenous cholesterol, hMPV recovered quickly. These data suggest that lipid raft plays an important role in hMPV endocytosis and maybe one of the pathways for hMPV cell entry.


title: 4 Cell Entry of Enveloped Viruses

text: Abstract Enveloped viruses penetrate their cell targets following the merging of their membrane with that of the cell. This fusion process is catalyzed by one or several viral glycoproteins incorporated on the membrane of the virus. These envelope glycoproteins (EnvGP) evolved in order to combine two features. First, they acquired a domain to bind to a specific cellular protein, named “receptor.” Second, they developed, with the help of cellular proteins, a function of finely controlled fusion to optimize the replication and preserve the integrity of the cell, specific to the genus of the virus. Following the activation of the EnvGP either by binding to their receptors and/or sometimes the acid pH of the endosomes, many changes of conformation permit ultimately the action of a specific hydrophobic domain, the fusion peptide, which destabilizes the cell membrane and leads to the opening of the lipidic membrane. The comprehension of these mechanisms is essential to develop medicines of the therapeutic class of entry inhibitor like enfuvirtide (Fuzeon) against human immunodeficiency virus (HIV). In this chapter, we will summarize the different envelope glycoprotein structures that viruses develop to achieve membrane fusion and the entry of the virus. We will describe the different entry pathways and cellular proteins that viruses have subverted to allow infection of the cell and the receptors that are used. Finally, we will illustrate more precisely the recent discoveries that have been made within the field of the entry process, with a focus on the use of pseudoparticles. These pseudoparticles are suitable for high-throughput screenings that help in the development of natural or artificial inhibitors as new therapeutics of the class of entry inhibitors.


title: Antigenic relationship of the feline infectious peritonitis virus to coronaviruses of other species

text: Utilizing the direct and indirect fluorescent antibody procedure, the antigenic relationship of the feline infectious peritonitis virus (FIPV) to 7 other human and animal coronaviruses was studied. FIPV was found to be closely related to transmissible gastroenteritis virus (TGEV) of swine. Transmissible gastroenteritis virus and FIPV were in turn antigenically related to human coronavirus 229E (HCV-229E) and canine coronavirus (CCV). An interesting finding in the study was that the 8 coronaviruses selected for this study fell into one of two antigenically distinct groups. Viruses in each group were antigenically related to each other to varying degrees, but were antigenically unrelated to coronaviruses of the second group. The first antigenically related group was comprised of mouse hepatitis virus, type 3 (MHV-3), hemeagglutinating encephalomyelitis virus 67N (HEV-67N) of swine, calf diarrhea coronavirus (CDCV), and human coronavirus OC43 (HCV-OC43). The second antigenically related group was comprised of FIPV, TGEV, HCV-229E and CCV.


title: A major gene for host response to porcine reproductive and respiratory syndrome is not unfavorably associated with overall performance under nonchallenging conditions in commercial pig lines

text: A QTL for host response to porcine reproductive and respiratory syndrome (PRRS) was identified in a previous study. The SNP WUR10000125 (WUR) is used as a tag SNP for this QTL. The favorable (B) allele at this SNP is in low frequency in commercial populations, possibly because this allele is unfavorably associated with an important trait under nonchallenging conditions and, therefore, may have been selected against. Therefore, objectives of this study were to estimate the effect of WUR on traits under selection in commercial lines under nonchallenging conditions and to estimate the effect of WUR genotype of parents on performance of crossbred progeny in a commercial-like environment. Data were collected on 4 purebred lines: a Landrace dam line (D1), a Large White dam line (D2), a synthetic sire line (S1), and a Pietrain sire line (S2). Traits analyzed included total number born, number stillborn, farrowing survival, lactation survival, litter mortality, daily feed intake (DFI), backfat, average test daily gain (TGR), average lifetime daily gain (LGR), and Topigs Norsvin selection index (TSI) value, indicative of overall economic value. Deregressed EBV were calculated for each trait (except TSI) and analyzed within line. In the S1 line, AB and BB pigs had significantly lower TGR (P = 0.002) and LGR (P = 0.001) than AA pigs but also lower DFI (P = 0.004). Conversely, AB and BB pigs had significantly higher DFI (P < 0.001) and AB pigs had significantly higher TGR (P = 0.03) than AA pigs in the S2 line. The effect of WUR on TSI was not significant for any line (P ≥ 0.15). Analyses of phenotypic records collected on crossbred progeny of S1 sires and D1 × D2 F(1) females showed no significant effect of parent WUR genotype on DFI, backfat, TGR, or LGR (P ≥ 0.07). In conclusion, the effect of WUR was nonsignificant for most traits but the magnitude and direction of the effect differed by trait and by line. The favorable allele for host response to PRRS was associated with greater DFI and a tendency for greater TGR in the S2 line, but the opposite direction of effect was detected for the S1 line. Regardless of the effect on individual traits, no significant effect of WUR on TSI was detected for any line. Therefore, selecting for the B allele is expected to result in progeny with increased resistance to PRRS without compromising overall economic value under normal, nonchallenging conditions.


COVID-19 lockdowns throughout the world


docid: lclxrwcm

title: Novel Viral Vectored Vaccines for the Prevention of Influenza

text: Influenza represents a substantial global healthcare burden, with annual epidemics resulting in 3–5 million cases of severe illness with a significant associated mortality. In addition, the risk of a virulent and lethal influenza pandemic has generated widespread and warranted concern. Currently licensed influenza vaccines are limited in their ability to induce efficacious and long-lasting herd immunity. In addition, and as evidenced by the H1N1 pandemic in 2009, there can be a significant delay between the emergence of a pandemic influenza and an effective, antibody-inducing vaccine. There is, therefore, a continued need for new, efficacious vaccines conferring cross-clade protection—obviating the need for biannual reformulation of seasonal influenza vaccines. Development of such a vaccine would yield enormous health benefits to society and also greatly reduce the associated global healthcare burden. There are a number of alternative influenza vaccine technologies being assessed both preclinically and clinically. In this review we discuss viral vectored vaccines, either recombinant live-attenuated or replication-deficient viruses, which are current lead candidates for inducing efficacious and long-lasting immunity toward influenza viruses. These alternate influenza vaccines offer real promise to deliver viable alternatives to currently deployed vaccines and more importantly may confer long-lasting and universal protection against influenza viral infection.


title: Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology

text: Human coronaviruses (hCoVs) can be divided into low pathogenic and highly pathogenic coronaviruses. The low pathogenic CoVs infect the upper respiratory tract and cause mild, cold-like respiratory illness. In contrast, highly pathogenic hCoVs such as severe acute respiratory syndrome CoV (SARS-CoV) and Middle East respiratory syndrome CoV (MERS-CoV) predominantly infect lower airways and cause fatal pneumonia. Severe pneumonia caused by pathogenic hCoVs is often associated with rapid virus replication, massive inflammatory cell infiltration and elevated pro-inflammatory cytokine/chemokine responses resulting in acute lung injury (ALI), and acute respiratory distress syndrome (ARDS). Recent studies in experimentally infected animal strongly suggest a crucial role for virus-induced immunopathological events in causing fatal pneumonia after hCoV infections. Here we review the current understanding of how a dysregulated immune response may cause lung immunopathology leading to deleterious clinical manifestations after pathogenic hCoV infections.


The Cuyahoga Is Still Burning


docid: qqudzabo

title: Reorganizing a Medicine Residency Program in Response to the COVID-19 Pandemic in New York

text: The COVID-19 pandemic has been particularly severe in New York City, resulting in a rapid influx of patients into New York–Presbyterian Hospital/Columbia University Irving Medical Center. The challenges precipitated by this pandemic have required urgent changes to existing models of care. Internal medicine residents are at the forefront of caring for patients with COVID-19, including the critically ill. This article describes the exigent restructuring of the New York–Presbyterian Hospital/Columbia University Internal Medicine Residency Program. Patient care and educational models were fundamentally reconceptualized, which required a transition away from traditional hierarchical team structures and a significant expansion in the program’s capacity and flexibility to care for large numbers of patients with disproportionately high levels of critical illness. These changes were made while the residency program maintained the priorities of patient care and safety, resident safety and well-being, open communication, and education. The process of adapting the residency program to the demands of the pandemic was iterative given the unprecedented nature of this crisis. The goal of this article is to share the experiences and lessons learned from this crisis, communicate the solutions that were designed, and inform others who may be facing the prospect of creating similar disaster response measures.


title: The novel immunomodulatory biologic LMWF5A for pharmacological attenuation of the “cytokine storm” in COVID-19 patients: a hypothesis

text: BACKGROUND: A common complication of viral pulmonary infections, such as in the ongoing COVID-19 pandemic, is a phenomenon described as a “cytokine storm”. While poorly defined, this hyperinflammatory response results in diffuse alveolar damage. The low molecular weight fraction of commercial human serum albumin (LMWF5A), a novel biologic in development for osteoarthritis, demonstrates beneficial in vitro immunomodulatory effects complimentary to addressing inflammation, thus, we hypothesize that LMWF5A could improve the clinical outcomes of COVID-19 by attenuating hyperinflammation and the potential development of a cytokine storm. PRESENTATION OF THE HYPOTHESIS: A variety of human in vitro immune models indicate that LMWF5A reduces the production of pro-inflammatory cytokines implicated in cytokine storm associated with COVID-19. Furthermore, evidence suggests LMWF5A also promotes the production of mediators required for resolving inflammation and enhances the barrier function of endothelial cultures. TESTING THE HYPOTHESIS: A randomized controlled trial, to evaluate the safety and efficacy of nebulized LMWF5A in adults with Acute Respiratory Distress Syndrome (ARDS) secondary to COVID-19 infection, was developed and is currently under review by the Food and Drug Administration. IMPLICATIONS OF HYPOTHESIS: If successful, this therapy may attenuate the cytokine storm observed in these patients and potentially reduce mortality, increase ventilation free days, improve oxygenation parameters and consequently lessen the burden on patients and the intensive care unit. CONCLUSIONS: In conclusion, in vitro findings suggest that the immunomodulatory effects of LMWF5A make it a viable candidate for treating cytokine storm and restoring homeostasis to the immune response in COVID-19.


title: Decisions under uncertainty: a computational framework for quantification of policies addressing infectious disease epidemics

text: Emerging infectious diseases continue to place a strain on the welfare of the population by decreasing the population’s general health and increasing the burden on public health infrastructure. This paper addresses these issues through the development of a computational framework for modeling and simulating infectious disease outbreaks in a specific geographic region facilitating the quantification of public health policy decisions. Effectively modeling and simulating past epidemics to project current or future disease outbreaks will lead to improved control and intervention policies and disaster preparedness. In this paper, we introduce a computational framework that brings together spatio–temporal geography and population demographics with specific disease pathology in a novel simulation paradigm termed, global stochastic field simulation (GSFS). The primary aim of this simulation paradigm is to facilitate intelligent what-if-analysis in the event of health crisis, such as an influenza pandemic. The dynamics of any epidemic are intrinsically related to a region’s spatio–temporal characteristics and demographic composition and as such, must be considered when developing infectious disease control and intervention strategies. Similarly, comparison of past and current epidemics must include demographic changes into any effective public health policy for control and intervention strategies. GSFS is a hybrid approach to modeling, implicitly combining agent-based modeling with the cellular automata paradigm. Specifically, GSFS is a computational framework that will facilitate the effective identification of risk groups in the population and determine adequate points of control, leading to more effective surveillance and control of infectious diseases epidemics. The analysis of past disease outbreaks in a given population and the projection of current or future epidemics constitutes a significant challenge to Public Health. The corresponding design of computational models and the simulation that facilitates epidemiologists’ understanding of the manifestation of diseases represents a challenge to computer and mathematical sciences.


title: Safety of Plasma Infusions in Parkinson's Disease

text: BACKGROUND: Young plasma infusions have emerged as a potential treatment for neurodegenerative disease, and convalescent plasma therapy has been used safely in the management of viral pandemics. However, the effect of plasma therapy in Parkinson's disease (PD) is unknown. OBJECTIVES: The objective of this study was to determine the safety, tolerability, and feasibility of plasma infusions in people with PD. METHODS: A total of 15 people with clinically established PD, at least 1 cognitive complaint, and on stable therapy received 1 unit of young fresh frozen plasma twice a week for 4 weeks. Assessments and adverse effects were performed/reported on and off therapy at baseline, immediately after, and 4 weeks after the infusions ended. Adverse effects were also assessed during infusions. The primary outcomes were safety, tolerability, and feasibility. Exploratory outcomes included Unified Parkinson's Disease Rating Scale Part III off medication, neuropsychological battery, Parkinson's Disease Questionnaire‐39, inflammatory markers (tumor necrosis factor‐α, interleukin‐6), uric acid, and quantitative kinematics. RESULTS: Adherence rate was 100% with no serious adverse effects. There was evidence of improvement in phonemic fluency (P = 0.002) and in the Parkinson's Disease Questionnaire‐39 stigma subscore (P = 0.013) that were maintained at the delayed evaluation. Elevated baseline tumor necrosis factor‐α levels decreased 4 weeks after the infusions ended. CONCLUSIONS: Young fresh frozen plasma was safe, feasible, and well tolerated in people with PD, without serious adverse effects and with preliminary evidence for improvements in phonemic fluency and stigma. The results of this study warrant further therapeutic investigations in PD and provide safety and feasibility data for plasma therapy in people with PD who may be at higher risk for severe complications of COVID‐19. © 2020 The Authors. Movement Disorders published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society.


title: Attractiveness of an Aggregation Pheromone Lure and Chicken Droppings to Adults and Larvae of Alphitobius diaperinus (Coleoptera: Tenebrionidae)

text: The chemical cues by which lesser mealworm, Alphitobius diaperinus (Panzer) (Coleoptera: Tenebrionidae) beetles find each other are still unknown. Laboratory two-choice pitfall bioassays were conducted to evaluate the attractiveness of synthetic aggregation pheromone lure to lesser mealworm adults and larvae. All components of this synthetic aggregation pheromone lure, including: (R)-(+)-limonene, (E)-β-ocimene, (S)-(+)-linalool, (R)-(+)-daucene, and 2-nonanone were also tested singly. Chicken dropping volatile compounds and fresh chicken droppings (CD) were evaluated singly or in combination with the pheromone lure. In Arkansas, trapping experiments were conducted in different poultry houses with low, moderate, and high lesser mealworm populations to evaluate the attraction of pheromone lure. Laboratory two-choice pitfall bioassay was found to be a useful and convenient tool for evaluating the attractants before testing them in the poultry house. Greater attraction of adults and larvae to a dose of 20–30 μg pheromone lure was identified in laboratory two-choice pitfall bioassays. Adults and larvae were highly attractive to a combination of fresh CD and pheromone lure, whereas, a combination of chicken dropping volatile and pheromone lure was not significantly attractive. The low attraction of limonene and linalool in the laboratory two-choice pitfall bioassays suggest that either they are nonattractive or attractive only at a narrow range of concentrations. Higher numbers of lesser mealworm adults and larvae were found in traps treated with pheromone lure as compared with untreated controls in field experiments. Results indicate a potential for combining the pheromone lure with the attractive CD compounds to enhance trap efficacy.


Unequally vulnerable: a food justice approach to racial disparities in COVID-19 cases


title: Targeting of proteins to the Golgi apparatus

text: The proteins that reside in the Golgi carry out functions associated with post-translational modifications, including glycosylation and proteolytic processing, membrane transport, recycling of endoplasmic reticulum proteins and maintenance of the structural organisation of the organelle itself. The latter includes Golgi stacking, interconnections between stacks and the microtubule-dependent positioning of the organelle within the cell. There are a number of distinct groups of Golgi membrane proteins, including glycosyltransferases, recycling trans-Golgi network (TGN) proteins, peripheral membrane proteins and receptors. Considerable effort has been directed at understanding the basis of the localisation of Golgi glycosyltransferases and recycling TGN proteins; in both cases there is increasing evidence that multiple signals may be involved in their specific localisation. A number of models for the Golgi retention of glycosyltransferases have been proposed including oligomerisation, lipid-mediated sorting and intra-Golgi retrograde transport. More information is required to determine the contribution of each of these potential mechanisms in the targeting of different glycosyltransferases. Future work is also likely to focus on the relationship between the localisation of resident Golgi proteins and the maintenance of Golgi structure.


Ultrasound-guided interventions during the COVID-19 pandemic – a new challenge


title: KILchip v1.0: A Novel Plasmodium falciparum Merozoite Protein Microarray to Facilitate Malaria Vaccine Candidate Prioritization

text: Passive transfer studies in humans clearly demonstrated the protective role of IgG antibodies against malaria. Identifying the precise parasite antigens that mediate immunity is essential for vaccine design, but has proved difficult. Completion of the Plasmodium falciparum genome revealed thousands of potential vaccine candidates, but a significant bottleneck remains in their validation and prioritization for further evaluation in clinical trials. Focusing initially on the Plasmodium falciparum merozoite proteome, we used peer-reviewed publications, multiple proteomic and bioinformatic approaches, to select and prioritize potential immune targets. We expressed 109 P. falciparum recombinant proteins, the majority of which were obtained using a mammalian expression system that has been shown to produce biologically functional extracellular proteins, and used them to create KILchip v1.0: a novel protein microarray to facilitate high-throughput multiplexed antibody detection from individual samples. The microarray assay was highly specific; antibodies against P. falciparum proteins were detected exclusively in sera from malaria-exposed but not malaria-naïve individuals. The intensity of antibody reactivity varied as expected from strong to weak across well-studied antigens such as AMA1 and RH5 (Kruskal–Wallis H test for trend: p < 0.0001). The inter-assay and intra-assay variability was minimal, with reproducible results obtained in re-assays using the same chip over a duration of 3 months. Antibodies quantified using the multiplexed format in KILchip v1.0 were highly correlated with those measured in the gold-standard monoplex ELISA [median (range) Spearman's R of 0.84 (0.65–0.95)]. KILchip v1.0 is a robust, scalable and adaptable protein microarray that has broad applicability to studies of naturally acquired immunity against malaria by providing a standardized tool for the detection of antibody correlates of protection. It will facilitate rapid high-throughput validation and prioritization of potential Plasmodium falciparum merozoite-stage antigens paving the way for urgently needed clinical trials for the next generation of malaria vaccines.


docid: fgdyzzty

title: A LAIR-1 insertion generates broadly reactive antibodies against malaria variant antigens

text: Plasmodium falciparum antigens expressed on the surface of infected erythrocytes are important targets of naturally acquired immunity against malaria, but their high number and variability provide the pathogen with a powerful means of escape from host antibodies(1–4). Although broadly reactive antibodies against these antigens could be useful as therapeutics and in vaccine design, their identification has proven elusive. Here, we report the isolation of human monoclonal antibodies that recognize erythrocytes infected by different P. falciparum isolates and opsonize these cells by binding to members of the RIFIN family. These antibodies acquired broad reactivity through a novel mechanism of insertion of a large DNA fragment between the V and DJ segments. The insert, which is both necessary and sufficient for binding to RIFINs, encodes the entire 100 amino acid collagen-binding domain of LAIR-1, an Ig superfamily inhibitory receptor encoded on chromosome 19. In each of the two donors studied, the antibodies are produced by a single expanded B cell clone and carry distinct somatic mutations in the LAIR-1 domain that abolish binding to collagen and increase binding to infected erythrocytes. These findings illustrate, with a biologically relevant example, a novel mechanism of antibody diversification by interchromosomal DNA transposition and demonstrate the existence of conserved epitopes that may be suitable candidates for the development of a malaria vaccine.


Embracing telemedicine into your otolaryngology practice amid the COVID-19 crisis: An invited commentary


Cross-neutralization of SARS coronavirus-specific antibodies against bat SARS-like coronaviruses


title: The 18th Rocky Mountain Virology Association Meeting

text: This autumn, approximately 100 scientists and students from the Rocky Mountain area along with invited speakers attended the 18th annual meeting of the Rocky Mountain Virology Association that was held at the Colorado State University Mountain Campus. The two-day gathering featured 31 talks and 33 posters all of which focused on specific areas of current virology and prion protein research. Since the keynote presentation focused on the oligoadenylate synthetase-ribonuclease L pathway the main area of focus was on host–virus interactions, however other areas of interest included virus vectors, current models of virus infections, prevention and treatment of virus infections, separate sessions on RNA viruses and prion proteins, and a special talk highlighting various attributes of targeted next-generation sequencing. The meeting was held at the peak of the fall Aspen colors surrounded by five mountains >11000 ft (3.3 km) where the secluded campus provided the ideal setting for extended discussions and outdoor exercise. On behalf of the Rocky Mountain Virology Association, this report summarizes 42 selected presentations.


title: Early Detection of Emerging Zoonotic Diseases with Animal Morbidity and Mortality Monitoring

text: Diseases transmitted between animals and people have made up more than 50% of emerging infectious diseases in humans over the last 60 years and have continued to arise in recent months. Yet, public health and animal disease surveillance programs continue to operate independently. Here, we assessed whether recent emerging zoonotic pathogens (n = 143) are known to cause morbidity or mortality in their animal host and if so, whether they were first detected with an animal morbidity/mortality event. We show that although sick or dead animals are often associated with these pathogens (52%), only 9% were first detected from an animal morbidity or mortality event prior to or concurrent with signs of illness in humans. We propose that an animal morbidity and mortality reporting program will improve detection and should be an essential component of early warning systems for zoonotic diseases. With the use of widespread low-cost technology, such a program could engage both the public and professionals and be easily tested and further incorporated as part of surveillance efforts by public health officials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10393-014-0988-x) contains supplementary material, which is available to authorized users.


title: Polysialic acid is a cellular receptor for human adenovirus 52

text: Human adenovirus 52 (HAdV-52) is one of only three known HAdVs equipped with both a long and a short fiber protein. While the long fiber binds to the coxsackie and adenovirus receptor, the function of the short fiber in the virus life cycle is poorly understood. Here, we show, by glycan microarray analysis and cellular studies, that the short fiber knob (SFK) of HAdV-52 recognizes long chains of α-2,8-linked polysialic acid (polySia), a large posttranslational modification of selected carrier proteins, and that HAdV-52 can use polySia as a receptor on target cells. X-ray crystallography, NMR, molecular dynamics simulation, and structure-guided mutagenesis of the SFK reveal that the nonreducing, terminal sialic acid of polySia engages the protein with direct contacts, and that specificity for polySia is achieved through subtle, transient electrostatic interactions with additional sialic acid residues. In this study, we present a previously unrecognized role for polySia as a cellular receptor for a human viral pathogen. Our detailed analysis of the determinants of specificity for this interaction has general implications for protein–carbohydrate interactions, particularly concerning highly charged glycan structures, and provides interesting dimensions on the biology and evolution of members of Human mastadenovirus G.


title: Study of surveillance data for class B notifiable disease in China from 2005 to 2014

text: Summary Background The surveillance of infection is very important for public health management and disease control. It has been 10 years since China implemented its new web-based infection surveillance system, which covers the largest population in the world. Methods In this study, time series data were collected for 28 infectious diseases reported from 2005 to 2014 . Seasonality and long-term trends were explored using decomposition methods. Seasonality was expressed by calculating the seasonal indices. Long-term trends in the diseases were assessed using a linear regression model on the deseasonalized series. Results During the 10-year period, 38 982 567 cases and 126 372 deaths were reported in the system. The proportion of deaths caused by AIDS increased from 12% in 2005 to 78% in 2014. There were six diseases for which the seasonal index range was greater than 2: dengue fever, Japanese encephalitis, leptospirosis, anthrax, cerebrospinal meningitis, and measles . Among the 28 diseases, the incidence of syphilis increased fastest, with an average increase of 0.018626/100 000 every month after adjustment for seasonality. Conclusions Effective surveillance is helpful in gaining a better understanding of the infection behaviour of infectious diseases; this will greatly facilitate disease control and management.


title: Management of infections in critically ill returning travellers in the intensive care unit—II: clinical syndromes and special considerations in immunocompromised patients

text: Summary This position paper is the second ESCMID Consensus Document on this subject and aims to provide intensivists, infectious disease specialists, and emergency physicians with a standardized approach to the management of serious travel-related infections in the intensive care unit (ICU) or the emergency department. This document is a cooperative effort between members of two European Society of Clinical Microbiology and Infectious Diseases (ESCMID) study groups and was coordinated by Hakan Leblebicioglu and Jordi Rello for ESGITM (ESCMID Study Group for Infections in Travellers and Migrants) and ESGCIP (ESCMID Study Group for Infections in Critically Ill Patients), respectively. A relevant expert on the subject of each section prepared the first draft which was then edited and approved by additional members from both ESCMID study groups. This article summarizes considerations regarding clinical syndromes requiring ICU admission in travellers, covering immunocompromised patients.


title: Transferrin receptor 1 is a cellular receptor for New World haemorrhagic fever arenaviruses

text: At least five arenaviruses cause viral haemorrhagic fevers in humans. Lassa virus, an Old World arenavirus, uses the cellular receptor α-dystroglycan to infect cells(1). Machupo, Guanarito, Junin and Sabia viruses are New World haemorrhagic fever viruses that do not use α-dystroglycan(2). Here we show a specific, high-affinity association between transferrin receptor 1 (TfR1) and the entry glycoprotein (GP) of Machupo virus. Expression of human TfR1, but not human transferrin receptor 2, in hamster cell lines markedly enhanced the infection of viruses pseudotyped with the GP of Machupo, Guanarito and Junin viruses, but not with those of Lassa or lymphocytic choriomeningitis viruses. An anti-TfR1 antibody efficiently inhibited the replication of Machupo, Guanarito, Junin and Sabia viruses, but not that of Lassa virus. Iron depletion of culture medium enhanced, and iron supplementation decreased, the efficiency of infection by Junin and Machupo but not Lassa pseudoviruses. These data indicate that TfR1 is a cellular receptor for New World haemorrhagic fever arenaviruses.


title: Erratum for Byukusenge et al., “Complete Genome Sequences of Four Bovine Coronavirus Isolates from Pennsylvania”

text: [This corrects the article DOI: 10.1128/genomeA.00467-18.].


title: Therapeutic Synergy Between Antibiotics and Pulmonary Toll-Like Receptor 5 Stimulation in Antibiotic-Sensitive or -Resistant Pneumonia

text: Bacterial infections of the respiratory tract constitute a major cause of death worldwide. Given the constant rise in bacterial resistance to antibiotics, treatment failure is increasingly frequent. In this context, innovative therapeutic strategies are urgently needed. Stimulation of innate immune cells in the respiratory tract [via activation of Toll-like receptors (TLRs)] is an attractive approach for rapidly activating the body's immune defenses against a broad spectrum of microorganisms. Previous studies of the TLR5 agonist flagellin in animal models showed that standalone TLR stimulation does not result in the effective treatment of pneumococcal respiratory infection but does significantly improve the therapeutic outcome of concomitant antibiotic treatment. Here, we investigated the antibacterial interaction between antibiotic and intranasal flagellin in a mouse model of pneumococcal respiratory infection. Using various doses of orally administered amoxicillin or systemically administered cotrimoxazole, we found that the intranasal instillation of flagellin (a dose that promotes maximal lung pro-inflammatory responses) induces synergistic rather than additive antibacterial effects against antibiotic–susceptible pneumococcus. We next set up a model of infection with pneumococcus that is resistant to multiple antibiotics in the context of influenza superinfection. Remarkably, the combination of amoxicillin and flagellin effectively treated superinfection with the amoxicillin-resistant pneumococcus since the bacterial clearance was increased by more than 100-fold compared to standalone treatments. Our results also showed that, in response to flagellin, the lung tissue generated an innate immune response even though it had been damaged by the influenza virus and pneumococcal infections. In conclusion, we demonstrated that the selective boosting of lung innate immunity is a conceptually advantageous approach for improving the effectiveness of antibiotic treatment and fighting antibiotic-resistant bacteria.


Comment on “Generalized pustular figurate erythema: A newly delineated severe cutaneous drug reaction linked with hydroxychloroquine”: report of a COVID‐19 patient with particular findings


title: Quantifying the transmission potential of pandemic influenza

text: Abstract This article reviews quantitative methods to estimate the basic reproduction number of pandemic influenza, a key threshold quantity to help determine the intensity of interventions required to control the disease. Although it is difficult to assess the transmission potential of a probable future pandemic, historical epidemiologic data is readily available from previous pandemics, and as a reference quantity for future pandemic planning, mathematical and statistical analyses of historical data are crucial. In particular, because many historical records tend to document only the temporal distribution of cases or deaths (i.e. epidemic curve), our review focuses on methods to maximize the utility of time-evolution data and to clarify the detailed mechanisms of the spread of influenza. First, we highlight structured epidemic models and their parameter estimation method which can quantify the detailed disease dynamics including those we cannot observe directly. Duration-structured epidemic systems are subsequently presented, offering firm understanding of the definition of the basic and effective reproduction numbers. When the initial growth phase of an epidemic is investigated, the distribution of the generation time is key statistical information to appropriately estimate the transmission potential using the intrinsic growth rate. Applications of stochastic processes are also highlighted to estimate the transmission potential using similar data. Critically important characteristics of influenza data are subsequently summarized, followed by our conclusions to suggest potential future methodological improvements.


title: A time-of–drug addition approach to target identification of antiviral compounds

text: Insight into the mode of action of newly discovered antiviral agents is now almost a prerequisite for clinical development. This protocol describes a method that provides information on the target of inhibitors of the human immunodeficiency virus (HIV); it can also be adapted to other viruses. The results from this experiment are available within 2 d. This time-based approach determines how long the addition of a compound can be postponed before losing its antiviral activity in cell culture. The target of an antiviral compound can be identified by comparing its relative position in the time scale to that of reference drugs. Therefore, it is more precise than, for example, in the case of HIV, a determination of pre- or postintegrational mode of action, and combines in one routine different assays for studying mechanisms of action.


title: In silico analysis of the cyanobacterial lectin scytovirin: new insights into binding properties

text: Scytovirin is a lectin isolated from the cyanobacterium Scytonema varium that has shown activity against HIV, SARS coronavirus and Zaire Ebola virus. Its 95 amino acids are divided into two structural domains (SD), the first spanning amino acids 1–48 (SD1) and the second 49–95 (SD2). Interestingly, the domains are nearly identical but differ in their affinities for carbohydrates. With the aim of enhancing understanding of the binding properties of scytovirin, we performed molecular dynamics (MD) simulations of scytovirin complexed with Man4. We set up three systems: (i) Man4 bound to both domains (SD1 + SD2) using the full-length protein; (ii) Man4 bound to an incomplete protein, containing only SD1 and (iii) Man4 bound to an incomplete protein containing only SD2. Contrary to other reports, binding free energy results suggest that Man4 can bind simultaneously to SD1 and SD2 binding regions, but SD1 individually has the best values of energy and the best affinity for Man4. Decomposition of the binding free energy showed that the residues that interact with Man4 were different in the three systems, suggesting that the binding mechanism of Man4 varies between full-length protein, SD1 and SD2. The results presented here may help to formulate strategies to use scytovirin and promote mutagenesis studies to improve the antiviral activity of scytovirin.


title: The traditional uses, chemical constituents and biological activities of Plantago major L. A review

text: Abstract Plantago major L. leaves have been used as a wound healing remedy for centuries in almost all parts of the world and in the treatment of a number of diseases apart from wound healing. These include diseases related to the skin, respiratory organs, digestive organs, reproduction, the circulation, against cancer, for pain relief and against infections. P. major contains biologically active compounds such as polysaccharides, lipids, caffeic acid derivatives, flavonoids, iridoid glycosides and terpenoids. Alkaloids and some organic acids have also been detected. A range of biological activities has been found from plant extracts including wound healing activity, anti-inflammatory, analgesic, antioxidant, weak antibiotic, immuno modulating and antiulcerogenic activity. Some of these effects may attribute to the use of this plant in folk medicine.


title: Pseudoscience in medicine: cautionary recommendations

text: INTRODUCTION: Certain real life applications of scientific and social science ideas that knowingly reject accumulated empirical biomedical evidence have been termed ‘pseudoscience,’ or empirical rejectionism. An uncritical acceptance of empiricism, or even of evidence-based medicine, however, can also be problematic. OBJECTIVES: With reference to a specific type of medical denialism associated with moral failure, justified by dissident AIDS and anti-vaccine scientific publications, this paper seeks to make the argument that this type of denialism meets certain longstanding definitions for classification as pseudoscience. METHODS: This paper uses a conceptual framework to make certain arguments and to juxtapose arguments for evidence-based approaches to medicine against literature that highlights certain limitations of an unquestioning approach to empiricism. RESULTS: Discussions of certain real life examples are used to derive the important insight that, under certain conditions, moral failure can result in the violation both Type I and Type II scientific error types, with catastrophic consequences. CONCLUSION: It is argued that the validity of all theory should not be assumed before sufficient empirical evidence has accumulated to support its validity across contexts. However, caution is required, to avoid the consequences of an unquestioning approach to empiricism.


title: A Primary Mediastinal Large B-Cell Lymphoma Patient With COVID-19 Infection After Intensive Immunochemotherapy: A Case Report

text: Background: The outbreak of coronavirus disease 2019 (COVID-19) had become a global public health event. Lymphoma patients need to be distinguished from the general population because of their deficient immune status and intensive anti-tumor treatment. The impacts of cancer subtypes and treatment on COVID-19 infection are unclear. Case Presentation: We here report the case of a primary mediastinal large B-cell lymphoma patient who was infected with COVID-19 after intensive immunochemotherapy (DA-EPOCH-R). The patient developed a neutropenic fever during chemotherapy, and fever was persistent, although antibiotics were used. Initial chest CT was negative, and the patient received a throat swab test since the second CT showed evidence of pneumonia. With treatment with Arbidol Hydrochloride and LianHuaQingWen capsule, his COVID-19 was cured. Conclusions: To the best of our knowledge, this is the first report focusing on COVID-19 infection in a lymphoma patient undergoing intensive immunochemotherapy. For those patients being treated with immunochemotherapy in epidemic areas, a reduced dose intensity of intensive chemotherapy should be considered, and the effect of immunotherapies such as rituximab on COVID-19 infection should be considered. The impacts of anti-cancer treatment on COVID-19 infection need to be explored further.


title: Does pandemic justify the use of Hydroxychloroquine for treatment and prevention of COVID‐19 in India?

text: The Indian Council of Medical Research (ICMR), recommended the use of hydroxychloroquine (HCQ) as a prophylactic against COVID‐19 among health care workers and asymptomatic contacts of laboratory confirmed cases of COVID. This is widely criticised as a hastily taken step with political inclination and minimal evidence backing. In the current scenario, where there is mass fear against COVID‐19, this recommendation has made the people to believe that it will kill the viruses. This has important public health implications which are discussed below. Better communication should have been planned to ensure everyone does not go out and buy it. However, as a nation of 1.3 billion, we need to capitalize on this opportunity to generate data and valuable evidence on the use of HCQ to beat this pandemic. All health care workers taking this drug should volunteer themselves to be part of a trial/observational study and get registered online to generate useful data related to its safety and efficacy and guide future recommendations. The other risk group which includes asymptomatic contacts of laboratory confirmed COVID‐19 patients are under surveillance by the state and local health authorities and could also be roped into this study to generate robust evidence. Of course, pandemic does not just justify the use of HCQ, but pandemic is the time to innovate, think out of box and generate evidence to prove the same so that we can lives. This article is protected by copyright. All rights reserved.


title: Evaluation of safety, efficacy, tolerability, and treatment-related outcomes of type I interferons for Human coronaviruses (HCoVs) infection in clinical practice: An updated critical systematic review and meta-analysis

text: BACKGROUND: There is no vaccine or specific antiviral treatment for HCoVs infection. The use of type I interferons for coronavirus is still under great debate in clinical practice. MATERIALS AND METHODS: A literature search of all relevant studies published on PubMed, Cochrane library, Web of Science database, Science Direct, Wanfang Data, and China National Knowledge Infrastructure (CNKI) until February 2020 was performed. RESULTS: Of the 1081 identified articles, only 15 studies were included in the final analysis. Comorbidities and delay in diagnosis were significantly associated with case mortality. Type I interferons seem to improve respiratory distress, relieve lung abnormalities, present better saturation, reduce needs for supplemental oxygen support. Type I interferons seem to be well tolerated, and don’t increase life threating adverse effects. Data on IFNs in HCoVs are limited, heterogenous and mainly observational. CONCLUSIONS: Current data do not allow making regarding robust commendations for the use of IFNs in HCoVs in general or in specific subtype. But we still recommend type I interferons serving as first-line antivirals in HCoVs infections within local protocols, and interferons may be adopted to the treatments of the SARS-CoV-2 as well. Well-designed large-scale prospective randomized control trials are greatly needed to provide more robust evidence on this topic.


title: Coronaviridae and SARS-associated Coronavirus Strain HSR1

text: During the recent severe acute respiratory (SARS) outbreak, the etiologic agent was identified as a new coronavirus (CoV). We have isolated a SARS-associated CoV (SARS-CoV) strain by injecting Vero cells with a sputum specimen from an Italian patient affected by a severe pneumonia; the patient traveled from Vietnam to Italy in March 2003. Ultrastructural analysis of infected Vero cells showed the virions within cell vesicles and around the cell membrane. The full-length viral genome sequence was similar to those derived from the Hong-Kong Hotel M isolate. By using both real-time reverse transcription–polymerase chain reaction TaqMan assay and an infectivity plaque assay, we determined that approximately 360 viral genomes were required to generate a PFU. In addition, heparin (100 μg/mL) inhibited infection of Vero cells by 50%. Overall, the molecular and biologic characteristics of the strain HSR1 provide evidence that SARS-CoV forms a fourth genetic coronavirus group with distinct genomic and biologic features.


title: MERS-CoV Antibody Responses 1 Year after Symptom Onset, South Korea, 2015

text: We investigated the kinetics of the Middle East respiratory syndrome coronavirus (MERS-CoV) neutralizing and spike protein antibody titers over the course of 1 year in 11 patients who were confirmed by reverse transcription PCR to have been infected during the outbreak in South Korea in 2015. Robust antibody responses were detected in all survivors who had severe disease; responses remained detectable, albeit with some waning, for <1 year. The duration of viral RNA detection (but not viral load) in sputum significantly correlated with the antibody response magnitude. The MERS S1 ELISA antibody titers correlated well with the neutralizing antibody response. Antibody titers in 4 of 6 patients who had mild illness were undetectable even though most had evidence of pneumonia. This finding implies that MERS-CoV seroepidemiologic studies markedly underestimate the extent of mild and asymptomatic infection. Obtaining convalescent-phase plasma with high antibody titers to treat MERS will be challenging.


New Variant of Porcine Epidemic Diarrhea Virus, United States, 2014


title: Risk Perception and COVID-19

text: The ongoing COVID-19 pandemic is shaking the foundations of public health governance all over the world. Researchers are challenged by informing and supporting authorities on acquired knowledge and practical implications. This Editorial applies established theories of risk perception research to COVID-19 pandemic, and reflects on the role of risk perceptions in these unprecedented times, and specifically in the framework of the International Journal of Environmental Research and Public Health Special Issue “Research about risk perception in the Environmental Health domain”.


title: Reverse Genetics of SARS-Related Coronavirus Using Vaccinia Virus-Based Recombination

text: Severe acute respiratory syndrome (SARS) is a zoonotic disease caused by SARS-related coronavirus (SARS-CoV) that emerged in 2002 to become a global health concern. Although the original outbreak was controlled by classical public health measures, there is a real risk that another SARS-CoV could re-emerge from its natural reservoir, either in its original form or as a more virulent or pathogenic strain; in which case, the virus would be difficult to control in the absence of any effective antiviral drugs or vaccines. Using the well-studied SARS-CoV isolate HKU-39849, we developed a vaccinia virus-based SARS-CoV reverse genetic system that is both robust and biosafe. The SARS-CoV genome was cloned in separate vaccinia virus vectors, (vSARS-CoV-5prime and vSARS-CoV-3prime) as two cDNAs that were subsequently ligated to create a genome-length SARS-CoV cDNA template for in vitro transcription of SARS-CoV infectious RNA transcripts. Transfection of the RNA transcripts into permissive cells led to the recovery of infectious virus (recSARS-CoV). Characterization of the plaques produced by recSARS-CoV showed that they were similar in size to the parental SARS-CoV isolate HKU-39849 but smaller than the SARS-CoV isolate Frankfurt-1. Comparative analysis of replication kinetics showed that the kinetics of recSARS-CoV replication are similar to those of SARS-CoV Frankfurt-1, although the titers of virus released into the culture supernatant are approximately 10-fold less. The reverse genetic system was finally used to generate a recSARS-CoV reporter virus expressing Renilla luciferase in order to facilitate the analysis of SARS-CoV gene expression in human dendritic cells (hDCs). In parallel, a Renilla luciferase gene was also inserted into the genome of human coronavirus 229E (HCoV-229E). Using this approach, we demonstrate that, in contrast to HCoV-229E, SARS-CoV is not able to mediate efficient heterologous gene expression in hDCs.


title: Clinical Characteristics of Critically Ill Patients Co-infected with SARS-CoV-2 and the Influenza Virus in Wuhan, China

text: OBJECTIVE: To delineate the clinical characteristics of critically ill COVID-19 patients co-infected with influenza. METHODS: In this study, we included adult patients with laboratory-confirmed COVID-19 form Tongji Hospital (Wuhan, China), with or without influenza, and compared their clinical characteristics. RESULTS: Among 93 patients, 44 died and 49 were discharged. Forty-four (47.3%) were infected with influenza virus A and 2 (2.2%) with influenza virus B. Twenty-two (50.0%) of the non-survivors and 24 (49.0%) of the survivors were infected with the influenza virus. Critically ill COVID-19 patients with influenza were more prone to cardiac injury than those without influenza. For the laboratory indicators at admission, white blood cell counts, neutrophil counts, levels of tumor necrosis factor-α, D-dimer value, and proportion of elevated creatinine were higher in non-survivors with influenza than in those without influenza. CONCLUSION: The results showed a high proportion of COVID-19 patients were co-infected with influenza in Tongji Hospital, with no significant difference in the proportion of co-infection between survivors and non-survivors. The critically ill COVID-19 patients with influenza exhibited more severe inflammation and organ injury, indicating that co-infection with the influenza virus may induce an earlier and more frequently occurring cytokine storm.


docid: kfohrmhl

title: Metabolomic Profiling of Infants With Recurrent Wheezing After Bronchiolitis

text: BACKGROUND: Bronchiolitis is associated with a greater risk of developing recurrent wheezing, but with currently available tools, it is impossible to know which infants with bronchiolitis will develop this condition. This preliminary prospective study aimed to assess whether urine metabolomic analysis can be used to identify children with bronchiolitis who are at risk of developing recurrent wheezing. METHODS: Fifty-two infants <1 year old treated in the emergency department at University Hospital of Padova for acute bronchiolitis were enrolled (77% tested positive for respiratory syncytial virus [RSV]). Follow-up visits were conducted for 2 years after the episode of bronchiolitis. Untargeted metabolomic analyses based on mass spectrometry were performed on urine samples collected from infants with acute bronchiolitis. Data modeling was based on univariate and multivariate data analyses. RESULTS: We distinguished children with and those without postbronchiolitis recurrent wheeze, defined as ≥3 episodes of physician-diagnosed wheezing. Pathway overrepresentation analysis pointed to a major involvement of the citric acid cycle (P < .001) and some amino acids (lysine, cysteine, and methionine; P ≤ .015) in differentiating between these 2 groups of children. CONCLUSION: This is the first study showing that metabolomic profiling of urine specimens from infants with bronchiolitis can be used to identify children at increased risk of developing recurrent wheezing.


Guillain-Barre Syndrome in a Patient With Evidence of Recent SARS-CoV-2 Infection


title: Burnout and PTSD in the COVID-19 Pandemic: Intersection, Impact and Interventions

text: Summary sentence Individual physicians and hospital administration should take proactive steps to minimize the compounding effects of high baseline burnout and the acute stressors of the COVID-19 pandemic in order to promote wellness among health-care providers.


Cardiac drugs and outcome in COVID-19: Reply


title: Guide pour le suivi respiratoire des patients ayant présenté une pneumonie à SARS-CoV-2.Propositions de prise en charge élaborées par la Société de Pneumologie de Langue Française. Version du 10 mai 2020

text: Résumé La Société de Pneumologie de Langue Française propose un guide pour le suivi respiratoire des patients ayant présenté une pneumonie à SARS-CoV-2 à partir des données connues des précédentes épidémies, des lésions aiguës constatées chez ces patients et d’opinions d’experts. Ce guide propose une conduite à tenir selon le type de patients : 1) patient pris en charge en ville pour une infection à SARS-CoV-2 possible ou prouvée adressé par son médecin traitant pour dyspnée persistante, 2) patient hospitalisé pour pneumonie à SARS-CoV-2 en unité conventionnelle, 3) patient hospitalisé pour pneumonie à SARS-CoV-2 ayant fait un séjour en réanimation. Le suivi ultérieur sera à adapter au bilan initial. Ce guide insiste sur le fait qu’il ne faut pas méconnaitre les autres causes de dyspnée (cardiaques, thromboemboliques, syndrome d’hyperventilation, …). Ces propositions pourront évoluer dans le temps au fil des connaissances sur le sujet. Abstract The French-language Respiratory Medicine Society proposes a guide for the follow-up of patients who have presented with SARS-CoV-2 pneumonia. The proposals are based on known data from previous epidemics, on acute lesions observed in SARS-CoV-2 patients and on expert opinion. This guide proposes a follow-up based on three categories of patients: 1) patients managed outside hospital for possible or proven SARS-CoV-2 infection, referred by their physician for persistent dyspnoea; 2) patients hospitalized for SARS-CoV-2 pneumonia in a medical unit; 3) patients hospitalized for SARS-CoV-2 pneumonia in an intensive care unit. The subsequent follow-up will have to be adapted to the initial assessment. This guide emphasises the possibility of others causes of dyspnoea (cardiac, thromboembolic, hyperventilation syndrome..). These proposals may evolve over time as more knowledge becomes available.