title: Echo Chambers on Social Media: A comparative analysis

text: Recent studies have shown that online users tend to select information adhering to their system of beliefs, ignore information that does not, and join groups - i.e., echo chambers - around a shared narrative. Although a quantitative methodology for their identification is still missing, the phenomenon of echo chambers is widely debated both at scientific and political level. To shed light on this issue, we introduce an operational definition of echo chambers and perform a massive comparative analysis on more than 1B pieces of contents produced by 1M users on four social media platforms: Facebook, Twitter, Reddit, and Gab. We infer the leaning of users about controversial topics - ranging from vaccines to abortion - and reconstruct their interaction networks by analyzing different features, such as shared links domain, followed pages, follower relationship and commented posts. Our method quantifies the existence of echo-chambers along two main dimensions: homophily in the interaction networks and bias in the information diffusion toward likely-minded peers. We find peculiar differences across social media. Indeed, while Facebook and Twitter present clear-cut echo chambers in all the observed dataset, Reddit and Gab do not. Finally, we test the role of the social media platform on news consumption by comparing Reddit and Facebook. Again, we find support for the hypothesis that platforms implementing news feed algorithms like Facebook may elicit the emergence of echo-chambers.


Information Diet in Covid-19 Crisis;a Commentary


Viral load of SARS-CoV-2 in clinical samples


COVID-19: Nephrology preparedness checklist


Prolonged SARS-CoV-2 RNA shedding: Not a rare phenomenon


title: Outcomes in Patients with COVID-19 Infection Taking ACEI/ARB

text: PURPOSE OF REVIEW: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the aggressive coronavirus disease (COVID-19) pandemic. Recently, investigators have stipulated that COVID-19 patients receiving angiotensin-converting-enzyme inhibitors (ACEI) may be subject to poorer outcomes. This editorial presents the available evidence to guide treatment practices during this pandemic. RECENT FINDINGS: Recent studies from Wuhan cohorts provide valuable information about COVID-19. A cohort with 52 critically ill patients revealed cardiac injury in 12% of patients. Worse outcomes appear to be more prevalent in patients with hypertension and diabetes mellitus (DM), possibly due to overexpression of angiotensin-converting enzyme 2 (ACE2) receptor in airway alveolar epithelial cells. Investigators suspect that SARS-CoV-2 uses the ACE2 receptor to enter the lungs in a mechanism similar to SARS-CoV. Several hypotheses have been proposed to date regarding the net effect of ACEI/ARB on COVID-19 infections. Positive effects include ACE2 receptor blockade, disabling viral entry into the heart and lungs, and an overall decrease in inflammation secondary to ACEI/ARB. Negative effects include a possible retrograde feedback mechanism, by which ACE2 receptors are upregulated. Even though physiological models of SARS-CoV infection show a theoretical benefit of ACEI/ARB, these findings cannot be extrapolated to SARS-CoV-2 causing COVID-19. Major cardiology scientific associations, including ACC, HFSA, AHA, and ESC Hypertension Council, have rejected these correlation hypotheses. After an extensive literature review, we conclude that there is no significant evidence to support an association for now, but given the rapid evolvement of this pandemic, findings may change.


title: Large Arabic Twitter Dataset on COVID-19

text: The 2019 coronavirus disease (COVID-19), emerged late December 2019 in China, is now rapidly spreading across the globe. At the time of writing this paper, the number of global confirmed cases has passed two millions and half with over 180,000 fatalities. Many countries have enforced strict social distancing policies to contain the spread of the virus. This have changed the daily life of tens of millions of people, and urged people to turn their discussions online, e.g., via online social media sites like Twitter. In this work, we describe the first Arabic tweets dataset on COVID-19 that we have been collecting since January 1st, 2020. The dataset would help researchers and policy makers in studying different societal issues related to the pandemic. Many other tasks related to behavioral change, information sharing, misinformation and rumors spreading can also be analyzed.


Temperature and COVID-19: India


title: Efficacy of slit lamp breath shields

text: PURPOSE: To evaluate the efficacy of slit lamp breath shields to prevent droplet spray from a simulated sneeze. DESIGN: Experimental study to test effectiveness of personal protective equipment. METHODS: The nozzle of a spray gun was adjusted to angularly disperse a mist of colored dye that approximated a patient sneezing on a dimensionally accurate cardboard slit lamp model. We tested the designs of six commercially available breath shields, and one breath shield repurposed from a plastic container lid. Each breath shield was sprayed in a standardized fashion three times and the amount of overspray compared with no shield was quantified. The surface area that was sprayed was calculated using Adobe Photoshop's color range function. The average percentage of overspray of each breath shield was computed in comparison to the control. RESULTS: The breath shields ranged in surface area from 116-1254 cm2 and the amount of overspray varied from 54% to virtually none. Larger breath shields offered better protection than smaller ones. Breath shields attached to the objective lens arm were a better barrier than those hung by the oculars of comparable size. A repurposed plastic lid breath shield was 513cm2, was slightly curved toward the examiner's face, and allowed only 2% overspray. The largest breath shield (1254 cm2) hung near the oculars and prevented essentially all the overspray. CONCLUSION: The performance of different designs of breath shields is variable. Even high functioning shields should be used in conjunction with personal protective equipment including masks, goggles and gloves, and handwashing. Ideally patients should also wear a cloth mask during all slit lamp exams.


SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients


title: COVID-19 pandemic: Impacts on the air quality during the partial lockdown in São Paulo state, Brazil

text: In early March 2020, the World Health Organization declared the COVID-19 as a pandemic, and in late March 2020 partial lockdown was ordered by the São Paulo state government. The aim of this study was to assess impacts on air quality in São Paulo - Brazil, during the partial lockdown implemented to provide social distancing required due to the COVID-19 pandemic. We have analyzed data from four air quality stations in São Paulo, Brazil to assess air pollutant concentration variations during the partial lockdown. Data were compared to the five-year monthly mean and to the four-week before the partial lockdown. Overall, drastic reductions on NO (up to -77.3%), NO2 (up to -54.3%), and CO (up to -64.8%) concentrations were observed in the urban area during partial lockdown compared to the five-year monthly mean. By contrast, an increase of approximately 30% in ozone concentrations was observed in urban areas highly influenced by vehicle traffic, probably related to nitrogen monoxide decreases. Although the partial lockdown has contributed to a positive impact on air quality, it is important to take into account the negative impacts on social aspects, considering the deaths caused by COVID-19 and also the dramatic economic effects.


title: The Role of Medical Student Government in Responding to COVID-19

text: The COVID-19 outbreak has sown clinical and administrative chaos at academic health centers throughout the country. As COVID-19-related burdens on the health care system and medical schools piled up, questions from medical students far outweighed the capacity of medical school administrators to respond in an adequate or timely manner, leaving students feeling confused and without clear guidance. In this Perspective, incoming and outgoing executive leaders of the University of Michigan Medical School Student Council and medical school deans outline the specific ways they were able to bridge the gap between medical students and administrators in a time of crisis. To illustrate the value of student government during uncertain times, the authors identify the most pressing problems faced by students at each phase of the curriculum-preclerkship, clerkship, and postclerkship-and explain how Student Council leadership partnered with administrators to find creative solutions to these problems and provide guidance to learners. They end by reflecting on the role of student government more broadly, identifying 3 guiding principles of student leadership and how these principles enable effective student representation.


Bilirubin levels in patients with mild and severe Covid-19: A pooled analysis


title: Monitoring COVID-19 through Trends in Influenza-like Illness and Laboratory-confirmed Influenza and COVID-19 - New York State, excluding New York City, January 1 - April 12, 2020

text: Innovative monitoring approaches are needed to track the COVID-19 epidemic and potentially assess the impact of community mitigation interventions. In this report, we present temporal data on influenza-like illness, influenza diagnosis and COVID-19 cases for all four regions of New York State through the first six weeks of the outbreak.


title: Recommandations CCAFU sur la prise en charge des cancers de l'appareil urogénital en période d'épidémie au Coronavirus COVID-19./ [Recommendations CCAFU on the management of cancers of the urogenital system during an epidemic with Coronavirus COVID-19]

text: AIM: The French population is facing the COVID-19 pandemic and the health system have been reoriented in emergency for the care of patients with coronavirus. The management of cancers of the urinary and male genital tracts must be adapted to this context. MATERIAL AND METHOD: An expert opinion documented by a literature review was formulated by the Cancerology Committee of the French Association of Urology (CCAFU). RESULTS: The medical and surgical management of patients with any cancers of the urinary and male genital tracts must be adapted by modifying the consultation methods, by prioritizing interventions according to the intrinsic prognosis of cancers, taking into account the patient's comorbidities. The protection of urologists from COVID-19 must be considered. CONCLUSION: The CCAFU issues an expert opinion on the measure to be taken to adapt the management of cancers of the male urinary and genital tract to the context of pandemic by COVID-19.


COVID-19: Possible reasons for the increased prevalence of Olfactory and Gustatory dysfunction observed in European studies


Decline in invasive pneumococcus diseases while combating the COVID-19 pandemic in Taiwan


A recommendation for IVF lab practice in light of the current COVID-19 pandemic


title: A high ATP concentration enhances the cooperative translocation of the SARS coronavirus helicase nsP13 in the unwinding of duplex RNA

text: Severe acute respiratory syndrome coronavirus nonstructural protein 13 (SCV nsP13), a superfamily 1 helicase, plays a central role in viral RNA replication through the unwinding of duplex RNA and DNA with a 5' single-stranded tail in a 5' to 3' direction. Despite its putative role in viral RNA replication, nsP13 readily unwinds duplex DNA by cooperative translocation. Herein, nsP13 exhibited different characteristics in duplex RNA unwinding than that in duplex DNA. nsP13 showed very poor processivity on duplex RNA compared with that on duplex DNA. More importantly, nsP13 inefficiently unwinds duplex RNA by increasing the 5'-ss tail length. As the concentration of nsP13 increased, the amount of unwound duplex DNA increased and that of unwound duplex RNA decreased. The accumulation of duplex RNA/nsP13 complexes increased as the concentration of nsP13 increased. An increased ATP concentration in the unwinding of duplex RNA relieved the decrease in duplex RNA unwinding. Thus, nsP13 has a strong affinity for duplex RNA as a substrate for the unwinding reaction, which requires increased ATPs to processively unwind duplex RNA. Our results suggest that duplex RNA is a preferred substrate for the helicase activity of nsP13 than duplex DNA at high ATP concentrations.


title: Cardiac imaging in congenital heart disease during the coronavirus disease-2019 pandemic: recommendations from the Working Group on Congenital Heart Disease of the Italian Society of Cardiology

text: : The recent outbreak of 2019 severe acute respiratory syndrome coronavirus-2 is having major repercussions on healthcare services provision in Italy and worldwide. Data suggest the virus has a strong impact on the cardiovascular system, and cardiac imaging will play an important role in patients affected by coronavirus disease-2019. Although paediatric patients are mildly affected, they represent a clear accelerator in spreading the virus, and healthcare workers are at higher risk of infection. The aim of this position paper is to provide clinical recommendation regarding the execution of imaging investigations for the cardiac diagnostic work-up of paediatric patients with suspected or confirmed infection.


docid: wmgtmrpk

title: SARS-CoV-2 Receptor ACE2 is upregulated in Colonic Organoids from Hypertensive Rats


Comment on: COVID-19: a recommendation to examine the effect of hydroxychloroquine in preventing infection and progression


Los derechos humanos de los niños con discapacidad durante emergencias sanitarias: el desafío de COVID-19


The day after COVID-19


title: Lessons from dermatology about inflammatory responses in Covid-19

text: The SARS-Cov-2 is a single-stranded RNA virus composed of 16 non-structural proteins (NSP 1-16) with specific roles in the replication of coronaviruses. NSP3 has the property to block host innate immune response and to promote cytokine expression. NSP5 can inhibit interferon (IFN) signalling and NSP16 prevents MAD5 recognition, depressing the innate immunity. Dendritic cells, monocytes, and macrophages are the first cell lineage against viruses' infections. The IFN type I is the danger signal for the human body during this clinical setting. Protective immune responses to viral infection are initiated by innate immune sensors that survey extracellular and intracellular space for foreign nucleic acids. In Covid-19 the pathogenesis is not yet fully understood, but viral and host factors seem to play a key role. Important points in severe Covid-19 are characterized by an upregulated innate immune response, hypercoagulopathy state, pulmonary tissue damage, neurological and/or gastrointestinal tract involvement, and fatal outcome in severe cases of macrophage activation syndrome, which produce a 'cytokine storm'. These systemic conditions share polymorphous cutaneous lesions where innate immune system is involved in the histopathological findings with acute respiratory distress syndrome, hypercoagulability, hyperferritinemia, increased serum levels of D-dimer, lactic dehydrogenase, reactive-C-protein and serum A amyloid. It is described that several polymorphous cutaneous lesions similar to erythema pernio, urticarial rashes, diffuse or disseminated erythema, livedo racemosa, blue toe syndrome, retiform purpura, vesicles lesions, and purpuric exanthema or exanthema with clinical aspects of symmetrical drug-related intertriginous and flexural exanthema. This review describes the complexity of Covid-19, its pathophysiological and clinical aspects.


title: Geographic risk assessment of COVID-19 transmission using recent data: An observational study

text: BACKGROUND: The US Centers for Disease Control and Prevention (CDC) regularly issues "travel health notices" that address disease outbreaks of novel coronavirus disease (COVID)-19 in destinations worldwide. The notices are classified into 3 levels based on the risk posed by the outbreak and what precautions should be in place to prevent spreading. What objectively observed criteria of these COVID-19 situations are required for classification and visualization? This study aimed to visualize the epidemic outbreak and the provisional case fatality rate (CFR) using the Rasch model and Bayes's theorem and developed an algorithm that classifies countries/regions into categories that are then shown on Google Maps. METHODS: We downloaded daily COVID-19 outbreak numbers for countries/regions from the GitHub website, which contains information on confirmed cases in more than 30 Chinese locations and other countries/regions. The Rasch model was used to estimate the epidemic outbreak for each country/region using data from recent days. All responses were transformed by using the logarithm function. The Bayes's base CFRs were computed for each region. The geographic risk of transmission of the COVID-19 epidemic was thus determined using both magnitudes (i.e., Rasch scores and CFRs) for each country. RESULTS: The top 7 countries were Iran, South Korea, Italy, Germany, Spain, China (Hubei), and France, with values of {4.53, 3.47, 3.18, 1.65, 1.34 1.13, 1.06} and {13.69%, 0.91%, 47.71%, 0.23%, 24.44%, 3.56%, and 16.22%} for the outbreak magnitudes and CFRs, respectively. The results were consistent with the US CDC travel advisories of warning level 3 in China, Iran, and most European countries and of level 2 in South Korea on March 16, 2020. CONCLUSION: We created an online algorithm that used the CFRs to display the geographic risks to understand COVID-19 transmission. The app was developed to display which countries had higher travel risks and aid with the understanding of the outbreak situation.


title: Impact of disease on plasma and lung exposure of chloroquine, hydroxy-chloroquine and azithromycin: application of PBPK modelling

text: We use a mechanistic lung model to demonstrate that accumulation of chloroquine (CQ), hydroxychloroquine (HCQ) and azithromycin (AZ) in the lungs is sensitive to changes in lung pH, a parameter that can be affected in patients with COVID-19. A reduction in pH from 6.7 to 6 in the lung, as observed in respiratory disease, led to 20-, 4.0- and 2.7-fold increases in lung exposure of CQ, HCQ and AZ, respectively. Simulations indicated that the relatively high concentrations of CQ and HCQ in lung tissue were sustained long after administration of the drugs had stopped. Patients with COVID-19 often present with kidney failure. Our simulations indicate that renal impairment (plus lung pH reduction) caused 30-, 8.0- and 3.4-fold increases in lung exposures for CQ, HCQ and AZ, respectively, with relatively small accompanying increases (20 to 30%) in systemic exposure. Although a number of different dosage regimens were assessed, the purpose of our study was not to provide recommendations for a dosing strategy, but to demonstrate the utility of a PBPK modelling approach to estimate lung concentrations. This, used in conjunction with robust in vitro and clinical data, can help in the assessment of COVID-19 therapeutics going forward.


Retraction-Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis


How Much Covid-19 Will Change the World


The Management of Patients With Lung Cancer During the Outbreak of Coronavirus Disease 2019


title: Chest CT findings of COVID-19 pneumonia by duration of symptoms

text: PURPOSE: To evaluate lung abnormalities on thin-section computed tomographic (CT) scans in patients with COVID-19 and correlate findings to duration of symptoms. METHODS: In total, 348 CT scans in 112 patients were classified according to the time after the onset of the initial symptoms, namely stage-1 (0-4 days); stage-2 (5-9 days); stage-3 (10-14 days); stage-4 (15-21 days); stage-5 (22-28 days); and stage-6 (ï¼28 days). Each lung lobe was evaluated for extent affected by ground-glass opacities (GGO), crazy-paving pattern and consolidation, in five categories of percentual severity. Summation of scores from all five lung lobes provided the total CT score (maximal CT score, 25). RESULTS: The predominant patterns of lung abnormalities were GGOs, crazy-paving pattern, consolidation and linear opacities. The frequency of crazy-paving pattern, consolidation and linear opacities peaked at stage-3 (62.7 %), stage-4 (75.0 %) and stage-5 (83.1 %), respectively, and decreased thereafter. Total CT scores increased from stage-1 to stage-2 (2.8 ± 3.1, vs. 6.5 ± 4.6, respectively, P < 0.01), and thereafter remained high. The lower lobes were more inclined to be involved with higher CT scores except for stage-1. At stage-6 98.1 % of CT scans still showed abnormalities (CT score 7.5 ± 4.1). CONCLUSION: Thin-section CT could provide semi-quantitative analysis of pulmonary damage severity. This disease changed rapidly at the early stage, then tended to be stable and lasted for a long time.


title: Anti-RAS drugs and SARS-CoV-2 infection

text: â¢There is no enough evidence to indicate that ACEIs and ARBs result in ACE2 upregulation.â¢The level of ACE2 expression is not completely related with the risk of COVID-19 infection.â¢There is currently no evidence that ACEI/ARB increase risk for COVID-19 infection from clinical trials.â¢It is not recommended that COVID-19 patients with hypertension or normal hypertensive patients at risk for exposure to stop using ACEI/ARB or change to other antihypertensive drugs.


Toward understanding the 2019 Coronavirus and its impact on the heart


Children's role in pandemic is still a puzzle


Long term care settings in the times of the COVID-19: Challenges and future directions


Comment on "Digital Mental Health and COVID-19: Using Technology Today to Accelerate the Curve on Access and Quality Tomorrow": A UK Perspective


title: Introductions and early spread of SARS-CoV-2 in France, 24 January to 23 March 2020

text: Following SARS-CoV-2 emergence in China, a specific surveillance was implemented in France. Phylogenetic analysis of sequences retrieved through this surveillance suggests that detected initial introductions, involving non-clade G viruses, did not seed local transmission. Nevertheless, identification of clade G variants subsequently circulating in the country, with the earliest from a patient who neither travelled to risk areas nor had contact with travellers, suggests that SARS-CoV-2 might have been present before the first recorded local cases.


Delayed diagnosis of COVID-19 in a 34-year-old man with atypical presentation


Cardiac arrest in a COVID-19 patient after receiving succinylcholine for tracheal reintubation


Key highlights from the Canadian Thoracic Society's Position Statement on the Optimization of Asthma Management during the COVID-19 Pandemic


title: COVID-19 forecasting based on an improved interior search algorithm and multi-layer feed forward neural network

text: COVID-19 is a novel coronavirus that was emerged in December 2019 within Wuhan, China. As the crisis of its serious increasing dynamic outbreak in all parts of the globe, the forecast maps and analysis of confirmed cases (CS) becomes a vital great changeling task. In this study, a new forecasting model is presented to analyze and forecast the CS of COVID-19 for the coming days based on the reported data since 22 Jan 2020. The proposed forecasting model, named ISACL-MFNN, integrates an improved interior search algorithm (ISA) based on chaotic learning (CL) strategy into a multi-layer feed-forward neural network (MFNN). The ISACL incorporates the CL strategy to enhance the performance of ISA and avoid the trapping in the local optima. By this methodology, it is intended to train the neural network by tuning its parameters to optimal values and thus achieving high-accuracy level regarding forecasted results. The ISACL-MFNN model is investigated on the official data of the COVID-19 reported by the World Health Organization (WHO) to analyze the confirmed cases for the upcoming days. The performance regarding the proposed forecasting model is validated and assessed by introducing some indices including the mean absolute error (MAE), root mean square error (RMSE) and mean absolute percentage error (MAPE) and the comparisons with other optimization algorithms are presented. The proposed model is investigated in the most affected countries (i.e., USA, Italy, and Spain). The experimental simulations illustrate that the proposed ISACL-MFNN provides promising performance rather than the other algorithms while forecasting task for the candidate countries.


title: Economic analysis of healthcare-associated infection prevention and control interventions in medical and surgical units: Systematic review using a discounting approach

text: BACKGROUND: Nosocomial or healthcare-associated infections (HCAIs) are associated with a financial burden that affects both patients and healthcare institutions worldwide. The clinical best care practices (CBPs) of hand hygiene, hygiene and sanitation, screening, and basic and additional precautions aim to reduce this burden. The COVID-19 pandemic has confirmed these four CBPs are critically important prevention practices that limit the spread of HCAIs. AIM: This paper conducted a systematic review of economic evaluations related to these four CBPs using a discounting approach. METHODS: We searched for articles published between 2000 and 2019. We included economic evaluations of infection prevention and control of Clostridioides difficile-associated diarrhoea, meticillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and carbapenem-resistant Gram-negative bacilli. Results were analyzed with: cost-minimization, cost-effectiveness, cost-utility, cost-benefit and cost-consequence analyses. Articles were assessed for quality. RESULTS: A total of 11 898 articles were screened and seven were included. Most studies (4/7) were of overall moderate quality. All studies demonstrated cost effectiveness of CBPs. The average yearly net cost savings from the CBPs ranged from $252 847 (2019 $CAD) to $1 691 823 depending on the rate of discount (3% and 8%). The average incremental benefit cost ratio of CBPs varied from 2.48 to 7.66. CONCLUSION: In order to make efficient use of resources and maximize health benefits, ongoing research in the economic evaluation of infection control should be carried out to support evidence-based healthcare policy decisions.


title: Identification of nsp1 gene as the target of SARS-CoV-2 real-time RT-PCR using nanopore whole-genome sequencing

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic. Accurate detection of SARS-CoV-2 using molecular assays is critical for patient management and the control of the COVID-19 pandemic. However, there is an increasing number of SARS-CoV-2 viruses with mutations at the primer or probe binding sites, and these mutations may affect the sensitivity of currently available real-time reverse transcription-polymerase chain reaction (RT-PCR) assays targeting the nucleocapsid (N), envelope (E), and open reading frame 1a or 1b genes. Using sequence-independent single-primer amplification and nanopore whole-genome sequencing, we have found that the nonstructural protein 1 (nsp1) gene, located at the 5' end of the SARS-CoV-2 genome, was highly expressed in the nasopharyngeal or saliva specimens of 9 COVID-19 patients of different clinical severity. Based on this finding, we have developed a novel nsp1 real-time RT-PCR assay. The primers and probes are highly specific for SARS-CoV-2. Validation with 101 clinical specimens showed that our nsp1 RT-PCR assay has a sensitivity of 93.1% (95% confidence interval [CI]: 86.2%-97.2%), which was similar to those of N and E gene RT-PCR assays. The diagnostic specificity was 100% (95% CI: 92.9%-100%). The addition of nsp1 for multitarget detection of SARS-CoV-2 can avoid false-negative results due to mutations at the primers/probes binding sites of currently available RT-PCR assays.


title: COVID-19 complicated by parainfluenza co-infection in a patient with chronic lymphocytic leukemia

text: The number of people suffering from the new coronavirus SARS-CoV-2 continues to rise. In SARS-CoV-2, superinfection with bacteria or fungi seems to be associated with increased mortality. The role of co-infections with respiratory viral pathogens has not yet been clarified. Here, we report the course of COVID-19 in a CLL patient with secondary immunodeficiency and viral co-infection with parainfluenza.


title: Response to Commentary on "The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients"

text: In a recent review, we have suggested a neuroinvasive potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its possible role in the causation of acute respiratory failure of coronavirus disease 2019 (COVID-19) patients (J Med Viol doi: 10.1002/jmv.25728), based upon the clinical and experimental data available on the past SARS-CoV-1 and the recent SARS-CoV-2 pandemic. In this article, we provide new evidence recently reported regarding the neurotropic potential of SARS-CoV-2 and respond to several comments on our previously published article. In addition, we also discuss the peculiar manifestations of respiratory failure in COVID-19 patients and the possible involvement of nervous system.


title: [Covid-19 in patients on dialysis: infection prevention and control strategies]

text: Covid-19 is a disease caused by a new coronavirus presenting a variability of flu-like symptoms including fever, cough, myalgia and fatigue;in severe cases, patients develop pneumonia, acute respiratory distress syndrome, sepsis and septic shock, that can result in their death This infection, which was declared a global epidemic by the World Health Organization, is particularly dangerous for dialysis patients, as they are frail and more vulnerable to infections due to the overlap of multiple pathologies In patients with full-blown symptoms, there is a renal impairment of various degrees in 100% of the subjects observed However, as Covid-19 is an emerging disease, more work is needed to improve prevention, diagnosis and treatment strategies It is essential to avoid nosocomial spread;in order to control and reduce the rate of infections it is necessary to strengthen the management of medical and nursing personnel through the early diagnosis, isolation and treatment of patients undergoing dialysis treatment We cover here a series of recommendations for the treatment of dialysis patients who are negative to the virus, and of those who are suspected or confirmed positive


Covid-19: Trump cancels all flights from Europe, apart from the UK


COVID-19 outbreak: The early response of a UK orthopaedic department


title: Dos terapias conocidas podrían ser efectivas como adyuvantes en el paciente crítico infectado por COVID-19./ Dos terapias conocidas podrían ser efectivas como adyuvantes en el paciente crítico infectado por COVID-19./ Two known therapies could be useful as adjuvant therapy in critical patients infected by COVID-19

text: Pneumonia caused by coronavirus, which originated in Wuhan, China, in late 2019, has been spread around the world already becoming a pandemic. Unfortunately, there is not yet a specific vaccine or effective antiviral drug for treating COVID-19. Many of these patients deteriorate rapidly and require intubation and are mechanically ventilated, which is causing the collapse of the health system in many countries due to lack of ventilators and intensive care beds. In this document we review two simple adjuvant therapies to administer, without side effects, and low cost that could be useful for the treatment of acute severe coronavirus infection associated with acute respiratory syndrome (SARS-CoV-2). VitaminC, a potent antioxidant, has emerged as a relevant therapy due to its potential benefits when administered intravenous. The potential effect of vitaminC in reducing inflammation in the lungs could play a key role in lung injury caused by coronavirus infection. Another potential effective therapy is ozone: it has been extensively studied and used for many years and its effectiveness has been demonstrated so far in multiples studies. Nevertheless, our goal is not to make an exhaustive review of these therapies but spread the beneficial effects themselves. Obviously clinical trials are necessaries, but due to the potential benefit of these two therapies we highly recommended to add to the therapeutic arsenal.


title: Expanding coverage for essential care during COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic will exacerbate the financial situations of the millions of Americans who struggle to afford their medical care, but policy solutions are available to quickly mitigate this problem.


Les traitements à base d'hydroxychloroquine dans le cadre de la pandémie de CoViD-19


Wearing the N95 mask with a plastic handle reduces pressure injury


title: AAR-LN-DQ: Automatic Anatomy Recognition based Disease Quantification in Thoracic Lymph Node Zones via FDG PET/CT images without Nodal Delineation

text: PURPOSE: The derivation of quantitative information from medical images in a practical manner is essential for quantitative radiology (QR) to become a clinical reality, but still faces a major hurdle because of image segmentation challenges. With the goal of performing disease quantification in lymph node (LN) stations without explicit nodal delineation, this paper presents a novel approach for disease quantification (DQ) by automatic recognition of LN zones and detection of malignant lymph nodes within thoracic LN zones via positron emission tomography/computed tomography (PET/CT) images. Named AAR-LN-DQ, this approach decouples DQ methods from explicit nodal segmentation via a LN recognition strategy involving a novel globular filter and a deep neural network called SegNet. METHOD: The methodology consists of four main steps: (a) Building lymph node zones models by automatic anatomy recognition (AAR) method. It incorporates novel aspects of model building that relate to finding an optimal hierarchy for organs and lymph node zones in the thorax. (b) Recognizing lymph node zones by the built lymph node models. (c) Detecting pathologic LNs in the recognized zones by using a novel globular filter (g-filter) and a multi-level support vector machine (SVM) classifier. Here, we make use of the general globular shape of LNs to first localize them and then use a multi-level SVM classifier to identify pathologic LNs from among the LNs localized by the g-filter. Alternatively, we designed a deep neural network called SegNet which is trained to directly recognize pathologic nodes within AAR localized LN zones. (d) Disease quantification based on identified pathologic LNs within localized zones. A fuzzy disease map is devised to express the degree of disease burden at each voxel within the identified LNs to simultaneously handle several uncertain phenomena such as PET partial volume effects, uncertainty in localization of LNs, and gradation of disease content at the voxel level. We focused on the task of disease quantification in patients with lymphoma based on PET/CT acquisitions and devised a method of evaluation. Model building was carried out using 42 near-normal patient data sets via contrast-enhanced CT examinations of their thorax. PET/CT data sets from an additional 63 lymphoma patients were utilized for evaluating the AAR-LN-DQ methodology. We assess the accuracy of the three main processes involved in AAR-LN-DQ via 5-fold cross validation: lymph node zone recognition, abnormal lymph node localization, and disease quantification. RESULTS: The recognition and scale error for LN zones were 12.28 mm ± 1.99 and 0.94 ± 0.02, respectively, on normal CT data sets. On abnormal PET/CT data sets, the sensitivity and specificity of pathologic LN recognition were 84.1% ± 0.115 and 98.5% ± 0.003, respectively, for the g-filter-SVM strategy, and 91.3% ± 0.110 and 96.1% ± 0.016, respectively, for the SegNet method. Finally, the mean absolute percent errors for disease quantification of the recognized abnormal LNs were 8% ± 0.09 and 14% ± 0.10 for the g-filter-SVM method and the best SegNet strategy, respectively. CONCLUSIONS: Accurate disease quantification on PET/CT images without performing explicit delineation of lymph nodes is feasible following lymph node zone and pathologic LN localization. It is very useful to perform LN zone recognition by AAR as this step can cover most (95.8%) of the abnormal LNs and drastically reduce the regions to search for abnormal LNs. This also improves the specificity of deep networks such as SegNet significantly. It is possible to utilize general shape information about LNs such as their globular nature via g-filter and to arrive at high recognition rates for abnormal LNs in conjunction with a traditional classifier such as SVM. Finally, the disease map concept is effective for estimating disease burden, irrespective of how the LNs are identified, to handle various uncertainties without having to address them explicitly one-by-one.


Imaging Findings in Four COVID-19 Patients


title: Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)

text: Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors. We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals. First comparisons exposed a higher rate of COVID-19 patients requiring ventilation. There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort. Hospitals should prepare for high utilisation of ventilation and intensive care resources.


COVID-19, osteoarthritis and women's health


title: The role of triage in the prevention and control of COVID-19

text: OBJECTIVE: To prevent and control public health emergencies, we set up a prescreening and triage workflow and analyzed the effects on coronavirus disease 2019 (COVID-19). METHODS: In accordance with the requirements of the level 1 emergency response of public health emergencies in Shaanxi Province, China, a triage process for COVID-19 was established to guide patients through a 4-level triage process during their hospital visits. The diagnosis of COVID-19 was based on positive COVID-19 nucleic acid testing according to the unified triage standards of the Guidelines for the Diagnosis and Treatment of Novel Coronavirus Pneumonia (Trial version 4),4 issued by the National Health Commission of the People's Republic of China. RESULTS: The screened rate of suspected COVID-19 was 1.63% (4 of 246) in the general fever outpatient clinic and 8.28% (13 of 157) in the COVID-19 outpatient clinic, and they showed a significant difference (P = .00). CONCLUSIONS: The triage procedure effectively screened the patients and identified the high-risk population.


Coronavirus Disease (COVID-19) in Children: Indian Perspectives


South Africa's lockdown regulations and the reinforcement of anti-informality bias


title: Mega-COV: A Billion-Scale Dataset of 65 Languages For COVID-19

text: We describe Mega-COV, a billion-scale dataset from Twitter for studying COVID-19. The dataset is diverse (covers 234 countries), longitudinal (goes as back as 2007), multilingual (comes in 65 languages), and has a significant number of location-tagged tweets (~32M tweets). We release tweet IDs from the dataset, hoping it will be useful for studying various phenomena related to the ongoing pandemic and accelerating viable solutions to associated problems.


title: Proinflammatory Cytokines in the Olfactory Mucosa Result in COVID-19 Induced Anosmia

text: Studies have found increased rates of dysosmia in patients with Novel Coronavirus disease 2019 (COVID-19). However, the mechanism that causes olfactory loss is unknown. The primary objective of this study was to explore local proinflammatory cytokine levels in the olfactory epithelium in patients with COVID-19. Biopsies of the olfactory epithelium were taken from patients with confirmed COVID-19 as well as uninfected controls. Levels of tumor necrosis factor α (TNF-α) and interleukin-1-beta (IL-1ß) were assessed using ELISA and compared between groups. Average TNF-α levels were significantly increased in the olfactory epithelium of the COVID-19 group compared to the control group (P < 0.05). However, no differences in IL-1ß were seen between groups. Elevated levels of the proinflammatory cytokine TNF-α were seen in the olfactory epithelium in patients with COVID-19. This suggests that direct inflammation of the olfactory epithelium could play a role in the acute olfactory loss described in many patients with COVID-19.


Summary of the latest information on novel coronavirus pneumonia as of February 12


docid: wbdgwxoi

title: Development of Genetic Diagnostic Methods for Novel Coronavirus 2019 (nCoV-2019) in Japan

text: At the end of 2019, pneumonia caused by novel coronavirus 2019 (nCoV) emerged in Wuhan city, China. Many airline travelers moved between Wuhan and Japan at that time, suggesting that Japan is at high risk of invasion by the virus. Diagnostic systems for 2019-nCoV were developed with urgency. Two nested RT-PCR assays and two real-time RT-PCR assays were adapted to local Japanese conditions. As of 8 February 2020, the assays developed have successfully detected 25 positive cases of infection in Japan.


title: The Role of Lipid Metabolism in COVID-19 Virus Infection and as a Drug Target

text: The current Coronavirus disease 2019 or COVID-19 pandemic has infected over two million people and resulted in the death of over one hundred thousand people at the time of writing this review. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Even though multiple vaccines and treatments are under development so far, the disease is only slowing down under extreme social distancing measures that are difficult to maintain. SARS-COV-2 is an enveloped virus that is surrounded by a lipid bilayer. Lipids are fundamental cell components that play various biological roles ranging from being a structural building block to a signaling molecule as well as a central energy store. The role lipids play in viral infection involves the fusion of the viral membrane to the host cell, viral replication, and viral endocytosis and exocytosis. Since lipids play a crucial function in the viral life cycle, we asked whether drugs targeting lipid metabolism, such as statins, can be utilized against SARS-CoV-2 and other viruses. In this review, we discuss the role of lipid metabolism in viral infection as well as the possibility of targeting lipid metabolism to interfere with the viral life cycle.


Genetic Analysis Tracks SARS-CoV-2 Mutations in Human Hosts


title: Good Inter- and Intra-Observer Reliability for Assessment of Radiographic Femoral and Tibial Frontal and Sagittal Planes Joints Angles in Normal Cats

text: OBJECTIVE: The aim of this study was to evaluate the inter- and intra-observer reliability of plain digital radiographs for assessing normal feline femoral and tibial joint reference angles in the sagittal and frontal planes. STUDY DESIGN: This was a cadaveric radiographic anatomical study. that involved 20 short-haired domestic adult cats. METHODS: Sagittal and frontal plane tibial and femoral joint angles of 40 limbs were measured twice by three observers with different levels of experience. Inter- and intraobserver reliability was determined by the intra-class correlation coefficient (ICC). An ICC > 0.75 was considered high correlation, 0.74 > ICC > 0.60 good correlation, 0.59 > ICC > 0.4 fair correlation and an ICC < 0.40 poor correlation. RESULTS: Mean ± standard deviation angles were anatomic lateral proximal femoral angle (aLPFA) 110.6 ± 3.6; anatomic lateral distal femoral angle (aLDFA) 91.9 ± 2.1; mechanical lateral proximal femoral angle; mLPFA (mLPFA) 107.3 ± 3.6; mechanical lateral distal femoral angle (mLDFA) 95.5 ± 1.7; femoral neck anteversion (FNA) 121.9 ± 4.1; anatomical caudal proximal femoral angle (aCPFA) 156.1 ± 3.9; anatomical caudal distal femoral angle (aCDFA) 101.4 ± 1.4; mechanical medial proximal tibial angle (mMPTA) 93.5 ± 1.2; mechanical medial distal tibial angle (mMDTA) 100.5 ± 2.3; mechanical cranial proximal tibial angle (mCrPTA) 113.1 ± 3.2; tibial plateau angle (TPA) 23.1 ± 3.2; mechanical cranial proximal tibial angle (mCrDTA) 86.7 ± 3.1.The intra-observer ICC indicated high correlation for 70% or more of the measurements. The inter-observer agreement among observers was high. These results show that the radiographic method for measuring femoral and tibial joint angles was good or high, except for FNA and mCrDTA. CONCLUSIONS: This study provides some radiographic anatomical and mechanical joint angles of the femurs and tibias of normal domestic short-haired cats. We found good reliability for both intra- and interobserver measurements.


Asymptomatic and Pre-Symptomatic COVID-19 in China


Stroke in COVID-19 and SARS-CoV-1


docid: waqogwok

title: Will COVID-19 lead to a major change of the EU Public Health mandate? A renewed approach to EU's role is needed


title: Let us unite against COVID-19 - a New Zealand perspective

text: Novel coronavirus 2019 (COVID-19) has shaken the existence of mankind worldwide, including that of New Zealand. In comparison to other countries, New Zealand has had a very low number of confirmed and probable cases as well as COVID-19-related deaths. New Zealand closed its borders and rapidly declared a stringent lockdown to eliminate COVID-19. The country's 'go hard, go early' policy serves as an exemplar for the rest of the world to date. The mysterious nature of COVID-19 has caused tremendous stress and uncertainty leading to universal conflict between public health and state economy. Mental health services and non-government organisations have been proactive in the fight against COVID-19. Though there has been no significant rise in referrals to secondary mental health services to date (4 May 2020), a rapid surge in mental health presentations is widely anticipated. Telehealth may prove to be an efficient and cost-effective tool for the provision of future health services.


title: Effects of Corticosteroid Treatment for Non-Severe COVID-19 Pneumonia: A Propensity Score-Based Analysis

text: BACKGROUND AND OBJECTIVE: The effects of corticosteroid treatment on non-severe COVID-19 pneumonia patients are unknown. To determine the impacts of adjuvant corticosteroid administrated to patients with non-severe COVID-19 pneumonia. METHOD: A retrospective cohort study based on propensity score analysis was designed to explore the effects of corticosteroid on several clinical outcomes. RESULTS: 132 patients satisfied the inclusion criteria and 35 pairs were generated according to propensity score matching. Compared to non-corticosteroid group, the CT score on day 7 was significantly higher in corticosteroid group (8.6 (IQR, 2.8-11.5) versus 12.0 (IQR, 5.0-19.3), Pâ=â0.046). In corticosteroid group, more patients progressed to severe cases (11.4% versus 2.9%, Pâ=â0.353), hospital stay (23.5 days (IQR, 19-29 d) versus 20.2 days (IQR, 14-25.3 d), Pâ=â0.079) and duration of viral shedding (20.3 days (IQR, 15.2-24.8 d) versus 19.4 days (IQR, 11.5-28.3 d), Pâ=â0.669) were prolonged, while fever time (9.5 days (IQR, 6.5-12.2 d) versus 10.2 days (IQR, 6.8-14 d), Pâ=â0.28) was shortened, however all these data revealed no statistically significant differences. CONCLUSION: Corticosteroid might have a negative effect on lung injury recovery in non-severe COVID-19 pneumonia patients, however the results of this study must be interpreted with caution because of confounding factors.


docid: rovhtehw

title: Febrile Infant: COVID-19 in Addition to the Usual Suspects


On the relationship between androgen-deprivation therapy for prostate cancer and risk of infection by SARS-CoV-2


title: Hospital financial preparedness and covid-19

text: It is highly likely that COVID-19 will result in a drain on hospitals financial resources, not the least of which being cash Not all hospitals are financially prepared for any enduring loss of cash, with hospitals in few states being well prepared Those states that have experienced early cases of COVID-19 are less well prepared financially Several policy options merit consideration


title: COVID-19: Initial Perioperative and Perianesthesia Nursing Response in a Military Medical Center

text: Nurses have historically led efforts to improve the health of populations while simultaneously and unselfishly providing care during pivotal moments of national need. The COVID-19 pandemic has placed an unprecedented strain on the US health care system, including severe shortages of hospital beds, supplies, equipment, pharmaceuticals, and healthy frontline clinicians. Perioperative and perianesthesia leaders and clinicians have unique opportunities to provide patient care during the COVID-19 crisis. In this manuscript, we describe the initial changing roles and contributions of perioperative and perianesthesia registered nurses during the COVID-19 pandemic and share recent experiences from a military medical center. Perioperative and perianesthesia nurses are vital to the overall nursing viability of the health care system, as they possess the requisite knowledge and skills to provide expert clinical care in many hospital settings and meet the demands of a global pandemic.


Huge mass of the scalp: follicular lymphoma with complete regression after therapy


title: Publisher Correction: Science in the time of coronavirus

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Challenges of coronavirus disease 2019


Outcome of Parkinson's Disease Patients Affected by COVID-19


title: Assisted breastfeeding technique to improve knowledge, attitude, and practices of mothers with cleft lip- and palate-affected infants: A randomized trial

text: BACKGROUND: Cleft lip and palate is one of the most common developmental anomalies affecting the craniofacial region leading to an array of problems including the inability to feed properly. OBJECTIVES: This study aimed to compare the effectiveness of specially designed audio-visual module over traditional instructional module in improving the assisted breastfeeding habits. METHODOLOGY: Sixteen patients received training regarding the feeding practices through the traditional instructional method, and 16 subjects received training through audio-visual module. Infants in both the groups received the standard care. These infants were followed up longitudinally for 6 months. During the follow up period, the growth parameters were recorded monthly. The knowledge, attitude, and practices of the mothers regarding feeding practices were assessed using KAP questionnaire. RESULTS: There was significant improvement in the knowledge of the mothers from baseline to 6 months, however, the practices indicated that the mothers belonging to the audio-visual module group showed better understating of the condition and earlier adaptation of the breastfeeding practices. Correspondingly, the growth parameters also showed significant difference. CONCLUSION: The custom-made audio-visual module would help the mothers adapt better to the stressful situation following the birth of the infant affected with cleft lip and palate.


docid: trcybnkx

title: COVID-19 Pandemic and Acute Myocardial Infarction: Management Protocol From a British Cardiac Centre


Fear of COVID 2019: First suicidal case in India !


COVID-19: Possible Impact of the Genetic Background in IFNL Genes on Disease Outcomes


title: COVID-19 and Acute Heart Failure: Screening the Critically Ill - A Position Statement of the Cardiac Society of Australia and New Zealand (CSANZ)

text: Up to one-third of COVID-19 patients admitted to intensive care develop an acute cardiomyopathy, which may represent myocarditis or stress cardiomyopathy. Further, while mortality in older patients with COVID-19 appears related to multi-organ failure complicating acute respiratory distress syndrome (ARDS), the cause of death in younger patients may be related to acute heart failure. Cardiac involvement needs to be considered early on in critically ill COVID-19 patients, and even after the acute respiratory phase is passing. This Statement presents a screening algorithm to better identify COVID-19 patients at risk for severe heart failure and circulatory collapse, while balancing the need to protect health care workers and preserve personal protective equipment (PPE). The significance of serum troponin levels and the role of telemetry and targeted transthoracic echocardiography (TTE) in patient investigation and management are addressed, as are fundamental considerations in the management of acute heart failure in COVID-19 patients.


title: "Monoclonal-Type" Plastic Antibodies for COVID-19 Treatment: What Is the Idea?

text: In late December 2019, an outbreak due to a novel coronavirus, initially called 2019-nCoV, was reported in Wuhan, China [...].


title: An uncommon cold

text: The covid-19 virus isn't the first coronavirus to jump from animals to humans. What can we learn from previous encounters, asks Anthony King.


title: Extractos de los documentos de posicionamientos y recomendaciones mexicanas en enfermedades cardiovasculares y COVID-19./ Excerpts from the documents of Mexican positions and recommendations in cardiovascular diseases and COVID-19

text: The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic. Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation. The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19.


title: Extractos de los documentos de posicionamientos y recomendaciones mexicanas en enfermedades cardiovasculares y COVID-19

text: The recommendations in which the Mexican Society of Cardiology (SMC) in conjunction with the National Association of Cardiologists of Mexico (ANCAM) as well as different Mexican medical associations linked to cardiology are presented, after a comprehensive and consensual review and analysis of the topics related to cardiovascular diseases in the COVID-19 pandemic Scientific positions are analyzed and responsible recommendations on general measures are given to patients, with personal care, healthy eating, regular physical activity, actions in case of cardio-respiratory arrest, protection of the patient and health personnel as well as precise indications in the use of non-invasive cardiovascular imaging, prescription of medications, care in specific topics such as systemic arterial hypertension, heart failure, arrhythmias and acute coronary syndromes, in addition to emphasizing electrophysiology, interventionism, cardiac surgery and in cardiac rehabilitation The main interest is to provide the medical community with a general orientation on what to do in daily practice and patients with cardiovascular diseases in the setting of this unprecedented epidemiological crisis of COVID-19


title: COVID-19 and Computer Audition: An Overview on What Speech&Sound Analysis Could Contribute in the SARS-CoV-2 Corona Crisis

text: At the time of writing, the world population is suffering from more than 10,000 registered COVID-19 disease epidemic induced deaths since the outbreak of the Corona virus more than three months ago now officially known as SARS-CoV-2. Since, tremendous efforts have been made worldwide to counter-steer and control the epidemic by now labelled as pandemic. In this contribution, we provide an overview on the potential for computer audition (CA), i.e., the usage of speech and sound analysis by artificial intelligence to help in this scenario. We first survey which types of related or contextually significant phenomena can be automatically assessed from speech or sound. These include the automatic recognition and monitoring of breathing, dry and wet coughing or sneezing sounds, speech under cold, eating behaviour, sleepiness, or pain to name but a few. Then, we consider potential use-cases for exploitation. These include risk assessment and diagnosis based on symptom histograms and their development over time, as well as monitoring of spread, social distancing and its effects, treatment and recovery, and patient wellbeing. We quickly guide further through challenges that need to be faced for real-life usage. We come to the conclusion that CA appears ready for implementation of (pre-)diagnosis and monitoring tools, and more generally provides rich and significant, yet so far untapped potential in the fight against COVID-19 spread.


Pandemic-related excess mortality (COVID-19), public health measures and funerary rituals


title: Leveraging User Experience to Improve Video Consultations in a Cardiology Practice During the COVID-19 Pandemic: Initial Insights

text: During the coronavirus disease (COVID-19) pandemic, cardiologists have attempted to minimize risks to their patients by using telehealth to provide continuing care. Rapid implementation of video consultations in outpatient clinics for patients with heart disease can be challenging. We employed a design thinking tool called a customer journey to explore challenges and opportunities when using video communication software in the cardiology department of a regional hospital. Interviews were conducted with 5 patients with implanted devices, a nurse, an information technology manager and two cardiologists. Three lessons were identified based on these challenges and opportunities. Attention should be given to the ease of use of the technology, the meeting features, and the establishment of the connection between the cardiologist and the patient. Further, facilitating the role of an assistant (or virtual assistant) with the video consultation software who can manage the telehealth process may improve the success of video consultations. Employing design thinking to implement video consultations in cardiology and to further implement telehealth is crucial to build a resilient health care system that can address urgent needs beyond the COVID-19 pandemic.


Cardiac and Muscle Injury Might Partially Contribute to Elevated Aminotransferases in COVID-19 Patients


title: Management of Adult Inpatient Otolaryngologic Consultations During the COVID-19 Pandemic: A Proposed Tier-Based Triage System

text: The coronavirus disease 2019 (COVID-19) pandemic has placed tremendous strain on health care systems, leading to unprecedented challenges and obstacles in the delivery of patient care. Otolaryngologists are frequently called on for inpatient consultations for an array of pathologies, ranging from chronic benign conditions to acutely life-threatening processes. Professional otolaryngologic societies across the world have proposed limiting patient care to time-sensitive and urgent matters; however, limited literature is available to describe how this transient change in philosophy may translate to clinical practice. Here we present a structured algorithm that allows for rapid triage of otolaryngologic consults during the ongoing pandemic, in efforts to minimize infectious spread and protect clinicians while preserving high-quality patient care. Considerations for managing these consults are presented, with a commentary on practical and ethical considerations.


title: Ethical considerations for allocation of scarce resources and alterations in surgical care during a pandemic

text: The COVID-19 pandemic caused by SARS-CoV-2 is unprecedented in modern history. Its effects on social behavior and health care delivery have been dramatic. The resultant burden of disease and critical illness has outpaced the diagnostic, therapeutic, and health care professional resources of many clinics and hospitals. It continues to do so globally. The allocation of hospital beds and ventilators, personal protective equipment, investigational therapeutics, and other scarce resources has required difficult decisions. Clinical and surgical practices which are standard in normal times may not be standard or safe during the COVID-19 crisis. How can we best adapt as physicians and surgeons? What foundational ethical principles and systems of principle application can help guide our decision-making? Fortunately, a large body of work in medical ethics addresses these questions. Unfortunately, many surgeons and other health care professionals are probably not as familiar with these concepts. This brief communication is intended to provide a concise explanation of ethical considerations which readers may find helpful when addressing allocation of scarce resources and alterations in surgical care brought on by the current pandemic.


title: Lung, Heart, Vascular, and Diaphragm Ultrasound Examination of COVID-19 Patients: A Comprehensive Approach

text: Lung ultrasound (LU) has a multitude of features and capacities that make it a useful medical tool to assist physicians contending with the pandemic spread of novel coronavirus disease-2019 (COVID-19) caused by coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Thus, an LU approach to patients with suspected COVID-19 is being implemented worldwide. In noncritical COVID-19 patients, 2 new LU signs have been described and proposed, the "waterfall" and the "light beam" signs. Both signs have been hypothesized to increase the diagnostic accuracy of LU for COVID-19 interstitial pneumonia. In critically ill patients, a distinct pattern of LU changes seems to follow the disease's progression, and this information can be used to guide decisions about when a patient needs to be ventilated, as occurs in other disease states similar to COVID-19. Furthermore, a new algorithm has been published, which enables the automatic detection of B-lines as well as quantification of the percentage of the pleural line associated with lung disease. In COVID-19 patients, a direct involvement of cardiac function has been demonstrated, and ventilator-induced diaphragm dysfunction might be present due to the prolonged mechanical ventilation often involved, as reported for similar diseases. For this reason, cardiac and diaphragm ultrasound evaluation are highly important. Last but not least, due to the thrombotic tendency of COVID-19 patients, particular attention also should be paid to vascular ultrasound. This review is primarily devoted to the study of LU in COVID-19 patients. The authors explain the significance of its "light and shadows," bearing in mind the context in which LU is being used-the emergency department and the intensive care setting. The use of cardiac, vascular, and diaphragm ultrasound is also discussed, as a comprehensive approach to patient care.


Telemedicine allows quantitative measuring of olfactory dysfunction in COVID-19


title: Evidence for and against vertical transmission for severe acute respiratory syndrome coronavirus 2

text: COVID-19 can severely affect pregnant women Furthermore, issues regarding vertical transmission of severe acute respiratory syndrome coronavirus 2 are emerging. In patients and neonates who are showing symptoms of coronavirus disease 2019, real-time polymerase chain reaction of nasal and throat swabs, sputum, and feces is performed to detect the presence of severe acute respiratory syndrome coronavirus 2. In addition, real-time polymerase chain reaction of vaginal swabs, amniotic fluid, placenta, cord blood, neonatal blood, or breast milk for the detection of severe acute respiratory syndrome coronavirus 2 did not show substantial results. Viremia was present in 1% of adult patients who were showing symptoms of coronavirus disease 2019. Here, we reviewed 12 articles published between Feb. 10, 2020, and April 4, 2020, that reported on 68 deliveries and 71 neonates with maternal infection in the third trimester of pregnancy. To determine whether infection occurred congenitally or perinatally, perinatal exposure, mode of delivery, and time interval from delivery to the diagnosis of neonatal infection were considered. Neonates with severe acute respiratory syndrome coronavirus 2 infection are usually asymptomatic. In 4 cases, a diagnostic test for severe acute respiratory syndrome coronavirus 2 infection was performed within 48 hours of life. Furthermore, detection rates of real-time polymerase chain reaction and the interpretation of immunoglobulin M and immunoglobulin G antibodies levels in cord and neonatal blood were discussed in relation with the immaturity of the fetal and neonatal immune system.


Baricitinib: A chance to treat COVID-19?


title: Comparison of test performance of commercial anti-SARS-CoV-2 immunoassays in serum and plasma samples

text: BACKGROUND: For epidemiologic, social and economic reasons, assessment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection prevalence and immunity are important to adapt decisions to current demands. Hence, immunoassays for detection of anti-SARS-CoV-2 antibodies are introduced rapidly without requiring FDA emergency use authorization approval. Thus, evaluation of test performance predominantly relies on laboratories. This study aimed to evaluate the test performance of recently launched commercial immunoassays in serum and plasma samples. METHODS: 51 serum samples from 26 patients with confirmed SARS-CoV-2 infection after end of quarantine and 25 control patients were analyzed using anti-SARS-CoV-2 IgG immunoassays from Roche, Euroimmun and Epitope to assess diagnostic sensitivity and specificity. 20 matching pairs of serum and plasma samples were included to analyze comparability between different specimens. RESULTS: Overall, a diagnostic sensitivity of 92.3%, 96.2-100% and 100% with a respective diagnostic specificity of 100%, 100% and 84-86% for the immunoassays from Roche, Euroimmun and Epitope were determined. In total, 84-96 % of samples were correctly classified as negative and 92.3-95.2% as positive. The level of concordance between plasma- and serum-based testing diverged between the assays (Epitope r2=0.97; Euroimmun r2=0.91; Roche r2=0.76). CONCLUSIONS: The immunoassays from Euroimmun and Roche revealed a higher specificity than the Epitope assay without a substantial drop of diagnostic sensitivity. Significant differences between plasma- and serum-based testing highlights the need for determination of appropriate cut-offs per specimen type. Hence, there is an urgent need for test harmonization and establishment of quality standards for an appropriate use of COVID-19 serological tests.


title: Similarities and Evolutionary Relationships of COVID-19 and Related Viruses

text: Today, we are all threatened by an unprecedented pandemic: COVID-19. How different is it from other coronaviruses? Will it be attenuated or become more virulent? Which animals may be its original host? In this study, we analyzed 377 publicly available complete genome sequences for the COVID-19 virus, the previously known flu-causing coronaviruses (HCov-229E, HCov-OC43, HCov-NL63 and HCov-HKU1) and the lethal, pathogenic viruses, SARS, MERS, Victoria, Lassa, Yamagata, Ebola, and Dengue. We found strong similarities between the current circulating COVID-19 and SARS and MERS, as well as COVID-19 in rhinolophines and pangolins. On the contrary, COVID-19 shares little similarity with the flu-causing coronaviruses and the other known viruses. Strikingly, we observed divergence of COVID-19 strains isolated from human hosts has steadily increased from December 2019 to March 2020, suggesting COVID-19 is actively evolving in human hosts. From all existing human COVID-19 genome sequences, we calculated the first common model that represents the shared sequences of the human COVID-19 strains, which provides important information for vaccine and antibody development. Geographic and time -course analysis of the evolutionary trees of the human COVID-19 reveals possible evolutional paths among strains from 21 countries. This finding has important implications to the management of COVID-19 and the development of vaccines.


title: Push-Sum Distributed Online Optimization With Bandit Feedback

text: In this article, we concentrate on distributed online convex optimization problems over multiagent systems, where the communication between nodes is represented by a class of directed graphs that are time varying and uniformly strongly connected. This problem is in bandit feedback, in the sense that at each time only the cost function value at the committed point is revealed to each node. Then, nodes update their decisions by exchanging information with their neighbors only. To deal with Lipschitz continuous and strongly convex cost functions, a distributed online convex optimization algorithm that achieves sublinear individual regret for every node is developed. The algorithm is built on the algorithm called the push-sum scheme that releases the request of doubly stochastic weight matrices, and the one-point gradient estimator that requires the function value at only one point at every iteration, instead of the gradient information of loss function. The expected regret of our proposed algorithm scales as O ( T2/3 ln2/3(T) ), and T is the number of iterations. To validate the performance of the algorithm developed in this article, we give a simulation of a common numerical example.


A systematic approach is needed to contain COVID-19 globally


title: The impact of the SARS-CoV-2 infection, with special reference to the hematological setting

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a disease known from a few months, caused by a recently arisen virus and, consequently, it is little known. The disease has a benign course in most infected subjects (children and young adults), is often symptomatic in adults over the age of 50 and often serious and life threatening in people with comorbidities and the elderly. The few data published on coronavirus disease-2019 (COVID-19) in the blood-oncology field report a serious clinical presentation, a serious course of the disease, and a high mortality rate, as has also been reported for other cancer contexts. The current strategy for treating patients with SARS-CoV-2 includes antivirals that are effective against other viral infections and drugs that can moderate the cytokine storm. There is no specific vaccine and consequently all possible precautions must be taken to prevent SARS-CoV-2 infection in the areas of oncology, oncohematology, and bone marrow transplantation. In this reviewer's article, we report the information currently available on SARS-CoV-2 infection to help young doctors and hematologists to successfully manage patients with COVID-19.


title: The impact of the SARS-CoV-2 infection, with special reference to the haematological setting

text: SARS-CoV-2 is a disease known from a few months, caused by a recently arisen virus and, consequently, it is little known. The disease has a benign course in most infected subjects (children and young adults), is often symptomatic in adults over the age of 50 and often serious and life threatening in people with comorbidities and the elderly. The few data published on COVID-19 in the blood-oncology field report a serious clinical presentation, a serious course of the disease and a high mortality rate, as has also been reported for other cancer contexts. The current strategy for treating patients with SARS-CoV-2 includes antivirals that are effective against other viral infections and drugs that can moderate the cytokine storm. There is no specific vaccine and consequently all possible precautions must be taken to prevent SARS-CoV-2 infection in the areas of oncology, onco-hematology, and bone marrow transplantation. In this reviewer's article, we report the information currently available on SARS-CoV-2 infection to help young doctors and hematologists to successfully manage patients with COVID-19. This article is protected by copyright. All rights reserved.


title: Prioritizing resident and patient safety while maintaining educational value: emergency restructuring of a Canadian surgical residency program during COVID-19

text: Summary: Surgical programs are facing major and fluctuating changes to the resident workforce because of decreased elective volumes and high exposure risk during the coronavirus disease 2019 pandemic. Rapid restructuring of a residency program to protect its workforce while maintaining educational value is imperative. We describe the experience of the Division of General Surgery at the University of Ottawa in Ontario, Canada. The residency program was restructured to feature alternating "on" and "off" weeks, maintaining a healthy resident cohort in case of exposure. Teams were restructured and subdivided to maximize physical distancing and minimize resident exposure to pathogens. Educational initiatives doubled, with virtual sessions targeting every resident year and incorporating intraoperative teaching. The divisional research day and oral exams proceeded uninterrupted, virtually. A small leadership team enabled fast and flexible restructuring of a system for patient care while prioritizing resident safety and maintaining a commitment to resident education in a pandemic.


Prevalence of COVID-19 diagnosis in Dutch CML patients during the 2020 SARS-CoV2 pandemic. A prospective cohort study


title: Gynecological laparoscopic surgery in the shade of COVID-19 pandemic

text: A global public health problem with a high rate spread and transmission, Coronavirus outbreak has become the most talked-about matter throughout the world. We are severely affected by the nations with vast numbers of deaths; it was hard to predict such a colossal pandemic with terrifying consequences. Elective surgeries are limited, but situations requiring an urgent gynaecological or obstetric surgical approach must still be performed during the COVID-19 pandemic. Concerns regarding surgical safety and the risk of viral transmission during surgery are of great importance. In this review, we aimed to summarize the concepts related to laparoscopic gynecological surgery during COVID-19 pandemic in the light of current literature.


Safety of antiviral and anti-inflammatory drugs prolonging QT interval in patients with coronavirus disease 2019: an opinion of the Heart Rhythm Section of the Polish Cardiac Society


title: The impact of SARS-Cov-2 pandemic on stroke care: A warning message

text: The recent coronavirus disease (COVID-19) pandemic intensely impacted the health systems worldwide, which had to deal with the challenge of contemporarily answering to the needs of COVID-19 patients and managing other life threatening disorders. Several European countries such as Italy, France and Spain, particularly hit by the pandemic, had to deeply reorganize healthcare and to redistribute personnel, resources and beds to deal with the demands of the uncontrolled spreading of the COVID-19 infection.


Supresión de angiotensina II en la infección por el virus SARS-CoV-2: una propuesta terapéutica./ Supresión de angiotensina II en la infección por el virus SARS-CoV-2: una propuesta terapéutica./ [Angiotensin II suppression in SARS-CoV-2 infection: a therapeutic approach]


Employing dermatologists on the frontline against COVID-19: All hands on deck


Treating COVID-19 with Chloroquine


title: Efficacies of lopinavir/ritonavir and abidol in the treatment of novel coronavirus pneumonia/ 中华传染病杂志

text: Objective@#To evaluate the efficacies of lopinavir/ritonavir and abidol in the treatment of NCP.@*Methods@#The clinical data of 134 patients with NCP receiving treatment at Shanghai Public Health Clinical Center during Jan 20 to Feb 6, 2020 were retrospectively collected. All the patients received interferon-α2b spray and symptomatic supportive treatment, and 52 cases received oral lopinavir/ritonavir treatment, 34 cases received oral abidol treatment, the remaining 48 cases did not take any antiviral drugs. The efficacies at median day 7 among the three groups were compared by using Kruskal-Wallis or chi-square tests.@*Results@#The 134 patients included 69 males (51.5%) and 65 females, aged 35-62 years with the average of 48 years. The median time to temperature normalization in patients receiving abidol or lopinavir/ritonavir treatment was both 6 days after admission, and that was 4 days in the control group, with no significant difference (χ2=2.37, P=0.31). The median time to PCR negative in the respiratory specimens in the three groups was all 7 days after admission, and the PCR negative rates at day 7 after admission in lopinavir/ritonavir, abidol and control groups were 71.8% (28/39), 82.6% (19/23) and 77.1% (27/35), respectively, which were not significantly different (χ2=0.46, P=0.79). Radiological worsening at day 7 was observed in comparable proportions of patients in the three groups, which were 42.3% (n=22), 35.3% (n=12) and 52.1% (n=25), respectively (χ2=2.38, P=0.30) . Adverse reactions occurred in 17.3% (n=9), 8.8% (n=3) and 8.3% (n=4) patients, respectively in the three groups (χ2=2.33, P=0.33).@*Conclusions@#This study did not find any effects of lopinavir/ritonavir and abidol on relieving symptoms or accelerating virus clearance. The efficacies of these two drugs in NCP treatment need further investigation.


Are erythema multiforme and urticaria related to a better outcome of COVID-19?


title: Electrical stimulation as a therapeutic approach in obstructive sleep apnea - a meta-analysis

text: PURPOSE: Electrical stimulation of the upper airway dilator muscles is an emerging treatment for obstructive sleep apnea (OSA). Invasive hypoglossal nerve stimulation (HNS) has been accepted as treatment alternative to continuous positive airway pressure (CPAP) for selected patients, while transcutaneous electrical stimulation (TES) of the upper airway is being investigated as non-invasive alternative. METHODS: A meta-analysis (CRD42017074674) on the effects of both HNS and TES on the apnea-hypopnea index (AHI) and the Epworth Sleepiness Scale (ESS) in OSA was conducted including published evidence up to May 2018. Random-effects models were used. Heterogeneity and between-study variance were assessed by I2 and τ2, respectively. RESULTS: Of 41 identified clinical trials, 20 interventional trials (n = 895) could be pooled in a meta-analysis (15 HNS [n = 808], 5 TES [n = 87]). Middle-aged (mean ± SD 56.9 ± 5.5 years) and overweight (body mass index 29.1 ± 1.5 kg/m2) patients with severe OSA (AHI 37.5 ± 7.0/h) were followed-up for 6.9 ± 4.0 months (HNS) and 0.2 ± 0.4 months (TES), respectively. The AHI improved by - 24.9 h-1 [95%CI - 28.5, - 21.2] in HNS (χ2 79%, I2 82%) and by - 16.5 h-1 [95%CI - 25.1, - 7.8] in TES (χ2 7%, I2 43%; both p < 0.001). The ESS was reduced by - 5.0 (95%CI - 5.9, - 4.1) (p < 0.001). CONCLUSION: Both invasive and transcutaneous electrical stimulation reduce OSA severity by a clinically relevant margin. HNS results in a clinically relevant improvement of symptoms. While HNS represents an invasive treatment for selected patients with moderate to severe OSA, TES should be further investigated as potential non-invasive approach for OSA.


title: COVID-19 Pandemic and Africa: From the Situation in Zimbabwe to a Case for Precision Herbal Medicine

text: This opinion commentary on the coronavirus disease 2019 (COVID-19) pandemic brings together observations from Zimbabwe specifically, and Africa broadly, drawing from the fields of pharmacogenomics, precision herbal medicine, and responsible innovation so as to respond to the pandemic in ways that are efficient, critically informed, principled, and responsive to needs in rural and urban communities across Africa. With new findings suggesting that COVID-19 is a systemic disease, impacting the respiratory system and beyond in some individuals, we need new molecular targets for therapeutics innovation more than ever. We argue that the current pandemic will likely strip the limited resources from other diseases such as malaria, human immunodeficiency virus (HIV) infection, and among others affecting the African continent. Hence, we need to address not only COVID-19 but also its broader health care and societal impacts in Africa. Extensive diagnostic testing to trace and isolate the COVID-19 cases as well as basic income and economic support for those who are unable to work will be needed. A critically informed and democratic governance that builds on transparency and trust for the elected leaders is crucial. Finally, the pandemic offers a silver lining for Africa: the prospects to integrate omics research with long-standing expertise in herbal medicine in Africa, thus accelerating the advances toward novel molecular therapeutic targets for COVID-19 and precision herbal medicine worldwide.


Number of Healthcare Workers Who Have Died of COVID-19


title: Drone aggregation behavior in the social wasp Vespula germanica (Hymenoptera: Vespidae): Effect of kinship and density

text: Inbreeding can have negative consequences on population viability because of the reduced fitness of the progeny. In general, most species have developed mechanisms to minimize inbreeding such as dispersal and kin avoidance behavior. In the eusocial Hymenoptera, related individuals typically share a common nest and have relatively short mating periods, this could lead to inbreeding, and because of their single-locus complementary sex determination system, it may generate diploid males that could result in infertile triploid progeny representing a cost for the colony. Vespula germanica, is an eusocial wasp that has invaded many parts of the world, despite likely facing a reduced genetic pool during the arrival phases. We ask whether male wasp display specific aggregation behavior that favors genetic diversity, key to reduce inbreeding. Through a set of laboratory experiments, we investigated the effects of drone nestmateship and density on the aggregation behavior of V. germanica drones. We show that drones avoid aggregating with their nestmates at all densities while non-nestmates are avoided only at high densities. This suggests that lek genetic diversity and density could be regulated through drone behavior and in the long run minimize inbreeding favoring invasion success.


title: Pharmacy services at a temporary COVID-19 hospital in Wuhan, China

text: In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.


title: All for one and one for all: Why a pandemic preparedness league of nations?

text: In light of today's COVID-19 crisis, it is argued that new ways to collaborate among all nations for pandemic preparedness may be the next big thing. A workable solution for pandemic preparedness requires leaders of all nations to be on the same page (all for one), aiming at a swift turnaround of the crisis in tandem that can only benefit everyone on a global scale (one for all). After all, a public health crisis of this magnitude involves all humankind, demanding not only the most sensible and intelligent adoption of progressive policies and innovative technology, but an effective balancing of emergency supply chain management (SCM) reserve of personal protective equipment (PPE), professional workers and/or other urgently needed resources (e.g., ICU beds) to save lives. Above all, accurate sharing of information and massive-scale testings vis-à-vis targeted isolations must be sustained. Notably, such a framework may not just be limited to infuenza. Here, the authors elaborate on several key strategies and aim to provide grounds for scientific innovations and clearer policy thinking across international boundaries to combat a global public health pandemic via a league of nations conceived as IPPO: Intercontinental Pandemic Preparedness Organization.


title: COVID-19 is likely to impact animal health

text: Responses to the ongoing COVID-19 pandemic have included travel bans and social distancing with "shelter in place" orders, resulting in sudden changes in human activity and subsequent effects on the global and national economy. We speculate that animal health will likely be impacted by COVID-19 through the immediate consequences of sudden human confinement and inactivity, and through the long-term consequences of the upcoming economic crisis on farmer livelihoods and veterinary service capacities. We expect the COVID-19 pandemic and the subsequent economic crisis to impact negatively on the control of diseases that are already present in Europe, as well as on the European capacity to prevent and respond in a timely manner to new and emerging animal diseases. We also expect an increased attention to the animal health implications of coronavirus infections in animals. Mechanisms explaining these outcomes include increased wildlife-livestock contacts due to human confinement; disruption of ongoing testing schemes for endemic diseases; lower disease surveillance efforts; and lower capacity for managing populations of relevant wildlife reservoirs. The main mitigation action consists in adapting animal health management strategies to the available resources.


title: Data Mining and Content Analysis of the Chinese Social Media Platform Weibo During the Early COVID-19 Outbreak: Retrospective Observational Infoveillance Study

text: BACKGROUND: The coronavirus disease (COVID-19) pandemic, which began in Wuhan, China in December 2019, is rapidly spreading worldwide with over 1.9 million cases as of mid-April 2020. Infoveillance approaches using social media can help characterize disease distribution and public knowledge, attitudes, and behaviors critical to the early stages of an outbreak. OBJECTIVE: The aim of this study is to conduct a quantitative and qualitative assessment of Chinese social media posts originating in Wuhan City on the Chinese microblogging platform Weibo during the early stages of the COVID-19 outbreak. METHODS: Chinese-language messages from Wuhan were collected for 39 days between December 23, 2019, and January 30, 2020, on Weibo. For quantitative analysis, the total daily cases of COVID-19 in Wuhan were obtained from the Chinese National Health Commission, and a linear regression model was used to determine if Weibo COVID-19 posts were predictive of the number of cases reported. Qualitative content analysis and an inductive manual coding approach were used to identify parent classifications of news and user-generated COVID-19 topics. RESULTS: A total of 115,299 Weibo posts were collected during the study time frame consisting of an average of 2956 posts per day (minimum 0, maximum 13,587). Quantitative analysis found a positive correlation between the number of Weibo posts and the number of reported cases from Wuhan, with approximately 10 more COVID-19 cases per 40 social media posts (P<.001). This effect size was also larger than what was observed for the rest of China excluding Hubei Province (where Wuhan is the capital city) and held when comparing the number of Weibo posts to the incidence proportion of cases in Hubei Province. Qualitative analysis of 11,893 posts during the first 21 days of the study period with COVID-19-related posts uncovered four parent classifications including Weibo discussions about the causative agent of the disease, changing epidemiological characteristics of the outbreak, public reaction to outbreak control and response measures, and other topics. Generally, these themes also exhibited public uncertainty and changing knowledge and attitudes about COVID-19, including posts exhibiting both protective and higher-risk behaviors. CONCLUSIONS: The results of this study provide initial insight into the origins of the COVID-19 outbreak based on quantitative and qualitative analysis of Chinese social media data at the initial epicenter in Wuhan City. Future studies should continue to explore the utility of social media data to predict COVID-19 disease severity, measure public reaction and behavior, and evaluate effectiveness of outbreak communication.


title: COVID-19 and autism

text: The current pandemic of Covid-19 has created a paradigm for possibly gaining greater insight in two conditions:Studies since the beginning of this century have supported the view that IGF-1 deficiency in the neonate defines the basis of autism. As a result, it appears that interleukin-6 in corona virus-based infections causes reduced defenses because of suppressed IGF-1, especially in older patients. This may also portend an increase of autism in the offspring of gravidas currently affected severely by Covid-19.


docid: ctqpkjbz

title: Response to 'Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa' (Epidemiology and Infection - HYG-LE-10513-May-20)


title: The impact of preoperative screening system on head and neck cancer surgery during the COVID-19 pandemic: Recommendations from the nationwide survey in Japan

text: Objective: the pandemic of coronavirus disease 2019 (COVID-19), hospitals worldwide are at risk of nosocomial infection. Preoperative identification of COVID-19 in patients who are scheduled to be admitted to the hospital is essential to preventing the collapse of medical facility. In Japan, the preoperative observation and screening tests with the RT-PCR testing for the new coronavirus (SARS-CoV-2) and chest CT scan are recommended for head and neck cancer surgery during the COVID-19 pandemic. Method: We conducted surveys of the current situation in Japan through the internet. Results: Chest CT scan was fully performed (90%), but the RT-PCR testing was not adequately performed (51%). Conclusion: Although the current screening system can be considered effective to a certain extent, we recommend further widespread use of pre-admission RT-PCR testing not only for patients with head and neck cancer surgery but also for all the hospitalized patients, in order to promote safer treatments, during the COVID-19 pandemic.


title: Medical students' knowledge of and attitudes towards LGBT people and their health care needs: Impact of a lecture on LGBT health

text: OBJECTIVES: Lesbian, gay, bisexual, and transgender (LGBT) adolescents have specific health care needs and are susceptible to health care disparities. Lack of skills and knowledge on the part of health care providers have a negative effect on their access to care and health outcomes. This study 1) explores the knowledge and attitudes of medical students regarding LGBT people, and 2) assesses the impact of a one-hour lecture targeting adolescent LGBT health needs. METHODS: Fourth-year medical students attended a compulsory one-hour lecture on sexual orientation and gender identity development in adolescence, highlighting health issues. We created a questionnaire with items to elicit students' knowledge and attitudes about LGBT health issues. Students were invited to complete this questionnaire online anonymously one week before the lecture and one month after the lecture. RESULTS: Out of a total of 157 students, 107 (68.2%) responded to the pre-intervention questionnaire and 96 (61.1%) to the post-intervention questionnaire. A significant proportion-13.7% of all respondents-identified as LGBT or questioning. Our results show that most medical students already show favorable attitudes towards LGBT people and a certain degree of knowledge of LGBT health needs. They demonstrated a large and significant increase in knowledge of LGBT health issues one month after the lecture. DISCUSSION: A single one-hour lecture on sexual orientation and LGBT health issues may increase knowledge among medical students. Medical students and professionals should receive such training to increase their knowledge about LGBT patients as it, together with favorable attitudes, has the potential to improve health outcomes among this vulnerable population.


Protective Device during Airway Management in Patients with Coronavirus Disease 2019 (COVID-19)


title: Prevalence and Mortality due to Outbreak of Novel Coronavirus Disease (COVID-19) in ß-Thalassemias: The Nationwide Iranian Experience

text: In late December 2019, an ongoing outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection that was termed Coronavirus Disease 2019 (COVID-19), was reported in Wuhan, China (Zhu, et al 2020).


Prevalence and mortality in ß-thalassaemias due to outbreak of novel coronavirus disease (COVID-19): the nationwide Iranian experience


title: New coronavirus outbreak: Framing questions for pandemic prevention

text: We need to understand and quantify the dominant variables that govern the SARS-CoV-2 outbreak, rather than relying exclusively on confirmed cases and their geospatial spread.


COVID alias challenge to onco-rehabilitation and to viable indications and decisions: Cues from an Italian COVID+ oral cancer patient


title: Dynamics of an imprecise stochastic multimolecular biochemical reaction model with L\'{e}vy jumps

text: Population dynamics are often affected by sudden environmental perturbations. Parameters of stochastic models are often imprecise due to various uncertainties. In this paper, we formulate a stochastic multimolecular biochemical reaction model that includes L\'{e}vy jumps and interval parameters. Firstly, we prove the existence and uniqueness of the positive solution. Moreover, the threshold between extinction and persistence of the reaction is obtained. Finally, some simulations are carried out to demonstrate our theoretical results.


title: MRA-Wavelet subspace architecture for logic, probability, and symbolic sequence processing

text: The linear subspaces of a multiresolution analysis (MRA) and the linear subspaces of the wavelet analysis induced by the MRA, together with the set inclusion relation, form a very special lattice of subspaces which herein is called a"primorial lattice". This paper introduces an operator R that extracts a set of 2^{N-1} element Boolean lattices from a 2^N element Boolean lattice. Used recursively, a sequence of Boolean lattices with decreasing order is generated---a structure that is similar to an MRA. A second operator, which is a special case of a"difference operator", is introduced that operates on consecutive Boolean lattices L_2^n and L_2^{n-1} to produce a sequence of orthocomplemented lattices. These two sequences, together with the subset ordering relation, form a primorial lattice P. A logic or probability constructed on a Boolean lattice L_2^N likewise induces a primorial lattice P. Such a logic or probability can then be rendered at N different"resolutions"by selecting any one of the N Boolean lattices in P and at N different"frequencies"by selecting any of the N different orthocomplemented lattices in P. Furthermore, P can be used for symbolic sequence analysis by projecting sequences of symbols onto the sublattices in P using one of three lattice projectors introduced. P can be used for symbolic sequence processing by judicious rejection and selection of projected sequences. Examples of symbolic sequences include sequences of logic values, sequences of probabilistic events, and genomic sequences (as used in"genomic signal processing").


Italian Physical Therapists' Response to the Novel COVID-19 Emergency


title: Travel-related fever in the time of COVID-19 travel restrictions

text: Travel-related infections with prolonged incubation periods should be considered in febrile patients despite the current epidemiological situation, especially if alternative more frequent diagnoses, such as COVID-19, are not confirmed.


title: Efficient adaptive designs for clinical trials of interventions for COVID-19

text: The COVID-19 pandemic has led to an unprecedented response in terms of clinical research activity. An important part of this research has been focused on randomized controlled clinical trials to evaluate potential therapies for COVID-19. The results from this research need to be obtained as rapidly as possible. This presents a number of challenges associated with considerable uncertainty over the natural history of the disease and the number and characteristics of patients affected, and the emergence of new potential therapies. These challenges make adaptive designs for clinical trials a particularly attractive option. Such designs allow a trial to be modified on the basis of interim analysis data or stopped as soon as sufficiently strong evidence has been observed to answer the research question, without compromising the trial's scientific validity or integrity. In this paper we describe some of the adaptive design approaches that are available and discuss particular issues and challenges associated with their use in the pandemic setting. Our discussion is illustrated by details of four ongoing COVID-19 trials that have used adaptive designs.


Labor and Delivery Visitor Policies During the COVID-19 Pandemic: Balancing Risks and Benefits