title: Association between male sex and outcomes of Coronavirus Disease 2019 (Covid-19) - a Danish nationwide, register-based study

text: BACKGROUND AND OBJECTIVES: Male sex has been associated with severe Coronavirus disease 2019 (Covid-19) infection. We examined the association between male sex and severe Covid-19 infection and if an increased risk remains after adjustment for age and comorbidities. METHODS: Nationwide register-based follow-up study of Covid-19 patients in Denmark until May 16, 2020. Average risk ratio comparing 30-day composite outcome of all-cause death, severe Covid-19 diagnosis or intensive care unit (ICU) admission for men versus women standardized to the age and comorbidity distribution of all patients were derived from multivariable Cox regression. Included covariates were age, hypertension, diagnoses including obesity, alcohol, sleep apnea, diabetes, chronic obstructive pulmonary disease, previous myocardial infarction (MI), ischemic heart disease (IHD), heart failure (HF), atrial fibrillation (AF), stroke, peripheral artery disease, cancer, liver-, rheumatic-, and chronic kidney disease (CKD). RESULTS: Of 4,842 Covid-19 patients, 2,281 (47.1%) were men. Median age was 57 [25%-75% 43-73] for men versus 52 [38-71] for women (P<0.001); however, octogenarians had equal sex distribution. Alcohol diagnosis, diabetes, hypertension, sleep apnea, prior MI and IHD (all P<0.001) as well as AF, stroke and HF (all P=0.01) were more often seen in men, and so was CKD (P=0.03). Obesity diagnosis (P<0.001) were more often seen in women. Other comorbidity differences were insignificant (P>0.05). The fully adjusted average risk ratio was 1.63 [95% CI 1.44-1.84]. CONCLUSIONS: Men with Covid-19 infection have >50% higher risk of all-cause death, severe Covid-19 infection, or ICU admission than women. The excess risk was not explained by age and comorbidities.


title: Radiology of COVID-19 - Imaging the pulmonary damage

text: A large part of the world is presently in the grip of the coronavirus disease (COVID-19) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), declared a pandemic in March 2020. This document is a brief commentary of the imaging modalities used in the screening, diagnosis and management of COVID-19 pneumonia. Chest x-rays, especially portable, still form a part of majority of official guidelines, with reports of the suggestive radiologic features. The potential of CT scan and ultrasound is also realised, with earlier detection rate. Typical radiologic findings of bilateral, asymmetrical, crazy-paved ground glass opacification, consolidation, reverse halo sign, opacities, progressing to fibrosis are well described for both the X-ray and CT scan. Atypical findings include airway changes, pleural effusion, pulmonary nodules and acute pulmonary embolism. Absence of lymphadenopathy, pleural effusion and pneumothorax is notable. The role of portable lung ultrasound, reported to be useful in emergency, is yet to be established in the guidelines. Disinfection of the equipment is a major concern. Governmental guidelines still advocate X-ray despite professional societies increasingly recommending CT scan.


title: Manejo farmacológico de pacientes con enfermedades hepáticas y pancreáticas que involucran terapias inmunosupresoras. Posicionamiento en el marco de la pandemia de SARS-CoV-2 (COVID-19)./ Manejo farmacológico de pacientes con enfermedades hepáticas y pancreáticas que involucran terapias inmunosupresoras. Posicionamiento en el marco de la pandemia de SARS-CoV-2 (COVID-19)./ Pharmacologic management of patients with hepatic and pancreatic diseases that involve immunosuppressive therapies. Positioning within the framework of the SARS-CoV-2 (COVID-19) pandemic

text: The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) virus. COVID-19 affected close to 6million persons worldwide in fewer than 4 months, after the report of the first cases in China in December 2019. The relation of the disease caused by SARS-Cov-2 to immunosuppressive treatment used in different gastrointestinal disorders is uncertain, resulting in debate with regard to suspending immunosuppressive therapy to improve infection outcome. Said suspension implies the inherent risk for graft rejection or autoimmune disease exacerbation that can potentially worsen the course of the infection. Based on the presently available evidence, a treatment stance has been established for patients with gastrointestinal diseases that require immunosuppressive therapy.


Network pharmacological approach for elucidating the mechanisms of traditional Chinese medicine in treating COVID-19 patients


docid: foaagway

title: Clinical and epidemiological characteristics of children with COVID-19


title: The particulars of certain drugs' effect on the endogenous coenzyme Q10 plasma level in patients with cardiovascular diseases

text: Objectives Coenzyme Q10 (CoQ10) has many vital functions in human body and its endogenous level can be affected either by various diseases or by administrated drugs. This study reveals the effect of atorvastatin, amlodipine and ethoxidol on the endogenous CoQ10 plasma concentration. Methods It was determined the total plasma concentration of endogenous CoQ10 in the plasma of 54 healthy individuals and 62 patients with cardiovascular diseases during treatment with various drugs using high performance liquid chromatography with mass spectrometric detection (HPLC-MS/MS). Results It was found that CoQ10 plasma concentration in patients is statistically significantly lower (on average -49.0 Δ%) than in practically healthy individuals. The total CoQ10 plasma level in patients receiving atorvastatin in the complex therapy is statistically significantly lower (-15.2 Δ%), and in patients taking amlodipine or ethoxidol is statistically significantly higher (+18.2 and + 20.2 Δ%, respectively) than in patients of control groups (a group of patients who receive the same drugs, except for the studied one). Conclusions The study showed that in patients with CVDs treated with various drugs the CoQ10 plasma level is statistically significantly lower than in practically healthy individuals. So, to avoid the adverse reactions connected with low CoQ10 plasma levels, it is recommended to adjust the therapy to maintain its constant level.


Evidence for important COVID-19 community transmission in Somalia using a clinical case definition


Chloroquine for COVID-19 Infection


De-isolating COVID-19 Suspect Cases: A Continuing Challenge


Lessons from the Belgian experience with regulatory control during the COVID-19 pandemic for the implementation of the European IVD regulation 2017/746


COVID-19 effect on mental health: patients and workforce


Letter to the Editor: Covid-19 and the Challenges of Frailty Screening in Older Adults


The ethical challenges of the SARS-CoV-2 pandemic in the global south and the global north - same and different


title: Variation of Aerosol Pollution in Peru during the Quarantine Due to COVID-19

text: Due to COVID-19, which is a type of pneumonia produced by a coronavirus family virus, the Peruvian government has decreed mandatory social isolation This isolation is extended until 26 April 2020 Due to this situation, people must stay at home and only go out to make purchases to cover basic needs This situation, between other things, probably causes pollution reduction that is important for our ecosystem In Peru, there is not a measurable way to quantify the impact of social isolation on air pollution The present work aims to show more objectively how much decrease the aerosol pollution in Peru For this purpose, one uses remote sensing data from Copernicus Data Hub of the European Space Agency, specifically, Sentinel-5 Precursor satellite The results show an essential reduction of aerosol pollution in different regions of Peru, especially in Lima and the Amazon regions


The wounded healer: A narrative review of the mental health effects of the COVID-19 pandemic on healthcare workers


title: Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era

text: AIMS: To evaluate the impact of the COVID-19 pandemic on patient admissions to Italian cardiac care units (CCUs). METHODS AND RESULTS: We conducted a multicentre, observational, nationwide survey to collect data on admissions for acute myocardial infarction (AMI) at Italian CCUs throughout a 1 week period during the COVID-19 outbreak, compared with the equivalent week in 2019. We observed a 48.4% reduction in admissions for AMI compared with the equivalent week in 2019 (P < 0.001). The reduction was significant for both ST-segment elevation myocardial infarction [STEMI; 26.5%, 95% confidence interval (CI) 21.7-32.3; P = 0.009] and non-STEMI (NSTEMI; 65.1%, 95% CI 60.3-70.3; P < 0.001). Among STEMIs, the reduction was higher for women (41.2%; P = 0.011) than men (17.8%; P = 0.191). A similar reduction in AMI admissions was registered in North Italy (52.1%), Central Italy (59.3%), and South Italy (52.1%). The STEMI case fatality rate during the pandemic was substantially increased compared with 2019 [risk ratio (RR) = 3.3, 95% CI 1.7-6.6; P < 0.001]. A parallel increase in complications was also registered (RR = 1.8, 95% CI 1.1-2.8; P = 0.009). CONCLUSION: Admissions for AMI were significantly reduced during the COVID-19 pandemic across Italy, with a parallel increase in fatality and complication rates. This constitutes a serious social issue, demanding attention by the scientific and healthcare communities and public regulatory agencies.


COVID-19 and Trauma Care: Improvise, Adapt and Overcome!


title: A Review of Coronavirus Disease-2019 (COVID-19)

text: There is a new public health crises threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus originated in bats and was transmitted to humans through yet unknown intermediary animals in Wuhan, Hubei province, China in December 2019. There have been around 96,000 reported cases of coronavirus disease 2019 (COVID-2019) and 3300 reported deaths to date (05/03/2020). The disease is transmitted by inhalation or contact with infected droplets and the incubation period ranges from 2 to 14 d. The symptoms are usually fever, cough, sore throat, breathlessness, fatigue, malaise among others. The disease is mild in most people; in some (usually the elderly and those with comorbidities), it may progress to pneumonia, acute respiratory distress syndrome (ARDS) and multi organ dysfunction. Many people are asymptomatic. The case fatality rate is estimated to range from 2 to 3%. Diagnosis is by demonstration of the virus in respiratory secretions by special molecular tests. Common laboratory findings include normal/ low white cell counts with elevated C-reactive protein (CRP). The computerized tomographic chest scan is usually abnormal even in those with no symptoms or mild disease. Treatment is essentially supportive; role of antiviral agents is yet to be established. Prevention entails home isolation of suspected cases and those with mild illnesses and strict infection control measures at hospitals that include contact and droplet precautions. The virus spreads faster than its two ancestors the SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV), but has lower fatality. The global impact of this new epidemic is yet uncertain.


Diagnostic options for coronavirus disease 2019 (COVID-19)


title: Estimation of SARS-CoV-2 infection fatality rate by real-time antibody screening of blood donors

text: BACKGROUND: The pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has tremendous consequences for our societies. Knowledge of the seroprevalence of SARS-CoV-2 is needed to accurately monitor the spread of the epidemic and to calculate the infection fatality rate (IFR). These measures may help the authorities to make informed decisions and adjust the current societal interventions. The objective was to perform nationwide real-time seroprevalence surveying among blood donors as a tool to estimate previous SARS-CoV-2 infections and the population based IFR. METHODS: Danish blood donors aged 17-69 years giving blood April 6 to May 3 were tested for SARS-CoV-2 immunoglobulin M and G antibodies using a commercial lateral flow test. Antibody status was compared between geographical areas and an estimate of the IFR was calculated. The seroprevalence was adjusted for assay sensitivity and specificity taking the uncertainties of the test validation into account when reporting the 95% confidence intervals (CI). RESULTS: The first 20,640 blood donors were tested and a combined adjusted seroprevalence of 1.9% (CI: 0.8-2.3) was calculated. The seroprevalence differed across areas. Using available data on fatalities and population numbers a combined IFR in patients younger than 70 is estimated at 89 per 100,000 (CI: 72-211) infections. CONCLUSIONS: The IFR was estimated to be slightly lower than previously reported from other countries not using seroprevalence data. The IFR is likely several fold lower than the current estimate. We have initiated real-time nationwide anti-SARS-CoV-2 seroprevalence surveying of blood donations as a tool in monitoring the epidemic.


Preanalytical issues affecting the diagnosis of COVID-19


New Zealand's elimination strategy for the COVID-19 pandemic and what is required to make it work


title: 80-year-old man with dyspnoea and bilateral groundglass infiltrates: an elusive case of COVID-19

text: COVID-19 is a novel viral infection caused by severe acute respiratory syndrome-coronavirus-2 virus, first identified in Wuhan, China in December 2019. COVID-19 has spread rapidly and is now considered a global pandemic. We present a case of a patient with minimal respiratory symptoms but prominent bilateral groundglass opacities in a 'crazy paving' pattern on chest CT imaging and a negative initial infectious workup. However, given persistent dyspnoea and labs suggestive of COVID-19 infection, the patient remained hospitalised for further monitoring. Forty-eight hours after initial testing, the PCR test was repeated and returned positive for COVID-19. This case illustrates the importance of clinical vigilance to retest patients for COVID-19, particularly in the absence of another compelling aetiology. As COVID-19 testing improves to rapidly generate results, selective retesting of patients may uncover additional COVID-19 cases and strengthen measures to minimise the spread of COVID-19.


title: A single center observational study of the clinical characteristics and short-term outcome of 20 kidney transplant patients admitted for SARS-CoV2 pneumonia

text: The outcome of SARS-CoV2 infection in patients who have received a kidney allograft and are being treated with immunosuppression is unclear. We describe 20 kidney transplant recipients (median age 59 years [inter quartile range 51-64 years], median age of transplant 13 years [9-20 years], baseline eGFR 36.5 [23-47.5]) with SARS-CoV2 induced pneumonia. At admission, all had immunosuppression withdrawn and were started on methylprednisolone 16 mg/day, all but one was commenced on antiviral therapy and hydroxychloroquine with doses adjusted for kidney function. At baseline, all patients presented fever but only one complained of difficulty in breathing. Half of patients showed chest radiographic evidence of bilateral infiltrates while the other half showed unilateral changes or no infiltrates. During a median follow-up of seven days, 87% experienced a radiological progression and among those 73% required escalation of oxygen therapy. Six patients developed acute kidney injury with one requiring hemodialysis. Six of 12 patients were treated with tocilizumab, a humanized monoclonal antibody to the IL-6 receptor. Overall, five kidney transplant recipients died after a median period of 15 days [15-19] from symptom onset. These preliminary findings describe a rapid clinical deterioration associated with chest radiographic deterioration and escalating oxygen requirement in renal transplant recipients with SARS-Cov2 pneumonia. Thus, in this limited cohort of long-term kidney transplant patients, SARS-CoV-2 induced pneumonia is characterized by high risk of progression and significant mortality.


Leaning on Community-Based Participatory Research to Respond During COVID-19


Global risk to the community and clinical setting: Flocking of fake masks and protective gears during the COVID-19 pandemic


COVID-19 and Healthcare worker's families: behind the scenes of frontline response


Treating COVID-19 in Rural America


title: Simulations of Deliveries of SARS-CoV-2 Positive Pregnant Women and Their Newborn Babies: Plan to Implement a Complex and Ever-Changing Protocol

text: Management of severe acute respiratory Syndrome corona virus-2 (SARS-CoV-2) infected pregnant women at time of delivery presents a unique challenge. The variability in the timing and the method of delivery, ranging from normal vaginal delivery to an emergent cesarean section, adds complexity to the role of the health care providers in the medical care of the patient and in the interactions, they have with other providers. These variations are further influenced by the availability of isolation rooms in the facility and adequacy of personal protective equipment. The protocols already set in place can be further challenged when the facility reaches its capacity to manage the patients.To fulfill the goal of providing adequate management to the SARS-CoV-2 infected pregnant women and their infants, avoid variation from suggested guidelines, and decrease risk of exposure of the health care workers, the health care provider team needs to review the variations regularly. While familiarity can be achieved by reviewing the guidelines, clinical case simulations provide a more hands-on approach.Using case-based simulations and current guidance from the Center for Disease Control, American Academy of Pediatrics, and recent reviews, we discuss a management guideline developed at our institution to facilitate provision of care to SARS-CoV-2 infected pregnant women during delivery and to their infants, while protecting health care providers from exposure, and in keeping with the local facility logistics. KEY POINTS: · Simulation of delivery of SARS-CoV-2 positive pregnant women can minimize the risk of exposure to healthcare professionals.. · Four common scenarios of delivery as described can be adapted for the evolving guidelines for the management of SARS-CoV-2 positive pregnant women.. · Integrating simulations of management of SARS-CoV-2 positive pregnant women is feasible in daily clinical routine..


Rapid sputum testing and not thermal screening alone should be the first-line screening test at airports: A Bayesian analysis


docid: cwceforo

title: Guidance for rebooting electrophysiology through the COVID-19 pandemic from the Heart Rhythm Society and the American Heart Association Electrocardiography and Arrhythmias Committee of the Council on Clinical Cardiology

text: Coronavirus disease 2019 (COVID-19) has presented substantial challenges to patient care and impacted health care delivery, including cardiac electrophysiology practice throughout the globe. Based upon the undetermined course and regional variability of the pandemic, there is uncertainty as to how and when to resume and deliver electrophysiology services for arrhythmia patients. This joint document from representatives of the Heart Rhythm Society, American Heart Association, and American College of Cardiology seeks to provide guidance for clinicians and institutions reestablishing safe electrophysiological care. To achieve this aim, we address regional and local COVID-19 disease status, the role of viral screening and serologic testing, return-to-work considerations for exposed or infected health care workers, risk stratification and management strategies based on COVID-19 disease burden, institutional preparedness for resumption of elective procedures, patient preparation and communication, prioritization of procedures, and development of outpatient and periprocedural care pathways.


title: COVID-19, Medicine, and Sports

text: The COVID-19 outbreak has brought our lives to a sudden and complete lockdown. While the numbers of confirmed cases and deaths continue to rise, people around the world are taking brave actions to mitigate transmission and save lives. The role sports play in this pandemic is unprecedented, fascinating, and reveals the immense impact sports has on every aspect of our lives. We must all do our part to keep each other safe until this outbreak subsides and sports and humanity are back to being greater than ever.


title: SARS-CoV-2 and the COVID-19 disease: a mini review on diagnostic methods

text: Coronavirus disease 2019 (COVID-19) is an infectious disease initially reported in China and currently worldwide dispersed caused by a new coronavirus (SARS-CoV-2 or 2019-nCoV) affecting more than seven million people around the world causing more than 400 thousand deaths (on June 8th, 2020). The diagnosis of COVID-19 is based on the clinical and epidemiological history of the patient. However, the gold standard for COVID-19 diagnosis is the viral detection through the amplification of nucleic acids. Although the quantitative Reverse-Transcription Polymerase Chain Reaction (RT-PCR) has been described as the gold standard for diagnosing COVID-19, there are several difficulties involving its use. Here we comment on RT-PCR and describe alternative tests developed for the diagnosis of COVID-19.


Sixty seconds on . . . the two metre rule


title: The role of head and neck cancer advocacy organizations during the COVID-19 pandemic

text: The COVID-19 pandemic has had a significant impact on many aspects of head and neck cancer (HNC) care. The uncertainty and stress resulting from these changes has led many patients and caregivers to turn to HNC advocacy groups for guidance and support. Here we outline some of the issues being faced by patients with HNC during the current crisis and provide examples of programs being developed by advocacy groups to address them. We also highlight the increased utilization of these organizations that has been observed as well as some of the challenges being faced by these not-for-profit groups as they work to serve the head and neck community.


Effect of the COVID-19 Pandemic on ST-Segment-Elevation Myocardial Infarction Presentations and In-Hospital Outcomes


title: Modeling the early evolution of the COVID-19 in Brazil: results from a Susceptible-Infectious-Quarantined-Recovered (SIQR) model

text: The world evolution of the Severe acute respiratory syndrome coronavirus 2 (SARS-Cov2 or simply COVID-19) led the World Health Organization to declare it a pandemic. The disease appeared in China in December 2019, and it has spread fast around the world, specially in european countries like Italy and Spain. The first reported case in Brazil was recorded in February 26, and after that the number of cases growed fast. In order to slow down the initial growth of the disease through the country, confirmed positive cases were isolated to not transmit the disease. To better understand the early evolution of COVID-19 in Brazil, we apply a Susceptible-Infectious-Quarantined-Recovered (SIQR) model to the analysis of data from the Brazilian Department of Health, obtained from February 26, 2020 through March 25, 2020. Based on analyical and numerical results, as well on the data, the basic reproduction number is estimated to $R_{0}=5.25$. In addition, we estimate that the ratio unidentified infectious individuals and confirmed cases at the beginning of the epidemic is about $10$, in agreement with previous studies. We also estimated the epidemic doubling time to be $2.72$ days.


Impact of COVID-19 on Physical Therapist Practice in Portugal


Sports Medicine in a Time of Pandemic


title: Structural Genomics of SARS-CoV-2 Indicates Evolutionary Conserved Functional Regions of Viral Proteins

text: During its first two and a half months, the recently emerged 2019 novel coronavirus, SARS-CoV-2, has already infected over one-hundred thousand people worldwide and has taken more than four thousand lives However, the swiftly spreading virus also caused an unprecedentedly rapid response from the research community facing the unknown health challenge of potentially enormous proportions Unfortunately, the experimental research to understand the molecular mechanisms behind the viral infection and to design a vaccine or antivirals is costly and takes months to develop To expedite the advancement of our knowledge, we leveraged data about the related coronaviruses that is readily available in public databases and integrated these data into a single computational pipeline As a result, we provide comprehensive structural genomics and interactomics roadmaps of SARS-CoV-2 and use this information to infer the possible functional differences and similarities with the related SARS coronavirus All data are made publicly available to the research community


title: A Secure Location-based Alert System with Tunable Privacy-Performance Trade-off

text: Monitoring location updates from mobile users has important applications in many areas, ranging from public safety and national security to social networks and advertising. However, sensitive information can be derived from movement patterns, thus protecting the privacy of mobile users is a major concern. Users may only be willing to disclose their locations when some condition is met, for instance in proximity of a disaster area or an event of interest. Currently, such functionality can be achieved using searchable encryption. Such cryptographic primitives provide provable guarantees for privacy, and allow decryption only when the location satisfies some predicate. Nevertheless, they rely on expensive pairing-based cryptography (PBC), of which direct application to the domain of location updates leads to impractical solutions. We propose secure and efficient techniques for private processing of location updates that complement the use of PBC and lead to significant gains in performance by reducing the amount of required pairing operations. We implement two optimizations that further improve performance: materialization of results to expensive mathematical operations, and parallelization. We also propose an heuristic that brings down the computational overhead through enlarging an alert zone by a small factor (given as system parameter), therefore trading off a small and controlled amount of privacy for significant performance gains. Extensive experimental results show that the proposed techniques significantly improve performance compared to the baseline, and reduce the searchable encryption overhead to a level that is practical in a computing environment with reasonable resources, such as the cloud.


COVID-19: The Shift From Clinical to Public Health Ethics


The COVID-19 Pandemic Revealed the Importance and Shortcomings of Technologies for Diabetes Support


Good IgA bad IgG in SARS-CoV-2 infection?


Editorial: Dental practitioners' role in the assessment and containment of coronavirus disease (COVID-19): Evolving recommendations from the Centers for Disease Control


COVID-19 patients with respiratory failure: what can we learn from aviation medicine?


title: A Structured Approach for Safely Reintroducing Bariatric Surgery in a COVID-19 Environment

text: Due to the profound effect of novel coronavirus disease 2019 (COVID-19) on healthcare systems, surgical programs across the country have paused surgical operations and have been utilizing virtual visits to help maintain public safety. For those who treat obesity, the importance of bariatric surgery has never been more clear. Emerging studies continue to identify obesity and several other obesity-related comorbid conditions as major risk factors for a more severe COVID-19 disease course. However, this also suggests that patients seeking bariatric surgery are inherently at risk of suffering severe complications if they were to contract COVID-19 in the perioperative period. The aim of this protocol is to utilize careful analysis of existing risk stratification for bariatric patients, novel COVID-19-related data, and consensus opinion from multiple academic bariatric centers within our organization to help guide the reanimation of our programs when appropriate and to use this template to prospectively study this risk-stratified population in real time. The core principles of this protocol can be applied to any surgical specialty.


title: Epidemiologie von SARS-CoV-2-Infektion und COVID-19./ [Epidemiology of SARS-CoV-2 infection and COVID-19]

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new ßCoronavirus that was first detected in 2019 in Wuhan, China. In the ensuing months it has been transmitted worldwide. Here the authors present the current knowledge on the epidemiology of this virus. SARS-CoV2 replicates mainly in the upper and lower respiratory tract and is primarily transmitted by droplets from asymptomatic and symptomatic infected subjects. The estimate for the basic reproduction number (R) is currently between 2 and 3, while the incubation period is 6 (median, range 2-14) days. Although most infections are uncomplicated, 5-10% of cases develop pneumonia, which can lead to hospitalization, respiratory failure and multiorgan failure. Risk factors for a complicated disease course include age, hypertension, chronic cardiovascular and pulmonary disease and immunodeficiency. The overall case fatality rate is 1.4%, with the rate rising in the sixth decade of life. Nosocomial and infections in medical personnel have been reported. Drastic reductions in social contact have been implemented in many countries with outbreaks of SARS-CoV2, leading to rapid reductions in R. Which of the measures have been effective is still unknown.


Covid-19: Public health must be "at the core" of global recovery plans, say doctors


COVID-19 and burns: Lessons learned?


Delivering healthcare at distance to cardiac patients during the COVID-19 pandemic: Experiences from clinical practice


title: A multi-component framework for the analysis and design of explainable artificial intelligence

text: The rapid growth of research in explainable artificial intelligence (XAI) follows on two substantial developments. First, the enormous application success of modern machine learning methods, especially deep and reinforcement learning, which have created high expectations for industrial, commercial and social value. Second, the emergence of concern for creating trusted AI systems, including the creation of regulatory principles to ensure transparency and trust of AI systems.These two threads have created a kind of"perfect storm"of research activity, all eager to create and deliver it any set of tools and techniques to address the XAI demand. As some surveys of current XAI suggest, there is yet to appear a principled framework that respects the literature of explainability in the history of science, and which provides a basis for the development of a framework for transparent XAI. Here we intend to provide a strategic inventory of XAI requirements, demonstrate their connection to a history of XAI ideas, and synthesize those ideas into a simple framework to calibrate five successive levels of XAI.


title: Diagnosis and treatment of novel coronavirus pneumonia based on the theory of traditional Chinese medicine

text: Since the outbreak of novel coronavirus pneumonia (coronavirus disease 2019, COVID-19) in December 2019, it has rapidly spread to 187 countries, causing serious harm to the health of people and a huge social burden. However, currently, drugs specifically approved for clinical use are not available, except for vaccines against COVID-19 that are being evaluated. Traditional Chinese medicine (TCM) is capable of performing syndrome differentiation and treatment according to the clinical manifestations of patients, and has a better ability of epidemic prevention and control. The authors comprehensively analyzed the etiology and pathogenesis of COVID-19 based on the theory of TCM, and discussed its syndrome differentiation, treatment and prevention measures so as to provide strategies and reference for the prevention and treatment with TCM.


title: Famotidine use and quantitative symptom tracking for COVID-19 in non-hospitalised patients: a case series

text: OBJECTIVE: Treatment options for non-hospitalised patients with coronavirus disease 2019 (COVID-19) to reduce morbidity, mortality and spread of the disease are an urgent global need. The over-the-counter histamine-2 receptor antagonist famotidine is a putative therapy for COVID-19. We quantitively assessed longitudinal changes in patient reported outcome measures in non-hospitalised patients with COVID-19 who self-administered high-dose famotidine orally. DESIGN: Patients were enrolled consecutively after signing written informed consent. Data on demographics, COVID-19 diagnosis, famotidine use, drug-related side effects, temperature measurements, oxygen saturations and symptom scores were obtained using questionnaires and telephone interviews. Based on a National Institute of Health (NIH)-endorsed Protocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of five symptoms (cough, shortness of breath, fatigue, headaches and anosmia) and general unwellness on a four-point ordinal scale modelled on performance status scoring. All data are reported at the patient level. Longitudinal combined normalised symptom scores were statistically compared. RESULTS: Ten consecutive patients with COVID-19 who self-administered high-dose oral famotidine were identified. The most frequently used famotidine regimen was 80 mg three times daily (n=6) for a median of 11 days (range: 5-21 days). Famotidine was well tolerated. All patients reported marked improvements of disease related symptoms after starting famotidine. The combined symptom score improved significantly within 24 hours of starting famotidine and peripheral oxygen saturation (n=2) and device recorded activity (n=1) increased. CONCLUSIONS: The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient-reported outcomes in non-hospitalised patients with COVID-19.


Septic shock presentation in adolescents with COVID-19


Preparing Telemedicine for the Frontlines of Healthcare Equity


title: Estimating the number of COVID-19 infections in Indian hot-spots using fatality data

text: In India the COVID-19 infected population has not yet been accurately established. As always in the early stages of any epidemic, the need to test serious cases first has meant that the population with asymptomatic or mild sub-clinical symptoms has not yet been analyzed. Using counts of fatalities, and previously estimated parameters for the progress of the disease, we give statistical estimates of the infected population. The doubling time is a crucial unknown input parameter which affects these estimates, and may differ strongly from one geographical location to another. We suggest a method for estimating epidemiological parameters for COVID-19 in different locations within a few days, so adding to the information required for gauging the success of public health interventions


On the occasion of World Autism Awareness Day 2020


title: High-Risk Aerosol-Generating Procedures in COVID-19: Respiratory Protective Equipment Considerations

text: The correct selection and utilization of respiratory personal protective equipment is of the utmost importance in the current COVID-19 pandemic. This is especially true for health care workers exposed to high-risk aerosol-generating procedures, including otolaryngologists, ophthalmologists, neurosurgeons, maxillofacial surgeons, and laparoscopic surgeons. This communication provides a review of approved forms of respiratory protection and compares their characteristics, including surgical masks, N95 respirator, elastomeric respirators, powered air-purifying respirators, and controlled air-purifying respirators. For standard airborne precautions, N95 respirator are appropriate for respiratory protection. However, high-risk aerosol-generating procedures may create aerosolization of high viral loads that represent increased risk to health care workers. In these situations, enhanced respiratory protection with filters certified as 99, 100, or HEPA (high-efficiency particulate air) may be appropriate.


Antihypertensive drugs and risk of COVID-19? - Authors' reply


docid: hudydjlk

title: Serial Interval of COVID-19 among Publicly Reported Confirmed Cases

text: We estimate the distribution of serial intervals for 468 confirmed cases of coronavirus disease reported in China as of February 8, 2020. The mean interval was 3.96 days (95% CI 3.53-4.39 days), SD 4.75 days (95% CI 4.46-5.07 days); 12.6% of case reports indicated presymptomatic transmission.


Approaching Surgical Triage During the COVID-19 Pandemic


Trainee-Directed Educational Pursuits and Advocacy During the COVID-19 Pandemic


title: Retos del farmacéutico de hospital en la evaluación de la evidencia científica y su incorporación a los protocolos farmacoterapéuticos a través de las comisiones en tiempos de COVID-19./ Hospital pharmacist challenges in evaluation of scientific evidence and its incorporation to pharmacotherapeutic protocols through therapeutic committees in COVID-19 times

text: Type 2 coronavirus pandemics that is plaguing almost all the world has caused qualitative and quantitative strains in health systems that have had to be responded to. The lack of known vaccines and effective treatments has generated the need to use drugs with very little evidence for their incorporation into pharmacotherapeutic protocols agreed by the clinical team. The hospital pharmacist, within the multidisciplinary team, has been responsible for critically evaluating the alternatives and positioning them in these protocols. Finally, some ethical and legal questions that should be considered in this scenario are analyzed in this article.


Preventive measures and management of COVID-19 in pregnancy


Riding the coronacoaster of uncertainty


Caring for Loved Ones with Cancer during the COVID-19 Pandemic: A Double Hit Risk for Social Isolation and Need for Action


docid: bycyzejg

title: An updated analysis of turning point, duration and attack rate of COVID-19 outbreaks in major Western countries with data of daily new cases

text: As coronavirus spreads around the world, the study of its effects is of great practical significance. We collated data on daily new cases of the COVID-19 outbreaks in the six Western countries of the Group of Seven and the dates of governments' interventions. We studied the periods before and after the dates of major governments' interventions integrally based on a segmented Poisson model. The relevant results are published in the paper of "Predicting turning point, duration and attack rate of COVID - 19 outbreaks in major Western countries" [1]. Our method can be used to update prediction daily as COVID-19 outbreaks evolve. In this article, we illustrate an updated analysis with our method to facilitate reproducibility. Both datasets used and updated are provided.


title: CT Imaging and Differential Diagnosis of COVID-19

text: Since the beginning of 2020, coronavirus disease 2019 (COVID-19) has spread throughout China. This study explains the findings from lung computed tomography images of some patients with COVID-19 treated in this medical institution and discusses the difference between COVID-19 and other lung diseases.


Data transparency: "Nothing has changed since Tamiflu"


Sex and gender differences in the outcome of patients with COVID-19


title: Long Non-coding RNAs in Pulmonary Neuroendocrine Neoplasms

text: Pulmonary neuroendocrine neoplasms (NENs) are classified into low-grade neuroendocrine tumors and high-grade neuroendocrine carcinomas (NECs). There are significant differences in therapeutic strategies of the different NEN subtypes, and therefore, precise classification of pulmonary NENs is critical. However, challenges in pulmonary NEN classification include overlap of diagnostic histological features among the subtypes and reduced or negative expression of neuroendocrine markers in poorly differentiated pulmonary NECs. Recently, transcription factor insulinoma-associated protein 1 (INSM1) was identified as a sensitive marker of neuroendocrine and neuroepithelial differentiation. In this study, INSM1 expression was detected by immunohistochemistry in greater than 94% of pulmonary NENs, indicating that it is a highly sensitive marker of pulmonary NENs and is useful to detect poorly differentiated pulmonary NECs. Although there are well-established morphological and immunohistologic criteria to diagnose pulmonary NENs, there is no universal consensus regarding prognostic markers of pulmonary NENs. Studies have shown that non-small cell lung cancers express long non-coding RNAs (lncRNAs), which regulate gene expression, epithelial-to-mesenchymal transition, and carcinogenesis. We characterized expression and function of lncRNAs, including HOX transcript antisense RNA (HOTAIR), maternally expressed 3 (MEG3), and prostate cancer antigen 3 (PCA3) in pulmonary NENs, including typical carcinoid tumors, atypical carcinoid tumors, small cell lung carcinoma (SCLC/NEC), and large cell neuroendocrine carcinoma (LCNEC/NEC). In situ hybridization and real-time polymerase chain reaction studies showed higher expression (p < 0.01) of all lncRNAs in SCLC/NEC. Small interfering RNA studies indicated a role for MEG3 and PCA3 in tumor proliferation. Therefore, these lncRNAs may serve as prognostic indicators of pulmonary NEN aggressiveness and as possible therapeutic targets.


Appropriate selection of convalescent plasma donors for COVID-19


title: Repurpose Open Data to Discover Therapeutics for COVID-19 using Deep Learning

text: There have been more than 850,000 confirmed cases and over 48,000 deaths from the human coronavirus disease 2019 (COVID-19) pandemic, caused by novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), in the United States alone. However, there are currently no proven effective medications against COVID-19. Drug repurposing offers a promising way for the development of prevention and treatment strategies for COVID-19. This study reports an integrative, network-based deep learning methodology to identify repurposable drugs for COVID-19 (termed CoV-KGE). Specifically, we built a comprehensive knowledge graph that includes 15 million edges across 39 types of relationships connecting drugs, diseases, genes, pathways, and expressions, from a large scientific corpus of 24 million PubMed publications. Using Amazon AWS computing resources, we identified 41 repurposable drugs (including indomethacin, toremifene and niclosamide) whose therapeutic association with COVID-19 were validated by transcriptomic and proteomic data in SARS-CoV-2 infected human cells and data from ongoing clinical trials. While this study, by no means recommends specific drugs, it demonstrates a powerful deep learning methodology to prioritize existing drugs for further investigation, which holds the potential of accelerating therapeutic development for COVID-19.


title: SARS-CoV-2 Infection in Infants Less than 90 Days Old

text: This is a single-center US case series of 18 infants <90 days old who tested positive for SARS-CoV-2. These infants had a mild febrile illness without significant pulmonary disease. One half were hospitalized; one had bacterial urinary tract co-infection. Nasopharyngeal viral loads were notably high. Latinx ethnicity was overrepresented.


Novel Coronavirus disease 2019 (COVID-19) outbreak in Nigeria: how effective are government interventions?


The impact of covid-19 on midwives' practice in Kenya, Uganda and Tanzania: A reflective account


Ancillary considerations for endodontic emergency treatment of Covid-19 positive patients


title: Analysis of the clinical characteristics, drug treatments and prognoses of 136 patients with coronavirus disease 2019

text: WHAT IS KNOWN AND OBJECTIVE: Since the December 2019 discovery of several cases of coronavirus disease 2019 (COVID-19) in Wuhan, China, the infection has spread worldwide. Our aim is to report on the clinical characteristics, treatments and prognoses of COVID-19. METHODS: This was a retrospective, single-centre, case series of 136 patients who were diagnosed with COVID-19 at Wuhan Third Hospital in Wuhan, China, between 28 January 2020 and 12 February 2020. The clinical characteristics, laboratory tests, treatment features and prognoses were summarized. RESULTS AND DISCUSSION: The 136 patients were divided into a moderate (M) group (n = 103, 75.7%) and a severe and critical (SC) group (n = 33, 24.3%). There were significant differences in the incidences of concomitant chronic medical illnesses (eg, hypertension, diabetes and cardiovascular disease), fever, dry cough and dyspnoea among the two groups (P < .05). Compared with those in the M group, lymphocyte count (LYM) decreased significantly in the SC group, while the serum levels of C-reactive protein (CRP), procalcitonin (PCT), creatinine (Cre), D-dimer, lactic dehydrogenase (LDH), myoglobin (MB) and troponin I (cTnl) increased significantly in the SC group (P < .05). The main therapeutic drugs were antivirals, antibiotics, glucocorticoids, immunomodulators, traditional Chinese medicine preparations and symptomatic support drugs. There were significant differences in the incidences of shock, myocardial injury, acute respiratory distress syndrome (ARDS) and renal injury among the two groups (P < .05). Among the 136 patients, 99 (72.7%) were cured, 14 (10.3%) were transferred to other hospital and 23 (16.9%) died. WHAT IS NEW AND CONCLUSION: Elderly patients with chronic diseases are more likely to develop severe or critical COVID-19 with multiple organ damage or systemic injuries. The improvement of LYM and CRP may be associated with the prognoses of COVID-19. The combined use of three or more antiviral drugs is to be avoided. The combination of broad-spectrum antibacterial drugs is not recommended and the risk of drug-induced liver injury should be monitored. Throughout a patient's hospitalization, their treatment plan should be evaluated and adjusted according to their vital signs, clinical symptoms, laboratory tests and imaging changes. Patients should receive effective psychological counselling.


title: Nanomaterials and nanoparticles: Sources and toxicity

text: This review is written with the goal of informing public health concerns related to nanoscience, while raising awareness of nanomaterials toxicity among scientists and manufacturers handling them. We show that humans have always been exposed to nanoparticles and dust from natural sources and human activities, the recent development of industry and combustion-based engine transportation profoundly increasing anthropogenic nanoparticulate pollution. The key to understanding the toxicity of nanoparticles is that their minute size, smaller than cells and cellular organelles, allows them to penetrate these basic biological structures, disrupting their normal function. Among diseases associated with nanoparticles are asthma, bronchitis, lung cancer, neurodegenerative diseases (such as Parkinson`s and Alzheimer`s diseases), Crohn`s disease, colon cancer. Nanoparticles that enter the circulatory system are related to occurrence of arteriosclerosis, and blood clots, arrhythmia, heart diseases, and ultimately cardiac death. We show that possible adverse effects of nanoparticles on human health depend on individual factors such as genetics and existing disease, as well as exposure, and nanoparticle chemistry, size, shape, and agglomeration state. The faster we will understand their causes and mechanisms, the more likely we are to find cures for diseases associated with nanoparticle exposure. We foresee a future with better-informed, and hopefully more cautious manipulation of engineered nanomaterials, as well as the development of laws and policies for safely managing all aspects of nanomaterial manufacturing, industrial and commercial use, and recycling.


The Importance of Vaginal Natural Orifice Surgeries in the Era of COVID-19 Pandemic


docid: vayoebve

title: Smell and taste dysfunction during the COVID-19 outbreak: a preliminary report

text: In late December 2019, in Wuhan (China), health authorities reported several clusters of pneumo- nia of unknown cause, subsequently attributed to a novel coronavirus, identified as Severe Acute Respiratory Syndrome-Coronavirus 2. Anosmia and dysgeusia have been reported as particular symptoms.4,5 Notably, these sensory symptoms seem to have a peculiar trend, such as usually precede the onset of respiratory symp- toms. So, they have been defined as "sentinel" symptoms. We presented a series of COVID-19 patients. Anos- mia and dysgeusia frequently preceded respiratory complaints. Anosmia and dysgeusia seem to be short-lived and self-resolving in COVID-19, thus a neurotoxic effect swiftly disappearing and/or cytopathic damage could be hypothesized similarly to other viral infections.


Potential Treatments for COVID-19 Related Cytokine Storm - Beyond Corticosteroids


title: Avoiding health worker infection and containing the coronavirus disease 2019 pandemic: Perspectives from the frontline in Wuhan

text: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused great public concern worldwide due to its high rates of infectivity and pathogenicity. The Chinese government responded in a timely manner, alleviated the dilemma, achieved a huge victory and lockdown has now been lifted in Wuhan. However, the outbreak has occurred in more than 200 other countries. Globally, as of 9:56 am CEST on 19 May 2020, there have been 4,696,849 confirmed cases of COVID-19, including 315,131 deaths, reported to Word Health Organization (WHO). The spread of COVID-19 overwhelmed the healthcare systems of many countries and even crashed the fragile healthcare systems of some. Although the situation in each country is different, health workers play a critical role in the fight against COVID-19. In this review, we highlight the status of health worker infections in China and other countries, especially the causes of infection in China and the standardised protocol to protect health workers from the perspective of an anaesthesiologist, in the hope of providing references to reduce medical infections and contain the COVID-19 epidemic.


title: SARS, MERS, COVID-19: Clinical Manifestations and Organ-System Complications: A Mini Review

text: Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS) and Coronavirus Disease 2019 (COVID-19) are caused by three distinct coronaviruses belonging to the same genus. COVID-19 and its two predecessors share many important features in their clinical presentations, and in their propensity for progression to severe disease which is marked by high rates of morbidity and mortality. However, comparison of the three viral illnesses also reveals a number of specific differences in clinical manifestations and complications, which suggest variability in the disease process. This narrative review delineates the pulmonary, cardiac, renal, gastrointestinal, hepatic, neurological, and hematologic complications associated with these three respiratory coronaviruses. It further describes the mechanisms of immune hyperactivation-particularly cytokine release syndrome-implicated in the multi-organ system injury seen in severe cases of MERS, SARS, and COVID-19.


docid: dsreueoa

title: Elevated exhaustion levels and reduced functional diversity of T cells in peripheral blood may predict severe progression in COVID-19 patients


title: Hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, and Taenia solium taeniasis/cysticercosis, Italy, 2011-2016

text: PURPOSE: To analyze epidemiology and burden of Neglected Tropical Diseases (NTDs) in Italy. METHODS: We used Hospital Discharge Records and number of residents in Italy to calculate number and rate of hospitalization for Chagas disease, dengue, filariasis, leishmaniasis, schistosomiasis, strongyloidiasis, Taenia solium taeniasis, and cysticercosis by sex, citizenship group, and region in the period 2011-2016. RESULTS: 7195 hospitalizations for NTDs were retrieved, accounting for 7375 diagnoses, 60% in Italians and 40% in foreigners. Male-to-female ratio was 2; the age group more commonly affected was 25-44 years (32.5%). The most common diagnoses were leishmaniasis (34%), schistosomiasis (29%), strongyloidiasis (12%), Chagas disease (8%), and dengue (8%). Average yearly hospitalization rate per 100,000 residents for all NTDs was 2.05, 1.33, and 10.39 in general population, Italians, and foreign citizens, respectively. Hospitalization rates higher than 100 per 100,000 subjects were found in citizens from Sub-Saharan Africa (SSA) and Bolivia. CONCLUSIONS: NTDs have a not negligible burden in Italy. The most clinically relevant NTDs in Italy are leishmaniasis and schistosomiasis, followed by strongyloidiasis, Chagas disease, and dengue. Cystic echinococcosis, that was not included in the analysis since a similar study on this disease was recently published, should also be listed among the leading NTD in Italy. While schistosomiasis has its highest burden on population coming from highly endemic areas such as SSA, leishmaniasis is especially relevant in Italian-born residents of southern regions. Education at university and post-graduate levels, to increase the awareness of healthcare professionals on these topics, as well as targeted public health interventions (such as screening or presumptive treatment in high-risk groups), are an asset to improve clinical management and control of these diseases.


Interaction between RAAS inhibitors and ACE2 in the context of COVID-19


title: Helium-rich mixtures for improved batch-mode clinical-scale spin-exchange optical pumping of Xenon-129

text: We present studies of spin-exchange optical pumping (SEOP) using ternary xenon-nitrogen-helium gas mixtures at high xenon partial pressures (up to 1330 Torr partial pressure at loading, out of 2660 Torr total pressure) in a 500-mL volume SEOP cell, using two automated batch-mode clinical-scale 129Xe hyperpolarizers operating under continuous high-power (~170 W) pump laser irradiation. In this pilot study, we explore SEOP in gas mixtures with up to 45% 4He content under a wide range of experimental conditions. When an aluminum jacket cooling/heating design was employed (GEN-3 hyperpolarizer), 129Xe polarization (%PXe) of 55.9 ± 0.9% was observed with mono-exponential build-up rate Î³SEOP of 0.049 ± 0.001 min-1 for the 4He-rich mixture (1000 Torr Xe/900 Torr He, 100 Torr N2), compared to %PXe of 49.3 ± 3.3% at Î³SEOP of 0.035 ± 0.004 min-1 for the N2-rich gas mixture (1000 Torr Xe/100 Torr He, 900 Torr N2). When forced-air cooling/heating was used (GEN-2 hyperpolarizer), %PXe of 83.9 ± 2.7% was observed at Î³SEOP of 0.045 ± 0.005 min-1 for the 4He-rich mixture (1000 Torr Xe/900 Torr He, 100 Torr N2), compared to %PXe of 73.5 ± 1.3% at Î³SEOP of 0.028 ± 0.001 min-1 for the N2-rich gas mixture (1000 Torr Xe and 1000 Torr N2). Additionally, %PXe of 72.6 ± 1.4% was observed at a build-up rate Î³SEOP of 0.041 ± 0.003 min-1 for a super-high-density 4He-rich mixture (1330 Torr Xe/1200 Torr 4He/130 Torr N2), compared to %PXe = 56.6 ± 1.3% at a build-up rate of Î³SEOP of 0.034 ± 0.002 min-1 for an N2-rich mixture (1330 Torr Xe/1330 Torr N2) using forced air cooling/heating. The observed SEOP hyperpolarization performance under these conditions corresponds to %PXe improvement by a factor of 1.14 ± 0.04 at 1000 Torr Xe density and by up to a factor of 1.28 ± 0.04 at 1330 Torr Xe density at improved SEOP build-up rates by factors of 1.61 ± 0.18 and 1.21 ± 0.11 respectively. Record %PXe levels have been obtained here: 83.9 ± 2.7% at 1000 Torr Xe partial pressure and 72.6 ± 1.4% at 1330 Torr Xe partial pressure. In addition to improved thermal stability for SEOP, the use of 4He-rich gas mixtures also reduces the overall density of produced inhalable HP contrast agents; this property may be desirable for HP 129Xe inhalation by human subjects in clinical settings-especially in populations with heavily impaired lung function. The described approach should enjoy ready application in the production of inhalable 129Xe contrast agent with near-unity 129Xe nuclear spin polarization.


Covid-19 - Mourir riche ou puiser dans le bas de laine


title: Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020

text: Healthcare workers (n = 803) with mild symptoms were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 90 positive) and asked to complete a symptom questionnaire. Anosmia, muscle ache, ocular pain, general malaise, headache, extreme tiredness and fever were associated with positivity. A predictive model based on these symptoms showed moderate discriminative value (sensitivity: 91.2%; specificity: 55.6%). While our models would not justify presumptive SARS-CoV-2 diagnosis without molecular confirmation, it can contribute to targeted screening strategies.


ISTH interim guidance on recognition and management of coagulopathy in COVID-19


Reopening Colleges and Universities During the COVID-19 Pandemic


Critical role of laboratory medicine in the global response to the COVID-19 pandemic


title: Transplant Patients' Isolation and Social Distancing Because of COVID-19: Analysis of the Resilient Capacities of the Transplant in the Management of the Coronavirus Emergency

text: BACKGROUND: One of the peculiar aspects of the transplant patient's life is that, in the post-surgery phase, the patient lives in an "isolation" condition, having to pay particular attention to the living environment and preferring a limited social life given that the immunosuppressive treatment entails immunodepression in the patient. With coronavirus disease 2019 (COVID)-19, as in a post-surgery situation, social isolation is being implemented. MATERIALS AND METHODS: The study started on March 17, 2020, and ended on April 24, 2020. Consulting/phone interviews were made. The phone questionnaire, submitted to 71 patients, consisted of a set of 15 questions that investigated structure and psychological resistance. Eight patients have been monitored exclusively for the psychological aspect through a more articulate supporting path. RESULTS: In essence, from the overall analysis of the data derived from the study of the positioning of patients based on the stage of renal function, the bands related to the development of psychopathological aspects, and the use of positive personal resources, it emerges that patients in stage V kidney failure are in the first bracket as regards the development of psychopathological aspects (absence of these experiences) and in the third bracket as regards the good use of positive resources to deal with isolation. Therefore, it can be deduced that, although with data that can be expanded, a serious or medium-serious situation from an organic point of view in this socio-health emergency situation is well addressed by the transplanted patient. CONCLUSION: Transplant patients have faced the measure of social distancing adequately and in adherence to the treatment thanks to the phone assistance of all the medical-surgical and psychological team.


Virtual treatment and social distancing


Emerging evidence to support not always "just saying no" to SARS-CoV-2 positive donors


title: Deep Vein Thrombosis in Hospitalized Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: Prevalence, Risk Factors, and Outcome

text: Background: To investigate deep vein thrombosis (DVT) in hospitalized patients with coronavirus disease 2019 (COVID-19), we performed a single institutional study to evaluate its prevalence, risk factors, prognosis, and potential thromboprophylaxis strategies in a large referral and treatment center. Methods: We studied a total of 143 patients with COVID-19 from January 29 to February 29, 2020. Demographic and clinical data, laboratory data, including ultrasound scans of the lower extremities, and outcome variables were obtained, comparisons were made between DVT and non-DVT groups. Results: Of the 143 patients hospitalized with COVID-19 (aged 63 ± 14 years; 74 [51.7%] man), 66 patients developed lower extremity DVT (46.1%, included 23 [34.8%] with proximal DVT and 43 [65.2%] with distal DVT).Compared with patients who with no DVT, patients with DVT were older and had a lower oxygenation index, a higher rate of cardiac injury, and worse prognosis including an increased proportion of deaths (23 [34.8%] vs 9 [11.7%], P = 0.001) and a decreased proportion of patients discharged (32 [48.5%] vs 60 [77.9%], P < 0.001). Multivariant analysis only showed an association between CURB-65 score 3-5 (OR = 6.122, P = 0.031), Padua prediction score ≥ 4 (OR = 4.016, P = 0.04), and D-dimer >1.0 (µg/ml) (OR = 5.818, P < 0.014) and DVT in this cohort, respectively. The combination of a CURB-65 score 3-5, a Padua prediction score ≥ 4, and D-dimer > 1.0 (µg/ml) has a sensitivity of 88.52% and a specificity of 61.43% for screening for DVT. In the subgroup of patients with a Padua prediction score ≥ 4 and whose ultrasound scans were performed Ë72 hours after admission, DVT was present in 18 (34.0%) of the subgroup receiving venous thromboembolism prophylaxis vs 35 (63.3%) in the nonprophylaxis group (P = 0.010). Conclusions: The prevalence of DVT is high and is associated with adverse outcomes in hospitalized patients with COVID-19. Prophylaxis for venous thromboembolism may be protective in patients with a Padua protection score ≥ 4 after admission. Our data seem to suggest that COVID-19 is probably an additional risk factor for DVT in the hospitalized patients.


Severe maternal morbidity and mortality associated with COVID-19: The risk should not be downplayed


title: AI in Medical Imaging Informatics: Current Challenges and Future Directions

text: This paper reviews state-of-the-art research solutions across the spectrum of medical imaging informatics, discusses clinical translation, and provides future directions for advancing clinical practice. More specifically, it summarizes advances in medical imaging acquisition technologies for different modalities, highlighting the necessity for efficient medical data management strategies in the context of AI in big healthcare data analytics. It then provides a synopsis of contemporary and emerging algorithmic methods for disease classification and organ/ tissue segmentation, focusing on AI and deep learning architectures that have already become the de facto approach. The clinical benefits of in-silico modelling advances linked with evolving 3D reconstruction and visualization applications are further documented. Concluding, integrative analytics approaches driven by associate research branches highlighted in this study promise to revolutionize imaging informatics as known today across the healthcare continuum for both radiology and digital pathology applications. The latter, is projected to enable informed, more accurate diagnosis, timely prognosis, and effective treatment planning, underpinning precision medicine.


docid: vgolgkqk

title: Brief report of the first cured 2019-nCoV pneumonia patient in West China Hospital


The first Global Pneumonia Forum: recommendations in the time of coronavirus


title: Selection of viral variants during persistent infection of insectivorous bat cells with Middle East respiratory syndrome coronavirus

text: Coronaviruses that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) are speculated to have originated in bats. The mechanisms by which these viruses are maintained in individuals or populations of reservoir bats remain an enigma. Mathematical models have predicted long-term persistent infection with low levels of periodic shedding as a likely route for virus maintenance and spillover from bats. In this study, we tested the hypothesis that bat cells and MERS coronavirus (CoV) can co-exist in vitro. To test our hypothesis, we established a long-term coronavirus infection model of bat cells that are persistently infected with MERS-CoV. We infected cells from Eptesicus fuscus with MERS-CoV and maintained them in culture for at least 126 days. We characterized the persistently infected cells by detecting virus particles, protein and transcripts. Basal levels of type I interferon in the long-term infected bat cells were higher, relative to uninfected cells, and disrupting the interferon response in persistently infected bat cells increased virus replication. By sequencing the whole genome of MERS-CoV from persistently infected bat cells, we identified that bat cells repeatedly selected for viral variants that contained mutations in the viral open reading frame 5 (ORF5) protein. Furthermore, bat cells that were persistently infected with ΔORF5 MERS-CoV were resistant to superinfection by wildtype virus, likely due to reduced levels of the virus receptor, dipeptidyl peptidase 4 (DPP4) and higher basal levels of interferon in these cells. In summary, our study provides evidence for a model of coronavirus persistence in bats, along with the establishment of a unique persistently infected cell culture model to study MERS-CoV-bat interactions.


title: Multisystem Inflammatory Syndrome in Children (MIS-C) with COVID-19: Insights from simultaneous familial Kawasaki Disease cases

text: Recently, an increasing number of SARS-CoV-2 patients with COVID-19 syndrome, which overlaps with Kawasaki Disease (KD), have been reported, supporting the suggestion that infection is one of the triggers of KD. We summarized the reports of simultaneous familial KD cases to better understand the etiopathogenesis of both KD and Multisystem Inflammatory Syndrome in Children (MIS-C) related to COVID-19. Here we discuss the etiology of these syndromes from the point of view of infection and genetic susceptibility.


The disguised pandemic: the importance of data normalization in COVID-19 web mapping


title: Exclusion of Pregnant Women from Clinical Trials during the Coronavirus Disease 2019 Pandemic: A Review of International Registries

text: OBJECTIVE: Pregnant women have been historically excluded from clinical trials for nonobstetric conditions, even during prior epidemics. The objective of this review is to describe the current state of research for pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN: We conducted a search of international trial registries for trials relating to the novel coronavirus. The eligibility criteria for each trial were reviewed for inclusion/exclusion of pregnant women. Relevant data were extracted and descriptive statistics were calculated for individual and combined data. The total number of trials from each registry were compared, as well as the proportions of pregnancy-related trials within each. RESULTS: Among 621,370 trials in the World Health Organization International Clinical Trials Registry, 927 (0.15%) were COVID-19 related. Of those, the majority (52%) explicitly excluded pregnancy or failed to address pregnancy at all (46%) and only 16 (1.7%) were pregnancy specific. When categorized by region, 688 (74.2%) of COVID-19 trials were in Asia, followed by 128 (13.8%) in Europe, and 66 (7.2%) in North America. Of the COVID-19 trials which included pregnant women, only three were randomized-controlled drug trials. CONCLUSION: Approximately 1.7% of current COVID-19 research is pregnancy related and the majority of trials either explicitly exclude or fail to address pregnancy. Only three interventional trials worldwide involved pregnant women. The knowledge gap concerning the safety and efficacy of interventions for COVID-19 created by the exclusion of pregnant women may ultimately harm them. While "ethical" concerns about fetal exposure are often cited, it is in fact unethical to habitually exclude pregnant women from research. KEY POINTS: · Pregnancy was excluded from past pandemic research.. · Pregnancy is being excluded from COVID-19 research.. · Exclusion of pregnant women is potentially harmful..


To Be a Partner in Life-Resident Training During the COVID-19 Pandemic


docid: wzkjarnc

title: Coronavirus Disease-19 Has Come Home to Roost in Gastroenterology


title: Quarantine Fatigue: first-ever decrease in social distancing measures after the COVID-19 outbreak before reopening United States

text: By the emergence of the novel coronavirus disease (COVID-19) in Wuhan, China, and its rapid outbreak worldwide, the infectious illness has changed our everyday travel patterns. In this research, our team investigated the changes in the daily mobility pattern of people during the pandemic by utilizing an integrated data panel. To incorporate various aspects of human mobility, the team focused on the Social Distancing Index (SDI) which was calculated based on five basic mobility measures. The SDI patterns showed a plateau stage in the beginning of April that lasted for about two weeks. This phenomenon then followed by a universal decline of SDI, increased number of trips and reduction in percentage of people staying at home. We called the observation Quarantine Fatigue. The Rate of Change (ROC) method was employed to trace back the start date of quarantine fatigue which was indicated to be April 15th. Our analysis showed that despite the existence of state-to-state variations, most states started experiencing a quarantine fatigue phenomenon during the same period. This observation became more important by knowing that none of the states had officially announced the reopening until late April showing that people decided to loosen up their social distancing practices before the official reopening announcement. Moreover, our analysis indicated that official reopening led to a rapid decline in SDI, raising the concern of a second wave of outbreak. The synchronized trend among states also emphasizes the importance of a more nationwide decision-making attitude for the future as the condition of each state depends on the nationwide behavior.


docid: tesebwwz

title: Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: A call for action

text: Pregnancy and early parenthood are life-changing periods characterized by intense emotions and a high vulnerability to emotional problems. Overall, 10-20% of pregnant women and women in the early postpartum period suffer from mental health problems. In the first months of 2020, pregnant and breastfeeding women have also needed to face the COVID-19 pandemic, including the exceptional quarantine measures that have disturbed private and professional life.


title: Custom-made 3D-printed face masks in case of pandemic crisis situations with a lack of commercially available FFP2/3 masks

text: In the case of pandemic crisis situations, a crucial lack of protective material such as protective face masks for healthcare professionals can occur. A proof of concept (PoC) and prototype are presented, demonstrating a reusable custom-made three-dimensionally (3D) printed face mask based on materials and techniques (3D imaging and 3D printing) with global availability. The individualized 3D protective face mask consists of two 3D-printed reusable polyamide composite components (a face mask and a filter membrane support) and two disposable components (a head fixation band and a filter membrane). Computer-aided design (CAD) was used to produce the reusable components of the 3D face mask based on individual facial scans, which were acquired using a new-generation smartphone with two cameras and a face scanning application. 3D modelling can easily be done by CAD designers worldwide with free download software. The disposable non-woven melt-blown filter membrane is globally available from industrial manufacturers producing FFP2/3 protective masks for painting, construction, agriculture, and the textile industry. Easily available Velcro fasteners were used as a disposable head fixation band. A cleaning and disinfection protocol is proposed. Leakage and virological testing of the reusable components of the 3D face mask, following one or several disinfection cycles, has not yet been performed and is essential prior to its use in real-life situations. This PoC should allow the reader to consider making and/or virologically testing the described custom-made 3D-printed face masks worldwide. The surface tessellation language (STL) format of the original virtual templates of the two reusable components described in this paper can be downloaded free of charge using the hyperlink (Supplementary Material online).


[Facing the pandemic of 2019 novel coronavirus infections: the pediatric perspectives]


COVID-19 in a UK neurology hospital


title: Internet-based self-help intervention aimed at increasing social self-efficacy among internal migrants in Poland: Study protocol for a randomized controlled trial

text: Background: Migration is a challenging life transition that may be a source of various problems related to well-being and mental health. However, the psychological adaptation of migrants may be potentially facilitated by social self-efficacy-the beliefs in one's ability to initiate and maintain interpersonal relationships. Previous research suggests that social self-efficacy is positively related to adjustment and negatively related to loneliness, depression, and psychological distress. Research also confirms that self-efficacy beliefs can be effectively enhanced using Internet-based interventions. These results served as a background for creating the New in Town, a self-help Internet-based intervention for internal migrants in Poland that aims at increasing social self-efficacy. Exercises in the intervention are based on the principles of Cognitive Behavioral Therapy and relate to sources of self-efficacy beliefs: mastery experiences, vicarious experiences, verbal persuasions, and emotional and physiological states. Users complete increasingly challenging tasks that encourage them to interact with their environment. The aim of this trial was to investigate the efficacy of the New in Town intervention. Methods: The efficacy of the New in Town intervention will be tested in a two-arm randomized controlled trial with a waitlist control group. Social self-efficacy will be the primary outcome. Secondary outcomes will include loneliness, perceived social support, and satisfaction with life. Additionally, we will measure user experience among participants allocated to the experimental group. We aim to recruit a total of Nâ¯=â¯280 participants aged at least 18â¯years who have changed their place of residence in the last 6â¯months and have an Internet connection. Participants will be assessed at baseline, 3-week post-test, and 8-week follow-up. Discussion: The trial will provide insights into the efficacy of Internet-based self-help interventions in increasing social self-efficacy. Given that the intervention works, New in Town could provide an easily accessible support option for internal migrants in Poland. Trial registration: The trial was registered with ClinicalTrials.gov (identifier: NCT04088487) on 11th September 2019.


docid: zpthhysu

title: SecureABC: Secure AntiBody Certificates for COVID-19

text: COVID-19 has resulted in unprecedented social distancing policies being enforced worldwide. As governments urgently seek to reopen society, there is a demand for technologies that may alleviate the requirement for social distancing whilst also protecting healthcare services and maintaining human and civil rights. In this work we explore the controversial technique of so-called immunity passports and present SecureABC: a decentralised, privacy-preserving system for issuing and verifying antibody certificates. We consider the implications of immunity passport systems, develop a set of general principles and security requirements for their deployment and show that these may be satisfied in practice.


title: Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection

text: CoV-19/SARS-CoV-2 is a highly pathogenic virus that causes coronavirus-19 disease (COVID-19) an acute respiratory distress syndrome which provokes serious problems for global health. Studies suggest that there are many differences between men and women in the immune response to CoV-19 infection and inflammatory diseases. Women, compared to men, are less susceptible to viral infections based on a different innate immunity, steroid hormones and factors related to sex chromosomes. The presence of two X chromosomes in women emphasize the immune system even if one is inactive. The immune regulatory genes encoded by X chromosome in female gender causes lower viral load levels, and less inflammation than in man, while CD4+ T cells are higher with better immune response. In addition, women generally produce higher levels of antibodies which remain in the circulation longer. The levels of activation of the immune cells are higher in women than in men, and it is correlated with the trigger of TLR7 and the production of IFN. TLR7 is higher in women than in men and its biallelic expression leads to higher immune responses and increases the resistance to viral infections. TLR7 is expressed in innate immune cells which recognizes single strand RNA virus by promoting the production of antibodies against the virus and the generation of pro-inflammatory cytokines including IL-6 and IL-1 family members. Moreover, in women the production of inflammatory IL-6 after viral infection is lower than in males and is often correlated with a better longevity. In addition, on the X chromosome there are loci that code for the genes involved in the regulation of immune cells such as FOXP3, and transcription factor for Treg involved in virus pathogenesis. The X chromosome influences the immune system by acting on many other proteins, including TLR8, CD40L and CXCR3 which can be over-expressed in women, and influence the response to viral infections and vaccinations. However, the biallelic expression of the X-linked genes can promote harmful autoimmune and inflammatory responses. Cardiovascular diseases are more frequent in males and subjects without cardiovascular dysfunctions infected by CoV-19 have a better prognosis, but these effects are still under study. It is hoped that certain drugs, such as CoV-19 receptor blockers, anti-inflammatories (against rheumatic diseases), monoclonal antibodies, anti-IL-1 and anti-IL-6, the remdesevir drug (analogue adenosine, effective against ebola), hydroxychloroquine (for the treatment of malaria) and vaccines, will open up new strategies and new therapeutic ways to combat this terrible virus.


The COVID-19 Pandemic Illuminates Persistent and Emerging Disparities among Rural Black Populations


title: Nurse infected with Covid-19 from a provisional dengue patient

text: We report a 35-year-old female nurse who possibly received the SARS-CoV-2 virus during the blood sampling of a 35-year-old male patient initially suspected as a dengue infection. The patient had mild thrombocytopenia and positive dengue IgG and IgM whereas the clinicians were not aware of the possibility of false-positive dengue serology revealed in the published case report from Singapore. The nurse put on a pair of gloves but did not wear a mask during the only encounter with this patient. This nosocomial transmission raised a safety concern among healthcare professionals in an area with a relatively low Covid-19 prevalence, especially when the clinical and laboratory characteristics could be confused with other viral infections.


title: AOU Policlinico di Bari - West China Hospital of Sichuan University. Global experience of medical profession, battle, health, friendship against COVID -19

text: BACKGROUND: The global context we are experiencing, characterized by the pandemic spread of SARS-CoV2, imposes strict containment, isolation and physical distance measures, necessary to control and contain the risk of contagion. Despite social distances and isolation in this context of threat to Global Health, the sharing of experiences, professionalism, scientific research and Public Health strategies is fundamental. Never before has telemedicine played a decisive role in supporting the healthcare organization, The University Hospital Consortium Policlinico of Bari has launched an experimental partnership project with West China Hospital of Sichuan University through periodic and scheduled video conferences. MATERIALS AND METHODS: The Company Strategic Management, the Dean of the Faculty of Medicine and Surgery of the University of Bari, Medical Executives of the Health Department, of the U.O of Infectious Diseases, Anesthesia and Resuscitation, Pulmonology, Emergency, Hygiene, Occupational Medicine, Psychiatry and Doctors Resident operating in the COVID Area. are involved in the Experimental Project., all adequately trained and instructed on the operating protocol. RESULTS: From the preliminary data of this study, it appears that the Bari Polyclinic has adopted the same therapeutic strategies started in China in the previous months, believing early diagnosis and treatment to be a strength in the battle against COVID-19. The project makes it possible to make the management of COVID-19 patients optimal, safe and better, using the experience acquired in the field by Chinese doctors who, first caught by this health emergency, have obtained positive results.


COVID-19 y cronicidad. Una oportunidad de reinventar los servicios de Medicina Física y Rehabilitación./ [COVID-19 and chronic diseases. An opportunity to reinvent the services of Physical Medicine and Rehabilitation]


Hyposalivation as a potential risk for SARS-CoV-2 infection: Inhibitory role of saliva


title: Crisis Psychodrama in the Era of COVID-19

text: This work gives an overview of the methods of scenic expression which can be used to help cope with the crisis caused by the global threat of the coronavirus pandemic. The virus is new, the vaccine has not been developed yet and there are no unified prevention and post-prevention policies. In the following lines some modified elements of psychodrama interventions are presented including the ways of preventing the retraumatization of the patient (protagonist). This can be achieved by conscious reliving of the trauma and by activating new, transformative roles to guide the protagonist on his way to recovery.


title: COVID-19-Triage: Wer bleibt stationär? Das Modell Essen./ [COVID-19 Triage: Who is an inpatient? The Essen triage model]

text: INTRODUCTION: Data about optimal initial assessment in patients with suspicion for COVID19-infection or already confirmed infection are sparse. Especially, in preparation for expected mass casualty incident it is necessary to distinguish early and efficiently between outpatient and inpatient treatment including the need for intensive care therapy. METHODS: We present a model for a safe and efficient triage, which is established and used in the university hospital of Essen, Germany. It is intended for a non-disaster situation. This model is a combination of clinical assessment by using vital parameters and Manchester triage scale (MTS). Possible additional parameters are POCT (point-of-care-testing) values, electrocardiogram, CT pulmonary angiography, SARS-Cov2-PCR as well as detailed diagnostic of laboratory values. The model was validated by 100 consecutive patients. We demonstrate three patients to illustrate this model. RESULTS: During the first two weeks after implementing this model in our normal operation at the emergency department, we had an efficient selectivity between need for inpatient and outpatient treatment. 16 patients were classified as "inpatients" according to initial assessment. Among 84 patients who were initially classified as "outpatients", 7 patients returned to our emergency department within 14 days. Three of these patients returned due to complaints other than COVID19. One female patient had to be admitted due to progressive dyspnea. CONCLUSIONS: This introduced triage-model seems to be an efficient concept. Adjustment might be necessary after further experience and after a growing number of patients.


title: An Unsupervised Machine Learning Approach to Assess the ZIP Code Level Impact of COVID-19 in NYC

text: New York City has been recognized as the world's epicenter of the novel Coronavirus pandemic. To identify the key inherent factors that are highly correlated to the Increase Rate of COVID-19 new cases in NYC, we propose an unsupervised machine learning framework. Based on the assumption that ZIP code areas with similar demographic, socioeconomic, and mobility patterns are likely to experience similar outbreaks, we select the most relevant features to perform a clustering that can best reflect the spread, and map them down to 9 interpretable categories. We believe that our findings can guide policy makers to promptly anticipate and prevent the spread of the virus by taking the right measures.


Global haemostatic tests in rapid diagnosis and management of COVID-19 associated coagulopathy in acute limb ischaemia


title: Generic probabilistic modelling and non-homogeneity issues for the UK epidemic of COVID-19

text: Coronavirus COVID-19 spreads through the population mostly based on social contact. To gauge the potential for widespread contagion, to cope with associated uncertainty and to inform its mitigation, more accurate and robust modelling is centrally important for policy making. We provide a flexible modelling approach that increases the accuracy with which insights can be made. We use this to analyse different scenarios relevant to the COVID-19 situation in the UK. We present a stochastic model that captures the inherently probabilistic nature of contagion between population members. The computational nature of our model means that spatial constraints (e.g., communities and regions), the susceptibility of different age groups and other factors such as medical pre-histories can be incorporated with ease. We analyse different possible scenarios of the COVID-19 situation in the UK. Our model is robust to small changes in the parameters and is flexible in being able to deal with different scenarios. This approach goes beyond the convention of representing the spread of an epidemic through a fixed cycle of susceptibility, infection and recovery (SIR). It is important to emphasise that standard SIR-type models, unlike our model, are not flexible enough and are also not stochastic and hence should be used with extreme caution. Our model allows both heterogeneity and inherent uncertainty to be incorporated. Due to the scarcity of verified data, we draw insights by calibrating our model using parameters from other relevant sources, including agreement on average (mean field) with parameters in SIR-based models.


COVID-19. The new normal for midwives, women and families


title: Machine learning using intrinsic genomic signatures for rapid classification of novel pathogens: COVID-19 case study

text: The 2019 novel coronavirus (renamed SARS-CoV-2, and generally referred to as the COVID-19 virus) has spread to 184 countries with over 1.5 million confirmed cases. Such major viral outbreaks demand early elucidation of taxonomic classification and origin of the virus genomic sequence, for strategic planning, containment, and treatment. This paper identifies an intrinsic COVID-19 virus genomic signature and uses it together with a machine learning-based alignment-free approach for an ultra-fast, scalable, and highly accurate classification of whole COVID-19 virus genomes. The proposed method combines supervised machine learning with digital signal processing (MLDSP) for genome analyses, augmented by a decision tree approach to the machine learning component, and a Spearman's rank correlation coefficient analysis for result validation. These tools are used to analyze a large dataset of over 5000 unique viral genomic sequences, totalling 61.8 million bp, including the 29 COVID-19 virus sequences available on January 27, 2020. Our results support a hypothesis of a bat origin and classify the COVID-19 virus as Sarbecovirus, within Betacoronavirus. Our method achieves 100% accurate classification of the COVID-19 virus sequences, and discovers the most relevant relationships among over 5000 viral genomes within a few minutes, ab initio, using raw DNA sequence data alone, and without any specialized biological knowledge, training, gene or genome annotations. This suggests that, for novel viral and pathogen genome sequences, this alignment-free whole-genome machine-learning approach can provide a reliable real-time option for taxonomic classification.


docid: rqgykqja

title: Synthesis of adenine dinucleosides SAM analogs as specific inhibitors of SARS-CoV nsp14 RNA cap guanine-N7-methyltransferase

text: The spreading of new viruses is known to provoke global human health threat. The current COVID-19 pandemic caused by the recently emerged coronavirus SARS-CoV-2 is one significant and unfortunate example of what the world will have to face in the future with emerging viruses in absence of appropriate treatment. The discovery of potent and specific antiviral inhibitors and/or vaccines to fight these massive outbreaks is an urgent research priority. Enzymes involved in the capping pathway of viruses and more specifically RNA N7- or 2'O-methyltransferases (MTases) are now admitted as potential targets for antiviral chemotherapy. We designed bisubstrate inhibitors by mimicking the transition state of the 2'-O-methylation of the cap RNA in order to block viral 2'-O MTases. This work resulted in the synthesis of 16 adenine dinucleosides with both adenosines connected by various nitrogen-containing linkers. Unexpectedly, all the bisubstrate compounds were barely active against 2'-O MTases of several flaviviruses or SARS-CoV but surprisingly, seven of them showed efficient and specific inhibition against SARS-CoV N7-MTase (nsp14) in the micromolar to submicromolar range. The most active nsp14 inhibitor identified is as potent as but particularly more specific than the broad-spectrum MTase inhibitor, sinefungin. Molecular docking suggests that the inhibitor binds to a pocket formed by the S-adenosyl methionine (SAM) and cap RNA binding sites, conserved among SARS-CoV nsp14. These dinucleoside SAM analogs will serve as starting points for the development of next inhibitors for SARS-CoV-2 nsp14 N7-MTase.


Olanzapine versus Metoclopramide for Treatment of Nausea and Vomiting in Advanced Cancer Patients with Incomplete Malignant Bowel Obstruction


title: Rapid Response Crop Maps in Data Sparse Regions

text: Spatial information on cropland distribution, often called cropland or crop maps, are critical inputs for a wide range of agriculture and food security analyses and decisions. However, high-resolution cropland maps are not readily available for most countries, especially in regions dominated by smallholder farming (e.g., sub-Saharan Africa). These maps are especially critical in times of crisis when decision makers need to rapidly design and enact agriculture-related policies and mitigation strategies, including providing humanitarian assistance, dispersing targeted aid, or boosting productivity for farmers. A major challenge for developing crop maps is that many regions do not have readily accessible ground truth data on croplands necessary for training and validating predictive models, and field campaigns are not feasible for collecting labels for rapid response. We present a method for rapid mapping of croplands in regions where little to no ground data is available. We present results for this method in Togo, where we delivered a high-resolution (10 m) cropland map in under 10 days to facilitate rapid response to the COVID-19 pandemic by the Togolese government. This demonstrated a successful transition of machine learning applications research to operational rapid response in a real humanitarian crisis. All maps, data, and code are publicly available to enable future research and operational systems in data-sparse regions.


title: Psychological symptoms of ordinary Chinese citizens based on SCL-90 during the level I emergency response to COVID-19

text: The World Health Organization (WHO) has declared that the Corona Virus (COVID-19) has become a global pandemic. This study aimed to investigate the psychological symptoms of ordinary Chinese citizens during the Level I Emergency Response throughout China. From January 31 to February 2 2020, an online questionnaire, Symptom Checklist 90 (SCL-90) was designed, and differences in GSI T-scores among subgroups were examined by ANOVA. Based on a cut-off point of the GSI T-scores of 63, the overall sample was divided into high and low-risk groups. of the 1,060 participants investigated in China, more than 70% of them have moderate and higher level of psychological symptoms specifically elevated scores for obsessive compulsion, interpersonal sensitivity, phobic anxiety, and psychoticism. There were no significant differences between males and females. Those who were of over 50 years old, had an undergraduate education and below, were divorced or widowed, and agricultural workers had significantly more symptoms. However, significantly more minors and medical staff were in the high-risk group. These results show that COVID-19 has a significant adverse socio-psychological influence on ordinary citizens. Therefore, governments should equip psychological health departments and pay attention to the people who are in high-risk groups, providing psychological interventions and assistance.


Pulmonary embolism and Sars-Cov-2 infection: A new indication for surgical pulmonary endarterectomy?


title: Restoration of leg length and offset correlates with trochanteric pain syndrome in total hip arthroplasty

text: Persistent pain around the greater trochanter is a common complication after total hip arthroplasty. Restoration of biomechanics such as leg length, femoral und acetabular offset is crucial in THA. The purpose of this study was to evaluate postoperative differences of these parameters after THA and to analyze their association to greater trochanteric pain syndrome. Furthermore, we aimed to evaluate the clinical relevance of trochanteric pain syndrome compared to patient reported outcome measures. 3D-CT scans of 90 patients were analyzed after minimalinvasive total hip arthroplasty and leg length, femoral and acetabular offset differences were measured. Clinical evaluation was performed three years after THA regarding the presence of trochanteric pain syndrome and using outcome measures. Furthermore, the patients' expectation were evaluated. Patients with trochanteric pain syndrome showed a higher absolute discrepancy of combined leg length, femoral and acetabular offset restoration compared to the non-operated contralateral side with 11.8 ± 6.0 mm than patients without symptoms in the trochanteric region with 7.8 ± 5.3 mm (p = 0.01). Patients with an absolute deviation of the combined parameters of more than 5 mm complained more frequently about trochanteric symptoms (29.2%, 19/65) than patients with a biomechanical restoration within 5 mm compared to the non-affected contralateral side (8.0%, 2/25, p = 0.03). Clinical outcome measured three years after THA was significantly lower in patients with trochanteric symptoms than without trochanteric pain (p < 0.03). Similarly, fulfillment of patient expectations as measured by THR-Survey was lower in the patients with trochanteric pain (p < 0.005). An exact combined restoration of leg length, acetabular and femoral offset reduces significantly postoperative trochanteric pain syndrome and improves the clinical outcome of the patients.


title: [Management strategy for the resumption of regular diagnosis and treatment in gastrointestinal surgery department during the outbreak of coronavirus disease 2019 (COVID-19)]

text: Acute abdomen, abdominal trauma, gastrointestinal bleeding and gastrointestinal tumors are the main conditions that are routinely treated in gastrointestinal surgery department with high incidence and critical condition. These conditions need emergency or selective operations. During the outbreak of the coronavirus disease 2019 (COVID-19), it's a great challenge for us to meet the patients' requirement under the situation. As the COVID-19 was brought under control in China, the Department of General Surgery in Nanfang Hospital resumed regular medical services gradually. Based on our clinical practice, the four major measures of strengthening pre-hospital screening, perioperative prevention and control, medical staff protection, and ward management were adopted. These main measures include the strict implementation of the appointment system and triage system before admission; the conduction of epidemiological and preliminary screening of viral nucleic acids; the chest CT examination during the perioperative period to re-screen COVID-19; the reduction of the risk of droplets and aerosol transmission; the minimally invasive surgery combined with enhanced recovery program in order to reduce patient's susceptibility and shorten the length of postoperative hospital stay; the reinforcement of specific infection control training for medical staff; the strict implementation of hierarchical protection; the establishment of gastrointestinal surgery prevention and control system; the rehearsal of emergency exercise; the installation of quarantine wards; the screening and management of family care-givers; the strict disinfection of environment and materials. Our preliminary practice shows that following the work guidelines issued by the Guangdong Province COVID-19 Prevention and Control Office and adopting precise management strategies in combination with the specific clinical features of gastrointestinal surgery, it is possible to safely resume regular care for the patients and comply to epidemic control at the same time.


Asymptomatic SARS-CoV-2 infections: What do we need to know?


Helping the Radiologist: The Role of Scientific Journals to Help Prevent the Spread of COVID-19