The pandemic is challenging China's breakneck race to the top of science


Positive result of Sars-Cov-2 in sputum from a cured patient with COVID-19


Smart learning for urology residents during the COVID-19 pandemic and beyond: insights from a nationwide survey in Italy


title: Nuklearmedizin zu Zeiten der SARS-CoV-2 Pandemie: 18F-FDG-PET/CT zur Visualisierung von COVID-19./ Nuclear medicine in SARS-CoV-2 pandemia: 18F-FDG-PET/CT to visualize COVID-19

text: The current outbreak of coronavirus SARS-CoV-2 has reached multiple countries worldwide. While the number of newly diagnosed cases and fatalities is rising quickly, far-reaching measures were enacted to prevent further spread. Diagnosis relies on clinical presentation, exposure history, PCR using specimens from the respiratory tract together with computed tomography (CT) imaging. One of the hallmarks of a critical course of COVID-19 is the development of severe acute respiratory distress syndrome (ARDS). As management of COVID-19 can be considered a multi-disciplinary approach involving various medical specialties, we here review the first 18F-FDG-PET/CT scans of COVID-19 to discuss how Nuclear Medicine could contribute to management of this disease.


docid: crmfwjvf

title: Emerging Polynomial Growth Trends in COVID-19 Pandemic Data and Their Reconciliation with Compartment Based Models

text: We study the reported data from the COVID-19 pandemic outbreak in January - May 2020 in 119 countries. We observe that the time series of active cases in individual countries (the difference of the total number of confirmed infections and the sum of the total number of reported deaths and recovered cases) display a strong agreement with polynomial growth and at a later epidemic stage also with a combined polynomial growth with exponential decay. Our results are also formulated in terms of compartment type mathematical models of epidemics. Within these models the universal scaling characterizing the observed regime in an advanced epidemic stage can be interpreted as an algebraic decay of the relative reproduction number $R_0$ as $T_M/t$, where $T_M$ is a constant and $t$ is the duration of the epidemic outbreak. We show how our findings can be applied to improve predictions of the reported pandemic data and estimate some epidemic parameters. Note that although the model shows a good agreement with the reported data we do not make any claims about the real size of the pandemics as the relation of the observed reported data to the total number of infected in the population is still unknown.


title: Winds in Star Clusters Drive Kolmogorov Turbulence

text: Intermediate and massive stars drive fast and powerful isotropic winds that interact with the winds of nearby stars in star clusters and the surrounding interstellar medium (ISM). Wind-ISM collisions generate astrospheres around these stars that contain hot $T\sim 10^7$ K gas that adiabatically expands. As individual bubbles expand and collide they become unstable, potentially driving turbulence in star clusters. In this paper we use hydrodynamic simulations to model a densely populated young star cluster within a homogeneous cloud to study stellar wind collisions with the surrounding ISM. We model a mass-segregated cluster of 20 B-type young main sequence stars with masses ranging from 3--17 $M_{\odot}$. We evolve the winds for $\sim$11 kyrs and show that wind-ISM collisions and over-lapping wind-blown bubbles around B-stars mixes the hot gas and ISM material generating Kolmogorov-like turbulence on small scales early in its evolution. We discuss how turbulence driven by stellar winds may impact the subsequent generation of star formation in the cluster


Universal Screening for SARS-CoV-2 in Women Admitted for Delivery


SARS-CoV-2 in upper and lower airway samples of a laryngectomized patient: New insights and many lessons


title: Caring for the carers: Ensuring the provision of quality maternity care during a global pandemic

text: The COVID-19 pandemic is impacting health systems worldwide. Maternity care providers must continue their core business in caring and supporting women, newborns and their families whilst also adapting to a rapidly changing health system environment. This article provides an overview of important considerations for supporting the emotional, mental and physical health needs of maternity care providers in the context of the unprecedented crisis that COVID-19 presents. Cooperation, planning ahead and adequate availability of PPE is critical. Thinking about the needs of maternity providers to prevent stress and burnout is essential. Emotional and psychological support needs to be available throughout the response. Prioritising food, rest and exercise are important. Healthcare workers are every country's most valuable resource and maternity providers need to be supported to provide the best quality care they can to women and newborns in exceptionally trying circumstances.


title: Estimating the burden of SARS-CoV-2 in France

text: France has been heavily affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and went into lockdown on 17 March 2020. Using models applied to hospital and death data, we estimate the impact of the lockdown and current population immunity. We find that 2.9% of infected individuals are hospitalized and 0.5% of those infected die (95% credible interval: 0.3 to 0.9%), ranging from 0.001% in those under 20 years of age to 8.3% in those 80 years of age or older. Across all ages, men are more likely to be hospitalized, enter intensive care, and die than women. The lockdown reduced the reproductive number from 2.90 to 0.67 (77% reduction). By 11 May 2020, when interventions are scheduled to be eased, we project that 3.5 million people (range: 2.1 million to 6.0 million), or 5.3% of the population (range: 3.3 to 9.3%), will have been infected. Population immunity appears to be insufficient to avoid a second wave if all control measures are released at the end of the lockdown.


title: Renin-Angiotensin-Aldosterone System Blockers and the Risk of Covid-19

text: BACKGROUND: A potential association between the use of angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors and the risk of coronavirus disease 2019 (Covid-19) has not been well studied. METHODS: We carried out a population-based case-control study in the Lombardy region of Italy. A total of 6272 case patients in whom infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was confirmed between February 21 and March 11, 2020, were matched to 30,759 beneficiaries of the Regional Health Service (controls) according to sex, age, and municipality of residence. Information about the use of selected drugs and patients' clinical profiles was obtained from regional databases of health care use. Odds ratios and 95% confidence intervals for associations between drugs and infection, with adjustment for confounders, were estimated by means of logistic regression. RESULTS: Among both case patients and controls, the mean (±SD) age was 68±13 years, and 37% were women. The use of ACE inhibitors and ARBs was more common among case patients than among controls, as was the use of other antihypertensive and non-antihypertensive drugs, and case patients had a worse clinical profile. Use of ARBs or ACE inhibitors did not show any association with Covid-19 among case patients overall (adjusted odds ratio, 0.95 [95% confidence interval {CI}, 0.86 to 1.05] for ARBs and 0.96 [95% CI, 0.87 to 1.07] for ACE inhibitors) or among patients who had a severe or fatal course of the disease (adjusted odds ratio, 0.83 [95% CI, 0.63 to 1.10] for ARBs and 0.91 [95% CI, 0.69 to 1.21] for ACE inhibitors), and no association between these variables was found according to sex. CONCLUSIONS: In this large, population-based study, the use of ACE inhibitors and ARBs was more frequent among patients with Covid-19 than among controls because of their higher prevalence of cardiovascular disease. However, there was no evidence that ACE inhibitors or ARBs affected the risk of COVID-19.


docid: gqsouqql

title: Video Conferencing Impact on Facial Appearance: Looking Beyond the COVID-19 Pandemic


title: Early characteristics of the COVID-19 outbreak predict the subsequent epidemic scope

text: OBJECTIVES: The mostly-resolved first wave of the COVID-19 epidemic in China provided a unique opportunity to investigate how the initial characteristics of the COVID-19 outbreak predict its subsequent magnitude. METHODS: We collected publicly available COVID-19 epidemiological data from 436 Chinese cities from 16th January-15th March 2020. Based on 45 cities that reported >100 confirmed cases, we examined the correlation between early-stage epidemic characteristics and subsequent epidemic magnitude. RESULTS: We identified a transition point from a slow- to a fast-growing phase for COVID-19 at 5.5 (95% CI, 4.6-6.4) days after the first report, and 30 confirmed cases marked a critical threshold for this transition. The average time for the number of confirmed cases to increase from 30 to 100 (time from 30-to-100) was 6.6 (5.3-7.9) days, and the average case-fatality rate in the first 100 confirmed cases (CFR-100) was 0.8% (0.2-1.4%). The subsequent epidemic size per million population was significantly associated with both of these indicators. We predicted a ranking of epidemic size in the cities based on these two indicators and found it highly correlated with the actual classification of epidemic size. CONCLUSIONS: Early epidemic characteristics are important indicators for the size of the entire epidemic.


title: Impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric oncology care in the Middle East, North Africa, and West Asia Region: A report from the Pediatric Oncology East and Mediterranean (POEM) Group

text: BACKGROUND: Childhood cancer is a highly curable disease when timely diagnosis and appropriate therapy are provided. A negative impact of the coronavirus disease 2019 (COVID-19) pandemic on access to care for children with cancer is likely but has not been evaluated. METHODS: A 34-item survey focusing on barriers to pediatric oncology management during the COVID-19 pandemic was distributed to heads of pediatric oncology units within the Pediatric Oncology East and Mediterranean (POEM) collaborative group, from the Middle East, North Africa, and West Asia. Responses were collected on April 11 through 22, 2020. Corresponding rates of proven COVID-19 cases and deaths were retrieved from the World Health Organization database. RESULTS: In total, 34 centers from 19 countries participated. Almost all centers applied guidelines to optimize resource utilization and safety, including delaying off-treatment visits, rotating and reducing staff, and implementing social distancing, hand hygiene measures, and personal protective equipment use. Essential treatments, including chemotherapy, surgery, and radiation therapy, were delayed in 29% to 44% of centers, and 24% of centers restricted acceptance of new patients. Clinical care delivery was reported as negatively affected in 28% of centers. Greater than 70% of centers reported shortages in blood products, and 47% to 62% reported interruptions in surgery and radiation as well as medication shortages. However, bed availability was affected in <30% of centers, reflecting the low rates of COVID-19 hospitalizations in the corresponding countries at the time of the survey. CONCLUSIONS: Mechanisms to approach childhood cancer treatment delivery during crises need to be re-evaluated, because treatment interruptions and delays are expected to affect patient outcomes in this otherwise largely curable disease.


title: Coronavirus Disease 2019 (COVID-19): Clinical Perspectives and Ongoing Challenges

text: BACKGROUND: Emerging infectious diseases pose a great hazard to public health and the global economy A novel coronavirus, SARS-CoV-2, causing coronavirus disease 2019 (COVID-19), emerged from Wuhan, China, in December 2019 Since then, it has spread globally causing a global health emergency of inconceivable magnitude, with significant morbidity and mortality There is the need for clinicians and health care providers to understand and gain knowledge of the different aspects of the disease as it evolves OBJECTIVE: We reviewed existing literature on COVID-19 in order to present a synopsis of current understanding of the disease METHODS: Using PubMed, Embase and Medline, articles published between January and April 2020 on Coronavirus disease 2019 (COVID-19), and resources from World Health Organisation were analyzed in order to have an understanding of the clinical characteristics, transmission dynamics, virology, diagnostic possibilities, prevention, management approach, controversies and impact of COVID-19 on the healthcare workforce RESULTS: Our review revealed that COVID-19 patients present with a myriad of symptoms, ranging from mild to severe respiratory disease, which can often be fatal The mode of transmission via droplet infections makes it unduly contagious and difficult to control Currently, antiviral drugs or vaccines are being developed to manage this condition CONCLUSION: There is urgent need for potent antivirals and vaccine to manage those infected with COVID 19 and prevent infection Global efforts need to be unified in combating this public health emergency and flattening the curve of spread


Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North-supports vitamin D as a factor determining severity. Authors' reply


title: Favorable COVID-19 course despite significant comorbidities in a ruxolitinib-treated patient with primary myelofibrosis

text: COVID-19 carries a high risk of severe disease course, particularly in patients with comorbidities. Therapy of severe COVID-19 infection has relied on supportive intensive care measures. More specific approaches including drugs that limit the detrimental "cytokine storm", such as Janus-activated kinase (JAK) inhibitors, are being discussed. Here, we report a compelling case of a 55-yo patient with proven COVID-19 pneumonia, who was taking the JAK1/2 inhibitor ruxolitinib in-label for co-existing primary myelofibrosis for 15 months prior to coronavirus infection. The patient had significant comorbidities, including chronic kidney disease, arterial hypertension, and obesity, and our previous cohort suggested that he was thus at high risk for acute respiratory distress syndrome (ARDS) and death from COVID-19. Since abrupt discontinuation of ruxolitinib may cause fatal cytokine storm and ARDS, ruxolitinib treatment was continued and was well tolerated, and the patient´s condition remained stable, without the need for mechanical ventilation or vasopressors. The patient became negative for SARS-CoV-2 and was discharged home after 15 days. In conclusion, our report provides clinical evidence that ruxolitinib treatment is feasible and can be beneficial in patients with COVID-19 pneumonia, preventing cytokine storm and ARDS.


title: Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020

text: Globally, approximately 170,000 confirmed cases of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) have been reported, including an estimated 7,000 deaths in approximately 150 countries (1). On March 11, 2020, the World Health Organization declared the COVID-19 outbreak a pandemic (2). Data from China have indicated that older adults, particularly those with serious underlying health conditions, are at higher risk for severe COVID-19-associated illness and death than are younger persons (3). Although the majority of reported COVID-19 cases in China were mild (81%), approximately 80% of deaths occurred among adults aged ≥60 years; only one (0.1%) death occurred in a person aged ≤19 years (3). In this report, COVID-19 cases in the United States that occurred during February 12-March 16, 2020 and severity of disease (hospitalization, admission to intensive care unit [ICU], and death) were analyzed by age group. As of March 16, a total of 4,226 COVID-19 cases in the United States had been reported to CDC, with multiple cases reported among older adults living in long-term care facilities (4). Overall, 31% of cases, 45% of hospitalizations, 53% of ICU admissions, and 80% of deaths associated with COVID-19 were among adults aged ≥65 years with the highest percentage of severe outcomes among persons aged ≥85 years. In contrast, no ICU admissions or deaths were reported among persons aged ≤19 years. Similar to reports from other countries, this finding suggests that the risk for serious disease and death from COVID-19 is higher in older age groups.


Percutaneous Dilatational Tracheostomy in Coronavirus Disease 2019 Extracorporeal Membrane Oxygenation Patients: A Case Series


title: COVID-19 infection among asymptomatic and symptomatic pregnant women: Two weeks of confirmed presentations to an affiliated pair of New York City hospitals

text: The novel coronavirus 2019, or COVID-19, infection has rapidly spread through the New York metropolitan area since the first reported case in the state on March 1, 2020. New York currently represents an epicenter for COVID-19 infection in the United States, with 84,735 cases reported as of April 2, 2020. We previously presented an early experience with seven COVID-positive patients in pregnancy, including two women who were diagnosed with COVID-19 following an asymptomatic initial presentation. We now describe a series of 43 test-confirmed cases of COVID-19 presenting to a pair of affiliated New York City hospitals over two weeks from March 13 to 27, 2020. Fourteen (32.6%) patients presented without any COVID-associated viral symptoms, and were identified either after developing symptoms during admission or following the implementation of universal testing for all obstetrical admissions on March 22. Of these, 10/14 (71.4%) developed symptoms or signs of COVID-19 infection over the course of their delivery admission or early after postpartum discharge. Of the other 29 (67.4%) patients who presented with symptomatic COVID-19 infection, three women ultimately required antenatal admission for viral symptoms, and an additional patient represented six days postpartum after a successful labor induction with worsening respiratory status that required oxygen supplementation. There were no confirmed cases of COVID-19 detected in neonates upon initial testing on the first day of life. Applying COVID-19 disease severity characteristics as described by Wu et al, 37 (86%) women possessed mild disease, four (9.3%) exhibited severe disease, and two (4.7%) developed critical disease; these percentages are similar to those described for non-pregnant adults with COVID-19 infections (about 80% mild, 15% severe, and 5% critical disease).


docid: ngbjaecp

title: COVID-19 pandemic, healthcare providers' contamination and death: an international view


Treatment options for patients with HR+/HER2- advanced breast cancer during the COVID-19 pandemic: dose reduction of ribociclib does not diminish efficacy


title: The Doctor's Dilemma: lessons from GB Shaw in a modern pandemic COVID-19

text: In the current COVID 19 pandemic, the only treatments are supportive as no definitive pharmacological intervention is available. The heterogeneity of the immune response in different patient groups is clear with less severe illness in children. Understanding these disparities is particularly important as severely affected patients with COVID19 cannot always be predicted before they experience a cytokine storm and multiorgan dysfunction. Over 100 years ago, the concept of individualised immunotherapy was introduced by Sir Almroth Wright and immortalised in GB Shaw's play The Doctor's Dilemma. Shaw's play The Doctor's Dilemma explores the issues of private medical practice, equality of health care delivery, rationing of scarce resources (intensive care) and high-risk therapies. The play also describes the dilemma of rationing of resources and selecting the correct patient for new experimental therapies. Immunological theories of the time are now reflected in current understanding of inflammatory responses in sepsis and immunomodulation during the COVID19 pandemic.


title: A Discrete Probabilistic Approach to Dense Flow Visualization

text: Dense flow visualization is a popular visualization paradigm. Traditionally, the various models and methods in this area use a continuous formulation, resting upon the solid foundation of functional analysis. In this work, we examine a discrete formulation of dense flow visualization. From probability theory, we derive a similarity matrix that measures the similarity between different points in the flow domain, leading to the discovery of a whole new class of visualization models. Using this matrix, we propose a novel visualization approach consisting of the computation of spectral embeddings, i.e., characteristic domain maps, defined by particle mixture probabilities. These embeddings are scalar fields that give insight into the mixing processes of the flow on different scales. The approach of spectral embeddings is already well studied in image segmentation, and we see that spectral embeddings are connected to Fourier expansions and frequencies. We showcase the utility of our method using different 2D and 3D flows.


title: "The ancient and the new": is there an interaction between cytomegalovirus and SARS-CoV-2 infection?

text: The SARS-CoV-2 pandemic represents one of the greatest infectious challenges to humanity in recent history. One of the striking features of infection is the heterogeneous clinical response with worse outcomes observed in older patients and those with underlying health conditions. To date the potential impact of previous infection history has been poorly investigated as a potential determinant of risk. Cytomegalovirus (CMV), a persistent herpesvirus infection whose prevalence increases with age, is a major modulator of immune function and several observations suggest that infection might act to influence clinical outcome following SARS-CoV-2 infection. In particular, CMV is associated with the acceleration of immune senescence and has been linked to a range of cardiovascular and metabolic disorders. This review addresses mechanisms by which cytomegalovirus infection may act to worsen the clinical outcome of SARS-CoV-2 infection, discusses how these potential links could be investigated, and assesses the potential significance of any findings that emerge.


title: Review article: COVID-19 and liver disease-what we know on 1st May 2020

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19), became a global threat to human health. Liver impairment has been frequently reported as a common manifestation, although its clinical significance is still unclear, particularly in patients with underlying chronic liver disease (CLD). AIMS: To summarise the changes in liver function tests during SARS-CoV-2 infection and the impact of COVID-19 in patients with underlying CLD. METHODS: A literature review using online database PubMed was done using the search terms "SARS-CoV-2", "COVID-19", "liver", "cirrhosis" and "liver transplantation". RESULTS: COVID-19 is frequently associated with different degrees of abnormal liver function tests, most notably transaminases, which are usually transitory and of mild degree. Available evidence suggests that liver injury may result from direct pathogenic effect by the virus, systemic inflammation or toxicity from commonly used drugs in this subset of patients. SARS-CoV-2 infection in children is associated with minimal or no increase in liver enzymes, thus the presence of abnormal liver function tests should trigger evaluation for underlying liver diseases. Although it seems that patients with CLD are not at greater risk for acquiring the infection, those with cirrhosis, hepatocellular carcinoma, non-alcoholic fatty liver disease, autoimmune liver diseases or liver transplant may have a greater risk for severe COVID-19. CONCLUSIONS: Abnormal liver function tests during the course of COVID-19 are common, though clinically significant liver injury is rare. Further research is needed focusing on the effect of existing liver-related comorbidities on treatment and outcome of COVID-19.


Understanding Observational Treatment Comparisons in the Setting of Coronavirus Disease 2019 (COVID-19)


Lessons from the present: Intraoperative neurophysiological monitoring organization during the COVID-19 pandemic in Lombardy, northern Italy


title: Incorporating Geographic Information Science and Technology in Response to the COVID-19 Pandemic

text: Incorporating geographic information science and technology (GIS&T) into COVID-19 pandemic surveillance, modeling, and response enhances understanding and control of the disease. Applications of GIS&T include 1) developing spatial data infrastructures for surveillance and data sharing, 2) incorporating mobility data in infectious disease forecasting, 3) using geospatial technologies for digital contact tracing, 4) integrating geographic data in COVID-19 modeling, 5) investigating geographic social vulnerabilities and health disparities, and 6) communicating the status of the disease or status of facilities for return-to-normal operations. Locations and availability of personal protective equipment, ventilators, hospital beds, and other items can be optimized with the use of GIS&T. Challenges include protection of individual privacy and civil liberties and closer collaboration among the fields of geography, medicine, public health, and public policy.


title: Changes of EEG phase synchronization and EOG signals along the use of steady state visually evoked potential-based brain computer interface

text: The steady-state visual evoked potential (SSVEP)-based brain computer interface (BCI) has demonstrated relatively high performance with little user training, and thus becomes a popular BCI paradigm. However, due to the performance deterioration over time, its robustness and reliability appear not sufficient to allow a non-expert to use outside laboratory. It would be thus helpful to study what happens behind the decreasing tendency of the BCI performance. This paper explores the changes of brain networks and electrooculography (EOG) signals to investigate the cognitive capability changes along the use of the SSVEP-based BCI. The EOG signals are characterized by the blink amplitudes and the speeds of saccades, and the brain networks are estimated by the instantaneous phase synchronizations of electroencephalography (EEG) signals. Experimental results revealed that the characteristics derived from EOG and brain networks have similar trends which contain two stages. At the beginning, the blink amplitudes and the saccade speeds start to reduce. Meanwhile, the global synchronizations of the brain networks are formed quickly. These observations implies that the cognitive decline along the use of the SSVEP-based BCI. Then, the EOG and the brain networks related characteristics demonstrate a slow recovery or relatively stable trend. This study could be helpful for a better understanding about the depreciation of the BCI performance as well as its relationship with the brain networks and the EOG along the use of the SSVEP-based BCI.


title: Lineamientos que refuerzan el cuidado integral de salud en el Primer Nivel de Atención en el contexto de la pandemia COVID-19/ Guidelines that reinforce comprehensive health care at the First Level of Care in the context of the COVID-19 pandemic

text: El documento contiene los lineamientos que refuerzan el cuidado integral de salud por curso de vida y con un enfoque de derechos humanos e interculturalidad en el Primer Nivel de Atención en el contexto de la pandemia y el aislamiento social obligatorio por COVID-19


Surgical Decision Making in the Era of COVID-19: A New Set of Rules


title: A case series of COVID-19 patients with chronic hepatitis B virus infection

text: Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies reported the impacts of COVID-19 on liver function in patients with chronic liver diseases. We aimed to describe a case series of COVID-19 patients with chronic hepatitis B virus (HBV) infection. Confirmed hospitalized COVID-19 patients from hospitals in 10 cities of Jiangsu province, China were retrospectively included between January 18, 2020, and February 26, 2020. Demographic information, epidemiologic data, clinical features and treatment data were extracted from medical records. Seven COVID-19 patients with chronic HBV infection were included. Six (85.7%) patients were male. The patients aged from 33 years to 49 years. Two patients had HBV-related cirrhosis. One patients (14.3%) were positive for serum hepatitis B virus e antigen. On admission, 1 (14.3%) patients had mildly elevated ALT level (>40 U/L) and 1 (14.3%) had elevated AST level (>40 U/L). The serum albumin level and platelet counts were decreased in 2 patients with HBV-related liver cirrhosis. Three (42.9%) patients had elevated ALT level and 2 (28.6%) patients had elevated AST level in hospitalization. However, the peak ALT and AST level during hospitalization was 51 U/L and 44 U/L, respectively. As of February 29, 2020, all patients were discharged. No patient was admitted to the intensive care units or developed liver failure during hospitalization. The abnormalities of liver function are not uncommon on COVID-19 patients with chronic HBV infection in our case series. However, no patient developed severe liver-related complications during hospitalization. This article is protected by copyright. All rights reserved.


title: The Story of #GetMePPE and GetUsPPE.org - Rapidly Deploying Digital Tools for Better Healthcare

text: UNSTRUCTURED: Physicians, nurses, and other healthcare providers initiated the #GetMePPE movement on Twitter to spread awareness of the shortage of personal protective equipment (PPE) during the COVID-19 pandemic. Dwindling supplies, such as face masks, gowns and goggles, and inadequate production to meet increasing demands, has left healthcare workers and patients at risk. The momentum of this Twitter hashtag resulted in a petition to urge public officials to address the PPE shortage through increased funding and production. Simultaneously, GetUsPPE.org was launched by a collaborative of physicians and software engineers to develop a digital platform for the donation, request, and distribution of multi-modal sources of PPE. GetUsPPE.org and #GetMePPE merged in an attempt to combine public engagement and advocacy on social media with the coordination of PPE donation and distribution. Within ten days, over 1800 hospitals and PPE suppliers were registered in a database that allowed for the rapid coordination and distribution of scarce and in-demand materials. One month after its launch, the organization has distributed hundreds of thousands of items of PPE and built a database of over 6,000 PPE requesters[1] The call for action on social media and the rapid development of this digital tool created a productive channel for the public to contribute to the healthcare response to COVID-19 in meaningful ways. #GetMePPE and GetUsPPE.org were able to mobilize individuals and organizations outside of the healthcare system to address the unmet needs of the medical community. The success of GetUsPPE.org demonstrates the potential of digital tools as a platform for larger healthcare institutions (table 1) to rapidly address urgent issues in healthcare. In this manuscript, we outline this process and discuss key factors determining success.


Climate change, Covid-19, preparedness, and consciousness


title: Cataloguing the response by emergency veterinary hospitals during the COVID-19 pandemic via weekly surveys

text: BACKGROUND: The COVID-19 pandemic has presented veterinary emergency hospitals with unique challenges. Rapid online surveys represent an efficient way of collating responses to rapidly shifting circumstances. METHODS: Fifty, 24-h small animal emergency veterinary hospital representatives were recruited to participate in weekly surveys in April 2020 to catalog changes due to COVID-19 pandemic. KEY FINDINGS: The majority of emergency veterinary hospitals surveyed reported significant changes to day-to-day operations as a result of the COVID-19 pandemic. SIGNIFICANCE: Reporting of weekly survey results provides useful information on how emergency veterinary hospitals with similar challenges are responding to the COVID-19 pandemic.


title: Gene signatures of SARS-CoV/SARS-CoV-2-infected ferret lungs in short- and long-term models

text: Coronaviruses (CoVs) consist of six strains, and the severe acute respiratory syndrome coronavirus (SARS-CoV), newly found coronavirus (SARS-CoV-2) has rapidly spread leading to a global outbreak. The ferret (Mustela putorius furo) serves as a useful animal model for studying SARS-CoV/SARS-CoV-2 infection and developing therapeutic strategies. A holistic approach for distinguishing differences in gene signatures during disease progression is lacking. The present study discovered gene expression profiles of short-term (3 days) and long-term (14 days) ferret models after SARS-CoV/SARS-CoV-2 infection using a bioinformatics approach. Through Gene Ontology (GO) and MetaCore analyses, we found that the development of stemness signaling was related to short-term SARS-CoV/SARS-CoV-2 infection. In contrast, pathways involving extracellular matrix and immune responses were associated with long-term SARS-CoV/SARS-CoV-2 infection. Some highly expressed genes in both short- and long-term models played a crucial role in the progression of SARS-CoV/SARS-CoV-2 infection, including DPP4, BMP2, NFIA, AXIN2, DAAM1, ZNF608, ME1, MGLL, LGR4, ABHD6, and ACADM. Meanwhile, we revealed that metabolic, glucocorticoid, and reactive oxygen species-associated networks were enriched in both short- and long-term infection models. The present study showed alterations in gene expressions from short-term to long-term SARS-CoV/SARS-CoV-2 infection. The current result provides an explanation of the pathophysiology for post-infectious sequelae and potential targets for treatment.


title: A self-supervised neural-analytic method to predict the evolution of COVID-19 in Romania

text: Analysing and understanding the transmission and evolution of the COVID-19 pandemic is mandatory to be able to design the best social and medical policies, foresee their outcomes and deal with all the subsequent socio-economic effects. We address this important problem from a computational and machine learning perspective. More specifically, we want to statistically estimate all the relevant parameters for the new coronavirus COVID-19, such as the reproduction number, fatality rate or length of infectiousness period, based on Romanian patients, as well as be able to predict future outcomes. This endeavor is important, since it is well known that these factors vary across the globe, and might be dependent on many causes, including social, medical, age and genetic factors. We use a recently published improved version of SEIR, which is the classic, established model for infectious diseases. We want to infer all the parameters of the model, which govern the evolution of the pandemic in Romania, based on the only reliable, true measurement, which is the number of deaths. Once the model parameters are estimated, we are able to predict all the other relevant measures, such as the number of exposed and infectious people. To this end, we propose a self-supervised approach to train a deep convolutional network to guess the correct set of Modified-SEIR model parameters, given the observed number of daily fatalities. Then, we refine the solution with a stochastic coordinate descent approach. We compare our deep learning optimization scheme with the classic grid search approach and show great improvement in both computational time and prediction accuracy. We find an optimistic result in the case fatality rate for Romania which may be around 0.3% and we also demonstrate that our model is able to correctly predict the number of daily fatalities for up to three weeks in the future.


docid: wjwmsvpf

title: Is low dose radiation therapy a potential treatment for COVID-19 pneumonia?


title: Beveridgean Unemployment Gap

text: This paper proposes a new method to estimate the unemployment gap (the actual unemployment rate minus the efficient rate). While lowering unemployment puts more people into work, it forces firms to post more vacancies and devote more resources to recruiting. This unemployment-vacancy tradeoff, governed by the Beveridge curve, determines the efficient unemployment rate. Accordingly, the unemployment gap can be measured from three sufficient statistics: the elasticity of the Beveridge curve, cost of recruiting, and social cost of unemployment. In the United States the unemployment gap is countercyclical, reaching 1.5--6.5 percentage points in slumps. Thus the US labor market appears inefficient---especially inefficiently slack in slumps.


title: Disinfection technology of hospital wastes and wastewater: Suggestions for disinfection strategy during coronavirus Disease 2019 (COVID-19) pandemic in China

text: Hospitals are important sources of pollutants resulted from diagnostic, laboratory and research activities as well as medicine excretion by patients, which include active component of drugs and metabolite, chemicals, residues of pharmaceuticals, radioactive markers, iodinated contrast media, etc. The discharge of hospital wastes and wastewater, especially those without appropriate treatment would expose the public in danger of infection. In particular, under the Coronavirus Disease 2019 (COVID-19) pandemic context in China, it is of great significance to reduce the health risks to the public and environment. In this study, technologies of different types of hospital wastes and wastewater disinfection have been summarized. Liquid chlorine, sodium hypochlorite, chlorine dioxide, ozone, and ultraviolet irradiation disinfection are commonly used for hospital wastewater disinfection. While incineration, chemical disinfection, and physical disinfection are commonly used for hospital wastes disinfection. In addition, considering the characteristics of various hospital wastes, the classification and selection of corresponding disinfection technologies are discussed. On this basis, this study provides scientific suggestions for management, technology selection, and operation of hospital wastes and wastewater disinfection in China, which is of great significance for development of national disinfection strategy for hospital wastes and wastewater during COVID-19 pandemic.


title: Blood pressure trend in hospitalized adult dengue patients

text: BACKGROUND: Monitoring of blood pressure is an important part of management of dengue illness. Large scale studies of temporal trend of blood pressure in adult dengue are lacking. In this study, we examined the differences in time trend of systolic (SBP) and diastolic blood pressure (DBP) in patients with and without severe dengue (SD), dengue hemorrhagic fever (DHF) and pre-existing hypertension, and elderly versus non-elderly patients. METHODS: We studied a retrospective cohort from 2005 to 2008 of 6,070 hospitalized adult dengue patients confirmed by polymerase chain reaction or clinical criteria plus positive dengue serology. Dengue severity was defined according to World Health Organization 1997 and 2009 guidelines. We used Bayesian hierarchical Markov models to compare the daily mean SBP and DBP between different subgroups. Analysis was conducted by day of defervescence (denoted as day 0), and day of illness onset (denoted as day 1) respectively. RESULTS: SBP decreased to a nadir during the critical phase before defervescence and was significantly lower for patients with SD or DHF, compared with patients without SD or DHF. DBP increased marginally more for patients with SD or DHF in the critical phase before defervescence. By day of defervescence, comparison of patients with and without SD showed significant difference in SBP from day -6 to day +6, except days +1, +3 and +5, and similarly in DBP except days 0, and +4 to +6. Comparison of patients with and without DHF showed significant difference in SBP from day -6 to day -1, but for DBP, significant difference was noted from day -6 to day +6, except day -2 to day 0. By day of illness, SBP differed significantly between patients with and without SD from illness days 1 to 10, and DBP from illness days 7 to 12. Between patients with and without DHF, SBP differed significantly on illness days 1, 2, 4 to 7, while DBP from days 7 to 12. On analysis by days of defervescence or by days of illness, elderly patients and those with hypertension showed consistently higher SBP and DBP throughout their hospitalization, as compared with their younger and non-hypertensive counterparts. CONCLUSION: In SD or DHF, SBP decreased to a nadir around the day of defervescence, and recovered to a level exceeding that in febrile phase by days 2 or 3 post-defervescence. Elderly patients and patients with pre-existing hypertension maintained higher SBP and DBP throughout the duration of dengue infection.


docid: jdxnfsaf

title: Role of esophageal manometry and 24-h pH testing in patients with refractory reflux symptoms

text: BACKGROUND: A proportion of patients with gastroesophageal reflux disease (GERD) do not respond to proton pump inhibitor (PPI) therapy. AIM OF THE STUDY: To determine the findings on high-resolution esophageal manometry (HREM) and 24-h pH recording in patients with typical GERD symptoms, refractory to PPI treatment. METHODS: Retrospective analysis of prospectively maintained database of patients referred for HREM and 24-h pH recording was done. We selected patients who were referred for evaluation of refractory GERD symptoms despite > 8 weeks of at least once-daily PPI treatment. Details noted were demographic profile, upper gastrointestinal endoscopy report, HREM findings and 24-h pH findings. RESULTS: Ninety-six patients had symptoms of GERD that were refractory to PPI therapy. Seven patients (7.1%) were diagnosed having diseases mimicking GERD: eosinophilic esophagitis (n=2), supragastric belching (n=4) and rumination (n=1). After excluding these patients and those with insufficient data, the final study cohort included 82 cases. Fifty patients (61%) had normal motility. Major motility disorders were detected in 8 (9.75%) patients: achalasia cardia (6) and distal esophageal spasm (2). Ineffective esophageal motility was noted in 24 patients. A total of 74 patients underwent 24-h pH testing. Significant acid reflux with good symptom correlation was noted in 56 patients. Eighteen patients did not have significant acid reflux (Johnson-DeMeester score < 14.7): hypersensitive esophagus (12) and functional heartburn (6). CONCLUSION: Fifty-six patients (68.3%) had definite diagnosis of GERD and 31.7% (26) had non-GERD conditions like motility disorders, functional heartburn and hypersensitive esophagus.


docid: ktjbgcnw

title: An Investigation of COVID-19 Spreading Factors with Explainable AI Techniques

text: Since COVID-19 was first identified in December 2019, various public health interventions have been implemented across the world. As different measures are implemented at different countries at different times, we conduct an assessment of the relative effectiveness of the measures implemented in 18 countries and regions using data from 22/01/2020 to 02/04/2020. We compute the top one and two measures that are most effective for the countries and regions studied during the period. Two Explainable AI techniques, SHAP and ECPI, are used in our study; such that we construct (machine learning) models for predicting the instantaneous reproduction number ($R_t$) and use the models as surrogates to the real world and inputs that the greatest influence to our models are seen as measures that are most effective. Across-the-board, city lockdown and contact tracing are the two most effective measures. For ensuring $R_t<1$, public wearing face masks is also important. Mass testing alone is not the most effective measure although when paired with other measures, it can be effective. Warm temperature helps for reducing the transmission.


Delayed presentation and increased prevalence of proliferative vitreoretinopathy for primary rhegmatogenous retinal detachments presenting during the COVID-19 pandemic lockdown


Letter to the editor: Neuroleptic malignant syndrome in COVID-19 patients by Soh et al


title: Proximity: a recipe to break the outbreak

text: We present a mobile app solution to help the containment of an epidemic outbreak by keeping track of possible infections in the incubation period. We consider the particular case of an infection which primarily spreads among people through proximal contact, via respiratory droplets. This smartphone application will work offline and will be able to detect other devices in close proximity and list all the interactions in an anonymous and encrypted way. If an app user is tested positive and so is certified as infected, the application notifies immediately the potential contagion to the devices in the list and suggests to start a voluntary quarantine and undergo a medical test. We believe this solution may be useful in particular in the current COVID-19 pandemic and moreover could be used to prevent similar events in the future.


The Social, Economic and Sanitary Impact of COVID-19 Pandemic


title: Serum KL-6 concentrations as a novel biomarker of severe COVID-19

text: Severe acute respiratory syndrome coronavirus 2-induced direct cytopathic effects against type I and II pneumocytes mediate lung damage. Krebs von den Lungen-6 (KL-6) is mainly produced by damaged or regenerating alveolar type II pneumocytes. This preliminary study analyzed serum concentrations of KL-6 in patients with coronavirus disease (COVID-19) to verify its potential as a prognostic biomarker of severity. Twenty-two patients (median age [interquartile range] 63 [59-68] years, 16 males) with COVID-19 were enrolled prospectively. Patients were divided into mild-moderate and severe groups, according to respiratory impairment and clinical management. KL-6 serum concentrations and lymphocyte subset were obtained. Peripheral natural killer (NK) cells/µL were significantly higher in nonsevere patients than in the severe group (P = .0449) and the best cut-off value was 119 cells/µL. KL-6 serum concentrations were significantly higher in severe patients than the nonsevere group (P = .0118). Receiver operating characteristic analysis distinguished severe and nonsevere patients according to KL-6 serum levels and the best cut-off value was 406.5 U/mL. NK cell analysis and assay of KL-6 in serum can help identify severe COVID-19 patients. Increased KL-6 serum concentrations were observed in patients with severe pulmonary involvement, revealing a prognostic value and supporting the potential usefulness of KL-6 measurement to evaluate COVID-19 patients' prognosis.


Rational hand hygiene during the coronavirus 2019 (COVID-19) pandemic


title: COVID in NYC: What We Could Do Better

text: New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into hospital systems. Nonetheless, this historic public health disaster still created scarcities and the need for formal crisis standards of care. These were not available to NY clinicians because of the state's failure to implement, with or without revision, long-standing guidance documents intended for just such a pandemic. The authors argue that public health plans for disasters should be well-funded and based on available research and expertise. Communities should insist that political representatives demonstrate responsible leadership by implementing and updating as needed, crisis standards of care. Finally, surge requirements should address the needs of both those expected to survive and those who will not, by expanding palliative care and other resources for the dying.


title: Is hesperidin essential for prophylaxis and treatment of COVID-19 Infection?

text: SARS-CoV-2 or COVID-19 is representing the major global burden that implicated more than 4.7 million infected cases and 310 thousand deaths worldwide in less than 6 months. The prevalence of this pandemic disease is expected to rise every day. The challenge is to control its rapid spread meanwhile looking for a specific treatment to improve patient outcomes. Hesperidin is a classical herbal medicine used worldwide for a long time with an excellent safety profile. Hesperidin is a well-known herbal medication used as an antioxidant and anti-inflammatory agent. Available shreds of evidence support the promising use of hesperidin in prophylaxis and treatment of COVID 19. Herein, we discuss the possible prophylactic and treatment mechanisms of hesperidin based on previous and recent findings. Hesperidin can block coronavirus from entering host cells through ACE2 receptors which can prevent the infection. Anti-viral activity of hesperidin might constitute a treatment option for COVID-19 through improving host cellular immunity against infection and its good anti-inflammatory activity may help in controlling cytokine storm. Hesperidin mixture with diosmin co-administrated with heparin protect against venous thromboembolism which may prevent disease progression. Based on that, hesperidin might be used as a meaningful prophylactic agent and a promising adjuvant treatment option against SARS-CoV-2 infection.


title: [Case of Recurrent Breast Cancer with BRCA2 Mutation Successfully Treated with Olaparib Therapy]

text: A 70-year-old woman was diagnosed with cT2N2M0 left triple negative breast cancer. She received neoadjuvant chemotherapy. Around 30 months after the surgery, she developed carcinomatous pericardial tamponade, carcinomatous pleurisy, and metastatic thyroid cancer due to the breast cancer. Around the same time, a BRCA2 mutation was confirmed. Thus, olaparib therapy was started. Around 45 days after the start of olaparib administration, the therapeutic effect was cPR. The treatment remains effective even after approximately 1 year.


Comments on: Tool kit for survival: How to run and manage ophthalmic practices during the difficult time of COVID-19 crisis


title: Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis

text: Background As coronavirus disease 2019 (COVID-19) pandemic rages on, there is urgent need for identification of clinical and laboratory predictors for progression towards severe and fatal forms of this illness. In this study we aimed to evaluate the discriminative ability of hematologic, biochemical and immunologic biomarkers in patients with and without the severe or fatal forms of COVID-19. Methods An electronic search in Medline (PubMed interface), Scopus, Web of Science and China National Knowledge Infrastructure (CNKI) was performed, to identify studies reporting on laboratory abnormalities in patients with COVID-19. Studies were divided into two separate cohorts for analysis: severity (severe vs. non-severe and mortality, i.e. non-survivors vs. survivors). Data was pooled into a meta-analysis to estimate weighted mean difference (WMD) with 95% confidence interval (95% CI) for each laboratory parameter. Results A total number of 21 studies was included, totaling 3377 patients and 33 laboratory parameters. While 18 studies (n = 2984) compared laboratory findings between patients with severe and non-severe COVID-19, the other three (n = 393) compared survivors and non-survivors of the disease and were thus analyzed separately. Patients with severe and fatal disease had significantly increased white blood cell (WBC) count, and decreased lymphocyte and platelet counts compared to non-severe disease and survivors. Biomarkers of inflammation, cardiac and muscle injury, liver and kidney function and coagulation measures were also significantly elevated in patients with both severe and fatal COVID-19. Interleukins 6 (IL-6) and 10 (IL-10) and serum ferritin were strong discriminators for severe disease. Conclusions Several biomarkers which may potentially aid in risk stratification models for predicting severe and fatal COVID-19 were identified. In hospitalized patients with respiratory distress, we recommend clinicians closely monitor WBC count, lymphocyte count, platelet count, IL-6 and serum ferritin as markers for potential progression to critical illness.


Combating COVID-19: East meets West


Practical indications for management of patients candidate to Interventional and Intraoperative Radiotherapy (Brachytherapy, IORT) during COVID-19 pandemic - A document endorsed by AIRO (Italian Association of Radiotherapy and Clinical Oncology) Interventional Radiotherapy Working Group


title: Systemic immunosuppressive therapy for inflammatory skin diseases in children: Expert consensus-based guidance for clinical decision-making during the COVID-19 pandemic

text: BACKGROUND/OBJECTIVES: The COVID-19 pandemic has raised questions about the approach to management of systemic immunosuppressive therapies for dermatologic indications in children. Change to: Given the absence of data to address concerns related to SARS-CoV-2 infection and systemic immunosuppressive therapies in an evidence-based manner, a Pediatric Dermatology COVID-19 Response Task Force (PDCRTF) was assembled to offer time-sensitive guidance for clinicians. METHODS: A survey was distributed to an expert panel of 37 pediatric dermatologists on the PDCRTF to assess expert opinion and current practice related to three primary domains of systemic therapy: initiation, continuation, and laboratory monitoring. RESULTS: Nearly all respondents (97%) reported that the COVID-19 pandemic had impacted their decision to initiate immunosuppressive medications. The majority of pediatric dermatologists (87%) reported that they were pausing or reducing the frequency of laboratory monitoring for certain immunosuppressive medications. In asymptomatic patients, continuing therapy was the most popular choice across all medications queried. The majority agreed that patients on immunosuppressive medications who have a household exposure to COVID-19 or test positive for new infection should temporarily discontinue systemic and biologic medications, with the exception of systemic steroids, which may require tapering. CONCLUSIONS: The ultimate decision regarding initiation, continuation, and laboratory monitoring of immunosuppressive therapy during the pandemic requires careful deliberation, consideration of the little evidence available, and discussion with families. Consideration of an individual's adherence to COVID-19 preventive measures, risk of exposure, and the potential severity if infected must be weighed against the dermatological disease, medication, and risks to the patient of tapering or discontinuing therapies.


docid: fgbilulc

title: SARS-CoV-2: Recent Reports on Antiviral Therapies Based on Lopinavir/Ritonavir, Darunavir/Umifenovir, Hydroxychloroquine, Remdesivir, Favipiravir and Other Drugs for the Treatment of the New Coronavirus

text: Here we report on the most recent updates on experimental drugs successfully em- ployed in the treatment of the disease caused by SARS-CoV-2 coronavirus, also referred to as COVID-19 (COronaVIrus Disease 19). In particular, several cases of recovered patients have been reported after being treated with lopinavir/ritonavir (which is widely used to treat human immunodeficiency virus (HIV) infection) in combination with the anti-flu drug oseltamivir. In addition, remdesivir, which has been previously administered to Ebola virus patients, has also proven effective in the U.S. against coronavirus, while antimalarial chloroquine and hydroxy- chloroquine, favipiravir and co-administered darunavir and umifenovir (in patient therapies) were also recently recorded as having anti-SARS-CoV-2 effects. Since the recoveries/deaths ratio in the last weeks significantly increased, especially in China, it is clear that the experi- mental antiviral therapy, together with the availability of intensive care unit beds in hospitals and rigorous government control measures, all play an important role in dealing with this vi- rus. This also stresses the urgent need for the scientific community to devote its efforts to the development of other more specific antiviral strategies.


Bridging the distance: continuing psycho-oncological care via video-consults during the COVID-19 pandemic


title: Impact of complete lockdown on total infection and death rates: A hierarchical cluster analysis

text: INTRODUCTION AND AIMS: Retarding the spread of SARS-CoV-2 infection by preventive strategies is the first line of management. Several countries have declared a stringent lockdown in order to enforce social distancing and prevent the spread of infection. This analysis was conducted in an attempt to understand the impact of lockdown on infection and death rates over a period of time in countries with declared lock-down. MATERIAL AND METHODS: A validated database was used to generate data related to countries with declared lockdown. Simple regression analysis was conducted to assess the rate of change in infection and death rates. Subsequently, a k-means and hierarchical cluster analysis was done to identify the countries that performed similarly. Sweden and South Korea were included as counties without lockdown in a second-phase cluster analysis. RESULTS: There was a significant 61% and 43% reduction in infection rates 1-week post lockdown in the overall and India cohorts, respectively, supporting its effectiveness. Countries with higher baseline infections and deaths (Spain, Germany, Italy, UK, and France-cluster 1) fared poorly compared to those who declared lockdown early on (Belgium, Austria, New Zealand, India, Hungary, Poland and Malaysia-cluster 2). Sweden and South Korea, countries without lock-down, fared as good as the countries in cluster 2. CONCLUSION: Lockdown has proven to be an effective strategy is slowing down the SARS-CoV-2 disease progression (infection rate and death) exponentially. The success story of non-lock-down countries (Sweden and South Korea) need to be explored in detail, to identify the variables responsible for the positive results.


title: Inversion of a SIR-based model: a critical analysis about the application to COVID-19 epidemic

text: Calibration of a SIR (Susceptibles-Infected-Recovered) model with official international data for the COVID-19 pandemics provides a good example of the difficulties inherent the solution of inverse problems. Inverse modeling is set up in a framework of discrete inverse problems, which explicitly considers the role and the relevance of data. Together with a physical vision of the model, the present work addresses numerically the issue of parameters calibration in SIR models, it discusses the uncertainties in the data provided by international authorities, how they influence the reliability of calibrated model parameters and, ultimately, of model predictions.


Coronavirus Disease 2019 (COVID-19): Prevention and Control in the Radiology Department


Recurrence of positive SARS-CoV-2 in patients recovered from COVID-19


title: ''Treatment adherence in psoriatic patients during COVID-19 pandemic: Real-world data from a tertiary hospital in Greece''

text: COVID-19 pandemic raised questions both in dermatologists and in patients about the use of immunosuppressive medications. Although dermatologic societies recommend the continuing of psoriatic systemic therapies and biologics, little is known about treatment adherence in psoriatic patients during COVID-19 outbreak. Medication self-management may feel burdensome to patients with psoriasis due to the nature of treatments and many of them face additional challenges as they may suffer from comorbidities. Under these already difficult conditions, COVID-19 disease puts extra pressure on individuals and may undermine adherence. Acknowledging treatment non-adherence as a consequence of conflicting goals may help to find the reasons for but, most important, solutions to non-adherence especially during public health crises. The objective of our study was to evaluate the adherence of psoriatic patients in traditional systemic treatment as well as biologics and identify possible influencing factors of drug interruption during COVID-10 pandemic.


Impact of the COVID-19 Pandemic on Neurosurgical Residency Training in New Orleans


Diabetes and the COVID-19 Pandemic: How Insights from Recent Experience Might Guide Future Management


COVID-19 in Children With Cancer in New York City


title: Complete Title: Use of Incident Command System for Disaster Preparedness: A Model for an Emergency Department COVID-19 Response

text: The COVID-19 pandemic has placed unprecedented demands on health systems, where hospitals have become overwhelmed with patients amidst limited resources. Disaster response and resource allocation during such crises present multiple challenges. A breakdown in communication and organization can lead to unnecessary disruptions and adverse events. The Federal Emergency Management Agency (FEMA) promotes the use of an incident command system (ICS) model during large-scale disasters, and we hope that an institutional disaster plan and ICS will help to mitigate these lapses. In this article, we describe the alignment of an Emergency Department (ED) specific Forward Command structure with the hospital ICS and address the challenges specific to the ED. Key components of this ICS include a hospital-wide incident command or Joint Operation Center (JOC) and an ED Forward Command. This type of structure leads to a shared mental model with division of responsibilities that allows institutional adaptations to changing environments and maintenance of specific roles for optimal coordination and communication. We present this as a model that can be applied to other hospital EDs around the country to help structure the response to the COVID-19 pandemic while remaining generalizable to other disaster situations.


title: The COVID-19 Pandemic in Japan

text: Since its initial outbreak in China, in December, 2019, COVID-19 has spread rapidly across the globe. At the time of writing, on April 29, 2020, infections had been confirmed in more than 200 countries and regions and 3,018,681 infections and 207,973 deaths had been recorded. In Japan, the first confirmed case of SARS-CoV-2 infection was reported on January 16, 2020, since when, the number of domestic infections and the death toll have reached 13,852 and 389, respectively, representing exponential increases. Moreover, both domestically and internationally, the shortage of medical resources and the spread of infection among medical personnel, caused by nosocomial transmissions have become problematic. The pathology of COVID-19, including the exact infection route, remains largely unknown. Given the unavailability of an effective cure and vaccine, people are required to respond to this adversity without becoming complacent. The global efforts against the COVID-19 pandemic are ongoing endeavors, far from over. New epidemiological data and clinical findings are emerging on a daily basis, making it critical to always refer to the latest information.


title: Chilblain-like lesions: a case series of 41 patients during the COVID-19 pandemic

text: During the COVID-19 pandemic dermatologists in countries with the highest incidence have noted an increase in consultations for chilblain-like lesions. In the Region of Murcia, a south-east Spanish area with around 1.5 million population, dermatologists have collected these findings during one week. In most cases photographs were taken by the patients themselves and referred to their General Practitioners before getting to us via our regional teledermatology platform. Patients were asked about fever, cough, shortness of breath or gastrointestinal symptoms.


title: Dynamical modelling and analysis of COVID-19 in India

text: We consider the pandemic spreading of COVID-19 in India after the outbreak of the coronavirus in Wuhan city, China. We estimate the transmission rate of the initial infecting individuals of COVID-19 in India by using the officially reported data at the early stage of the epidemic with the help of Susceptible (S), Exposed (E), Infected (I), and Removed (R) population model, the so-called SEIR dynamical model. Numerical analysis and model verification are performed to calibrate the system parameters with official public information about the number of people infected, and then to evaluate several COVID -19 scenarios potentially applicable to India. Our findings provide an estimation of disease occurrence in the near future and also demonstrate the importance of governmental and individual efforts to control the effects and time of the pandemic-related critical situations. We also give special emphasis to individual reactions in the containment process.


What Counts as "Good" Clinical Communication in the COVID-19 Era and Beyond?: Ditching Checklists for Juggling Communication Goals


title: Triage Considerations for Patients Referred for Structural Heart Disease Intervention During the COVID-19 Pandemic: An ACC/SCAI Position Statement

text: The coronavirus disease-2019 (COVID-19) pandemic has strained health care resources around the world, causing many institutions to curtail or stop elective procedures. This has resulted in an inability to care for patients with valvular and structural heart disease in a timely fashion, potentially placing these patients at increased risk for adverse cardiovascular complications, including CHF and death. The effective triage of these patients has become challenging in the current environment as clinicians have had to weigh the risk of bringing susceptible patients into the hospital environment during the COVID-19 pandemic against the risk of delaying a needed procedure. In this document, the authors suggest guidelines for how to triage patients in need of structural heart disease interventions and provide a framework for how to decide when it may be appropriate to proceed with intervention despite the ongoing pandemic. In particular, the authors address the triage of patients in need of transcatheter aortic valve replacement and percutaneous mitral valve repair. The authors also address procedural issues and considerations for the function of structural heart disease teams during the COVID-19 pandemic.


title: The COVID-19 (Coronavirus) pandemic: reflections on the roles of librarians and information professionals

text: This Regular Feature explores the role of health science librarians in the coronavirus pandemic. COVID-19 has spread rapidly all over the world. All major cities around the globe are in lockdown. In Pakistan, the first case was diagnosed on 26 February 2020, and currently, there are more than 2039 diagnosed cases and 26 deaths as on 31 March 2020. Across the country, there are further 12 000 suspected cases. This will undoubtedly increase if precautionary measures are not taken. Pakistani universities, colleges and schools were in lockdown. The role of university librarians in this emergency included raising awareness through public health education, providing support to medical staff, researchers and providing ongoing traditional services to regular library patrons in Pakistan. The Regular Feature also provides links to useful resources. JM.


Radiology Department Preparedness in the Coronavirus Disease 2019 (COVID-19) Postshutdown Environment


Radiology Department Preparedness in the Coronavirus Disease 2019 COVID-19 Postshutdown Environment


Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity


docid: takfnbmm

title: The pulmonary-proteoliposome as a new therapeutic approach for Coronaviruses

text: We are proposingÂ the use of pulmonary-proteoliposome as a new therapeutic approach for Coronaviruses. The designed strategy represents a potential treatment to reduce the overall viral load in the lungs and to help the immune system to successfully stave off the infection.


The Shifting Roles of the SOGC in the Face of the COVID-19 Pandemic


Asymptomatic Transmission, the Achilles' Heel of Current Strategies to Control Covid-19


Integrated sports and respiratory medicine in the aftermath of COVID-19


title: Targeted conservation genetics of the endangered chimpanzee

text: Populations of the common chimpanzee (Pan troglodytes) are in an impending risk of going extinct in the wild as a consequence of damaging anthropogenic impact on their natural habitat and illegal pet and bushmeat trade. Conservation management programmes for the chimpanzee have been established outside their natural range (ex situ), and chimpanzees from these programmes could potentially be used to supplement future conservation initiatives in the wild (in situ). However, these programmes have often suffered from inadequate information about the geographical origin and subspecies ancestry of the founders. Here, we present a newly designed capture array with ~60,000 ancestry informative markers used to infer ancestry of individual chimpanzees in ex situ populations and determine geographical origin of confiscated sanctuary individuals. From a test panel of 167 chimpanzees with unknown origins or subspecies labels, we identify 90 suitable non-admixed individuals in the European Association of Zoos and Aquaria (EAZA) Ex situ Programme (EEP). Equally important, another 46 individuals have been identified with admixed subspecies ancestries, which therefore over time, should be naturally phased out of the breeding populations. With potential for future re-introduction to the wild, we determine the geographical origin of 31 individuals that were confiscated from the illegal trade and demonstrate the promises of using non-invasive sampling in future conservation action plans. Collectively, our genomic approach provides an exemplar for ex situ management of endangered species and offers an efficient tool in future in situ efforts to combat the illegal wildlife trade.


Covid-19 hot spots appear across Latin America


Benign course of COVID-19 in a multiple sclerosis patient treated with Ocrelizumab


title: COVID-19 paraclinical diagnostic tools: Updates and future trends

text: MOTIVATION: COVID-19 is one of the most widely affecting pandemics. As for many respiratory viruses-caused diseases, diagnosis of COVID-19 relies on two main compartments: clinical and paraclinical diagnostic criteria. Rapid and accurate diagnosis is vital in such a pandemic. On one side, rapidity may enhance management effectiveness, while on the other, coupling efficiency and less costly procedures may permit more effective community-scale management. METHODOLOGY AND MAIN STRUCTURE: In this review, we shed light on the most used and the most validated diagnostic tools. Furthermore, we intend to include few under-development techniques that may be potentially useful in this context. The practical intent of our work is to provide clinicians with a realistic summarized review of the essential elements in the applied paraclinical diagnosis of COVID-19.


Africa prepares for coronavirus


title: Symptom extraction from the narratives of personal experiences with COVID-19 on Reddit

text: Social media discussion of COVID-19 provides a rich source of information into how the virus affects people's lives that is qualitatively different from traditional public health datasets. In particular, when individuals self-report their experiences over the course of the virus on social media, it can allow for identification of the emotions each stage of symptoms engenders in the patient. Posts to the Reddit forum r/COVID19Positive contain first-hand accounts from COVID-19 positive patients, giving insight into personal struggles with the virus. These posts often feature a temporal structure indicating the number of days after developing symptoms the text refers to. Using topic modelling and sentiment analysis, we quantify the change in discussion of COVID-19 throughout individuals' experiences for the first 14 days since symptom onset. Discourse on early symptoms such as fever, cough, and sore throat was concentrated towards the beginning of the posts, while language indicating breathing issues peaked around ten days. Some conversation around critical cases was also identified and appeared at a roughly constant rate. We identified two clear clusters of positive and negative emotions associated with the evolution of these symptoms and mapped their relationships. Our results provide a perspective on the patient experience of COVID-19 that complements other medical data streams and can potentially reveal when mental health issues might appear.


title: Universal masking in hospitals in the COVID-19 era: Is it time to consider shielding?

text: With concerns for presymptomatic transmission of COVID-19 and increasing burden of contact tracing and employee furloughs, several hospitals have supplemented pre-existing infection prevention measures with universal masking of all personnel in hospitals. Other hospitals are currently faced with the dilemma of whether or not to proceed with universal masking in a time of critical mask shortages. We summarize the rationale behind a universal masking policy in healthcare settings, important considerations before implementing such a policy and the challenges with universal masking. We also discusses proposed solutions such as universal face shields.


docid: qxyawgba

title: Is COVID-19 a proteiform disease inducing also molecular mimicry phenomena?


docid: aqiqgrjd

title: After Life


COVID-19 and mental health equity in the United States


title: Molecular simulation of SARS-CoV-2 spike protein binding to pangolin ACE2 or human ACE2 natural variants reveals altered susceptibility to infection

text: We constructed complex models of SARS-CoV-2 spike protein binding to pangolin or human ACE2, the receptor for virus transmission, and estimated the binding free energy changes using molecular dynamics simulation. SARS-CoV-2 can bind to both pangolin and human ACE2, but has a significantly lower binding affinity for pangolin ACE2 due to the increased binding free energy (9.5 kcal mol-1). Human ACE2 is among the most polymorphous genes, for which we identified 317 missense single-nucleotide variations (SNVs) from the dbSNP database. Three SNVs, E329G (rs143936283), M82I (rs267606406) and K26R (rs4646116), had a significant reduction in binding free energy, which indicated higher binding affinity than wild-type ACE2 and greater susceptibility to SARS-CoV-2 infection for people with them. Three other SNVs, D355N (rs961360700), E37K (rs146676783) and I21T (rs1244687367), had a significant increase in binding free energy, which indicated lower binding affinity and reduced susceptibility to SARS-CoV-2 infection.


title: Study of SARS-CoV-2 in semen and urine samples of a volunteer with positive naso-pharyngeal swab

text: INTRODUCTION: The recent appearance of SARS-CoV-2 in Wuhan in 2019 has started a pandemic which has involved over a million people worldwide. A matter of debate is the possible viral detection in different body fluids than respiratory droplets. Thus, we evaluated the possible presence of SARS-CoV-2 in semen and urine samples of a volunteer with confirmed COVID-19. MATERIALS AND METHODS: A 31-year-old man with fever, myalgia, anosmia, and ageusia was tested and found positive for SARS-CoV-2 through a pharyngeal swab. Eight days after he provided semen and urine samples in which viral RNA presence was measured using a Real time RT PCR system (RealStar SARS-CoV-2 RT-PCR, Altona Diagnostics) targeting E and S viral genes. RESULTS AND DISCUSSION: Semen and urine samples search for SARS-CoV-2 RNA was negative. Although this should be interpreted cautiously, it may be possible that either the viral clearance kinetics in these matrices matches the progressive clinical recovery of the patient or that the virus was never present in these fluids at the time of the laboratory diagnosis.


Moral outrage in COVID19-Understandable but not a strategy


Whole body point-care ultrasound for COVID-19: a multi-system approach to a multi-system disease


Tracking the impact of interventions against COVID-19 in absence of extensive testing


title: Modeling and forecasting the early evolution of the Covid-19 pandemic in Brazil

text: We model and forecast the early evolution of the COVID-19 pandemic in Brazil using Brazilian recent data from February 25, 2020 to March 30, 2020. This early period accounts for unawareness of the epidemiological characteristics of the disease in a new territory, sub-notification of the real numbers of infected people and the timely introduction of social distancing policies to flatten the spread of the disease. We use two variations of the SIR model and we include a parameter that comprises the effects of social distancing measures. Short and long term forecasts show that the social distancing policy imposed by the government is able to flatten the pattern of infection of the COVID-19. However, our results also show that if this policy does not last enough time, it is only able to shift the peak of infection into the future keeping the value of the peak in almost the same value. Furthermore, our long term simulations forecast the optimal date to end the policy. Finally, we show that the proportion of asymptomatic individuals affects the amplitude of the peak of symptomatic infected, suggesting that it is important to test the population.


Contamination of personal protective equipment by SARS-CoV-2 during routine care of patients with mild COVID-19


title: Chloroquine dosage regimens in patients with COVID-19: Safety risks and optimization using simulations

text: Currently no specific medicinal treatment exists against the new SARS-CoV2 and chloroquine is widely used, since it can decrease the length of hospital stay and improve the evolution of the associated COVID-19 pneumonia. However, several safety concerns have been raised from chloroquine use due to the lack of essential information regarding its dosing. The aim of this study is to provide a critical appraisal of the safety information regarding chloroquine treatment and to apply simulation techniques to unveil relationships between the observed serious adverse events and overdosing, as well as to propose optimized dosage regimens. The dose related adverse events of chloroquine are unveiled and maximum tolerated doses and concentration levels are quoted. Among others, treatment with chloroquine can lead to severe adverse effects like prolongation of the QT interval and cardiomyopathy. In case of chloroquine overdosing, conditions similar to those produced by SARS-CoV2, such as pulmonary oedema with respiratory insufficiency and circulatory collapse, can be observed. Co-administration of chloroquine with other drugs for the treatment of COVID-19 patients, like azithromycin, can further increase the risk of QT prolongation and cardiomyopathy. For elder patients there is a high risk for toxicity and dose reduction should be made. This study unveils the risks of some widely used dosing regimens and binds the observed serious adverse events with dosing. Based on simulations, safer alternative dosage regimens are proposed and recommendations regarding chloroquine dosing are made.


The ethical dimension of prioritization and allocation decisions within the context of the coronavirus disease 2019 pandemic


title: Ranking the explanatory power of factors associated with worldwide new Covid-19 cases

text: Disease spread is a complex phenomenon requiring an interdisciplinary approach. Covid-19 exhibited a global spatial spread in a very short time frame resulting in a global pandemic. Data of new Covid-19 cases per million were analysed worldwide at the spatial scale of a country and time replicated from the end of December 2019 to late May 2020. Data driven analysis of epidemiological, economic, public health, and governmental intervention variables was performed in order to select the optimal variables in explaining new Covid-19 cases across all countries in time. Sequentially, hierarchical variance partitioning of the optimal variables was performed in order to quantify the independent contribution of each variable in the total variance of new Covid-19 cases per million. Results indicated that from the variables available new tests per thousand explained the vast majority of the total variance in new cases (51.6%) followed by the governmental stringency index (15.2%). Availability of hospital beds per 100k inhabitants explained 9% extreme poverty explained 8.8%, hand washing facilities 5.3%, the fraction of the population aged 65 or older explained 3.9%, and other disease prevalence (cardiovascular diseases plus diabetes) explained 2.9%. The percentage of smokers within the population explained 2.6% of the total variance, while population density explained 0.6%.


Clomipramine Could Be Useful in Preventing Neurological Complications of SARS-CoV-2 Infection


Joint HFSA/ACC/AHA Statement Addresses Concerns Re: Using RAAS Antagonists in COVID-19


title: Dis-ease Surveillance: How Might Surveillance Studies Address COVID-19?

text: We are currently in the midst of a global pandemic with the spread of Coronavirus Disease 2019 (COVID-19) While we do not know how this situation will unfold or resolve, we do have insight into how it fits within existing patterns and relations, particularly those pertaining to sociocultural constructions of (in)security, vulnerability, and risk We can see evidence of surveillance dynamics at play with how bodies and pathogens are being measured, tracked, predicted, and regulated We can grasp how threat is being racialized, how and why institutions are flailing, and how social media might be fueling social divisions There is, in other words, a lot that our scholarly community could add to the conversation In this rapid-response editorial, we provide an introduction to the framing devices of disease surveillance and discuss how a surveillance studies orientation could help us think critically about the present crisis and its possible aftermath


Simulation of the effects of COVID-19 testing rates on hospitalizations


title: Rates of Maternal and Perinatal Mortality and Vertical Transmission in Pregnancies Complicated by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Co-V-2) Infection: A Systematic Review

text: OBJECTIVE: To ascertain the frequency of maternal and neonatal complications, as well as maternal disease severity, in pregnancies affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. DATA SOURCES: MEDLINE, Ovid, ClinicalTrials.gov, MedRxiv, and Scopus were searched from their inception until April 29, 2020. The analysis was limited to reports with at least 10 pregnant patients with SARS-CoV-2 infection that reported on maternal and neonatal outcomes. METHODS OF STUDY SELECTION: Inclusion criteria were pregnant women with a confirmed diagnosis of SARS-CoV-2 infection. A systematic search of the selected databases was performed by implementing a strategy that included the MeSH terms, key words, and word variants for "coronavirus," "SARS-CoV-2," "COVID-19," and "pregnancy.r The primary outcomes were maternal admission to the intensive care unit (ICU), critical disease, and death. Secondary outcomes included rate of preterm birth, cesarean delivery, vertical transmission, and neonatal death. Categorical variables were expressed as percentages with number of cases and 95% CIs. TABULATION, INTEGRATION, AND RESULTS: Of the 99 articles identified, 13 included 538 pregnancies complicated by SARS-CoV-2 infection, with reported outcomes on 435 (80.9%) deliveries. Maternal ICU admission occurred in 3.0% of cases (8/263, 95% CI 1.6-5.9) and maternal critical disease in 1.4% (3/209, 95% CI 0.5-4.1). No maternal deaths were reported (0/348, 95% CI 0.0-1.1). The preterm birth rate was 20.1% (57/284, 95% CI 15.8-25.1), the cesarean delivery rate was 84.7% (332/392, 95% CI 80.8-87.9), the vertical transmission rate was 0.0% (0/310, 95% CI 0.0-1.2), and the neonatal death rate was 0.3% (1/313, 95% CI 0.1-1.8). CONCLUSION: With data from early in the pandemic, it is reassuring that there are low rates of maternal and neonatal mortality and vertical transmission with SARS-CoV-2. The preterm birth rate of 20% and the cesarean delivery rate exceeding 80% seems related to geographic practice patterns. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, CRD42020181497.


Metformin and COVID-19: A novel deal of an old drug


title: Health behaviour changes during COVID-19 and the potential consequences: A mini-review

text: The COVID-19 pandemic has brought about profound changes to social behaviour. While calls to identify mental health effects that may stem from these changes should be heeded, there is also a need to examine potential changes with respect to health behaviours. Media reports have signalled dramatic shifts in sleep, substance use, physical activity and diet, which may have subsequent downstream mental health consequences. We briefly discuss the interplay between health behaviours and mental health, and the possible changes in these areas resulting from anti-pandemic measures. We also highlight a call for greater research efforts to address the short and long-term consequences of changes to health behaviours.


title: Outpatient Otolaryngology in the Era of COVID-19: A Data-Driven Analysis of Practice Patterns

text: INTRODUCTION: Coronavirus disease 2019 (COVID-19) has induced a prioritization of acute care and telehealth, affecting the quantity of patients seen and the modality of their care. STUDY DESIGN: Retrospective review. SETTING: Single-institution study conducted within the Division of Otolaryngology at the Yale School of Medicine. SUBJECTS AND METHODS: Data on all outpatient appointments within the Division of Otolaryngology were obtained from administrative records of billing and scheduling from March 16 to April 10, 2020. For comparison, a corresponding period from 2019 was also utilized. RESULTS: Of 5913 scheduled visits, 3665 (62.0%) were seen between March 18 and April 12, 2019, in comparison with 649 of 5044 (12.9%) during the corresponding COVID-19-affected period. The majority of completed visits performed in weeks 1 and 2 were in person, while the majority in weeks 3 and 4 were via telehealth. Among subspecialties, a larger proportion of completed visits in 2020 were performed by pediatric and head and neck oncology otolaryngologists as compared with general/specialty otolaryngologists (P < .001). Older adults (≥65 years) were less likely to have telehealth visits than younger adults (18-64 years; 45.6% vs 59.6%, P = .003). CONCLUSIONS: A major decrease in the completion rates of scheduled visits was seen in the COVID-19-affected period, though this was not proportional among subspecialties. An associated increase in telehealth visits was observed. After COVID-19-related hospital policy changes, approximately 2 weeks passed before telehealth visits surpassed in-person visits, though this was not true among older adults.


Coronavirus replication factories


title: Public Health Responses to COVID-19 Outbreaks on Cruise Ships - Worldwide, February-March 2020

text: An estimated 30 million passengers are transported on 272 cruise ships worldwide each year* (1). Cruise ships bring diverse populations into proximity for many days, facilitating transmission of respiratory illness (2). SARS-CoV-2, the virus that causes coronavirus disease (COVID-19) was first identified in Wuhan, China, in December 2019 and has since spread worldwide to at least 187 countries and territories. Widespread COVID-19 transmission on cruise ships has been reported as well (3). Passengers on certain cruise ship voyages might be aged ≥65 years, which places them at greater risk for severe consequences of SARS-CoV-2 infection (4). During February-March 2020, COVID-19 outbreaks associated with three cruise ship voyages have caused more than 800 laboratory-confirmed cases among passengers and crew, including 10 deaths. Transmission occurred across multiple voyages of several ships. This report describes public health responses to COVID-19 outbreaks on these ships. COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread. All persons should defer all cruise travel worldwide during the COVID-19 pandemic.


title: Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

text: What is already known about this topic? Cruise ships are often settings for outbreaks of infectious diseases because of their closed environment and contact between travelers from many countries What is added by this report? More than 800 cases of laboratory-confirmed COVID-19 cases occurred during outbreaks on three cruise ship voyages, and cases linked to several additional cruises have been reported across the United States Transmission occurred across multiple voyages from ship to ship by crew members;both crew members and passengers were affected;10 deaths associated with cruise ships have been reported to date What are the implications for public health practice? Outbreaks of COVID-19 on cruise ships pose a risk for rapid spread of disease beyond the voyage Aggressive efforts are required to contain spread All persons should defer all cruise travel worldwide during the COVID-19 pandemic


title: Ouderen met complexe, gecombineerde problemen: noodzaak tot samenwerken op maat./ [Older people with complex, combined care needs: the need for tailored collaborative care]

text: Older patients with combined psychiatric, physical and cognitive health problems - patients who need double care - benefit from integrated medical and psychiatric care. The characteristics of these patients, as well as the problems that may exist in offering them adequate integrated care, are illustrated on the basis of a case description. Improvement of existing regional arrangements, premised on a collaborative care model, and involving hospital care, mental health services, nursing home care and community care services, is recommended. In settings that offer 24 hour long-term residential care and treatment, the expertise of mental health services and nursing homes must be structurally combined.


title: COVID-19 PICU guidelines: for high- and limited-resource settings

text: Fewer children than adults have been affected by the COVID-19 pandemic, and the clinical manifestations are distinct from those of adults. Some children particularly those with acute or chronic comorbidities are likely to develop critical illness. Recently, a Multisystem Inflammatory Syndrome (MIS-C) has been described in children with these patients often requiring care in the Pediatric ICU. An international collaboration was formed to review the available evidence and develop evidence-based guidelines for the care of critically ill children with SARS-CoV-2 infection. Where the evidence was lacking, those gaps were replaced with consensus-based guidelines. This process has generated 44 recommendations related to pediatric COVID-19 patients presenting with respiratory distress or failure, sepsis or septic shock, cardiopulmonary arrest, MIS-C, or those requiring adjuvant therapies, or ECMO. Evidence to explain the milder disease patterns in children and the potential to use repurposed antiviral drugs, anti-inflammatory or antithrombotic therapies are also described. Brief summaries of pediatric SARS-CoV-2 infection in different regions of the world are included since few registries are capturing these data globally. These guidelines seek to harmonize the standards and strategies for intensive care that critically ill children with COVID-19 receive across the world. IMPACT: At the time of publication, this is the latest evidence for managing critically ill children infected with SARS-CoV-2.Referring to these guidelines can decrease the morbidity and potentially the mortality of children effected by COVID-19 and its sequalae.These guidelines can be adapted to both high- and limited-resource settings.


Participation of the nursing workforce to address COVID-19 among people who use alcohol, tobacco, and drugs


docid: olsavhmp

title: COVID-19 Abortion Bans and Their Implications for Public Health


title: Experience of Diagnosing and Managing Patients in Oral Maxillofacial Surgery during the Prevention and Control Period of the New Coronavirus Pneumonia

text: The newly emerged coronavirus disease (COVID-19) is a respiratory disease caused by a novel coronavirus (2019-nCoV) which was first identified in China in December 2019. It is a highly contagious infection that can spread from person to person through close contact and respiratory droplets. The healthcare personnel of the Department of Oral and Maxillofacial Surgery are especially vulnerable to the infection due to their extensive and close exposure to patients' oral and nasal cavities and secretions. As one of the busiest specialised hospitals in the world, the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology summarised the experience with disease prevention and control and clinical recommendations on the examination, diagnosis and treatment processes, clinical management, healthcare personnel protection and disinfection amid the continued spread of the pandemic.


title: Complex Human Action Recognition in Live Videos Using Hybrid FR-DL Method

text: Automated human action recognition is one of the most attractive and practical research fields in computer vision, in spite of its high computational costs. In such systems, the human action labelling is based on the appearance and patterns of the motions in the video sequences; however, the conventional methodologies and classic neural networks cannot use temporal information for action recognition prediction in the upcoming frames in a video sequence. On the other hand, the computational cost of the preprocessing stage is high. In this paper, we address challenges of the preprocessing phase, by an automated selection of representative frames among the input sequences. Furthermore, we extract the key features of the representative frame rather than the entire features. We propose a hybrid technique using background subtraction and HOG, followed by application of a deep neural network and skeletal modelling method. The combination of a CNN and the LSTM recursive network is considered for feature selection and maintaining the previous information, and finally, a Softmax-KNN classifier is used for labelling human activities. We name our model as Feature Reduction&Deep Learning based action recognition method, or FR-DL in short. To evaluate the proposed method, we use the UCF dataset for the benchmarking which is widely-used among researchers in action recognition research. The dataset includes 101 complicated activities in the wild. Experimental results show a significant improvement in terms of accuracy and speed in comparison with six state-of-the-art articles.


title: IFSO Endoscopy Committee Position Statement on the Practice of Bariatric Endoscopy During the COVID-19 Pandemic

text: COVID-19 (Coronavirus disease 2019) caused by SARS-CoV-2 has become a global pandemic. Obesity is a risk factor for severe disease, and the practice of endoscopy poses special challenges and risks of SARS-CoV-2 transmission to patients and providers given the evolving role of the gastrointestinal tract in viral transmission and aerosol generation during endoscopic procedures. It is therefore necessary to distinguish between urgent interventions that cannot be postponed despite the risks during the pandemic and, in contrast, purely elective interventions that could be deferred in order to minimize transmission risks during a time of infection surge and limited access. Semi-urgent bariatric procedures have an intermediate position. Since the chronological course of the pandemic is still unpredictable, these interventions were defined according to whether or not they should be performed within a nominal 8-week period. In this position statement, the IFSO Endoscopy Committee offers guidance on navigating bariatric endoscopic procedures in patients with obesity during the COVID-19 pandemic, in the hope of mitigating the risk of SARS-CoV-2 transmission to vulnerable patients and healthcare workers. These recommendations may evolve as the pandemic progresses.


docid: mfuoiijk

title: Deep Sentiment Classification and Topic Discovery on Novel Coronavirus or COVID-19 Online Discussions: NLP Using LSTM Recurrent Neural Network Approach

text: Internet forums and public social media, such as online healthcare forums, provide a convenient channel for users (people/patients) concerned about health issues to discuss and share information with each other. In late December 2019, an outbreak of a novel coronavirus (infection from which results in the disease named COVID-19) was reported, and, due to the rapid spread of the virus in other parts of the world, the World Health Organization declared a state of emergency. In this paper, we used automated extraction of COVID-19 related discussions from social media and a natural language process (NLP) method based on topic modeling to uncover various issues related to COVID-19 from public opinions. Moreover, we also investigate how to use LSTM recurrent neural network for sentiment classification of COVID-19 comments. Our findings shed light on the importance of using public opinions and suitable computational techniques to understand issues surrounding COVID-19 and to guide related decision-making.