title: Investigation of the Impact of Infrared Sensors on Core Body Temperature Monitoring by Comparing Measurement Sites

text: Many types of thermometers have been developed to measure body temperature. Infrared thermometers (IRT) are fast, convenient and ease to use. Two types of infrared thermometers are uses to measure body temperature: tympanic and forehead. With the spread of COVID-19 coronavirus, forehead temperature measurement is used widely to screen people for the illness. The performance of this type of device and the criteria for screening are worth studying. This study evaluated the performance of two types of tympanic infrared thermometers and an industrial infrared thermometer. The results showed that these infrared thermometers provide good precision. A fixed offset between tympanic and forehead temperature were found. The measurement values for wrist temperature show significant offsets with the tympanic temperature and cannot be used to screen fevers. The standard operating procedure (SOP) for the measurement of body temperature using an infrared thermometer was proposed. The suggestion threshold for the forehead temperature is 36 °C for screening of fever. The body temperature of a person who is possibly ill is then measured using a tympanic infrared thermometer for the purpose of a double check.


Global coalition to accelerate COVID-19 clinical research in resource-limited settings


Facing the COVID-19 Pandemic in France: From Managerialism to Business Logistics


Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72â¯314 Cases From the Chinese Center for Disease Control and Prevention


Retrospective screening for SARS-CoV-2 in Greater Glasgow and Clyde ICUs between December 2019 and February 2020


docid: gqfltyso

title: All roads lead to coronavirus


Editorial: COVID-19 and Older Adults


title: Quantification of the South African Lockdown Regimes, for the SARS-CoV-2 Pandemic, and the Levels of Immunity They Require to Work

text: This research quantifies the various South African lockdown regimes, for the SARS-CoV-2 pandemic, in terms of the basic reproduction number, $r_0$. It further calculates the levels of immunity required for these selfsame lockdown regimes to begin to work and predicts perceived values, should infections have been underestimated by a factor of 10. The latter results are compelling. The first, level-5 lockdown was a valiant attempt to contain the highly infectious, SARS-CoV-2 virus, based on a limited knowledge. Its basic reproduction number ($r_0 = 1.93$) never came anywhere close to the requirement of being less than unity. Obviously, it could be anticipated that the same would apply for subsequent, lower levels of lockdown. The basic reproduction number for the level-3 lockdown was found to be $2.34$ and that of the level-4 lockdown, $1.69$.The suggestion is therefore that the level-4 lockdown might have been marginally `smarter' than the `harder', level-5 lockdown, although its basic reproduction number may merely reflect an adjustment by the public to the new normal, or the ever-present error associated with data sets, in general. The pandemic's basic reproduction number was calculated to be $3.16$, in the Swedish context. The lockdowns therefore served to ensure that the medical system was not overwhelmed, bought it valuable time to prepare and provided useful data. The lockdowns nonetheless failed significantly in meeting any objective to curtail the pandemic.


title: Heating, ventilation and air conditioning (HVAC) in intensive care unit

text: The aim of this review is to describe variation in standards and guidelines on 'heating, ventilation and air-conditioning (HVAC)' system maintenance in the intensive care units, across the world, which is required to maintain good 'indoor air quality' as an important non-pharmacological strategy in preventing hospital-acquired infections. An online search and review of standards and guidelines published by various societies including American Institute of Architects (AIA), American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), Centers for Disease Control and Prevention (CDC), Department of Health Estates and Facilities Division, Health Technical Memorandum 2025 (HTM) and Healthcare Infection Control Practices Advisory Committee (HICPAC) along with various national expert committee consensus statements, regional and hospital-based protocols available in a public domain were retrieved. Selected publications and textbooks describing HVAC structural aspects were also reviewed, and we described the basic structural details of HVAC system as well as variations in the practised standards of HVAC system in the ICU, worldwide. In summary, there is a need of universal standards for HVAC system with a specific mention on the type of ICU, which should be incorporated into existing infection control practice guidelines.


docid: xpuwvosr

title: Thoughts on Living in a Nursing Facility during the Pandemic


title: Multi-tiered screening and diagnosis strategy for COVID-19: a model for sustainable testing capacity in response to pandemic

text: Coronavirus disease 2019 (COVID-19), caused by novel enveloped single stranded RNA coronavirus (SARS-CoV-2), is responsible for an ongoing global pandemic. While other countries deployed widespread testing as an early mitigation strategy, the U.S. experienced delays in development and deployment of organism identification assays. As such, there is uncertainty surrounding disease burden and community spread, severely hampering containment efforts. COVID-19 illuminates the need for a tiered diagnostic approach to rapidly identify clinically significant infections and reduce disease spread. Without the ability to efficiently screen patients, hospitals are overwhelmed, potentially delaying treatment for other emergencies. A multi-tiered, diagnostic strategy incorporating a rapid host immune response assay as a screening test, molecular confirmatory testing and rapid IgM/IgG testing to assess benefit from quarantine/further testing and provide information on population exposure/herd immunity would efficiently evaluate potential COVID-19 patients. Triaging patients within minutes with a fingerstick rather than hours/days after an invasive swab is critical to pandemic response as reliance on the existing strategy is limited by assay accuracy, time to results, and testing capacity. Early screening and triage is achievable from the outset of a pandemic with point-of-care host immune response testing which will improve response time to clinical and public health actions.Key messagesDelayed testing deployment has led to uncertainty surrounding overall disease burden and community spread, severely hampering public health containment and healthcare system preparation efforts.A multi-tiered testing strategy incorporating rapid, host immune point-of-care tests can be used now and for future pandemic planning by effectively identifying patients at risk of disease thereby facilitating quarantine earlier in the progression of the outbreak during the weeks and months it can take for pathogen specific confirmatory tests to be developed, validated and manufactured in sufficient quantities.The ability to triage patients at the point of care and support the guidance of medical and therapeutic decisions, for viral isolation or confirmatory testing or for appropriate treatment of COVID-19 and/or bacterial infections, is a critical component to our national pandemic response and there is an urgent need to implement the proposed strategy to combat the current outbreak.


title: Mutation Patterns of Human SARS-CoV-2 and Bat RaTG13 Coronavirus Genomes Are Strongly Biased Towards C>U Transitions, Indicating Rapid Evolution in Their Hosts

text: The pandemic caused by the spread of SARS-CoV-2 has led to considerable interest in its evolutionary origin and genome structure. Here, we analyzed mutation patterns in 34 human SARS-CoV-2 isolates and a closely related RaTG13 isolated from Rhinolophus affinis (a horseshoe bat). We also evaluated the CpG dinucleotide contents in SARS-CoV-2 and other human and animal coronavirus genomes. Out of 1136 single nucleotide variations (~4% divergence) between human SARS-CoV-2 and bat RaTG13, 682 (60%) can be attributed to C>U and U>C substitutions, far exceeding other types of substitutions. An accumulation of C>U mutations was also observed in SARS-CoV2 variants that arose within the human population. Globally, the C>U substitutions increased the frequency of codons for hydrophobic amino acids in SARS-CoV-2 peptides, while U>C substitutions decreased it. In contrast to most other coronaviruses, both SARS-CoV-2 and RaTG13 exhibited CpG depletion in their genomes. The data suggest that C-to-U conversion mediated by C deamination played a significant role in the evolution of the SARS-CoV-2 coronavirus. We hypothesize that the high frequency C>U transitions reflect virus adaptation processes in their hosts, and that SARS-CoV-2 could have been evolving for a relatively long period in humans following the transfer from animals before spreading worldwide.


COVID-19 containment measures adopted by Italian Paediatric Oncology and Haematology Association (AIEOP) centres to prevent the virus spread among healthcare providers


Addressing the Question of Dermatologic Manifestations of SARS-CoV-2 Infection in the Lower Extremities: A Closer Look at the Available Data and its Implications


title: Suspension of ulipristal acetate for uterine fibroids during ongoing EMA's review of liver injury risk: Unfortunate timing during the Covid-19 pandemic!

text: OBJECTIVE: EMA decided that with ulipristal acetate (UPA) treatment for uterine fibroids, should be discontinued due to the associated risk of hepatic failure, We analyzed whether the risk of recurrent symptoms due to fibroids may lead to an increased risk of Covid -19 infection and death, that would exceed the former risk of hepatic failure and transplantation. STUDY DESIGN, SIZE, DURATION: We used a Markov model to generate probabilities. PARTICIPANTS/MATERIALS, SETTING, METHODS: There are currently about 36,250 treated patients in Europe. We estimated bleeding probabilities, while using or discontinuing UPA, which may induce a need of medical or surgical management in symptomatic patients, and increase the risk of acquiring a Covid-19 infection, and die from it. We also estimated the risk of suffering a hepatic failure and hepatic transplantation. MAIN RESULTS AND THE ROLE OF CHANCE: Based on our assumptions, ceasing UPA during a Covid 19 pandemic may be associated with a fatality ratio between 4 and 18, due to the Pandemic, whereas pursuing UPA would be associated with a fatality rate due to the pandemic between 1-2, and an added fatality rate due to hepatic impairment of 1. The added risk of stopping UPA may range between 2 and 15 additional deaths. Our calculations suggest that the decision to stop UPA in the middle of the Covid- 19 pandemic may be untimely, since it may result in an increased risk of Covid-19 infection, due to the recurrence of symptoms and the need for medical and surgical treatment. WIDER IMPLICATIONS OF THE FINDINGS: A decision, like the one EMA took need to be taken in a wider health context of a population, than simply analyzing its role as regulating agent for medications.


Defective Anti-oxidant System: An Aggravating Factor for COVID-19 Patients Outcome?


Potential Infection Risk Control in the Radiology Department during Economic Recovery after the COVID-19 Pandemic


title: Clinical Outcomes in 55 Patients With Severe Acute Respiratory Syndrome Coronavirus 2 Who Were Asymptomatic at Hospital Admission in Shenzhen, China

text: An epidemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread unexpectedly in Wuhan, Hubei Province, China, since December 2019. There are few reports about asymptomatic contacts of infected patients identified as positive for SARS-CoV-2 through screening. We studied the epidemiological and clinical outcomes in 55 asymptomatic carriers who were laboratory confirmed to be positive for SARS-CoV-2 through nucleic acid testing of pharyngeal swab samples. The asymptomatic carriers seldom occurred among young people (aged 18-29 years) who had close contact with infected family members. In the majority of patients, the outcome was mild or ordinary 2019 novel coronavirus disease during hospitalization.


title: The need for fully bio-based facemasks to counter coronavirus outbreaks: A perspective

text: The onset of coronavirus pandemic has sparked a shortage of facemasks in almost all nations. Without this personal protective equipment, healthcare providers, essential workers, and the general public are exposed to the risk of infection. In light of the aforementioned, it is critical to balance the supply and demand for masks. COVID-19 will also ensure that masks are always considered as an essential commodity in future pandemic preparedness. Moreover, billions of facemasks are produced from petrochemicals derived raw materials, which are non-degradable upon disposal after their single use, thus causing environmental pollution and damage. The sustainable way forward is to utilise raw materials that are side-stream products of local industries to develop facemasks having equal or better efficiency than the conventional ones. In this regard, wheat gluten biopolymer, which is a by-product or co-product of cereal industries, can be electrospun into nanofibre membranes and subsequently carbonised at over 700 °C to form a network structure, which can simultaneously act as the filter media and reinforcement for gluten-based masks. In parallel, the same gluten material can be processed into cohesive thin films using plasticiser and hot press. Additionally, lanosol, a naturally-occurring substance, imparts fire (V-0 rating in vertical burn test), and microbe resistance in gluten plastics. Thus, thin films of flexible gluten with very low amounts of lanosol (<10 wt%) can be bonded together with the carbonised mat and shaped by thermoforming to create the facemasks. The carbon mat acting as the filter can be attached to the masks through adapters that can also be made from injection moulded gluten. The creation of these masks could simultaneously be effective in reducing the transmittance of infectious diseases and pave the way for environmentally benign sustainable products.


COVID-19 FAQs in Pediatric Cardiac Surgery


title: Cross-Country Age Disparities in COVID-19 Cases with Hospitalization, ICU Usage, and Morbidity

text: In this paper, we examine cross-country differences, in terms of the age distribution of symptomatic cases, hospitalizations, intensive care unit (ICU) cases, and fatalities due to the novel COVID-19. By calculating conditional probabilities, we bridge country-level incidence data gathered from different countries and attribute the variability in data to country demographics. We then provide case, hospitalization, ICU, and fatality estimates for a comprehensive list of countries using the existing data from a variety of countries.


title: DREAM-in-CDM Approach and Identification of a New Generation of Anti-inflammatory Drugs Targeting mPGES-1

text: Microsomal prostaglandin E2 synthase-1 (mPGES-1) is known as an ideal target for next generation of anti-inflammatory drugs without the side effects of currently available anti-inflammatory drugs. However, there has been no clinically promising mPGES-1 inhibitor identified through traditional drug discovery and development route. Here we report a new approach, called DREAM-in-CDM (Drug Repurposing Effort Applying Integrated Modeling-in vitro/vivo-Clinical Data Mining), to identify an FDA-approved drug suitable for use as an effective analgesic targeting mPGES-1. The DREAM-in-CDM approach consists of three steps: computational screening of FDA-approved drugs; in vitro and/or in vivo assays; and clinical data mining. By using the DREAM-in-CDM approach, lapatinib has been identified as a promising mPGES-1 inhibitor which may have significant anti-inflammatory effects to relieve various forms of pain and possibly treat various inflammation conditions involved in other inflammation-related diseases such as the lung inflammation caused by the newly identified COVID-19. We anticipate that the DREAM-in-CDM approach will be used to repurpose FDA-approved drugs for various new therapeutic indications associated with new targets.


title: [Application of continuous renal replacement therapy in coronavirus disease 2019]

text: Continuous renal replacement therapy (CRRT) has become an effective multiple organ support therapy instead of single renal replacement as initially expected, and it is widely used in intensive care unit (ICU). After the outbreak of coronavirus disease 2019 (COVID-19), a series of expert recommendation or consensus have been developed to diagnose and treat the disease, including CRRT in acute kidney injury (AKI) and hyper inflammatory response. However, CRRT in COVID-19 is extraordinarily different from regular one due to different pathophysiology and infectious clinical scenarios. Accordingly, the paper aims to elaborate the similarities and differences between CRRT in COVID-19 and routine treatment in terms of safety and accessibility, indications and timing, clinical operation, anticoagulation, fluid management, prevention and control of infectious diseases, etc.


Forensic Nursing in the Wake of COVID-19


Covid-19 and the pandemic of fear: reflections on mental health


Coronavirus Disease 2019 or Lung Cancer: What Should We Treat?


title: Contingent assessment of the COVID-19 vaccine

text: The COVID-19 pandemic has not only had a negative impact on people's health and life behavior, but also on economies around the world. At the same time, laboratories and institutions are working hard to obtain a COVID-19 vaccine, which we hope will be available soon. However, there has been no assessment of whether an individual and society value ââa vaccine monetarily, and what factors determine this value. Therefore, the objective of this research was to estimate the individual's willingness to pay (WTP) for a hypothetical COVID-19 vaccine and, at the same time, find the main factors that determine this valuation. For this, we used the contingent valuation approach, in its single and double-bounded dichotomous choice format, which was based on a hypothetical market for a vaccine. The sample used was obtained through an online survey of n = 566 individuals from Chile. The main results showed that the WTP depends on the preexistence of chronic disease (p≤0.05), knowledge of COVID-19 (p≤0.05), being sick with COVID-19 (p≤0.05), perception of government performance (p≤0.01), employment status (p≤0.01), income (p≤0.01), health care (p≤0.05), adaptation to quarantine with children at home (p≤0.01) and whether the person has recovered from COVID-19 (p≤0.10). According to our discrete choice model in double-bounded dichotomous format, it was concluded that the individuals' WTP is US$184.72 (CI: 165.52-203.92; p < 0.01). This implies a social valuation of approximately US$2232 million, corresponding to 1.09% of the GNP per capita.


SARS-CoV-2 human disinfection chambers: a critical analysis


title: Accelerated launch of video visits in ambulatory neurology during COVID-19: Key lessons from the Stanford experience

text: The COVID-19 pandemic has rapidly moved telemedicine from discretionary to necessary. Here we describe how the Stanford Neurology Department: 1) rapidly adapted to the COVID-19 pandemic, resulting in over 1000 video visits within four weeks and 2) accelerated an existing quality improvement plan of a tiered roll out of video visits for ambulatory neurology to a full-scale roll out. Key issues we encountered and addressed were related to: equipment/software, provider engagement, workflow/triage, and training. Upon reflection, the key drivers of our success were provider engagement and a supportive physician champion. The physician champion played a critical role understanding stakeholder needs, including staff and physicians' needs, and creating workflows to coordinate both stakeholder groups. Prior to COVID-19, physician interest in telemedicine was mixed. However, in response to county and state stay-at-home orders related to COVID-19, physician engagement changed completely; all providers wanted to convert a majority of visits to video visits as quickly as possible. Rapid deployment of neurology video visits across all its subspecialties is feasible. Our experience and lessons learned can facilitate broader utilization, acceptance, and normalization of video visits for neurology patients in the present as well as the much anticipated post-pandemic era.


title: COVID-19 and diabetes: Is there enough evidence?

text: The pandemic of COVID-19, a disease caused by a novel coronavirus SARS-CoV-2, is associated with significant morbidity and mortality. Recent data showed that hypertension, diabetes mellitus, cardiovascular diseases, and chronic obstructive pulmonary disease were the most prevalent comorbidities in COVID-19 patients. Additionally, data indicate that hypertension, diabetes, and cardiovascular diseases are important risk factors for progression and unfavorable outcome in COVID-19 patients. There is only limited amount of data regarding follow-up of these patients, and they provided conflicting results. The main limitation is a small number of participants and particularly those who experienced primary composite outcome (admission in intensive care unit, use of mechanical ventilation, or death). Additionally, the limited number of patients was essential obstacle for performing analysis that would include many confounding factors such as advanced age, smoking status, and obesity and potentially change conclusion. So far, there is no study that demonstrated independent predictive value of diabetes on mortality in COVID-19 patients, but there are many speculations about the association between diabetes and susceptibility to novel coronavirus, as well as its impact on progression and prognosis of COVID-19. The aim of this review article was to summarize the current knowledge about the relationship between diabetes and COVID-19 and its role in outcome in these patients.


title: Laboratory practices to mitigate biohazard risks during the COVID-19 outbreak: an IFCC global survey

text: Objectives A global survey was conducted by the IFCC Task Force on COVID-19 to better understand how general biochemistry laboratories manage the pre-analytical, analytical and post-analytical processes to mitigate biohazard risks during the coronavirus disease 2019 (COVID-19) pandemic. Methods An electronic survey was developed to record the general characteristics of the laboratory, as well as the pre-analytical, analytical, post-analytical and operational practices of biochemistry laboratories that are managing clinical samples of patients with COVID-19. Results A total of 1210 submissions were included in the analysis. The majority of responses came from hospital central/core laboratories that serve hospital patient groups and handle moderate daily sample volumes. There has been a decrease in the use of pneumatic tube transport, increase in hand delivery and increase in number of layers of plastic bags for samples of patients with clinically suspected or confirmed COVID-19. Surgical face masks and gloves are the most commonly used personal protective equipment (PPE). Just >50% of the laboratories did not perform an additional decontamination step on the instrument after analysis of samples from patients with clinically suspected or confirmed COVID-19. A fifth of laboratories disallowed add-on testing on these samples. Less than a quarter of laboratories autoclaved their samples prior to disposal. Conclusions The survey responses showed wide variation in pre-analytical, analytical and post-analytical practices in terms of PPE adoption and biosafety processes. It is likely that many of the suboptimal biosafety practices are related to practical local factors, such as limited PPE availability and lack of automated instrumentation.


title: Privacy-Preserving Contact Tracing: current solutions and open questions

text: The COVID-19 pandemic has posed a unique challenge for the world to find solutions, ranging from vaccines to ICT solutions to slow down the virus spreading. Due to the highly contagious nature of the virus, social distancing is one fundamental measure which has already adopted by many countries. At the technical level, this prioritises contact tracing solutions, which can alert the users who have been in close contact with the infected persons and meanwhile allow heath authorities to take proper actions. In this paper, we examine several existing privacy-aware contact tracing solutions and analyse their (dis)advantages. At the end, we describe several major observations and outline an interdisciplinary research agenda towards more comprehensive and effective privacy-aware contact tracing solutions.


title: CRISPR-cas systems based molecular diagnostic tool for infectious diseases and emerging 2019 novel coronavirus (COVID-19) pneumonia

text: Emerging infectious diseases, the persistent potential for destabilising pandemics, remain a global threat leading to excessive morbidity and mortality. The current outbreak of pneumonia caused by 2019 novel coronavirus (COVID-19) illustrated difficulties in lack of effective drugs for treatment. Accurate and rapid diagnostic tools are essential for early recognition and treatment of infectious diseases, allowing timely implementation of infection control, improved clinical care and other public health measures to stop the spread of the disease. CRISPR-Cas technology speed up the development of infectious disease diagnostics with high rapid and accurate. In this review, we summarise current advance regarding diverse CRISPR-Cas systems, including CRISPR-Cas9, CRISPR-Cas12 and CRISPR-Cas13, in the development of fast, accurate and portable diagnostic tests and highlight the potential of CRISPR-Cas13 in COVID-19 Pneumonia and other emerging infectious diseases diagnosis.


title: Occupational exposure to SARS-CoV-2 in burns treatment during the COVID-19 epidemic: Specific diagnosis and treatment protocol

text: Epidemic prevention and control measures for the new coronavirus disease 2019 (COVID-19) has achieved significant results. As of 8 April 2020, 22,073 infection cases of COVID-19 among healthcare workers from 52 countries had been reported to WHO. COVID-19 has strong infectivity, high transmission speeds, and causes serious infection among healthcare worker. Burns are an acute-care condition, and burn treatment needs to be initiated before COVID-19 infection status can be excluded. The key step to infection prevention is to identify risk points of infection exposure, strengthen the protection against those risk points, and formulate an appropriate diagnosis and treatment protocol. Following an in-depth study of the latest literature on COVID-19 diagnosis and treatment, we reviewed the protocols surrounding hospitalization of patients with extensive burns (area≥50 %) in our hospital from February 2009 to February 2019 and, in accordance with the epidemiological characteristics of COVID-19, developed an algorithm for protection during diagnosis and treatment of burns. Therefore, the aspects of medical protection and the diagnosis and treatment of burns appear to be particularly important during the prevention and control of the COVID-19. This algorithm was followed for 4 patients who received emergency treatment in February 2020 and were hospitalized. All healthcare worker were protected according to the three-tiered protective measures, and there was no nosocomial infection. During the COVID-19 epidemic, the early stages of emergency treatment for patients with extensive burns requiring the establishment of venous access for rehydration, endotracheal intubation or tracheostomy, wound treatment, and surgery are the risk points for exposure to infection. The implementation of effective, appropriate-grade protection and formulation of practical treatment protocols can increase protection of healthcare worke and reduce the risk of COVID-19 infection exposure.


docid: bbafqsty

title: Community-Acquired Respiratory Viruses in Oncology: Lessons to Be Learnt from the SARS-CoV-2 Pandemic


Addressing the public mental health challenge of COVID-19


Old and new antirheumatic drugs for the treatment of COVID-19


title: Forecasting the transmission of Covid-19 in India using a data driven SEIRD model

text: The infections and fatalities due to SARS-CoV-2 virus for cases specific to India have been studied using a deterministic susceptible-exposed-infected-recovered-dead (SEIRD) compartmental model. One of the most significant epidemiological parameter, namely the effective reproduction number of the infection is extracted from the daily growth rate data of reported infections and it is included in the model with a time variation. We evaluate the effect of control interventions implemented till now and estimate the case numbers for infections and deaths averted by these restrictive measures. We further provide a forecast on the extent of the future Covid-19 transmission in India and predict the probable numbers of infections and fatalities under various potential scenarios.


title: The Impact of COVID-19 on Physical Activity Behavior and Well-Being of Canadians

text: A global pandemic caused by the novel coronavirus (COVID-19) resulted in restrictions to daily living for Canadians, including social distancing and closure of city and provincial recreation facilities, national parks and playgrounds. The objective of this study was to assess how these preemptive measures impacted physical activity behaviour and well-being of Canadians. An online survey was utilized to measure participant physical activity behavior, nature exposure, well-being and anxiety levels. Results indicate that while 40.5% of inactive individuals became less active, only 22.4% of active individuals became less active. Comparatively, 33% of inactive individuals became more active while 40.3% of active individuals became more active. There were significant differences in well-being outcomes in the inactive population between those who were more active, the same or less active (p < 0.001) but this was not seen in the active population. Inactive participants who spent more time engaged in outdoor physical activity had lower anxiety than those who spent less time in outdoor physical activity. Public health measures differentially affected Canadians who were active and inactive and physical activity was strongly associated with well-being outcomes in inactive individuals. This suggests that health promoting measures directed towards inactive individuals may be essential to improving well-being.


Yoga for infirmity in geriatric population amidst COVID-19 pandemic: Comment on "Age and Ageism in COVID-19: Elderly mental health-care vulnerabilities and needs"


A possible probiotic (S. salivarius K12) approach to improve oral and lung microbiotas and raise defenses against SAR S-CoV-2


title: Use of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in context of COVID-19 outbreak: a retrospective analysis

text: The possible effects of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) on COVID-19 disease severity have generated considerable debate. We performed a single-center, retrospective analysis of hospitalized adult COVID-19 patients in Wuhan, China, who had definite clinical outcome (dead or discharged) by February 15, 2020. Patients on anti-hypertensive treatment with or without ACEI/ARB were compared on their clinical characteristics and outcomes. The medical records from 702 patients were screened. Among the 101 patients with a history of hypertension and taking at least one anti-hypertensive medication, 40 patients were receiving ACEI/ARB as part of their regimen, and 61 patients were on antihypertensive medication other than ACEI/ARB. We observed no statistically significant differences in percentages of in-hospital mortality (28% vs. 34%, P = 0.46), ICU admission (20% vs. 28%, P = 0.37) or invasive mechanical ventilation (18% vs. 26%, P = 0.31) between patients with or without ACEI/ARB treatment. Further multivariable adjustment of age and gender did not provide evidence for a significant association between ACEI/ARB treatment and severe COVID-19 outcomes. Our findings confirm the lack of an association between chronic receipt of renin-angiotensin system antagonists and severe outcomes of COVID-19. Patients should continue previous anti-hypertensive therapy until further evidence is available.


docid: wocewdiw

title: Emergency gynecological surgery for life-threatening conditions in the COVID-19 pandemic period


Arterial hypertension and the risk of severity and mortality of COVID-19


title: Bisphenol A induces protection through modulation of the immune response against the helminth parasite Taenia crassiceps

text: AIMS: Industrial growth has increased the exposure to endocrine disruptor compounds (EDCs) in all organisms. Bisphenol A (BPA), an EDC, has been demonstrated to be involved in the susceptibility to parasite infections. However, few studies have analyzed this connection in more depth. The aim of this study was to determine if early BPA exposure in female mice affects the systemic immune response and the susceptibility to T. crassiceps infection. METHODS AND RESULTS: BALB/cice were exposed to BPA at postnatal day 3. At 6 weeks of age, they were inoculated with T. crassiceps larvae, and 2 weeks later, were euthanized. The number of parasites was quantified. By flow cytometry, in the spleen, the peripheral and mesenteric lymph nodes, the different innate and adaptive immune cell modulation was analyzed, and RT-PCR cytokine expression was also evaluated. BPA induced a reduction of 40% in parasite load. BPA treatment modulated some lineages of the innate immune response and caused slight changes in cells belonging to the adaptive immune response. Additionally, BPA enhanced the type 2 cytokine profile. CONCLUSION: Neonatal BPA treatment in female mice affects not only the percentage of different immune cells but also theirex vivo cytokine gene expression., decreasing T. crassiceps cysticercosis susceptibility.


docid: xqjinbim

title: Pädiatrie aktuell  Forschung kurz notiert./ [Pediatrics up to date-brief notes on research]


Team management in critical care units for patients with COVID-19: an experience from Hunan Province, China


Phytotherapic compounds against coronaviruses: Possible streams for future research


docid: cmkbdqbe

title: Convalescent Plasma Therapy: Helpful Treatment of COVID-19 in a Kidney Transplant Recipient presenting with serve clinical manifestation and complex complications

text: The latest study observed that KTRs with COVID-19 had a higher early mortality than persons with COVID-19 in the general population[1] . To date, there is no specific drugs. Previous studies showed convalescent plasma could help patient recovery from SARS[2, 3] . However, only a very limit evidences has been showed it is effective in COVID-19 treatment[4, 5] . Here, we describe the first successful recovery of case of COVID-19 in a KTR treated with convalescent plasma therapy.


title: The Psychosocial Impact of COVID-19 on health care workers

text: At the end of 2019, a disease was identified, COVID-19, caused by a new type of easy and fast spreading virus, which led to the beginning of a worldwide pandemic. One of the most exposed groups to the virus and its psychosocial consequences is the healthcare workers, due to their implication in caring for affected people. Health workers are exposed to a fast and unpredictable situation that requires more human resources and materials than usual, however, the lack of means on account to this situation entails an increased probability of suffering different consequences, including the burnout syndrome, to which, generally, this professionals are already vulnerable. In addition, quarantine is added as a measure to prevent the spread of the pandemic, which is another handicap for healthcare workers. Quarantine means these professionals are more likely to suffer the foreseeable psychological consequences in general population, specifically, it has been observed that Post-Traumatic Stress Disorder (PTSD) is more prevalent, because of the stress load of the situation experienced.


title: Ion torrent-based nasopharyngeal swab metatranscriptomics in COVID-19

text: Herein, we describe the detection of a SARS-CoV-2 genome through metatranscriptome next-generation sequencing directly from the nasopharyngeal swab of a suspected case of local transmission of Covid-19, in Brazil. Depletion of human ribosomal RNA and use of an optimized in-house developed bioinformatics strategy contributed to successful detection of the virus.


SARS-CoV-2 Does Not Replicate in Aedes Mosquito Cells nor Present in Field-Caught Mosquitoes from Wuhan


title: Structural Basis of the SARS-CoV-2/SARS-CoV Receptor Binding and Small-Molecule Blockers as Potential Therapeutics

text: Over the past two decades, deadly coronaviruses have caused major challenges to public health, with the most recent being the severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2, 2019) pandemic. The path for virus invasion into humans and other hosts is mediated by "host-pathogen" interactions, specifically, virus-receptor binding. An in-depth understanding of the virus-receptor binding mechanism is a prerequisite for the discovery of vaccines, antibodies, and/or small-molecule inhibitors that can interrupt this interaction and prevent or cure infection. In this review, we discuss the viral entry mechanism, the known structural aspects of virus-receptor interactions (SARS-CoV-2 S/humanACE2, SARS-CoV S/humanACE2, and MERS-CoV S/humanDPP4), the key protein domains and amino acid residues involved in binding, and the small-molecule inhibitors and other drugs that have (as of June, 2020) exhibited therapeutic potential. Specifically, we review the potential clinical utility of two transmembrane serine protease 2 (TMPRSS2)-targeting protease inhibitors, nafamostat mesylate and camostat mesylate, as well as two novel potent fusion inhibitors and the repurposed Ebola drug, remdesivir, which is specific to RdRp, against human coronaviruses, including SARS-CoV-2. This article has been accepted for publication on June 23, 2020. Changes may still occur before final publication. Expected final online publication date for the Annual Review of Pharmacology and Toxicology, Volume 61 is January 8, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.


title: 3D Self-Supervised Methods for Medical Imaging

text: Self-supervised learning methods have witnessed a recent surge of interest after proving successful in multiple application fields. In this work, we leverage these techniques, and we propose 3D versions for five different self-supervised methods, in the form of proxy tasks. Our methods facilitate neural network feature learning from unlabeled 3D images, aiming to reduce the required cost for expert annotation. The developed algorithms are 3D Contrastive Predictive Coding, 3D Rotation prediction, 3D Jigsaw puzzles, Relative 3D patch location, and 3D Exemplar networks. Our experiments show that pretraining models with our 3D tasks yields more powerful semantic representations, and enables solving downstream tasks more accurately and efficiently, compared to training the models from scratch and to pretraining them on 2D slices. We demonstrate the effectiveness of our methods on three downstream tasks from the medical imaging domain: i) Brain Tumor Segmentation from 3D MRI, ii) Pancreas Tumor Segmentation from 3D CT, and iii) Diabetic Retinopathy Detection from 2D Fundus images. In each task, we assess the gains in data-efficiency, performance, and speed of convergence. We achieve results competitive to state-of-the-art solutions at a fraction of the computational expense. We also publish the implementations for the 3D and 2D versions of our algorithms as an open-source library, in an effort to allow other researchers to apply and extend our methods on their datasets.


title: COVID-19, Australia: Epidemiology Report 10 (Reporting week to 23:59 AEST 5 April 2020)

text: Confirmed cases in Australia notified up to 5 April 2020: Notifications = 5,805; Deaths = 33. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases are able to be linked back to a confirmed case, with a small portion unable to be epidemiologically link. The distribution of overseas-acquired cases to locally acquired cases varies by jurisdiction. Early indications are that reduction in international travel, domestic movement, social distancing measures and public health action are slowing the spread of the disease. Internationally, cases continue to increase, with high rates of increase observed in the European region and the United States of America. The epidemiology differs from country to country depending not only on the disease, but also on differences in case detection, testing and implemented public health measures.


title: Value of chest CT screening in the early COVID-19 outbreak/ 中华放射学杂志

text: Objective@#In view of the difficulty of the shortage of new coronavirus nucleal acid test in the early COVID-19 outbreak, to explore the application value of chest CT in screening COVID-19 patients.@*Methods@#Retrospective analysis was performed on the data of patients with fever who received chest CT and new coronavirus nucleal acid test during January 25, 2020 to February 2, 2020 in Zhongnan Hospital of Wuhan University. A total of 587 patients were enrolled, including 290 males and 297 females, aged from 11.0 to 96.0 (51.3±17.1) years old. Take the nucleic acid test results as the gold standard, the sensitivity, specificity and rate of missed diagnosis of CT screening COVID-19 were calculated.@*Results@#Among the 587 patients, there were 433 positive cases (73.8%, 433/587) and 154 negative cases (26.2%, 154/587) of novel coronavirus nucleic acid test. Using CT screening, 494 cases (84.2%, 494/587) were positive and 93 cases (15.8%, 93/587) were negative. The sensitivity of CT screening COVID-19 was 97.7% (423/433), specificity was 53.9% (83/154) and rate of missed diagnosis was 2.3% (10/433).@*Conclusions@#In the early COVID-19 outbreak, CT screening has the advantages of high sensitivity and low rate of missed diagnosis of COVID-19, which can compensate for the shortage of new coronavirus nucleal acid test and can be used as the basis for rapid screening for early prevention and control of COVID-19 outbreak.


Errors in Text, Figure, and End Matter


title: Detection of Recombinant Rousettus Bat Coronavirus GCCDC1 in Lesser Dawn Bats (Eonycteris spelaea) in Singapore

text: Rousettus bat coronavirus GCCDC1 (RoBat-CoV GCCDC1) is a cross-family recombinant coronavirus that has previously only been reported in wild-caught bats in Yúnnan, China. We report the persistence of a related strain in a captive colony of lesser dawn bats captured in Singapore. Genomic evidence of the virus was detected using targeted enrichment sequencing, and further investigated using deeper, unbiased high throughput sequencing. RoBat-CoV GCCDC1 Singapore shared 96.52% similarity with RoBat-CoV GCCDC1 356 (NC_030886) at the nucleotide level, and had a high prevalence in the captive bat colony. It was detected at five out of six sampling time points across the course of 18 months. A partial segment 1 from an ancestral Pteropine orthoreovirus, p10, makes up the recombinant portion of the virus, which shares high similarity with previously reported RoBat-CoV GCCDC1 strains that were detected in Yúnnan, China. RoBat-CoV GCCDC1 is an intriguing, cross-family recombinant virus, with a geographical range that expands farther than was previously known. The discovery of RoBat-CoV GCCDC1 in Singapore indicates that this recombinant coronavirus exists in a broad geographical range, and can persist in bat colonies long-term.


Anticoagulation in COVID-19


The human rights of children with disabilities during health emergencies: the challenge of COVID-19


Reallocating ventilators during the coronavirus disease 2019 pandemic: Is it ethical?


Yield and Implications of Pre-Procedural COVID-19 PCR Testing on Routine Endoscopic Practice


title: Spatio-temporal variation and risk assessment of hydrochemical indices in a large diversion project of the Yellow River, northern China, from 2008 to 2017

text: Large-scale, inter-basin water diversion projects have been developed to relieve water scarcity crisis and water pollution problems. Environmental status and ecosystem impacts are largely unknown for the Wanjiazhai Yellow River Diversion Project (YRDP-WJZ), a water body critical in northern China. In the current study, twelve hydrochemical indices (including Mn, Cu, Zn, Hg, Pb, NH3-N, COD-Mn, DO, BOD5, COD, TP, and TN) were collected from 2008 to 2017 based on multiple analytical approaches to understand environmental status and ecological risks. Human health risk and threats to aquatic organisms from heavy metals were assessed. Heavy metals have no regular spatial distribution. Biochemical parameters and nutrients pollute seriously in midstream and downstream, respectively. Hydrochemical indices suggested high levels of pollution in the midstream section. Water quality improved downstream of the Fenhe Reservoir, but total nitrogen and total phosphorus in the downstream section increased in recent years. The Canadian Council of Ministers of the Environment Water Quality Index (CWQI) suggested midstream water quality was poor in general, and 80% of annual calculations had a marginal grade. For aquatic organisms, ecological risks of Cu and Zn were high. For local residents, drinking water was generally safe, but continued monitoring is critical due to ongoing threats to water quality in these areas.


Management of patients with multiple myeloma during the COVID-19 pandemic


title: Opioid Policy Changes During the COVID-19 Pandemic - and Beyond

text: : The United States is currently in the midst of 2 public health emergencies: COVID-19 and the ongoing opioid crisis. In an attempt to reduce preventable harm to individuals with opioid use disorder (OUD), federal, state, and local governments have temporarily modified law and policy to increase access to OUD treatment and divert some individuals at high risk away from the correctional system. In this Commentary, we briefly describe how people with OUD are at increased risk for COVID-19, discuss existing policy barriers to evidence-based prevention and treatment for individuals with OUD, explain the temporary rollbacks of those barriers, and argue that these changes should be made permanent. We also suggest several additional steps that federal and state governments can urgently take to reduce barriers to care for individuals with OUD, both during the current crisis and beyond.


title: Non-optimal effectiveness of convalescent plasma transfusion and hydroxychloroquine in treating COVID-19: a case report

text: BACKGROUND: Convalescent plasma (CP) transfusion was reported to be effective in treating critically ill patients with COVID-19, and hydroxychloroquine could potently inhibit SARS-CoV-2 in vitro. Herein, we reported a case receiving combination therapy with CP transfusion and hydroxychloroquine for the first time. CASE PRESENTATION: Laboratory findings showed high lactic acid level (2.1 mmol/L) and C-reactive protein (CRP, 48.8 mg/L), and low white blood cell count (1.96 × 109/L) in a 65-year-old Chinese man, who was diagnosed with severe COVID-19. CP was intravenously given twice, and hydroxychloroquine was orally administrated for a week (0.2 g, three times a day). The lactic acid and C-reactive protein levels remained high (2.1 mmol/L and 73.23 mg/L, respectively), while the arterial oxyhemoglobin saturation decreased to 86% with a low oxygenation index (OI, 76 mmHg) on day 4 after CP transfusion. His temperature returned to normal and the OI ascended above 300 on day 11. Moreover, the RNA test remained positive in throat swab, and computed tomography revealed severe pulmonary lesions on day 11 after admission. CONCLUSION: These findings suggested that the effectiveness of combination therapy with CP and hydroxychloroquine may be non-optimal, and specific therapy needs to be explored.


Design for extreme scalability: A wordless, globally scalable COVID-19 prevention animation for rapid public health communication


title: Bovine Respiratory Disease Treatment Failure: Impact and Potential Causes

text: Bovine respiratory disease (BRD) is often attributed to complex interactions between the host, pathogen, and the environment. Likewise, many BRD treatment failures result from interactions between the host, pathogen, environment, drug, and drug administrator. Investigating and addressing the underlying causes of BRD treatment failures can improve clinical outcomes and animal welfare of future cases, improve morale of employees, reduce direct costs of dealing with BRD treatment failures, refine antimicrobial prescribing practices, and advance antimicrobial stewardship. This article discusses these interactions and provides guidance to veterinary practitioners on evaluating the success of treatment protocols.


title: Communication and coronavirus crisis in Spain. First lessons

text: Coronavirus crisis has caused a complicated situation at a sanitary, economic and social levels, that requires of a fundamental work in communication area so that the society comprise and collaborate with the adopted measures Through the review and synthesis of the scientific and reference literature, the present paper contrasts lessons learnt in previous public health crisis against the communication implemented from the institutional voices and from the press coverage during the first stages of the Covid-19 outbreak in Spain This paper detects that the absence of an early announcement (or overtaking of the negative stage) and the control messages in a context of uncertainty caused a brusque transition to the following stage of the crisis, coincident with an explosion of the number of contagions, what generated fear The spokesperson formula applied is against all recommendations of crisis communication Regarding the journalistic coverage, examples of alarmism and sensationalism news arised The numeric data have been the resource more valuable and the computer graphics the multimedia content more developed Since the pandemic is still on course, it is recommended the learning and the adjustment of the communication and information to the citizens in the following stages of this crisis or in future crisis taking into account the group of first lessons presented here


Advanced forecasting of SARS-CoV-2-related deaths in Italy, Germany, Spain, and New York State


COVID-19, Pandemic, and Social Distancing


title: Hip Fracture Outcomes During the COVID-19 Pandemic: Early Results from New York

text: OBJECTIVE: To evaluate inpatient outcomes among hip fracture patients treated during the COVID-19 pandemic in New York City. DESIGN: Multicenter retrospective cohort study SETTING:: One Level 1 Trauma Center and one orthopaedic specialty hospital in New York CityPatients/Participants: Fifty-nine consecutive patients (average age 85, range: 65 - 100 years) treated for a hip fracture (OTA/AO 31, 32.1) over a 5-week period, March 20, 2020 to April 24, 2020, during the height of the COVID-19 crisis. MAIN OUTCOME MEASUREMENTS: COVID-19 infection status was used to stratify patients. The primary outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, unexpected intubation, pneumonia, deep venous thrombosis, pulmonary embolus, myocardial infarction, cerebrovascular accident, urinary tract infection, and transfusion. Baseline demographics, comorbidities, treatment characteristics, and COVID-related symptomatology were also evaluated. RESULTS: Ten patients (15%) tested positive for COVID-19 (COVID+) (n=9; 7 preoperatively, 2 postoperatively) or were presumed positive (n=1), 40 (68%) patients tested negative, and 9 (15%) patients were not tested in the primary hospitalization. American Society of Anesthesiologists (ASA) scores were higher in the COVID+ group (d=-0.83; p=0.04); however, the Charlson Comorbidity Index was similar between the study groups (d=-0.17; p=0.63). Inpatient mortality was significantly increased in the COVID+ cohort (56% vs. 4%; OR 30.0, 95% CI 4.3-207; p=0.001). Including the one presumed positive case in the COVID+ cohort increased this difference (60% vs. 2%; OR 72.0, 95% CI 7.9-754; p<0.001). CONCLUSIONS: Hip fracture patients with concomitant COVID-19 infection had worse ASA scores but similar baseline comorbidities with significantly higher rates of inpatient mortality compared to those without concomitant COVID-19 infection. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.


title: Chest X-ray severity index as a predictor of in-hospital mortality in coronavirus disease 2019: A study of 302 patients from Italy

text: OBJECTIVES: This study aimed to assess the usefulness of a new chest X-ray scoring system - the Brixia score - to predict the risk of in-hospital mortality in hospitalized patients with coronavirus disease 2019 (COVID-19). METHODS: Between March 4, 2020 and March 24, 2020, all CXR reports including the Brixia score were retrieved. We enrolled only hospitalized Caucasian patients with COVID-19 for whom the final outcome was available. For each patient, age, sex, underlying comorbidities, immunosuppressive therapies, and the CXR report containing the highest score were considered for analysis. These independent variables were analyzed using a multivariable logistic regression model to extract the predictive factors for in-hospital mortality. RESULTS: 302 Caucasian patients who were hospitalized for COVID-19 were enrolled. In the multivariable logistic regression model, only Brixia score, patient age, and conditions that induced immunosuppression were the significant predictive factors for in-hospital mortality. According to receiver operating characteristic curve analyses, the optimal cutoff values for Brixia score and patient age were 8 points and 71 years, respectively. Three different models that included the Brixia score showed excellent predictive power. CONCLUSIONS: Patients with a high Brixia score and at least one other predictive factor had the highest risk of in-hospital death.


SARS-CoV-2: Naso-bronchial cytological correlations


title: Convalescent plasma, an apheresis research project targeting and motivating the fully recovered COVID 19 patients: A rousing message of clinical benefit to both donors and recipients alike

text: This concise manuscript aims to make suggestions for a small step forward in both preventative and therapeutic measures against the Coronavirus disease 2019 (COVID 19) pandemic. This targeted strategy consists of using fully recovered COVID 19 Heroes, that is, brave volunteers, as the source of antibodies in plasma collected by plasmapheresis or affinity column- derived antibodies, both are sterilised and pathogen inactivated for substitution therapy for use in those populations in need of antibody. This include for use in critically ill COVID 19 patients and as a preventative measure, in those at potential risk of infection as no vaccine is yet available. This would be a small step forward, while we are waiting to produce an effective, validated vaccine and witnessing increasing demands for testing and self-isolation which are the two most effective current strategies. In line with this concept, some methodological aspects of the use of the UVC sterilization of FFP/ cryoprecipitate-depleted FFP or immunoglobulins containing neutralizing antibodies for clinical use against COVID-19 are highlighted. The plasmapheresis procedure is, of course, particularly targeted to male donors, who consist of about 75 % of the COVID-19 population and who are able to undergo multiple double, or even triple plasmapheresis procedures. Moreover, as some of these donors have already been in an induced-hypercoagulable state and prone to thrombosis and DVT, this strategy will be partially aimed at improving their health with the use of citrate based anticoagulants and removal of high molecular weight viscous components which contribute to the untoward clinical effects of DVT. Repeated targeted plasmapheresis or plasma exchange of selected COVID-19 positive individuals would undoubtedly lower their state of hypercoagulability and normalize their hypercoagulability. The recipients of such a derived FFP-product would benefit from the two to 3 doses of viral inactivated antibodies, which could neutralize the viral antigens even at very low concentration if present in the early stage. So, this practice would be a double-edged sword with benefits for both donors and recipients.


Protect the vulnerable from extreme heat during the COVID-19 pandemic


COVID-19 Curbside Consults at www.CCJM.org


Resuming bowel cancer screening post-COVID-19


title: Methods for forecasting the effect of exogenous risk on stock markets

text: Markets are subjected to both endogenous and exogenous risks that have caused disruptions to financial and economic markets around the globe, leading eventually to fast stock market declines. In the past, markets have recovered after any economic disruption. On this basis, we focus on the outbreak of COVID-19 as a case study of an exogenous risk and analyze its impact on the Standard and Poor's 500 (S\&P500) index. We assumed that the S\&P500 index reaches a minimum before rising again in the not-too-distant future. Here we present two cases to forecast the S\&P500 index. The first case uses an estimation of expected deaths released on 02/04/2020 by the University of Washington. For the second case, it is assumed that the peak number of deaths will occur 2-months since the first confirmed case occurred in the USA. The decline and recovery in the index were estimated for the following three months after the initial point of the predicted trend. The forecast is a projection of a prediction with stochastic fluctuations described by $q$-gaussian diffusion process with three spatio-temporal regimes. Our forecast was made on the premise that any market response can be decomposed into an overall deterministic trend and a stochastic term. The prediction was based on the deterministic part and for this case study is approximated by the extrapolation of the S\&P500 data trend in the initial stages of the outbreak. The stochastic fluctuations have the same structure as the one derived from the past 24 years. A reasonable forecast was achieved with 85\% of accuracy.


title: Protocol for an Observational Study on the Effects of Social Distancing on Influenza-Like Illness and COVID-19

text: The novel coronavirus disease (COVID-19) is a highly contagious respiratory disease that was first detected in Wuhan, China in December 2019, and has since spread around the globe, claiming more than 69,000 lives by the time this protocol is written. It has been widely acknowledged that the most effective public policy to mitigate the pandemic is \emph{social and physical distancing}: keeping at least six feet away from people, working from home, closing non-essential businesses, etc. There have been a lot of anecdotal evidences suggesting that social distancing has a causal effect on disease mitigation; however, few studies have investigated the effect of social distancing on disease mitigation in a transparent and statistically-sound manner. We propose to perform an optimal non-bipartite matching to pair counties with similar observed covariates but vastly different average social distancing scores during the first week (March 16th through Match 22nd) of President's \emph{15 Days to Slow the Spread} campaign. We have produced a total of $302$ pairs of two U.S. counties with good covariate balance on a total of $16$ important variables. Our primary outcome will be the average observed illness collected by Kinsa Inc. two weeks after the intervention period. Although the observed illness does not directly measure COVID-19, it reflects a real-time aspect of the pandemic, and unlike confirmed cases, it is much less confounded by counties' testing capabilities. We also consider observed illness three weeks after the intervention period as a secondary outcome. We will test a proportional treatment effect using a randomization-based test with covariance adjustment and conduct a sensitivity analysis.


Characteristics of COVID-19 disease in multiple sclerosis patients


Pandemic research: UK must coordinate


Mask-wearing in pediatric age


Cardiopulmonary resuscitation in COVID-19 patients - To do or not to?


docid: uxlmcyga

title: Hopelessness, helplessness and resilience: The importance of safeguarding our trainees' mental wellbeing during the COVID-19 pandemic


Editorial: Tele-ICU in the Age of COVID-19: Built for This Challenge


title: Virtual screening based on molecular docking of possible inhibitors of Covid-19 main protease

text: Coronavirus (COVID-19) is an enveloped RNA virus that is diversely found in humans and that has now been declared a global pandemic by the World Health Organization. Thus, there is an urgent need to develop effective therapies and vaccines against this disease. In this context, this study aimed to evaluate in silico the molecular interactions of drugs with therapeutic indications for treatment of COVID-19 (Azithromycin, Baricitinib and Hydroxychloroquine) and drugs with similar structures (Chloroquine, Quinacrine and Ruxolitinib) in docking models from the SARS-CoV-2 main protease (M-pro) protein. The results showed that all inhibitors bound to the same enzyme site, more specifically in domain III of the SARS-CoV-2 main protease. Therefore, this study allows proposing the use of baricitinib and quinacrine, in combination with azithromycin; however, these computer simulations are just an initial step for conceiving new projects for the development of antiviral molecules.


title: Novel therapeutic approaches for treatment of COVID-19

text: To date, there is no licensed treatment or approved vaccine to combat the coronavirus disease of 2019 (COVID-19), and the number of new cases and mortality multiplies every day. Therefore, it is essential to develop an effective treatment strategy to control the virus spread and prevent the disease. Here, we summarized the therapeutic approaches that are used to treat this infection. Although it seems that antiviral drugs are effective in improving clinical manifestation, there is no definite treatment protocol. Lymphocytopenia, excessive inflammation, and cytokine storm followed by acute respiratory distress syndrome are still unsolved issues causing the severity of this disease. Therefore, immune response modulation and inflammation management can be considered as an essential step. There is no doubt that more studies are required to clarify immunopathogenesis and immune response; however, new therapeutic approaches including mesenchymal stromal cell and immune cell therapy showed inspiring results.


Covid-19: Patients who are improving could have treatment withdrawn if others could benefit more


title: Spiritual care - 'A deeper immunity' - A response to Covid-19 pandemic

text: Coronavirus disease 2019 (COVID-19) has presented unprecedented health challenges across all strata in society throughout the world. The COVID experience has caused us to reflect on quality of life, health and well-being and, just as important, end of life. During this time, spiritual care forms a vital component of holistic health management, especially in terms of coping, coming to terms with illness, suffering and ultimately death. The relationship with the transcendent or sacred has a strong influence on a people's beliefs, attitudes, emotions and behaviour. Populations, communities, families and individuals have always found solace through their religious or philosophical beliefs during times of personal adversity and widespread anxiety or disaster. Although spiritual care has always been a part of the domain of religious beliefs, a more contemporary perspective is that spiritual care forms part of the human psyche and thus forms part of human care, health and well-being for families, patients and healthcare workers. Spiritual care deals with the provision of compassion and empathy during periods of heightened stress, distress and anxiety within care. This article provides insights into the necessity of providing spiritual care as a means of coping and well-being for families, patients and healthcare workers during the COVID-19 pandemic.


Supporting Clinicians During the COVID-19 Pandemic


COVID-19: Once upon a time in Portugal: A brief atlas of ongoing pandemic Portuguese research


Comment on "Practice Recommendations for Risk-Adapted Head and Neck Cancer Radiotherapy During the COVID-19 Pandemic: An ASTRO-ESTRO Consensus Statement"


title: Expression and prognostic significance of pyruvate dehydrogenase kinase 1 in bladder urothelial carcinoma

text: Muscular infiltrating bladder urothelial carcinoma (MIBC) is a highly malignant disease with a poor prognosis. Radical cystectomy is the standard treatment. However, due to surgery and postoperative complications, the quality of life of patients is seriously affected. Therefore, it is increasingly important to find prognostic markers and new therapeutic targets for MIBC. Here, we investigated the expression of PDK1, a key regulator of glucose metabolism, in bladder urothelial carcinoma (BLCA) and its effect on prognosis. The expression pattern of PDK1 was examined by bioinformatics analysis and immunohistochemistry. A total of 101 cases of BLCA were selected for tissue microarrays (TMAs) that contained both tumour and paired normal tissues. We demonstrated that PDK1 expression was correlated with tumour grade and Ki67expression in our TMA cohort (all p values < 0.05). Kaplan-Meier survival analysis showed that patients with MIBC with high PDK1 expression had a worse prognosis than patients with low PDK1 expression (p = 0.016). Multifactor risk analysis showed that increased PDK1 expression was an independent prognostic factor affecting the overall survival of MIBC patients. GSEA showed that the mTOR pathway, HIF pathway, glycolysis, PI3K/AKT/mTOR signalling, etc. were differentially enriched in the PDK1 high expression phenotype. Hence, PDK1 may be a prognostic and therapeutic target for MIBC.


A framework for identifying regional outbreak and spread of COVID-19 from one-minute population-wide surveys


Evans syndrome in a patient with COVID-19


title: Safety and Efficacy of Anti-il6-receptor Tocilizumab Use in Severe and Critical Patients Affected by Coronavirus Disease 2019: a Comparative Analysis

text: BACKGROUND: As the novel SARS-CoV-2 pandemic occurred, no specific treatment was yet available. Inflammatory response secondary to viral infection might be the driver of severe diseases. We report the safety and efficacy (in terms of overall survival and hospital discharge) of the anti-IL6 tocilizumab (TCZ) in subjects with COVID-19. METHODS: This retrospective, single-center analysis included all the patients consecutively admitted to our Hospital with severe or critical COVID-19 who started TCZ treatment from March 13th to April 03rd, 2020. A 1:2 matching to patients not treated with TCZ was performed according to age, sex, severity of disease, P/F, Charlson Comorbidity Index and length of time between symptoms onset and hospital admittance. Descriptive statistics and non-parametric tests to compare the groups were applied. Kaplan Meier probability curves and Cox regression models for survival, hospital discharge and orotracheal intubation were used. RESULTS: Seventy-four patients treated with TCZ were matched with 148 matched controls. They were mainly males (81.5%), Caucasian (82.0%) and with a median age of 59 years. The majority (69.8%) showed critical stage COVID-19 disease. TCZ use was associated with a better overall survival (HR 0.499 [95% CI 0.262-0.952], p=0.035) compared to controls but with a longer hospital stay (HR 1.658 [95% CI 1.088-2.524], p=0.019) mainly due to biochemical, respiratory and infectious adverse events. DISCUSSION: TCZ use resulted potentially effective on COVID-19 in terms of overall survival. Caution is warranted given the potential occurrence of adverse events. FINANCIAL SUPPORT: Some of the tocilizumab doses used in the subjects included in this analysis were provided by the "Multicenter study on the efficacy and tolerability of tocilizumab in the treatment of patients with COVID-19 pneumonia" (EudraCT Number: 2020-001110-38) supported by the Italian National Agency for Drugs (AIFA). No specific funding support was planned for study design, data collection and analysis and manuscript writing of this paper.


Innovative liver research continues during the current pandemic


title: Banxia Xiexin Decoction () Treats Diabetic Gastroparesis through PLC-IP3-Ca2+/NO-cGMP-PKG Signal Pathway

text: OBJECTIVE: To test the effect of Banxia Xiexin Decoction (, BXD) on the contraction and relaxation of gastric smooth muscle (SM) in diabetic gastroparesis (DGP) model rats, and to explore the mechanism of BXD in the prevention and treatment of DGP through experiments of signal pathway both in vivo and in vitro. METHODS: Sixty Sprague-Dawley rats were divided into 6 groups according to a random number table: control group, model group, high-, medium- and low-dose BXD groups (9.2, 4.6 and 1.8 g/(kg·d), respectively), and domperidone group (10 mg/(kg·d)), 10 rats per group. DGP model was established initially by a single intraperitoneal injection of streptozotocin (STZ), and was confirmed by recording gastric emptying, intestinal transport velocity and gastric myoelectric activity of rats after 2 months. Each group was treated with a corresponding drug for 4 weeks. The mRNA and protein expressions of phospholipase C (PLC), inositol triphosphate (IP3), neuronal nitric oxide synthase (nNOS), and cyclic guanosine monophosphate (cGMP) dependent protein kinase G (PKG) were detected by reverse transcription-polymerase chain reaction and Western blot, respectively, while nitric oxide (NO) and cGMP expressions were detected by enzyme-linked immunosorbent assay. Gastric tissues were obtained from rats for primary cell culture preparation. Gastric SM cells were treated with 0.8 µmol/L of STZ or STZ plus 1,000, 500 and 200 µg/mL of BXD or STZ plus 2.5 µmol/mL of domperidone for 24, 48, 72 or 96 h, respectively. The length of gastric SM cells and intracellular Ca2+ concentration ([Ca2+]i) before and after BXD treatment was measured. RESULTS: Compared with the model group, high- and medium-dose BXD and domperidone significantly increased the expressions of PLC, IP3, NO, nNOS, cGMP and PKG in rat's gastric tissue (P<0.01). Gastric SM cells treated with BXD showed a time- and dose-dependent increase in cell viability (P<0.01). The treatment with high- and medium-dose BXD and domperidone inhibited the increase in gastric SM cells length and increased [Ca2+]i compared with the model cells (P<0.01). CONCLUSIONS: Treatment with high- and medium-dose BXD significantly attenuated STZ-induced experimental DGP in rats. The therapeutic effect of BXD on DGP rats might be associated with the PLC-IP3-Ca2+/NO-cGMP-PKG signal pathway.


title: [A Case of Gastric Schwannoma Diagnosed Preoperatively]

text: The patient was a 52-year-old woman, who was found to have an abnormality in the upper gastrointestinal(UGI)tract, via a contrast-imaging study; she had no symptoms.Computed tomography(CT)revealed a tumor, measuring approximately 100mm in diameter, in the antrum of the stomach.The tumor was diagnosed as gastric schwannoma using endoscopic ultrasonography-guided fine-needle aspiration(EUS-FNA).Preoperative CT revealed multiple lymph adenopathies around the antrum, which led to the suspicion of lymph node metastasis. The patient underwent a laparoscopic partial gastrectomy after the confirmation of the absence of lymph node metastasis by intraoperative rapid diagnosis.


docid: uqzmlvcc

title: The role of the environment and its pollution in the prevalence of COVID-19


title: Using Insights from Behavioral Economics to Mitigate the Spread of COVID-19

text: The outbreak of 2019 coronavirus disease (COVID-19) has become a public health emergency of international concern. The number of COVID-infected individuals and related deaths continues to rise rapidly. Encouraging people to adopt and sustain preventive behaviors is a central focus of public health policies that seek to mitigate the spread of COVID-19. Public health policy needs improved methods to encourage people to adhere to COVID-19-preventive behaviors. In this paper, we introduce a number of insights from behavioral economics that help explain why people may behave irrationally during the COVID-19 pandemic. In particular, present bias, status quo bias, framing effect, optimism bias, affect heuristic, and herding behavior are discussed. We hope this paper will shed light on how insights from behavioral economics can enrich public health policies and interventions in the fight against COVID-19.


docid: igwuuwmi

title: Tocilizumab in COVID-19: Beware the risk of intestinal perforation


title: Basic Immunology may lead to translational therapeutic rationale:: SARS-CoV-2 and Rheumatic Diseases

text: COVID-19 pandemia is a major concern for patients and health care systems. The fear of infection by patients with concomitant rheumatic diseases (either adult or children) and connective tissue diseases is arising worldwide, because of their immunological background and immunological therapies. Analyzing the basic biology of single diseases, the data suggest that there is an "immunological umbrella" that seems to protect against the infection, through IFN type 1 and NK cell function. To date, reports from China, US and Europe, did not reveal an higher risk of infection, either for Rheumatoid Arthritis, Juvenile Idiopathic Arthritis nor for Lupus Erythematosus. Antimalarials, anti-IL6-Anti-IL6-receptor, anti-IL1, anti-GM-CSF-receptor , JAK1/2/3 inhibitors, are under investigation in COVID-dedicated clinical trials to control the inflammation raised by SARS-CoV-2 infection. Initial reports on the occurrence of autoimmune phenomena in the convalescence phase of SARS-CoV-2 infection, suggests that the immunological consequences of the infection need to be strictly understood.


title: The dynamics of entropy in the COVID-19 outbreaks

text: With the unfolding of the COVID-19 pandemic, mathematical modeling of epidemics has been perceived and used as a central element in understanding, predicting, and governing the pandemic event. However, soon it became clear that long term predictions were extremely challenging to address. Moreover, it is still unclear which metric shall be used for a global description of the evolution of the outbreaks. Yet a robust modeling of pandemic dynamics and a consistent choice of the transmission metric is crucial for an in-depth understanding of the macroscopic phenomenology and better-informed mitigation strategies. In this study, we propose a Markovian stochastic framework designed to describe the evolution of entropy during the COVID-19 pandemic and the instantaneous reproductive ratio. We then introduce and use entropy-based metrics of global transmission to measure the impact and temporal evolution of a pandemic event. In the formulation of the model, the temporal evolution of the outbreak is modeled by the master equation of a nonlinear Markov process for a statistically averaged individual, leading to a clear physical interpretation. We also provide a full Bayesian inversion scheme for calibration. The time evolution of the entropy rate, the absolute change in the system entropy, and the instantaneous reproductive ratio are natural and transparent outputs of this framework. The framework has the appealing property of being applicable to any compartmental epidemic model. As an illustration, we apply the proposed approach to a simple modification of the Susceptible-Exposed-Infected-Removed (SEIR) model. Applying the model to the Hubei region, South Korean, Italian, Spanish, German, and French COVID-19 data-sets, we discover a significant difference in the absolute change of entropy but highly regular trends for both the entropy evolution and the instantaneous reproductive ratio.


title: Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020 ;MMWR

text: Fourteen cases have been diagnosed in the United States, in addition to 39 cases among repatriated persons from high-risk settings, for a current total of 53 cases within the United States U S government agencies and public health partners are implementing aggressive measures to slow and try to contain transmission of COVID-19 in the United States


title: Update: Public Health Response to the Coronavirus Disease 2019 Outbreak - United States, February 24, 2020

text: An outbreak of coronavirus disease 2019 (COVID-19) caused by the 2019 novel coronavirus (SARS-CoV-2) began in Wuhan, Hubei Province, China in December 2019, and has spread throughout China and to 31 other countries and territories, including the United States (1). As of February 23, 2020, there were 76,936 reported cases in mainland China and 1,875 cases in locations outside mainland China (1). There have been 2,462 associated deaths worldwide; no deaths have been reported in the United States. Fourteen cases have been diagnosed in the United States, and an additional 39 cases have occurred among repatriated persons from high-risk settings, for a current total of 53 cases within the United States. This report summarizes the aggressive measures (2,3) that CDC, state and local health departments, multiple other federal agencies, and other partners are implementing to slow and try to contain transmission of COVID-19 in the United States. These measures require the identification of cases and contacts of persons with COVID-19 in the United States and the recommended assessment, monitoring, and care of travelers arriving from areas with substantial COVID-19 transmission. Although these measures might not prevent widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare state and local health departments, health care systems, businesses, educational organizations, and the general public in the event that widespread transmission occurs; and 3) better characterize COVID-19 to guide public health recommendations and the development and deployment of medical countermeasures, including diagnostics, therapeutics, and vaccines. U.S. public health authorities are monitoring the situation closely, and CDC is coordinating efforts with the World Health Organization (WHO) and other global partners. Interim guidance is available at https://www.cdc.gov/coronavirus/index.html. As more is learned about this novel virus and this outbreak, CDC will rapidly incorporate new knowledge into guidance for action by CDC, state and local health departments, health care providers, and communities.


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title: COVID-19 and Shock: A Cautionary Tale for Elderly Patients From a Pooled Analysis


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title: Will the COVID-19 Pandemic Change National Security and Healthcare in the Spectrum of Cardiovascular Disease?

text: COVID-19 pandemic changed the current state of healthcare, especially in terms of reorganization of resources. Chief complaints of patients admitted to hospitals changed drastically in the proceeding months, which worsened the treatment of many acute and chronic conditions involving cardiovascular system pathologies and resources were moved in order to fight COVID-19. Moreover, the pandemic had long-term effects not only on healthcare but also national security on global scale. The COVID-19 drastically changed perception of global health and safety, trust in healthcare professionals as well as patients' willingness to seek medical help. The long-term effect of the epidemic, in terms of its impact cardiovascular disease progression and prognosis remain to be observed. The current paper discusses the impact of COVID-19 on healthcare and national security based on the currently available data.


title: The psychological status of people affected by the COVID-19 outbreak in China

text: OBJECTIVE: An outbreak of 2019 coronavirus disease (COVID-19) occurred in Wuhan (Hubei, China) in December, 2019. Facing this largescale infectious public health event, everyone is under great psychological pressure. The aim was to investigate the psychological status of people affected by the COVID-19 outbreak in China. METHODS: The online cross-sectional study involving 922 participants (656 medical staff and 266 general population) was conducted in China between February and March, 2020. The psychological status was evaluated using the Symptom Check List 90 Revised (SCL-90). Linear and logistic regression analysis were used to examine the effect in the study. RESULTS: Of the 922 participants, approximately 18.3% had psychological health problems. The score of the SCL-90 was significant higher in medical staff (mean = 1.49) than that in general population (mean = 1.36). In addition, the participants enrolled in March were less likely to have psychological health problems than in February (odds ratio = 0.42, 95% confidence interval [CI] = 0.30 to 0.59). Female had a 1.44-fold risk of psychological health problems than male (95% CI = 1.01 to 2.03). CONCLUSIONS: In the study, 18.3% had psychological health problems during the outbreak of COVID-19 epidemic. With the remission of the epidemic, the psychological health status of participants has been improved. Medical staff were likely to have higher SCL-90 scores than general population and female had more psychological problems than male. Our findings can be used to formulate psychological interventions for improving the mental health of vulnerable groups during the COVID-19 epidemic.


Commentary: Evolving understanding of coronavirus disease 2019: Molecular biology, immunology, and surgery


A case of cefditoren-induced acute generalized exanthematous pustulosis during COVID-19 pandemics. Severe cutaneous adverse reactions are an issue


title: Quantitative Detection and Viral Load Analysis of SARS-CoV-2 in Infected Patients

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has become a public health emergency. The widely used reverse transcription PCR (RT-PCR) method has limitations for clinical diagnosis and treatment. METHODS: A total of 323 samples from 76 COVID-19 confirmed patients were analyzed by droplet digital PCR (ddPCR) and RT-PCR based two target genes (ORF1ab and N). Nasal swabs, throat swabs, sputum, blood, and urine were collected. Clinical and imaging data were obtained for clinical staging. RESULTS: In 95 samples tested positive by both methods, the cycle threshold (Ct) of RT-PCR was highly correlated with the copy numbed of ddPCR (ORF1ab gene, R2 = 0.83; N gene, R2 = 0.87). 4 (4/161) negative and 41 (41/67) single-gene positive samples tested by RT-PCR were positive according to ddPCR with viral load ranging from 11.1 to 123.2 copies/test. Then the viral load of respiratory samples was compared and the average viral load in sputum (17429 ± 6920 copies/test) was found to be significantly higher than in throat swabs (2552 ± 1965 copies/test, p < 0.001) and nasal swabs (651 ± 501 copies/test, p < 0.001). Furthermore, the viral load in the early and progressive stages were significantly higher than that in the recovery stage (46800 ± 17272 vs 1252 ± 1027, p < 0.001) analyzed by sputum samples. CONCLUSIONS: Quantitative monitoring of viral load in lower respiratory tract samples helps to evaluate disease progression, especially in cases of low viral load.


COVID-19: the current situation in Afghanistan


title: Evaluation of ocular symptoms and tropism of SARS-CoV-2 in patients confirmed with COVID-19

text: PURPOSE: The SARS-CoV-2 RNA has been detected in tears and conjunctival samples from infected individuals. Conjunctivitis is also reported in a small number of cases. We evaluated ocular symptoms and ocular tropism of SARS-CoV-2 in a group of patients with COVID-19. METHOD: Fifty-six patients infected with SARS-CoV-2 were recruited as subjects. Relevant medical histories were obtained from the electronic medical record system. Ocular history and ocular symptoms data were obtained by communicating directly with the subjects. The Ocular Surface Disease Index (OSDI) and Salisbury Eye Evaluation Questionnaire (SEEQ) were used to assess the anterior ocular surface condition before and after the onset of disease. RESULTS: Patients classified as severe COVID-19 cases were more likely to have hypertension compared to mild cases (p = 0.035). Of the 56 subjects, thirteen patients (23%) were infected in Wuhan, 32 patients (57%) were community-infected, 10 patients (18%) were unknown origin, 1 (2%) was a physician likely infected by a confirmed patient. Three patients wore face mask with precaution when contacting the confirmed patients. Fifteen (27%) had aggravated ocular symptoms, of which 6 (11%) had prodromal ocular symptoms before disease onset. The differences in mean scores of OSDI questionnaire and SEEQ between before and after onset of COVID-19 were all significant (p < 0.05 for both). CONCLUSIONS: Ocular symptoms are relatively common in COVID-19 disease and may appear just before the onset of respiratory symptoms. Our data provided the anecdotal evidences of transmission of SARS-CoV-2 via ocular surface.


title: Prediction for the spread of COVID-19 in India and effectiveness of preventive measures

text: The spread of COVID-19 in the whole world has put the humanity at risk. The resources of some of the largest economies are stressed out due to the large infectivity and transmissibility of this disease. Due to the growing magnitude of number of cases and its subsequent stress on the administration and health professionals, some prediction methods would be required to predict the number of cases in future. In this paper, we have used data-driven estimation methods like long short-term memory (LSTM) and curve fitting for prediction of the number of COVID-19 cases in India 30 days ahead and effect of preventive measures like social isolation and lockdown on the spread of COVID-19. The prediction of various parameters (number of positive cases, number of recovered cases, etc.) obtained by the proposed method is accurate within a certain range and will be a beneficial tool for administrators and health officials.


title: Comparison of the Elecsys® Anti-SARS-CoV-2 immunoassay with the EDI™ enzyme linked immunosorbent assays for the detection of SARS-CoV-2 antibodies in human plasma

text: BACKGROUND: Here, we report on a head-to-head comparison of the fully-automated Elecsys® Anti-SARS-CoV-2 immunoassay with the EDITM enzyme linked immunosorbent assays (ELISA) for the detection of SARS-CoV-2 antibodies in human plasma. METHODS: SARS-CoV-2 antibodies were measured with the Elecsys® assay and the EDITM ELISAs (IgM and IgG) in 64 SARS-CoV-2 RT-PCR confirmed COVID-19 patients with serial blood samples (n = 104) collected at different time points from symptom onset. Blood samples from 200 healthy blood donors and 256 intensive care unit (ICU) patients collected before the COVID-19 outbreak were also used. RESULTS: In COVID-19 patients, the percentage of positive results rose with time from symptom onset, peaking to positivity rates after 15-22 days of 100% for the Elecsys® assay, of 94% for the EDITM IgM-ELISA and of 100% for the EDITM IgG ELISA. In the 104 blood samples, the agreement between positive/negative classifications of the Elecsys® assay and the EDITM ELISAs (IgM or IgG) was 90%. The false positivity rates in the healthy blood donors and the ICU patients were < 1% for the Elecsys® assay and < 3% for the EDITM ELISAs. CONCLUSIONS: Our results indicate a high sensitivity and specificity for the Elecsys® assay and an acceptable agreement with the EDITM ELISAs.


title: Stress detection using ECG and EMG signals: A comprehensive study

text: BACKGROUND AND OBJECTIVE: In recent years, stress and mental health have been considered as important worldwide concerns. Stress detection using physiological signals such as electrocardiogram (ECG), skin conductance (SC), electromyogram (EMG) and electroencephalogram (EEG) is a traditional approach. However, the effect of stress on the EMG signal of different muscles and the efficacy of combination of the EMG and other biological signals for stress detection have not been taken into account yet. This paper presents a comprehensive review of the EMG signal of the right and left trapezius and right and left erector spinae muscles for multi-level stress recognition. Also, the ECG signal was employed to evaluate the efficacy of EMG signals for stress detection. METHODS: Both EMG and ECG signals were acquired simultaneously from 34 healthy students (23 females and 11 males, aged 20-37 years). Mental arithmetic, Stroop color-word test, time pressure, and stressful environment were employed to induce stress in the laboratory. RESULTS: The accuracies of stress recognition in two, three and four levels were 100%, 97.6%, and 96.2%, respectively, obtained from the distinct combination of feature selection and machine learning algorithms. CONCLUSIONS: The comparison of stress detection accuracies resulted from EMG and ECG indicators demonstrated the strong ability and the effectiveness of EMG signal for multi-level stress detection.


Starting a biologic therapy in IBD patients amidst COVID-19: hold, careful monitoring or testing?


Human patient simulation: educational issues and practical implications in COVID-19 times


title: SARS-CoV-2: fear versus data

text: SARS-CoV-2, the novel coronavirus from China, is spreading around the world, causing a huge reaction despite its current low incidence outside China and the Far East. Four common coronaviruses are in current circulation and cause millions of cases worldwide. This article compares the incidence and mortality rates of these four common coronaviruses with those of SARS-CoV-2 in Organisation for Economic Co-operation and Development countries. It is concluded that the problem of SARS-CoV-2 is probably being overestimated, as 2.6 million people die of respiratory infections each year compared with less than 4000 deaths for SARS-CoV-2 at the time of writing.


title: Extra-respiratory manifestations of COVID-19

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global health threat. Although most patients with COVID-19 manifest fever and respiratory tract symptoms, SARS-CoV-2 infection may also involve other organs/systems and present with extra-respiratory manifestations, including cardiac, gastrointestinal, hepatic, renal, neurological, olfactory, gustatory, ocular, cutaneous and haematological symptoms. Occasionally, these extra-respiratory symptoms/signs represent the initial presentation of SARS-CoV-2 infection, prior to fever or respiratory manifestations. Therefore, this comprehensive review of the extra-respiratory manifestations of COVID-19 is intended to help clinicians better understand the range of clinical presentations associated with SARS-CoV-2 infection, allowing the consideration of COVID-19 in differential diagnoses. A screening test for SARS-CoV-2 should be performed when patients have these extra-respiratory manifestations. In addition, clinicians should be alerted to the adverse effects of anti-SARS-CoV-2 agents that can mimic the extra-respiratory manifestations of COVID-19. Moreover, some extra-respiratory manifestations, such as ocular and gastrointestinal involvement, may be caused by direct invasion of SARS-CoV-2. Therefore, protective measures should be taken while managing the associated clinical specimens. Finally, several extra-respiratory manifestations, such as cardiac involvement, acute kidney injury, coagulation disorders and thrombotic complications, could be associated with a poor prognosis.


Psychological effects of COVID-19 on parenting and maternal-fetal mental health


Rising Concern on Damaged Testis of COVID-19 Patients


Leveraging IR's Adaptability During COVID-19: A Multicenter Single Urban Health System Experience


title: COVID-19 infection and recovery in various countries: Modeling the dynamics and evaluating the non-pharmaceutical mitigation scenarios

text: The coronavirus disease 2019 (COVID-19) pandemic radically impacts our lives, while the transmission/infection and recovery dynamics of COVID-19 remain obscure. A time-dependent Susceptible, Exposed, Infectious, and Recovered (SEIR) model was proposed and applied to fit and then predict the time series of COVID-19 evolution observed in the last three months (till 3/22/2020) in various provinces and metropolises in China. The model results revealed the space dependent transmission/infection rate and the significant spatiotemporal variation in the recovery rate, likely due to the continuous improvement of screening techniques and public hospital systems, as well as full city lockdowns in China. The validated SEIR model was then applied to predict COVID-19 evolution in United States, Italy, Japan, and South Korea which have responded differently to monitoring and mitigating COVID-19 so far, although these predictions contain high uncertainty due to the intrinsic change of the maximum infected population and the infection/recovery rates within the different countries. In addition, a stochastic model based on the random walk particle tracking scheme, analogous to a mixing-limited bimolecular reaction model, was developed to evaluate non-pharmaceutical strategies to mitigate COVID-19 spread. Preliminary tests using the stochastic model showed that self-quarantine may not be as efficient as strict social distancing in slowing COVID-19 spread, if not all of the infected people can be promptly diagnosed and quarantined.


Insight into the relationship between obesity-induced low-level chronic inflammation and COVID-19 infection


title: The Role of the Global Health Development/Eastern Mediterranean Public Health Network and the Eastern Mediterranean Field Epidemiology Training Programs in Preparedness for COVID-19

text: The World Health Organization (WHO) declared the current COVID-19 a public health emergency of international concern on January 30, 2020. Countries in the Eastern Mediterranean Region (EMR) have a high vulnerability and variable capacity to respond to outbreaks. Many of these countries addressed the need for increasing capacity in the areas of surveillance and rapid response to public health threats. Moreover, countries addressed the need for communication strategies that direct the public to actions for self- and community protection. This viewpoint article aims to highlight the contribution of the Global Health Development (GHD)/Eastern Mediterranean Public Health Network (EMPHNET) and the EMR's Field Epidemiology Training Program (FETPs) to prepare for and respond to the current COVID-19 threat. GHD/EMPHNET has the scientific expertise to contribute to elevating the level of country alert and preparedness in the EMR and to provide technical support through health promotion, training and training materials, guidelines, coordination, and communication. The FETPs are currently actively participating in surveillance and screening at the ports of entry, development of communication materials and guidelines, and sharing information to health professionals and the public. However, some countries remain ill-equipped, have poor diagnostic capacity, and are in need of further capacity development in response to public health threats. It is essential that GHD/EMPHNET and FETPs continue building the capacity to respond to COVID-19 and intensify support for preparedness and response to public health emergencies.


title: The COVID-19 Epidemic and the Prison System in Italy

text: The Italian Ministry of Justice and that of Health have established two strategies to limit the spread of COVID-19 in prisons: progressive isolation from the external world and adoption of practices to identify possible cases and to treat infected subjects. After the announcement of regulations revolts erupted in numerous Italian prisons. The motivations and effects of these strategy are discussed critically into the search for a balance between the right to health and other rights of prisoners in Italian prisons with the problem of an occupancy level of 121.75%.


Critical Concerns About 2019 Novel Coronavirus Infection in Pediatric Population


title: Personalized workflow to identify optimal T-cell epitopes for peptide-based vaccines against COVID-19

text: Traditional vaccines against viruses are designed to target their surface proteins, i.e., antigens, which can trigger the immune system to produce specific antibodies to capture and neutralize the viruses. However, viruses often evolve quickly, and their antigens are prone to mutations to avoid recognition by the antibodies (antigenic drift). This limitation of the antibody-mediated immunity could be addressed by the T-cell mediated immunity, which is able to recognize conserved viral HLA peptides presented on virus-infected cells. Thus, by targeting conserved regions on the genome of a virus, T-cell epitope-based vaccines are less subjected to mutations and may work effectively on different strains of the virus. Here we propose a personalized workflow to identify an optimal set of T-cell epitopes based on the HLA alleles and the immunopeptidome of an individual person. Specifically, our workflow trains a machine learning model on the immunopeptidome and then predicts HLA peptides from conserved regions of a virus that are most likely to trigger responses from the person T cells. We applied the workflow to identify T-cell epitopes for the SARS-COV-2 virus, which has caused the recent COVID-19 pandemic in more than 100 countries across the globe.