title: Tracheotomy in the SARS-CoV-2 pandemic

text: The severe acute respiratory syndrome (SARS)-CoV-2 pandemic continues to produce a large number of patients with chronic respiratory failure and ventilator dependence. As such, surgeons will be called upon to perform tracheotomy for a subset of these chronically intubated patients. As seen during the SARS and the SARS-CoV-2 outbreaks, aerosol-generating procedures (AGP) have been associated with higher rates of infection of medical personnel and potential acceleration of viral dissemination throughout the medical center. Therefore, a thoughtful approach to tracheotomy (and other AGPs) is imperative and maintaining traditional management norms may be unsuitable or even potentially harmful. We sought to review the existing evidence informing best practices and then develop straightforward guidelines for tracheotomy during the SARS-CoV-2 pandemic. This communication is the product of those efforts and is based on national and international experience with the current SARS-CoV-2 pandemic and the SARS epidemic of 2002/2003.


title: Covid-19: Data analysis of the Lombardy region and the provinces of Bergamo and Brescia

text: The data analysis on deaths in the Lombardy Region and of both the provinces of Bergamo and Brescia shows a twofold aspect on the trend of the epidemic: - all the data show a bias linked to the event of March 10th (day for which the Lombardy region data is partial) and the subsequent change in the way in which positive cases and deaths are calculated; - following the containment measures of the Prime Minister's Decree of March 11th, the spread of the epidemic, although still exponential in nature, has a reduced multiplication coefficient. Our analysis concludes that the situation is not yet compatible with a plateau trend and allows us to predict the trend in the number of deaths in the Lombardy region. We therefore conclude that the containment measures put in place by the government on March 11th will allow a reduction in deaths from around 8000 to just over 6500 for March 27th.


COVID-19 and cancer: Looking for evidence


NSAIDs may increase the risk of thrombosis and acute renal failure in patients with COVID-19 infection


Transverse myelitis related to COVID-19 infection


docid: unyakhgo

title: Supporting children with autism spectrum disorder in the face of the COVID-19 pandemic


title: Unterricht an der Berufsfachschule für Notfallsanitäter der Landeshauptstadt München im Angesicht der COVID-19-Pandemie./ [Teaching at the paramedics school of the City of Munich during the COVID-19 pandemic]

text: The ongoing Coronavirus crisis forced both the Berufsfachschule für Notfallsanitäter (emergency paramedic vocational school) of the Munich fire department and all other German schools to quit classroom teaching within just a few days. Similarly, all practical trainings at clinics and on ambulances had to be put on hold. As the apprentices' training objective was acutely endangered by the expected lengthy teaching downtimes, it was of crucial importance to successfully establish homeschooling. While members of our teaching staff were additionally bound by support for the Munich crisis unit, the switch to virtual classroom teaching for all ongoing courses significantly increased the overall workload of the staff. In a first step, we established a fast video and communication platform via Microsoft Skype. All other issues had to be solved on the fly due to the lack of preparation time. Soon it became obvious that using only classic upfront teaching methods was not an option due to the resulting monotony of a full-time 35â¯h training week. Additionally, we had to ensure that exams would also be possible during homeschooling to avoid the accumulation of missing performance assessments. Within a few days, it became clear that almost all forms of social interactions and teaching methods could be integrated into the virtual classroom with minor limitations. A survey among students showed that while homeschooling cannot fully replace classroom teaching, it is considered a good alternative in emergency situations. Furthermore, many trainees think that homeschooling could be a valuable addition to normal classroom teaching. Maybe this crisis could turn out to be the beginning of a new complementary teaching strategy.


Using imaging to combat a pandemic: rationale for developing the UK National COVID-19 Chest Imaging Database


docid: gprvoecp

title: Role of respirators in controlling the spread of novel coronavirus (COVID-19) amongst dental healthcare providers: a review

text: During the ongoing COVID-19 pandemic, healthcare professionals are at the forefront of managing the highly infectious coronavirus. As the most common route of transmission is via aerosols and droplet inhalation, it is critical for healthcare workers to have the correct personal protective equipment (PPE) including gowns, masks and goggles. Surgical masks are not effective in preventing the influenza and SARS, so they are unlikely to be able to resist contaminated aerosols from entering the respiratory system. Therefore, it is vital to use respirators which have been proven to offer better protection against droplets, aerosols and fluid penetration and which form a tight seal around the mouth and nose. Various types of respirators are used in healthcare settings, such as half-mask filtering facepiece respirators (FFRs) and powered air-purifying respirators (PAPRs). The most commonly used FFR is the N95 disposable respirator, which is tight fitting and has a 95% or above particle filtering efficiency for a median particle size of 0.3 µm. This review discusses respirators, their purpose, types, clinical efficiency and proper donning and doffing techniques.


docid: ggbtwmiv

title: 3CL hydrolase-based multiepitope peptide vaccine against SARS-CoV-2 using immunoinformatics

text: The present study provides the first multiepitope vaccine construct using the 3CL hydrolase protein of SARS-CoV-2. The coronavirus 3CL hydrolase (Mpro) enzyme is essential for proteolytic maturation of the virus. This study was based on immunoinformatics and structural vaccinology strategies. The design of the multiepitope vaccine was built using helper T-cell and cytotoxic T-cell epitopes from the 3CL hydrolase protein along with an adjuvant to enhance immune response; these are joined to each other by short peptide linkers. The vaccine also carries potential B-cell linear epitope regions, B-cell discontinuous epitopes, and interferon-Î³-inducing epitopes. Epitopes of the constructed multiepitope vaccine were found to be antigenic, nonallergic, nontoxic, and covering large human populations worldwide. The vaccine construct was modeled, validated, and refined by different programs to achieve a high-quality three-dimensional structure. The resulting high-quality model was applied for conformational B-cell epitope selection and docking analyses with toll-like receptor-3 for understanding the capability of the vaccine to elicit an immune response. In silico cloning and codon adaptation were also performed with the pET-19b plasmid vector. The designed multiepitope peptide vaccine may prompt the development of a vaccine to control SARS-CoV-2 infection.


title: Convalescent plasma to treat coronavirus disease 2019 (COVID-19): considerations for clinical trial design

text: Case series studying convalescent plasma use in the treatment of COVID-19 have been promising, but additional, high-quality studies are needed to determine the efficacy of the treatment when applied for prophylaxis, for early phases of illness, and for severe illness. Previous studies of convalescent plasma in treating other viral diseases have identified factors to consider when designing treatment protocols, including timing of administration relative to onset of illness, timing of donation relative to resolution of symptoms, severity of illness of the donor, pretransfusion serology of the recipient, and antibody titers of the donor. There are many clinical trials studying treatment of, and prophylaxis against, COVID-19 using convalescent plasma. In addition to clinical trials, the FDA also allows treatment through two other pathways: the "Expanded Access to Convalescent Plasma for the Treatment of Patients with COVID-19" protocol, and emergency investigational new drug applications. The FDA also provides criteria for donation of convalescent plasma.


title: Epidemiological characteristics of the first 53 laboratory-confirmed cases of COVID-19 epidemic in Hong Kong, 13 February 2020

text: BackgroundCOVID-19, caused by SARS-CoV-2, first appeared in China and subsequently developed into an ongoing epidemic. Understanding epidemiological factors characterising the transmission dynamics of this disease is of fundamental importance.AimsThis study aimed to describe key epidemiological parameters of COVID-19 in Hong Kong.MethodsWe extracted data of confirmed COVID-19 cases and their close contacts from the publicly available information released by the Hong Kong Centre for Health Protection. We used doubly interval censored likelihood to estimate containment delay and serial interval, by fitting gamma, lognormal and Weibull distributions to respective empirical values using Bayesian framework with right truncation. A generalised linear regression model was employed to identify factors associated with containment delay. Secondary attack rate was also estimated.ResultsThe empirical containment delay was 6.39 days; whereas after adjusting for right truncation with the best-fit Weibull distribution, it was 10.4 days (95% CrI: 7.15 to 19.81). Containment delay increased significantly over time. Local source of infection and number of doctor consultations before isolation were associated with longer containment delay. The empirical serial interval was 4.58-6.06 days; whereas the best-fit lognormal distribution to 26 certain-and-probable infector-infectee paired data gave an estimate of 4.77 days (95% CrI: 3.47 to 6.90) with right-truncation. The secondary attack rate among close contacts was 11.7%.ConclusionWith a considerable containment delay and short serial interval, contact-tracing effectiveness may not be optimised to halt the transmission with rapid generations replacement. Our study highlights the transmission risk of social interaction and pivotal role of physical distancing in suppressing the epidemic.


title: The evaluation of sleep disturbances for Chinese frontline medical workers under the outbreak of COVID-19

text: OBJECTIVE: To evaluate sleep disturbances of Chinese frontline medical workers (FMW) under the outbreak of coronavirus disease 2019 (COVID-19), and make a comparison with non-FMW. METHODS: The medical workers from multiple hospitals in Hubei Province, China, volunteered to participate in this cross-sectional study. An online questionnaire, including Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS) and Visual Analogue Scale (VAS), was used to evaluate sleep disturbances and mental status. Sleep disturbances were defined as PSQI>6 points or/and AIS>6 points. We compared the scores of PSQI, AIS, anxiety and depression VAS, as well as prevalence of sleep disturbances between FMW and non-FMW. RESULTS: A total of 1306 subjects (801 FMW and 505 non-FMW) were enrolled. Compared to non-FMW, FMW had significantly higher scores of PSQI (9.3 ± 3.8 vs 7.5 ± 3.7; P < 0.001; Cohen's d = 0.47), AIS (6.9 ± 4.3 vs 5.3 ± 3.8; P < 0.001; Cohen's d = 0.38), anxiety (4.9 ± 2.7 vs 4.3 ± 2.6; P < 0.001; Cohen's d = 0.22) and depression (4.1 ± 2.5 vs 3.6 ± 2.4; P = 0.001; Cohen's d = 0.21), as well as higher prevalence of sleep disturbances according to PSQI > 6 points (78.4% vs 61.0%; relative risk [RR] = 1.29; P < 0.001) and AIS > 6 points (51.7% vs 35.6%; RR = 1.45; P < 0.001). CONCLUSION: FMW have higher prevalence of sleep disturbances and worse sleep quality than non-FMW. Further interventions should be administrated for FMW, aiming to maintain their healthy condition and guarantee their professional performance in the battle against COVID-19.


Is the type of diabetes treatment relevant to outcome of COVID-19?


[Novel coronavirus infection (COVID-19) and cytokine storms - treatment options based on inflammatory processes]


title: Diagnóstico De Neumonía Covid 19 En Pacientes Asintomáticos Tras La Realización De Un Pet-tc Oncológico

text: INTRODUCTION: On January 30, 2020, the World Health Organization (WHO) declared an international emergency due to the pandemic caused by a new coronavirus. There are some oncological indications that have special priority and studies are still being carried out despite the current situation. In these studies we have found suspicious findings of COVID-19 pneumonia in asymptomatic patients. The objective of this work is to assess the incidence of these findings, describe their characteristics and the evolution of suspected patients. MATERIAL AND METHODS: Oncological PET studies carried out in asymptomatic patients between March 18 and April 8, 2020 have been reviewed. Patients who presented findings suggestive of corresponding to an pulmonary infectious process were selected. Clinical findings have been reviewed to confirm or rule out SARS-CoV2 infection. RESULTS: During the specified period, a total of 129 PET-CT studies were performed. Of these, 11 (8.5%) found suspicious findings of a pulmonary infectious process. These were 8 men and 3 women aged between 30 and 79 years (mean 62.2). CONCLUSIONS: Patients with COVID 19 can present few symptoms of the disease, and in PET-CT studies both presymptomatic and almost asymptomatic patients can be detected, so nuclear medicine physicians should take special attention to the pulmonary evaluation of PET-CT studies.


Editorial: Obstetric anesthesia and COVID 19 times


title: Técnica de TightRope modificada no tratamento da doença do ligamento cruzado cranial em cães: resultados a longo prazo/ Modified TightRope technique for treatment of the cranial cruciate ligament disease in dogs: long term outcomes

text: O objetivo deste estudo foi descrever os resultados a longo prazo do uso da técnica extracapsular TightRope (TR) modificada no tratamento da doença do ligamento cruzado cranial (LCCr) em oito cães (10 articulações) com peso corporal variando entre 4kg e 28kg. Todos os animais selecionados foram submetidos aos exames ortopédicos específicos, sendo diagnosticada ruptura completa do LCCr pelos testes de gaveta e de compressão tibial. Realizaram-se exames radiográficos convencionais e em posição de estresse das articulações. A técnica TR foi modificada utilizando-se o fio de náilon substituindo o fio de fibra empregado na técnica original, facilitando a disponibilidade de obtenção do material. Houve também modificação na origem da perfuração do túnel tibial, sendo realizada imediatamente cranial ao sulco do tendão extensor digital longo. Todos os cães foram submetidos ao exame radiográfico tanto no pós-operatório imediato como no tardio. Aos 30 dias após a intervenção cirúrgica, os pacientes apresentavam claudicação nos membros pélvicos operados de grau discreto a moderado. Foi observado discreto movimento de gaveta cranial em 60% das articulações acometidas. Aos três meses após o procedimento cirúrgico, os animais apresentaram ausência de dor e discreta redução na amplitude dos movimentos articulares. Em duas articulações (20%) observou-se discreto deslocamento cranial da tíbia no teste de gaveta. Nesta fase, 80% dos membros avaliados apresentavam apoio normal. Um ano após a intervenção cirúrgica, observou-se ao exame radiográfico discreta progressão da doença articular degenerativa em 50% das articulações operadas. Das oito articulações avaliadas a longo prazo, em apenas um membro operado observou-se discreta claudicação com reduzida transferência de peso para o membro contralateral. Os demais membros pélvicos avaliados (87,5%) demonstraram ausência de claudicação e adequada recuperação da função articular. Concluiu-se que a técnica cirúrgica extracapsular TR modificada mostrou-se efetiva como opção de tratamento para doença do LCCr em cães de porte pequeno e médio, não apresentando complicações. As modificações do fio cirúrgico e da perfuração da tíbia na técnica TR parecem ter efeitos positivos na estabilização da articulação do joelho.(AU)


Mental health at the age of coronavirus: time for change


Proactive measures for the pandemic COVID-19 infection in outpatient clinics of Otolaryngology Department


title: Valve-in-valve transcatheter aortic valve replacement in a young patient with a suspected COVID-19 infection: a surgical dilemma in the era of the COVID-19 pandemic

text: We report on a case of a 57-year-old male patient, who underwent full root replacement in 2005 and now presented with high grade aortic insufficiency. On admission, the patient underwent a computed tomography scan which demonstrated interstitial infiltration in the left lung, highly suspicious for a COVID-19 infection that could not be confirmed by reverse transcription polymerase chain reaction (RT-PCR) testing. As there usually is a delay between infection and positive RT-PCR test results, the initial decision was to perform additional testing. However, the patient deteriorated quickly in spite of optimal medical therapy making urgent aortic valve replacement necessary. We decided to perform transcatheter aortic valve replacement to avoid cardiopulmonary bypass with shorter operative times, presumably shorter ventilation times and duration of intensive care unit stay, and thus a lesser risk for pulmonary complications.


title: Preventing nosocomial infections in resource-limited settings: An interventional approach in healthcare facilities in Burkina Faso

text: BACKGROUND: Nosocomial pathogens are transmitted by contamination of surfaces causing healthcare-associated infections (HAI). The impact of locally produced disinfectant with operational training as a means to improve hygiene in resource-limited healthcare facilities and prevent HAI was evaluated. METHOD: In Burkina Faso, 4 types of electro-chlorinator devices that convert salt and water into sodium hypochlorite through electrolysis were installed in 26 healthcare facilities distributed across 3 sanitary districts. The program was evaluated at 4 months and 11 months and performance compared with a control group. RESULTS: After 11 months, over 90% of the facilities applied 8 of the 11 essential hygiene practices defined by the Ministry of Health, compared to 20% in the control group. 61.5% of the healthcare facilities improved the chlorine concentration of their sodium hypochlorite solutions, reaching an average concentration of 5.1 g/L compared to an average of 2.1 g/L in the control group. Additionally, a cost-benefit analysis demonstrated that locally produced sodium hypochlorite led to daily savings ranging between 2.7 and 53 euros depending on the device compared with the purchase of chlorine tablets. CONCLUSION: Results, therefore, suggest that electro-chlorinator devices in addition to hygiene sensitization can be a simple, cost-effective and tailored intervention to reduce the prevalence of HAI in low-resource settings.


Low rate of severe acute respiratory syndrome coronavirus 2 spread among health-care personnel using ordinary personal protection equipment in a medium-incidence setting


title: The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

text: Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.


title: Graph Neural Network Based Coarse-Grained Mapping Prediction

text: The selection of coarse-grained (CG) mapping operators is a critical step for CG molecular dynamics (MD) simulation. It is still an open question about what is optimal for this choice and there is a need for theory. The current state-of-the art method is mapping operators manually selected by experts. In this work, we demonstrate an automated approach by viewing this problem as supervised learning where we seek to reproduce the mapping operators produced by experts. We present a graph neural network based CG mapping predictor called DEEP SUPERVISED GRAPH PARTITIONING MODEL(DSGPM) that treats mapping operators as a graph segmentation problem. DSGPM is trained on a novel dataset, Human-annotated Mappings (HAM), consisting of 1,206 molecules with expert annotated mapping operators. HAM can be used to facilitate further research in this area. Our model uses a novel metric learning objective to produce high-quality atomic features that are used in spectral clustering. The results show that the DSGPM outperforms state-of-the-art methods in the field of graph segmentation.


title: Projected Development of COVID-19 in Louisiana

text: At the time of writing, Louisiana has the third highest COVID-19 infection per capita in the United States. The state government issued a stay-at-home order effective March 23rd. We analyze the projected spread of COVID-19 in Louisiana without including the effects of the stay-at-home order. We predict that a large fraction of the state population would be infected without the mitigation efforts, and would certainly overwhelm the capacity of Louisiana health care system. We further predict the outcomes with different degrees of reduction in the infection rate. More than 70% of reduction is required to cap the number of infected to under one million.


title: Recent progress and challenges in drug development against COVID-19 coronavirus (SARS-CoV-2) - an update on the status

text: Coronaviruses are a large group of viruses known to cause illnesses that vary between the common cold and more severe diseases to include severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). A novel coronavirus was identified in December 2019 in Wuhan city, Hubei province, China. This virus represents a new strain that has not been previously identified in humans. The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting disease is called coronavirus disease 2019 (COVID-19). The World Health Organization (WHO) declared the novel coronavirus outbreak a global pandemic in March 2020. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise, with more than 1,948,617 laboratory-confirmed cases and over 121,846 deaths worldwide. Currently, no specific medication is recommended to treat COVID-19 patients. However, governments and pharmaceutical companies are struggling to quickly find an effective drug to defeat the coronavirus. In the current review, we summarize the existing state of knowledge about COVID-19, available medications, and treatment options. Favilavir is an antiviral drug that is approved in Japan for common influenza treatment and is now approved to treat symptoms of COVID-19 in China. Moreover, Chloroquine and hydroxychloroquine, drugs used to treat malaria and arthritis, respectively, were recommended by the National Health Commission of the People's Republic of China for treatment of COVID-19. Presently, chloroquine and hydroxychloroquine are under investigation by the US Food and Drug Administration (FDA) as a treatment for COVID-19. The first COVID-19 vaccine is not expected to be ready for clinical trials before the end of the year.


title: A preliminary systematic review and meta-analysis of randomized-controlled trials of cognitive remediation therapy for anorexia nervosa

text: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) was developed as an adjuvant treatment to target set-shifting and central coherence inefficiencies important in AN and to ultimately improve clinical outcomes of those with AN. The primary aim of this preliminary systematic review and meta-analysis was to determine the effect of CRT for AN relative to control treatments in randomized-controlled trials (RCTs) on neuropsychological inefficiencies at end-of-treatment. Secondary aims were to assess the effect of CRT for AN on dropout, eating-disorder-related, and other psychological outcomes at end-of-treatment. Systematic review and meta-analytic procedures were conducted in accordance with PRISMA Guidelines. RCTs evaluating CRT for AN compared to a control treatment were identified via ProQuest, PsycINFO, PubMed, and SCOPUS. Seven RCTs and one quasi-RCT of CRT for AN were included. RCT quality ratings ranged from fair (n = 3) to good (n = 4). Random-effects meta-analysis was conducted using Hedge's g. Study heterogeneity was assessed using I2 and publication bias was assessed with Begg's adjusted-rank correlation and the trim-and-fill method. CRT was not associated with improvement in central coherence compared to control treatments at end-of-treatment (g = 0.25, 95% CI = -0.35, 0.85, k = 3). Set-shifting outcomes were mixed due to heterogeneity of set-shifting measures across studies. CRT may prevent dropout; yet, more studies are needed to draw conclusions. CRT did not confer advantage over control treatments for eating-disorder-related and other psychological outcomes at end-of-treatment. Future RCTs of CRT for AN should use precise measures to assess constructs (particularly for set shifting), increase sample size, and implement longitudinal follow-up. (Word Count: 247 words).


Covid-19: Risk of second wave is very real, say researchers


docid: pndiiiue

title: Role of doctors in epidemics: historical perspectives and implications for COVID-19


COVID-19: A Defining Moment for Clinical Pharmacology?


title: Ending the COVID-19 epidemic in the United Kingdom

text: Social distancing and lockdown are the two main non-pharmaceutical interventions being used by the UK government to contain and control the COVID-19 epidemic; these are being applied uniformly across the entire country, even though the results of the Imperial College report by Ferguson et al show that the impact of the infection increases sharply with age. This paper develops a variant of the workhorse SIR model for epidemics, where the population is classified into a number of age groups. This allows us to understand the effects of age-dependent controls on the epidemic, and explore possible exit strategies.


title: Phosphate and nitrate uptake dynamics in Palmaria palmata (Rhodophyceae): ecological and physiological aspects of nutrient availability

text: Uptake dynamics of dissolved inorganic phosphate (DIP) and dissolved inorganic nitrate (DIN) in young Palmaria palmata (n=49), cultivated in a range of DIP concentrations (0.0-6.0 µmol · L-1 ) and non-limiting DIN concentration (50 µmol · L-1 ) under fully controlled laboratory conditions, were quantified in a 'pulse-and-chase' approach over 5 weeks. Two different uptake rates were specified: (1) surge uptake (VS ) after starvation and (2) maintenance uptake with filled nutrient pools (VM ). VS for DIP of 1.57±0.29 µmol · cm-2 · d-1 and DIN of 15.6±4.3 µmol · cm-2 · d-1 , as well as VM for DIP of 0.57±0.22 µmol · cm-2 · d-1 and DIN of 5.6±2.1 µmol · cm-2 · d-1 were calculated. In addition, an absolute size of the internal storage capacity (ISC) for DIP of 22 µmol · cm2 and DIN of 222 µmol · cm2 was determined. A DIP to DIN uptake ratio of 1:10 under VM showed a weekly rhythmic uptake pattern, highlighted by a high correlation between DIP and DIN uptake (R=0.943). VS for DIN did not occur under DIP depletion, but uptake rates increased with increasing DIP availability. Hence, DIP availability limited access to DIN, which was also reflected by total dissolvable protein concentrations in sporophytes, which ranged from 10.2±2.5% to 24.6±8.0% dry weight depending on DIP availability. Similarly, total dissolvable carbohydrate concentration ranged from 22.1±3.6% to 54.3±12.3% dry weight. The data presented in this study opens further insight into ecological and physiological aspects of nutrient availability in P. palmata and allows for an optimization in cultivation.


title: Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review

text: Available information on chest Computed Tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) is constantly evolving. Ground glass opacities and consolidation with bilateral and peripheral distribution were reported as the most common CT findings, but also less typical features could be identified. All radiologists should be aware of the imaging spectrum of the COVID-19 pneumonia and imaging changes in the course of the disease. Our aim is to display the chest CT findings at first assessment and follow-up through a pictorial essay, to help in the recognition of these features for an accurate diagnosis.


Positive FIT or Cologuard in the Era of COVID-19 Pandemic


Impending Shortages of Kidney Replacement Therapy for COVID-19 Patients


What COVID-19 outbreak in Iran teaches us about virtual medical education


title: Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

text: The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient's ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.


COVID-19: a time to reflect


docid: bqlgpkmo

title: Middle East Respiratory Syndrome Coronavirus and Severe Acute Respiratory Syndrome Coronavirus

text: Emerging infectious diseases continue to be of a significant importance worldwide with the potential to cause major outbreaks and global pandemics. In 2002, the world had witnessed the appearance of the severe acute respiratory syndrome coronavirus in China which disappeared abruptly within 6 months. About a decade later, a new and emerging novel coronavirus named the Middle East respiratory syndrome coronavirus (MERS-CoV) was described in a patient from Saudi Arabia. These two coronaviruses shared multiple similarities in the epidemiology, clinical presentations, and posed challenges in its prevention and management. Seven years since its discovery, MERS-CoV continues to be a lethal zoonotic pathogen capable of causing severe pneumonia with high case fatality rates and the ability to cause large health care-associated outbreaks.


VEGF-D: a novel biomarker for detection of COVID-19 progression


Corona-associated suicide - Observations made in the autopsy room


title: Measuring Human and Economic Activity from Satellite Imagery to Support City-Scale Decision-Making during COVID-19 Pandemic

text: The COVID-19 outbreak forced governments worldwide to impose lockdowns and quarantines over their population to prevent virus transmission. As a consequence, there are disruptions in human and economic activities all over the globe. The recovery process is also expected to be rough. Economic activities impact social behaviors, which leave signatures in satellite images that can be automatically detected and classified. Satellite imagery can support the decision-making of analysts and policymakers by providing a different kind of visibility into the unfolding economic changes. Such information can be useful both during the crisis and also as we recover from it. In this work, we use a deep learning approach that combines strategic location sampling and an ensemble of lightweight convolutional neural networks (CNNs) to recognize specific elements in satellite images and compute economic indicators based on it, automatically. This CNN ensemble framework ranked third place in the US Department of Defense xView challenge, the most advanced benchmark for object detection in satellite images. We show the potential of our framework for temporal analysis using the US IARPA Function Map of the World (fMoW) dataset. We also show results on real examples of different sites before and after the COVID-19 outbreak to demonstrate possibilities. Among the future work is the possibility that with a satellite image dataset that samples a region at a weekly (or biweekly) frequency, we can generate more informative temporal signatures that can predict future economic states. Our code is being made available at https://github.com/maups/covid19-satellite-analysis


title: Particulate multivalent presentation of the receptor binding domain induces protective immune responses against MERS-CoV

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is a WHO priority pathogen for which vaccines are urgently needed. Using an immune-focusing approach, we created self-assembling particles multivalently displaying critical regions of the MERS-CoV spike protein âfusion peptide, heptad repeat 2, and receptor binding domain (RBD) â and tested their immunogenicity and protective capacity in rabbits. Using a "plug-and-display" SpyTag/SpyCatcher system, we coupled RBD to lumazine synthase (LS) particles producing multimeric RBD-presenting particles (RBD-LS). RBD-LS vaccination induced antibody responses of high magnitude and quality (avidity, MERS-CoV neutralizing capacity, and mucosal immunity) with cross-clade neutralization. The antibody responses were associated with blocking viral replication and upper and lower respiratory tract protection against MERS-CoV infection in rabbits. This arrayed multivalent presentation of the viral RBD using the antigen-SpyTag/LS-SpyCatcher is a promising MERS-CoV vaccine candidate and this platform may be applied for the rapid development of vaccines against other emerging viruses such as SARS-CoV-2.


title: COVID-19 crisis in Jordan: Response, scenarios, strategies, and recommendations

text: UNSTRUCTURED: As of 12th April 2020, a total of 389 cases of COVID-19 were confirmed in Jordan. To control this imminent threat, Jordan has enforced public health infection prevention and control measures, called for social distancing, seized all forms of inbound and outbound movement/ international travel, and enacted the Defence Law that transferred the authority to Minister of Defence to work and formulate orders according to the situation. In an effort to support the government in anticipating the requirements of the health system in the upcoming period, an in-depth reflection and examination of different scenarios of the disease spread were developed. This viewpoint suggested different strategies and measures for case detection and contact tracing, clinical management of cases, public health system functioning, and civil society organizations contribution. It is necessary to accelerate containment of the disease to protect the economy and to maintain the continuity of some activities to mitigate the subsequent social, economic and financial impacts. This requires finding a coping mechanism for a period that may be prolonged until laboratories develop a vaccine. In specific, it is strongly recommended to promote community health awareness towards public health prevention and control measures, increase the efficiency and comprehensiveness of the epidemiological investigation/ active and passive surveillance, and employ technology and digital health solutions to track cases and contacts. It is also recommended to increase and expand resources of intensive care units including respirators, increase the capacity and the number of trained health staff in the area of public health and epidemiology, ensure continued provision of essential public health programs and mobilize the resources of non-governmental sector and donors to provide services for refugees and vulnerable populations.


Responding to the COVID-19 pandemic in complex humanitarian crises


Covid-19: Doctors are told not to perform CPR on patients in cardiac arrest


Thrombotic complications in critically ill patients with COVID 19


title: The problem of medical-psychiatric illness in the homeless and its occurrence in the midst of a viral pandemic: A commentary

text: This article has the purpose of examining the problem of getting help for the medical-psychiatric-substance use group of "homeless" people on the streets of our cities, who refuse treatment. The problem has gradually worsened since closure of state hospitals and subsequent lack of community resources. It has been stalemated, in part, by advocates, who argue for personal autonomy and freedom rather than involuntary diagnosis and treatment over the life of these people. It has reached a crisis situation secondary to such potential patients being imprisoned and/or sick with COVID-19 being potential health and legal threats. We review A) the nature of the problem, B) the current social-legal availability of treatment and long-term management (or lack of one) in the context of societal rejection of these potential patients, and C) suggest what might be done, locally and nationally. Mandating scientifically-based medical orders to citizens regardless of personal freedom - are now being implemented to manage the COVID-19 pandemic. We argue for creating a similar med-psych short- and long-term system as a new approach to help this group. They are now mostly being ignored "to die on the streets."


Is the conclusion available? Letter to the Editor concerning the study of Prof. Jin titled "Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019"


Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome


The COVID-19 pandemonium continues: (Withdrawal of published clinical studies in Lancet and N Engl J Med, 2020)


title: Investigating the Determinants of High Case-Fatality Rate for Coronavirus Disease 2019 in Italy

text: Case-Fatality Rate (CFR) for COVID-19 in Italy is apparently much higher than in other countries. Using data from Italy and other countries we evaluated the role of different determinants of this phenomenon. We found that the Italian testing strategy could explain an important part of the observed difference in CFR. In particular, the majority of patients that are currently tested in Italy have severe clinical symptoms that usually require hospitalization and this translates to a large CFR. We are confident that, once modifications in the testing strategy leading to higher population coverage are consistently adopted in Italy, CFR will realign with the values reported worldwide.


title: COVID-19. La historia se repite y seguimos tropezando con la misma piedra./ [COVID-19. History repeats itself and we keep stumbling on the same stone]

text: The COVID-19 pandemic has caused a mismatch in all health systems. Most countries had forgotten how to behave in the face of such an epidemic without adequate resources. We need to take stock of everything that has happened, instruct the population and generate a new knowledge that allows us to face new epidemics.


title: Covid-19 pandemic by the "real-time" monitoring: the Tunisian case and lessons for global epidemics in the context of 3PM strategies

text: Covid-19 is neither the first nor the last viral epidemic which societies around the world are, were and will be affected by. Which lessons should be taken from the current pandemic situation? The Covid-19 disease is still not well characterised, and many research teams all over the world are working on prediction of the epidemic scenario, protective measures to populations and sub-populations, therapeutic and vaccination issues, amongst others. Contextually, countries with currently low numbers of Covid-19-infected individuals such as Tunisia are intended to take lessons from those countries which already reached the exponential phase of the infection distribution as well as from those which have the exponential phase behind them and record a minor number of new cases such as China. To this end, in Tunisia, the pandemic wave has started with a significant delay compared with Europe, the main economic partner of the country. In this paper, we do analyse the current pandemic situation in this country by studying the infection evolution and considering potential protective strategies to prevent a pandemic scenario. The model is predictive based on a large number of undetected Covid-19 cases that is particularly true for some country regions such as Sfax. Infection distribution and mortality rate analysis demonstrate a highly heterogeneous picture over the country. Qualitative and quantitative comparative analysis leads to a conclusion that the reliable "real-time" monitoring based on the randomised laboratory tests is the optimal predictive strategy to create the most effective evidence-based preventive measures. In contrast, lack of tests may lead to incorrect political decisions causing either unnecessary over-protection of the population that is risky for a long-term economic recession, or under-protection of the population leading to a post-containment pandemic rebound. Recommendations are provided in the context of advanced predictive, preventive and personalised (3P) medical approach.


title: The Role of Chest Imaging in Patient Management During the COVID-19 Pandemic: A Multinational Consensus Statement From the Fleischner Society

text: With more than 900,000 confirmed cases worldwide and nearly 50,000 deaths during the first 3 months of 2020, the coronavirus disease 2019 (COVID-19) pandemic has emerged as an unprecedented health care crisis. The spread of COVID-19 has been heterogeneous, resulting in some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 and others having community transmission that has led to overwhelming numbers of severe cases. For these regions, health care delivery has been disrupted and compromised by critical resource constraints in diagnostic testing, hospital beds, ventilators, and health care workers who have fallen ill to the virus exacerbated by shortages of personal protective equipment. Although mild cases mimic common upper respiratory viral infections, respiratory dysfunction becomes the principal source of morbidity and mortality as the disease advances. Thoracic imaging with chest radiography and CT are key tools for pulmonary disease diagnosis and management, but their role in the management of COVID-19 has not been considered within the multivariable context of the severity of respiratory disease, pretest probability, risk factors for disease progression, and critical resource constraints. To address this deficit, a multidisciplinary panel comprised principally of radiologists and pulmonologists from 10 countries with experience managing patients with COVID-19 across a spectrum of health care environments evaluated the utility of imaging within three scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions, corresponding to 11 decision points within the three scenarios and three additional clinical situations, were rated by the panel based on the anticipated value of the information that thoracic imaging would be expected to provide. The results were aggregated, resulting in five main and three additional recommendations intended to guide medical practitioners in the use of chest radiography and CT in the management of COVID-19.


title: The Role of Chest Imaging in Patient Management during the COVID-19 Pandemic: A Multinational Consensus Statement from the Fleischner Society

text: With more than 900 000 confirmed cases worldwide and nearly 50 000 deaths during the first 3 months of 2020, the coronavirus disease 2019 (COVID-19) pandemic has emerged as an unprecedented health care crisis. The spread of COVID-19 has been heterogeneous, resulting in some regions having sporadic transmission and relatively few hospitalized patients with COVID-19 and others having community transmission that has led to overwhelming numbers of severe cases. For these regions, health care delivery has been disrupted and compromised by critical resource constraints in diagnostic testing, hospital beds, ventilators, and health care workers who have fallen ill to the virus exacerbated by shortages of personal protective equipment. Although mild cases mimic common upper respiratory viral infections, respiratory dysfunction becomes the principal source of morbidity and mortality as the disease advances. Thoracic imaging with chest radiography and CT are key tools for pulmonary disease diagnosis and management, but their role in the management of COVID-19 has not been considered within the multivariable context of the severity of respiratory disease, pretest probability, risk factors for disease progression, and critical resource constraints. To address this deficit, a multidisciplinary panel comprised principally of radiologists and pulmonologists from 10 countries with experience managing patients with COVID-19 across a spectrum of health care environments evaluated the utility of imaging within three scenarios representing varying risk factors, community conditions, and resource constraints. Fourteen key questions, corresponding to 11 decision points within the three scenarios and three additional clinical situations, were rated by the panel based on the anticipated value of the information that thoracic imaging would be expected to provide. The results were aggregated, resulting in five main and three additional recommendations intended to guide medical practitioners in the use of chest radiography and CT in the management of COVID-19.


title: Family-Centered Care During the COVID-19 Era

text: Family support is more, not less, important during crisis. However, during the COVID-19 pandemic, maintaining public safety necessitates restricting the physical presence of families for hospitalized patients. In response, health systems must rapidly adapt family-centric procedures and tools to circumvent restrictions on physical presence. Strategies for maintaining family integrity must acknowledge clinicians' limited time and attention to devote to learning new skills. Internet-based solutions can facilitate the routine, predictable, and structured communication, which is central to family-centered care. But the reliance on technology may compromise patient privacy and exacerbate racial, socioeconomic, and geographic disparities for populations that lack access to reliable internet access, devices, or technological literacy. We provide a toolbox of strategies for supporting family-centered inpatient care during physical distancing responsive to the current clinical climate. Innovations in the implementation of family involvement during hospitalizations may lead to long-term progress in the delivery of family-centered care.


title: Natural compounds from Clerodendrum spp. as possible therapeutic candidates against SARS-CoV-2: An in silico investigation

text: The COVID-19 pandemic caused by the novel coronavirus SARS-CoV-2 has rattled global public health, with researchers struggling to find specific therapeutic solutions. In this context, the present study employed an in silico approach to assess the inhibitory potential of the phytochemicals obtained from GC-MS analysis of twelve Clerodendrum species against the imperative spike protein, main protease enzyme Mpro and RNA-dependent RNA polymerase (RdRp) of SARS-CoV-2. An extensive molecular docking investigation of the phytocompounds at the active binding pockets of the viral proteins revealed promising inhibitory potential of the phytochemicals taraxerol, friedelin and stigmasterol. Decent physicochemical attributes of the compounds in accordance with Lipinski's rule of five and Veber's rule further established them as potential therapeutic candidates against SARS-CoV-2. Molecular mechanics-generalized Born surface area (MM-GBSA) binding free energy estimation revealed that taraxerol was the most promising candidate displaying the highest binding efficacy with all the concerned SARS-CoV-2 proteins included in the present analysis. Our observations were supported by robust molecular dynamics simulations of the complexes of the viral proteins with taraxerol for a timescale of 40 nanoseconds. It was striking to note that taraxerol exhibited better binding energy scores with the concerned viral proteins than the drugs that are specifically targeted against them. The present results promise to provide new avenues to further evaluate the potential of the phytocompound taraxerol in vitro and in vivo towards its successful deployment as a SARS-CoV-2 inhibitor and combat the catastrophic COVID-19.Communicated by Ramaswamy H. Sarma.


Nationwide survey of COVID-19 prevention measures in Japanese radiotherapy departments via online questionnaire for radiation oncologists


From Hendra to Wuhan: what has been learned in responding to emerging zoonotic viruses


title: The different tests for the diagnosis of COVID-19 - A review in Brazil so far

text: SARS-CoV-2 is a novel virus from the coronavirus family that emerged in the end of December 2019 in Wuhan, China. The virus is now widespread and causing the current pandemic of COVID-19, a highly pathogenic viral pneumonia, commonly presented with fever and cough, which frequently lead to lower respiratory tract disease with poor clinical outcomes associated with older age and underlying health conditions. Supportive care for patients is typically the standard protocol because no specific effective antiviral therapies have been identified so far. The current outbreak is challenging governments and health authorities all over the world. In here we present a comparison among the current diagnostic tools and kits being used to test Brazilian population.


title: Tocilizumab Treatment for Cytokine Release Syndrome in Hospitalized COVID-19 Patients: Survival and Clinical Outcomes

text: BACKGROUND: Tocilizumab, an IL-6 receptor antagonist, can be used to treat cytokine release syndrome (CRS), with observed improvements in a coronavirus disease 2019 (COVID-19) case series. RESEARCH QUESTION: The goal of this study was to determine if tocilizumab benefits patients hospitalized with COVID-19. STUDY DESIGN AND METHODS: This observational study of consecutive COVID-19 patients hospitalized between March 10, 2020, and March 31, 2020, and followed up through April 21, 2020, was conducted by chart review. Patients were treated with tocilizumab using an algorithm that targeted CRS. Survival and mechanical ventilation (MV) outcomes were reported for 14 days and stratified according to disease severity designated at admission (severe, ≥ 3 L supplemental oxygen to maintain oxygen saturation > 93%). For tocilizumab-treated patients, pre/post analyses of clinical response, biomarkers, and safety outcomes were assessed. Post hoc survival analyses were conducted for race/ethnicity. RESULTS: Among the 239 patients, median age was 64 years; 36% and 19% were black and Hispanic, respectively. Hospital census increased exponentially, yet MV census did not. Severe disease was associated with lower survival (78% vs 93%; P < .001), greater proportion requiring MV (44% vs 5%; P < .001), and longer median MV days (5.5 vs 1.0; P = .003). Tocilizumab-treated patients (n = 153 [64%]) comprised 90% of those with severe disease; 44% of patients with nonsevere disease received tocilizumab for evolving CRS. Tocilizumab-treated patients with severe disease had higher admission levels of high-sensitivity C-reactive protein (120 vs 71 mg/L; P < .001) and received tocilizumab sooner (2 vs 3 days; P < .001), but their survival was similar to that of patients with nonsevere disease (83% vs 91%; P = .11). For tocilizumab-treated patients requiring MV, survival was 75% (95% CI, 64-89). Following tocilizumab treatment, few adverse events occurred, and oxygenation and inflammatory biomarkers (eg, high-sensitivity C-reactive protein, IL-6) improved; however, D-dimer and soluble IL-2 receptor (also termed CD25) levels increased significantly. Survival in black and Hispanic patients, after controlling for age, was significantly higher than in white patients (log-rank test, P = .002). INTERPRETATION: A treatment algorithm that included tocilizumab to target CRS may influence MV and survival outcomes. In tocilizumab-treated patients, oxygenation and inflammatory biomarkers improved, with higher than expected survival. Randomized trials must confirm these findings.


The "helmet bundle" in COVID-19 patients undergoing non invasive ventilation


title: Threatening drug-drug interaction in a kidney transplant patient with Coronavirus Disease 2019 (COVID-19)

text: During the novel coronavirus pandemic, organ transplant recipients represent a frail susceptible category due to long-term immunosuppressive therapy. For this reason, clinical manifestations may differ from general population and different treatment approaches may be needed. We present the case of a 36-year-old kidney transplanted woman affected by Senior-Loken syndrome diagnosed with COVID-19 pneumonia after a contact with her positive mother. Initial symptoms were fatigue, dry cough and coryza; she never had fever nor oxygen supplementation. Hydroxychloroquine and lopinavir/ritonavir were started, and the antiviral drug was replaced with darunavir/cobicistat after two days for diarrhea. Immunosuppressant levels were closely monitored, and we observed very high tacrolimus trough levels despite initial dose reduction. The patient was left with steroid therapy alone. The peculiarity of clinical presentation and the management difficulties represent the flagship of our case-report. We stress the need for guidelines in transplant recipients with COVID-19 infection with particular regard to the management of therapy.


History in a Crisis - Lessons for Covid-19


title: Nursing Informatics and School Nursing: Specialists Wanted

text: Hospitals and healthcare systems have nursing informaticists who contribute to quality patient care and safety by managing data and facilitating the use of technology. Schools typically do not employ nurses specifically in positions labeled as nursing informaticists, though the role is critical in the schools. This article highlights the subspecialty of nursing informatics within the school nurse role. Three school nurses will share their use of nursing informatics skills to optimize student health.


title: Abrupt declines in tropospheric nitrogen dioxide over China after the outbreak of COVID-19

text: China's policy interventions to reduce the spread of the coronavirus disease 2019 have environmental and economic impacts. Tropospheric nitrogen dioxide indicates economic activities, as nitrogen dioxide is primarily emitted from fossil fuel consumption. Satellite measurements show a 48% drop in tropospheric nitrogen dioxide vertical column densities from the 20 days averaged before the 2020 Lunar New Year to the 20 days averaged after. This is 20% larger than that from recent years. We relate to this reduction to two of the government's actions: the announcement of the first report in each province and the date of a province's lockdown. Both actions are associated with nearly the same magnitude of reductions. Our analysis offers insights into the unintended environmental and economic consequences through reduced economic activities.


title: Population dynamics of Prochilodus nigricans (Characiformes: Prochilodontidae) in the Putumayo River

text: The black prochilodus (Prochilodus nigricans) is one of the most landed scaled fish species of the middle and upper parts of the Putumayo River, in the tri-national area between Colombia, Ecuador and Peru. Despite its importance, biological information about this species is too scant to guide fisheries management in this portion of the Colombian Amazon. In this study, 10884 individuals were sampled in the fish markets of Puerto Leguízamo between 2009 and 2017. This sampling was used to document reproductive patterns, but also growth and mortality parameters from length frequency distributions. The size at which all fish were mature was 22 cm Ls, which should be the established as the minimum size of capture to ensure that all fish have had a chance to reproduce before being caught. Growth and mortality parameters indicated a slower growth in the Putumayo than in other Amazonian rivers and a relatively high exploitation rate.(AU)


SARS-CoV-2 was found in the bile juice from a patient with severe COVID-19


text: SARS-CoV-2 has infected over 170,000 people worldwide and was associated with substantial mortality. Previous studies have reported that the SARS-CoV-2 could be detected in sputum, faeces, urine and other specimens from COVID-19 patients. In the case report, the novel coronavirus was found in the bile specimen from a patient with severe COVID-19 by real-time fluorescent RT-PCR. In addition, much higher viral load in the bile juice than in the sputum indicated that a false positive error in the specimen was hardly possible. As far as we know, it is the first report about SARS-CoV-2 in the bile juice. We would love to share the information to other researchers. The report may have a significant impact on the clinical management and public health decision making. This article is protected by copyright. All rights reserved.


Virtual dermatopathology: A potential educational tool during COVID-19 pandemic


'And breathe '? The sociology of health and illness in COVID-19 time


Pflegeforschung zu COVID-19: Aus den Versäumnissen der Vergangenheit für die Zukunft lernen


Medical and gastroenterological education during the COVID-19 outbreak


title: Strategies to halt 2019 novel coronavirus (SARS-CoV-2) spread for organ transplantation programs at the Sichuan Academy of Medical Science and Sichuan Provincial People's Hospital, China

text: During the 2019 novel coronavirus (SARS-CoV-2) outbreak in China (from January 24 to March 11, 2020), our center performed 16 organ transplants (10 kidney, 4 liver, and 2 lung transplants) harvested from deceased donors. Regarding the strategies to prevent infections of SARS-CoV-2, we implemented specific measures for the donor and recipient management, as well as prevention of hospital-acquired infections. All 16 organ recipients had a favorable outcome without SARS-CoV-2 infection. Our approaches aiming to interrupt the spread of SARS-CoV-2 within the transplantation wards were successful, and allowed us to maintain the transplantation program for deceased liver, kidney, and lung organ recipients.


docid: wztxnvkv

title: Influence of wind and relative humidity on the social distancing effectiveness to prevent COVID-19 airborne transmission: A numerical study

text: It has been confirmed that the coronavirus disease 2019 (COVID-19) can transmit through droplets created when an infected human coughs or sneezes. Accordingly, 1.83-m (6-feet) social distancing is advised to reduce the spread of the disease among humans. This is based on the assumption that no air circulation exists around people. However, it is not well investigated whether the ambient wind and relative humidity (RH) will cause SARS-CoV-2 laden droplets to transport farther in the air, making the current social distancing policy insufficient. To provide evidence and insight into the "social distancing" guidelines, a validated computational fluid-particle dynamics (CFPD) model was employed to simulate the transient transport, condensation/evaporation, and deposition of SARS-CoV-2 laden droplets emitted by coughs, with different environmental wind velocities and RHs. Initial droplet diameters range from 2 to 2000â¯µm, and the wind velocities range from 0 to 16â¯km/h, representing different wind forces from calm air to moderate breeze. The comparison between a steady-state wind and a gust with a constant frequency has also been performed. Ambient RHs are 40% and 99.5%. The distances between the two virtual humans are 1.83â¯m and 3.05â¯m (6 feet and 10 feet). The facial covering effect on reducing the airborne transmission of the cough droplets has also been evaluated. Numerical results indicate that the ambient wind will enhance the complexity of the secondary flows with recirculation between the two virtual humans. Microdroplets follow the airflow streamlines well and deposit on both human bodies and head regions, even with the 3.05-m (10-feet) separation distance. The rest of the microdroplets can transport in the air farther than 3.05â¯m (10 feet) due to wind convection, causing a potential health risk to nearby people. High RH will increase the droplet sizes due to the hygroscopic growth effect, which increases the deposition fractions on both humans and the ground. With the complex environmental wind and RH conditions, the 6-feet social distancing policy may not be sufficient to protect the inter-person aerosol transmission, since the suspending micro-droplets were influenced by convection effects and can be transported from the human coughs/sneezes to the other human in less than 5â¯s. Thus, due to the complex real-world environmental ventilation conditions, a social distance longer than 6 feet needs to be considered. Wearing masks should also be recommended for both infected and healthy humans to reduce the airborne cough droplet numbers.


Letter to the Editor Re: Coronavirus disease 2019: The harms of exaggerated information and nonevidence-based measures


COVID-19 in long-term care facilities: An upcoming threat that cannot be ignored


The equity of remote-access open-book examinations during Covid-19 and beyond: Medical students' perspective


docid: ksuthspb

title: First considerations on the SARS-CoV-2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy


title: Nitrogen sources associated with different physical forms of corn grain in the diet for steers in feedlot/ Fontes nitrogenadas associadas a diferentes formas físicas do grão de milho na dieta de novilhos confinados

text: This study evaluated the substitution of soybean meal with non-protein nitrogen sources, in combination with ground or whole corn for feedlot cattle. Fifty-four Charolais x Nellore steers with 22 ± 0.23 months and 250 ± 15.80 kg were assigned to a 3 x 2 factorial completely randomized experimental design. The treatments consisted of different combinations of concentrate formulation: soybean meal with whole or ground corn, conventional urea with whole or ground corn, and protected urea with whole or ground corn. There was interaction between nitrogen source and collection date for serum albumin, with increasing elevation for soybean meal; while there was elevation from day 0 to day 84, stabilizing until the slaughter, for urea. Higher intakes of dry matter and crude protein, daily weight gain and rumination efficiency were observed for soybean meal. Steers that received protect urea spent more time to feed, in comparison to soybean meal. Longer idle time was verified for soybean meal; while conventional urea was superior to protected urea. Replacing soybean meal by sources of non-protein nitrogen limits the results of blood metabolites, performance and ingestive behavior.(AU)


title: RT-LAMP for rapid diagnosis of coronavirus SARS-CoV-2

text: The pandemic coronavirus SARS-CoV-2 in the world has caused a large infected population suffering from COVID-19. To curb the spreading of the virus, WHO urgently demanded an extension of screening and testing; thus, a rapid and simple diagnostic method is needed. We applied a reverse transcription-loop-mediated isothermal amplification (RT-LAMP) to achieve the detection of SARS-CoV-2 in 30 min. We designed four sets of LAMP primers (6 primers in each set), targeting the viral RNA of SARS-CoV-2 in the regions of orf1ab, S gene and N gene. A colorimetric change was used to report the results, which enables the outcome of viral RNA amplification to be read by the naked eye without the need of expensive or dedicated instrument. The sensitivity can be 80 copies of viral RNA per ml in a sample. We validated the RT-LAMP method in a hospital in China, employing 16 clinic samples with 8 positives and 8 negatives. The testing results are consistent with the conventional RT-qPCR. In addition, we also show that one-step process without RNA extraction is feasible to achieve RNA amplification directly from a sample. This rapid, simple and sensitive RT-LAMP method paves a way for a large screening at public domain and hospitals, particularly regional hospitals and medical centres in rural areas.


title: Self-reported Impact of Respirator Use on Healthcare Worker Ability to Perform Patient Care

text: In a study of 1152 healthcare workers surveyed prior to the COVID-19 pandemic, most disagreed that respiratory protective equipment use interferes with patient care but reported that it would affect respirator use compliance if it did. A patient's fear reaction variably influenced self-reported healthcare worker compliance with respirator use. Strategies to improve protective equipment design may remove potential barriers to respirator use and allow better healthcare worker-patient relationships.


title: Why have nanotechnologies been underutilized in the global uprising against the coronavirus pandemic?

text: Prior research on nanotechnologies in diagnostics, prevention and treatment of coronavirus infections is reviewed. Gold nanoparticles and semiconductor quantum dots in colorimetric and immunochromatographic assays, silica nanoparticles in a polymerase chain reaction and spike protein nanospheres as antigen carriers and adjuvants in vaccine formulations present notable examples in diagnostics and prevention, while uses of nanoparticles in coronavirus infection treatments have been merely sporadic. The current absence of antiviral therapeutics that specifically target human coronaviruses, including SARS-CoV-2, might be largely due to the underuse of nanotechnologies. Elucidating the interface between nanoparticles and coronaviruses is timely, but presents the only route to the rational design of precisely targeted therapeutics for coronavirus infections. Such a fundamental approach is also a viable prophylaxis against future pandemics of this type.


Encephalitis Associated with COVID-19 Infection in an 11-Year-Old Child


Prévention de la Covid-19 après le confinement : pour un retour rapide « à la vie d'avant ¼


Response to: "Risks of hydroxychloroquine use for COVID-19 prophylaxis"


Annulation du congrès annuel de la SIFUD-PP et nouvelles dates des futurs événements./ [Cancellation of the annual SIFUD-PP congress and upcoming dates]


Tracheal trauma after difficult airway management in morbidly obese patients with COVID-19


title: COVID-19 and heme oxygenase: novel insight into the disease and potential therapies

text: The COVID-19 pandemic needs therapies that are presently available and safe. We propose that subjects with metabolic syndrome, old age, and male gender have the greatest morbidity and mortality and have low stress proteins, in particular, low intracellular heme oxygenase (HO-1), making them particularly vulnerable to the disease. Additionally, COVID-19's heme reduction may contribute to even lower HO-1. Low-grade inflammation associated with these risk factors contributes to triggering a cytokine storm that spreads to multi-organ failure and near death. The high mortality of those treated with ventilator assistance may partially be explained by ventilator-induced inflammation. The cytoprotective and anti-inflammatory properties of HO-1 can limit the infection's damage. A paradox of COVID-19 hospital admissions data suggests that fewer cigarette-smokers are admitted compared with non-smokers in the general population. This unexpected observation may result from smoke induction of HO-1. Therapies with anti-viral properties that raise HO-1 include certain anesthetics (sevoflurane or isoflurane), hemin, estrogen, statins, curcumin, resveratrol, and melatonin. Controlled trials of these HO-1 inducers should be done in order to prevent or treat COVID-19 disease.


title: [Development and improvement of Chinese oral public health system]

text: The pandemic of COVID-19 in early 2020 is a big challenge to the mechanism of major epidemic prevention and control, the national public health management system, as well as medical and health resources in China. Going through the COVID-19 crisis, we should fully understand the problems and vulnerabilities of the current public health system in China, and it is imperative to deepen and strengthen the public health system which should be throughout whole life cycle and whole process. Oral cavity is the first portal of human body, while illness finds its way in by the mouth. Oral health is highly related to general health and quality of life. The outbreak has drawn the public's attention to the public health system. The establishment and improvement of the oral public health system with the concept of "public health with Chinese characteristics" should also attract people's attentions and thoughts. Furthermore it is urgent to recognize the importance of oral public health.


title: COVID-19 in older people: a rapid clinical review

text: INTRODUCTION: the COVID-19 pandemic poses a high risk to older people. The aim of this article is to provide a rapid overview of the COVID-19 literature, with a specific focus on older adults. We frame our findings within an overview of the disease and have also evaluated the inclusion of older people within forthcoming clinical trials. METHODS: we searched PubMed and bioRxiv/medRxiv to identify English language papers describing the testing, treatment and prognosis of COVID-19. PubMed and bioRxiv/medRxiv searches took place on 20 and 24 March 2020, respectively. RESULTS: screening of over 1,100 peer-reviewed and pre-print papers yielded n = 22 on COVID-19 testing, n = 15 on treatment and n = 13 on prognosis. Viral polymerase chain reaction (PCR) and serology are the mainstays of testing, but a positive diagnosis may be increasingly supported by radiological findings. The current evidence for the effectiveness of antiviral, corticosteroid and immunotherapies is inconclusive, although trial data are largely based on younger people. In addition to age, male gender and comorbidities, specific laboratory and radiology findings are important prognostic factors. Evidence suggests that social distancing policies could have important negative consequences, particularly if in place for an extended period. CONCLUSION: given the established association between increasing age and poor prognosis in COVID-19, we anticipate that this rapid review of the current and emergent evidence might form a basis on which future work can be established. Exclusion of older people, particularly those with comorbidities, from clinical trials is well recognised and is potentially being perpetuated in the field of current COVID-19 research.


title: Viral loads in throat and anal swabs in children infected with SARS-CoV-2

text: Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay on anal swabs was recently reported to be persistently positive even after throat testing was negative during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, data about the consistent performance of RT-PCR assay on throat and anal swabs remain limited in paediatric patients. Here, we retrospectively reviewed RT-PCR-testing results of 212 paediatric patients with suspected SARS-CoV-2 infection at Wuhan Children's Hospital. The diagnostic potential of these two types of specimens showed significant difference (positive rate: 78.2% on throat swabs vs. 52.6% on anal swabs, McNemar Test P = 0.0091) and exhibited a weak positive consistency (Kappa value was 0.311, P < 0.0001) in paediatric patients. Furthermore, viral loads detected on both throat and anal swabs also showed no significant difference (P = 0.9511) and correlation (Pearson r = 0.0434, P = 0.8406), and exhibited an inconsistent kinetic change through the course of SARS-CoV-2 infection. Besides, viral loads in the throat and anal swabs were correlated with different types of immune states, immune-reactive phase, and the resolution phase/immunologic tolerance, respectively. These findings revealed that RT-PCR-testing on throat and anal swabs showed significant difference for monitoring SARS-CoV-2 infection and correlated with different immune state in paediatric patients.


title: Age-dependent gender differences of COVID-19 in mainland China: comparative study

text: BACKGROUND: The ongoing pandemic of novel coronavirus disease 2019 (COVID-19) is challenging global public health system. Sex-differences in infectious diseases are a common but neglected problem. METHODS: We used the national surveillance database of COVID-19 in mainland China to compared gender differences in attack rate (AR), proportion of severe and critical cases (PSCC) and case fatality rate (CFR) in relation to age, affected province, and onset-to-diagnosis interval. RESULTS: The overall AR was significantly higher in female population than in males (63.9 versus 60.5 per million persons; P Ë .001). By contrast, PSCC and CFR were significantly lower among female patients (16.9% and 4.0%) than among males (19.5% and 7.2%), with ORs of 0.87 and 0.57, respectively (both P Ë .001). The female-to-male differences were age-dependent, which were significant among people aged 50-69 years for AR, and in the patients of 30-years or older for both PSCC and CFR (all P ≤ .001). The AR, PSCC and CFR varied greatly from province to province. However, female-to-male differences in AR, PSCC and CFR were significant in the epicenter, Hubei province, where 82.2% confirmed cases and 97.4% deaths occurred. After adjusting for age, affected province and onset-to-diagnosis interval, the female-to-male difference in AR, PSCC and CFR remained significant in multivariate logistic regression analyses. CONCLUSIONS: We elucidate an age-dependent gender dimorphism for COVID-19, in which the females have higher susceptibility but lower severity and fatality. Further epidemiological and biological investigations are required to better understand the sex-specific differences for effective interventions.


The time is now: expedited HIV differentiated service delivery during the COVID-19 pandemic


Justification of the Safety and Efficacy of Angiotensin II for the Treatment of SARS-CoV-Induced Shock


title: EpiMob: Interactive Visual Analytics of Citywide Human Mobility Restrictions for Epidemic Control

text: The coronavirus disease 2019 (COVID-19) outbreak has swept more than 180 countries and territories since late January 2020. As a worldwide emergency response, governments have taken various measures and policies such as self-quarantine, travel restriction, work at home, and region lockdown, to control the rapid spread of this epidemic. The common concept of these countermeasures is to conduct human mobility restrictions as COVID-19 is a highly contagious disease with human-to-human transmission. It becomes an urgent request from medical experts and policymakers to effectively evaluate the effects of human restriction policies with the aid of big data and information technology. Thus, in this study, based on big human mobility data and city POI data, we design an interactive visual analytics system called EpiMob (Epidemic Mobility) to intuitively demonstrate and simulate how the human mobility, as well as the number of infected people, will change according to a certain restriction policy or a combination of policies. EpiMob is made up of a set of coupled modules: a data processing module for data cleansing, interpolation, and indexing; a simulation module based on a modified trajectory-based SEIR model; an interaction visualization module to interactively visualize the analytical results in light of user's settings. Through multiple case studies for the biggest city of Japan (i.e., Tokyo) and domain expert interviews, we demonstrate that our system can be beneficial to give an illustrative insight in measuring and comparing the effects of different human mobility restriction policies for epidemic control.


COVID-19 paranoia in a patient suffering from schizophrenic psychosis - a case report


A perfect storm: Root cause analysis of supra-therapeutic anticoagulation with vitamin K antagonists during the COVID-19 pandemic


Coronavirus Disease 2019 Pandemic - Public Health Preparedness in Nepal and One Health Approach


title: Retrospective Study of Risk Factors for Myocardial Damage in Patients with Critical Coronavirus Disease 2019, in Wuhan

text: Background The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens human health and the mortality rate is higher in patients who develop myocardial damage. However, the possible risk factors for myocardial damage in patients with coronavirus disease 2019 (COVID-19) are not fully known. Methods and Results Critical type patients were selected randomly from 204 confirmed COVID-19 cases occurring in Renmin Hospital of Wuhan University, from February 1, 2020 to February 24, 2020. Univariate analyses were used to compare the two groups: the myocardial damage group and the non-myocardial damage group. A total of 82 critical patients with COVID-19 were recruited: 34 with myocardial damage and 48 without myocardial damage. Thirty patients died in the myocardial damage group, and 20 died in the non-myocardial damage group. In univariate analysis, the proportion of elderly patients (>70 y: 70.59% vs 37.50%; P=0.003) and patients with cardiovascular disease (41.18% vs 12.50%; P=0.003) was higher among myocardial damage patients than among non-myocardial damage patients. Multivariate analysis showed that age>70 years old (HR 2.44, 95% CI 1.01-5.40), C-reactive protein greater than 100 mg/L (HR 1.92, 95% CI 0.94-3.92), lactate dehydrogenase greater than 300 U/L (HR 2.67, 95% CI 1.03-6.90), and lactic acid greater than 3 mmol/L (HR 3.25, 95% CI 1.57-6.75) were independent risk factors for myocardial damage in patients with COVID-19. Conclusions Old age (>70 years), C-reactive protein greater than 100 mg/L, lactate dehydrogenase greater than 300 U/L and lactic acid greater than 3 mmol/L are high-risk factors related to myocardial damage in critical patients with COVID-19.


India's COVID-19 Testing Strategy: Why Pediatric Hospitals Need to Focus More on ILI than SARI?


Internal Hernia in the Times of COVID-19: to Laparoscope or Not to Laparoscope?


A potential role for integrins in host cell entry by SARS-CoV-2


Clinical and Imaging features of COVID-19 Patients: Analysis of Data from High-Altitude Areas


title: Diagnosis and Management of First Case of COVID-19 in Canada: Lessons applied from SARS

text: We report diagnosis and management of the first laboratory-confirmed case of coronavirus disease 2019 (COVID-19) hospitalized in Toronto, Canada. No healthcare-associated transmission occurred. In the face of a potential pandemic of COVID-19, we suggest sustainable and scalable control measures developed based on lessons learned from SARS.


Narcolepsy risk and COVID-19


Supporting more than one patient with a single mechanical ventilator: useful last resort or unjustifiable risk?


title: A single centre study of viral community-acquired pneumonia in children: No evidence of SARS-CoV-2 from October 2019 to March 2020

text: Pneumonia is an important cause of morbidity and mortality in children. We described viral aetiologies, with particular interest in detecting SARS-CoV-2, in hospitalized pneumonia children. Human rhinovirus was the most frequently detected agent. No children tested positive for SARS-CoV-2. Our findings suggest that SARS-CoV-2 infection is rare in children and it was not circulating in Rome before COVID-19 outbreak.


docid: bzvkirhl

title: The role of the radiologist in diagnosing the COVID-19 infection. Parma experiences

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new virus responsible for the coronavirus disease 2019 (COVID-19), a respiratory disease that ranges from an asymptomatic or mild flu-like illness to severe pneumonia, multiorgan failure, and death. Imaging might play an important role in clinical decision making by supporting rapid triage of patients with suspected COVID-19 and assessing supervening complications, such as super-added bacterial infection and thrombosis. Further studies will clarify the real impact of imaging on COVID-19 patients' management and the potential role of radiology in future outbreaks.


Tracheobronchitis signs observed on ventilation lung scintigraphy during the course of COVID-19 infection


Acute Pulmonary Embolism in COVID-19 Patients on CT Angiography and Relationship to D-Dimer Levels


Fear, Preparedness and Covid-19


Symptomatic COVID-19 in Eye Professionals in Wuhan, China


docid: ninlpuas

title: The changing face of family medicine in the COVID and post-COVID era

text: This article describes the prospective changes and the fundamental values of the relationships between family doctors, patients and community according to an ethical-social concept of medicine. New aspects of the organization of the activity and of the roles of family doctors are reported in order to build hypotheses pointing to a modern and efficient management of patients in the coming the post-COVID era.


What the NHS is learning from the British army in the covid-19 crisis


title: A Case Series of Patients Coinfected With Influenza and COVID-19

text: Coronavirus disease 2019, also called COVID-19, is a global pandemic resulting in significant morbidity and mortality worldwide. In the United States, influenza infection occurs mainly during winter and several factors influence the burden of the disease, including circulating virus characteristics, vaccine effectiveness that season, and the duration of the season. We present a case series of 3 patients with coinfection of COVID-19 and influenza, with 2 of them treated successfully and discharged home. We reviewed the literature of patients coinfected with both viruses and discussed the characteristics, as well as treatment options.


title: Efficient Inference of Nonparametric Interaction in Spiking-neuron Networks

text: Hawkes process provides an effective statistical framework for analyzing the time-dependent interaction of neuronal spiking activities. Although utilized in many real applications, the classical Hawkes process is incapable of modelling inhibitory interactions among neurons. Instead, the nonlinear Hawkes process allows for a more flexible influence pattern with excitatory or inhibitory interactions. In this paper, three sets of auxiliary latent variables (P\'{o}lya-Gamma variables, latent marked Poisson processes and sparsity variables) are augmented to make synapses connection weights in a Gaussian form, which allows for a simple iterative algorithm with analytical updates. As a result, an efficient expectation-maximization (EM) algorithm is derived to obtain the maximum a posteriori (MAP) estimate. We demonstrate the accuracy and efficiency performance of our algorithm on synthetic and real data. For real neural recordings, we show our algorithm can estimate the temporal dynamics of interaction and reveal the interpretable synaptic structure underlying neural spike trains.


Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia


Community participation is crucial in a pandemic


title: The early pattern of human corpus callosum development: A transvaginal 3D neurosonographic study

text: OBJECTIVE: to provide an in-vivo description of early corpus callosum (CC) development. METHODS: we reviewed 3D US volumes acquired transvaginally (TVUS) through the anterior fontanelle, between 14-17 weeks. The following landmarks were recognized: tela-choroidea (TC), foramina of Moro, early CC and the evolving cavum septi pellucidi. The following measurements were taken: total, anterior and posterior sections, and height of the CC (referenced to the anterior TC border). All measurements were correlated to both the gestational age and the transverse cerebellar diameter (TCD). RESULTS: Eighty nine volumes were included in the study (mean 15.1 weeks +/- 0.84, TCD range: 13.1-18.4 mm) with high inter and intra observer correlation of the measurements. We found high correlation between CC length and height, and TCD. The anterior segment of the CC appear earlier than the posterior one, and growth continues bi-directionally. Initially, the posterior elongation is significantly larger than the anterior one. Association of all CC measurements with TCD remained significant when co-varying for maternal age and fetal sex. CONCLUSIONS: imaging the fetal CC is feasible from 14 weeks by TVUS, by following the suggested insonation approach. The early CC develops bi-directionally, and the posterior elongation is more significant than the anterior one. This article is protected by copyright. All rights reserved.


COVID-19 Research in Brief: 11 April to 17 April, 2020


title: [Infection prevention and control of bedside blood purification treatment in patients with COVID-19]

text: OBJECTIVE: To explore the infection prevention and control strategy of bedside blood purification treatment in corona virus disease 2019 (COVID-19) isolation ward, and to evaluate the effect of infection prevention and control management measures. METHODS: We summarized and analyzed the clinical features, infection status, outcome and infection prevention and control measures of bedside blood purification treatment patients in COVID-19 isolation ward from February 8, 2020 to March 31, 2020, analyzed the COVID-19 cross-infection between the patients and medical staffs, and the blood-borne pathogens cross-infection situation between the patients, and analyzed the effect of bundle prevention and control measures in controlling the occurrence and spread of cross-infection. RESULTS: A total of 101 COVID-19 patients were hospitalized in this COVID-19 isolation ward, of whom 10 patients (9.90%) received bedside blood purification treatment and the blood purification treatment method was continuous hemodialysis filtration (CVVHDF), and the 10 patients received 79 times of blood purification treatment in total. The prevention and control management measures adopted included divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room air purification, object surfaces, medical devices and medical fabrics dis-infection management. There were no occurrence and spread of COVID-19 in the medical healthcare workers and blood-borne pathogens cross-infection in the patients. And all the twice throat swabs (two sampling interval > 1 day) of the medical staffs in COVID-19 virus nucleic acid test were negative. The 2 suspected COVID-19 patients' throat swab virus nucleic acid test and the COVID-19 IgG, IgM were always both negative, the chest CT showed no viral pneumonia. CONCLUSION: Bedside blood purification treatment in the COVID-19 isolation ward, the occurrence and spread of healthcare associated infection can be effectively controlled through effective infection prevention and control management, including divisional isolation, patient behavior isolation and patient placement, operator personal protection and hand hygiene, dialysis waste fluid disposal, isolation room's air purification, object surfaces, medical devices and medical fabrics disinfection, which can provide experience for diagnosis, treatment and prevention and control of patients in the respiratory infectious disease ward.


COVID-19 and a shifted perspective on infectious farm animal disease research


Proposed clinical guidance for orthodontists and orthodontic staff in the post-COVID-19 environment: a clinician's perspective


title: Forced Disruption of Anatomy Education in Australia and New Zealand: An Acute Response to the Covid-19 Pandemic

text: Australian and New Zealand universities commenced a new academic year in February/March 2020 largely with "business as usual." The subsequent Covid-19 pandemic imposed unexpected disruptions to anatomical educational practice. Rapid change occurred due to government-imposed physical distancing regulations from March 2020 that increasingly restricted anatomy laboratory teaching practices. Anatomy educators in both these countries were mobilized to adjust their teaching approaches. This study on anatomy education disruption at pandemic onset within Australia and New Zealand adopts a social constructivist lens. The research question was "What are the perceived disruptions and changes made to anatomy education in Australia and New Zealand during the initial period of the Covid-19 pandemic, as reflected on by anatomy educators?." Thematic analysis to elucidate "the what and why" of anatomy education was applied to these reflections. About 18 anatomy academics from ten institutions participated in this exercise. The analysis revealed loss of integrated "hands-on" experiences, and impacts on workload, traditional roles, students, pedagogy, and anatomists' personal educational philosophies. The key opportunities recognized for anatomy education included: enabling synchronous teaching across remote sites, expanding offerings into the remote learning space, and embracing new pedagogies. In managing anatomy education's transition in response to the pandemic, six critical elements were identified: community care, clear communications, clarified expectations, constructive alignment, community of practice, ability to compromise, and adapt and continuity planning. There is no doubt that anatomy education has stepped into a yet unknown future in the island countries of Australia and New Zealand.


title: Will the guidelines and recommendations for surgery during COVID-19 pandemic still be valid if it becomes endemic?

text: The current COVID-19 pandemic has impacted all the healthcare sectors all over the world. The WHO and various other health organizations have been issuing recommendations and guidelines for surgical practice and patient management during the current pandemic. Some of these guidelines include triaging of the patients, prioritizing emergency surgery and delaying the elective surgical procedures till the COVID-19 pandemic is over. However, it seems that COVID-19 might become endemic in the community and current guidelines might not hold true. Surgical practices cannot remain suspended forever as it will have a deleterious effect on surgeons and patients. Therefore we need novel guidelines so that the surgeons can resume their general surgical practice as soon as possible.


The use of Google Trends for acral symptoms during COVID-19 outbreak in France


title: Evaluating Incidence and Impact Estimates of the COVID-19 Outbreak from Wuhan before Lockdown

text: Background: Wuhan, China was the epicenter of COVID-19 pandemic. The goal of current study is to understand the infection transmission dynamics before intervention measures were taken. Methods: Data and key events were searched through pubmed and internet. Epidemiological data were calculated using data extracted from a variety of data sources. Results: We established a timeline showing by January 1, 2020, Chinese authorities had been presented convincing evidence of human-to-human transmission; however, it was not until January 20, 2020 that this information was shared with the public. Our study estimated that there would have been 10989 total infected cases if interventions were taken on January 2, 2020, versus 239875 cases when lockdown was put in place on January 23, 2020. Conclusions: China's withholding of key information about the 2020 COVID-19 outbreak and its delayed response ultimately led to the largest public health crisis of this century and could have been avoided with earlier countermeasures.


Could patients taking isotretinoin therapy be immune against SARS-CoV-2?


title: Protective role of ACE2 and its downregulation in SARS-CoV-2 infection leading to Macrophage Activation Syndrome: Therapeutic implications

text: In light of the outbreak of the 2019 novel coronavirus disease (COVID-19), the international scientific community has joined forces to develop effective treatment strategies. The Angiotensin-Converting Enzyme (ACE) 2, is an essential receptor for cell fusion and engulfs the SARS coronavirus infections. ACE2 plays an important physiological role, practically in all the organs and systems. Also, ACE2 exerts protective functions in various models of pathologies with acute and chronic inflammation. While ACE2 downregulation by SARS-CoV-2 spike protein leads to an overactivation of Angiotensin (Ang) II/AT1R axis and the deleterious effects of Ang II may explain the multiorgan dysfunction seen in patients. Specifically, the role of Ang II leading to the appearance of Macrophage Activation Syndrome (MAS) and the cytokine storm in COVID-19 is discussed below. In this review, we summarized the latest research progress in the strategies of treatments that mainly focus on reducing the Ang II-induced deleterious effects rather than attenuating the virus replication.


docid: pfsvdmaz

title: On the fallibility of simulation models in informing pandemic responses


Been there, done that - what now? New avenues for dealing with chronic pain


title: [Roles of the public-facility-turned temporary hospital in prevention and control of coronavirus disease 2019 in Wuhan, China and clinical experience in the hospital]

text: Since the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan, China, the public-facility-turned temporary hospital (PFTH) has played an important role in preventing the spread of the epidemic. Wuchang PFTH is the first one to put into clinical practice and the last one suspended in Wuhan. The National Emergency Medical Rescue Team of the Second Xiangya Hospital of Central South University, together with other 13 medical teams (841 medical staff in total), have fulfilled the task for the treatment of non-severe COVID-19 patients, without any medical staff infected. The first author of the article was the only pediatrician working in the Wuchang PFTH. The author describes and summarizes the features/functions, management/operations, and advantages/challenges of the PFTH, in order to provide reference for medical institutions and relevant departments to deal with public health emergencies.


title: COVID-19: From pathogenesis models to the first drug trials

text: The number of people infected with SARS-CoV-2, and sadly dying from COVID-19, has exploded, and so the amount of literature on the novel coronavirus and the disease it causes has increased proportionately. The case numbers in some countries are beyond the epidemic peak, but the uncertainty about a second wave keeps politicians and societies under pressure. Appropriate decision-making and winning support from the population depends on precise scientific information rather than leaving the field to scaremongers of all proveniences. This mini-review is an update of earlier reports (Brüssow, Microb Biotechnol 2020a;13:607; Brüssow, Microb Biotechnol 2020b; https://doi.org/10.1111/1751-7915.13592).


Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the neuroendocrine stress axis


title: Personal Safety during the COVID-19 Pandemic: Realities and Perspectives of Healthcare Workers in Latin America

text: Healthcare workers exposed to coronavirus (COVID-19) may not have adequate access to personal protective equipment (PPE), safety procedures, and diagnostic protocols. Our objective was to evaluate the reality and perceptions about personal safety among healthcare workers in Latin America. This is a cross-sectional, online survey-based study administered to 936 healthcare professionals in Latin America from 31 March 2020 to 4 April 2020. A 12-item structured questionnaire was developed. A total of 936 healthcare workers completed the online survey. Of them, 899 (95.1%) were physicians, 28 (2.9%) were nurses, and 18 (1.9%) were allied health professionals. Access to protective equipment was as follows: gel hand sanitizer (n = 889; 95%), disposable gloves (n = 853; 91.1%), disposable gowns (n = 630; 67.3%), disposable surgical masks (785; 83.9%), N95 masks (n = 516; 56.1%), and facial protective shields (n = 305; 32.6%). The vast majority (n = 707; 75.5%) had access to personal safety policies and procedures, and 699 (74.7%) participants had access to diagnostic algorithms. On a 1-to-10 Likert scale, the participants expressed limited human resources support (4.92 ± 0.2; mean ± SD), physical integrity protection in the workplace (5.5 ± 0.1; mean ± SD), and support from public health authorities (5.01 ± 0.12; mean ± SD). Healthcare workers in Latin America had limited access to essential PPE and support from healthcare authorities during the COVID-19 pandemic.


Medical conferences in the post-COVID world: a challenge, and an opportunity


Further Recommendations on Commutability Assessment