title: Can hyperimmune anti-CMV globulin substitute for convalescent plasma for treatment of COVID-19?

text: Information on treatment of COVID-19 infection in renal transplant recipients is scarce, especially in symptomatic patients and patients with recent major clinical events. This group of patients suffers from different opportunistic infections which may coexist with COVID-19. Currently available expert opinions suggest reduction of immunosuppression therapy for renal transplant recipients with symptomatic COVID-19 infection with either antiviral drugs, hydroxychloroquine and/or azithromycin. Inspired by our experience in treatment of CMV pneumonia and literature data on the potential benefit of convalescent plasma for treatment of different viral diseases we suggest use of the hyperimmune anti-CMV gamma globulins in addition to other available therapies. Besides the immunosuppression reduction which is supposed to be beneficial, immunoglobulins with their immunomodulatory effects and possible antiviral role, may increase a possibility for favorable outcome.


Mental Health Nurses are not quite 'all in this together': The struggle for equitable access to the Medicare Benefit Scheme


title: New onset of loss of smell or taste in household contacts of home-isolated SARS-CoV-2-positive subjects

text: PURPOSE: To estimate the prevalence of smell or taste impairment in household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. METHODS: Cross-sectional study based on ad hoc questions. RESULTS: Of 214 mildly symptomatic COVID-19 patients managed at home under self-isolation, 179 reported to have at least one household contact, with the total number of no study participants contacts being 296. Among 175 household contacts not tested for SARS-CoV-2 infection, 67 (38.3%) had SARS-CoV-2 compatible symptoms, 39 (22.3%) had loss of smell or taste with 7 (4.0%) having loss of smell or taste in the absence of other symptoms. The prevalence of smell or taste impairment was 1.5% in patients tested negative compared to 63.0% of those tested positive for SARS-CoV-2 (p < 0.001). CONCLUSION: Smell or taste impairment are quite common in not-tested household contacts of mildly symptomatic home-isolated SARS-CoV-2-positive patients. This should be taken into account when estimating the burden of loss of sense of smell and taste during COVID-19 pandemic, and further highlights the value of loss of sense of smell and taste as a marker of infection.


title: Automatic Detection of Coronavirus Disease (COVID-19) Using X-ray Images and Deep Convolutional Neural Networks

text: The 2019 novel coronavirus (COVID-19), with a starting point in China, has spread rapidly among people living in other countries, and is approaching approximately 12,245,417 cases worldwide according to the statistics of European Centre for Disease Prevention and Control. There are a limited number of COVID-19 test kits available in hospitals due to the increasing cases daily. Therefore, it is necessary to implement an automatic detection system as a quick alternative diagnosis option to prevent COVID-19 spreading among people. In this study, three different convolutional neural network based models (ResNet50, InceptionV3 and Inception-ResNetV2) have been proposed for the detection of coronavirus pneumonia infected patient using chest X-ray radiographs. ROC analyses and confusion matrices by these three models are given and analyzed using 5-fold cross validation. Considering the performance results obtained, it is seen that the pre-trained ResNet50 model provides the highest classification performance with 98% accuracy among other two proposed models (97% accuracy for InceptionV3 and 87% accuracy for Inception-ResNetV2).


title: A Deep Convolutional Neural Network for COVID-19 Detection Using Chest X-Rays

text: Purpose: We present image classifiers based on Dense Convolutional Networks and transfer learning to classify chest X-Ray images according to three labels: COVID-19, viral pneumonia and normal. Methods: We fine-tuned neural networks pretrained on ImageNet and applied a twice transfer learning approach, using NIH ChestX-Ray14 dataset as an intermediate step. We also suggested an output neuron keeping strategy. In order to clarify the modus operandi of the models, we used Layer-wise Relevance Propagation (LRP) to generate heatmaps. Results: We were able to reach state-of-the-art test accuracy (99.4%) and F1 Score (0.994). Twice transfer learning improved classification performances in the first half of the training process but, after many epochs, we could achieve the same results using common transfer learning. Output neuron keeping improved twice transfer learning performances. Although LRP showed that words on the X-Rays can influence the networks predictions, we discovered this had only a very small effect on accuracy. Conclusion: The state-of-the-art performances we achieved show that, with the help of artificial intelligence, chest X-Rays can become a cheap and accurate auxiliary method for COVID-19 diagnosis. heatmaps generated by LRP improve the interpretability of the deep neural networks and indicate an analytical path for future research on diagnosis.


title: COVID-MobileXpert: On-Device COVID-19 Screening using Snapshots of Chest X-Ray

text: With the increasing demand for millions of COVID-19 screenings, Computed Tomography (CT) based test has emerged as a promising alternative to the gold standard RT-PCR test. However, it is primarily provided in hospital setting due to the need for expensive equipment and experienced radiologists. An accurate, rapid yet inexpensive test that is suitable for COVID-19 population screenings at mobile, urgent and primary care clinics is urgently needed. We present COVID-MobileXpert: a lightweight deep neural network (DNN) based mobile app that can use noisy snapshots of chest X-ray (CXR) for point-of-care COVID-19 screening. We design and implement a novel three-player knowledge transfer and distillation (KTD) framework including a pre-trained attending physician (AP) network that extracts CXR imaging features from large scale of lung disease CXR images, a fine-tuned resident fellow (RF) network that learns the essential CXR imaging features to discriminate COVID-19 from pneumonia and/or normal cases using a small amount of COVID-19 cases, and a trained lightweight medical student (MS) network that performs on-device COVID-19 screening. To accommodate the need for screening using noisy snapshots of CXR images, we employ novel loss functions and training schemes for the MS network to learn the robust imaging features for accurate on-device COVID-19 screening. We demonstrate the strong potential of COVID-MobileXpert for rapid deployment via extensive experiments with diverse MS network architecture, CXR imaging quality, and tuning parameter settings. The source code of cloud and mobile based models are available from https://github.com/xinli0928/COVID-Xray.


[Suggestions for emergency operation of otorhinolaryngology head and neck during the period of prevention and control of 2019 novel coronavirus]


title: Fish diversity in the cascade of reservoirs along the Paranapanema River, southeast Brazil

text: The Paranapanema River is a major tributary of the upper Paraná river basin. Eleven hydropower dams regulate its main course, but no study has investigated fish diversity in these impoundments at the basin-scale. The present study investigated spatial patterns of richness, composition, and abundance of native (non-migratory and migratory) and non-native fishes in the cascade of reservoirs along the Paranapanema River. The study is based on data collected from 34 independent studies conducted in nine reservoirs (47 samples). The compilation recorded 161 species, being 111 native (14 migratory) and 50 non-native. Total richness ranged between 56 and 112 species/reservoir, with a mean of 72 (49.9 non-migratory, 8.1 migratory and 14 non-native). The number of non-migratory species showed no spatial trend along the cascade system, but migratory and non-native richness increased toward downstream reaches. We also observed spatial variation in species composition along the cascade system, but some non-native fishes were widely distributed. Migratory fishes showed low relative abundance (usually < 10%), while non-native species were common and more abundant, especially in reservoirs downstream. Our results revealed a high diversity of fishes in the cascade of impoundments, but indicated that migratory fishes are rare, while non-native species are common or dominant.(AU)


Response to SARS-Covid-19-related visitor restrictions on labor and delivery wards in New York City


[Practice and Reflection on the Battle against COVID-19 by Guangdong Medical Aid Team in the city of Honghu]


title: Biochemical evidences for M1-, M17- and M18-like aminopeptidases in marine invertebrates from Cuban coastline

text: Metallo-aminopeptidases (mAPs) control many physiological processes. They are classified in different families according to structural similarities. Neutral mAPs catalyze the cleavage of neutral amino acids from the N-terminus of proteins or peptide substrates; they need one or two metallic cofactors in their active site. Information about marine invertebrate's neutral mAPs properties is scarce; available data are mainly derived from genomics and cDNA studies. The goal of this work was to characterize the biochemical properties of the neutral APs activities in eight Cuban marine invertebrate species from the Phyla Mollusca, Porifera, Echinodermata, and Cnidaria. Determination of substrate specificity, optimal pH and effects of inhibitors (1,10-phenanthroline, amastatin, and bestatin) and cobalt on activity led to the identification of distinct neutral AP-like activities, whose biochemical behaviors were similar to those of the M1 and M17 families of mAPs. Additionally, M18-like glutamyl AP activities were detected. Thus, marine invertebrates express biochemical activities likely belonging to various families of metallo-aminopeptidases.


Teaching Public Health Will Never Be the Same


title: Fate of respiratory droplets in tropical vs temperate environments and implications for SARS-CoV-2 transmission

text: The new pandemic of SARS-CoV-2 has shown stark differences in number of affected patients between countries in the tropics and those with temperate environments. Though there have been many theories on reasons for these differences, we hypothesise that this could be due to differences in the fate of respiratory droplets in the two environments. A simple understanding of the mechanics of droplet size, dispersion and displacement could help infection control and public health measures to minimize spread and mitigate the risk of people getting infected especially in hotspots like hospital environments or other closed spaces. This paper discusses the possibility of differences in number of infections and spread between different countries based on the spread of droplets.


Das MDK-Reformgesetz mit allen nachfolgenden Änderungen : In der Fassung des Zweiten Gesetzes zum Schutz der Bevölkerung bei einer epidemischen Lage von nationaler Tragweite./ [The MDK Reform Act with all subsequent amendments : As amended by the Second Act for the Protection of the Population in the Event of an Epidemic Situation of National Significance]


The Invisible Hand - Medical Care during the Pandemic


Online mental health services in Indonesia during the COVID-19 outbreak


In Reply: COVID-19 Infection Affects Surgical Outcome of Chronic Subdural Hematoma


Endonasal drilling may be employed safely in the COVID-19 era


COVID-19 disease in children: not as mild as we have been led to believe


title: Bioengineering tools to speed up the discovery and preclinical testing of vaccines for SARS-CoV-2 and therapeutic agents for COVID-19

text: This review provides an update for the international research community on the cell modeling tools that could accelerate the understanding of SARS-CoV-2 infection mechanisms and could thus speed up the development of vaccines and therapeutic agents against COVID-19. Many bioengineering groups are actively developing frontier tools that are capable of providing realistic three-dimensional (3D) models for biological research, including cell culture scaffolds, microfluidic chambers for the culture of tissue equivalents and organoids, and implantable windows for intravital imaging. Here, we review the most innovative study models based on these bioengineering tools in the context of virology and vaccinology. To make it easier for scientists working on SARS-CoV-2 to identify and apply specific tools, we discuss how they could accelerate the discovery and preclinical development of antiviral drugs and vaccines, compared to conventional models.


title: [Effectiveness of the contingency plan of the internal inflammatory disease unit before Covid-19 infection.]

text: OBJECTIVE: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnés METHODS: A team of managers and professionals adapted the 10 measures recommended by Deloitte to face a pandemic to the healthcare environment The measures were then formulated as a checklist From the Plan-Do-Check-Act improvement cycle, they were grouped into categories: risk management, organizational management and decision-making Finally, an external team carried out a qualitative evaluation of the implementation of the contingency plan carried out RESULTS: The Intestinal Inflammatory Disease Unit of the Digestive Service has obtained an assessment of compliance with the 10 recommended measures to confidently face a pandemic CONCLUSIONS: Sharing the deployment of the contingency plan and its results is useful to identify good practices This article shows a method to evaluate decision-making in pandemic situations The outcomes faces the The Intestinal Inflammatory Disease Unit in an excelent position


title: Effectiveness of the contingency plan of the internal inflammatory disease unit before Covid-19 infection./ Efectividad del plan de contingencia de la Unidad de Enfermedad Inflamatoria Intestinal ante la infeccion de Covid-19

text: OBJECTIVE: Decision making in hospitals, and especially in their own healthcare services, is hardly referenced in the literature During the pandemic period, healthcare services have put in place contingency plans to minimize the consequences of the coronavirus on professionals and patients However, the deployment of contingency plans and results are hardly shared, depriving other services of references to refute, compare or emulate the aforementioned plans The objective of this work was the description of the implementation and evaluation of Contingency Plans in the Covid-19 pandemic in a unit of inflammatory bowel disease of a Digestive Service in the Sanitary Area of Pontevedra and O Salnes METHODS: A team of managers and professionals adapted the 10 measures recommended by Deloitte to face a pandemic to the healthcare environment The measures were then formulated as a checklist From the Plan-Do-Check-Act improvement cycle, they were grouped into categories: risk management, organizational management and decision-making Finally, an external team carried out a qualitative evaluation of the implementation of the contingency plan carried out RESULTS: The Intestinal Inflammatory Disease Unit of the Digestive Service has obtained an assessment of compliance with the 10 recommended measures to confidently face a pandemic CONCLUSIONS: Sharing the deployment of the contingency plan and its results is useful to identify good practices This article shows a method to evaluate decision-making in pandemic situations The outcomes faces the The Intestinal Inflammatory Disease Unit in an excelent position OBJETIVO: La toma de decisiones en los hospitales y en sus propios servicios asistenciales apenas esta referenciada en la literatura Durante el periodo de pandemia por Covid-19, los servicios asistenciales han puesto en marcha planes de contingencia para minimizar las consecuencias del coronavirus en los profesionales y pacientes Sin embargo, apenas se comparte el despliegue de esos planes de contingencia, ni sus resultados, privando de referencias para refutar, comparar o emular los citados planes a otros servicios asistenciales u hospitales El objetivo del trabajo fue la descripcion de la puesta en marcha de dichos planes ante la pandemia de Covid-19 en la Unidad de Enfermedad Inflamatoria Intestinal de un Servicio de Digestivo en el Area Sanitaria de Pontevedra e O Salnes (Galicia) METODOS: Un equipo de directivos y profesionales adaptaron al entorno sanitario las 10 medidas recomendadas por Deloitte para afrontar una pandemia A continuacion, se formularon las medidas como listado de comprobacion A partir del ciclo de mejora Plan-Do-Check-Act, se agruparon las 10 medidas en las siguientes categorias: gestion del riesgo, gestion organizacional y toma de decisiones Por ultimo, un equipo externo realizo una evaluacion cualitativa de la puesta en marcha del plan de contingencia realizado RESULTADOS: La Unidad de Enfermedad Inflamatoria Intestinal del Servicio de Digestivo realizo un plan de contingencia que presenta un cumplimiento de las 10 medidas recomendadas para hacer frente a la pandemia de Covid-19 con garantias CONCLUSIONES: Compartir el despliegue del plan de contingencia y sus resultados es util para identificar buenas practicas Este trabajo ofrece un metodo para evaluar las tomas de decisiones en los plantes de contingencia en situaciones de pandemia Los resultados situan a la Unidad de Enfermedad Inflamatoria Intestinal en el rango de la excelencia


title: A Commentary on Safety Precautions for Otologic Surgery during the COVID-19 Pandemic

text: There are insufficient data regarding the safety of otologic procedures in the setting of the coronavirus disease 2019 (COVID-19) pandemic. Given the proclivity for respiratory pathogens to involve the middle ear and the significant aerosolization associated with many otologic procedures, safety precautions should follow current recommendations for procedures involving the upper airway. Until preoperative diagnostic testing becomes standardized and readily available, elective cases should be deferred and emergent/urgent cases should be treated as high risk for COVID-19 exposure. Necessary otologic procedures on positive, suspected, or unknown COVID-19 status patients should be performed using enhanced personal protective equipment, including an N95 respirator and eye protection or powered air-purifying respirator (PAPR, preferred), disposable cap, disposable gown, and gloves. Powered instrumentation should be avoided unless absolutely necessary, and if performed, PAPR or sealed eye protection is recommended.


Case Report of a SARS-CoV-2 Infection in a Patient With Ulcerative Colitis on Tofacitinib


title: Investigation of Nosocomial SARS-CoV-2 Transmission from Two Patients to Health Care Workers Identifies Close Contact but not Airborne Transmission Events

text: OBJECTIVE: To describe the pattern of transmission of SARS-CoV-2 during 2 nosocomial outbreaks of COVID-19 with regard to the possibility of airborne transmission. DESIGN: Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. SETTING: A community hospital and university medical center in the United States, in February and March, 2020, early in the COVID-19 pandemic. PATIENTS: Two index patients and 421 exposed health care workers. METHODS: Exposed staff were identified by analyzing the EMR and conducting active case finding in combination with structured interviews. Staff were tested for COVID-19 by obtaining oropharyngeal/nasopharyngeal specimens, with RT-PCR testing to detect SARS-CoV-2. RESULTS: Two separate index patients were admitted in February and March 2020, without initial suspicion for COVID-19 and without contact or droplet precautions in place; both patients underwent several aerosol generating procedures in this context. A total of 421 health care workers were exposed in total, and the results of the case contact investigations identified 8 secondary infections in health care workers. In all 8 cases, the staff had close contact with the index patients without sufficient personal protective equipment. Importantly, despite multiple aerosol generating procedures, there was no evidence of airborne transmission. CONCLUSION: These observations suggest that, at least in a healthcare setting, a majority of SARS-CoV-2 transmission is likely to take place during close contact with infected patients through respiratory droplets, rather than by long-distance airborne transmission.


Potential inhibitors against 2019-nCoV coronavirus M protease from clinically approved medicines


Non-contact tonometer use during the COVID-19 pandemic


title: Assessment of Lockdown Effect in Some States and Overall India: A Predictive Mathematical Study on COVID-19 Outbreak

text: In the absence of neither an effective treatment or vaccine and with an incomplete understanding of the epidemiological cycle, Govt. has implemented a nationwide lockdown to reduce COVID-19 transmission in India. To study the effect of social distancing measure, we considered a new mathematical model on COVID-19 that incorporates lockdown effect. By validating our model to the data on notified cases from five different states and overall India, we estimated several epidemiologically important parameters as well as the basic reproduction number ($R_{0}$). Combining the mechanistic mathematical model with different statistical forecast models, we projected notified cases in the six locations for the period May 17, 2020, till May 31, 2020. A global sensitivity analysis is carried out to determine the correlation of two epidemiologically measurable parameters on the lockdown effect and also on $R_{0}$. Our result suggests that lockdown will be effective in those locations where a higher percentage of symptomatic infection exists in the population. Furthermore, a large scale COVID-19 mass testing is required to reduce community infection. Ensemble model forecast suggested a high rise in the COVID-19 notified cases in most of the locations in the coming days. Furthermore, the trend of the effective reproduction number ($R_{t}$) during the projection period indicates if the lockdown measures are completely removed after May 17, 2020, a high spike in notified cases may be seen in those locations. Finally, combining our results, we provided an effective lockdown policy to reduce future COVID-19 transmission in India.


title: Cardiac surgery in the time of the coronavirus

text: The current Covid-19 pandemic is a significant global health threat. The outbreak has profoundly affected all healthcare professionals, including heart surgeons. To adapt to these exceptional circumstances, cardiac surgeons had to change their practice significantly. We herein discuss the challenges and broad implications of the Covid-19 pandemic from the perspective of the heart surgeons.


title: Hercules: An Autonomous Logistic Vehicle for Contact-less Goods Transportation During the COVID-19 Outbreak

text: Since December 2019, the coronavirus disease 2019 (COVID-19) has spread rapidly across China. As at the date of writing this article, the disease has been globally reported in 100 countries, infected over 100,000 people and caused over 3,000 deaths. Avoiding person-to-person transmission is an effective approach to control and prevent the epidemic. However, many daily activities, such as logistics transporting goods in our daily life, inevitably involve person-to-person contact. To achieve contact-less goods transportation, using an autonomous logistic vehicle has become the preferred choice. This article presents Hercules, an autonomous logistic vehicle used for contact-less goods transportation during the outbreak of COVID-19. The vehicle is designed with autonomous navigation capability. We provide details on the hardware and software, as well as the algorithms to achieve autonomous navigation including perception, planning and control. This paper is accompanied by a demonstration video and a dataset, which are available here: https://sites.google.com/view/contact-less-transportation.


title: Pharmacotherapy in COVID-19; A narrative review for emergency providers

text: INTRODUCTION: The COVID-19 pandemic has been particularly challenging due to a lack of established therapies and treatment guidelines. With the rapid transmission of disease, even the off-label use of available therapies has been impeded by limited availability. Several antivirals, antimalarials, and biologics are being considered for treatment at this time. The purpose of this literature review is to synthesize the available information regarding treatment options for COVID-19 and serve as a resource for health care professionals. OBJECTIVES: This narrative review was conducted to summarize the effectiveness of current therapy options for COVID-19 and address the controversial use of non-steroidal anti-inflammatory drugs (NSAIDs), angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers (ARBs). PubMed and SCOPUS were queried using a combination of the keywords "COVID 19," "SARS-CoV-2," and "treatment." All types of studies were evaluated including systematic reviews, case-studies, and clinical guidelines. DISCUSSION: There are currently no therapeutic drugs available that are directly active against SARS-CoV-2; however, several antivirals (remdesivir, favipiravir) and antimalarials (chloroquine, hydroxychloroquine) have emerged as potential therapies. Current guidelines recommend combination treatment with hydroxychloroquine/azithromycin or chloroquine, if hydroxychloroquine is unavailable, in patients with moderate disease, although these recommendations are based on limited evidence. Remdesivir and convalescent plasma may be considered in critical patients with respiratory failure; however, access to these therapies may be limited. Interleukin-6 (IL-6) antagonists may be used in patients who develop evidence of cytokine release syndrome (CRS). Corticosteroids should be avoided unless there is evidence of refractory septic shock, acute respiratory distress syndrome (ARDS), or another compelling indication for their use. ACE inhibitors and ARBs should not be discontinued at this time and ibuprofen may be used for fever. CONCLUSION: There are several ongoing clinical trials that are testing the efficacy of single and combination treatments with the drugs mentioned in this review and new agents are under development. Until the results of these trials become available, we must use the best available evidence for the prevention and treatment of COVID-19. Additionally, we can learn from the experiences of healthcare providers around the world to combat this pandemic.


title: Ensuring Sustainability of Continuous Kidney Replacement Therapy in the Face of Extraordinary Demand: Lessons From the COVID-19 Pandemic

text: With the exponential surge in patients with coronavirus disease 2019 (COVID-19) worldwide, the resources needed to provide continuous kidney replacement therapy (CKRT) for patients with acute kidney injury or kidney failure may be threatened. This article summarizes subsisting strategies that can be implemented immediately. Pre-emptive weekly multicenter projections of CKRT demand based on evolving COVID-19 epidemiology and routine workload should be made. Corresponding consumables should be quantified and acquired, with diversification of sources from multiple vendors. Supply procurement should be stepped up accordingly so that a several-week stock is amassed, with administrative oversight to prevent disproportionate hoarding by institutions. Consumption of CKRT resources can be made more efficient by optimizing circuit anticoagulation to preserve filters, extending use of each vascular access, lowering blood flows to reduce citrate consumption, moderating the CKRT intensity to conserve fluids, or running accelerated KRT at higher clearance to treat more patients per machine. If logistically feasible, earlier transition to intermittent hemodialysis with online-generated dialysate, or urgent peritoneal dialysis in selected patients, may help reduce CKRT dependency. These measures, coupled to multicenter collaboration and a corresponding increase in trained medical and nursing staffing levels, may avoid downstream rationing of care and save lives during the peak of the pandemic.


title: Optimal quarantine strategies for the COVID-19 pandemic in a population with a discrete age structure

text: The goal of this work is to study the optimal controls for the COVID-19 epidemic in Brazil. We consider an age-structured SEIRQ model with quarantine compartment, where the controls are the quarantine entrance parameters. We then compare the optimal controls for different quarantine lengths and distribution of the total control cost by assessing their respective reductions in deaths in comparison to the same period without quarantine. The best strategy provides a calendar of when to relax the isolation measures for each age group. Finally, we analyse how a delay in the beginning of the quarantine affects this calendar by changing the initial conditions.


title: Tor Vergata University-Hospital in the Beginning of COVID-19-Era: Experience and Recommendation for Breast Cancer Patients

text: COVID-19 has been officially declared as a pandemic by the WHO. Italy was the first European country to be strongly affected by this outbreak. All elective and health promotion activities were reduced. Accordingly, Italian Breast Units and breast cancer (BC) screening programs scaled down significantly their activities. The aim of this study was to evaluate measures that could potentially reduce the clinical impact of COVID-19 on BC patients. Temporary recommendations are needed that could assist specialists in preventing COVID-19 infection and optimizing resources for diagnosis and treatment of BC patients.


The Impact of COVID-19 Pandemic on Obesity and Bariatric Surgery


title: Classification of COVID-19 patients from chest CT images using multi-objective differential evolution-based convolutional neural networks

text: Early classification of 2019 novel coronavirus disease (COVID-19) is essential for disease cure and control. Compared with reverse-transcription polymerase chain reaction (RT-PCR), chest computed tomography (CT) imaging may be a significantly more trustworthy, useful, and rapid technique to classify and evaluate COVID-19, specifically in the epidemic region. Almost all hospitals have CT imaging machines; therefore, the chest CT images can be utilized for early classification of COVID-19 patients. However, the chest CT-based COVID-19 classification involves a radiology expert and considerable time, which is valuable when COVID-19 infection is growing at rapid rate. Therefore, an automated analysis of chest CT images is desirable to save the medical professionals' precious time. In this paper, a convolutional neural networks (CNN) is used to classify the COVID-19-infected patients as infected (+ve) or not (-ve). Additionally, the initial parameters of CNN are tuned using multi-objective differential evolution (MODE). Extensive experiments are performed by considering the proposed and the competitive machine learning techniques on the chest CT images. Extensive analysis shows that the proposed model can classify the chest CT images at a good accuracy rate.


title: [Countermeasures and treatment for aortic acute syndrome with 2019 coronavirus disease]

text: The 2019 coronavirus disease(COVID-19) has cost a great loss to the health and economic property of Chines people. Under such a special circumstance, how to deal with such patients with acute aortic syndrome has become a serious challenge. Rapid diagnosis of concomitant COVID-19, safe and effective transportation, implementation of the interventional procedure, protection of vascular surgical team and postoperative management and follow-up of such patients have become urgent problems for us. Combined with the latest novel government documents, the literature and the experiences from Wuhan, we answered the above questions briefly and plainly. We also hope to inspire the national vascular surgeons to manage critical emergencies in vascular surgery and even routine vascular diseases with COVID-19, as a final point to limit the severe epidemic situation, and minimize the damage of COVID-19.


title: The Unique Impact of COVID-19 on Older Adults in Rural Areas

text: Older adults in rural areas of the U.S. face unique risks related to COVID-19. Rural areas are older, on average, than urban areas, and have more underlying health conditions and fewer economic resources. Rural health care is more limited, as is access to technology and online connectivity. Altogether, this puts rural older adults at risk of not only the virus, but of not being able to meet their health care, social, and basic needs. Rural/urban inequities, combined with within-rural inequities in health, health care, and financial resources cause particular challenges to health and well-being from COVID-19 for some older adults.


Reply to the letter concerning Kawasaki Disease and Covid-19


title: Artificial Intelligence Forecasting of Covid-19 in China

text: BACKGROUND An alternative to epidemiological models for transmission dynamics of Covid-19 in China, we propose the artificial intelligence (AI)-inspired methods for real-time forecasting of Covid-19 to estimate the size, lengths and ending time of Covid-19 across China. METHODS We developed a modified stacked auto-encoder for modeling the transmission dynamics of the epidemics. We applied this model to real-time forecasting the confirmed cases of Covid-19 across China. The data were collected from January 11 to February 27, 2020 by WHO. We used the latent variables in the auto-encoder and clustering algorithms to group the provinces/cities for investigating the transmission structure. RESULTS We forecasted curves of cumulative confirmed cases of Covid-19 across China from Jan 20, 2020 to April 20, 2020. Using the multiple-step forecasting, the estimated average errors of 6-step, 7-step, 8-step, 9-step and 10-step forecasting were 1.64%, 2.27%, 2.14%, 2.08%, 0.73%, respectively. We predicted that the time points of the provinces/cities entering the plateau of the forecasted transmission dynamic curves varied, ranging from Jan 21 to April 19, 2020. The 34 provinces/cities were grouped into 9 clusters. CONCLUSIONS The accuracy of the AI-based methods for forecasting the trajectory of Covid-19 was high. We predicted that the epidemics of Covid-19 will be over by the middle of April. If the data are reliable and there are no second transmissions, we can accurately forecast the transmission dynamics of the Covid-19 across the provinces/cities in China. The AI-inspired methods are a powerful tool for helping public health planning and policymaking.


Patterns of heart injury in COVID-19 and relation to outcome


Investigating hypothiocyanite against SARS-CoV-2


20/20 Foresight for 2020?


Evolving COVID-19 conundrum and its impact


title: Increased expression of CD8 marker on T-cells in COVID-19 patients

text: BACKGROUND: Cell-mediated immunity including T-cells (T helper and cytotoxic) plays an essential role in efficient antiviral responses against coronavirus disease-2019 (COVID-19). Therefore, in this study, we evaluated the ratio and expression of CD4 and CD8 markers in COVID-19 patients to clarify the immune characterizations of CD4 and CD8 T-cells in COVID-19 patients. METHODS: Peripheral blood samples of 25 COVID-19 patients and 25 normal individuals with similar age and sex as the control group were collected. White blood cells, platelets, and lymphocytes were counted and CD4 and CD8 T lymphocytes were evaluated by flow cytometry. RESULTS: The number of white blood cells, lymphocytes, and platelets were reduced significantly in COVID-19 patients (P < 0.05). The difference in CD4:CD8 ratio, CD4 T-cell frequency, CD8 T-cell frequency, and CD4 mean fluorescence intensity (MFI) was not significant between COVID-19 patients and healthy individuals (P > 0.05); however, the CD8 MFI increased significantly in COVID-19 infected patients (P < 0.05). CONCLUSION: Although, there is no significant difference in the ratio of CD4 to CD8 between two groups, the expression level of CD8 in COVID-19 patients was significantly higher than the normal individuals. This result suggested that the cellular immune responses triggered by COVID-19 infection were developed through overexpression of CD8 and hyperactivation of cytotoxic T lymphocytes.


title: Clinical trials for the prevention and treatment of COVID-19: current state of play

text: Since coronavirus disease 2019 (COVID-19) emerged in Wuhan, China in December 2019 and spread around the world, over 1100 clinical studies have been registered globally on clinical trials registries, including over 500 randomised controlled trials. Such rapid development and launch of clinical trials is impressive but presents challenges, including the potential for duplication and competition. There is currently no known effective treatment for COVID-19. In order to focus on those studies most likely to influence clinical practice, we summarise the 31 currently registered randomised trials with a target sample size of at least 1000 participants. We have grouped these trials into four categories: prophylaxis; treatment of outpatients with mild COVID-19; treatment of hospitalised patients with moderate COVID-19; and treatment of hospitalised patients with moderate or severe disease. The most common therapeutic agent being trialled currently is hydroxychloroquine (24 trials with potential sample size of over 25 000 participants), followed by lopinavir-ritonavir (seven trials) and remdesevir (five trials) There are many candidate drugs in pre-clinical and early phase development, and these form a pipeline for future large clinical trials if current candidate therapies prove ineffective or unsafe.


title: Psychosocial Reactions to Plagues in the Cultural History of Medicine: A Medical Humanities Approach

text: The aim of this work is to elucidate psychosocial reactions to plagues by analyzing three landmark descriptions from different eras: Thucydides' description of the plague of Athens (430 BC) in The History of the Peloponnesian War, Giovanni Boccaccio's description of the plague in Florence (1348) in The Decameron, and Albert Camus' description in The Plague (1947). Using a narrative inquiry, we found psychosocial reactions to be complex and ambivalent and could discern several coping strategies. We propose that this knowledge can help psychiatrists and other healthcare professionals during the ongoing COVID-19 pandemic.


title: Clinical characteristics and outcomes of older patients with coronavirus disease 2019 (COVID-19) in Wuhan, China (2019): a single-centered, retrospective study

text: BACKGROUND: In December 2019, the coronavirus disease 2019 (COVID-19) emerged in Wuhan city and spread rapidly throughout China and the world. In this study, we aimed to describe the clinical course and outcomes of older patients with COVID-19. METHODS: This is a retrospective investigation of hospitalized older patients with confirmed COVID-19 at Zhongnan Hospital of Wuhan University from January 1, 2020, to February 10, 2020. RESULTS: In total, 203 patients were diagnosed with COVID-19, with a median age of 54 years (interquartile range, 41-68; range, 20-91 years). Men accounted for 108 (53.2%) of the cases, and 55 patients (27.1%) were >65 years of age. Among patients who were 65 years and older, the mortality rate was 34.5% (19/55), which was significantly higher than that of younger patients at 4.7% (7/148). Common symptoms of older patients with COVID-19 included fever (94.5%; n=52), dry cough (69.1%; n=38), and chest distress (63.6%; n=35). Compared with young patients, older patients had more laboratory abnormalities and comorbidities. Through a multivariate analysis of the causes of death in older patients, we found that males, comorbidities, time from disease onset to hospitalization, abnormal kidney function, and elevated procalcitonin levels were all significantly associated with death. CONCLUSIONS: In the recent outbreak of COVID-19, our local hospital in Wuhan found that patients aged 65 and older had greater initial comorbidities, more severe symptoms, and were more likely to experience multi-organ involvement and death, as compared with younger patients.


title: Social Distancing and Transmission-reducing Practices during the 2019 Coronavirus Disease and 2015 Middle East Respiratory Syndrome Coronavirus Outbreaks in Korea

text: BACKGROUND: The absence of effective antiviral medications and vaccines increased the focus on non-pharmaceutical preventive behaviors for mitigating against the coronavirus disease 2019 (COVID-19) pandemic. To examine the current status of non-pharmaceutical preventive behaviors practiced during the COVID-19 outbreak and factors affecting behavioral activities, we compared to the 2015 Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea. METHODS: This was a serial cross-sectional population-based study in Korea with four surveys conducted on June 2 and 25, 2015 (MERS-CoV surveys), and February 4, and April 2, 2020 (COVID-19 surveys). Of 25,711 participants selected using random digit dialing numbers, 4,011 participants (aged ≥ 18 years) were successfully interviewed, for the 2020 COVID-19 (n = 2,002) and 2015 MERS-CoV (n = 2,009) epidemics were included. Participants were selected post-stratification by sex, age, and province. The total number of weighted cases in this survey equaled the total number of unweighted cases at the national level. We measured the levels of preventive behaviors (social distancing [avoiding physical contact with others]), and practicing transmission-reducing behaviors such as wearing face mask and handwashing. RESULTS: Between the surveys, respondents who reported practicing social distancing increased from 41.9%-58.2% (MERS-CoV) to 83.4%-92.3% (COVID-19). The response rate for the four surveys ranged between 13.7% and 17.7%. Practicing transmission-reducing behaviors (wearing face masks and handwashing) at least once during COVID-19 (78.8%, 80.2%) also increased compared to that during MERS-CoV (15.5%, 60.3%). The higher affective risk perception groups were more likely to practice transmission-reducing measures (adjusted odds ratio, 3.24-4.81; 95 confidence interval, 1.76-6.96) during both COVID-19 and MERS-CoV. CONCLUSION: The study findings suggest markedly increased proportions of non-pharmaceutical behavioral practices evenly across all subgroups during the two different novel virus outbreaks in Korea. Strategic interventions are needed to attempt based on preventive behavior works.


title: TMPRSS2 and COVID-19: Serendipity or Opportunity for Intervention?

text: TMPRSS2 is both the most frequently altered gene in primary prostate cancer and a critical factor enabling cellular infection by coronaviruses, including SARS-CoV-2. The modulation of its expression by sex steroids could contribute to the male predominance of severe infections, and given that TMPRSS2 has no known indispensable functions, and inhibitors are available, it is an appealing target for prevention or treatment of respiratory viral infections.


title: Visual Data Analysis and Simulation Prediction for COVID-19

text: The COVID-19 (formerly, 2019-nCoV) epidemic has become a global health emergency, as such, WHO declared PHEIC. China has taken the most hit since the outbreak of the virus, which could be dated as far back as late November by some experts. It was not until January 23rd that the Wuhan government finally recognized the severity of the epidemic and took a drastic measure to curtain the virus spread by closing down all transportation connecting the outside world. In this study, we seek to answer a few questions: How did the virus get spread from the epicenter Wuhan city to the rest of the country? To what extent did the measures, such as, city closure and community quarantine, help controlling the situation? More importantly, can we forecast any significant future development of the event had some of the conditions changed? By collecting and visualizing publicly available data, we first show patterns and characteristics of the epidemic development; we then employ a mathematical model of disease transmission dynamics to evaluate the effectiveness of some epidemic control measures, and more importantly, to offer a few tips on preventive measures.


title: Urology in the Time of Coronavirus: Reduced Access to Urgent and Emergent Urological Care during the Coronavirus Disease 2019 Outbreak in Italy

text: PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy. MATERIALS AND METHODS: A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes. RESULTS: Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05). CONCLUSION: In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions.


Triagestrategie für COVID-19-Verdachtsfälle bei steigender Patientenzahl./ [Triage strategy for suspected cases of COVID-19 with increasing numbers of patients]


Reforming our general surgery residency program at an urban level 1 Trauma Center during the COVID-19 pandemic: Towards maintaining resident safety and wellbeing


title: COVID-19 Pandemic in India: Present Scenario and a Steep Climb Ahead

text: Amid the ongoing COVID-19 pandemic, India has witnessed a massive surge of cases in the past 3 weeks. As of April 30, 33 610 confirmed cases and 1075 deaths have been reported from 32 states/union territories in India. Apart from the nationwide lockdown, India has increased its testing rate and has markedly strengthened the health care sector to combat COVID-19. With India's population of more than 1.3 billion people at a significant population density compared with the rest of the world, the lack of universal access to clean water and overall poor socioeconomic status, all have posed a major challenge to India's fight against COVID-19. Failure to contain the pandemic in India could have disastrous consequences with widespread cases and thousands of deaths that could easily overwhelm the health care infrastructure. Unabated spread of the pandemic could make India the next COVID-19 hotspot; hence the World Health Organization has recently stated that the "future of the pandemic will depend on how India handles it." Here, we have summarized the present scenario of the pandemic in India and the myriad challenges being faced by the country in its fight against COVID-19.


title: Recommendations for Deep Brain Stimulation Device Management During a Pandemic

text: Most medical centers are postponing elective procedures and deferring non-urgent clinic visits to conserve hospital resources and prevent spread of COVID-19. The pandemic crisis presents some unique challenges for patients currently being treated with deep brain stimulation (DBS). Movement disorder (Parkinson's disease, essential tremor, dystonia), neuropsychiatric disorder (obsessive compulsive disorder, Tourette syndrome, depression), and epilepsy patients can develop varying degrees of symptom worsening from interruption of therapy due to neurostimulator battery reaching end of life, device malfunction or infection. Urgent intervention to maintain or restore stimulation may be required for patients with Parkinson's disease who can develop a rare but potentially life-threatening complication known as DBS-withdrawal syndrome. Similarly, patients with generalized dystonia can develop status dystonicus, patients with obsessive compulsive disorder can become suicidal, and epilepsy patients can experience potentially life-threatening worsening of seizures as a result of therapy cessation. DBS system infection can require urgent, and rarely emergent surgery. Elective interventions including new implantations and initial programming should be postponed. For patients with existing DBS systems, the battery status and electrical integrity interrogation can now be performed using patient programmers, and employed through telemedicine visits or by phone consultations. The decision for replacement of the implantable pulse generator to prevent interruption of DBS therapy should be made on a case-by-case basis taking into consideration battery status and a patient's tolerance to potential therapy disruption. Scheduling of the procedures, however, depends heavily on the hospital system regulations and on triage procedures with respect to safety and resource utilization during the health crisis.


title: An In-hospital Pathway for Acute Coronary Syndrome Patients During the COVID-19 Outbreak: Initial Experience Under Real-World Suboptimal Conditions

text: Owing to the COVID-19 outbreak in Lombardy, Italy) there is an urgent need to manage cardiovascular emergencies, including acute coronary syndrome (ACS), with appropriate standards of care and dedicated preventive measures and pathways against the risk of SARS-CoV-2 infection. For this reason, the Government of Lombardy decided to centralize the treatment of ACS patients in a limited number of centers, including our university cardiology institute, which in the past 4 weeks became a cardiovascular emergency referral center in a regional hub-and-spoke system. Therefore, we rapidly developed a customized pathway to allocate patients to the appropriate hospital ward, and treat them according to ACS severity and risk of suspected SARS-CoV-2 infection. We present here the protocol dedicated to ACS patients adopted in our center since March 13, 2020, and our initial experience in the management of ACS patients during the first 4 weeks of its use. Certainly, the protocol has room for further improvement as everyone's experience grows, but we hope that it could be a starting point, adaptable to different realities and local resources.


Cardio-oncology services during the COVID-19 pandemic: practical considerations and challenges


Policy Recommendations to Address High Risk of COVID-19 Among Immigrants


text: The health and economic consequences of COVID-19 will be devastatingly widespread, but the populations that will suffer most are those who have experienced longstanding health disparities. For example, emerging evidence strongly suggests that incidence and case fatality rates are higher among Blacks than Whites.1 Immigrants are among the groups most likely to experience disproportionate effects from COVID-19. Unlike race/ethnicity, however, nativity and citizenship status are not included on the Centers for Disease Control and Prevention's (CDC's) coronavirus case report form,2 so data regarding testing and spread across immigrant groups are likely to remain scarce. Information from other health and social surveys-including data that I present in Table 1-suggest that noncitizens experience barriers to physical distancing that will place them at high risk of contracting COVID-19 and have high levels of disadvantage that leave them vulnerable to its economic effects. I recommend three policy changes to address the high health and economic risk among noncitizens, goals that are in the best interest of public health and the broader economy. (Am J Public Health. Published online ahead of print June 25, 2020: e1-e3. doi:10.2105/AJPH.2020.305792).


docid: zncfnipp

title: Research Progress of Drug Treatment in Novel Coronavirus Pneumonia

text: As of March 10, 2020, more than 100,000 novel coronavirus pneumonia cases have been confirmed globally. With the continuous spread of the new coronavirus pneumonia epidemic in even the world, prevention and treatment of the disease have become urgent tasks. The drugs currently being developed are not adequate to deal with this critical situation. In addition to being controlled through effective isolation, we need a rapid response from the healthcare and biotechnology industries to accelerate drug treatment research. By reviewing the currently available literature published at home and abroad, we summarize the current research progress of drug treatment during the epidemic period. At present, the drugs that can be used for treatment mainly include antiviral drugs, antimalarials, glucocorticoids, plasma therapy, biological agents, and traditional Chinese medicine. The effectiveness and safety of drug therapy need to be confirmed by more clinical studies.


Perniosis del confinamiento, una vieja conocida en el contexto del COVID-19./ [Chilblains in lockdown: An old acquaintance in the context of COVID-19]


title: Detecting Community Depression Dynamics Due to COVID-19 Pandemic in Australia

text: The recent COVID-19 pandemic has caused unprecedented impact across the globe. We have also witnessed millions of people with increased mental health issues, such as depression, stress, worry, fear, disgust, sadness, and anxiety, which have become one of the major public health concerns during this severe health crisis. For instance, depression is one of the most common mental health issues according to the findings made by the World Health Organisation (WHO). Depression can cause serious emotional, behavioural and physical health problems with significant consequences, both personal and social costs included. This paper studies community depression dynamics due to COVID-19 pandemic through user-generated content on Twitter. A new approach based on multi-modal features from tweets and Term Frequency-Inverse Document Frequency (TF-IDF) is proposed to build depression classification models. Multi-modal features capture depression cues from emotion, topic and domain-specific perspectives. We study the problem using recently scraped tweets from Twitter users emanating from the state of New South Wales in Australia. Our novel classification model is capable of extracting depression polarities which may be affected by COVID-19 and related events during the COVID-19 period. The results found that people became more depressed after the outbreak of COVID-19. The measures implemented by the government such as the state lockdown also increased depression levels. Further analysis in the Local Government Area (LGA) level found that the community depression level was different across different LGAs. Such granular level analysis of depression dynamics not only can help authorities such as governmental departments to take corresponding actions more objectively in specific regions if necessary but also allows users to perceive the dynamics of depression over the time.


COVID-19 and Cutaneous manifestations


Letter to the Editor: Wastewater-Based Epidemiology Can Overcome Representativeness and Stigma Issues Related to COVID-19


One ventilator for two patients: feasibility and considerations of a last resort solution in case of equipment shortage


Response to "COVID-19: room for treating T cell exhaustion?"


title: Controlling Particle Currents with Evaporation and Resetting

text: We investigate the Brownian diffusion of particles in one spatial dimension and in the presence of finite regions within which particles can either evaporate or be reset to a given location. For open boundary conditions, we highlight the appearance of a Brownian yet non-Gaussian diffusion: at long times, the particle distribution is non-Gaussian but its variance grows linearly in time. Moreover, we show that the effective diffusion coefficient of the particles in such systems is bounded from below by $(1-2/\pi)$ times their bare diffusion coefficient. For periodic boundary conditions, i.e., for diffusion on a ring with resetting, we demonstrate a ``gauge invariance'' of the spatial particle distribution for different choices of the resetting probability currents, in both stationary and non-stationary regimes. Finally, we apply our findings to a stochastic biophysical model for the motion of RNA polymerases during transcriptional pauses, deriving analytically the distribution of the length of cleaved RNA transcripts and the efficiency of RNA cleavage in backtrack recovery.


title: A Bioethical Perspective for Navigating Moral Dilemmas Amidst the COVID-19 Pandemic

text: The Coronavirus disease 2019 pandemic has been an unprecedented challenge to healthcare systems and clinicians around the globe. As the virus has spread, critical questions arose about how to best deliver health care in emergency situations where material and personnel resources become scarce. Clinicians who excel at caring for the individual patient at the bedside are now being reoriented into a system where they are being asked to see the collective public as their responsibility. As such, the clinical ethics that clinicians are accustomed to practicing are being modified by a framework of public health ethics defined by the presence of a global pandemic. There are many unknowns about Coronavirus disease 2019, which makes it difficult to provide consistent recommendations and guidelines that uniformly apply to all situations. This lack of consensus leads to the clinicians' confusion and distress. Real-life dilemmas about how to allocate resources and provide care in hotspot cities make explicit the need for careful ethical analysis, but the need runs far deeper than that; even when not trading some lives against others, the responsibilities of both individual clinicians and the broader healthcare system are changing in the face of this crisis.


title: A review of South Indian medicinal plant has the ability to combat against deadly viruses along with COVID-19?

text: SARS-CoV2 is a source of coronavirus infectious disease (COVID-19), this is considered as a fatal disease to universal communal health apprehension. This rapid pathogenic virus plays an important role in finding the pathogenic virus, treatment and prevention of pandemics. Virus can present everywhere in Global village. As it is virus it can extend easily and cause severe illness to the society. Hence, an efficient international attentiveness of plan is necessary to the prediction and prevention. In this review, epidemic outbreak, clinical findings, prevention recommendations of COVID-19 and suggestive medicinal value of south Indian plant sources has been discussed. Though the varieties of improved approaches have been taken in scientific and medicinal concern, we have to pay attention on medicinal value of the plant based sources to prevent these types of endemic diseases. This is one of the suggestive and effective ways to control the spreading of viruses. In future its required to provide medicinal plant based clinical products (Masks, sanitizers, soap etc.) with better techniques by clinicians to contend the scarcity and expose towards the nature based medicine rather than chemical drugs. This could be a benchmark for the economical clinical trials of specific plant material to treat the viral diseases.


title: Operational strategies of a trauma hub in early coronavirus disease 2019 pandemic

text: PURPOSE: The "Spedali Civili", one of the largest hospitals in the Italian region most affected by SARS-CoV-2 infection, is managing a large number of traumatic injuries. The objective of this article is to share our operational protocols to deliver an appropriate hospital trauma care in the context of the COVID-19 pandemic. METHODS: We changed our work shifts, in consideration of the high number of patients; colleagues from smaller hospitals in the area joined us to increase the number of surgeons available. Thanks to the collaboration between orthopaedists, anaesthesiologists, and nurses, we created a flow chart and separate routes (in the emergency room, in the wards, and in the operating rooms) to optimize patient management. Our protocols allow us to always provide healthcare professionals with the correct personal protective equipment for the task they are performing. RESULTS: Our strategies proved to be practical and feasible. Having a well thought plan helped us to provide for the most robust response possible. We have not yet been able to study the effectiveness of our protocols, and our recommendations may not be applicable to all healthcare facilities. Nonetheless, sharing our early experience can help other institutions conducting and adapting such plans more quickly. CONCLUSIONS: Having a clear strategy during the COVID-19 pandemic kept our systems resilient and effective and allowed us to provide high-quality trauma care. We offer this approach for other institutions to adopt and adapt to their local setting.


title: Dry Taps? A Synthesis of Alternative "Wash" Methods in the Absence of Water and Sanitizers in the Prevention of Coronavirus in Low-Resource Settings

text: Objective: Social distancing and hand washing with soap and water have been advocated as the main proactive measures against the spread of coronavirus. We sought to find out what other alternative materials and methods would be used among populations without running water and who may not afford alcohol-based sanitizers. Results: We reviewed studies that reported use of sand, soil, ash, soda ash, seawater, alkaline materials, and sunlight as possible alternatives to handwashing with soap and water. We identified the documented mechanism of actions of these alternative wash methods on both inanimate surfaces and at cellular levels. The consideration of use of these alternative locally available in situations of unavailability of soap and water and alcohol-based sanitizers is timely in the face of coronavirus pandemic. Further randomized studies need to be carried out to evaluate the effectiveness of these alternatives in management of SARS-Cov-2.


title: Video calls for reducing social isolation and loneliness in older people: a rapid review

text: BACKGROUND: The current COVID-19 pandemic has been identified as a possible trigger for increases in loneliness and social isolation among older people due to the restrictions on movement that many countries have put in place. Loneliness and social isolation are consistently identified as risk factors for poor mental and physical health in older people. Video calls may help older people stay connected during the current crisis by widening the participant's social circle or by increasing the frequency of contact with existing acquaintances. OBJECTIVES: The primary objective of this rapid review is to assess the effectiveness of video calls for reducing social isolation and loneliness in older adults. The review also sought to address the effectiveness of video calls on reducing symptoms of depression and improving quality of life. SEARCH METHODS: We searched CENTRAL, MEDLINE, PsycINFO and CINAHL from 1 January 2004 to 7 April 2020. We also searched the references of relevant systematic reviews. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-RCTs (including cluster designs) were eligible for inclusion. We excluded all other study designs. The samples in included studies needed to have a mean age of at least 65 years. We included studies that included participants whether or not they were experiencing symptoms of loneliness or social isolation at baseline. Any intervention in which a core component involved the use of the internet to facilitate video calls or video conferencing through computers, smartphones or tablets with the intention of reducing loneliness or social isolation, or both, in older adults was eligible for inclusion. We included studies in the review if they reported self-report measures of loneliness, social isolation, symptoms of depression or quality of life. Two review authors screened 25% of abstracts; a third review author resolved conflicts. A single review author screened the remaining abstracts. The second review author screened all excluded abstracts and we resolved conflicts by consensus or by involving a third review author. We followed the same process for full-text articles. DATA COLLECTION AND ANALYSIS: One review author extracted data, which another review author checked. The primary outcomes were loneliness and social isolation and the secondary outcomes were symptoms of depression and quality of life. One review author rated the certainty of evidence for the primary outcomes according to the GRADE approach and another review author checked the ratings. We conducted fixed-effect meta-analyses for the primary outcome, loneliness, and the secondary outcome, symptoms of depression. MAIN RESULTS: We identified three cluster quasi-randomised trials, which together included 201 participants. The included studies compared video call interventions to usual care in nursing homes. None of these studies were conducted during the COVID-19 pandemic. Each study measured loneliness using the UCLA Loneliness Scale. Total scores range from 20 (least lonely) to 80 (most lonely). The evidence was very uncertain and suggests that video calls may result in little to no difference in scores on the UCLA Loneliness Scale compared to usual care at three months (mean difference (MD) -0.44, 95% confidence interval (CI) -3.28 to 2.41; 3 studies; 201 participants), at six months (MD -0.34, 95% CI -3.41 to 2.72; 2 studies; 152 participants) and at 12 months (MD -2.40, 95% CI -7.20 to 2.40; 1 study; 90 participants). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness. None of the included studies reported social isolation as an outcome. Each study measured symptoms of depression using the Geriatric Depression Scale. Total scores range from 0 (better) to 30 (worse). The evidence was very uncertain and suggests that video calls may result in little to no difference in scores on the Geriatric Depression Scale compared to usual care at three months' follow-up (MD 0.41, 95% CI -0.90 to 1.72; 3 studies; 201 participants) or six months' follow-up (MD -0.83, 95% CI -2.43 to 0.76; 2 studies, 152 participants). The evidence suggests that video calls may have a small effect on symptoms of depression at one-year follow-up, though this finding is imprecise (MD -2.04, 95% CI -3.98 to -0.10; 1 study; 90 participants). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness. Only one study, with 62 participants, reported quality of life. The study measured quality of life using a Taiwanese adaptation of the Short-Form 36-question health survey (SF-36), which consists of eight subscales that measure different aspects of quality of life: physical function; physical role; emotional role; social function; pain: vitality; mental health; and physical health. Each subscale is scored from 0 (poor health) to 100 (good health). The evidence is very uncertain and suggests that there may be little to no difference between people allocated to usual care and those allocated to video calls in three-month scores in physical function (MD 2.88, 95% CI -5.01 to 10.77), physical role (MD -7.66, 95% CI -24.08 to 8.76), emotional role (MD -7.18, 95% CI -16.23 to 1.87), social function (MD 2.77, 95% CI -8.87 to 14.41), pain scores (MD -3.25, 95% CI -15.11 to 8.61), vitality scores (MD -3.60, 95% CI -9.01 to 1.81), mental health (MD 9.19, 95% CI 0.36 to 18.02) and physical health (MD 5.16, 95% CI -2.48 to 12.80). We downgraded the certainty of this evidence by three levels for study limitations, imprecision and indirectness. AUTHORS' CONCLUSIONS: Based on this review there is currently very uncertain evidence on the effectiveness of video call interventions to reduce loneliness in older adults. The review did not include any studies that reported evidence of the effectiveness of video call interventions to address social isolation in older adults. The evidence regarding the effectiveness of video calls for outcomes of symptoms of depression was very uncertain. Future research in this area needs to use more rigorous methods and more diverse and representative participants. Specifically, future studies should target older adults, who are demonstrably lonely or socially isolated, or both, across a range of settings to determine whether video call interventions are effective in a population in which these outcomes are in need of improvement.


MFM guidance for COVID-19


title: In silico studies on therapeutic agents for COVID-19: Drug repurposing approach

text: AIMS: The severe acute respiratory syndrome coronavirus 2, better known as COVID-19 has become the current health concern to the entire world. Initially appeared in Wuhan, China around December 2019, it had spread to almost 187 countries due to its high contagious nature. Precautionary measures remain the sole obliging tactic to cease the person to person transmissions till any effective method of treatment or vaccine is developed. Amidst the pandemic, research and development of new molecule is labour-intensive and tedious process. Drug repurposing is the concept of identifying therapeutically potent molecule from the library of pre-existing molecules. MATERIALS AND METHODS: In the present study, 61 molecules that are already being used in clinics or under clinical scrutiny as antiviral agents are surveyed via docking study. Docking study was performed using Maestro interface (Schrödinger Suite, LLC, NY). KEY FINDINGS: Out of these 61 molecules, 37 molecules were found to interact with >2 protein structures of COVID-19. The docking results indicate that amongst the reported molecules, HIV protease inhibitors and RNA-dependent RNA polymerase inhibitors showed promising features of binding to COVID-19 enzyme. Along with these, Methisazone an inhibitor of protein synthesis, CGP42112A an angiotensin AT2 receptor agonist and ABT450 an inhibitor of the non-structural protein 3-4A might become convenient treatment option as well against COVID-19. SIGNIFICANCE: The drug repurposing approach provide an insight about the therapeutics that might be helpful in treating corona virus disease.


Lymphopenia and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection Among Hospitalized Obstetric Patients


title: Facial protection in the era of COVID-19: a narrative review

text: We live in extraordinary times, where COVID-19 pandemic has brought the whole world to a screeching halt. Tensions and contradictions that surround the pandemic ridden world include the availability, and the lack thereof, various facial protection measures to mitigate the viral spread. Here, we comprehensively explore the different type of facial protection measures, including masks, needed both for the pubic and the health care workers (HCW). We discuss the anatomy, the critical issues of disinfection and reusability of masks, the alternative equipment available for the protection of the facial region from airborne diseases, such as face shields and powered air purifying respirators (PAPR), and the skin-health impact of prolonged wearing of facial protection by HCW. Clearly, facial protection, either in the form of masks or alternates, appears to have mitigated the pandemic as seen from the minimal COVID-19 spread in countries where public mask wearing is strictly enforced. On the contrary, the healthcare systems, that appear to have been unprepared for emergencies of this nature, should be appropriately geared to handle the imbalance of supply and demand of personal protective equipment including face masks. These are two crucial lessons we can learn from this tragic experience.


title: Facial protection in the era of COVID-19: A narrative review

text: We live in extraordinary times, where COVID-19 pandemic has brought the whole world to a screeching halt. Tensions and contradictions that surround the pandemic ridden world include the availability, and the lack thereof, various facial protection measures to mitigate the viral spread. Here, we comprehensively explore the different types of facial protection measures, including masks, needed both for the public and the healthcare workers (HCW). We discuss the anatomy, the critical issues of disinfection and reusability of masks, the alternative equipment available for the protection of the facial region from airborne diseases, such as face shields and powered air-purifying respirators (PAPR), and the skin health impact of prolonged wearing of facial protection by HCW. Clearly, facial protection, either in the form of masks or alternates, appears to have mitigated the pandemic as seen from the minimal COVID-19 spread in countries where public mask wearing is strictly enforced. On the contrary, the healthcare systems, that appear to have been unprepared for emergencies of this nature, should be appropriately geared to handle the imbalance of supply and demand of personal protective equipment including face masks. These are two crucial lessons we can learn from this tragic experience.


title: The Psychological Impact of Epidemic and Pandemic Outbreaks on Healthcare Workers: Rapid Review of the Evidence

text: PURPOSE OF REVIEW: We aim to provide quantitative evidence on the psychological impact of epidemic/pandemic outbreaks (i.e., SARS, MERS, COVID-19, ebola, and influenza A) on healthcare workers (HCWs). RECENT FINDINGS: Forty-four studies are included in this review. Between 11 and 73.4% of HCWs, mainly including physicians, nurses, and auxiliary staff, reported post-traumatic stress symptoms during outbreaks, with symptoms lasting after 1-3 years in 10-40%. Depressive symptoms are reported in 27.5-50.7%, insomnia symptoms in 34-36.1%, and severe anxiety symptoms in 45%. General psychiatric symptoms during outbreaks have a range comprised between 17.3 and 75.3%; high levels of stress related to working are reported in 18.1 to 80.1%. Several individual and work-related features can be considered risk or protective factors, such as personality characteristics, the level of exposure to affected patients, and organizational support. Empirical evidence underlines the need to address the detrimental effects of epidemic/pandemic outbreaks on HCWs' mental health. Recommendations should include the assessment and promotion of coping strategies and resilience, special attention to frontline HCWs, provision of adequate protective supplies, and organization of online support services.


Acute coronary syndrome in the time of the COVID-19 pandemic


title: Endothelial dysfunction in Coronavirus disease 2019 (COVID-19): Gender and age influences

text: Several risk factors are associated with a worse outcome for COVID-19 patients; the most recognized are demographic characteristics such as older age and male gender, and pre-existing cardiovascular conditions. About the latter, hypertension and coronary heart disease are among the most common comorbidities recorded in infected patients, together with type 2 diabetes mellitus (T2DM). Data from Istituto Superiore di Sanità (ISS, Italy) show that more than 68.3% of patients had hypertension, 28.2% ischemic heart disease, 22.5% atrial fibrillation, while 30.1% T2DM. Several authors suggested that cardiovascular diseases and diabetes mellitus are linked to endothelial dysfunction, and all of them are strictly related to aging. Considering the impact of the gender on the COVID-19 epidemic, even if confirmed cases from each nation are changing every day, epidemiological data clearly evidence that in men the infection causes worse outcomes compared to women. In Italy, up to 21 May, in the age range of 60-89 years, male deaths were 63.9% of total cases. The reason behind this difference between genders appears not clear; however, the diversity in sex-hormones and styles of life are believed to play a role in the patient's susceptibility to severe SARS-CoV-2 outcomes. It is known that the activation of endothelial estrogen receptors increases NO and decreases ROS, protecting the vascular system from angiotensin II-mediated vasoconstriction, inflammation, and ROS production. During the pandemic, joining forces is vital; thus, as people help doctors by limiting their displacements out of their houses avoiding hence the spread of the infection, doctors help patients to overcome severe SARS-CoV-2 infections by using multiple pharmacological approaches. In this context, the preservation of endothelial function and the mitigation of vascular inflammation are prominent targets, essential to reduce severe outcomes also in male older patients.


Kidney transplantation with presymptomatic COVID-19-positive surgeon


Covid-19: how to be careful with trust and expertise on social media


Mobile X-rays are highly valuable for critically ill COVID patients


title: Exposure to Social Engagement Metrics Increases Vulnerability to Misinformation

text: News feeds in virtually all social media platforms include engagement metrics, such as the number of times each post is liked and shared. We find that exposure to these social engagement signals increases the vulnerability of users to misinformation. This finding has important implications for the design of social media interactions in the misinformation age. To reduce the spread of misinformation, we call for technology platforms to rethink the display of social engagement metrics. Further research is needed to investigate whether and how engagement metrics can be presented without amplifying the spread of low-credibility information.


title: The Role and Response of Palliative Care and Hospice Services in Epidemics and Pandemics: A Rapid Review to Inform Practice During the COVID-19 Pandemic

text: Cases of coronavirus disease 2019 (COVID-19) are escalating rapidly across the globe, with the mortality risk being especially high among those with existing illness and multimorbidity. This study aimed to synthesize evidence for the role and response of palliative care and hospice teams to viral epidemics/pandemics and inform the COVID-19 pandemic response. We conducted a rapid systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in five databases. Of 3094 articles identified, 10 were included in this narrative synthesis. Included studies were from West Africa, Taiwan, Hong Kong, Singapore, the U.S., and Italy. All had an observational design. Findings were synthesized using a previously proposed framework according to systems (policies, training and protocols, communication and coordination, and data), staff (deployment, skill mix, and resilience), space (community provision and use of technology), and stuff (medicines and equipment as well as personal protective equipment). We conclude that hospice and palliative services have an essential role in the response to COVID-19 by responding rapidly and flexibly; ensuring protocols for symptom management are available, and training nonspecialists in their use; being involved in triage; considering shifting resources into the community; considering redeploying volunteers to provide psychosocial and bereavement care; facilitating camaraderie among staff and adopting measures to deal with stress; using technology to communicate with patients and carers; and adopting standardized data collection systems to inform operational changes and improve care.


title: Forty years with coronaviruses

text: I have been researching coronaviruses for more than forty years. This viewpoint summarizes some of the major findings in coronavirus research made before the SARS epidemic and how they inform current research on the newly emerged SARS-CoV-2.


title: Clinical Profile of Covid-19 Infected Patients Admitted in a Tertiary Care Hospital in North India

text: Background: The novel coronavirus (Covid-19) continues to wreck havoc across China, European countries, USA and now seems to gain a strong foothold in India. The aim of this report is to describe the clinical profiles of these Covid-19 infected patients admitted in Sawai Mansingh Hospital(S.M.S), Jaipur ranging from their age, sex, travel history, clinical symptoms, laboratory evaluation, radiological characteristics, treatment provided along with common side effects and the final outcome. The described cases are one of the earliest cases of Covid-19 in the Indian subcontinent. Methods: Epidemiological, clinical, laboratory, and radiological characteristics and treatment and outcomes data were obtained with data collection forms from electronic medical records and history given by 21 Covid-19 infected patients admitted in S.M.S., Jaipur. Patients were tested for Covid-19 by real-time reverse transcription polymerase chain reaction (RT-PCR) assay of 2019-nCoVRNA. Results and Discussion: During the course of this study 21 Covid-19 positive patients were admitted in S.M.S Hospital, Jaipur. Male patients constituted 66.66% of total patients and majority of the patients (80.90%) were below 60 years of age. Most of the patients (71.40%) were either foreigners or had a history of foreign travel suggesting that these cases were not community acquired except for 4 cases from textile producing district Bhilwara (known as Manchester of India), an epicenter of North India. Approximately 33.33% patients were completely asymptomatic and of those who were symptomatic cough was the most common symptom (85.71%) followed by fever (78.57%), myalgia (64.28%), headache (28.57%) and dyspnea (28.57%). Three patients (14.28 %) had underlying co morbidity in the form of hypertension, diabetes mellitus, hypothyroidism, chronic kidney disease or coronary artery disease. 11 patients (52.38%) had lymphopenia in their hemogram during the course of admission. 3 patients (14.28%) had leucocytosis and 4 patients (19.04%) presented with thrombocytopenia. All 4 patients in the severe category had raised FDP, D-Dimer levels and they needed oxygen support. These patients had deranged liver functions and had elevated pro-calcitonin levels, serum ferritin levels and LDH levels. 1 out of the these 4 cases went into ARDS during the course of treatment. 10 patients yielded negative results for Covid-19. The mean duration from admission to getting 1st Covid-19 sample negative was 8.3 days. 18 patients (85.71%) are still under treatment. Conclusion: Clinical investigations in initial Covid-19 patients in the Indian subcontinent reveal lymphopenia as predominant finding in hemogram. Patients with older age and associated comorbid conditions (COPD and diabetes) seem to have greater risk for lung injury thereby requiring oxygen support during the course of disease and these patients also had greater derangement in their biochemical profile.


title: Restructuring an academic dermatology practice during the COVID-19 pandemic

text: Severe acute respiratory syndrome coronavirus 2 is a highly virulent positive-sense single stranded RNA virus that spreads rapidly via respiratory droplets, causing severe acute respiratory syndromes with significant mortality and morbidity. Currently 210 countries and territories are affected around the world with a reported 2.6 million confirmed cases. The coronavirus disease 2019 pandemic has changed the way patients attend their specialist appointments and receive medical care. While some specialist clinics have closed we have implemented strategies and restructured our academic practice in Australia to minimize the spread of disease while treating patients who need urgent care. We hope to share these strategies in the hope they may be useful to the dermatology community.


The maternity response to COVID-19: An example from one maternity unit in Taiwan


title: Food as medicine: a possible preventive measure against coronavirus disease (COVID-19)

text: The recent and ongoing outbreak of coronavirus disease (COVID-19) is a huge global challenge. The outbreak, which first occurred in Wuhan City, Hubei Province, China and then rapidly spread to other provinces and to more than 200 countries abroad, has been declared a global pandemic by the World Health Organization (WHO). Those with compromised immune systems and/or existing respiratory, metabolic or cardiac problems are more susceptible to the infection and are at higher risk of serious illness or even death. The present review was designed to report important functional food plants with immunomodulatory and anti-viral properties. Data on medicinal food plants was retrieved and downloaded from English-language journals using online search engines. The functional food plants herein documented might not only enhance the immune system and cure respiratory tract infections but can also greatly impact the overall health of the general public. As many people in the world are now confined to their homes, inclusion of these easily accessible plants in the daily diet may help to strengthen the immune system and guard against infection by SARS-CoV-2. This might reduce the risk of COVID-19 and initiate a rapid recovery in cases of SARS-CoV-2 infection. This article is protected by copyright. All rights reserved.


Laboratory Abnormalities in Pregnant Women with Novel Coronavirus Disease 2019


title: De eerste 29 COVID-19-patiënten in de kliniek./ [The first 29 COVID-19-patients in a clinic: early experiences from a Dutch hospital]

text: The SARS-CoV-2 virus and COVID-19 disease is of pandemic proportions and reached the Netherlands on February 27 2020. Here we present the first Dutch cohort of 29 hospitalized patients during the first two weeks of the epidemic in the Netherlands. Demographic characteristics of patients, clinical presentation and course of disease up to the moment of analysis showed similarity with what has been described in Chinese and Italian literature. However the higher proportion of patients presenting with gastro-intestinal symptoms and the high number of patients with overweight and obesity stood out. Based on the experience in our hospital very early on in the epidemic COVID-19 impresses as a severe illness with risk of acute respiratory deterioration.


Telephonic triage before surgical ward admission and telemedicine during COVID-19 outbreak in Italy. Effective and easy procedures to reduce in-hospital positivity


The invisible pandemic


title: Berg Balance Scale: inter-rater and intra-rater reliability of the Spanish version with incomplete spinal cord injured subjects

text: STUDY DESIGN: Cross sectional. OBJECTIVES: To determine the inter-rater and intra-rater reliability of the Spanish version of the Berg Balance Scale with incomplete spinal cord injured subjects. SETTING: CINER Rehabilitation Center. METHODS: We administered and video recorded the Spanish version of the Berg Balance Scale to 20 incomplete SCI patients. Two raters scored the videos on two different occasions at least three weeks apart. We used intraclass correlation coefficient (ICC) and a confidence interval (CI) of 95% to evaluate the inter-rater and intra-rater (test-retest) reliability of the BBS total scores. RESULTS: ICC values for inter-rater reliability at first and second observation were 0.99 (95% CI 0.97-1.00) and 0.99 (95% CI 0.99-1.00), respectively. Intra-rater ICC for rater 1 was 1.00 (95% CI 1.00-1.00) and for rater 2 was 1.00 (95% CI 0.99-1.00). All of them were excellent. CONCLUSIONS: The results indicate that the Spanish version of the Berg Balance Scale is a reliable tool to evaluate spinal cord injured patients' balance.


title: Using CËerenkov radiation for measuring the refractive index in thick samples by interferometric cathodoluminescence

text: Cathodoluminescence (CL) has evolved into a standard analytical technique in (scanning) transmission electron microscopy. CL utilizes light excited due to the interactions between the electron-beam and the sample. In the present study we focus on CËerenkov radiation. We make use of the fact that the electron transparent specimen acts as a Fabry-Pérot interferometer for coherently emitted radiation. From the wavelength dependent interference pattern of thickness dependent measurements we calculate the refractive index of the studied material. We describe the limits of this approach and compare it with the determination of the refractive index by using valence electron energy loss spectrometry (VEELS).


title: Practicing the ABCDEs of Self-Care in Pandemic Times

text: Updated several times a week with posts by a wide variety of authors, AJN's blog Off the Charts allows us to provide more timely-and often more personal-perspectives on professional, policy, and clinical issues. Best of the Blog is a regular column to draw the attention of AJN readers to posts we think deserve a wider audience. To read more, please visit: www.ajnoffthecharts.com.


title: Coping with COVID: How a Research Team Learned To Stay Engaged in This Time of Physical Distancing

text: Physical distancing imposed by the COVID-19 pandemic has led to alterations in routines and new responsibilities for much of the research community. We provide some tips for how research teams can cope with physical distancing, some of which require a change in how we define productivity. Importantly, we need to maintain and strengthen social connections in this time when we can't be physically together.


Covid-19: Many trusts have not done risk assessments for ethnic minority staff, BMJ investigation finds


title: PhishGAN: Data Augmentation and Identification of Homoglpyh Attacks

text: Homoglyph attacks are a common technique used by hackers to conduct phishing. Domain names or links that are visually similar to actual ones are created via punycode to obfuscate the attack, making the victim more susceptible to phishing. For example, victims may mistake"|inkedin.com"for"linkedin.com"and in the process, divulge personal details to the fake website. Current State of The Art (SOTA) typically make use of string comparison algorithms (e.g. Levenshtein Distance), which are computationally heavy. One reason for this is the lack of publicly available datasets thus hindering the training of more advanced Machine Learning (ML) models. Furthermore, no one font is able to render all types of punycode correctly, posing a significant challenge to the creation of a dataset that is unbiased toward any particular font. This coupled with the vast number of internet domains pose a challenge in creating a dataset that can capture all possible variations. Here, we show how a conditional Generative Adversarial Network (GAN), PhishGAN, can be used to generate images of hieroglyphs, conditioned on non-homoglpyh input text images. Practical changes to current SOTA were required to facilitate the generation of more varied homoglyph text-based images. We also demonstrate a workflow of how PhishGAN together with a Homoglyph Identifier (HI) model can be used to identify the domain the homoglyph was trying to imitate. Furthermore, we demonstrate how PhishGAN's ability to generate datasets on the fly facilitate the quick adaptation of cybersecurity systems to detect new threats as they emerge.


title: Coronavirus (COVID-19) - An epidemic or pandemic for financial markets

text: The novel Coronavirus disease (COVID-19) has quickly evolved from a provincial health scare to a global meltdown. While it has brought nearly half the world to a standstill it has affected the financial markets in unseen ways by eroding a quarter of wealth in nearly a month. This paper investigates the reaction of financial markets globally in terms of their decline and volatility as Coronavirus epicentre moved from China to Europe and then to the US. Findings suggest that the earlier epicentre China has stabilised while the global markets have gone into a freefall especially in the later phase of the spread. Even the relatively safer commodities have suffered as the pandemic moves into the US.


title: Correlation between the variables collected at admission and progression to severe cases during hospitalization among patients with COVID-19 in Chongqing

text: Mortality is high among severe patients with 2019 novel coronavirus-infected disease (COVID-19). Early prediction of progression to severe cases is needed. We retrospectively collected patients with COVID-19 in two hospital of Chongqing from 1st January to 29th February 2020. At admission, we collected the demographics and laboratory tests to predict whether the patient would progress to severe cases in hospitalization. Severe case was confirmed when one of the following criteria occurred: (a) dyspnea, respiratory rate ≥30 breaths/min, (b) blood oxygen saturation ≤93%, and (c) PaO2 /FiO2 ≤ 300 mm Hg. At admission, 348 mild cases were enrolled in this study. Of them, 20 (5.7%) patients progressed to severe cases after median 4.0 days (interquartile range: 2.3-6.0). Pulmonary inflammation index, platelet counts, sodium, C-reactive protein, prealbumin, and PaCO2 showed good distinguishing power to predict progression to severe cases (each area under the curve of receiver operating characteristics [AUC] ≥ 0.8). Age, heart rate, chlorine, alanine aminotransferase, aspartate aminotransferase, procalcitonin, creatine kinase, pH, CD3 counts, and CD4 counts showed moderate distinguishing power (each AUC between 0.7-0.8). And potassium, creatinine, temperature, and D-dimer showed mild distinguishing power (each AUC between 0.6-0.7). In addition, higher C-reactive protein was associated with shorter time to progress to severe cases (r = -0.62). Several easily obtained variables at admission are associated with progression to severe cases during hospitalization. These variables provide a reference for the medical staffs when they manage the patients with COVID-19.


The 'Black Death' and the physician at the time of COVID-19


title: SARS-CoV-2 From the Trenches: A Perspective From New York City

text: OBJECTIVE. The response to coronavirus disease (COVID-19) is evolving in New York City. We would like to share our experiences, thoughts, and perspectives on coping with the pandemic. CONCLUSION. This article presents experiences that are meant to help foster discussion as the wave of COVID-19 continues. Thoughtful leadership and careful continuous communication will help us minimize anxiety and frustration during this difficult time.


Recommendations for altitude training programming to preserve athletes' health after COVID-19 pandemic


title: A syndemic of COVID-19 and methanol poisoning in Iran: Time for Iran to consider alcohol use as a public health challenge?

text: Methanol poisoning has been a significant public health challenge for several decades in Iran. Even though alcohol use is highly criminalized, people consume illicit alcohol, which tends to be predominantly homemade and often contains methanol. Consequently, thousands of individual poisonings and hundreds of deaths annually are attributable to methanol poisoning. From February 19, 2020 through April 27, 2020, the 2019 coronavirus disease (COVID-19) epidemic rapidly expanded in Iran, and has been associated with 90,481 confirmed cases and 5710 confirmed deaths. Secondary to misinformation about the potential for alcohol to neutralize SARS-CoV-2, there has also been a significant escalation in methanol-related morbidity and mortality, with over 5000 people poisoned and over 500 confirmed deaths for the same period from February through April 2020. In some provinces, the case-fatality rate of methanol poisoning was higher than that from COVID-19. The high morbidity and mortality associated with methanol poisoning preceding and exacerbated by COVID-19 highlight the potential population level health impacts of the implementation of evidence-based education and harm reduction strategies focused on alcohol use across Iran.