docid: rimxkpuy

title: COVID-19 and the endothelium

text: There is growing evidence that COVID-19 not only affects the lungs but beyond that the endothelial system. Recent studies showed that this can lead to microcirculatory impairments and in consequence to functional disorders of all inner organs. The combination of endothelial dysfunction with a generalized inflammatory state and complement elements may together contribute to the overall pro-coagulative state described in COVID-19 patients leading to venular as well as to arteriolar occlusions.


SARS-CoV-2 Positivity Rate for Latinos in the Baltimore-Washington, DC Region


An Approach to Consolidating Pediatric Hospital Beds During the COVID-19 Surge


title: A surgeon's role in fighting a medical pandemic: Experiences from the unit at the epicentre of COVID-19 in Singapore - A cohort perspective

text: IMPORTANCE: Although Singapore was one of the first countries outside of China to be affected by COVID-19, for the first 2.5 months since its first reported case on January 23, 2020, it remained one of the few nations with successful containment of spread of the pandemic with little mortality and zero intra-hospital transmissions, without instituting a major lockdown of the country. In times of an infectious epidemic where medical subspecialties lead the frontline, a surgeon's role becomes rather vague. However, the only obstacle that stands in between the surgeon and fighting in the frontline of an infectious disease outbreak, is the traditional perception of what a surgeon can do. By presenting the strategies employed by our institution and its surgical unit, which remains the epicenter of the COVID-19 fight in Singapore, together with our medical counterparts, we hope to be able to improve our practices to respond and prevent the pandemic from escalating further as a collective community of surgeons across the globe. OBSERVATIONS: Contingencies should be in place for prioritization of existing patients, triaging and treatment of suspected patients, infection control, manpower management and novel strategies for inter-disciplinary communications and education in a hospital's surgical unit during a pandemic. Working in a high risk environment with manpower and resource limitations for prolonged periods of time has effect on morale and affects surgeon burn-out. Transparent communication, avenues to address psychological needs of surgeons and leadership by example are key strategies in ensuring a sustainable fight against the pandemic. CONCLUSIONS AND RELEVANCE: With the varies strategies implemented, every surgical discipline and every surgeon should be unified and place their desire to operate aside. There should not be any differentiation between surgeon and physician, but instead, everyone has to work together as one united health care front battling the common enemy - COVID-19.


Coronavirus and quarantine: will we sacrifice our elderly to protect them?


COVID-19 in Australian health care workers: early experience of the Royal Melbourne Hospital emphasises the importance of community acquisition


title: Impact of the COVID-19 pandemic on the Internet latency: a large-scale study

text: The COVID-19 pandemic dramatically changed the way of living of billions of people in a very short time frame. In this paper, we evaluate the impact on the Internet latency caused by the increased amount of human activities that are carried out on-line. The study focuses on Italy, which experienced significant restrictions imposed by local authorities, but results about Spain, France, Germany, Sweden, and the whole Europe are also included. The analysis of a large set of measurements shows that the impact on the network is significant, especially in terms of increased variability of latency. In Italy we observed that the standard deviation of the additional delay -- the additional time with respect to the minimum for a given path -- during lockdown is ~3-6 times as much as the value before the pandemic. Similarly, packet loss is ~1.4-7 times as much as before the pandemic. The impact is not negligible also for the other countries and for the whole Europe, but with different levels and distinct patterns.


The application of strong matrix management and PDCA cycle in the management of severe COVID-19 patients


Is home isolation appropriate for preventing the spread of COVID-19


title: Maternal and Neonatal Response to COVID-19

text: The risk of severe acute respiratory distress syndrome-associated coronavirus-2 (SARS-CoV-2) to maternal and newborn health has yet to be determined. Several reports suggest pregnancy does not typically increase the severity of disease, however, several cases of pre-eclampsia and preterm birth have been reported. Reports of placental infection and vertical transmission are rare. Interestingly, despite lack of SARS-CoV-2 placenta productive infection there are several reports of significant abnormalities in placenta morphology. Continued research on pregnant women infected with SARS-CoV-2 and their offspring is vitally important.


title: Rapid detection of SARS-CoV-2 by low volume real-time single tube reverse transcription recombinase polymerase amplification using an exo probe with an internally linked quencher (exo-IQ)

text: BACKGROUND: The current outbreak of SARS-CoV-2 has spread to almost every country with more than three million confirmed cases and over two hundred thousand deaths as of April 28, 2020. Rapid first-line testing protocols are needed for outbreak control and surveillance. METHODS: We used computational and manual design to generate a suitable set of reverse transcription recombinase polymerase amplification (RT-RPA) primer and exonuclease probe, internally quenched (exo-IQ) probe sequences targeting the SARS-CoV-2 N gene. RT-RPA sensitivity was determined by amplification of in vitro transcribed RNA standards. Assay selectivity was demonstrated with a selectivity panel of 32 nucleic acid samples derived from common respiratory viruses. To validate the assay against full-length SARS-CoV-2 RNA, total viral RNA derived from cell culture supernatant and 19 nasopharyngeal swab samples (8 positive and 11 negative for SARS-CoV-2) were screened. All results were compared to established RT-qPCR assays. RESULTS: The 95% detection probability of the RT-RPA assay was determined to be 7.74 (95% CI: 2.87 - 27.39) RNA copies per reaction. The assay showed no cross-reactivity to any other screened coronaviruses or respiratory viruses of clinical significance. The developed RT-RPA assay produced 100% diagnostic sensitivity and specificity when compared to RT-qPCR (n=20). CONCLUSION: With a run time of 15 to 20 minutes and first results being available in under 7 minutes for high RNA concentrations, the reported assay constitutes one of the fastest nucleic acid based detection methods for SARS-CoV-2 to date and may provide a simple to use alternative to RT-qPCR for first-line screening at the point of need.


title: COVID-19 challenges to Pakistan: Is GIS analysis useful to draw solutions?

text: The outbreak of novel coronavirus (COVID-19) is a public health emergency that had caused disastrous results in more than 100 countries. The ability to detect disease outbreaks in the early stages is a key component of efficient disease control and prevention. With the increased availability of electronic health-care data and spatial analysis techniques, there is great potential to develop algorithms to enable more effective disease surveillance. The research focuses to develop a transparent user-friendly method to simulate the outbreak data. The paper describes the GIS tools to identify and define the field of investigation which requires consideration of the strengths and limitations of data collection instruments, facility of locational data collection, accuracy of locational data, and pertinent attributes for understanding disease risk. Using such information, it is quite easy for authorities to locate the highly effected area and take appropriate actions in that particular areas. However, GIS techniques, resources, and methods can be used in Pakistan for more effective investigation of vulnerable geographical locations.


title: Possible Role of Adipose Tissue and Endocannabinoid System in COVID-19 Pathogenesis: Can Rimonabant Return?

text: This is the main conclusion of a recent study describing a strong relationship between the degree of obesity and the severity of COVID-19 infection. Obesity has various negative consequences relative to the course of COVID-19, including adverse effects on lung physiology, and induces comorbidities such as type II diabetes or hypertension. However, additional mechanisms involving the low-grade inflammatory state accompanying obesity can also be suggested.


title: Firefly-Algorithm Supported Scheme to Detect COVID-19 Lesion in Lung CT Scan Images using Shannon Entropy and Markov-Random-Field

text: The pneumonia caused by Coronavirus disease (COVID-19) is one of major global threat and a number of detection and treatment procedures are suggested by the researchers for COVID-19. The proposed work aims to suggest an automated image processing scheme to extract the COVID-19 lesion from the lung CT scan images (CTI) recorded from the patients. This scheme implements the following procedures; (i) Image pre-processing to enhance the COVID-19 lesions, (ii) Image post-processing to extract the lesions, and (iii) Execution of a relative analysis between the extracted lesion segment and the Ground-Truth-Image (GTI). This work implements Firefly Algorithm and Shannon Entropy (FA+SE) based multi-threshold to enhance the pneumonia lesion and implements Markov-Random-Field (MRF) segmentation to extract the lesions with better accuracy. The proposed scheme is tested and validated using a class of COVID-19 CTI obtained from the existing image datasets and the experimental outcome is appraised to authenticate the clinical significance of the proposed scheme. The proposed work helped to attain a mean accuracy of>92% during COVID-19 lesion segmentation and in future, it can be used to examine the real clinical lung CTI of COVID-19 patients.


Can COVID-19 related mental health issues be measured?


Pre-season football preparation in the era of COVID-19: Croatian Football Association Model


Lockdown fears for key populations


docid: gyzosxmz

title: Detection of severe acute respiratory syndrome Coronavirus-2 in the tears of patients with Coronavirus disease 2019

text: OBJECTIVES: Since there are few reports on the ocular involvement of coronavirus disease 2019 (COVID-19) patients, this study aimed to assess the presence of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) in the tears of patients with COVID-19. METHODS: In this prospective case series, nasopharyngeal and tear sampling of 43 patients with severe COVID-19 were performed. The quantitative reverse transcription polymerase chain reaction (RT-PCR) was conducted to detect SARS-CoV-2. Ocular and systemic signs and symptoms were recorded from their medical history. RESULTS: The mean age of patients was 56 ± 13 years. The average disease time from initiation of symptoms was 3.27 days, range: 1-7 days. Forty-one patients (95.3%) had fever at the time of sampling. Only one patient had conjunctivitis. Thirty (69.8%) nasopharyngeal and three (7%) tear samples were positive for SARS-CoV-2. The result of tear sample was positive in the patient with conjunctivitis. All patients with positive tear RT-PCR results had positive nasopharyngeal RT-PCR results. CONCLUSIONS: Ocular manifestation was rare in this series of severe COVID-19 patients, however, 7% of the patients had viral RNA in their conjunctival secretions. Therefore, possibility of ocular transmission should be considered even in the absence of ocular manifestations.


title: COVID-19, coagulopathy and venous thromboembolism: more questions than answers

text: The acute respiratory illnesses caused by severe acquired respiratory syndrome corona Virus-2 (SARS-CoV-2) is a global health emergency, involving more than 8.6 million people worldwide with more than 450,000 deaths. Among the clinical manifestations of COVID-19, the disease that results from SARS-CoV-2 infection in humans, a prominent feature is a pro-thrombotic derangement of the hemostatic system, possibly representing a peculiar clinicopathologic manifestation of viral sepsis. The severity of the derangement of coagulation parameters in COVID-19 patients has been associated with a poor prognosis, and the use of low molecular weight heparin (LMWH) at doses registered for prevention of venous thromboembolism (VTE) has been endorsed by the World Health Organization and by Several Scientific societies. However, some relevant issues on the relationships between COVID-19, coagulopathy and VTE have yet to be fully elucidated. This review is particularly focused on four clinical questions: What is the incidence of VTE in COVID-19 patients? How do we frame the COVID-19 associated coagulopathy? Which role, if any, do antiphospolipid antibodies have? How do we tackle COVID-19 coagulopathy? In the complex scenario of an overwhelming pandemic, most everyday clinical decisions have to be taken without delay, although not yet supported by a sound scientific evidence. This review discusses the most recent findings of basic and clinical research about the COVID-associated coagulopathy, to foster a more thorough knowledge of the mechanisms underlying this compelling disease.


Could ferritin help the screening for COVID-19 in hemodialysis patients?


title: Thalidomide-Revisited: Are COVID-19 Patients Going to Be the Latest Victims of Yet Another Theoretical Drug-Repurposing?

text: The coronavirus disease 2019 (COVID-19) pandemic is a worldwide threatening health issue. The progression of this viral infection occurs in the airways of the lungs with an exaggerated inflammatory response referred to as the "cytokine storm" that can lead to lethal lung injuries. In the absence of an effective anti-viral molecule and until the formulation of a successful vaccine, anti-inflammatory drugs might offer a complementary tool for controlling the associated complications of COVID-19 and thus decreasing the subsequent fatalities. Drug repurposing for several molecules has emerged as a rapid temporary solution for COVID-19. Among these drugs is Thalidomide; a historically emblematic controversial molecule that harbors an FDA approval for treating erythema nodosum leprosum (ENL) and multiple myeloma (MM). Based on just one-case report that presented positive outcomes in a patient treated amongst others with Thalidomide, two clinical trials on the efficacy and safety of Thalidomide in treating severe respiratory complications in COVID-19 patients were registered. Yet, the absence of substantial evidence on Thalidomide usage in that context along with the discontinued studies on the efficiency of this drug in similar pulmonary diseases, might cause a significant obstacle for carrying out further clinical evaluations. Herein, we will discuss the theoretical effectiveness of Thalidomide in attenuating inflammatory complications that are encountered in COVID-19 patients while pinpointing the lack of the needed evidences to move forward with this drug.


docid: ekefoqcm

title: COVID-19 in a patient with HIV infection


title: Leadership in the time of crisis

text: Sam Foster, Chief Nurse, Oxford University Hospitals, considers what leaders need to do in this time of COVID-19.


COVID-19 in patients with rheumatological diseases treated with anti-TNF


title: Surviving the surge: Evaluation of early impact of COVID-19 on inpatient pharmacy services at a community teaching hospital

text: PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has presented novel challenges to healthcare systems; however, an analysis of the impact of the pandemic on inpatient pharmacy services has not yet been conducted. METHODS: Results of an observational assessment of operational and clinical pharmacy services at a community teaching hospital during the first weeks of the COVID-19 pandemic are presented. Service outcomes of the inpatient pharmacy were evaluated from February 1 to April 8, 2020. Outcomes during the weeks preceding the first COVID-19 admission (February 1 to March 11, 2020) and during the pandemic period (March 12 to April 8, 2020) were compared. Evaluated outcomes included daily order verifications, clinical interventions, and usage of relevant medications. An exploratory statistical analysis was conducted using Student's t test. RESULTS: During the pandemic period, the number of new order verifications decreased from approximately 5,000 orders per day to 3,300 orders per day (P < 0.01), a reduction of 30% during the first 4 weeks of the pandemic compared to the weeks prior. Average daily pharmacokinetic dosing consults were reduced in the pandemic period (from 82 to 67; P < 0.01) compared to the prepandemic period; however, total daily pharmacist interventions did not differ significantly (473 vs 456; P = 0.68). Dispensing of hydroxychloroquine, azithromycin, enoxaparin, and sedative medications increased substantially during the pandemic period (P < 0.01 for all comparisons). CONCLUSION: The operational and clinical requirements of an inpatient pharmacy department shifted considerably during the first weeks of the COVID-19 pandemic. Pharmacy departments must be adaptable in order to continue to provide effective pharmaceutical care during the pandemic.


docid: ltmbvkwv

title: "Women and children last"-effects of the covid-19 pandemic on reproductive, perinatal, and paediatric health


title: All-polymer hybrid electret fibers for high-efficiency and low-resistance filter media

text: A one-step and controllable strategy to prepare all-polymer hybrid electret fibers is reported based on the coupling of polystyrene and polyvinylidene fluoride in electric response. The complementary dielectric properties between PS and PVDF generate dual-system electret charges within PS/PVDF fibers, thereby improving the electret effect. The bi-component all-polymer electret fibers show enhanced electret property and structural continuity, contributing to a N95 protective respirator with high filtration efficiency (99.752%), low air resistance (72 Pa) and long service life. The fabrication of all-polymer electret fibers solves the challenge of nanoparticle toxicity for existing polymer/nanoparticle electret fibers.


SARS-CoV-2 and co-infections detection in nasopharyngeal throat swabs of COVID-19 patients by metagenomics


title: Application of a Risk Analysis Tool to Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Outbreak in Saudi Arabia

text: The Grunow-Finke assessment tool (GFT) is an accepted scoring system for determining likelihood of an outbreak being unnatural in origin. Considering its high specificity but low sensitivity, a modified Grunow-Finke tool (mGFT) has been developed with improved sensitivity. The mGFT has been validated against some past disease outbreaks, but it has not been applied to ongoing outbreaks. This study is aimed to score the outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia using both the original GFT and mGFT. The publicly available data on human cases of MERS-CoV infections reported in Saudi Arabia (2012-2018) were sourced from the FluTrackers, World Health Organization, Saudi Ministry of Health, and published literature associated with MERS outbreaks investigations. The risk assessment of MERS-CoV in Saudi Arabia was analyzed using the original GFT and mGFT criteria, algorithms, and thresholds. The scoring points for each criterion were determined by three researchers to minimize the subjectivity. The results showed 40 points of total possible 54 points using the original GFT (likelihood: 74%), and 40 points of a total possible 60 points (likelihood: 67%) using the mGFT, both tools indicating a high likelihood that human MERS-CoV in Saudi Arabia is unnatural in origin. The findings simply flag unusual patterns in this outbreak, but do not prove unnatural etiology. Proof of bioattacks can only be obtained by law enforcement and intelligence agencies. This study demonstrated the value and flexibility of the mGFT in assessing and predicting the risk for an ongoing outbreak with simple criteria.


What's Old is New! Similarities Between SARS-CoV-2 and HIV


title: Caring for Children and Adolescents With Eating Disorders in the Current Coronavirus 19 Pandemic: A Singapore Perspective

text: Our public pediatric tertiary hospital in Singapore has been a part of a robust public health response to coronavirus 19 that has been calibrated in a timely manner to the evolving international situation. As of mid-March, Singapore remains in a containment mode with enhanced surveillance and limited community spread. Within this context, our service for pediatric eating disorder care has had to make significant adaptations to our models of service delivery as well as respond to the changing psychosocial needs of our patients. Given infection control requirements, we have instituted modular staffing for our inpatient and outpatient settings, necessitating task shifting and an increased use of technology for communication. Because of the reduced outpatient capacity and the need to minimize nonurgent trips to the hospital, we have implemented telemedicine and have leveraged on partnerships with school counselors and other community partners. "Coronaphobia" has influenced our patients' willingness to attend visits and worsened existing health anxiety for some. Responsiveness to families' and patients' health and financial concerns has been essential. As coronavirus 19 impacts more countries, our institution's experience can provide insight into challenges and possible adaptations to providing ongoing care for eating disorder patients in this environment.


title: Eleven faces of coronavirus disease 2019

text: BACKGROUND AND AIMS: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently spread worldwide and been declared a pandemic. We aim to describe here the various clinical presentations of this disease by examining eleven cases. METHODS: Electronic medical records of 11 patients with COVID-19 were collected, and demographics, clinical manifestations, outcomes, key laboratory results, and radiological images are discussed. RESULTS: The clinical course of the eleven cases demonstrated the complexity of the COVID-19 profile with different clinical presentations. Clinical manifestations range from asymptomatic cases to patients with mild and severe symptoms, with or without pneumonia. Laboratory detection of the viral nucleic acid can yield false-negative results, and serological testing of virus-specific IgG and IgM antibodies should be used as an alternative for diagnosis. Patients with common allergic diseases did not develop distinct symptoms and severe courses. Cases with a pre-existing condition of chronic obstructive pulmonary disease or complicated with a secondary bacterial pneumonia were more severe. CONCLUSION: All different clinical characteristics of COVID-19 should be taken into consideration to identify patients that need to be in strict quarantine for the efficient containment of the pandemic.


title: Hot Hydride Superconductivity above 550 K

text: The search for room temperature superconductivity has accelerated dramatically in the last few years driven largely by theoretical predictions that first indicated alloying dense hydrogen with other elements could produce conventional phonon-mediated superconductivity at very high temperatures and at accessible pressures, and more recently, with the success of structure search methods that have identified specific candidates and pressure-temperature (P-T) conditions for synthesis. These theoretical advances have prompted improvements in experimental techniques to test these predictions. As a result, experimental studies of simple binary hydrides under pressure have yielded high critical superconducting transition temperatures (Tc), of 260 K in LaH10, close to the commonly accepted threshold for room temperature, 293 K, at pressures near 180 GPa. We successfully synthesized a metallic La-based superhydride from La metal and ammonia borane, NH3BH3, and find a multi-step transition with a Tc of 294 K for the highest onset. When subjected to subsequent thermal excursions to higher temperatures that promoted a chemical reaction to what we believe is a ternary or higher order system, the transition temperature was driven to higher temperatures. Although the reaction does not appear to be complete, the onset temperature was pushed from 294 K to 556 K before the experiments had to be terminated. The results provide evidence for hot superconductivity well above room temperature, in line with recent predictions for a higher order hydride under pressure.


Turning a surgical unit into a COVID-19 facility: Governance counts


title: Development of an openEHR Template for COVID-19 Based on Clinical Guidelines

text: BACKGROUND: The coronavirus disease (COVID-19) was discovered in China in December 2019. It has developed into a threatening international public health emergency. With the exception of China, the number of cases continues to increase worldwide. A number of studies about disease diagnosis and treatment have been carried out, and many clinically proven effective results have been achieved. Although information technology can improve the transferring of such knowledge to clinical practice rapidly, data interoperability is still a challenge due to the heterogeneous nature of hospital information systems. This issue becomes even more serious if the knowledge for diagnosis and treatment is updated rapidly as is the case for COVID-19. An open, semantic-sharing, and collaborative-information modeling framework is needed to rapidly develop a shared data model for exchanging data among systems. openEHR is such a framework and is supported by many open software packages that help to promote information sharing and interoperability. OBJECTIVE: This study aims to develop a shared data model based on the openEHR modeling approach to improve the interoperability among systems for the diagnosis and treatment of COVID-19. METHODS: The latest Guideline of COVID-19 Diagnosis and Treatment in China was selected as the knowledge source for modeling. First, the guideline was analyzed and the data items used for diagnosis and treatment, and management were extracted. Second, the data items were classified and further organized into domain concepts with a mind map. Third, searching was executed in the international openEHR Clinical Knowledge Manager (CKM) to find the existing archetypes that could represent the concepts. New archetypes were developed for those concepts that could not be found. Fourth, these archetypes were further organized into a template using Ocean Template Editor. Fifth, a test case of data exchanging between the clinical data repository and clinical decision support system based on the template was conducted to verify the feasibility of the study. RESULTS: A total of 203 data items were extracted from the guideline in China, and 16 domain concepts (16 leaf nodes in the mind map) were organized. There were 22 archetypes used to develop the template for all data items extracted from the guideline. All of them could be found in the CKM and reused directly. The archetypes and templates were reviewed and finally released in a public project within the CKM. The test case showed that the template can facilitate the data exchange and meet the requirements of decision support. CONCLUSIONS: This study has developed the openEHR template for COVID-19 based on the latest guideline from China using openEHR modeling methodology. It represented the capability of the methodology for rapidly modeling and sharing knowledge through reusing the existing archetypes, which is especially useful in a new and fast-changing area such as with COVID-19.


docid: buvzvrmr

title: The SARS-CoV-2 receptor ACE2 expression of maternal-fetal interface and fetal organs by single-cell transcriptome study

text: The new type of pneumonia caused by the SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) has been declared as a global public health concern by WHO. As of April 3, 2020, more than 1,000,000 human infections have been diagnosed around the world, which exhibited apparent person-to-person transmission characteristics of this virus. The capacity of vertical transmission in SARS-CoV-2 remains controversial recently. Angiotensin-converting enzyme 2 (ACE2) is now confirmed as the receptor of SARS-CoV-2 and plays essential roles in human infection and transmission. In present study, we collected the online available single-cell RNA sequencing (scRNA-seq) data to evaluate the cell specific expression of ACE2 in maternal-fetal interface as well as in multiple fetal organs. Our results revealed that ACE2 was highly expressed in maternal-fetal interface cells including stromal cells and perivascular cells of decidua, and cytotrophoblast and syncytiotrophoblast in placenta. Meanwhile, ACE2 was also expressed in specific cell types of human fetal heart, liver and lung, but not in kidney. And in a study containing series fetal and post-natal mouse lung, we observed ACE2 was dynamically changed over the time, and ACE2 was extremely high in neonatal mice at post-natal day 1~3. In summary, this study revealed that the SARS-CoV-2 receptor was widely spread in specific cell types of maternal-fetal interface and fetal organs. And thus, both the vertical transmission and the placenta dysfunction/abortion caused by SARS-CoV-2 need to be further carefully investigated in clinical practice.


title: Precaution and prevention of coronavirus disease 2019 infection in the eye

text: Although current studies suggested that conjunctivitis is not a common presentation of coronavirus disease 2019 (COVID-19), several studies have reported the presence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in ocular secretions. Coronavirus had not yet been successfully cultured from tears or conjunctival swabs in humans, neither SARS-CoV-2 nor SARS-CoV. However, live feline coronavirus has been isolated from conjunctival swabs. In addition, infection of COVID-19 through unprotected eye exposure had been suspected in several articles. Reports of ophthalmologists and otolaryngologists died of COVID-19 also raised concern on ocular transmission. As a result, we strongly suggest that personal protective equipment (PPE) should cover the mouth, nose, and eyes of ophthalmologists, especially when conjunctivitis caused by SARS-CoV-2 is clinically indistinguishable from other viral follicular conjunctivitis.


title: Precaution and Prevention of Coronavirus Disease 2019 (COVID-19) Infection in the Eye

text: Although current studies suggested that conjunctivitis is not a common presentation of coronavirus disease 2019(COVID-19), several studies have reported the presence of Severe Acute Respiratory Syndrome Coronavirus-2(SARS-CoV-2) in ocular secretions. Coronavirus had not yet been successfully cultured from tears or conjunctival swabs in humans, neither SARS-CoV-2 nor SARS-CoV. However, live feline coronavirus has been isolated from conjunctival swabs. In addition, infection of COVID-19 through unprotected eye exposure had been suspected in several articles. Reports of ophthalmologists and otolaryngologists died of COVID-19 also raised concern on ocular transmission. As a result, we strongly suggest that personal protective equipment (PPE) should cover the mouth, nose, and eyes of ophthalmologists, especially when conjunctivitis caused by SARS-CoV-2 is clinically indistinguishable from other viral follicular conjunctivitis.


title: The deep impact of novel CoVID-19 infection in an Orthopedics and Traumatology Department: the experience of the Piacenza Hospital

text: Since February 21st, 2020 CoVID-19 spread throughout all Italy expanding like a "tsunami" from Codogno (Lodi, Lombardy, Northern Italy) to neighboring cities. In a few days Lodi, Piacenza, Milano, Brescia and Bergamo were forced to deal with this disaster starting the lockdown at different time. No national plan had been prepared. As result, CoVID-19 has paralyzed the Italian healthcare system. At time of writing, in Italy there are 169 323 infected patients and 22 260 deaths. Italy is fighting hard to manage CoVID-19 crisis even if most hospitals were unprepared to deal with massive influx of critically ill CoVID-19 patients. Piacenza in Emilia-Romagna region (Northern Italy) is one of the epicenters of the Italian pandemic, and the local hospital - Guglielmo da Saliceto - has quickly become a "CoVID-19 hospital" with the great effort of all the medical staff. Here we report the experience of our hospital, particularly the strategy adopted in the Orthopedics and Traumatology Department.


The Role of Augmented Intelligence (AI) in Detecting and Preventing the Spread of Novel Coronavirus


title: Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19

text: Severe acute respiratory syndrome coronavirus 2 was isolated from feces of a patient in China with coronavirus disease who died. Confirmation of infectious virus in feces affirms the potential for fecal-oral or fecal-respiratory transmission and warrants further study.


title: COVID-19 and the role of chronic inflammation in patients with obesity

text: Coronavirus disease 2019 (COVID-19) and the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a particular risk to people living with preexisting conditions that impair immune response or amplify pro-inflammatory response. Low-grade chronic systemic inflammation, common in people with obesity, is associated with the development of atherosclerosis, type 2 diabetes, and hypertension, well known comorbidities that adversely affect the outcomes of patients with COVID-19. Risk stratification based on the Edmonton Obesity Staging System (EOSS), which classifies obesity based on the presence of medical, mental, and/or functional complications rather than on body mass index (BMI), has been shown to be a better predictor of all-cause mortality and it may well be that EOSS stages may better describe the risk of hyperinflammation in patients with COVID-19 infection. Analyzing a group of metabolic ill patients with obesity (EOSS 2 and 3), we found an increased interleukin-6 and linear regression analysis showed a positive correlation with C-reactive protein (CRP) (p = 0.014) and waist-to-hip-ratio (WHR) (p = 0.031). Physicians should be aware of these findings in patients with COVID-19 infection. Early identification of possible hyperinflammation could be fundamental and should guide decision making regarding hospitalization, early respiratory support, and therapy with immunosuppression to improve mortality.


title: A Cascaded Learning Strategy for Robust COVID-19 Pneumonia Chest X-Ray Screening

text: We introduce a comprehensive screening platform for the COVID-19 (a.k.a., SARS-CoV-2) pneumonia. The proposed AI-based system works on chest x-ray (CXR) images to predict whether a patient is infected with the COVID-19 disease. Although the recent international joint effort on making the availability of all sorts of open data, the public collection of CXR images is still relatively small for reliably training a deep neural network (DNN) to carry out COVID-19 prediction. To better address such inefficiency, we design a cascaded learning strategy to improve both the sensitivity and the specificity of the resulting DNN classification model. Our approach leverages a large CXR image dataset of non-COVID-19 pneumonia to generalize the original well-trained classification model via a cascaded learning scheme. The resulting screening system is shown to achieve good classification performance on the expanded dataset, including those newly added COVID-19 CXR images.


title: "The COVID-19 outbreak"-An empirical phenomenological study on perceptions and psychosocial considerations surrounding the immediate incorporation of final-year Spanish nursing and medical students into the health system

text: The COVID-19 pandemic has caused an unprecedented health crisis worldwide, with the numbers of infections and deaths worldwide multiplying alarmingly in a matter of weeks. Accordingly, governments have been forced to take drastic actions such as the confinement of the population and the suspension of face-to-face teaching. In Spain, due to the collapse of the health system the government has been forced to take a series of important measures such as requesting the voluntary incorporation of final-year nursing and medical students into the health system. The objective of the present work is to study, using a phenomenological qualitative approach, the perceptions of students in this exceptional actual situation. A total of 62 interviews were carried out with final-year nursing and medicine students from Jaime I University (Spain), with 85% reporting having voluntarily joined the health system for ethical and moral reasons. Results from the inductive analysis of the descriptions highlighted two main categories and a total of five sub-categories. The main feelings collected regarding mood were negative, represented by uncertainty, nervousness, and fear. This study provides a description of the perceptions of final-year nursing and medical students with respect to their immediate incorporation into a health system aggravated by a global crisis.


title: Molecular mechanisms and epidemiology of COVID-19 from an allergist's perspective

text: The global pandemic caused by the newly described severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused worldwide suffering and death of unimaginable magnitude from coronavirus disease 2019 (COVID-19). The virus is transmitted through aerosol droplets, and causes severe acute respiratory syndrome. SARS-CoV-2 uses the receptor-binding domain of its spike protein S1 to attach to the host angiotensin-converting enzyme 2 receptor in lung and airway cells. Binding requires the help of another host protein, transmembrane protease serine S1 member 2. Several factors likely contribute to the efficient transmission of SARS-CoV-2. The receptor-binding domain of SARS-CoV-2 has a 10- to 20-fold higher receptor-binding capacity compared with previous pandemic coronaviruses. In addition, because asymptomatic persons infected with SARS-CoV-2 have high viral loads in their nasal secretions, they can silently and efficiently spread the disease. PCR-based tests have emerged as the criterion standard for the diagnosis of infection. Caution must be exercised in interpreting antibody-based tests because they have not yet been validated, and may give a false sense of security of being "immune" to SARS-CoV-2. We discuss how the development of some symptoms in allergic rhinitis can serve as clues for new-onset COVID-19. There are mixed reports that asthma is a risk factor for severe COVID-19, possibly due to differences in asthma endotypes. The rapid spread of COVID-19 has focused the efforts of scientists on repurposing existing Food and Drug Administration-approved drugs that inhibit viral entry, endocytosis, genome assembly, translation, and replication. Numerous clinical trials have been launched to identify effective treatments for COVID-19. Initial data from a placebo-controlled study suggest faster time to recovery in patients on remdesivir; it is now being evaluated in additional controlled studies. As discussed in this review, till effective vaccines and treatments emerge, it is important to understand the scientific rationale of pandemic-mitigation strategies such as wearing facemasks and social distancing, and implement them.


Coronavirus diaries: a lockdown letter to myself as a PhD student


Role of computed tomography imaging in identifying COVID-19 cases


docid: sjdilzew

title: Guía técnica para el cuidado de la salud mental de la población afectada, familias y comunidad, en el contexto del COVID-19

text: La guía contienen los criterios técnicos y procedimientos para el cuidado y autocuidado de la salud mental de la población, en el contexto de COVID-19


docid: xfynhxwl

title: 'Masking' emotions: doctor-patient communication in the era of COVID-19


Nafamostat mesylate treatment in combination with favipiravir for patients critically ill with Covid-19: a case series


title: A Dual-Center Observational Review of Hospital-Based Palliative Care in Patients Dying With COVID-19

text: The current coronavirus disease 2019 (COVID-19) pandemic has put significant strain on all aspects of health care delivery, including palliative care services. Given the high mortality from this disease, particularly in the more vulnerable members of society, it is important to examine how best to deliver a high standard of end-of-life care during this crisis. This case series collected data from two acute hospitals examining the management of patients diagnosed with COVID-19 who subsequently died (n = 36) and compared this with national and local end-of-life audit data for all other deaths. Our results demonstrated a shorter dying phase (38.25 hours vs. 74 hours) and higher rates of syringe driver use (72% vs. 33% in local audits), although with similar average mediation doses. Of note was the significant heterogeneity in the phenotype of deterioration in the dying phase, two distinct patterns emerged, with one group demonstrating severe illness with a short interval between symptom onset and death and another group presenting with a more protracted deterioration. This brief report suggests a spectrum of mode of dying. Overall, the cohort reflects previously described experiences, with increased frailty (median Clinical Frailty Scale score of 5) and extensive comorbidity burden. This brief report provides clinicians with a contemporaneous overview of our experience, knowledge, and pattern recognition when caring for people with COVID-19 and highlights the value of proactive identification of patients and risk of deterioration and palliation.


Collateral Damage: The Cardiovascular Cost of Suppressing COVID-19 Transmission in Australia


title: Patient Follow-up after Discharge after COVID-19 Pneumonia: Considerations for Infectious Control

text: Coronavirus disease 2019 (COVID-19) represents a significant global medical issue, with a growing number of cumulative confirmed cases. However, a large number of COVID-19 patients have overcome the disease, meeting hospital discharge criteria, and are gradually returning to work and social life. Nonetheless, COVID-19 may cause further downstream issues in these patients, such as due to possible reactivation of the virus, long-term pulmonary defects, and post-traumatic stress disorder. In this study, we therefore queried relevant literature concerning SARS, MERS, and COVID-19 for reference to come to a consensus on follow-up strategies. We found that strategies such as implementation of PCR testing, imaging surveillance, and psychological assessments, starting at the time of discharge, were necessary for long-term follow-up. If close care is given to every aspect of coronavirus management, we expect that the pandemic outbreak will soon be overcome. This article is protected by copyright. All rights reserved.


title: Forward utilities and Mean-field games under relative performance concerns

text: We introduce the concept of mean field games for agents using Forward utilities to study a family of portfolio management problems under relative performance concerns. Under asset specialization of the fund managers, we solve the forward-utility finite player game and the forward-utility mean-field game. We study best response and equilibrium strategies in the single common stock asset and the asset specialization with common noise. As an application, we draw on the core features of the forward utility paradigm and discuss a problem of time-consistent mean-field dynamic model selection in sequential time-horizons.


Uncertainty upon uncertainty: supportive Care for Cancer and COVID-19


title: Protocol for a partially nested randomised controlled trial to evaluate the effectiveness of the scleroderma patient-centered intervention network COVID-19 home-isolation activities together (SPIN-CHAT) program to reduce anxiety among at-risk scleroderma patients

text: OBJECTIVE: Contagious disease outbreaks and related restrictions can lead to negative psychological outcomes, particularly in vulnerable populations at risk due to pre-existing medical conditions. No randomised controlled trials (RCTs) have tested interventions to reduce mental health consequences of contagious disease outbreaks. The primary objective of the Scleroderma Patient-centered Intervention Network COVID-19 Home-isolation Activities Together (SPIN-CHAT) Trial is to evaluate the effect of a videoconference-based program on symptoms of anxiety. Secondary objectives include evaluating effects on symptoms of depression, stress, loneliness, boredom, physical activity, and social interaction. METHODS: The SPIN-CHAT Trial is a pragmatic RCT that will be conducted using the SPIN-COVID-19 Cohort, a sub-cohort of the SPIN Cohort. Eligible participants will be SPIN-COVID-19 Cohort participants without a positive COVID-19 test, with at least mild anxiety (PROMIS Anxiety 4a v1.0 T-scoreâ¯≥â¯55), not working from home, and not receiving current counselling or psychotherapy. We will randomly assign 162 participants to intervention groups of 7 to 10 participants each or waitlist control. We will use a partially nested RCT design to reflect dependence between individuals in training groups but not in the waitlist control. The SPIN-CHAT Program includes activity engagement, education on strategies to support mental health, and mutual participant support. Intervention participants will receive the 4-week (3 sessions per week) SPIN-CHAT Program via videoconference. The primary outcome is PROMIS Anxiety 4a score immediately post-intervention. ETHICS AND DISSEMINATION: The SPIN-CHAT Trial will test whether a brief videoconference-based intervention will improve mental health outcomes among at-risk individuals during contagious disease outbreak.


Is herpes zoster being an indicator for COVID 19 infection?


title: Data, reagents, assays and merits of proteomics for SARS-CoV-2 research and testing

text: As the SARS-CoV-2 pandemic continues to spread, thousands of scientists around the globe have changed research direction to understand better how the virus works and to find out how it may be tackled. The number of manuscripts on preprint servers is soaring and peer-reviewed publications using mass spectrometry-based proteomics are beginning to emerge. To facilitate proteomic research on SARS-CoV-2, this report presents deep-scale proteomes (10,000 proteins; >130,000 peptides) of common cell line models, notably Vero E6, Calu-3, Caco-2, and ACE2-A549 that characterize their protein expression profiles including viral entry factors such as ACE2 or TMPRSS2. Using the 9 kDa protein SRP9 and the breast cancer oncogene BRCA1 as examples, we show how the proteome expression data can be used to refine the annotation of protein-coding regions of the African green monkey and the Vero cell line genomes. Monitoring changes of the proteome upon viral infection revealed widespread expression changes including transcriptional regulators, protease inhibitors, and proteins involved in innate immunity. Based on a library of 98 stable-isotope labeled synthetic peptides representing 11 SARS-CoV-2 proteins, we developed PRM (parallel reaction monitoring) assays for nano-flow and micro-flow LC-MS/MS. We assessed the merits of these PRM assays using supernatants of virus-infected Vero E6 cells and challenged the assays by analyzing two diagnostic cohorts of 24 (+30) SARS-CoV-2 positive and 28 (+9) negative cases. In light of the results obtained and including recent publications or manuscripts on preprint servers, we critically discuss the merits of mass spectrometry-based proteomics for SARS-CoV-2 research and testing.


title: Managing COVID-19 in Renal Transplant Recipients: A Review of Recent Literature and Case Supporting Corticosteroid-sparing Immunosuppression

text: Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome virus (SARS-CoV-2) has become a global health care crisis. The Centers for Disease Control and Prevention (CDC) lists immunocompromised patients, including those requiring immunosuppression following renal transplantation, as high risk for severe disease from SARS-CoV-2. Treatment for other viral infections in renal transplant recipients often includes a reduction in immunosuppression; however, no current guidelines are available recommending the optimal approach to managing immunosuppression in the patients who are infected with SARS-CoV-2. It is currently advised to avoid corticosteroids in the treatment of SARS-CoV-2 outside of critically ill patients. Recently published cases describing inpatient care of COVID-19 in renal transplant recipients differ widely in disease severity, time from transplantation, baseline immunosuppressive therapy, and the modifications made to immunosuppression during COVID-19 treatment. This review summarizes and compares inpatient immunosuppressant management strategies of recently published reports in the renal transplant population infected with SARS-CoV-2 and discusses the limitations of corticosteroids in managing immunosuppression in this patient population.


A Call for a Three-Tiered Pandemic Public Health Strategy in Context of SARS-CoV-2


Implementing shared ventilation must be scientific and ethical, or it risks harm


title: A Diabetic Patient With 2019-nCoV (COVID-19) Infection Who Recovered and Was Discharged From Hospital

text: Novel coronavirus has become a global health hazard and its high infectivity is alarming. The imaging findings of the 2019-nCoV infection in our young diabetic patient featured ground-glass opacities and consolidations in both lungs. The lung lesions may involute rapidly during the course. The patient showed improvement both clinically and on computed tomography imaging at discharged after 2 weeks' treatment. Computed tomography scans of patients helped monitor the changes continuously, which could timely provide the information of the evolution of the disease or therapeutic effect to clinicians.


COVID-19 in the Pediatric Population Admitted to a Tertiary Referral Hospital in Northern Italy: Preliminary Clinical Data


SARS-CoV-2 Infection in Children


title: Organ-protective effect of angiotensin-converting enzyme 2 and its effect on the prognosis of COVID-19

text: This article reviews the correlation between angiotensin-converting enzyme 2 (ACE2) and severe risk factors for coronavirus disease 2019 (COVID-19) and the possible mechanisms. ACE2 is a crucial component of the renin-angiotensin system (RAS). The classical RAS ACE-Ang II-AT1R regulatory axis and the ACE2-Ang 1-7-MasR counter-regulatory axis play an essential role in maintaining homeostasis in humans. ACE2 is widely distributed in the heart, kidneys, lungs, and testes. ACE2 antagonizes the activation of the classical RAS system and protects against organ damage, protecting against hypertension, diabetes, and cardiovascular disease. Similar to SARS-CoV, SARS-CoV-2 also uses the ACE2 receptor to invade human alveolar epithelial cells. Acute respiratory distress syndrome (ARDS) is a clinical high-mortality disease, and ACE2 has a protective effect on this type of acute lung injury. Current research shows that the poor prognosis of patients with COVID-19 is related to factors such as sex (male), age (>60 years), underlying diseases (hypertension, diabetes, and cardiovascular disease), secondary ARDS, and other relevant factors. Because of these protective effects of ACE2 on chronic underlying diseases and ARDS, the development of spike protein-based vaccine and drugs enhancing ACE2 activity may become one of the most promising approaches for the treatment of COVID-19 in the future.


docid: uvvsiltp

title: Novel coronavirus infection and children

text: BACKGROUND AND AIM: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its outbreak in many states of the world, forced the World Health Organization (WHO) to declare a pandemic. Currently, COVID-19 has infected 1 991 562 patients causing 130 885 deaths globally as of 16 April 2020. The aim of this review is to underline the epidemiological, clinical and management characteristics in children affected by COVID-19. METHODS: We searched Pubmed, from January to April 2020, for the following search terms: "COVID-19", "children", "SARS-COV2", "complications", "epidemiology", "clinical features", focusing our attention mostly on epidemiology and symptoms of COVID-19 in children. RESULTS: Usually, infants and children present milder symptoms of the disease with a better outcome than adults. Consequently, children may be considered an infection reservoir that may play a role as spreader of the infection in community.


The distress of Iranian adults during the Covid-19 pandemic - More distressed than the Chinese and with different predictors


Biobanks could identify medically actionable findings relevant for COVID-19 clinical care


The Value of Mindfulness During Trying and Uncertain Times


Patient anxiety and role of patient education during coronavirus disease 2019 epidemic


title: Approximating Euclidean by Imprecise Markov Decision Processes

text: Euclidean Markov decision processes are a powerful tool for modeling control problems under uncertainty over continuous domains. Finite state imprecise, Markov decision processes can be used to approximate the behavior of these infinite models. In this paper we address two questions: first, we investigate what kind of approximation guarantees are obtained when the Euclidean process is approximated by finite state approximations induced by increasingly fine partitions of the continuous state space. We show that for cost functions over finite time horizons the approximations become arbitrarily precise. Second, we use imprecise Markov decision process approximations as a tool to analyse and validate cost functions and strategies obtained by reinforcement learning. We find that, on the one hand, our new theoretical results validate basic design choices of a previously proposed reinforcement learning approach. On the other hand, the imprecise Markov decision process approximations reveal some inaccuracies in the learned cost functions.


title: The Case for Why Africa Should Host COVID-19 Candidate Vaccine Trials

text: In response to provocative comments by 2 European clinicians and scientists, the World Health Organization Director General has declared that Africa will not host COVID-19 vaccine trials. Such a stance risks stigmatizing COVID-19 vaccine trials in Africa and depriving Africa of critical research. To the contrary, there is a critical need for Africa to host COVID-19 vaccine trials on public health, scientific, and ethics grounds.


Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Vertical Transmission in Neonates Born to Mothers With Coronavirus Disease 2019 (COVID-19) Pneumonia


title: Evolution of CT findings in patients with mild COVID-19 pneumonia

text: OBJECTIVES: To delineate the evolution of CT findings in patients with mild COVID-19 pneumonia. METHODS: CT images and medical records of 88 patients with confirmed mild COVID-19 pneumonia, a baseline CT, and at least one follow-up CT were retrospectively reviewed. CT features including lobar distribution and presence of ground glass opacities (GGO), consolidation, and linear opacities were analyzed on per-patient basis during each of five time intervals spanning the 3 weeks after disease onset. Total severity scores were calculated. RESULTS: Of patients, 85.2% had travel history to Wuhan or known contact with infected individuals. The most common symptoms were fever (84.1%) and cough (56.8%). The baseline CT was obtained on average 5 days from symptom onset. Four patients (4.5%) had negative initial CT. Significant differences were found among the time intervals in the proportion of pulmonary lesions that are (1) pure GGO, (2) mixed attenuation, (3) mixed attenuation with linear opacities, (4) consolidation with linear opacities, and (5) pure consolidation. The majority of patients had involvement of ≥ 3 lobes. Bilateral involvement was more prevalent than unilateral involvement. The proportions of patients observed to have pure GGO or GGO and consolidation decreased over time while the proportion of patients with GGO and linear opacities increased. Total severity score showed an increasing trend in the first 2 weeks. CONCLUSIONS: While bilateral GGO are predominant features, CT findings changed during different time intervals in the 3 weeks after symptom onset in patients with COVID-19. KEY POINTS: â¢ Four of 88 (4.5%) patients with COVID-19 had negative initial CT. â¢ Majority of COVID-19 patients had abnormal CT findings in ≥ 3 lobes. â¢ A proportion of patients with pure ground glass opacities decreased over the 3 weeks after symptom onset.


title: ARIMA forecasting of COVID-19 incidence in Italy, Russia, and the USA

text: The novel Coronavirus disease (COVID-19) is a severe respiratory infection that officially occurred in Wuhan, China, in December 2019. In late February, the disease began to spread quickly across the world, causing serious health, social, and economic emergencies. This paper aims to forecast the short to medium-term incidence of COVID-19 epidemic through the medium of an autoregressive integrated moving average (ARIMA) model, applied to Italy, Russia, and the USA The analysis is carried out on the number of new daily confirmed COVID-19 cases, collected by Worldometer website. The best ARIMA models are Italy (4,2,4), Russia (1,2,1), and the USA (6,2,3). The results show that: i) ARIMA models are reliable enough when new daily cases begin to stabilize; ii) Italy, the USA, and Russia reached the peak of COVID-19 infections in mid-April, mid-May, and late May, respectively; and iii) Russia and the USA will require much more time than Italy to drop COVID-19 cases near zero. This may suggest the importance of the application of quick and effective lockdown measures, which have been relatively stricter in Italy. Therefore, even if the results should be interpreted with caution, ARIMA models seem to be a good tool that can help the health authorities to monitor the diffusion of the outbreak.


title: COVID-19 information propagation dynamics in the Chinese Sina-microblog

text: The outbreak of a novel coronavirus (COVID-19) generated an outbreak of public opinions in the Chinese Sina-microblog. To help in designing effective communication strategies during a major public health emergency, we propose a multiple-information susceptible-discussing-immune (M-SDI) model in order to understand the patterns of key information propagation on social networks. We develop the M-SDI model, based on the public discussion quantity and take into account of the behavior that users may re-enter another related topic or Weibo after discussing one. Data fitting using the real data of COVID-19 public opinion obtained from Chinese Sina-microblog can parameterize the model to make accurate prediction of the public opinion trend until the next major news item occurs. The reproduction ratio has fallen from 1.7769 and maintained around 0.97, which reflects the peak of public opinion has passed but it will continue for a period of time.


title: Sleepless in COVID-19: how not to lose sleep in lockdowns

text: The corona virus disease 2019 (COVID-19) outbreak started in December 2019 in Wuhan, China, and spread all over the world leading to declaration of a pandemic by World Health Organization (WHO) on 11th March 2020. Most countries around the world have been on lockdown in an effort to halt the spread of virus. People around the world have been pushed into uncharted waters of uncertainty, fear, anxiety, stress and depression due to economic crash down, job losses and fear for their own health and that of their loved ones. There is a known association between anxiety/stress and sleep disturbances and vice versa. The most vulnerable population in this isolation like condition, in this lockdown, are the chief earning member of the family, women, young ones, and people with psychiatric illness.


Prisons are "in no way equipped" to deal with COVID-19


title: Flattening the Mental Health Curve: COVID-19 Stay-at-Home Orders are Associated with Alterations in Mental Health Search Behavior in the United States

text: BACKGROUND: COVID-19 has led to dramatic changes globally in persons' everyday lives. To combat the pandemic, many governments have implemented social distancing, quarantine, and stay-at-home orders. There is limited research on the impact of such extreme measures on mental health. OBJECTIVE: The goal of the present study was to examine whether stay-at-home orders produced differential changes in mental health symptoms using internet search queries at a national scale. METHODS: In the United States, individual states vary in their adoption of measures to reduce the spread of COVID-19; as of March 23, 2020, eleven of the fifty states had issued stay-at-home orders. The staggered rollout of stay-at-home measures across the U.S. allows us to investigate whether these measures impact mental health by exploring variations in mental health search queries across the states. The current manuscript examines the changes in mental health search queries on Google between March 16-23, 2020 across each state and Washington D.C. Specifically, the current manuscript examines differential change in mental health searches based on patterns of search activity following issuance of stay-at-home orders in these states compared to all other states. Participants included all persons who searched mental health terms in Google between March 16-23. Between March 16-23, eleven states underwent stay-at-home orders to prevent the transmission of COVID-19. Outcomes included search terms measuring anxiety, depression, obsessive-compulsive, negative thoughts, irritability, fatigue, anhedonia, concentration, insomnia, and suicidal ideation. RESULTS: Analyzing over 10 million search queries using generalized additive mixed models, the results suggested that the implementation of stay-at-home orders are associated with a significant flattening of the curve for searches for suicidal ideation, anxiety, negative thoughts, and sleep disturbances with the most prominent flattening associated with suicidal ideation and anxiety. CONCLUSIONS: These results suggest that, despite decreased social contact, mental health search queries increased rapidly prior to the issuance of stay-at-home orders, and these changes dissipated following the announcement and enactment of these orders. Although more research is needed to examine sustained effects, these results suggest mental health symptoms were associated with an immediately leveling off following the issuance of stay-at-home orders.


title: Severe Acute Respiratory Syndrome Coronavirus 2-Specific Antibody Responses in Coronavirus Disease Patients

text: A new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged to cause a human pandemic. Although molecular diagnostic tests were rapidly developed, serologic assays are still lacking, yet urgently needed. Validated serologic assays are needed for contact tracing, identifying the viral reservoir, and epidemiologic studies. We developed serologic assays for detection of SARS-CoV-2 neutralizing, spike protein-specific, and nucleocapsid-specific antibodies. Using serum samples from patients with PCR-confirmed SARS-CoV-2 infections, other coronaviruses, or other respiratory pathogenic infections, we validated and tested various antigens in different in-house and commercial ELISAs. We demonstrated that most PCR-confirmed SARS-CoV-2-infected persons seroconverted by 2 weeks after disease onset. We found that commercial S1 IgG or IgA ELISAs were of lower specificity, and sensitivity varied between the 2 assays; the IgA ELISA showed higher sensitivity. Overall, the validated assays described can be instrumental for detection of SARS-CoV-2-specific antibodies for diagnostic, seroepidemiologic, and vaccine evaluation studies.


title: Disequilibrium between the Classic Renin-angiotensin System and Its Opposing Arm in Sars-cov-2 Related Lung Injury

text: A dysregulation of the renin-angiotensin-system (RAS) has been involved in the genesis of lung injury and acute respiratory distress syndrome (ARDS) from different causes, including several viral infections. The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection of pneumocytes, the hallmark of the pandemic coronavirus disease 2019 (COVID-19) involving both alveolar interstitium and capillaries, is linked to angiotensin-converting-enzyme 2 (ACE2) binding and its functional downregulation. ACE2 is a key enzyme for the balance between the two main arms of the RAS: the ACE/Angiotensin (Ang) II/Ang II type 1 receptor axis ("classic RAS"), and the ACE2/Ang 1-7/MasR axis ("anti-RAS"). The ACE2 downregulation, as a result of SARS-coronaviruses binding, enhances the "classic RAS", leading to lung damage and inflammation with leaky pulmonary blood vessels and fibrosis, when the attenuation mediated by the "anti-RAS" arm is reduced. ACE inhibitors (ACE-I) and Ang II type 1 receptor blockers (ARB), effective in cardiovascular diseases, were found to prevent and counteract acute lung injury in several experimental models, by restoring the balance between these two opposing arms. The evidence of RAS arms disequilibrium in COVID-19 and the hypothesis of a beneficial role of RAS modulation supported by preclinical and clinical studies are the focus of the present review. Preclinical and clinical studies on drugs balancing RAS arms might be the right way to counter COVID-19.


Student placement adaptability during COVID-19: Lessons learnt in 2020


COVID-19 convalescent plasma transfusion


title: Forecasting the daily and cumulative number of cases for the COVID-19 pandemic in India

text: The ongoing novel coronavirus epidemic has been announced a pandemic by the World Health Organization on March 11, 2020, and the Govt. of India has declared a nationwide lockdown from March 25, 2020, to prevent community transmission of COVID-19. Due to absence of specific antivirals or vaccine, mathematical modeling play an important role to better understand the disease dynamics and designing strategies to control rapidly spreading infectious diseases. In our study, we developed a new compartmental model that explains the transmission dynamics of COVID-19. We calibrated our proposed model with daily COVID-19 data for the four Indian provinces, namely Jharkhand, Gujarat, Andhra Pradesh, and Chandigarh. We study the qualitative properties of the model including feasible equilibria and their stability with respect to the basic reproduction number $\mathcal{R}_0$. The disease-free equilibrium becomes stable and the endemic equilibrium becomes unstable when the recovery rate of infected individuals increased but if the disease transmission rate remains higher then the endemic equilibrium always remain stable. For the estimated model parameters, $\mathcal{R}_0>1$ for all the four provinces, which suggests the significant outbreak of COVID-19. Short-time prediction shows the increasing trend of daily and cumulative cases of COVID-19 for the four provinces of India.


title: The impact of type 2 diabetes and its management on the prognosis of patients with severe COVID-19

text: BACKGROUND: Although T2DM patients with COVID-19 develop a more severe condition compared to those without diabetes, the mechanisms for this are unknown. Moreover, the impact of treatment with anti-hyperglycemic drugs and glucocorticoids is unclear. METHODS: From 1584 COVID-19 patients, 364 severe/critical COVID-19 patients with clinical outcome were enrolled for the final analysis and patients without pre-existing T2DM but elevated glucose levels were excluded. Epidemiological data were obtained and clinical-status evaluation carried out to assess the impact of T2DM and its management on clinical outcomes. RESULTS: Of 364 enrolled severe COVID-19 inpatients, 114 (31.3%) cases had a history of T2DM. 27(23.7%) cases died in T2DM patients, who had more severe inflammation, coagulation activation, myocardia injury, hepatic injury, and kidney injury, compared with non-DM patients. In severe COVID-19 patients with T2DM, we demonstrate a higher risk of all-cause fatality with glucocorticoid treatment (Adjusted HR, 3.61; 95%CI, 1.14-11.46; P = 0.029), and severe hyperglycemia (FPG ≥11.1 mmol/L) (Adjusted HR, 11.86; 95%CI, 1.21-116.44; P = 0.034). CONCLUSIONS: T2DM status aggravated the clinical condition of COVID-19 patients and increased their critical illness risk. Poor fasting blood glucose (≥ 11.1 mmol/L) and glucocorticoid treatment are associated with poor prognosis for T2DM patients with severe COVID-19. This article is protected by copyright. All rights reserved.


title: Beyond $R_0$: Heterogeneity in secondary infections and probabilistic epidemic forecasting

text: The basic reproductive number --- $R_0$ --- is one of the most common and most commonly misapplied numbers in public health. Although often used to compare outbreaks and forecast pandemic risk, this single number belies the complexity that two different pathogens can exhibit, even when they have the same $R_0$. Here, we show how to predict outbreak size using estimates of the distribution of secondary infections, leveraging both its average $R_0$ and the underlying heterogeneity. To do so, we reformulate and extend a classic result from random network theory that relies on contact tracing data to simultaneously determine the first moment ($R_0$) and the higher moments (representing the heterogeneity) in the distribution of secondary infections. Further, we show the different ways in which this framework can be implemented in the data-scarce reality of emerging pathogens. Lastly, we demonstrate that without data on the heterogeneity in secondary infections for emerging infectious diseases like COVID-19, the uncertainty in outbreak size ranges dramatically. Taken together, our work highlights the critical need for contact tracing during emerging infectious disease outbreaks and the need to look beyond $R_0$ when predicting epidemic size.


Crisis Leadership During and Following COVID-19


title: When Wireless Communication Faces COVID-19: Combating the Pandemic and Saving the Economy

text: The year 2020 is experiencing a global health and economic crisis due to the COVID-19 pandemic. Countries across the world are using digital technologies to fight this global crisis. These digital technologies, in one way or another, strongly rely on the availability of wireless communication technologies. In this paper, we present the role of wireless communications in the COVID-19 pandemic from different perspectives. First, we show how these technologies are helping to combat this pandemic, including monitoring of the virus spread, enabling healthcare automation, and allowing virtual education and conferencing. Also, we show the importance of digital inclusiveness in the pandemic and possible solutions to connect the unconnected. Next, we discuss the challenges faced by wireless technologies, including privacy, security, and misinformation. Then, we present the importance of wireless communication technologies in the survival of the global economy, such as automation of industries and supply chain, e-commerce, and supporting occupations that are at risk. Finally, we reveal that how the technologies developed during the pandemic can be helpful in the post-pandemic era.


Considerations for the Use of Respiratory Filters in Children During the COVID-19 Pandemic


title: Consensus guidelines for interventional cardiology services delivery during covid-19 pandemic in Australia and new Zealand

text: The global coronavirus disease (COVID-19) pandemic poses an unprecedented stress on healthcare systems internationally. These Health system-wide demands call for efficient utilisation of resources at this time in a fair, consistent, ethical and efficient manner would improve our ability to treat patients. Excellent co-operation between hospital units (especially intensive care unit [ICU], emergency department [ED] and cardiology) is critical in ensuring optimal patient outcomes. The purpose of this document is to provide practical guidelines for the effective use of interventional cardiology services in Australia and New Zealand. The document will be updated regularly as new evidence and knowledge is gained with time. Goals Considerations.


title: Management of Osteoarthritis During the COVID-19 Pandemic

text: The pandemic spread of the new coronavirus disease 2019 (COVID-19) infection in China first, and all over the world at present, has become a global health emergency due to the rapidly increasing number of affected patients. Currently, a clear relationship between COVID-19 infection incidence and/or complications due to chronic or occasional treatments for other pathologies is still not clear, albeit the COVID-19 pandemic may condition the treatment strategy of complex disorders, such as osteoarthritis (OA). Importantly, OA is the most common age-related joint disease, affecting more than 80% of people older than the age of 55, an age burden also shared with the highest severity in COVID-19 patients. OA patients often show a large array of concomitant pathologies, such as diabetes, inflammation, and cardiovascular diseases that are again shared with COVID-19 patients and may therefore increase complications. Moreover, different OA treatments, such as NSAIDs, paracetamol, corticosteroids, opioids, or other molecules have a wide array of iatrogenic effects, potentially increasing COVID-19 secondary infection incidence or complications. In this review we critically analyze the evidence on either negative or positive effects of drugs commonly used to manage OA in this particular scenario. This would provide orthopedic surgeons in particular, and physicians, pharmacologists, and clinicians in general, a comprehensive description about the safety of the current pharmacological approaches and a decision-making tool to treat their OA patients as the coronavirus pandemic continues.


Saliva samples as an alternative for novel coronavirus (COVID-19) diagnosis


How will country-based mitigation measures influence the course of the COVID-19 epidemic?


Toward a clinically based classification of disease severity for paediatric COVID-19


title: Immediate psychological distress in quarantined patients with COVID-19 and its association with peripheral inflammation: A mixed-method study

text: Since the end of 2019, Corona Virus Disease 2019 (COVID-19) has been the cause of a worldwide pandemic. The mental status of patients with COVID-19 who have been quarantined and the interactions between their psychological distress and physiological levels of inflammation have yet to be analyzed. Using a mixed-method triangulation design (QUAN + QUAL), this study investigated and compared the mental status and inflammatory markers of 103 patients who, while hospitalized with mild symptoms, tested positive with COVID-19 and 103 matched controls that were COVID-19 negative. The severity of depression, anxiety, and post-traumatic stress symptoms (PTSS) was measured via an on-line survey. Using a convenience sampling technique, qualitative data were collected until the point of data saturation. In addition, a semi-structured interview was conducted among five patients with COVID-19. Peripheral inflammatory markers were also collected in patients, both at baseline and within ± three days of completing the on-line survey. Results revealed that COVID-19 patients, when compared to non-COVID controls, manifested higher levels of depression (P < 0.001), anxiety (P < 0.001), and post-traumatic stress symptoms (P < 0.001). A gender effect was observed in the score of "Perceived Helplessness", the subscale of PSS-10, with female patients showing higher scores compared to male patients (Z = 2.56, P = 0.010), female (Z = 2.37, P = 0.018) and male controls (Z = 2.87, P = 0.004). Levels of CRP, a peripheral inflammatory indicator, correlated positively with the PHQ-9 total score (R = 0.37, P = 0.003, Spearman's correlation) of patients who presented symptoms of depression. Moreover, the change of CRP level from baseline inversely correlated with the PHQ-9 total score (R = -0.31, P = 0.002), indicative of improvement of depression symptoms. Qualitative analysis revealed similar results with respect to patient reports of negative feelings, including fear, guilt, and helplessness. Stigma and uncertainty of viral disease progression were two main concerns expressed by COVID-19 patients. Our results indicate that significant psychological distress was experienced by hospitalized COVID-19 patients and that levels of depressive features may be related to the inflammation markers in these patients. Thus, we recommend that necessary measures should be provided to address depression and other psychiatric symptoms for COVID-19 patients and attention should be paid to patient perceived stigma and coping strategies when delivering psychological interventions.


A Call to Action: Novel Ways that Hepatologists Can Contribute to Patient Care During the COVID-19 Pandemic


The Response of the Anesthesia & Analgesia Community to COVID-19


title: Diagnostic Performance of Chest X-Ray for COVID-19 Pneumonia During the SARS-CoV-2 Pandemic in Lombardy, Italy

text: Chest x-ray (CXR) can play a role in diagnosing patients with suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, but only few small-scale studies are available. We assessed the diagnostic performance of CXR in consecutive patients presenting at the emergency room at the Policlinico San Donato, Milan, Italy from February 24 to April 8, 2020 for suspected SARS-CoV-2 infection. The results of CXR were classified as positive or negative according to the original prospective radiologic reports. To overcome the limitations of reverse transcriptase-polymerase chain reaction (RT-PCR) swab, especially oscillating sensitivity, we added the information obtained from phone calls to discharged patients with negative initial RT-PCR. Thus, we included 535 patients with concomitant CXR and RT-PCR on admission (aged 65±17 y; 340 males, 195 females), resulting in 408 RT-PCR positive and 127 negative patients at the composite reference standard. Original CXR reports showed an 89.0% sensitivity (95% confidence intervals [CI], 85.5%-91.8%), 60.6% specificity (95% CI, 51.6%-69.2%), 87.9% positive predictive value (95% CI, 84.4%-90.9%), and 63.1% negative predictive value (95% CI, 53.9%-71.7%). The adoption of CXR alongside RT-PCR to triage patients with suspected SARS-CoV-2 infection could foster a safe and efficient workflow, counteracting possible false negative RT-PCR results.


title: Delayed Primary and Specialty Care: The Coronavirus Disease-2019 Pandemic Second Wave

text: Time is of the essence to continue the pandemic disaster cycle with a comprehensive post-COVID-19 health care delivery system RECOVERY analysis, plan and operation at the local, regional and state level.The second wave of COVID-19 pandemic response are not the ripples of acute COVID-19 patient clusters that will persist until a vaccine strategy is designed and implemented to effect herd immunity. The COVID-19 second wave are the patients that have had their primary and specialty care delayed. This exponential wave of patients requires prompt health care delivery system planning and response.


docid: syqmhjgr

title: Considerations for people with diabetes during the Coronavirus Disease (COVID-19) Pandemic

text: INTRODUCTION: The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) continues to cause havoc globally, resulting in unprecedented healthcare, societal and economic disruption. People with diabetes have been shown to be at higher risk of complications and death when exposed to pneumonia, influenza and other coronaviruses. Despite pandemic scale infection, there is currently limited understanding on the potential impact of SARS-CoV-2 on people with diabetes. AIMS: (1) To characterise the outcomes of SARS-CoV-2 for people with diabetes and (2) add value to current recommendations for healthcare providers and people with diabetes to encourage optimal management. METHODS: A search of PubMed, Embase and MEDLINE to March 2020 was undertaken, using search terms pertaining to diabetes, coronavirus and acute respiratory distress syndrome (ARDS). We briefly reviewed the epidemiology and pathophysiology of SARS-CoV in the context of diabetes. CONCLUSION: People with diabetes are at greater risk of severe infection and death with COVID-19. COVID-19 has significantly impacted the daily lives of individuals living with diabetes through financial implications, food and medication scarcity and its burden on mental health. In Australia, delivery of medical care has been adapted to reduce the risk of transmission, with a particular emphasis on telehealth and remote monitoring.


title: Pause, Persist, Pivot: Key Decisions Health Professions Education Researchers Must Make About Conducting Studies During Extreme Events

text: When extreme events occur some research becomes a clear priority, but what becomes of all other research? Does it stop indefinitely, or can it be paused with plans to resume, persist with modifications, or pivot to address new priorities? Facing this dilemma and witnessing it among their fellow health professions education researchers, the authors recognized a need for guidance. This commentary presents a framework, organized as key questions related to the research stage and process, to assist health professions education researchers in making decisions about how to proceed with research that was planned or in progress when an extreme event occurred. Although at the time of this writing, the COVID-19 pandemic was the extreme event at hand, the authors intentionally created questions and discussed considerations that can be helpful for thinking through decisions in a variety of disruptions in health professions education research-many of which require similar difficult decisions and creative solutions to carry important research forward and maintain high quality.


title: Assessing the Efficiency of Different Control Strategies for the Coronavirus (COVID-19) Epidemic

text: The goal of this work is to analyse the effects of control policies for the coronavirus (COVID-19) epidemic in Brazil. This is done by considering an age-structured SEIR model with a quarantine class and two types of controls. The first one studies the sensitivity with regard to the parameters of the basic reproductive number R0 which is calculated by the next generation method. The second one evaluates different quarantine strategies by comparing their relative total number of deaths.


SARS-CoV-2: What can saliva tell us?


title: COVID-19: The first documented coronavirus pandemic in history

text: The novel human coronavirus disease COVID-19 has become the fifth documented pandemic since the 1918 flu pandemic. COVID-19 was first reported in Wuhan, China, and subsequently spread worldwide. The coronavirus was officially named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Committee on Taxonomy of Viruses based on phylogenetic analysis. SARS-CoV-2 is believed to be a spillover of an animal coronavirus and later adapted the ability of human-to-human transmission. Because the virus is highly contagious, it rapidly spreads and continuously evolves in the human population. In this review article, we discuss the basic properties, potential origin, and evolution of the novel human coronavirus. These factors may be critical for studies of pathogenicity, antiviral designs, and vaccine development against the virus.


The plight of essential workers during the COVID-19 pandemic


COVID-19 in Hemodialysis Patients: A Report of 5 Cases


Delayed access or provision of care in Italy resulting from fear of COVID-19


title: Dynamics of SIR model with vaccination and heterogeneous behavioral response of individuals modeled by the Preisach operator

text: We study global dynamics of an SIR model with vaccination, where we assume that individuals respond differently to dynamics of the epidemic. Their heterogeneous response is modeled by the Preisach hysteresis operator. We present a condition for the global stability of the infection-free equilibrium state. If this condition does not hold true, the model has a connected set of endemic equilibrium states characterized by different proportion of infected and immune individuals. In this case, we show that every trajectory converges either to an endemic equilibrium or to a periodic orbit. Under additional natural assumptions, the periodic attractor is excluded, and we guarantee the convergence of each trajectory to an endemic equilibrium state. The global stability analysis uses a family of Lyapunov functions corresponding to the family of branches of the hysteresis operator.


title: Psychological status of postpartum women under the COVID-19 pandemic in Japan

text: Under the COVID-19 (Coronavirus Disease 2019) pandemic, limitations are known to cause some psychosocial problems. We compared the results of mental screening of the postpartum women conducted during the COVID-19 epidemic with those at the same period last year. Based on the results, the worse mother-infant bonding was suspected at 1 month after birth under the COVID-19 pandemic.


title: FDG-PET/CT imaging during the Covid-19 emergency: a southern Italian perspective

text: PURPOSE: To assess the impact of the Covid-19 pandemic on FDG-PET/CT work volume and to evaluate the occurrence of abnormal imaging findings suspicious or potentially diagnostic for interstitial pneumonia by Covid-19 infection in south Italy. METHODS: We retrospectively reviewed the number and the findings of FDG-PET/CT studies acquired between February and April 2020 during the Covid-19 pandemic at the University of Napoli Federico II. The number and the findings of FDG-PET/CT studies acquired in the corresponding period of 2019 were also assessed for direct comparison. RESULTS: The number of FDG-PET/CT studies performed during the pandemic (n = 299) and in the corresponding period of 2019 (n = 335) were comparable. The percentage of abnormal FDG-PET/CT findings, suspicious for interstitial pneumonia by Covid-19 infection, was significantly higher during the pandemic (9%) compared with that found in the corresponding period of 2019 (4%) (χ2 5.45, P = 0.02). No significant differences were observed in the distribution of Covid-19 reporting and data system (CO-RADS) classification and in the maximum standardized uptake value between the pandemic (2.6 ± 2.2) and the corresponding period of 2019 (3.2 ± 1.4). Of note, patients with abnormal imaging findings during the pandemic time had clinical data and/or laboratory tests negative for Covid-19 infection. CONCLUSION: Despite the restrictive medical measures for the emergency, the number of FDG-PET/CT studies was unchanged during the pandemic compared with the previous year. Our findings also indicate that Covid-19 infection was contained in our series of patients from southern Italy.


title: Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China

text: BACKGROUND: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients. METHOD: This retrospective, single-centre study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from 18 January 2020 to 22 February 2020. Liver function and related indexes were analysed to evaluate its relationship with disease progression in COVID-19 patients. RESULTS: Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different when compared with hospitalised community-acquired pneumonia patients, and the levels of albumin is even significantly higher. The levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age. CONCLUSIONS: Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.


title: User Attention and Behaviour in Virtual Reality Art Encounter

text: With the proliferation of consumer virtual reality (VR) headsets and creative tools, content creators have started to experiment with new forms of interactive audience experience using immersive media. Understanding user attention and behaviours in virtual environment can greatly inform creative processes in VR. We developed an abstract VR painting and an experimentation system to study audience encounters through eye gaze and movement tracking. The data from a user experiment with 35 participants reveal a range of user activity patterns in art exploration. Deep learning models are used to study the connections between behavioural data and audience background. New integrated methods to visualise user attention as part of the artwork are also developed as a feedback loop to the content creator.


docid: zmqeowya

title: The effect of the Covid-19 Pandemic on pediatric urology

text: Medical and surgical priorities have changed dramatically at the time of this pandemic. Scientific societies around the World have provided rapid guidance, underpinned by the best knowledge available, on the adaptation of their guidelines recommendations to the current situation. There are very limited scientific evidence especially in our subspecialty of pediatric urology. We carry out a review of the little scientific evidence based mainly on the few publications available to date and on the recommendations of the main scientific societies regarding which patients should undergo surgery, when surgery should be performed and how patient visits should be organize.


title: Review of Mental Health Response to COVID-19, China

text: Public mental health response to coronavirus disease is essential. After reviewing systemic and local efforts in China, we found efficient coordination and human resources. We recommend better symptom assessment, monitoring of organizations, and basic needs protection. This recommendation can inform how other countries can overcome mental health challenges during this pandemic.


Invited response to the comment on "Dermatology residents and the care of COVID-19 patients"


title: Immune monitoring of a child with autoimmune hepatitis and type 1 diabetes during COVID-19 infection

text: Immunocompromised patients may be at increased risk to develop COVID-19 during the 2019 ß-coronavirus infection. We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D). CD4 and CD8 T cells frequencies decreased because of prednisolone, followed by a plateauing increase whereas CD19CD20 B cell increased strongly and was unaffected by COVID-19 infection. Moreover, the percentage of activated CD8 T cells expressing HLA-DR (CD8HLA-DR) increased during COVID-19 and subsided after its clearance. Total regulatory T cells (Tregs: CD4CD25CD127FOXP3) remained stable. Although activated Tregs (CD4CD45RAFOXP3) strongly increased upon prednisolone, it decreased afterwards. Furthermore, regulatory B cells (Bregs: CD19CD20CD24CD38) declined sharply owing to prednisolone. Serum IL-6 remained undetectable at all times. We demonstrated for the first time immune monitoring in a child with AIH and T1D before, during and after COVID-19. We hypothesize that continuing with low level of prednisolone without azathioprine may have abrogated activated Tregs, Bregs and IL-6 production and therefore permitting the activation of CD8 T cells, clearing the virus.


title: "Quantifying the precision of ecological risk: Misunderstandings and errors in the methods for assessment factors versus species sensitivity distributions"

text: The science of species sensitivity distributions (SSDs) is a blend of statistical theory, ecotoxicological testing, study reliability, and biodiversity. The utility of SSDs has been well reviewed and they are viewed as a high tier assessment tool in environmental risk assessment and other disciplines. SSDs seek to improve upon probabilistic extrapolation of laboratory (and sometimes field) collected ecotoxicity data for environmental protection by modeling the diversity of multiple experimental results in the form of a single statistical distribution which reduces or eliminates the need for extrapolation with deterministic assessment factors. SSDs thus depend heavily on both statistical and biological knowledge. In this commentary we review recently published literature identifying areas of improvement based on fundamental statistical theory or application in environmental assessment contexts. We reveal that sound application of SSDs relies heavily upon a grasp of probability distributions, how asymmetric confidence intervals are derived for distributions common to SSDs, the influence of sample size on parameter estimation, and how these are collectively applied across the myriad of regulatory systems globally. Statisticians and ecotoxicologists are inextricably bound together in the goal of actually improving hazard assessment using both probabilistic and deterministic methodologies.


Alcohol and COVID-19


title: Targeted Pandemic Containment Through Identifying Local Contact Network Bottlenecks

text: Decision-making about pandemic mitigation often relies upon mathematical modelling. Models of contact networks are increasingly used for these purposes, and are often appropriate for infections that spread from person to person. Real-world human contact networks are rich in structural features that influence infection transmission, such as tightly-knit local communities that are weakly connected to one another. In this paper, we propose a new flow-based edge-betweenness centrality method for detecting bottleneck edges that connect communities in contact networks. In particular, we utilize convex optimization formulations based on the idea of diffusion with $p$-norm network flow. Using mathematical models of COVID-19 transmission through real network data at both individual and county levels, we demonstrate that targeting bottleneck edges identified by the proposed method reduces the number of infected cases by up to $10\%$ more than state-of-the-art edge-betweenness methods. Furthermore, we demonstrate empirically that the proposed method is orders of magnitude faster than existing methods.


title: [Management strategies for three patients with gynecological malignancies during the outbreak of COVID-19]

text: Objective: To explore the management strategies for patients with gynecological malignant tumors during the outbreak and transmission of COVID-19. Methods: We retrospectively analyzed the clinical characteristics, treatment, and disease outcomes of three patients with gynecological malignancies associated with COVID-19 in Renmin Hospital of Wuhan University, and proposed management strategies for patients with gynecological tumors underriskof COVID-19. Results: Based on the national diagnosis and treatment protocol as well as research progress for COVID-19, three patients with COVID-19 were treated. Meanwhile, they were also appropriately adjusted the treatment plan in accordance with the clinical guidelines for gynecological tumors. Pneumonia was cured in 2 patients, and one patient died of COVID-19. Conclusions: Patients with gynecological malignant tumors are high-risk groups prone to COVID-19, and gynecological oncologists need to carry out education, prevention, control and treatment according to specific conditions. While, actively preventing and controlling COVID-19, the diagnosis and treatment of gynecological malignant tumors should be carried out in an orderly and safe manner.