title: Genetic diversity of human rhinoviruses in Cambodia during a three-year period reveals novel genetic types

text: Abstract Acute respiratory viral infections are a major cause of morbidity during early childhood in developing countries. Human rhinoviruses are the most frequent cause of upper respiratory tract infections in humans, which can range in severity from asymptomatic to clinically severe disease. In this study we collected 4170 nasopharyngeal swabs from patients hospitalised with influenza-like illness in two Cambodian provincial hospitals between 2007 and 2010. Samples were screened for 18 respiratory viruses using 5 multiplex PCRs. A total of 11.2% of samples tested positive for human rhinoviruses (HRV). VP4/2 and VP1 regions were amplified and sequenced to study the distribution of rhinoviruses genotypes and species in Cambodia during this three-year period. Five novel genotypes, 2 species A, 2 species B and 1 species C were identified based on VP1 sequences. Co-infections with other viruses were demonstrated.


title: Lack of SARS Transmission among Public Hospital Workers, Vietnam

text: The severe acute respiratory syndrome (SARS) outbreak in Vietnam was amplified by nosocomial spread within hospital A, but no transmission was reported in hospital B, the second of two designated SARS hospitals. Our study documents lack of SARS-associated coronavirus transmission to hospital B workers, despite variable infection control measures and the use of personal protective equipment.


title: Commentary on: a comparative study of the healthcare delivery systems of korea and thailand

text: Abstract Original abstract The objectives of this study were to compare the health care delivery systems of Korea and Thailand and the health status of the people of the 2 countries. To analyze the health care delivery system government organization of health care, health care personnel, and health insurance programs were examined. The population distribution, life expectancy, maternal and infant death rates, cause of specific death rates, and health behaviors were examined to determine the health status of the 2 populations. From this comparison of the health care system and health status of the 2 countries, recommendations are made concerning government policy and activation of health care professionals and health workers to address the problems that were identified in the study. (Lee C et al. Nurs Outlook 2003;51:115-9.)


title: The cyclophilin-inhibitor alisporivir stimulates antigen presentation thereby promoting antigen-specific CD8(+) T cell activation

text: BACKGROUND & AIMS: Cyclophilin-inhibitors have potent antiviral activity against Hepatitis C virus (HCV) and are promising candidates for broad-spectrum antiviral therapy. Cyclosporine A (CsA) acts immunosuppressive by blocking T cell activation and antigen presentation. Alisporivir, a non-immunosuppressive CsA analog in clinical development, does not inhibit T cell activation. In this study we explored the impact of alisporivir on antigen presentation. METHODS: Hepatoma cells endogenously expressing the epitope-restricting major histocompatibility complex-class I (MHC-I) allele HLA-A2 and constitutively expressing a viral antigen were established to study the impact of cyclophilin-inhibitors on antigen presentation. Antigen-specific CD8(+) T cell activation and MHC-I surface expression were measured to quantify antigen presentation. RESULTS: Our work establishes a novel cell culture model to study antigen presentation in liver-derived cells. Authentic regulation of antigen presentation was ensured by the action of pro- and anti-inflammatory cytokines. Alisporivir pretreatment stimulated antigen presentation by hepatoma target cells, leading to enhancement of antigen-specific CD8(+) T cell activation by 40%. Alisporivir, as well as a panel of other cyclophilin-inhibitors, induced an increase of MHC-I and beta-2 microglobulin on the surface of several cell lines. The drug neither enhanced MHC-I transcript or protein levels nor affected surface expression of other proteins or protein trafficking in general. Proteasome-inhibitors completely blocked the alisporivir-directed enhancement of surface MHC-I, suggesting an influence of the drug on peptide-availability. CONCLUSIONS: Alisporivir stimulates antigen presentation by inducing enhanced MHC-I surface expression, thereby promoting antigen-specific CD8(+) T cell activation. This immunostimulatory function might further contribute to the antiviral activity of non-immunosuppressive cyclophilin-inhibitors.


title: Rapid replacement of human respiratory syncytial virus A with the ON1 genotype having 72 nucleotide duplication in G gene

text: Abstract Human respiratory syncytial virus (HRSV) is the main cause of severe respiratory illness in young children and elderly people. We investigated the genetic characteristics of the circulating HRSV subgroup A (HRSV-A) to determine the distribution of genotype ON1, which has a 72-nucleotide duplication in attachment G gene. We obtained 456 HRSV-A positive samples between October 2008 and February 2013, which were subjected to sequence analysis. The first ON1 genotype was discovered in August 2011 and 273 samples were identified as ON1 up to February 2013. The prevalence of the ON1 genotype increased rapidly from 17.4% in 2011–2012 to 94.6% in 2012–2013. The mean evolutionary rate of G protein was calculated as 3.275×10−3 nucleotide substitution/site/year and several positively selected sites for amino acid substitutions were located in the predicted epitope region. This basic and important information may facilitate a better understanding of HRSV epidemiology and evolution.


title: Common Features of Enveloped Viruses and Implications for Immunogen Design for Next-Generation Vaccines

text: Enveloped viruses enter cells by inducing fusion of viral and cellular membranes, a process catalyzed by a specialized membrane-fusion protein expressed on their surface. This review focuses on recent structural studies of viral fusion proteins with an emphasis on their metastable prefusion form and on interactions with neutralizing antibodies. The fusion glycoproteins have been difficult to study because they are present in a labile, metastable form at the surface of infectious virions. Such metastability is a functional requirement, allowing these proteins to refold into a lower energy conformation while transferring the difference in energy to catalyze the membrane fusion reaction. Structural studies have shown that stable immunogens presenting the same antigenic sites as the labile wild-type proteins efficiently elicit potently neutralizing antibodies, providing a framework with which to engineer the antigens for stability, as well as identifying key vulnerability sites that can be used in next-generation subunit vaccine design.


title: Emergence of novel strains of avian infectious bronchitis virus in Sweden

text: Abstract Infectious bronchitis virus (IBV) causes avian infectious bronchitis, an important disease that produces severe economic losses in the poultry industry worldwide. Recent IBV infections in Sweden have been associated with poor growth in broilers, drop in egg production and thin egg shells in layers. The complete spike gene of selected isolates from IBV cases was amplified and sequenced using conventional RT-PCR. Nucleotide and amino acid sequence comparisons have shown that the recent isolates bear 98.97% genetic similarity with strains of the QX-like genotype. The phylogenetic analysis revealed that strains predominant in the nineties, which were of the Massachusetts type, have been replaced by D388/QX-like strains, however the evolutionary link could not be established. The homology between the two genotypes was 79 and 81%. Remarkably, a strong positive selection pressure was determined, mostly involving the S1 subunit of the S gene. This strong selective pressure resulted in recombination events, insertions and deletions in the S gene. Two new isolates generated from recombination were found with nucleotide sequence diverging 1.7–2.4% from the D388/QX-like branch, indicating the emergence of a new lineage. The study demonstrates a constant evolution of IBV that might be in relation to increased poultry farming, trade and vaccine pressure. The findings underscore the importance of continuous monitoring to control spread of infections, as well as to timely adjust diagnostic methods, molecular epidemiological studies, development and use of vaccines that are adapted to the changing disease scenario.


docid: ebxvtpct

title: Optimization of the intravenous infusion workflow in the isolation ward for patients with coronavirus disease 2019

text: Abstract Objective This study aimed to evaluate the effect of optimization of the intravenous infusion workflow in isolation wards for patients with coronavirus disease 2019. Methods The infusion management group optimized the intravenous infusion workflow based on Hamer’s Process Reengineering Theory and applied it to the treatment of patients with coronavirus disease 2019. The work efficiency, patients’ satisfaction and economic indicators before and after optimization were compared. Results After the infusion workflow was optimized, average times for preparation drugs and intravenous admixture, and patients’ waiting time decreased from 4.84 min, 4.03 min, and 34.33 min to 3.50 min, 2.60 min, and 30.87 min, respectively, patients’ satisfaction increased from 66.7% to 93.3%, and the cost of personal protective equipment (PPE) decreased from 46.67 sets and 186.6 CNY per day to 36.17 sets and 144.6 CNY, with statistical significance. Conclusion The optimization of the intravenous infusion workflow can effectively decrease the cost of PPE while improving the efficiency of infusion and patients’ satisfaction.


title: A hierarchical temporal attention-based LSTM encoder-decoder model for individual mobility prediction

text: Prediction of individual mobility is crucial in human mobility related applications. Whereas, existing research on individual mobility prediction mainly focuses on next location prediction and short-term dependencies between traveling locations. Long-term location sequence prediction is of great importance for long-time traffic planning and location advertising, and long-term dependencies exist as individual mobility regularity typically occurs daily and weekly. This paper proposes a novel hierarchical temporal attention-based LSTM encoder-decoder model for individual location sequence prediction. The proposed hierarchical attention mechanism captures both long-term and short-term dependencies underlying in individual longitudinal trajectories, and uncovers frequential and periodical mobility patterns in an interpretable manner by incorporating the calendar cycle of individual travel regularities into location prediction. More specifically, the hierarchical attention consists of local temporal attention to identify highly related locations in each day, and global temporal attention to discern important travel regularities over a week. Experiments on individual trajectory datasets with varying degree of traveling uncertainty demonstrate that our method outperforms four baseline methods on three evaluation metrics. In addition, we explore the interpretability of the proposed model in understanding individual daily, and weekly mobility patterns by visualizing the temporal attention weights and frequent traveling patterns associated with locations.


Johns Manville makes nonwoven media for face masks


title: Rapid acute onset of bronchiolitis obliterans syndrome in a lung transplant recipient after respiratory syncytial virus infection

text: Bronchiolitis obliterans syndrome (BOS) can have either an acute or chronic onset with an abrupt or insidious course. The diagnosis is typically achieved by physiological criteria with development of a sustained decline in expiratory flow rates for at least 3 weeks. We review the rapid development of acute BOS and bronchiectasis after respiratory syncytial virus infection in a lung transplant recipient, who had been doing well with normal pulmonary function for 3 years after lung transplantation.


title: Characteristics of Australian human enteric coronavirus-like particles: comparison with human respiratory coronavirus 229E and duodenal brush border vesicles

text: The polypeptide profiles of highly purified coronavirus-like particles (CVLPs) proved to be very different from that of human respiratory coronavirus 229E and showed the particles not to be coronaviruses. Differences in polypeptide profiles and morphology between the CVLPs and duodenal brush border vesicles suggested that the CVLPs were also not such vesicles. Although they shared some basic overall similarity, the polypeptide profiles of three different but possibly antigenically identical CVLP preparations from Central Australian Aborigines were very dissimilar in detail. At least 38, 39 and 48 bands respectively were observed on the three profiles. At least 46 bands were visible on the polypeptide profile of CVLPs from a Vietnamese immigrant to Australia, and it also differed in detail from those of the Central Australian CVLPs. Indications of antigenic difference were obtained between Central Australian CVLPs and CVLPs from India, Kiribati, South Africa and Vietnamese immigrants to Australia. Antigenic difference was also suggested between the Central Australian CVLPs and those from one distant location within Australia, but antigenic similarity with those from another was indicated.


title: Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown

text: BACKGROUND: The COVID-19 pandemic and lockdown might increase anxiety and depressive symptoms, but some behaviors may protect against them. METHOD: To provide a preliminary evidence of the behaviors associated with decreased symptoms in the current COVID-19 pandemic and lockdown, we conducted a survey of 5545 adult individuals from the Spanish general population, two weeks after an official lockdown was established across the country. RESULTS: Sixty-five percent of the sample reported anxiety or depressive symptoms. Following a healthy/balanced diet and not reading news/updates about COVID-19 very often were the best predictors of lower levels of anxiety symptoms. Following a healthy/balanced diet, following a routine, not reading news/updates about COVID-19 very often, taking the opportunity to pursue hobbies, and staying outdoors or looking outside were the best predictors of lower levels of depressive symptoms. LIMITATIONS: Cross-sectional nature and use of sample of convenience. CONCLUSIONS: This study suggests that “simple” coping behaviors may protect against anxiety and depressive symptoms during the COVID-19 pandemic and lockdown.


title: Porcine arterivirus activates the NF-κB pathway through IκB degradation

text: Abstract Nuclear factor-kappaB (NF-κB) is a critical regulator of innate and adaptive immune function as well as cell proliferation and survival. The present study demonstrated for the first time that a virus belonging to the Arteriviridae family activates NF-κB in MARC-145 cells and alveolar macrophages. In porcine reproductive and respiratory syndrome virus (PRRSV)-infected cells, NF-κB activation was characterized by translocation of NF-κB from the cytoplasm to the nucleus, increased DNA binding activity, and NF-κB-regulated gene expression. NF-κB activation was increased as PRRSV infection progressed and in a viral dose-dependent manner. UV-inactivation of PRRSV significantly reduced the level of NF-κB activation. Degradation of IκB protein was detected late in PRRSV infection, and overexpression of the dominant negative form of IκBα (IκBαDN) significantly suppressed NF-κB activation induced by PRRSV. However, IκBαDN did not affect viral replication and viral cytopathic effect. PRRSV infection induced oxidative stress in cells by generating reactive oxygen species (ROS), and antioxidants inhibited NF-κB DNA binding activity in PRRSV-infected cells, suggesting ROS as a mechanism by which NF-κB was activated by PRRSV infection. Moreover, NF-κB-dependent expression of matrix metalloproteinase (MMP)-2 and MMP-9 was observed in PRRSV-infected cells, an observation which implies that NF-κB activation is a biologically significant aspect of PRRSV pathogenesis. The results presented here provide a basis for understanding molecular pathways of pathology and immune evasion associated with disease caused by PRRSV.


title: COVID-19's impact on the atmospheric environment in the Southeast Asia region

text: Abstract Since its first appearance in Wuhan, China at the end of 2019, the new coronavirus (COVID-19) has evolved a global pandemic within three months, with more than 4.3 million confirmed cases worldwide until mid-May 2020. As many countries around the world, Malaysia and other southeast Asian (SEA) countries have also enforced lockdown at different degrees to contain the spread of the disease, which has brought some positive effects on natural environment. Therefore, evaluating the reduction in anthropogenic emissions due to COVID-19 and the related governmental measures to restrict its expansion is crucial to assess its impacts on air pollution and economic growth. In this study, we used aerosol optical depth (AOD) observations from Himawari-8 satellite, along with tropospheric NO2 column density from Aura-OMI over SEA, and ground-based pollution measurements at several stations across Malaysia, in order to quantify the changes in aerosol and air pollutants associated with the general shutdown of anthropogenic and industrial activities due to COVID-19. The lockdown has led to a notable decrease in AOD over SEA and in the pollution outflow over the oceanic regions, while a significant decrease (27% - 30%) in tropospheric NO2 was observed over areas not affected by seasonal biomass burning. Especially in Malaysia, PM10, PM2.5, NO2, SO2, and CO concentrations have been decreased by 26–31%, 23–32%, 63–64%, 9–20%, and 25–31%, respectively, in the urban areas during the lockdown phase, compared to the same periods in 2018 and 2019. Notable reductions are also seen at industrial, suburban and rural sites across the country. Quantifying the reductions in major and health harmful air pollutants is crucial for health-related research and for air-quality and climate-change studies.


title: Expression of swine transmissible gastroenteritis virus envelope antigens on the surface of infected cells: epitopes externally exposed

text: Abstract The peplomer protein (S) and the transmembrane protein (M) of transmissible gastroenteritis virus (TGEV) of swine were identified by iodination and serologically on the surface of infected cells. Of a total of 4 monoclonal antibodies (mAb) directed against four antigenic sites of S protein (Correa et al., 1988), 3 specific for sites A, B and D attached to the plasma membrane of infected cells, as disclosed by indirect immunofluorescence and by complement-mediated cytolysis. Four of the mAbs assayed were specific for the viral protein M and two of them gave plasma membrane immunofluorescence and mediated cytolysis in the presence of complement. The viral nucleoprotein N could not be demonstrated on the surface of infected cells either by iodination or employing 3 mAbs against this protein. Finally, a time course infection experiment demonstrated that S and M proteins were expressed on the surface of infected cells at 4 h after infection, before infective virus was released from infected cells.


title: Unexplained diarrhoea in HIV-1 infected individuals

text: BACKGROUND: Gastrointestinal symptoms, in particular diarrhoea, are common in non-treated HIV-1 infected individuals. Although various enteric pathogens have been implicated, the aetiology of diarrhoea remains unexplained in a large proportion of HIV-1 infected patients. Our aim is to identify the cause of diarrhoea for patients that remain negative in routine diagnostics. METHODS: In this study stool samples of 196 HIV-1 infected persons, including 29 persons with diarrhoea, were examined for enteropathogens and HIV-1. A search for unknown and unexpected viruses was performed using virus discovery cDNA-AFLP combined with Roche-454 sequencing (VIDISCA-454). RESULTS: HIV-1 RNA was detected in stool of 19 patients with diarrhoea (66%) compared to 75 patients (45%) without diarrhoea. In 19 of the 29 diarrhoea cases a known enteropathogen could be identified (66%). Next to these known causative agents, a range of recently identified viruses was identified via VIDISCA-454: cosavirus, Aichi virus, human gyrovirus, and non-A non-B hepatitis virus. Moreover, a novel virus was detected which was named immunodeficiency-associated stool virus (IASvirus). However, PCR based screening for these viruses showed that none of these novel viruses was associated with diarrhoea. Notably, among the 34% enteropathogen-negative cases, HIV-1 RNA shedding in stool was more frequently observed (80%) compared to enteropathogen-positive cases (47%), indicating that HIV-1 itself is the most likely candidate to be involved in diarrhoea. CONCLUSION: Unexplained diarrhoea in HIV-1 infected patients is probably not caused by recently described or previously unknown pathogens, but it is more likely that HIV-1 itself plays a role in intestinal mucosal abnormalities which leads to diarrhoea.


title: Structure and Function of the HIV Envelope Glycoprotein as Entry Mediator, Vaccine Immunogen, and Target for Inhibitors

text: Publisher Summary This chapter discusses the advances of the envelope glycoprotein (Env) structure as related to the interactions of conserved Env structures with receptor molecules and antibodies with implications for the design of vaccine immunogens and inhibitors. The human immunodeficiency virus (HIV) Env binds to cell surface–associated receptor (CD4) and coreceptor (CCR5 or CXCR4) by one of its two non-covalently associated subunits, gp120. The induced conformational changes activate the other subunit (gp41), which causes the fusion of the viral with the plasma cell membranes resulting in the delivery of the viral genome into the cell and the initiation of the infection cycle. As the only HIV protein exposed to the environment, the Env is also a major immunogen to which neutralizing antibodies are directed and a target that is relatively easy to access by inhibitors. A fundamental problem in the development of effective vaccines and inhibitors against HIV is the rapid generation of alterations at high levels of expression during long chronic infection and the resulting signiﬁcant heterogeneity of the Env. The preservation of the Env function as an entry mediator and limitations on size and expression impose restrictions on its variability and lead to the existence of conserved structures.


title: Sialic acid tissue distribution and influenza virus tropism

text: Abstract Avian influenza A viruses exhibit a strong preference for using α2,3‐linked sialic acid as a receptor. Until recently, the presumed lack of this receptor in human airways was believed to constitute an efficient barrier to avian influenza A virus infection of humans. Recent zoonotic outbreaks of avian influenza A virus have triggered researchers to analyse tissue distribution of sialic acid in further detail. Here, we review and extend the current knowledge about sialic acid distribution in human tissues, and discuss viruses with ocular tropism and their preference for α2,3‐linked sialic acid.


title: Human coronaviruses are uncommon in patients with gastrointestinal illness

text: BACKGROUND: Coronaviruses infect numerous animal species causing a variety of illnesses including respiratory, neurologic and enteric disease. Human coronaviruses (HCoV) are mainly associated with respiratory tract disease but have been implicated in enteric disease. OBJECTIVES: To investigate the frequency of coronaviruses in stool samples from children and adults with gastrointestinal illness by RT-PCR. STUDY DESIGN: Clinical samples submitted for infectious diarrhea testing were collected from December 2007 through March 2008. RNA extraction and RT-PCR was performed for stools negative for Clostridium difficile using primer sets against HCoV-229E, HCoV-OC43, HCoV-NL63, and HCoV-HKU1. Clinical data from samples positive for coronaviruses were reviewed and recorded. RESULTS: Samples from 479 patients were collected including 151 pediatric (<= 18yrs), and 328 adults (> 18yrs). Of these samples, 4 patients (1.3%, 2 adult; 2 pediatric) screened positive for the presence of a coronavirus. All detected coronaviruses were identified as HCoV-HKU1. No stools screened positive for either HCoV-229E, HCoV-NL63 or HCoV-OC43. All HCoV-HKU1 positive samples occurred between mid January to mid February. Clinical manifestations from HCoV-HKU1 positive patients included diarrhea, emesis and respiratory complaints. Three (75%) patients were admitted to the hospital with a median length of stay of 6 days. CONCLUSIONS: Coronaviruses as a group are not commonly identified in stool samples of patients presenting with gastrointestinal illness. HCoV-HKU1 can be identified in stool samples from children and adults with gastrointestinal disease, with most individuals having respiratory findings as well. No stool samples screened positive for HCoV-NL63, HCoV-229E, or HCoV-OC43.


title: Electroconvulsive therapy protocol adaptation during the COVID-19 pandemic

text: BACKGROUND: During the COVID-19 pandemic, electroconvulsive therapy units have had to confront challenges such as the infectious hazard due to aerosol-generating ventilation, or the lack of staff and material resources. Our objective was to elaborate a protocol to make ECT during the COVID-19 pandemic a safer procedure for patients and professionals. METHODS: A multidisciplinary workgroup (including mental health, anesthesia, preventive medicine, and occupational risk professionals) was formed in the Hospital Clínic de Barcelona, in March 2020. A core group conducted a review of the scientific literature and healthcare organizations’ guidelines and wrote a protocol draft. Then, a discussion with the workgroup was made until consensus was reached. The protocol has been continuously updated. Discussions were made by group e-mailing and video conferencing. RESULTS: The protocol includes the following main areas: 1) ECT unit's structural and functional; 2) SARS-CoV-2 screening protocol; 3) ECT clinical practice adaptation (personal protective equipment, airway management, recovery room, and maintenance of the facilities); 4) management of COVID-19 cases; and 5) protocol assessment. LIMITATIONS: The literature review was not systematic; the consensus was not based on a structured methodology. For other ECT units, local advisories may not be valid, and resource shortages (such as anesthetist availability, or the lack of respirators and PCR tests) may impede or prevent their implementation. CONCLUSIONS: During the COVID-19 pandemic, ECT should continue to be advocated as an essential medical procedure. It is recommended that each ECT unit develop its own protocol. This proposal may be used as a reference.


title: Use of RAAS inhibitors and risk of clinical deterioration in COVID-19: results from an Italian cohort of 133 hypertensives

text: BACKGROUND: The effect of chronic use of renin–angiotensin–aldosterone system (RAAS) inhibitors on the severity of COVID-19 infection is still unclear in patients with hypertension. We aimed to investigate the association between chronic use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) and COVID-19 related outcomes in hypertensive patients. METHODS: A single center study was conducted on 133 consecutive hypertensive subjects presenting to the Emergency Department with acute respiratory symptoms and/or fever who were diagnosed with COVID-19 infection between 9(th) and 31(st) March 2020. RESULTS: All patients were grouped according to their chronic antihypertensive medications (ACEIs, N=40; ARBs, N=42; not on RAAS inhibitors, N=51). There was no statistical difference between ACEIs and ARBs groups in terms of hospital admission rate, oxygen therapy and need for non-invasive ventilation. Patients chronically treated with RAAS inhibitors showed a significantly lower rate of admission to semi-intensive/intensive care units, when compared to the non-RAAS population (odds ratio [OR] 0.25, CI95% 0.09-0.66 p=0.006). Similarly, the risk of mortality was lower in the former group, although not reaching statistical significance (OR 0.56, CI95% 0.17-1.83, p=0.341). CONCLUSIONS: Our data suggest that chronic use of RAAS inhibitors does not negatively affect clinical course of COVID-19 in hypertensive patients. Further studies are needed to confirm this finding and determine whether RAAS inhibitors may have a protective effect on COVID 19-related morbidity and mortality.


title: Risk of mortality associated with respiratory syncytial virus and influenza infection in adults

text: BACKGROUND: Respiratory syncytial virus (RSV) infection constitutes a substantial disease burden in the general population. However, the risk of death for RSV infection has been rarely evaluated with confounders or comorbidities adjusted. We aimed to evaluate whether RSV infection is associated with higher mortality than seasonal influenza after adjusting for confounders and comorbidities and the effect of oseltamivir on the mortality in patients with influenza infection. METHODS: A retrospective cohort study was conducted on adult (≥18 years) patients admitted to the emergency department and ward of a university teaching hospital for suspected viral infection during 2013–2015 (N = 3743). RSV infection was diagnosed by multiplex PCR (N = 87). Adults hospitalized for seasonal influenza during the study period were enrolled as a comparison group (n = 312). The main outcome was 20-day all-cause mortality.We used Cox proportional hazard regression analyses to calculate the relative risk of death. RESULTS: Adult patients were less likely to be diagnosed with RSV than with influenza (2.3 vs 8.3%, respectively), were older and more likely to be diagnosed with pneumonia, chronic obstructive pulmonary disease, hypoxemia, and bacterial co-infection. In patients with RSV infection, the 20-day all-cause mortality was higher than that for influenza, (18.4 vs 6.7%, respectively). RSV infection showed significantly higher risk of death compared to the seasonal influenza group, with hazard ratio, 2.32 (95% CI, 1.17–4.58). Oseltamivir had no significant effect on mortality in patients with influenza. CONCLUSIONS: RSV infection was significantly associated with a higher risk of death than seasonal influenza, adjusted for potential confounders and comorbidities.


Synthetic viruses—Anything new?


title: Spectral domain optical coherence tomography–based prevalence of hydroxychloroquine maculopathy in Indian patients on hydroxychloroquine therapy: A utopia of underdiagnosis

text: BACKGROUND: Spectral domain optical coherence tomography (SD-OCT) detects early structural damage to macula in patients on Hydroxychloroquine (HCQ) therapy. The current screening protocols emphasize concurrent use of both SD-OCT and Visual field analysis (VFA) which detects functional damage to detect Hydroxychloroquine maculopathy. However, VFA is a time-consuming and subjective test which is often neglected. This study gives the prevalence of Hydroxychloroquine maculopathy using SD-OCT alone which often fails to detect macular damage in peri-foveal and extra-foveal area of the retina. METHODS: Three hundred thirty four eyes of 167 patients taking systemic Hydroxychloroquine were studied with SD-OCT macular cube 512 x 128 to diagnose structural macular damage to detect prevalence of Hydroxychloroquine maculopathy. RESULTS: Out of 167 patients, only four patients showed features suggestive of Hydroxychloroquine maculopathy. One patient had ELM loss, two had para-foveal and one had peri-foveal IS-OS disruption. The SD-OCT gave prevalence as 2.4%. CONCLUSION: SD-OCT alone can underdiagnose burden of Hydroxychloroquine maculopathy (prevalence = 2.4%) when compared to studies which use both SD-OCT and Visual field analysis (prevalence = 7.5%).


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title: Falling stroke rates during COVID-19 pandemic at a Comprehensive Stroke Center: Cover title: Falling stroke rates during COVID-19

text: INTRODUCTION: Although there is evidence to suggest a high rate of cerebrovascular complications in patients with SARS-CoV-2 infection, anecdotal reports indicate a falling rate of new ischemic stroke diagnoses. We conducted an exploratory single-center analysis to estimate the change in number of new stroke diagnoses in our region, and evaluate the proximate reasons for this change during the COVID-19 pandemic at a tertiary care center in New Jersey. PATIENTS AND METHODS: A Comprehensive Stroke Center prospective cohort was retrospectively analyzed for the number of stroke admissions, demographic features, and short-term outcomes 5 months prior to 3/1/2020 (pre-COVID-19), and in the 6 weeks that followed (COVID-19 period). The primary outcome was the number of new acute stroke diagnoses before and during the COVID-19 period, as well as the potential reasons for a decline in the number of new diagnoses. RESULTS: Of the 328 included patients, 53 (16%) presented in the COVID-19 period. There was a mean fall of 38% in new stroke diagnoses (mean 1.13/day [SD 1.07] from 1.82/day [SD 1.38], p<0.01), which was related to a 59% decline in the number of daily transfers from referral centers (p<0.01), 25% fewer telestroke consultations (p=0.08), and 55% fewer patients presenting directly to our institution by private vehicle (p<0.01) and 29% fewer patients through emergency services (p=0.09). There was no significant change in the monthly number of strokes due to large vessel occlusion (LVO), however the proportion of new LVOs nearly doubled in the COVID-19 period (38% vs. 21%, p=0.01). CONCLUSIONS: The observations at our tertiary care corroborate anecdotal reports that the number of new stroke diagnoses is falling, which seems related to a smaller proportion of patients seeking healthcare services for milder symptoms. These preliminary data warrant validation in larger, multi-center studies.


title: Detection of low levels of SARS-CoV-2 RNA from nasopharyngeal swabs using three commercial molecular assays

text: Abstract In response to the COVID-19 pandemic, commercial molecular assays for SARS-CoV-2 testing have been rapidly developed and broadly deployed in laboratories worldwide. Although these assays have been reported to correlate well, we sought to compare the Xpert® Xpress SARS-CoV-2 to the cobas® SARS-CoV-2 or the Lightmix® Modular SARS and Wuhan CoV E-gene assay for nasopharyngeal (NP) swabs with low levels of SARS-CoV-2 RNA. Thirty-seven NP swabs were studied, including 10 samples with a moderate cycle threshold (Ct) between 30-33.9, and 22 with Ct≥34, and 5 negative for SARS-CoV-2. Overall concordance on initial comparison was 86.5% (32/37), which was 100% concordance for samples with Ct values ranging between 30-33.9. Discordance amongst samples showing a Ct ≥34 was 22.7% (5/22). Endpoint value analysis on the Xpress SARS-CoV-2 within the discordant samples noted two with an endpoint value >5, which were detected by the cobas® or Lightmix®. Testing of SARS-CoV-2 on the three commercial assays was comparable for NP swabs with moderate Ct values, while high Ct values were less concordant. Importantly, analysis of Xpert® endpoint values improved interpretation of discrepant results.


title: COVID-19 in the Eastern Mediterranean Region and Saudi Arabia: prevention and therapeutic strategies

text: • Prevention strategies for SARS-CoV-2 infection in Saudi Arabia. • Therapeutic options for COVID-19 in Saudi Arabia.


title: Asthma, Viruses, and Nitric Oxide

text: Over the last two decades there has been a worldwide increase in the morbidity and mortality associated with asthma, a chronic inflammatory disease of the airways. There is a growing body of evidence that suggests there is an association between upper respiratory viral infections, particularly rhinovirus infections, and asthma exacerbations. Virally induced airways hyperreactivity has been associated with elevated numbers of inflammatory cells in the bronchial mucosa. Upon virus infection, respiratory epithelial cells produce proinflammatory cytokines, including IL‐6, IL‐8, RANTES, and GM‐CSF, which could contribute to the increased inflammatory cell recruitment noted in the airways. Whether or not a viral infection triggers an asthma attack may depend upon many factors, including the types of inflammatory cells recruited to the airways, the viral load, and variations in the host antiviral response. There is evidence to support the idea that eosinophils from asthmatic and symptomatic atopic subjects may be primed to respond to chemotactic cytokines produced by infected epithelial cells. Rhinovirus infections may therefore enhance airway eosinophilia in asthmatics, leading to airway hyperresponsiveness and impaired pulmonary function. Nitric oxide is a potent inhibitor of both rhinovirus‐induced cytokine production and viral replication and may play an important role in the host response to viral infections. Based upon these observations, we speculate that nitric oxide donors may represent a novel therapeutic approach for the treatment of rhinovirus infections and viral exacerbations of asthma.


title: Traditional Chinese Medicine treatment of COVID-19

text: Abstract A new kind of Pneumonia caused by new corona virus has been widespread in China since winter of 2019. No effective treatment for this disease was verified, so the morbidity and mortality rate were supposed higher than flu. The Traditional Chinese Medicine is widely used in clinical practice in China, but many other countries of the world to deal with diseases that remain clinically challenging.


title: Long-term follow-up of laminin α2 (merosin)-deficient muscular dystrophy in a cat

text: Progressive muscle weakness beginning at 6 months of age was observed in a male Persian-mix cat. Muscle atrophy and joint contracture progressed over the next 3 years. The cat had developed gait difficulty at 8 months of age. The cat died at age of 5 years and 3 months due to an acute respiratory disorder. The clinical, laboratory, necropsy and histopathological findings of the cat were consistent with those of muscular dystrophy. The cat was diagnosed as having laminin α2 (merosin)-deficient muscular dystrophy on the basis of immunohistochemical findings. The cat was born in an inbred colony, and another related cat exhibited similar clinical signs. Few cases of laminin α2-deficient muscular dystrophy have been reported in cats, and this report provides additional information about the disease.


title: Noninfectious Acute Lung Injury Syndromes Early After Hematopoietic Stem Cell Transplantation

text: Noninfectious acute lung injury syndromes are major causes of respiratory failure and early mortality after hematopoietic stem cell transplantation (HSCT). Pulmonary edema and transfusion-related acute lung injuries are important respiratory complications seen after HSCT and in the nontransplant setting. Early transplant-specific causes of lung injury, such as idiopathic pneumonia syndrome, are reviewed. Several complications, such as drug-induced pneumonitis and cryptogenic organizing pneumonia, that occur in both the early and later time periods after HSCT are also briefly discussed. The important role of pretransplant pulmonary function testing measurements in predicting posttransplant respiratory failure is highlighted.


title: Complement receptor 1 gene polymorphisms are associated with cardiovascular risk

text: Abstract Background and aims Inflammation plays a key role in atherosclerosis. The complement system is involved in atherogenesis, and the complement receptor 1 (CR1) plays a role facilitating the clearance of immune complexes from the circulation. Limited evidence suggests that CR1 may be involved in cardiovascular disease. We investigated the relationship between CR1 gene polymorphisms and cardiovascular risk. Methods Single nucleotide polymorphisms (SNPs) within the CR1 region (n = 73) on chromosome 1 were assessed in 5244 participants in PROSPER (PROspective Study of Pravastatin in the Elderly at Risk) (mean age 75.3 years), who had been randomized to pravastatin 40 mg/day or placebo and followed for a mean of 3.2 years. Logistic regression, adjusted for gender, age, country and use of pravastatin, was used to assess the association between the SNPs and cardiovascular disease. Results All 73 SNPs within the genomic region of the CR1 gene on chromosome 1 were extracted. In this region, strong LD was present leading to the occurrence of two haploblocks. Twelve of the 73 investigated CR1 SNPs were significantly associated with the risk of fatal or nonfatal myocardial infarction (all p < 0.05). Moreover, most of the associated SNPs were also associated with levels of serum C-reactive protein (CRP). The global p-value for the tail strength method to control for multiple testing was 0.0489, implying that the null hypothesis of no associated SNPs can be rejected. Conclusions These data indicate that genetic variation within the CR1 gene is associated with inflammation and the risk of incident coronary artery disease.


docid: lqtobbwx

title: Tocilizumab in patients with severe COVID‐19: a single‐center observational analysis

text: OBJECTIVE: Patients with coronavirus disease 2019 (COVID‐19) may develop severe respiratory distress, thought to be mediated by cytokine release. Elevated proinflammatory markers have been associated with disease severity. Tocilizumab, an IL‐6 receptor antagonist, may be beneficial for severe COVID‐19, when cytokine storm is suspected. METHODS: This is a retrospective single‐center analysis of the records of patients diagnosed with COVID‐19 who received tocilizumab. Outcomes, including clinical improvement, mortality and changes in oxygen‐support at 24, 48, and 72 hours, and 7, 14 and 28 days post‐tocilizumab, are reported. Patients were evaluated by baseline pre‐tocilizumab oxygenation status and changes in proinflammatory markers within seven days post‐tocilizumab are reported. RESULTS: Sixty‐six patients received tocilizumab at a mean dose of 724mg (7.4mg/kg), 3.7 days from admission. At baseline, 53% of patients were on ventilation support and all had elevated proinflammatory markers, including c‐reactive protein (CRP). Common comorbidities were diabetes mellitus (43%) and hypertension (74%). Most patients received concomitant glucocorticoids and hydroxychloroquine. Seven days after tocilizumab, ten patients (15.2%) had clinical improvement in their oxygenation status, and there was a 95% decrease in CRP. Within 14 days of treatment, 29% of patients had clinical improvement, 20% had minimal or no improvement, 17% worsened, 27% died, and 7% were transferred to an outside hospital. Ultimately, 42% of all patients that received tocilizumab expired and 49% were discharged. CONCLUSION: This study found limited clinical improvement in patients that received tocilizumab in the setting of severe COVID‐19. Clinical trials are ongoing to further evaluate tocilizumab's benefit in this patient population. This article is protected by copyright. All rights reserved.


title: Key factors affecting healthcare professionals to adopt knowledge management: The case of infection control departments of Taiwanese hospitals

text: Abstract Facing new infectious diseases that are result of continuous mutation of virus and bacteria and ever advancing communication and medical technologies, infection control professionals (ICPs) in the healthcare industry must be able to obtain instantly the needed knowledge in order to increase efficiency and effectiveness in their practice. The purpose of this study is, after an exhaustive literature review and necessary interviews with specialists in this field, to propose a research framework that explores the factors that affect the ICPs’ willingness to adopt knowledge management (KM) into their tasks and to validate the usefulness of this research framework through a survey study. The research framework includes four constructs that affect infection control professionals’ decision and willingness to introduce and to adopt infection control KM, and they are namely: hospital characteristics, infection control department, external environment, and project planning. The study conducted a survey among ICPs from 425 hospitals in Taiwan. A total of 227 valid questionnaire responses were returned from the ICPs from 90 hospitals. Among these responses, 55.00% are from medical centers and 47.83% are from regional hospitals. After analyzing the responses through the discriminant analysis method, the study found that “Hospital Resource Support,” “Colleagues’ Attitude,” and “Users’ Participation” are the three factors that significantly impact the professionals’ willingness for adopting KM in infection control departments. This study not only provides the healthcare industry an understanding about introduction and impact of KM, which can assist in their decision making, but also emphasizes the importance of use of actual data in the study of research framework for introduction of KM in healthcare industry. Therefore, this study presents important results in both practical and academic aspects.


title: Description des patients adultes hospitalisés pour une grippe au cours de l’épidémie 2016–2017 : étude prospective multicentrique FLUVAC

text: Introduction La surveillance épidémiologique de la grippe saisonnière 2016–2017 montre une activité forte, principalement liée à la circulation du virus A (H3N2). L’objectif de ce travail était de décrire les caractéristiques des patients adultes hospitalisés durant l’épidémie grippale. Matériels et méthodes À partir du 15 décembre 2016, tous les patients adultes hospitalisés pour un syndrome grippal évoluant depuis moins de 7jours ont été prospectivement inclus dans le cadre de l’étude FLUVAC (Inserm) conduite dans 5 hôpitaux français dont l’objectif est d’évaluer l’efficacité de la vaccination antigrippale sur les grippes hospitalisées de l’adulte. Les caractéristiques démographiques, cliniques et virologiques ont été recueillies. Résultats Parmi, les 401 patients inclus jusqu’au 6 février, 155 (38 %) avaient une grippe documentée : dans 154 cas (99 %) il s’agissait d’un virus influenza de type A ; 9 patients avaient une co-infection avec un virus respiratoire (1 adénovirus, 1 bocavirus, 1 coronavirus, 1 métapneumovirus, 1 parainfluenzae, 2 Picornavirus, 2 virus respiratoire syncytiaux). Il y avait 83 hommes (53 %), l’âge médian était de 78 ans (intervalle interquartiles : 63–87), 34 % (53/155) avaient plus de 85 ans. Les symptômes étaient : fièvre (90 %, n =139), malaise (20 %, n =32), céphalées (23 %, n =36), myalgies (25 %, n =39), toux (89 %, n =139), altération de l’état général (44 %, n =68) et dyspnée (75 %, n =117). La couverture vaccinale globale était de 51 % (79/155), 61 % (69/113) chez les plus de 65 ans, 24 % (10/41) chez les moins de 65 ans. Chez les moins de 65 ans, 68 % (28/41) avaient des comorbidités : maladie respiratoire chronique (34 %, n =14), cardiopathie (17 %, n =7), néphropathie chronique (12 %, n =5), maladie neurologique (12 %, n =5), diabète (10 %, n =4), traitement immunosuppresseurs (29 %, n =12), tabagisme actif (29 %, n =12). Les complications en cours d’hospitalisation étaient principalement respiratoires dans 31 % des cas (5 SDRA, 24 recours à la ventilation mécanique), insuffisance cardiaque (13 %, n =20) et insuffisance rénale (15 %, n =24) dont 22 patients hospitalisés en réanimation (13 détresses respiratoires, 5 insuffisances rénales, 3 insuffisances cardiaques, 2 états de choc), d’âge médian 66 ans (59–75). Dans 86 % des cas (19/22), il existait chez ces patients une comorbidité : respiratoire (59 %, n =13), cardiaques (36 %, n =8), diabète (22 %, n =4). À la date du 6 février, trois décès ont été recensés et 93 patients sont sortis à leur domicile. Conclusion L’analyse démographique des patients hospitalisés en France au cours de l’épidémie grippale 2016–2017 montre une forte activité en particulier chez les patients âgés ou présentant des comorbidités et une couverture vaccinale modérée.


title: Environmental and Decontamination Issues for Human Coronaviruses and Their Potential Surrogates

text: Pandemic COVID‐19 gives ample reason to generally review coronavirus (CoV) containment. For establishing some preliminary views on decontamination and disinfection, surrogate CoVs have commonly been assessed. This review serves to examine the existing science in regards to CoV containment generically and then to translate these findings into timely applications for COVID‐19. There is widespread dissemination of CoVs in the immediate patient environment, and CoVs can potentially be spread via respiratory secretions, urine, and stool. Interpretations of the spread however must consider whether studies examine for viral RNA, virus viability by culture, or both. Pre‐symptomatic, asymptomatic, and post‐fourteen day virus excretion from patients may complicate the epidemiology. Whereas droplet spread is accepted, there continues to be controversy over the extent of possible airborne spread and especially now for SARS‐CoV‐2. CoVs are stable in body secretions and sewage at reduced temperatures. In addition to temperature, dryness or relative humidity, initial viral burden, concomitant presence of bioburden, and the type of surface can all affect stability. Generalizing, CoVs can be susceptible to radiation, temperature extremes, pH extremes, peroxides, halogens, aldehydes, many solvents, and several alcohols. Whereas detergent surfactants can have some direct activity, these agents are better used as complements to a complex disinfectant solution. Disinfectants with multiple agents and adverse pH are more likely to be best active at higher water temperatures. Real‐life assessments should be encouraged with working dilutions. The use of decontamination and disinfection should be balanced with considerations of patient and caregiver safety. Processes should also be balanced with considerations for other potential pathogens that must be targeted. Given some CoV differences and given that surrogate testing provides experimental correlates at best, direct assessments with SARS‐CoV, MERS‐CoV, and SARS‐CoV‐2 are required. This article is protected by copyright. All rights reserved.


title: Ad hoc laboratory-based surveillance of SARS-CoV-2 by real-time RT-PCR using minipools of RNA prepared from routine respiratory samples

text: Abstract Background A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in China in late 2019 and subsequently caused a pandemic. Surveillance is important to better appreciate this evolving pandemic and to longitudinally monitor the effectiveness of public health measures. Objectives We aimed to provide a rapid, easy to establish and costeffective laboratory-based surveillance tool for SARS-CoV-2. Study design: We used minipools of RNA prepared from nucleic acid extractions of routine respiratory samples. We technically validated the assay and distributed the protocol within an informal network of five German university laboratories. Results We tested a total of 70 minipools resembling 700 samples shortly before the upsurge of cases in Germany from 17.02.2020- 10.03.2020. One minipool reacted positive and after resolution one individual sample tested SARS-COV-2 positive. This sample was from a hospitalized patient not suspected of having contracted SARS-CoV-2. Conclusions Our approach of a laboratory-based surveillance for SARSCoV-2 using minipools proved its concept is easily adaptable and resource-saving. It might assist not only public health laboratories in SARS-CoV-2 surveillance.


title: Ultraviolet and COVID‐19 pandemic

text: BACKGROUND: COVID‐19 virus causes coronavirus disease. AIMS: It is a highly contagious viral infection. PATIENTS/METHODS/RESULTS/CONCLUSION: In this article, we will discuss the potential phototherapy problems and also alternative options for dermatologists, ultraviolet treatment against COVID‐19 virus, and vitamin D–associated problems in these coronavirus days.


title: Clinical and Epidemiologic Characteristics of Spreaders of Middle East Respiratory Syndrome Coronavirus during the 2015 Outbreak in Korea

text: Nosocomial transmission is an important characteristic of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Risk factors for transmission of MERS-CoV in healthcare settings are not well defined. During the Korean outbreak in 2015, 186 patients had laboratory-confirmed MERS-CoV infection. Those suspected as a source of viral transmission were categorized into the spreader groups (super-spreader [n = 5] and usual-spreader [n = 10]) and compared to the non-spreader group (n = 171). Body temperature of ≥ 38.5°C (adjusted odds ratio [aOR], 5.54; 95% confidence interval [CI], 1.38–22.30; P = 0.016), pulmonary infiltration of ≥ 3 lung zones (aOR, 7.33; 95% CI, 1.93–27.79; P = 0.003), and a more nonisolated in-hospital days (aOR, 1.32 per 1 day; 95% CI, 1.09–1.60; P = 0.004) were significant risk factors in the spreader group. There was no different clinical factor between super-spreaders and usual-spreaders. Nonisolated in-hospital days was the only factor which tended to be higher in super-spreaders than usual-spreaders (Mean, 6.6 vs. 2.9 days; P = 0.061). Early active quarantine might help reducing the size of an outbreak.


title: A compendium of reviews in biochemistry and molecular biology published in the first half of 1992

text: Abstract 1. 1. A compendium of reviews and mini-reviews in Biochemistry and Molecular Biology published in the first half of 1992 is presented. In all 499 titles are listed from 95 different publications. 2. 2. This compendium presents the references by Journal Name. Keywords have been included with each reference to increase the value of the collection. Keyword and author cross-reference indexes are not included but are available in the electronic database from which this version was constructed. Should anyone wish to have this information in electronic form it can be distributed on MS-DOS formatted flopppy disks in either Reference Manager or Medline format. The author should be contacted for details of the number of preformatted floppy disks required.


title: “It ain’t over … . till it’s over!” Risk‐mitigation strategies for patients with gastrointestinal diseases in the aftermath of the COVID‐19 pandemic

text: The available COVID‐19 literature has focussed on specific disease manifestations, infection control, and delivery or prioritisation of services for specific patient groups in the setting of the acute COVID‐19 pandemic. Local health systems aim to contain the COVID‐19 pandemic and hospitals and health care providers rush to provide the capacity for a surge of COVID‐19 patients. However, the short, medium‐ and long‐term outcomes of patients with gastrointestinal (GI) diseases without COVID‐19 will be affected by the ability to develop locally adapted strategies to meet their service needs in the COVID‐19 setting. To mitigate risks for patients with GI diseases, it is useful to differentiate three phases: 1) the acute phase, 2) the adaptation phase and 3) the consolidation phase. During the acute phase, service delivery for patients with GI disease will be curtailed to meet competing health care needs of COVID‐19 patients. During the adaptation phase, GI‐services are calibrated towards a ‘new normal’ and the consolidation phase is characterised by rapid introduction and ongoing refinement of services. Proactive planning with engagement of relevant stakeholders including consumer representatives is required to be prepared for a variety of scenarios that are dictated by thus far undefined long‐term economic and societal impacts of the pandemic. Since substantial changes ‐to the delivery of services are likely to occur, it is important that these changes are embedded into quality and research frameworks to ensure that data are generated that support evidence‐based decision‐making during the adaptation and consolidation phases.


title: The Pathology and Pathogenesis of Experimental Severe Acute Respiratory Syndrome and Influenza in Animal Models

text: Summary Respiratory viruses that emerge in the human population may cause high morbidity and mortality, as well as concern about pandemic spread. Examples are severe acute respiratory syndrome coronavirus (SARS-CoV) and novel variants of influenza A virus, such as H5N1 and pandemic H1N1. Different animal models are used to develop therapeutic and preventive measures against such viruses, but it is not clear which are most suitable. Therefore, this review compares animal models of SARS and influenza, with an emphasis on non-human primates, ferrets and cats. Firstly, the pathology and pathogenesis of SARS and influenza are compared. Both diseases are similar in that they affect mainly the respiratory tract and cause inflammation and necrosis centred on the pulmonary alveoli and bronchioles. Important differences are the presence of multinucleated giant cells and intra-alveolar fibrosis in SARS and more fulminant necrotizing and haemorrhagic pneumonia in H5N1 influenza. Secondly, the pathology and pathogenesis of SARS and influenza in man and experimental animals are compared. Host species, host age, route of inoculation, location of sampling and timing of sampling are important to design an animal model that most closely mimics human disease. The design of appropriate animal models requires an accurate pathological description of human cases, as well as a good understanding of the effect of experimental variables on disease outcome.


title: SARS‐CoV‐2 infection presenting as a febrile rash

text: The World Health Organization (WHO) has declared that Coronavirus disease 2019 (Covid-19) is a public health emergency of international concern as it continues to spread worldwide.1 After a median incubation period of 4 days, fever and cough are the two most common manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.


title: Respiratory-syncytial-virus- and rhinovirus-related bronchiolitis in children aged <2 years in an English district general hospital

text: Summary Background Bronchiolitis is the most common reason for hospitalization in young children. In addition to respiratory syncytial virus (RSV), other viruses have been increasingly implicated. Guidance on testing has also changed. Aims To compare clinicopathological outcomes in young children admitted with bronchiolitis due to RSV in comparison with rhinovirus (RV), and identify associated risk/epidemiological factors. Methods Children aged less than two years admitted to hospital with a clinical diagnosis of bronchiolitis with positive results for either RSV or RV were included in this study. Polymerase-chain-reaction-negative cases using an extended respiratory virus panel served as a control group. Retrospective data were collected on sex, risk factors, respiratory support, intravenous fluids and antibiotics. Outcomes such as length of stay (LOS) and need for transfer to the high-dependency unit/paediatric intensive care unit were included. Findings Two hundred and twenty-seven out of 437 nasopharyngeal aspirate samples were positive for either RSV (N = 162) or RV (N = 65). The median age of cases was three months and 75% had at least one risk factor. Risk factors were higher in the RV group (P = 0.004). RV accounted for the majority of cases outside the RSV season (P < 0.01). RV-associated bronchiolitis had a longer LOS (more than seven days) (P < 0.05) and increased need for chest X-rays and/or antibiotics (P < 0.05). Use of intravenous fluids and respiratory support were higher in the RV group, but the difference was not significant. Conclusions RV is the second most common pathogen associated with bronchiolitis and is isolated all year round. This may be important in those with risk factors resulting in prolonged LOS. Further research is necessary to establish the exact role of RV in this common condition, particularly outside the traditional RSV season.


title: Phylogenetic and phylogeographic mapping of the avian coronavirus spike protein-encoding gene in wild and synanthropic birds

text: Abstract The evolution and population dynamics of avian coronaviruses (AvCoVs) remain underexplored. In the present study, in-depth phylogenetic and Bayesian phylogeographic studies were conducted to investigate the evolutionary dynamics of AvCoVs detected in wild and synanthropic birds. A total of 500 samples, including tracheal and cloacal swabs collected from 312 wild birds belonging to 42 species, were analysed using molecular assays. A total of 65 samples (13%) from 22 bird species were positive for AvCoV. Molecular evolution analyses revealed that the sequences from samples collected in Brazil did not cluster with any of the AvCoV S1 gene sequences deposited in the GenBank database. Bayesian framework analysis estimated an AvCoV strain from Sweden (1999) as the most recent common ancestor of the AvCoVs detected in this study. Furthermore, the analysis inferred an increase in the AvCoV dynamic demographic population in different wild and synanthropic bird species, suggesting that birds may be potential new hosts responsible for spreading this virus.


title: Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors

text: Abstract Background Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). Objectives The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. Design PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV. Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Results Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. Conclusion The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases.


Antagonizing the renin–angiotensin–aldosterone system in the era of COVID-19


title: Antibody to human and simian retrovirus, HTLV‐I, HTLV‐II, HIV, STLV‐III, and SRV‐I not increased in patients with multiple sclerosis

text: We have tested sera from patients with multiple sclerosis, matched controls, and those with other neurological diseases, as well as sera from patients with the acquired immunodeficiency syndrome and controls and patients with tropical spastic paraparesis (TSP) and controls for antibody to human T‐lymphotropic virus type I (HTLV‐I), HTLV‐II, human immunodeficiency virus (HIV), simian T‐lymphotropic virus type III, or simian retrovirus type I by immunofluorescent activity test, and for HTLV‐I and HIV by the ELISA method. Sera from patients with multiple sclerosis and matched controls, and from patients with optic neuritis and Parkinson's or other neuromuscular diseases did not have antibody to any of the retroviruses tested. Specimens from TSP patients and some controls contained HTLV‐I antibody. We conclude from our study that only TSP patients had serological evidence of infection with one of the retroviruses studied.


title: Phototherapeutic approach to dermatological patients during the 2019 Coronavirus pandemic: Real‐life Data from the Italian Red Zone

text: Since the novel Coronavirus 2019, also known as COVID‐19 or SARS CoV‐2, crossed the Chinese borders and became pandemic, Italy has rapidly become the country with the highest number of patient deaths as well as confirmed and/or hospitalized patients, after China [1‐2]. On March 12(th) Italy was declared a red‐zone and special protocols were enacted to limit the spread of the virus. Although COVID‐19 does not have epidermotropism, cutaneous manifestations in Cov‐19 positive patients have been reported [3] and departments of dermatology are considered at high risk [4] and were ordered to admit only patients needing urgent treatments or undergoing chronic immunosuppressive therapy in order to minimize nosocomial virus spread.


title: Chapter 12 Immune System Disorders and Epigenetics

text: Abstract Our understanding of epigenetics in complex diseases is rapidly advancing and increasingly influencing the practice of medicine. Much is known about disruption of chromatin-modifying enzymes in malignant disease, but knowledge of irregular epigenetics in immune-driven disorders is just emerging. Epigenetic factors, such as DNA or histone modifications, are indispensable for precise gene expression in diverse immune cell types. Thus a disruption of epigenetic landscapes likely has a large impact on immune homeostasis. Moreover, the low concordance rates for most autoimmune diseases suggest that epigenetics contribute to immune tolerance disturbance. Here we review the important role of epigenetics for initiation, maintenance, tolerance, and training of immune responses. We discuss evolving evidence that DNA/histone modifications and chromatin-modifying enzymes are altered in immune-based diseases. Furthermore, we explore the potential of small molecules targeting epigenetic machinery, some of which are already used in oncology, as a way to reset the immune response in disease.


title: Environmental Impacts and Policy Responses to Covid-19: A View from Latin America

text: COVID-19 is currently having major short run effects with possible serious long run implications for the environment and the management of natural resources in Latin America. We discuss the possible effects of the pandemic on air pollution, deforestation and other relevant environmental dimensions across the region. With contributions from environmental economists from eight countries, we give an overview of the initial and expected environmental effects of this health crisis. We discuss potential effects on environmental regulations, possible policy interventions, and an agenda for future research for those interested in the design and evaluation of environmental policies relevant for the Latin American context.


title: Proceedings of the OMS COVID-19 Response Conference

text: The CoronaVirus Disease 2019 (COVID-19) pandemic has impacted the world in unprecedented ways. It is clear that this pandemic, unlike any public health challenge in recent memory, has the potential to fundamentally alter the delivery of many healthcare services, including the practice of oral and maxillofacial surgery. In response to this global health crisis, the Oral and Maxillofacial Surgery (OMS) COVID-19 Response Conference was held virtually on April 9, 2020, organized by oral and maxillofacial surgeons (OMSs) and administrators from multiple institutions to provide a forum for OMSs to discuss how COVID-19 has impacted the specialty. As evidence-based information on COVID-19 continues to emerge, this manuscript serves as a means to disseminate the current opinions and management strategies of a variety of experts in OMS.


title: DRodVir: A resource for exploring the virome diversity in rodents

text: Abstract Emerging zoonotic diseases have received tremendous interests in recent years, as they pose a significant threat to human health, animal welfare, and economic stability. A high proportion of zoonoses originate from wildlife reservoirs. Rodents are the most numerous, widespread, and diverse group of mammals on the earth and are reservoirs for many zoonotic viruses responsible for significant morbidity and mortality. A better understanding of virome diversity in rodents would be of importance for researchers and professionals in the field. Therefore, we developed the DRodVir database (http://www.mgc.ac.cn/DRodVir/), a comprehensive, up-to-date, and well-curated repository of rodent-associated animal viruses. The database currently covers 7690 sequences from 5491 rodent-associated mammal viruses of 26 viral families detected from 194 rodent species in 93 countries worldwide. In addition to virus sequences, the database provides detailed information on related samples and host rodents, as well as a set of online analytical tools for text query, BLAST search and phylogenetic reconstruction. The DRodVir database will help virologists better understand the virome diversity of rodents. Moreover, it will be a valuable tool for epidemiologists and zoologists for easy monitoring and tracking of the current and future zoonotic diseases. As a data application example, we further compared the current status of rodent-associated viruses with bat-associated viruses to highlight the necessity for including additional host species and geographic regions in future investigations, which will help us achieve a better understanding of the virome diversities in the two major reservoirs of emerging zoonotic infectious diseases.


title: Evaluation of Saline, Phosphate-Buffered Saline, and Minimum Essential Medium as Potential Alternatives to Viral Transport Media for SARS-CoV-2 Testing

text: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease-19 (COVID-19), has caused a global pandemic since being discovered in late 2019.….


title: Truth, hope, compassion in a time of corona virus and a presidential election

text: Despite signs of public unity in response to the COVID‐19 pandemic, the pandemic has also highlighted our divisions, disparities, and racism. The churches can have a voice for greater harmony and community if their public theology flows from their core beliefs and practices and is marked by engagement with truth, and a vision of hope acted out with compassion.


docid: bnzfljry

title: Severe Acute Respiratory Syndrome (SARS) in a Liver Transplant Recipient and Guidelines for Donor SARS Screening

text: Severe acute respiratory syndrome (SARS) is a recently described infectious entity with salient features of fever, headache and malaise, with rapid progression to pneumonitis. The etiology of SARS is likely a novel coronavirus. During the winter of 2003, an outbreak of SARS involving several hospitals occurred in Toronto, Canada. We describe a patient post liver transplant who contracted SARS and died during the outbreak, with subsequent infection of family and several health‐care workers. A novel coronavirus was detected in respiratory specimens by PCR. Due to the potential severity of SARS in transplant recipients and the large number of cases of SARS in the community, in order to avoid transmission of SARS from a donor, we developed guidelines for SARS screening of organ donors. A screening tool based on potential hospital SARS exposure, clinical symptoms, and epidemiological exposure was used to stratify donors as high, intermediate or low risk for SARS. As SARS spreads throughout the world, it may become an increasingly significant problem for transplant patients and programs.


title: Antivirals for Respiratory Viral Infections: Problems and Prospects

text: In the past two decades, several newly emerging and reemerging viral respiratory pathogens including several influenza viruses (avian influenza and pandemic influenza), severe acute respiratory syndrome coronavirus (SARS-CoV), and Middle East respiratory syndrome coronavirus (MERS-CoV), have continued to challenge medical and public health systems. Thereafter, the development of cost-effective, broad-spectrum antiviral agents is the urgent mission of both virologists and pharmacologists. Current antiviral developments have focused targets on viral entry, replication, release, and intercellular pathways essential for viral life cycle. Here, we review the current literature on challenges and prospects in the development of these antivirals.


title: Global stability for an HIV-1 infection model including an eclipse stage of infected cells

text: Abstract We consider the mathematical model for the viral dynamics of HIV-1 introduced in Rong et al. (2007) [37]. One main feature of this model is that an eclipse stage for the infected cells is included and cells in this stage may revert to the uninfected class. The viral dynamics is described by four nonlinear ordinary differential equations. In Rong et al. (2007) [37], the stability of the infected equilibrium has been analyzed locally. Here, we perform the global stability analysis using two techniques, the Lyapunov direct method and the geometric approach to stability, based on the higher-order generalization of Bendixsonʼs criterion. We obtain sufficient conditions written in terms of the system parameters. Numerical simulations are also provided to give a more complete representation of the system dynamics.


title: Entry of Bunyaviruses into Mammalian Cells

text: The Bunyaviridae constitute a large family of enveloped animal viruses, many members of which cause serious diseases. However, early bunyavirus-host cell interactions and entry mechanisms remain largely uncharacterized. Investigating Uukuniemi virus, a bunyavirus of the genus Phlebovirus, we found that virus attachment to the cell surface was specific but inefficient, with 25% of bound viruses being endocytosed within 10 min, mainly via noncoated vesicles. The viruses entered Rab5a+ early endosomes and, subsequently, Rab7a+ and LAMP-1+ late endosomes. Acid-activated penetration, occurring 20–40 min after internalization, required maturation of early to late endosomes. The pH threshold for viral membrane fusion was 5.4, and entry was sensitive to temperatures below 25°C. Together, our results indicate that Uukuniemi virus penetrates host cells by acid-activated membrane fusion from late endosomal compartments. This study also highlights the importance of the degradative branch of the endocytic pathway in facilitating entry of late-penetrating viruses.


title: Coinfection can trigger multiple pandemic waves

text: Abstract Sequences of epidemic waves have been observed in past influenza pandemics, such as the Spanish influenza. Possible explanations may be sought either in mechanisms altering the structure of the network of contacts, such as those induced by changes in the rates of movement of people or by public health measures, or in the genetic drift of the influenza virus, since the appearance of new strains can reduce or eliminate herd immunity. The pandemic outbreaks may also be influenced by coinfection with other acute respiratory infections (ARI) that increase transmissibility of influenza virus (by coughing, sneezing, running nose). In fact, some viruses (e.g., Rhinovirus and Adenovirus) have been found to induce “clouds” of bacteria and increase the transmissibility of Staphylococcus aureus. Moreover, Rhinovirus and Adenovirus were detected in patients during past pandemics, and their presence is linked to superspreading events. In this paper, by assuming increased transmissibility in coinfected individuals, we propose and study a model where multiple pandemic waves are triggered by coinfection with ARI. The model agrees well with mortality excess data during the 1918 pandemic influenza, thereby providing indications for potential pandemic mitigation.


title: Management of hip fractures during the COVID-19 pandemic at a high-volume hip fracture unit in the United Kingdom

text: This study aimed to compare the treatment pathway and 30-day outcomes of hip fracture patients admitted during the COVID-19 pandemic with the pre-pandemic period. Three periods were retrospectively analysed: period C = 23/03/2020–11/05/2020, period A = 23/03/2018–11/05/2018, period B = 23/03/2019–11/05/2019. No statistically significant differences in time to surgery, type of treatment, complications, and mortality rates were noted. A significant reduction (p = 0.021) in the time to orthogeriatric assessment and length of inpatient stay (p < 0.001) was found in period C. Institutional adaptions to facilitate prompt treatment in hip fractures during the pandemic resulted in favourable outcomes.


title: The Malabsorption Syndrome and Its Causes and Consequences

text: Abstract The indication for a small intestinal biopsy is usually the work-up of malabsorption, a clinicopathologic picture caused by a number of infectious and noninfectious inflammatory conditions. The biopsy is generally taken through an endoscope, by either forceps or suction, from the duodenum or proximal jejunum. Depending upon the underlying condition, morphological abnormalities are seen in malabsorption range from normal mucosa with increased intraepithelial lymphocytes (gluten-sensitive enteropathy, viral gastroenteritis, food allergies, etc.), villous shortening with crypt hyperplasia (celiac disease (CD), treated CD, tropical sprue, and bacterial overgrowth), to completely flat mucosa (CD, refractory sprue, enteropathy-induced T-cell lymphoma, and autoimmune enteropathy). Infectious agents that affect gastrointestinal tract can be grouped as food-borne and water-borne bacteria, opportunistic infections (bacterial, fungal, and viral), viral infections (extremely rarely biopsied), and parasitic and helminthic infections. The majority of these infections are, however, self-limited. Although biopsy is more invasive, the use of this procedure allows detection of other causes, including Whipple's disease, other protozoan forms of diarrhea (e.g., cryptosporidiosis, isosporiasis, or cyclosporiasis), Crohn's disease, or lymphoma that may also present as diarrhea and malabsorption.


title: The Politics of SARS – Rational Responses or Ambiguity, Symbols and Chaos?

text: Abstract The main focus in this article is on the SARS event as a political process, involving political leaders, administrators and health professionals. How can we understand the reactions to SARS of some of the main actors and institutions? What aspects were they preoccupied with and did their definition of what SARS was all about change during the process? A selection of jurisdictions is chosen – China, the Hong Kong SAR, Canada and the World Health Organization – to explore these questions. The starting point is a view that the reactions cannot primarily be seen as an instrumental, based on rational, standard-operating-procedures (SOPs) and technical expertise, but may be better understood by a garbage can-perspective. From a review of the events as publicly reported, we find, as suggested by garbage can theory, that politicians’ and administrators’ responses to the SARS outbreak were a combination of competing rationalities and overlapping agendas. Critical decisions were triggered by extraneous factors and administrative actions were shaped by dramatic switches from one set of standard operating procedures to another, as events unfolded. The public health issues constantly vied with other agendas and only when compelling alignments among them occurred did professional or technical rationales for “solving the problem” become dominant.


title: Patent pools and diagnostic testing

text: There is increasing concern that overlapping patents in the field of genetics will create a costly and legally complex situation known as a patent thicket, which, along with the associated issues of accumulating royalty payments, can act as a disincentive for innovation. One potential means of preventing this is for the patent holders to enter into a so-called patent pool, such as those established in the electronics and telecommunications industries. Precedents for these also exist in the field of genetics, notably with the patents pertaining to the SARS genome. In this review, we initially address the patent pool concept in general and its application in genetics. Following this, we will explore patent pools in the diagnostic field in more detail, and examine some existing and novel examples of patent pools in genetics.


title: Characterization of the Anti-Hepatitis C Virus Activity of New Nonpeptidic Small-Molecule Cyclophilin Inhibitors with the Potential for Broad Anti-Flaviviridae Activity

text: Although members of the Flaviviridae display high incidence, morbidity, and mortality rates, the development of specific antiviral drugs for each virus is unlikely. Cyclophilins, a family of host peptidyl-prolyl cis-trans isomerases (PPIases), play a pivotal role in the life cycles of many viruses and therefore represent an attractive target for broad-spectrum antiviral development. We report here the pangenotypic anti-hepatitis C virus (HCV) activity of a small-molecule cyclophilin inhibitor (SMCypI). Mechanistic and modeling studies revealed that the SMCypI bound to cyclophilin A in competition with cyclosporine (CsA), inhibited its PPIase activity, and disrupted the CypA-nonstructural protein 5A (NS5A) interaction. Resistance selection showed that the lead SMCypI hardly selected amino acid substitutions conferring low-level or no resistance in vitro. Interestingly, the SMCypI selected D320E and Y321H substitutions, located in domain II of the NS5A protein. These substitutions were previously associated with low-level resistance to cyclophilin inhibitors such as alisporivir. Finally, the SMCypI inhibited the replication of other members of the Flaviviridae family with higher 50% effective concentrations (EC(50)s) than for HCV. Thus, because of its chemical plasticity and simplicity of synthesis, our new family of SMCypIs represents a promising new class of drugs with the potential for broad-spectrum anti-Flaviviridae activity as well as an invaluable tool to explore the role of cyclophilins in viral life cycles.


title: Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms

text: Abstract The coronavirus disease 19 (COVID-19) pandemic is a significant psychological stressor in addition to its tremendous impact on every facet of individuals’ lives and organizations in virtually all social and economic sectors worldwide. Fear of illness and uncertainty about the future precipitate anxiety- and stress-related disorders, and several groups have rightfully called for the creation and dissemination of robust mental health screening and treatment programs for the general public and front-line healthcare workers. However, in addition to pandemic-associated psychological distress, the direct effects of the virus itself (several acute respiratory syndrome coronavirus; SARS-CoV-2), and the subsequent host immunologic response, on the human central nervous system (CNS) and related outcomes are unknown. We discuss currently available evidence of COVID-19 related neuropsychiatric sequelae while drawing parallels to past viral pandemic-related outcomes. Past pandemics have demonstrated that diverse types of neuropsychiatric symptoms, such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction, or demyelinating processes, may accompany acute viral infection, or may follow infection by weeks, months, or longer in recovered patients. The potential mechanisms are also discussed, including viral and immunological underpinnings. Therefore, prospective neuropsychiatric monitoring of individuals exposed to SARS-CoV-2 at various points in the life course, as well as their neuroimmune status, are needed to fully understand the long-term impact of COVID-19, and to establish a framework for integrating psychoneuroimmunology into epidemiologic studies of pandemics.


The host’s angiotensin-converting enzyme polymorphism may explain epidemiological findings in COVID-19 infections


African American COVID-19 Mortality: A Sentinel Event


title: 68 Respiratory viral detection in children with cystic fibrosis (CF)

text: Objective The aim of this study was to assess the presence of respiratory viruses in CF patients at routine visits during the two-month period (November-December 2014) and to determine the clinical impact of this finding. Methods Nasopharyngeal swabs/aspirates from 35 patients were tested using a PCR method (Serplex® RV15 Onestep ACE Detection), detecting 15 respiratory viruses (adenovirus, coronavirus 229E/NL63 and OC43, parainfluenza virus 1, 2, 3 and 4, influenza A and B, respiratory syncytial virus A and B, rhinovirus (RV), metapneumovirus, boccavirus and enterovirus). Results Patients were 2–24 yrs old (AVR 12 y), 13 chronically colonised with Pseudomonas aeruginosa (PA). Lung function test for 30 subjects showed: 9 normal findings; 11 mild, 7 moderate and 3 severe lung disease. There was no significant difference regarding lung function or PA status between the subgroups of patients positive or negative for viruses. Viruses were detected in 4/35 subjects (2 RV, 1 enterovirus, 1 parainfluenza virus 3) and 3 had concomitant PA isolation (1 chronic colonisation). However, no acute worsening of the respiratory status was found, determined as the presence of fever and upper respiratory symptoms or a recent change in at least two of the following: sputum volume or colour, cough intensity, increased malaise, increased dyspnea, loss of appetite, a decrease of FEV1 >10% (modified Fuchs criteria). Conclusion In this pilot study chronic PA infection wasn't associated with a higher rate of viral detection and no immediate negative consequences of virus detection on the respiratory status of CF patients was observed. Further study is needed.


title: The Role of Selenium Mineral Trace Element in Exercise: Antioxidant Defense System, Muscle Performance, Hormone Response, and Athletic Performance. A Systematic Review

text: Exercise overproduces oxygen reactive species (ROS) and eventually exceeds the body’s antioxidant capacity to neutralize them. The ROS produce damaging effects on the cell membrane and contribute to skeletal muscle damage. Selenium (Se), a natural mineral trace element, is an essential component of selenoproteins that plays an important role in antioxidant defense. The activity of the enzyme glutathione peroxidase (GPx), a highly-efficient antioxidant enzyme, is closely dependent on the presence of Se. These properties of Se may be potentially applicable to improve athletic performance and training recovery. We systematically searched for published studies to evaluate the effectiveness of Se supplementation on antioxidant defense system, muscle performance, hormone response, and athletic performance among physically active individuals. We used the Preferred Reporting Elements for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and searched in SCOPUS, Web of Science (WOS), and PubMed databases to identify published studies until March 2020. The systematic review incorporated original studies with randomized controlled crossover or parallel design in which intake of Se administered once a day was compared with the same placebo conditions. No exclusions were applied for the type of physical exercise performed, the sex, nor the age of the participants. Among 150 articles identified in the search, 6 met the criteria and were included in the systematic review. The methodological quality of the studies was evaluated using the McMaster Critical Review Form. Oral Se supplementation with 180 µg/day or 240 µg/day (selenomethionine) and 200 µg/day (Sodium Selenite), significantly decreased lipid hydroperoxide levels and increased GPx in plasma, erythrocyte, and muscle. No significant effects were observed on athletic performance, testosterone hormone levels, creatine kinase activity, and exercise training-induced adaptations on oxidative enzyme activities or on muscle fiber type myosin heavy chain expression. In addition, Se supplementation showed to have a dampening effect on the mitochondria changes in chronic and acute exercise. In summary, the use of Se supplementation has no benefits on aerobic or anaerobic athletic performance but it may prevent Se deficiencies among athletes with high-intensity and high-volume training. Optimal Se plasma levels may be important to minimize chronic exercise-induced oxidative effects and modulate the exercise effect on mitochondrial changes.


title: Dromedary camels and the transmission of Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is an existential threat to global public health. The virus has been repeatedly detected in dromedary camels (Camelus dromedarius). Adult animals in many countries in the Middle East as well as in North and East Africa showed high (>90%) sero-prevalence to the virus. MERS-CoV isolated from dromedaries is genetically and phenotypically similar to viruses from humans. We summarise current understanding of the ecology of MERS-CoV in animals and transmission at the animal-human interface. We review aspects of husbandry, animal movements and trade and the use and consumption of camel dairy and meat products in the Middle East that may be relevant to the epidemiology of MERS. We also highlight the gaps in understanding the transmission of this virus in animals and from animals to humans.


title: Porcine deltacoronavirus nsp5 inhibits interferon-β production through the cleavage of NEMO

text: Abstract Porcine deltacoronavirus (PDCoV) causes acute enteric disease and mortality in seronegative neonatal piglets. Previously we have demonstrated that PDCoV infection suppresses the production of interferon-beta (IFN-β), while the detailed mechanisms are poorly understood. Here, we demonstrate that nonstructural protein 5 (nsp5) of PDCoV, the 3C-like protease, significantly inhibits Sendai virus (SEV)-induced IFN-β production by targeting the NF-κB essential modulator (NEMO), confirmed by the diminished function of NEMO cleaved by PDCoV. The PDCoV nsp5 cleavage site in the NEMO protein was identified as glutamine 231, and was identical to the porcine epidemic diarrhea virus nsp5 cleavage site, revealing the likelihood of a common target in NEMO for coronaviruses. Furthermore, this cleavage impaired the ability of NEMO to activate the IFN response and downstream signaling. Taken together, our findings reveal PDCoV nsp5 to be a newly identified IFN antagonist and enhance the understanding of immune evasion by deltacoronaviruses.


title: A Large Variation in the Rates of Synonymous Substitution for RNA Viruses and Its Relationship to a Diversity of Viral Infection and Transmission Modes

text: RNA viruses successfully adapt to various environments by repeatedly producing new mutants, often through generating a number of nucleotide substitutions. To estimate the degree of variation in mutation rates of RNA viruses and to understand the source of such variation, we studied the synonymous substitution rate because synonymous substitution is exempt from functional constraints at the protein level, and its rate reflects the mutation rate to a great extent. We estimated the synonymous substitution rates for a total of 49 different species of RNA viruses, and we found that the rates had tremendous variation by 5 orders of magnitude (from 1.3 × 10(−7) to 6.2 × 10(−2) /synonymous site/year). Comparing the synonymous substitution rates with the replication frequencies and replication error rates for the RNA viruses, we found that the main source of the rate variation was differences in the replication frequency because the rates of replication error were roughly constant over different RNA viruses. Moreover, we examined a relationship between viral life strategies and synonymous substitution rates to understand which viral life strategies affect replication frequencies. The results show that the variation of synonymous substitution rates has been influenced most by either the difference in the infection modes or the differences in the transmission modes. In conclusion, the variation of mutation rates for RNA viruses is caused by different replication frequencies, which are affected strongly by the infection and transmission modes.


title: Review of Airline-within-Airline strategy: Case studies of the Singapore Airlines Group and Qantas Group

text: Abstract The growth of the aviation industry has seen a rapid increase in low-cost carriers (LCCs) commencing operations, threatening the sustainability of a number of legacy airlines. The response to this challenge and threat has been for legacy airlines to create an airline-within-airline (AWA). This study reviews prior literature regarding the hotel industry and multi-brand strategy, and also uses case studies to examine the evolution of the AWA strategy at the Singapore Airlines Group and the Qantas Group between 2000 and 2016 in order to identify why these airlines operate AWAs successfully. High levels of autonomy, clear strategies, complimentary route networks, appropriate resources and minimal cannibalisation are identified as the primary attributes required for a successful AWA operation. Legacy airlines whose AWA strategy failed in the past often did not operate with all these essential attributes, which resulted in their AWAs undermining and competing directly with their own operations.


title: COVID‐19 and Down syndrome

text: The outbreak of severe pneumonia due to the new SARS‐CoV‐2 has created a world emergency that is putting global public health institutions at high alert. Since the first official paper on January 20 up to now more than 10.000 publications have appeared on PubMed. Surprisingly, no single paper has been dealing with the potential impact of the COVID‐19 on Down Syndrome (DS). As COVID‐19 presents as an acute severe respiratory syndrome and DS is by far the most frequent chromosomal disease with the highest susceptibility to develop respiratory infections and complications (1), it seems timely to focus on this syndrome during the ongoing pandemic.


title: When basic supplies are missing, what to do? Specific demands of the local street population in times of coronavirus – a concern of social psychiatry

text: Abstract Background Homeless experts and some federal housing officials are sounding the alarm that the patchwork of government efforts to address the coronavirus outbreak risks leaving out one group of acutely vulnerable people: the homeless. In terms of isolation, it is too unclear what that looks like if you normally sleep on the streets. In this tough moment, when people should be turned away, not only it feels inhumane, but it is also a big public health risk, because where are they going to go? Method The studies were identified using large-sized newspapers with international circulation Results With more cities suspecting community transmission of the novel coronavirus, people who sleep in shelters or hunker down outside already have a lower life expectancy and often have underlying health conditions that put them at greater risk if they develop COVID-19 (Global News, 2020). These people face lack of sleep, malnutrition, and “extreme stress levels just to meet their daily needs”, all of which weakens the immune system. Along with mental illness or substance abuse disorders, they are “incredibly vulnerable to this virus”. Conclusions Health organizations are well aware of the risks involved in mental health. A large population of homeless people experience their pain and psychological distress intermittently. For low-income patients, the various borderline situations related to health/illness involve growing expectations regarding the basic needs. This is a serious concern when linked to the pandemic.


title: Statistical methods for detecting molecular adaptation

text: Abstract The past few years have seen the development of powerful statistical methods for detecting adaptive molecular evolution. These methods compare synonymous and nonsynonymous substitution rates in protein-coding genes, and regard a nonsynonymous rate elevated above the synonymous rate as evidence for darwinian selection. Numerous cases of molecular adaptation are being identified in various systems from viruses to humans. Although previous analyses averaging rates over sites and time have little power, recent methods designed to detect positive selection at individual sites and lineages have been successful. Here, we summarize recent statistical methods for detecting molecular adaptation, and discuss their limitations and possible improvements.


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title: Recommendations from the Sociedade Portuguesa de Cuidados Intensivos and Infection & Sepsis Group for intensive care approach to COVID-19

text: Current COVID-19 epidemics was declared on December 31, 2019 at the Wuhan city seafood market, rapidly spreading throughout China, and later reaching several countries (mainly South Korea, Japan, Italy and Iran) and, since March 1, reaching Portugal. Most of the infected patients present with mild symptoms, not requiring hospitalization. Among those admitted to the hospital, 6% to 10% require admission to the intensive care unit. These recommendations are aimed to support the organization of intensive care services to respond COVID-19, providing optimized care to the patient and protection for healthcare professionals.


Trying times for heart failure trials during the COVID-19 pandemic: American heart failure specialist William T. Abraham of the Wexler Medical Centre of Ohio State University talks to CardioPulse about the ramifications of the COVID-19 pandemic in relation to ongoing and future heart failure (HF) studies, and outlines some guiding principles and possible solutions