title: The COVID-19 pandemic: Important considerations for contact lens practitioners

text: A novel coronavirus (CoV), the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), results in the coronavirus disease 2019 (COVID-19). As information concerning the COVID-19 disease continues to evolve, patients look to their eye care practitioners for accurate eye health guidance. There is currently no evidence to suggest an increased risk of contracting COVID-19 through contact lens (CL) wear compared to spectacle lens wear and no scientific evidence that wearing standard prescription spectacles provides protection against COVID-19 or other viral transmissions. During the pandemic there will potentially be significant changes in access to local eyecare. Thus, it is imperative CL wearers are reminded of the steps they should follow to minimise their risk of complications, to reduce their need to leave isolation and seek care. Management of adverse events should be retained within optometric systems if possible, to minimise the impact on the wider healthcare service, which will be stretched. Optimal CL care behaviours should be the same as those under normal circumstances, which include appropriate hand washing (thoroughly with soap and water) and drying (with paper towels) before both CL application and removal. Daily CL cleaning and correct case care for reusable CL should be followed according to appropriate guidelines, and CL exposure to water must be avoided. Where the availability of local clinical care is restricted, practitioners should consider advising patients to reduce or eliminate sleeping in their CL (where patients have the appropriate knowledge about correct daily care and access to suitable lens-care products) or consider the option of moving patients to daily disposable lenses (where patients have appropriate lens supplies available). Patients should also avoid touching their face, including their eyes, nose and mouth, with unwashed hands and avoid CL wear altogether if unwell (particularly with any cold or flu-like symptoms).


title: In vitro evaluation of antioxidant activities of aqueous extracts from natural and cultured mycelia of Cordyceps sinensis

text: Abstract Cordyceps sinensis, one of the best known traditional Chinese medicines and health foods, has been highly valued for the treatment of a wide range of diseases and reported to have antioxidant properties. In the present study, the antioxidant activities of hot-water extracts from natural and cultured mycelia of C. sinensis were investigated and evaluated using six in vitro assays, including inhibition of linoleic acid peroxidation; scavenging abilities on DPPH, hydroxyl and superoxide anion radicals; the reducing power and the chelating ability on ferrous ions. Among these assays, the extracts showed the best effect on the inhibition of linoleic peroxidation with the lowest IC50 values and with an inhibition rate over 90% at concentration of 0.8–1.6mg/ml, more stable than that of α-tocopherol, a recognised natural antioxidant. The scavenging activities on superoxide anion and hydroxyl radicals of the two extracts were slightly lower than that of butylated hydroxytoluene. DPPH scavenging activities of both extracts reached over 80% inhibition at 4–8mg/ml. Both extracts showed moderate reducing power and ferrous ion chelating activity. The IC50 value of the extract from cultured mycelia in all the tests, except for linoleic acid peroxidation, was significantly lower than that of natural mycelia. There was no evident correlation between the antioxidant activity and the content of protein, polysaccharides and mannitol of extracts from C. sinensis; the antioxidant activity may be due to a combined effect of these or some other compounds. These results suggested that both the extracts from cultured and natural mycelia have direct and potent antioxidant activities and that the cultured mycelia of the fungus could be used for the antioxidant activity to reduce the human demands on the natural resources of the fungus, an endangered species.


title: Are Health e-Mavens the New Patient Influencers?

text: Even though the healthcare industry is usually considered a rather traditional and slowly evolving sector, change is happening. Digitalization is transforming the way of obtaining medical advice and treatment and the Internet has become a key source for the seeking of healthcare information. It has allowed people to turn into more active collaborators in matters of their own health by enabling them to easily search and share information with other patients. Although research points out the growing importance of user-generated content in many sectors and its positive impact on information credibility, trust, engagement, and, ultimately, customer behavior (Malthouse et al., 2016), there is a lack of attention to this topic in healthcare. In this brief review, we address this gap by analyzing the role of health e-mavens, which are a particular type of influencers that possesses both expertise and online social influence. We lastly illustrate possible benefits of their impact on other to the different parties involved and affected by this phenomenon.


title: Canine kobuviruses in diarrhoeic dogs in Italy

text: Abstract Canine kobuviruses (CaKVs) are newly recognized picornaviruses recently detected in dogs in the US. By molecular analysis of the whole genome, CaKV that appeared genetically closest to the murine kobuvirus (MuKV) and to the human Aichi virus (AiV), may be classified in the Kobuvirus genus as new genotype (CaKV type 1) within the species Aichivirus A. To date, there are no information on the epidemiology of these novel viruses in other continents. In this study, by screening a collection of 256 dog fecal samples either from diarrhoeic or asymptomatic animals, CaKV was identified in six specimens with an overall prevalence of 2.34% (6/256). All the positive dogs presented diarrhea and were found to be infected by CaKV alone or in mixed infections with canine coronavirus (CCoV) and/or canine parvovirus type 2 (CPV-2). By molecular analysis of the partial 3D gene, all the strains detected displayed a close relatedness with the CaKVs recently identified in the US. This study provides evidence that CaKVs circulate in diarrhoeic dogs in Italy and are not geographically restricted to the North American continent, where they were first signaled.


title: The potential of anti‐infectives and immunomodulators as therapies for asthma and asthma exacerbations

text: Asthma is responsible for approximately 25,000 deaths annually in Europe despite available medicines that maintain asthma control and reduce asthma exacerbations. Better treatments are urgently needed for the control of chronic asthma and reduction in asthma exacerbations, the major cause of asthma mortality. Much research spanning >20 years shows a strong association between microorganisms including pathogens in asthma onset, severity and exacerbation, yet with the exception of antibiotics, few treatments are available that specifically target the offending pathogens. Recent insights into the microbiome suggest that modulating commensal organisms within the gut or lung may also be a possible way to treat/prevent asthma. The European Academy of Allergy & Clinical Immunology Task Force on Anti‐infectives in Asthma was initiated to investigate the potential of anti‐infectives and immunomodulators in asthma. This review provides a concise summary of the current literature and aimed to identify and address key questions that concern the use of anti‐infectives and both microbe‐ and host‐based immunomodulators and their feasibility for use in asthma.


title: Análisis del impacto de los test de diagnóstico virológico en el consumo de antibióticos en pacientes pediátricos ingresados por neumonía adquirida en la comunidad

text: INTRODUCTION: Viruses are one of the most common causes of community-acquired pneumonia (CAP) in children. Early identification of respiratory viruses could result in a decrease in the use of antibiotics. METHODS: Observational, retrospective study from January 2014 to June 2018, that included paediatric patients admitted with a diagnosis of CAP in a tertiary hospital, in which antigenic tests and/or viral PCR on a respiratory sample was performed. RESULTS: A total of 105 CAP episodes were included, with identification of a respiratory virus in 93 (88.6%) cases. Patients with respiratory syncytial virus (RSV) detection had a lower onset of empirical antibiotic therapy (35.1% vs. 55.9%, P-value=.042). In addition, cases with RSV or influenza identification required shorter duration of antibiotic therapy (receiving 45.6% ≥2 days vs. 68.8% of those not identified, P=.017). CONCLUSION: The use of respiratory virus diagnostic techniques in our setting can optimise antibiotic use in children admitted with CAP.


title: Characterization of a recombinant coronavirus infectious bronchitis virus with distinct S1 subunits of spike and nucleocapsid genes and a 3′ untranslated region

text: Abstract An infectious bronchitis virus (IBV), ck/CH/LZJ/111113, was isolated from a H120-vaccinated chicken which showed disease suspected of IBV infection. Neutralization testing showed that ck/CH/LZJ/111113 was distinct from either the Chinese predominant IBV LX4-type or Mass-type vaccine strains. Phylogenetic analysis confirmed that ck/CH/LZJ/111113 is of the 4/91 type; however, further extensive analyses of full-length genomes identified occurrence of recombination events. Therefore, ck/CH/LZJ/111113 originated from the recombination events between ck/CH/LDL/091022- and 4/91-like strains at three switch sites located upstream of the spike (S) glycoprotein gene, and the 3′ ends of S1 and nuceocapsid (N) genes, respectively. The difference of serotypes and tissue tropisms in kidneys between ck/CH/LZJ/111113 and ck/CH/LDL/091022 may have been contributed by the uptake of the S1 gene by a ck/CH/LDL/091022-like virus from a 4/91-like strain. This recombination event took place at the 3′ end of the N gene and the 3′ untranslated region may account for differences in replication efficiency in tissues of chickens inoculated by the two viruses.


title: Secular trends in incidence of type 1 and type 2 diabetes in Hong Kong: A retrospective cohort study

text: BACKGROUND: There is very limited data on the time trend of diabetes incidence in Asia. Using population-level data, we report the secular trend of the incidence of type 1 and type 2 diabetes in Hong Kong between 2002 and 2015. METHODS AND FINDINGS: The Hong Kong Diabetes Surveillance Database hosts clinical information on people with diabetes receiving care under the Hong Kong Hospital Authority, a statutory body that governs all public hospitals and clinics. Sex-specific incidence rates were standardised to the age structure of the World Health Organization population. Joinpoint regression analysis was used to describe incidence trends. A total of 562,022 cases of incident diabetes (type 1 diabetes [n = 2,426]: mean age at diagnosis is 32.5 years, 48.4% men; type 2 diabetes [n = 559,596]: mean age at diagnosis is 61.8 years, 51.9% men) were included. Among people aged <20 years, incidence of both type 1 and type 2 diabetes increased. For type 1 diabetes, the incidence increased from 3.5 (95% CI 2.2–4.9) to 5.3 (95% CI 3.4–7.1) per 100,000 person-years (average annual percentage change [AAPC] 3.6% [95% CI 0.2–7.1], p < 0.05) in boys and from 4.3 (95% CI 2.7–5.8) to 6.4 (95% CI 4.3–8.4) per 100,000 person-years (AAPC 4.7% [95% CI 1.7–7.7], p < 0.05] in girls; for type 2 diabetes, the incidence increased from 4.6 (95% CI 3.2–6.0) to 7.5 (95% CI 5.5–9.6) per 100,000 person-years (AAPC 5.9% [95% CI 3.4–8.5], p < 0.05) in boys and from 5.9 (95% CI 4.3–7.6) to 8.5 (95% CI 6.2–10.8) per 100,000 person-years (AAPC 4.8% [95% CI 2.7–7.0], p < 0.05) in girls. In people aged 20 to <40 years, incidence of type 1 diabetes remained stable, but incidence of type 2 diabetes increased over time from 75.4 (95% CI 70.1–80.7) to 110.8 (95% CI 104.1–117.5) per 100,000 person-years (AAPC 4.2% [95% CI 3.1–5.3], p < 0.05) in men and from 45.0 (95% CI 41.4–48.6) to 62.1 (95% CI 57.8–66.3) per 100,000 person-years (AAPC 3.3% [95% CI 2.3–4.2], p < 0.05) in women. In people aged 40 to <60 years, incidence of type 2 diabetes increased until 2011/2012 and then flattened. In people aged ≥60 years, incidence was stable in men and declined in women after 2011. No trend was identified in the incidence of type 1 diabetes in people aged ≥20 years. The present study is limited by its reliance on electronic medical records for identification of people with diabetes, which may result in incomplete capture of diabetes cases. The differentiation of type 1 and type 2 diabetes was based on an algorithm subject to potential misclassification. CONCLUSIONS: There was an increase in incidence of type 2 diabetes in people aged <40 years and stabilisation in people aged ≥40 years. Incidence of type 1 diabetes continued to climb in people aged <20 years but remained constant in other age groups.


title: Hematological and coagulation profiles in dogs experimentally infected with Angiostrongylus vasorum (Baillet, 1866)

text: Abstract Hematological and coagulation profiles were studied in crossbred dogs experimentally infected with Angiostrongylus vasorum. Two groups of five dogs were experimentally inoculated with 50 and 100 third stage infective larvae (L3) of A. vasorum per kilogram of body weight. A third group of five uninfected animals was used as control. One sample of 10ml of blood was collected from each animal on the 10, 20, 30, and 45 days after inoculation (dai) and at 30-day intervals thereafter for the remainder of the 210-day experimental period. The blood sample was used for the complete hemogram and platelet count, as well as measurements of prothrombin time, partial thromboplastin time and factors V and VIII. Anemia was observed in infected dogs, 6 weeks after the infection. The eosinophils presented peaks in four periods after infection. Thrombocytopenia became accentuated on the 72dai. Decreased prothrombin time activity and increased partial thromboplastin time were observed at the 6 and 9 weeks after infection and decreased of factors VIII and V activities occurred from 4 to 6 weeks after infection. It may be conclude that infection by A. vasorum in dogs may cause a discrete anemia during the acute phase which is probably regenerative. In addition, important hemostatic alterations due to the infection suggest a chronic intravascular consumption coagulopathy.


title: Incidence and clinical profiles of COVID-19 pneumonia in pregnant women: A single-centre cohort study from Spain

text: BACKGROUND: Information regarding the incidence and characteristics of COVID-19 pneumonia amongst pregnant women is scarce. METHODS: Single-centre experience with 32 pregnant women diagnosed with COVID-19 between March 5 to April 5, 2020 at Madrid, Spain. FINDINGS: COVID-19 pneumonia was diagnosed in 61·5% (32/52) women. Only 18·7% (6/32) had some underlying condition (mostly asthma). Supplemental oxygen therapy was required in 18 patients (56·3%), with high-flow requirements in six (18·7%). Eight patients (25·0%) fulfilled the criteria for acute distress respiratory syndrome. Invasive mechanical ventilation was required in two patients (6·2%). Tocilizumab was administered in five patients (15·6%). Delivery was precipitated due to COVID-19 in three women (9·4%). All the newborns had a favourable outcome, with no cases of neonatal SARS-CoV-2 transmission. Severe cases of pneumonia requiring supplemental oxygen were more likely to exhibit bilateral alveolar or interstitial infiltrates on chest X-ray (55·6% vs. 0·0%; P-value = 0·003) and serum C-reactive protein (CRP) levels >10 mg/dL (33·0% vs. 0·0%; P-value = 0·05) at admission than those with no oxygen requirements. INTERPRETATION: Pregnant women with COVID-19 have a high risk of developing pneumonia, with a severe course in more than half of cases. The presence of bilateral kung infiltrates and elevated serum CRP at admission may identify women at-risk of severe COVID-19 pneumonia. FUNDING: Instituto de Salud Carlos III (COV20/00,181), Spanish Ministry of Science and Innovation.


title: Re-evaluation of the therapy of severe pneumonia caused by Streptococcus pneumoniae

text: Pneumonia caused by Streptococcus pneumoniae is the most deadly form of community-acquired pneumonia. The death rate of bacteremic pneumococcal pneumonia has remained constant over the past 50 years. Several retrospective reviews of bacteremic pneumococcal pneumonia suggest that dual therapy with a beta-lactam and a macrolide antimicrobial agent is associated with a lower case fatality rate than therapy with a beta-lactam alone. These studies are reviewed, potential mechanisms are suggested, and future studies are discussed.


A propósito de la carta científica "Sospecha de abdomen agudo como manifestación extrapulmonar d infección COVID-19”


title: A pseudoknot improves selection efficiency in ribosome display

text: The size and diversity of ribosome display libraries depends upon stability of the complex formed between the ribosome, mRNA and translated protein. To investigate if mRNA secondary structure improves stability of the complex, we tested a pseudoknot, originating from the genomic RNA of infectious bronchitis virus (IBV), a member of the positive-stranded coronavirus group. We used the previously-isolated anti-DNA scFv, 3D8, as a target protein. During in vitro translation in rabbit reticulocyte lysate, we observed that incorporation of the pseudoknot into the mRNA resulted in production of a translational intermediate that corresponded to the expected size for ribosomal arrest at the pseudoknot. Complexes containing the mRNA pseudoknot exhibited a higher efficiency of affinity selection than that those without, indicating that the pseudoknot improves stability of the mRNA-ribosome-antibody complex in a eukaryotic translation system. Thus, in order to improve the efficiency of selection, this relatively short pseudoknot sequence could be incorporated into ribosome display.


title: Capture ELISA and flow cytometry methods for toxicologic assessment following immunization and cyclophosphamide challenges in beagles

text: Abstract The purpose of this subacute 22-day study was to evaluate methods for canine circulating immunoglobulins (IgM, IgG, and IgE) and select B- and T-lymphocyte populations (CD4-helpers, CD8-suppressors, pan-T and pan-B) for immunotoxicity testing using an organ system (concordance) approach. The challenge substance for immunoglobulin testing was repeated immunization with six-way distemper vaccination (DHLAPP), while the challenge substance for leukocyte subpopulations was treatment with cyclophosphamide. Immunoglobulin measurements were made by capture enzyme-linked immunosorbent assay (ELISA), and leukocyte immunophenotyping by fluorescein isothiocyanate/phycoerythrin conjugation (flow cytometry). A battery of parameters that would be used in a typical regulatory study were taken to aid interpretation of the data generated by these methods. Body weights, food consumption, clinical observations, complete clinical chemistry and urinalysis measurements were taken. Gross pathology and micropathology of sternal bone marrow, spleen, mesenteric and retropharyngeal lymph nodes, thymus, liver and kidney were completed. The ELISA method demonstrated acceptable intra-assay reproducibility for IgM, IgG and IgE, with values in good agreement as reported for radial immunodiffusion. The immunologic challenge demonstrated a biological trend of an increase in IgM that preceded an increase in IgG with no discernible trend in IgE response, and no abnormalities in lymphocyte subpopulations. Principle flow cytometry findings related to cyclophosphamide were that the relative percent of B cells decreased dramatically and progressively after compound administration; being statistically decreased in males on day 22 compared with day −5. The relative percent CD4 and CD8 contribution increased, but the CD4/CD8 ratio remained relatively unchanged as total white blood cells decreased progressively. The increase in relative percent CD4 (males only) was statistically significant according to a two-sample t-test on days 17, 20 and 22 when compared with the pre-treatment day −5. There was a relative percent increase in CD5-panT, but absolute numbers were dramatically decreased. We conclude that an organ system approach to assessment of the immune system which incorporates humoral antibody, enumeration of lymphocyte populations and pathologic evaluation of the lymphoreticular organs assists in the interpretation of an adverse toxicological response. The ELISA method for measurement of Igs detected the expected levels of IgG, IgM and IgE due to repeated vaccinations and to cyclophosphamide treatment. The flow cytometry method was acceptable for measuring select canine lymphocyte populations and detecting the expected decrease in B cells due to cyclophosphamide treatment. Both methods may be added to a testing battery for assessing immunotoxicity in canine regulatory studies.


Tromboembolia pulmonar en la COVID-19. Cuando nada es lo que parece


title: Angiotensin-converting enzyme 2 and angiotensin 1–7: novel therapeutic targets

text: The renin–angiotensin system (RAS) has pivotal roles in the regulation of normal physiology and the pathogenesis of cardiovascular disease. Angiotensin-converting enzyme (ACE) 2, and its product angiotensin 1–7, are thought to have counteracting effects against the adverse actions of other, better known and understood, members of the RAS. The physiological and pathological importance of ACE2 and angiotensin 1–7 in the cardiovascular system are not completely understood, but numerous experimental studies have indicated that these components have protective effects in the heart and blood vessels. Here, we provide an overview on the basic properties of ACE2 and angiotensin 1–7 and a summary of the evidence from experimental and clinical studies of various pathological conditions, such as hypertension, atherosclerosis, myocardial remodelling, heart failure, ischaemic stroke, and diabetes mellitus. ACE2-mediated catabolism of angiotensin II is likely to have a major role in cardiovascular protection, whereas the relevant functions and signalling mechanisms of actions induced by angiotensin 1–7 have not been conclusively determined. The ACE2–angiotensin 1–7 pathway, however, might provide a useful therapeutic target for the treatment of cardiovascular disease, especially in patients with overactive RAS. SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1038/nrcardio.2014.59) contains supplementary material, which is available to authorized users.


title: Decline in the incidence of healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA) correlates with deceased antimicrobial consumption at a tertiary care hospital in Taiwan, 2001–2009

text: Abstract The present study investigated the long-term impact of antibiotic use policy on the rates of consumption (expressed as daily-defined doses/1000 patient-days) of various parenteral antibiotics and on the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and the incidence of healthcare-associated MRSA (HA-MRSA) infection at a tertiary care hospital from 2001 to 2009. During this time, consumption of all antimicrobials for systemic use decreased by 33%. This change was driven by a 44% decrease in the consumption of unrestricted antibacterials, which was offset by a 42% increase in the consumption of restricted agents. The trends in MRSA prevalence (number of isolates/1000 patient-days) and HA-MRSA incidence (number of HA-MRSA-infected persons/1000 patient-days) correlated with the trend in overall consumption of antimicrobials. Significant positive correlations were observed between MRSA prevalence and the consumption of extended-spectrum and β-lactamase-resistant penicillins, first-generation cephalosporins, macrolides, lincosamides and streptogramins, aminoglycosides, and glycopeptides. Significant positive correlations were found between the incidence of HA-MRSA infection and the consumption of tetracyclines, extended-spectrum and β-lactamase-resistant penicillins, sulfonamides and trimethoprim, macrolides, lincosamides and streptogramins, and aminoglycosides. In conclusion, we have documented the ongoing successful reduction in total consumption of antimicrobials associated with a decrease in the incidence of HA-MRSA and the prevalence of MRSA over a 9-year period.


title: Expression and Purification of Recombinant Proteins in Escherichia coli with a His(6) or Dual His(6)-MBP Tag

text: Rapid advances in bioengineering and biotechnology over the past three decades have greatly facilitated the production of recombinant proteins in Escherichia coli. Affinity-based methods that employ protein or peptide based tags for protein purification have been instrumental in this progress. Yet insolubility of recombinant proteins in E. coli remains a persistent problem. One way around this problem is to fuse an aggregation-prone protein to a highly soluble partner. E. coli maltose-binding protein (MBP) is widely acknowledged as a highly effective solubilizing agent. In this chapter, we describe how to construct either a His(6)- or a dual His(6)-MBP tagged fusion protein by Gateway(®) recombinational cloning and how to evaluate their yield and solubility. We also describe a simple and rapid procedure to test the solubility of proteins after removing their N-terminal fusion tags by tobacco etch virus (TEV) protease digestion. The choice of whether to use a His(6) tag or a His(6)-MBP tag can be made on the basis of this solubility test.


title: Case Study: Supplementation of cow-calf pairs grazing smooth bromegrass pastures with ethanol by-products and low-quality forages

text: ABSTRACT Multiparous, lactating, crossbred (Simmental × Angus) beef cows with spring-born calves at side (n = 16 per year; 4 per pasture) were used each of 3 yr to evaluate supplementing modified distillers grains plus solubles mixed with low-quality forage on cow and calf performance while grazing. Cow-calf pairs were assigned randomly to treatment with 2 replications (pasture) per year for 3 yr. Treatments were (1) recommended stocking rate of 9.46 animal-unit month/ha with no supplementation (CON) or (2) double the recommended stocking rate (18.9 animal-unit month/ha) and supplemented with a 30:70 modified distillers grains plus solubles:cornstalks (DM) mixture (SUPP). To replace 50% of grazed forage DMI, SUPP pairs were fed an average of 1.13% of BW (DM) over the grazing season. Pairs grazed adjacent smooth bromegrass pastures for 130 d during the summer. Gain was not different (P = 0.19) between SUPP and CON cows (0.28 vs. 0.19 kg/d, respectively). Ending cow BW was not affected (P = 0.46) by treatment. Similarly, calf gain was not affected (P = 0.31) by supplementation. In studies where confined cow-calf pairs were fed average-quality (IVDMD = 52.9%) forage, DMI was 2.58% of pair BW. Based on these data, CON and SUPP pairs consumed 18.6 and 19.1 kg of DM, respectively, of total feed per pair daily. The SUPP pairs consumed 7.1 kg of DM/pair daily of the supplement, replacing approximately 35% of grazed forage intake. These data suggest mixtures of ethanol co-products and low-quality forages can be supplemented to replace grazed forage intake of cattle, allowing for increased stocking rate without affecting animal performance.


title: Genetic diversification of penaeid shrimp infectious myonecrosis virus between Indonesia and Brazil

text: Abstract Infectious myonecrosis virus (IMNV) is a pathogen of penaeid shrimp, most notably the whiteleg shrimp Litopenaeus vannamei. First discovered in L. vannamei from Brazilian aquaculture farms in 2003, IMNV was additionally confirmed in L. vannamei from Indonesian farms in 2006 and has since been found in numerous provinces there. Only two complete sequences of IMNV strains have been reported to date, one strain from the Brazilian state of Piauí collected in 2003 and another from the Indonesian province of East Java collected in 2006. In this study, we determined the complete sequences of two additional Indonesian strains, one from Lampung province collected in 2011 and another from East Java province collected in 2012. We also determined partial sequences for six other strains to enhance phylogenetic comparisons, which have heretofore been limited by the small number of reported sequences, including only one for an Indonesian strain. The new results demonstrate clear genetic diversification of IMNV between Indonesia and Brazil, as well as within Indonesia. Analyses of conserved sequence motifs suggest a revised RNA pseudoknot prediction for ribosomal frameshifting.


title: Stroke priorities during COVID-19 outbreak: acting both fast and safe

text: Abstract While the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) spreads all over the world, the healthcare systems are facing the dramatic challenge of simultaneously fight against the outbreak and life-threating emergencies. In this biological setting, emergency departments and neurovascular teams are exposed to high risk of infection and should therefore be prepared to deal with neurological emergencies safely. The purpose of this article is to analyze the current evidence on COVID-19 in the context of acute ischemic stroke and to describe the model of behavior we are putting into action to maintain the stroke pathway both rapid for the patient and safe for the healthcare professionals. We reserve a specific focus on personal protection equipment, dress code and healthcare professional behavior.


title: Novel coronavirus 2019 (COVID‐19): Emergence and implications for emergency care

text: A novel coronavirus (COVID‐19) causing acute illness with severe symptoms has been isolated in Wuhan, Hubei Province, China. Since its emergence, cases have been found worldwide, reminiscent of severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks over the past 2 decades. Current understanding of this epidemic remains limited due to its rapid development and available data. While occurrence outside mainland China remains low, the likelihood of increasing cases globally continues to rise. Given this potential, it is imperative that emergency clinicians understand the preliminary data behind the dynamics of this disease, recognize possible presentations of patients, and understand proposed treatment modalities.


title: Influenza virus emitted by naturally-infected hosts in a healthcare setting

text: Abstract Background The emergence of novel respiratory viruses such as avian influenza A(H7N9) virus and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) highlights the importance of understanding determinants of transmission to healthcare workers (HCWs) and the public. Objectives We aim to determine the viral content of the air emitted by symptomatic inpatients or long-term care residents with laboratory-confirmed influenza virus infection (emitters), and in the breathing zones of healthcare workers who attend to them. Design A prospective pilot study of patients with laboratory-confirmed influenza virus infection was undertaken. Air within 1m of the patient was sampled using a high volume air sampler. In addition, a lower volume air sampler was placed <1m from the patient, with another >1m from the patient. Viral RNA was recovered from the samplers and submitted for quantitative real time PCR. In addition, personal button samplers were provided to HCWs. Results The air emitted by 15 participants with laboratory-confirmed influenza virus infection was sampled. Of the patients infected with influenza A, viral RNA was recovered from the air emitted by 9/12 patients using the low-volume sampler; no viral RNA was detected from air emitted by patients with influenza B (n =3). Influenza virus RNA was recovered from one HCW’s sampler. Conclusions Patients with respiratory virus infection emit virus into the air which disperses to >1m and may reach the breathing zone of a HCW. This pilot study highlights the feasibility and importance of conducting a larger-scale study to identify determinants of exposure and transmission from patient to HCW.


Uncertainty and fear of the unknown: What can human resource development do?


title: A Method for RNA Structure Prediction Shows Evidence for Structure in lncRNAs

text: To compare the secondary structure profiles of RNA molecules we developed the CROSSalign method. CROSSalign is based on the combination of the Computational Recognition Of Secondary Structure (CROSS) algorithm to predict the RNA secondary structure profile at single-nucleotide resolution and the Dynamic Time Warping (DTW) method to align profiles of different lengths. We applied CROSSalign to investigate the structural conservation of long non-coding RNAs such as XIST and HOTAIR as well as ssRNA viruses including HIV. CROSSalign performs pair-wise comparisons and is able to find homologs between thousands of matches identifying the exact regions of similarity between profiles of different lengths. In a pool of sequences with the same secondary structure CROSSalign accurately recognizes repeat A of XIST and domain D2 of HOTAIR and outperforms other methods based on covariance modeling. The algorithm is freely available at the webpage http://service.tartaglialab.com//new_submission/crossalign.


title: Etiologie, expression clinique de l'angine

text: Summary Angina is a tonsillopharangitis infection. Its definition appears somewhat ambiguous since angina is a symptom, whereas tonsillitis is due to a tonsil infection. The classification of angina is rather arbitrary, as angina presents various clinical aspects. Conversely, the same clinical aspects can also be due to different infectious agents. Clinical examination will define some aspects follows: erythematous angina of the oropharynx or erthematopultaceous tonsillitis, pseudomembranous, ulcerous and ulcero-necrotic or vesiculose angina. The etiology of angina is only partially understood and only very few studies have been reported. Viruses make up the main etiology. Group A streptococci is the main cause of angina. Group A streptococcus, particularly in children, is considered as a predominant factor, with a peak occuring between 5 and 10 years of age, while 30 % to 50 % of angina infections appear to be of viral origin in adults. The main difficulty lies in diagnosis and detection since the clinical aspect of angina, due to streptococcal infection has no specificity.


title: Design and implementation of a regional inpatient psychiatry unit for asymptomatic SARS-CoV-2 positive patients.

text: Patients with psychiatric illnesses are particularly vulnerable to highly contagious, droplet spread organisms like SARS-CoV-2. Patients with mental illnesses may not be able to consistently follow behavioral prescriptions to avoid contagion, and they are frequently found in settings with close contact and inadequate infection control, such as group homes, homeless shelters, residential rehabilitation centers, and correctional facilities. Further, inpatient psychiatry settings are generally designed as communal spaces, with heavy emphasis on group and milieu therapies. As such, inpatient psychiatry services are vulnerable to rampant spread of contagion. With this in mind, the authors outline the decision process and ultimate design and implementation of a regional inpatient psychiatry unit for asymptomatic SARS-CoV-2 infected patients, and share key points for consideration in implementing future units elsewhere. A major take-away point of the analysis is the particular expertise of trained experts in psychosomatic medicine for treating SARS-CoV-2 infected patients.


title: Mx1, OAS1 and OAS2 polymorphisms are associated with the severity of liver disease in HIV/HCV-coinfected patients: A cross-sectional study

text: The mechanisms involved in the chronic hepatitis C progression are incompletely understood. The aim was to analyze the association between 2′5′oligoadenylate synthetase 1,2 and 3 (OAS1-3) and myxovirus resistance proteins 1 (Mx1) polymorphisms and severity of liver disease in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) coinfected patients. We performed a cross-sectional study in 219 patients that underwent a liver biopsy. DNA genotyping for Mx1 (rs469390), OAS1 (rs2285934), OAS2 (rs1293762) and OAS3 (rs2010604) was performed by using GoldenGate assay. The outcome variables ion liver biopsy were: (i) significant fibrosis (F ≥ 2); (ii) moderate activity grade (A ≥ 2). Additive model of inheritance for genetic association test was used. The likelihood of having significant fibrosis (F ≥ 2) was lower in patients carrying OAS2 rs1293762 A allele [adjusted odds ratio (aOR) = 0.51; p = 0.040]. Besides, the likelihood of having moderate activity grade (A ≥ 2) was higher in patients carrying Mx1 rs464397 C allele (aOR = 1.63; p = 0.028) and Mx1 rs469390 G allele (aOR = 1.97; p = 0.005), while it was lower in patients carrying OAS1 rs2285934 A allele (aOR = 0.64; p = 0.039) and OAS2 rs1293762 A allele (aOR = 0.41; p = 0.009). In conclusion, Mx1 and OAS1-2 polymorphisms were associated with the severity of liver disease in HIV/HCV-coinfected patients, suggesting a significant role in the progression of hepatic fibrosis.


title: Suggested guidelines for emergency treatment of medical waste during COVID-19: Chinese experience

text: During the period of COVID-19, the medical waste disposal capacity is seriously inadequate. The main technical process of the municipal solid waste incineration system is the same as that of the medical waste incineration system. Under the conditions of optimizing the technological process, improving the supporting facilities, and controlling the co-processing ratio, the municipal solid waste incinerator (grate furnace) co-processing medical waste is feasible. Some suggested guidelines for emergency treatment of medical waste from COVID-19 have been provided by China.


title: Reconstructed Ancestral Sequences Improve Pathogen Identification Using Resequencing DNA Microarrays

text: We describe the benefit of using reconstructed ancestral sequences (RAS) on resequencing microarrays for rapid pathogen identification, with Enterobacteriaceae rpoB sequences as a model. Our results demonstrate a sharp improvement of call rate and accuracy when using RASs as compared to extant sequences. This improvement was attributed to the lower sequence divergence of RASs, which also expanded the sequence space covered by the microarray. Extension of this novel microarray design strategy to viruses, antimicrobial resistance elements or toxins is straightforward.


title: Emergency departments (EDs) in the United Kingdom (UK) are not prepared for emerging biological threats and bioterrorism

text: Summary Objective To assess the preparedness of emergency departments (EDs) in the United Kingdom (UK) for the management of potential biological incidents. Methods We telephoned all hospitals in the UK listed as having a major ED. We surveyed their ED facilities and procedures for managing patients with infectious diseases. We determined how many of the EDs had an isolation room available and, if present, whether this had an independent ventilation system and separate access from outside the ED. In addition, we determined how many of the EDs would isolate patients with suspected cases of chickenpox, tuberculosis (TB), severe acute respiratory syndrome (SARS) and other suspicious infections. Results We obtained complete data from 203 (79%) of the 257 hospitals approached. Only 49 (24%) of these hospitals had isolation facilities available in the ED. Of these 49 EDs, 30 (61%) reported an independent ventilation system and 18 (37%) reported a separate access from outside the ED. The majority of EDs would isolate patients with potential infectious diseases, however, 47 (23%) would not isolate patients with suspected chickenpox, 37 (18%) EDS would not isolate patients with suspected TB, 12 (6%) EDS would not isolate patients with suspected SARS and 55 (27%) EDS would not isolate patients with other suspicious infections. Conclusion EDs in the UK are not prepared for emerging biological threats and bioterrorism. With current facilities and procedures it is highly likely that an infectious agent will spread to staff and other patients in any future biological incident.


title: Remdesivir attenuates high fat diet (HFD)-induced NAFLD by regulating hepatocyte dyslipidemia and inflammation via the suppression of STING

text: Abstract High-fat diet (HFD) is a predisposing factor for metabolic syndrome-related systemic inflammation and non-alcoholic fatty liver disease (NAFLD). However, there is still no effective therapeutic treatment for NAFLD. Here, we showed that remdesivir (RDV, GS-5734), as a broad-spectrum antiviral nucleotide prodrug with anti-inflammatory effects, was effective for attenuating HFD-induced metabolic disorder and insulin resistance. Results revealed that the liver weight, hepatic dysfunction and lipid accumulation were markedly increased compared with that of the Control group, while that of the RDV group exhibited significant reduction, accompanied by the improved signaling pathway regulating fatty acid metabolism. In agreement with reduced lipid deposition, RDV supplementation suppressed the systematic and hepatic inflammation, as evidenced by reduction of inflammatory cytokines and the blockage of nuclear factor κB (NF-κB) signaling. In addition, stimulator of interferon genes (STING) and its down-streaming factor interferon regulatory factor 3 (IRF3) were greatly increased in livers of HFD-fed mice, which were considerably restrained by RDV treatment. The in vitro analysis suggested that RDV functioned as an inhibitor of STING, contributing to the suppression of dyslipidemia and inflammation induced by palmitate (PA). However, PA-triggered lipid deposition and inflammatory response was further accelerated in hepatocytes with STING over-expression. Notably, RDV-attenuated lipid disorder and inflammation were significantly abrogated by the over-expression of STING in PA-stimulated hepatocytes. Taken together, these findings indicated that RDV exhibited protective effects against NAFLD development mainly through repressing STING signaling, and thus could be considered as a potential therapeutic strategy.


docid: qvcgebjg

title: Multiple recombination sites at the 5′-end of murine coronavirus RNA

text: Abstract Mouse hepatitis virus (MHV), a murine coronavinus, contains a nonsegmented RNA genome. We have previously shown that MHV could undergo RNA-RNA recombination in crosses between temperature-sensitive mutants and wild-type viruses at a very high frequency (S. Makino, J. G. Keck, S. A. Stohlman, and M. M. C. Lai (1986) J. Virol. 57, 729–737). To better define the mechanism of RNA recombination, we have performed additional crosses involving different sets of MHV strains. Three or possibly four classes of recombinants were isolated. Recombinants in the first class, which are similar to the ones previously reported, contain a single crossover in either gene A or B, which are the 5′-most genes. The second class of recombinants contain double crossovers in gene A. The third class of recombinants have crossovers within the leader sequence located at the 5′-end of the genome. The crossover sites of the third class have been located between 35 and 60 nucleotides from the 5′-end of the leader RNA. One of these recombinants has double crossovers within the short region comprising the leader sequences. Finally, we describe one recombinant which may contain a triple crossover. The presence of so many recombination sites within the 5′-end of the genome of murine coronaviruses confirms that RNA recombination is a frequent event during MHV replication and is consistent with our proposed model of “copy-choice” recombination in which RNA replication occurs in a discontinuous and nonprocessive manner.


docid: bbdjklqv

title: Letter: Gastrointestinal ACE2, COVID-19 and IBD – opportunity in the face of tragedy?


title: The in situ distribution of glycoprotein-bound 4-O-Acetylated sialic acids in vertebrates

text: Sialic acids are located at the terminal branches of the cell glycocalyx and secreted glycan molecules. O-Acetylation is an important modification of the sialic acids, however very few studies have demonstrated the in situ distribution of the O-Acetylated sialic acids. Here the distribution of glycoprotein bound 4-O-Acetylated sialic acids (4-O-Ac sias) in vertebrates was determined using a novel virus histochemistry assay. The 4-O-Ac sias were found in the circulatory system, i.e. on the surface of endothelial cells and RBCs, of several vertebrate species, though most frequently in the cartilaginous fish (class Chondrichthyes) and the bony fish (class Osteichthyes). The O-Acetylated sialic acid was detected in 64 % of the examined fish species. Even though the sialic acid was found less commonly in higher vertebrates, it was found at the same location in the positive species. The general significance of this endothelial labelling pattern distribution is discussed. The seemingly conserved local position through the evolution of the vertebrates, suggests an evolutionary advantage of this sialic acid modification. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s10719-014-9529-7) contains supplementary material, which is available to authorized users.


title: Relation of Dietary Factors with Infection and Mortality Rates of COVID-19 Across the World

text: OBJECTIVE: Poor dietary habits are considered to be the second-leading risk factors for mortality and disability-adjusted life-years (DALYs) in the world. Dietary patterns are different based on cultural, environmental, technological, and economic factors. Nutritional deficiencies of energy, protein, and specific micronutrients have been shown to contribute to depressed immune function and increased susceptibility to infections. We aimed to explore the relation of dietary factors with global infection and mortality rates of COVID-19 in this study. DESIGN: In the current ecological study, the countries that had national dietary data from the Global Dietary Databases of the United Nations and Coronavirus disease statistics from the World Health Organization (WHO) were included. The countries that had Coronavirus disease statistics from the WHO were consecutively checked for the recent data of the dietary factors. SETTING: World. PARTICIPANTS: 158 countries across the world. MEASUREMENTS: infection and mortality rates of COVID-19; dietary factors. RESULTS: The median crude infection and mortality rates by COVID-19 were 87.78 (IQR: 468.03) and 0.0015 (IQR: 0.0059), respectively. The two highest percentage of the crude infection rate were between 0 and 500 (75.9%) and 500–1000 (8.9%) per one million persons. The regression analysis showed that the crude infection rate has been increased by raising consuming fruits (Beta: 0.237; P=0.006) and calcium (Beta: 0.286; P=0.007) and was decreased with rising consuming beans and legumes (Beta: −0.145; P=0.038). The analysis showed that the crude mortality rate was increased by raising consuming sugar-sweetened beverages (Beta: 0.340; P<0.001). Whereas, the crude mortality rate by COVID-19 has been decreased by increasing fruits consuming (Beta: −0.226; P=0.047) and beans and legumes (Beta: −0.176; P=0.046). CONCLUSION: The present study showed the higher intake of fruits and sugar-sweetened beverages had a positive effect on infection and mortally rates by COVID-19, respectively. In contrast, the higher intake of beans and legumes had a negative effect on both increasing infection and mortality rates.


docid: vnqxfdng

title: Public health services in Shenzhen: a case study

text: Summary As one of the fastest growing cities in Pearl River Delta of southern China, Shenzhen accommodates a higher percentage and increasing number of internal migrants, mainly coming from the inland areas. The public health issues that challenge its local government include the special population structure, high incidence of infectious diseases, high prevalence of mental problems, rising chronic disease burdens, and maternal and children’s health issues, although progress has been made in the past years. The health authority of Shenzhen has realized that provision of high quality equitable public health services to its residents, including migrants is of high priority, and should be supported by innovations in the health insurance system and establishment of community-based primary care networks. Making changes within the national-level health reform framework and learning from international experiences are necessary and important.


Lack of viral clearance by the combination of hydroxychloroquine and azithromycin or lopinavir and ritonavir in SARS-CoV-2-related acute respiratory distress syndrome


title: Toxoplasma gondii seroprevalence varies by cat breed

text: Toxoplasma gondii is a widespread zoonotic parasite that is relevant for veterinary and public health. The domestic cat, the definitive host species with the largest worldwide population, has become evolutionarily and epidemiologically the most important host of T. gondii. The outcome of T. gondii infection is influenced by congenital and acquired host characteristics. We detected differences in T. gondii seroprevalence by cat breed in our previous studies. The aims of this study were to estimate T. gondii seroprevalence in selected domestic cat breeds, and to evaluate whether being of a certain breed is associated with T. gondii seropositivity, when the age and lifestyle of the cat are taken into account. The studied breeds were the Birman, British Shorthair, Burmese, Korat, Norwegian Forest Cat, Ocicat, Persian, and Siamese. Plasma samples were analyzed for the presence of immunoglobulin G antibodies against T. gondii with a commercial direct agglutination test at dilution 1:40. The samples were accompanied by owner-completed questionnaires that provided background data on the cats. Overall, 41.12% of the 1121 cats tested seropositive, and the seroprevalence increased with age. The Burmese had the lowest seroprevalence (18.82%) and the Persian had the highest (60.00%). According to the final multivariable logistic regression model, the odds to test seropositive were four to seven times higher in Birmans, Ocicats, Norwegian Forest Cats, and Persians when compared with the Burmese, while older age and receiving raw meat were also risk factors for T. gondii seropositivity. This study showed that T. gondii seroprevalence varies by cat breed and identified being of certain breeds, older age, and receiving raw meat as risk factors for seropositivity.


title: Influence of the COVID‐19 pandemic on an emergency medical service (EMS) system: a population‐based, descriptive study in Osaka, Japan

text: BACKGROUND: Novel coronavirus infection (COVID‐19) was confirmed in Wuhan, China in December 2019, and the COVID‐19 pandemic has spread around the world. However, no clinical studies on the impact of the COVID‐19 pandemic on EMS systems has been conducted worldwide. METHODS: This was a retrospective study with a study period from January 1, 2020 to April 14, 2020. We included the patients transported by ambulance for acute diseases and traffic accidents in Osaka City. The main outcome of this study was the difficulty in hospital acceptance. We calculated the rate of difficulty of hospital acceptance for each month for acute diseases and traffic accidents. RESULTS: Between January 1 to April 14, 2020, 36,981 patients were transported to hospitals by ambulance for acute diseases and 3096 patients for traffic accidents. There was no difference in the proportion of the difficulty in hospital acceptance due to traffic accidents between 2019 and 2020, but there was an increase in the proportion of the difficulty in hospital acceptance due to acute disease after the 13th week (March 25‐March 31) of 2020 compared to that of 2019. The OR in April was 2.17 (95% CI, 1.84‐2.58) for acute disease. CONCLUSION: We assessed the impact of the COVID‐19 pandemic on the EMS system in Osaka city, Japan and found that since April 2020, the EMS system in Osaka city has been facing difficulty in terms of hospital acceptance of patients transported to hospital for acute diseases.


title: Call for national dialogue: Adapting standards of care in extreme events. We are not ready

text: Summary Clinical practices are based on a common understanding of nursing's professional standards in all aspects of patient care, no matter what the circumstances are. Circumstances can however, change dramatically due to emergencies, disasters, or pandemics and may make it difficult to meet the standard of care in the way nurses are accustomed. The Australian nursing profession has not yet facilitated a broad discussion and debate at the professional and institutional level about adapting standards of care under extreme conditions, a dialogue which goes beyond the content of basic emergency and disaster preparedness. The purpose of this paper is to encourage discussion within the nursing profession on this important ethical and legal issue. A comprehensive review of the literature was undertaken to determine the state of the evidence in relation to adapting standards of care under extreme conditions. Content analysis of the literature identified categories related to adapting standards of care that have been considered by individuals or groups that should be considered in Australia, should a dialogue be undertaken. The categories include ethical expectations of professional practice; legal interpretation of care requirements, resource priority between hospital and public health and informing communities. Literature reviews and commentary may provide the background for a national dialogue on the nursing response in an extreme event. However, it is only with the engagement of a broadly representative segment of the professional nursing community that appropriate guidance on adapting standards of care under extreme conditions can be developed and then integrated into the professional worldview of nursing in Australia.


title: Conversion of Positive Pressure Cardiac Catheterization and Electrophysiology Laboratories to a Novel 2‐Zone Negative Pressure System during COVID‐19 Pandemic

text: During COVID‐19 pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines, and hospital codes, catheterization and electrophysiology laboratories are usually built as positive pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID‐19 are best cared in negative ventilation rooms to minimize the risk of transmission. From mechanical and engineering perspective, positive pressure ventilation rooms cannot be readily converted to negative pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable and resource friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a positive pressure ventilation room to a 2‐zone negative ventilation system to minimize the risk of transmission. This article is protected by copyright. All rights reserved.


title: Electrostatic Charged Nanofiber Filter for Filtering Airborne Novel Coronavirus (COVID-19) and Nano-aerosols

text: Abstract The World Health Organization declared the novel coronavirus (COVID-19) outbreak as a pandemic on March 12, 2020. Within 3-1/2 months since outbreak in December 2019, over 1.3 million people have been infected across 206 countries with over 70,000 deaths. COVID-19 has a size of 60-140nm with mean size of the nano-aerosols, 100nm. The virus can be airborne by attaching to human secretion (fine particles, nasal/saliva droplets) of infected person or suspended fine particulates in air. While NIOSH has standardized N95 and N98 at 300nm, to-date there is no filter standards, nor special filter technologies, tailored for capturing airborne viruses and 100nm nano-aerosols. The latter also are present in high number concentration in atmospheric pollutants. This study addresses developing novel charged PVDF nanofiber filter technology to effectively capture the deadly airborne coronavirus with our target set at 100nm (nano-aerosol), and not 300nm. The virus and its attached particle were simulated by sodium chloride aerosols, 50-500nm, generated from sub-micron aerosol generator. PVDF nanofibers were produced with fiber diameters 84, 191, 349 and 525nm with excellent morphology. The fibers were subsequently charged by corona discharge. The amounts of charged fibers in a filter were increased to achieve high efficiency of 90% for the virus filter but the electrical interference between neighbouring fibers resulted in progressively marginal increase in efficiency and concurrently much higher pressure drop across the filter. The quality factor which measured the efficiency-to-pressure-drop kept decreasing. By redistributing the fibers in the filter into several modules, each separated by a permeable scrim material, the electrical interference was reduced, if not fully mitigated. Also, the additional scrim materials introduced macropores into the filter that further reduced the airflow resistance. With this approach, the quality factor can maintain relatively constant with increasing fiber amounts to achieve high filter efficiency. The optimal amounts of fiber in each module depended on the diameter of fibers in the module. Small fiber diameter that has already high performance required small amount of fibers per module. In contrast, large diameter fiber required more amounts of fiber per module to compensate for the poorer performance without incurring higher pressure drop. This approach was applied to develop four new nanofiber filters tailored for capturing 100nm airborne COVID-19 to achieve over 90% efficiency with pressure drop below 30Pa (3.1mm water). One filter developed meeting the 90% efficiency has ultralow pressure drop of only 18Pa (1.9mm water) while another filter meeting the 30Pa limit has high efficiency reaching 94%. These optimized filters based on rigorous engineering approach provide the badly needed technology for protecting the general public from the deadly airborne COVID-19 and other viruses, and nano-aerosols from air pollution which lead to chronic diseases.


title: Laboratory Systems and Services Are Critical in Global Health: Time to End the Neglect?

text: The $63 billion comprehensive global health initiative (GHI) emphasizes health systems strengthening (HSS) to tackle challenges, including child and maternal health, HIV/AIDS, family planning, and neglected tropical diseases. GHI and other initiatives are critical to fighting emerging and reemerging diseases in resource-poor countries. HSS is also an increasing focus of the $49 billion program of the US President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Laboratory systems and services are often neglected in resource-poor settings, but the funding offers an opportunity to end the neglect. To sustainably strengthen national laboratory systems in resource-poor countries, the following approaches are needed: (1) developing integrative national laboratory strategic plans and policies and building systems to address multiple diseases; (2) establishing public-private partnerships; (3) ensuring effective leadership, commitment, and coordination by host governments of efforts of donors and partners; (4) establishing and/or strengthening centers of excellence and field epidemiology and laboratory training programs to meet short- and medium-term training and retention goals; and (5) establishing affordable, scalable, and effective laboratory accreditation schemes to ensure quality of laboratory tests and bridge the gap between clinicians and laboratory experts on the use of test results.


title: Detection of six common human paramyxoviruses in patients with acute febrile respiratory symptoms using a novel multiplex real‐time RT‐PCR assay

text: Human metapneumovirus (hMPV), respiratory syncytial virus type A (RSV‐A), RSV‐B, and human parainfluenza viruses 1, 2, and 3 (HPIV‐1, HPIV‐2, and HPIV‐3) are common respiratory paramyxoviruses. Here, we developed a two‐tube triplex one‐step real‐time reverse‐transcription polymerase chain reaction (real‐time RT‐PCR) and evaluated its performance using clinical samples. The data showed that this novel assay was 100% consistent with the monoplex real‐time RT‐PCR assay (in‐house), which was superior to the commercial routine multiplex‐ligation‐NAT‐based assay. Meanwhile, the clinical nasopharyngeal swabs of 471 patients with the acute febrile respiratory syndrome (AFRS) were analyzed using the established method. The results showed that 52 (11.7%) cases were positive for paramyxovirus. Among them, HPIVs and RSV‐A had the highest detection rate. The age and seasonal distribution of human paramyxovirus infection were analyzed. In conclusion, we developed a novel multiplex real‐time RT‐PCR assay for the rapid detection of six common human paramyxoviruses, which were dominant in patients with AFRS in Qinghai.


title: Development of protein A-gold immunoelectron microscopy for detection of bovine coronavirus in calves: Comparison with ELISA and direct immunofluorescence of nasal epithelial cells

text: Abstract A protein A-colloidal gold immunoelectron microscopy (PAG-IEM) technique was developed for the detection of bovine coronavirus (BCV) in the feces and nasal secretions of infected calves. Feces or nasal swab fluids were incubated sequentially with hyperimmune bovine anti-bovine coronavirus serum and protein A-gold, negatively stained, applied to formvar-coated copper grids and viewed using an electron microscope. The PAG-IEM method specifically identified BCV particles and possible subviral particles in feces and nasal-swab fluids from infected calves. The PAG-IEM method did not label other enveloped enteric viruses or morphologically similar fringed particles commonly found in feces. Detection of BCV using PAG-IEM was compared with ELISA and direct immunofluorescence (IF) of nasal epithelial cells by monitoring fecal and respiratory tract shedding of BCV from two experimentally infected and two naturally infected calves from birth to 3 weeks of age. PAG-IEM and ELISA detected shedding of BCV in fecal ( 4 4 animals) and nasal ( 3 4 animals) samples for an average of 5.25 days each. The observed agreement of BCV detection by PAG-IEM and ELISA was 85%. PAG-IEM may be a more sensitive immunoassay for the detection of BCV in diagnostic specimens from infected neonatal calves than ELISA. BCV infection of nasal epithelial cells was detected by immunofluorescence in 4 4 calves, persisted for the duration of the study in 2 4 calves and was sporadic in the other two animals. The observed agreement of BCV detection by PAG-IEM and IF was 57%.


Improving Biosurveillance Systems to Enable Situational Awareness During Public Health Emergencies


title: Enteric Pathogens and Coinfections in Foals with and without Diarrhea

text: Diarrhea is a major clinical problem affecting foals up to 3 months of age. The aim of this study was to identify enteric microorganisms involved in monoinfections and coinfections and the associated virulence factors in healthy and diarrheic foals. Diarrheic (D) (n = 56) and nondiarrheic (ND) foals (n = 60) up to three months of age were studied. Fecal samples were analyzed for identification of infectious agents (microbiological culturing, molecular techniques, and microscopic analyses). Escherichia coli fimH (30% versus 25%), Salmonella spp. (25% versus 7%), Strongyloides westeri (25% versus 25%), Clostridium perfringens type A (21% versus 10%), E. coli ag43 (20% versus 35%), Strongylus (11% versus 18%), and vapA-positive Rhodococcus equi (5% versus 2%) were the most frequent enteric pathogens detected in D and ND foals, respectively. The frequency of toxin A-positive C. perfringens was significantly increased in the D (p = 0.033) compared with the ND animals. R. equi strains harboring virulent plasmids were also identified (VapA 85-kb type I and VapA 87-kb type I) in D and ND foals. Coinfections were observed in 46% of the D and 33% of the ND foals. Our results demonstrate the great diversity of enteric pathogens, virulence factors, and coinfections involved in enteric infections of foals.


title: Enrichment post-library preparation enhances the sensitivity of high-throughput sequencing-based detection and characterization of viruses from complex samples

text: BACKGROUND: Sequencing-based detection and characterization of viruses in complex samples can suffer from lack of sensitivity due to a variety of factors including, but not limited to, low titer, small genome size, and contribution of host or environmental nucleic acids. Hybridization-based target enrichment is one potential method for increasing the sensitivity of viral detection via high-throughput sequencing. RESULTS: This study expands upon two previously developed panels of virus enrichment probes (for filoviruses and for respiratory viruses) to include other viruses of biodefense and/or biosurveillance concern to the U.S. Department of Defense and various international public health agencies. The newly expanded and combined panel is tested using carefully constructed synthetic metagenomic samples that contain clinically relevant amounts of viral genetic material. Target enrichment results in a dramatic increase in sensitivity for virus detection as compared to shotgun sequencing, yielding full, deeply covered viral genomes from materials with Ct values suggesting that amplicon sequencing would be likely to fail. Increased pooling to improve cost- and time-effectiveness does not negatively affect the ability to obtain full-length viral genomes, even in the case of co-infections, although as expected, it does decrease depth of coverage. CONCLUSIONS: Hybridization-based target enrichment is an effective solution to obtain full-length viral genomes for samples from which virus detection would fail via unbiased, shotgun sequencing or even via amplicon sequencing. As the development and testing of probe sets for viral target enrichment expands and continues, the application of this technique, in conjunction with deeper pooling strategies, could make high-throughput sequencing more economical for routine use in biosurveillance, biodefense and outbreak investigations. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12864-019-5543-2) contains supplementary material, which is available to authorized users.


title: Pills to think about in allergic rhinitis children during COVID‐19 era

text: Allergic rhinitis (AR) is a common pediatric disease, that involves up to the 25% of children worldwide. Environmental pollution, passive smoke, and many viruses are actively involved in the chronic inflammation of the nasal mucosa. As described previously in the literature, novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in children is uncommon and often asymptomatic or mild.


title: Disposable Isolation Device to Reduce COVID-19 Contamination during CT scanning

text: Abstract Background The use of chest CT in the era of the COVID-19 pandemic raises concern regarding the transmission risks to patients and staff caused by CT room contamination. Meanwhile the CDC guidance for air exchange in between patients may heavily impact workflows. Purpose To design a portable custom isolation device to reduce imaging equipment contamination during a pandemic. Methods CDC air exchange guidelines and requirements were reviewed. Device functional requirements were outlined and designed. Engineering requirements were reviewed. Methods of practice and risk mitigation plans were outlined including donning and doffing procedures and failure modes. Cost impact was assessed in terms of CT patient throughput. Results CT air exchange solutions and alternatives were reviewed. Multiple isolation bag device designs were considered. Several designs were custom fabricated, prototyped and reduced to practice. A final design was tested on volunteers for comfort, test-fit, air seal and breathability. >14 times enhanced patient throughput was estimated, in an ideal setting, which could more than counterbalance the cost of the device itself. Conclusion A novel isolation bag device is feasible for use in CT and might facilitate containment and reduce contamination in radiology departments during the COVID Pandemic.


title: Telemedicine during COVID‐19 pandemic

text: Since 2015 most patients implanted with cardiac devices (Implantable Cardioverter Defibrillators (ICDs), Implantable Loop Recorders (ILRs), Pacemakers (PMs)) at Santa Croce e Carle Hospital (Cuneo, Italy) are remotely followed with home monitoring systems free of charge. From 2017 the home monitoring outpatient follow‐up service has been systematically organized mainly for the peculiar geographical features (typically mountainous, vast and with few roads) of the territory served by our hospital, making difficult for patients the access to the health care facilities.


title: Cryo-EM structures of HKU2 and SADS-CoV spike glycoproteins and insights into coronavirus evolution

text: A new porcine coronavirus SADS-CoV was recently identified from suckling piglets with severe diarrhea in southern China and its genome sequence is most identical (~95% identity) to that of bat α-coronavirus HKU2. It again indicates bats are the natural reservoir of many coronaviruses that have great potential for cross-species transmission to animals and humans by recombination and/or mutation. Here we report the cryo-EM structures of HKU2 and SADS-CoV spike glycoprotein trimers at 2.38 Å and 2.83 Å resolution, respectively. HKU2 and SADS-CoV spikes exhibit very high structural similarity, with subtle differences mainly distributed in the NTD and CTD of the S1 subunit responsible for cell attachment and receptor binding. We systematically analyzed and compared the NTD, CTD, SD1 and SD2 domains of the S1 subunit and the S2 subunit of HKU2 spike with those of α-, β-, γ-, and δ-coronavirus spikes. The results show that the NTD and CTD of HKU2/SADS-CoV are probably the most ancestral in the evolution of spike. Although the S2 subunit mediating membrane fusion is highly conserved, the connecting region after fusion peptide in HKU2/SADS-CoV S2 subunit also adopts a conformation distinct from other coronaviruses. These results structurally demonstrate a close evolutionary relationship between HKU2 /SADS-CoV and β-coronavirus spikes and provide new insights into the evolution and cross-species transmission of coronaviruses.


title: Can Bioactive Lipids Inactivate Coronavirus (COVID-19)?

text: SARS-CoV-2, SARS and MERS are all enveloped viruses that can cause acute respiratory syndrome. Arachidonic acid (AA) and other unsaturated fatty acids (especially eicosapentaenoic acd, EPA and docosahexaenoic acid DHA) are known to inactivate enveloped viruses and inhibit proliferation of various microbial organisms. The pro-inflammatory metabolites of AA and EPA such as prostaglandins, leukotrienes and thromboxanes induce inflammation whereas lipoxins, resolvins, protectins and maresins derived from AA, EPA and DHA not only suppress inflammation but also enhance would healing and augment phagocytosis of macrophages and other immunocytes and decrease microbial load. In view of these actions, it is suggested that AA and other unsaturated fatty acids and their metabolites may serve as endogenous anti-viral compounds and their deficiency may render humans susceptible to SARS-CoV-2, SARS and MERS and other similar viruses’ infections. Hence, oral or intravenous administration of AA and other unsaturated fatty acids may aid in enhancing resistance and recovery from SARS-CoV-2, SARS and MERS infections.


title: Combating Intracellular Pathogens with Repurposed Host-Targeted Drugs

text: There is a large, global unmet need for the development of countermeasures to combat intracellular pathogens. The development of novel antimicrobials is expensive and slow and typically focuses on selective inhibition of proteins encoded by a single pathogen, thereby providing a narrow spectrum of coverage. The repurposing of approved drugs targeting host functions required for microbial infections represents a promising alternative. This review summarizes progress and challenges in the repurposing of approved drugs as host-targeted broad-spectrum agents for the treatment of intracellular pathogens. These strategies include targeting both cellular factors required for infection by various viruses, intracellular bacteria, and/or protozoa as well as factors that modulate the host immune response to these microbial infections. The repurposed approach offers complementary means to develop therapeutics against existing and emerging intracellular microbial threats.


title: Correlation between travellers departing from Wuhan before the Spring Festival and subsequent spread of COVID-19 to all provinces in China

text: We found a strong correlation between travel volumes departing from Wuhan, Hubei Province before the Spring Festival and the extent of amplification of the outbreak of COVID-19 in China in 2020, with 100 top cities. Almost 70% of exportations were within cities in Hubei province.


title: Time variations in the transmissibility of pandemic influenza in Prussia, Germany, from 1918–19

text: BACKGROUND: Time variations in transmission potential have rarely been examined with regard to pandemic influenza. This paper reanalyzes the temporal distribution of pandemic influenza in Prussia, Germany, from 1918–19 using the daily numbers of deaths, which totaled 8911 from 29 September 1918 to 1 February 1919, and the distribution of the time delay from onset to death in order to estimate the effective reproduction number, Rt, defined as the actual average number of secondary cases per primary case at a given time. RESULTS: A discrete-time branching process was applied to back-calculated incidence data, assuming three different serial intervals (i.e. 1, 3 and 5 days). The estimated reproduction numbers exhibited a clear association between the estimates and choice of serial interval; i.e. the longer the assumed serial interval, the higher the reproduction number. Moreover, the estimated reproduction numbers did not decline monotonically with time, indicating that the patterns of secondary transmission varied with time. These tendencies are consistent with the differences in estimates of the reproduction number of pandemic influenza in recent studies; high estimates probably originate from a long serial interval and a model assumption about transmission rate that takes no account of time variation and is applied to the entire epidemic curve. CONCLUSION: The present findings suggest that in order to offer robust assessments it is critically important to clarify in detail the natural history of a disease (e.g. including the serial interval) as well as heterogeneous patterns of transmission. In addition, given that human contact behavior probably influences transmissibility, individual countermeasures (e.g. household quarantine and mask-wearing) need to be explored to construct effective non-pharmaceutical interventions.


title: Avian Infectious Bronchitis Virus

text: Publisher Summary This chapter provides an overview of the classification, description, hosts, key developments, diagnostic techniques, and diagnostic reagents for avian infectious bronchitis virus. Avian infectious bronchitis virus belongs to the family Coronaviridae; genus Coronavirus; and species Avian infectious bronchitis virus. The virus causes acute contagious respiratory illness and includes reproductive tissue disease in chickens. The hosts of avian infectious bronchitis virus are only chickens. Avian infectious bronchitis disease was first reported in the United States. Vaccines for this disease were developed in the 1950s and the economic impact diminished. The diagnostic techniques for avian infectious bronchitis virus are virus neutralisation (VN), agar gel immunodiffusion (AGID), fluorescent antibody (FA), compliment fixation (CF), and enzyme-linked immunosorbent assay (ELISA).


title: Molecular characteristics of a novel recombinant of porcine epidemic diarrhea virus

text: Porcine epidemic diarrhea (PED) is a contagious viral disease in pigs, caused by the coronavirus porcine epidemic diarrhea virus (PEDV). PEDV infection results in significant mortality in piglets in unvaccinated herds. Like many others RNA viruses, PEDV has high evolutionary rate and is prone to genetic mutations. In this study, we analyzed the complete genome sequence of the recently sequenced isolate PEDV/Belgorod/dom/2008. A recombination event in S gene of PEDV/Belgorod/dom/2008 was detected. Pairwise identity analysis of the whole genome sequences revealed that PEDV/Belgorod/dom/2008 is an intermediate between PEDV and transmissible gastroenteritis virus (TGEV) strains. These results can be used for further analysis of the evolutionary variability, prevalence, and epidemiology of the porcine epidemic diarrhea virus.


title: Qatar steps up to Global Health security: a reflection on the joint external evaluation, 2016

text: Since the commencement of the International Health Regulations in 2007, global public health security has been faced with numerous emerging and ongoing events. Moreover, the Joint External Evaluation is a voluntary tool developed in compliance with the Global Health Security Agenda that represents the high responsibility of international health community towards the increased incidence of emerging and re-emerging diseases. Against this background, between 29th May and 2nd June 2016, a team of World Health Organization consultants arrived to the State of Qatar to assess, in collaboration with national experts, the country’s capacity to prevent, detect, and rapidly respond to threats of public health aspect. They identified areas of strength, weakness, and recommendations for improving national health security of Qatar in anticipation of the 2022 FIFA World Cup event. Qatar has demonstrated a leading role in the region through its commitment to International Health Regulations (2005) and population health. Similarly, the Qatar was the first Arab state and seventh volunteering country globally to undergo the Joint External evaluation process. In this review, we highlighted Qatar’s achievements and shortcomings of International Health Regulations’ core capacities to inform healthcare professionals and the scientific community about the country’s contribution toward global health security.


title: Modulation of membrane traffic between endoplasmic reticulum, ERGIC and Golgi to generate compartments for the replication of bacteria and viruses

text: Abstract Several bacteria and viruses remodel cellular membranes to form compartments specialised for replication. Bacteria replicate within inclusions which recruit membrane vesicles from the secretory pathway to provide nutrients for microbial growth and division. Viruses generate densely packed membrane vesicles called viroplasm which provide a platform to recruit host and viral proteins necessary for replication. This review describes examples where both intracellular bacteria (Salmonella, Chlamydia and Legionella) and viruses (picornaviruses and hepatitis C) recruit membrane vesicles to sites of replication by modulating proteins that control the secretory pathway. In many cases this involves modulation of Rab and Arf GTPases.


title: Time-constrained maximal covering routing problem

text: We introduce the time-constrained maximal covering routing problem (TCMCRP), as a generalization of the covering salesman problem. In this problem, we are given a central depot, a set of facilities and several customers which are located within a pre-determined coverage distance of available facilities. Each facility can supply the demand of some customers which are within its coverage radius. Starting from the depot, the goal is to maximize the total number of covered customers, by constructing a set of p length constraint Hamiltonian cycles. We have proposed a mixed integer linear programming model and three heuristic algorithms, namely iterated local search (ILS), tabu search (TS) and variable neighborhood search (VNS), to solve the problem. Extensive computational tests on this problem and some of its variants clearly indicate the effectiveness of the developed solution methods.


The effect of cow udder score on subsequent calf performance in the Nebraska Sandhills


title: On order and disorder during the COVID‐19 pandemic

text: In this paper, we analyse the conditions under which the COVID‐19 pandemic will lead either to social order (adherence to measures put in place by authorities to control the pandemic) or to social disorder (resistance to such measures and the emergence of open conflict). Using examples from different countries (principally the United Kingdom, the United States, and France), we first isolate three factors which determine whether people accept or reject control measures. These are the historical context of state‐public relations, the nature of leadership during the pandemic and procedural justice in the development and operation of these measures. Second, we analyse the way the crisis is policed and how forms of policing determine whether dissent will escalate into open conflict. We conclude by considering the prospects for order/disorder as the pandemic unfolds.


title: Properties and use of novel replication-competent vectors based on Semliki Forest virus

text: BACKGROUND: Semliki Forest virus (SFV) has a positive strand RNA genome and infects different cells of vertebrates and invertebrates. The 5' two-thirds of the genome encodes non-structural proteins that are required for virus replication and synthesis of subgenomic (SG) mRNA for structural proteins. SG-mRNA is generated by internal initiation at the SG-promoter that is located at the complementary minus-strand template. Different types of expression systems including replication-competent vectors, which represent alphavirus genomes with inserted expression units, have been developed. The replication-competent vectors represent useful tools for studying alphaviruses and have potential therapeutic applications. In both cases, the properties of the vector, such as its genetic stability and expression level of the protein of interest, are important. RESULTS: We analysed 14 candidates of replication-competent vectors based on the genome of an SFV4 isolate that contained a duplicated SG promoter or an internal ribosomal entry site (IRES)-element controlled marker gene. It was found that the IRES elements and the minimal -21 to +5 SG promoter were non-functional in the context of these vectors. The efficient SG promoters contained at least 26 residues upstream of the start site of SG mRNA. The insertion site of the SG promoter and its length affected the genetic stability of the vectors, which was always higher when the SG promoter was inserted downstream of the coding region for structural proteins. The stability also depended on the conditions used for vector propagation. A procedure based on the in vitro transcription of ligation products was used for generation of replication-competent vector-based expression libraries that contained hundreds of thousands of different genomes, and maintained genetic diversity and the ability to express inserted genes over five passages in cell culture. CONCLUSION: The properties of replication-competent vectors of alphaviruses depend on the details of their construction. In the case of SFV4, such vectors should contain the SG promoter with structural characteristics for this isolate. The main factor for instability of SFV4-based replication-competent vectors was the deletion of genes of interest, since the resulting shorter genomes had a growth advantage over the original vector.


title: Camelid Herd Health

text: The area of herd health is particularly important when considering camelid operations because of the high frequency of travel for exhibition, breeding, and boarding. This article outlines the considerations for routine husbandry, facility and animal maintenance, and infectious disease control in the form of biosecurity, vaccination, and health testing that should be included in any farm's herd-health plan. Veterinary input into the design of programs for biosecurity and infectious disease prevention is critical and requires an active veterinary client-patient relationship with identification of the goals of the operation. Risk assessments should be made based on farm activities and should be the foundation for herd-health program design.


title: Lipidomics of Glycosphingolipids

text: Glycosphingolipids (GSLs) contain one or more sugars that are attached to a sphingolipid moiety, usually to a ceramide, but in rare cases also to a sphingoid base. A large structural heterogeneity results from differences in number, identity, linkage, and anomeric configuration of the carbohydrate residues, and also from structural differences within the hydrophobic part. GSLs form complex cell-type specific patterns, which change with the species, the cellular differentiation state, viral transformation, ontogenesis, and oncogenesis. Although GSL structures can be assigned to only a few series with a common carbohydrate core, their structural variety and the complex pattern are challenges for their elucidation and quantification by mass spectrometric techniques. We present a general overview of the application of lipidomics for GSL determination. This includes analytical procedures and instrumentation together with recent correlations of GSL molecular species with human diseases. Difficulties such as the structural complexity and the lack of standard substances for complex GSLs are discussed.


title: Immunomodulator expression in trophoblasts from the feline immunodeficiency virus (FIV)-infected cat

text: BACKGROUND: FIV infection frequently compromises pregnancy under experimental conditions and is accompanied by aberrant expression of some placental cytokines. Trophoblasts produce numerous immunomodulators that play a role in placental development and pregnancy maintenance. We hypothesized that FIV infection may cause dysregulation of trophoblast immunomodulator expression, and aberrant expression of these molecules may potentiate inflammation and compromise pregnancy. The purpose of this project was to evaluate the expression of representative pro-(TNF-α, IFN-γ, IL-1β, IL-2, IL-6, IL-12p35, IL-12p40, IL-18, and GM-CSF) and anti-inflammatory cytokines (IL-4, IL-5, and IL-10); CD134, a secondary co-stimulatory molecule expressed on activated T cells (FIV primary receptor); the chemokine receptor CXCR4 (FIV co-receptor); SDF-1α, the chemokine ligand to CXCR4; and FIV gag in trophoblasts from early-and late-term pregnancy. METHODS: We used an anti-cytokeratin antibody in immunohistochemistry to identify trophoblasts selectively, collected these cells using laser capture microdissection, and extracted total RNA from the captured cell populations. Real time, reverse transcription-PCR was used to quantify gene expression. RESULTS: We detected IL-4, IL-5, IL-6, IL-1β, IL-12p35, IL-12p40, and CXCR4 in trophoblasts from early-and late-term pregnancy. Expression of cytokines increased from early to late pregnancy in normal tissues. A clear, pro-inflammatory microenvironment was not evident in trophoblasts from FIV-infected queens at either stage of pregnancy. Reproductive failure was accompanied by down-regulation of both pro-and anti-inflammatory cytokines. CD134 was not detected in trophoblasts, and FIV gag was detected in only one of ten trophoblast specimens collected from FIV-infected queens. CONCLUSION: Feline trophoblasts express an array of pro-and anti-inflammatory immunomodulators whose expression increases from early to late pregnancy in normal tissues. Non-viable pregnancies were associated with decreased expression of immunomodulators which regulate trophoblast invasion in other species. The detection of FIV RNA in trophoblasts was rare, suggesting that the high rate of reproductive failure in FIV-infected queens was not a direct result of viral replication in trophoblasts. The influence of placental immune cells on trophoblast function and pregnancy maintenance in the FIV-infected cat requires additional study.


title: Utility of adding Pneumocystis jirovecii DNA detection in nasopharyngeal aspirates in immunocompromised adult patients with febrile pneumonia

text: Detection of viral and bacterial DNA in nasopharyngeal aspirates (NPAs) is now a routine practice in emergency cases of febrile pneumonia. We investigated whether Pneumocystis jirovecii DNA could also be detected in these cases by conducting retrospective screening of 324 consecutive NPAs from 324 adult patients (198 or 61% were immunocompromised) admitted with suspected pulmonary infections during the 2012 influenza epidemic season, using a real-time quantitative polymerase chain reaction (PCR) assay (PjqPCR), which targets the P. jirovecii mitochondrial large subunit ribosomal RNA gene. These NPAs had already been tested for 22 respiratory pathogens (18 viruses and 4 bacteria), but we found that 16 NPAs (4.9%) were PjqPCR-positive, making P. jirovecii the fourth most prevalent of the 23 microorganisms in the screen. Eleven of the 16 PjqPCR-positive patients were immunocompromised, and five had underlying pulmonary conditions. Nine NPAs were also positive for another respiratory pathogen. Six had PjqPCR-positive induced sputa less than 3 days after the NPA procedure, and five were diagnosed with pneumocystis pneumonia (four with chronic lymphoproliferative disorders and one AIDS patient). In all six available pairs quantification of P. jirovecii DNA showed fewer copies in NPA than in induced sputum and three PjqPCR-negative NPAs corresponded to PjqPCR-positive bronchoalveolar lavage fluids, underscoring the fact that a negative PjqPCR screen does not exclude a diagnosis of pneumocystosis. Including P. jirovecii DNA detection to the panel of microorganisms included in screening tests used for febrile pneumonia may encourage additional investigations or support use of anti-pneumocystis pneumonia prophylaxis in immunocompromised patients.


title: The effect of respiratory syncytial virus on subsequent recurrent wheezing in atopic and nonatopic children

text: Background Although respiratory syncytial virus (RSV) lower respiratory tract infections (LRTIs) in early life are followed by later airway hyperreactivity, it is unclear whether there is a causal relationship between this and an atopic diathesis. Objectives To separate the effects of RSV LRTI and an atopic diathesis on subsequent recurrent wheezing, we examined the protective effect of previous palivizumab administration against subsequent recurrent wheeze in infants with and without a family history of atopy. Methods A prospective multicenter, matched, double cohort study was conducted in 27 centers in Europe and Canada. The rates of physician-diagnosed recurrent wheezing in premature infants <36 weeks gestation who had received palivizumab in the first year of life were compared to those of gestational age–matched controls. Results The relative protective effect of palivizumab on physician-diagnosed recurrent wheezing through the ages of 2 to 5 years was 68% in those with no family history of asthma (odds ratio, 0.32; (95% CI, 0.14-0.75; N = 146 palivizumab-treated, 171 untreated) and 80% in those with no family history of atopy or food allergies (odds ratio, 0.20; 95% CI, 0.07-0.59; N = 101 palivizumab-treated, 100 untreated). In contrast, there was no effect of palivizumab on subsequent recurrent wheezing in the 90 children with a family history of atopy or food allergies compared to 130 untreated infants with atopic families. Conclusion Respiratory syncytial virus prophylaxis in nonatopic children decreases by 80% the relative risk of recurrent wheezing but does not have any effect in infants with an atopic family history. This suggests that RSV predisposes to recurrent wheezing in an atopy-independent mechanism.


title: The effect of immunosuppression on protective immunity of turkey poults against infection with turkey coronavirus

text: Abstract The objective of the present study was to evaluate the protective effect of humoral and cellular immunities on turkeys infected with turkey coronavirus (TCV). Two trials were conducted with two separate hatches of turkey poults. Turkeys were experimentally immunosuppressed with cyclosporin A (CsA) or cyclophosphamide (CY) and infected with TCV. Prior to infection, treatment with CsA selectively suppressed T cell activity as revealed by 2–3 fold decreased (p<0.1) lymphocyte proliferation responses to a T cell mitogen, concanavalin A (Con A). Treatment with CY mainly induced B cell deficiency as indicated by significant reductions (p<0.05) in antibody responses to sheep erythrocytes 7 days after injection. Body weight gain of turkeys treated with CY was significantly lower (p<0.05) than that of untreated turkeys at 9 days post-infection (PI). Turkeys treated with CY had 1–2 fold higher immunofluorescent antibody assay (IFA) scores for TCV antigens (p<0.05) in the intestine than untreated turkeys at 9 or 14 days PI. These results suggested that humoral immunity against TCV infection may be important in turkeys.


title: A Survey of Canadian Public Health Personnel Regarding Knowledge, Practice and Education of Zoonotic Diseases

text: Zoonoses, diseases that can spread under natural conditions between humans and other animals, are become a major public health concern in many countries including Canada. In Canada, investigations of zoonotic disease incidents are often conducted by public health inspectors (PHIs). However, little is known about PHIs' knowledge of transmission of zoonotic pathogens, their perceptions of zoonotic disease importance or their education regarding zoonotic diseases. The objective of this study was therefore to assess the knowledge, perceptions and education of Canadian PHIs regarding zoonotic diseases. Data were collected from December 2008–January 2009 using an internet‐based survey distributed to members of the Canadian Institute of Public Health Inspectors national listserv. Responses were received from 229 PHIs in four provinces, with a response rate of approximately 20%. The majority of respondents reported at least 10 years of experience in the public health sector, 80% (181/225) were in frontline positions, and 62% (137/222) were routinely involved in investigations of infectious diseases. Two‐thirds believed that the importance of zoonotic diseases with regards to public health would increase in the next 5 years. Whilst most respondents were able to correctly identify animals capable of directly transmitting common zoonotic pathogens, there were gaps in knowledge, particularly with regard to rabies and transmission of gastrointestinal pathogens by companion animals. PHIs tended to feel that their training on zoonotic diseases prior to working as PHIs was deficient in some areas, or left some room for improvement. Their responses also suggested that there is a need for improvement in both the quantity and the quality of continuing education on zoonotic diseases. In particular, less than one‐third of PHIs received ongoing continuing education regarding zoonotic diseases, and of those that did, nearly two‐thirds rated the quantity and quality as only fair.


title: Clinical characteristics of influenza virus-induced lower respiratory infection during the 2015 to 2016 season

text: Abstract Background Influenza A(H1N1)pdm09 virus infections often manifest severe respiratory symptoms, particularly in patients with a past history of allergic disease. Most of these findings were reported during the 2009 pandemic. The purpose of this study was to detail the clinical characteristics of influenza virus-induced lower respiratory infection (LRI) during the A(H1N1)pdm09-predominant 2015–2016 season. Methods We retrospectively reviewed the clinical characteristics of influenza-induced LRI cases in children admitted to a tertiary children's hospital. Molecular diagnostic evaluation was performed on samples obtained from the most severe cases. Results We identified 66 patients with influenza-associated hospitalization and included 21 patients with influenza virus-induced LRI for analyses. Twelve patients (57%) were admitted to the pediatric intensive care unit, seven (33%) required mechanical ventilation, and three (14%) required extracorporeal membrane oxygenation. Plastic bronchitis (PB) was identified in six patients (29%), among whom a past medical history of asthma or food allergy were noted in all six patients. A past history of allergic disease was more common among patients with, than among those without, PB (p = 0.009). A(H1N1)pdm09 was detected from all the PB cases, and phylogenetic analyses of the hemagglutinin and neuraminidase genes demonstrated that this virus belonged to subclades 6B.1 and 6B.2. In the six PB cases, we found one patient with H275Y mutation in neuraminidase. Conclusion Allergic disease was a risk factor for developing PB due to influenza A(H1N1)pdm09 infection during the 2015–16 season.


‘To all the anti‐vaxxers out there…’: ethnography of the public controversy about vaccination in the time of COVID‐19


Recently published papers: all the usual suspects and carbon dioxide


title: Did Whatsapp(®) reveal a new cutaneous COVID‐19 manifestation?

text: In March 2020, Europe became the epicenter of COVID-19 pandemic. Several countries organized nationwide population containment, starting on March 9th in Italy and March 17th in France1 . For the continuity of care and to avoid in person consultation and disease propagation, the French ministry of health released incentives to facilitate live interactive consultation for COVID and non-COVID patients.