title: Gross anatomy of the intrinsic muscles of the scapular and humeral joint regions in crab-eating fox (Cerdocyon thous, Linnaeus 1776)/ Anatomia macroscópica dos músculos intrínsecos das regiões escapular e da articulação do úmero de cachorro-do-mato (Cerdocyon thous, Linnaeus 1776)

text: The crab-eating fox (Cerdocyon thous) is a wild canid with a wide distribution in South America that is susceptible to traumas due to road kills - an event in which some specimens can survive. Therefore, anatomical studies in their thoracic limbs may be a base for rehabilitation. Six dead specimens were donated by Wildlife Rescue Centre of CORPOCALDAS (Environmental Authority of the Department of Caldas in Colombia), which were then filled with silicone rubber via the common carotid artery, and later fixed with formaldehyde through the external jugular vein. One male was dissected in fresh, and after a week, the others were dissected on the scapular and humeral joint regions. The intrinsic muscles of these regions in the crab-eating fox were homologous to domestic dog, with similar characteristics in terms of shape, origin, insertion, innervation and arterial blood supply. However, the crab-eating fox did have some differences, such as its supraspinatus muscle being conformed by two bellies and attached into the articular capsule of the humeral joint in same manner as the subscapularis muscle, thus conferring greater stability to the humeral. However, the clinical and surgical approaches that must be performed in this region may be homologous to the domestic dog.(AU)


title: Saliva as a non-invasive specimen for detection of SARS-CoV-2

text: Diagnostic testing for COVID-19 is central to controlling the global pandemic. .


title: Molecular mechanisms of synergistic action of Ramucirumab and Paclitaxel in Gastric Cancers cell lines

text: Ramucirumab is approved both as monotherapy and in combination with Paclitaxel for advanced gastric cancer in patients with disease progression after chemotherapy. In tumor cells, the VEGFA-VEGFR2 binding activates autocrine survival and migration signaling in angiogenesis independent manner. The present in vitro study investigated the effects of single and combined treatments with Ramucirumab and Paclitaxel on cell growth and migration highlighting the mechanisms underlying the interaction between the two drugs in gastric cancer cells. Cell growth and motility were investigated in human gastric cancer cell lines characterized by different tumorigenicity. The inhibitory effect on cell growth exerted by both drugs was potentiated by their combination and was synergistic. Ramucirumab was able to enhance the inhibitory effect exerted by Paclitaxel on cell cycle progression. A synergistic action was also observed in the expression of proteins crucial for cell motility, microtubule organization and epithelial-mesenchymal transition. Furthermore, synergistic inhibition of VEGFR2 expression was obtained by the drug combination. These findings highlighted the importance of the combined treatment to strongly inhibit all the main molecules of both PI3K/Akt/mTOR and MAPK pathways thus preventing possible reactivations due to cross-talk phenomena. The combined treatment with Ramucirumab seems to be a promising option to overcome the Paclitaxel resistance.


N'oublions pas le moral des « troupes ¼ ! La santé mentale des soignants et l'impact psychiatrique de la pandémie de COVID-19./ [Let us not forget the morale of "our troops"!]


N'oublions pas le moral des « troupes ¼ ! La santé mentale des soignants et l'impact psychiatrique de la pandémie de COVID-19


title: Mental health status of medical staff in emergency departments during the Coronavirus disease 2019 epidemic in China

text: BACKGROUND: The emergency department is considered to be a high-risk area, as it is often the first stop for febrile patients who are subsequently diagnosed with coronavirus disease 2019. This study, which employed a cross-sectional design, aimed to assess the mental health of emergency department medical staff during the epidemic in China. METHODS: Demographic data and mental health measurements were collected by electronic questionnaires from February 28, 2020 to March 18, 2020. OUTCOMES: A total of 14,825 doctors and nurses in 31 provinces of mainland China completed the survey. The prevalence rates of depressive symptoms and post-traumatic stress disorder (PTSD) were 25.2% and 9.1%, respectively. Men were more likely to have depressive symptoms and PTSD than women. Those who were middle aged, worked for fewer years, had longer daily work time, and had lower levels of social support were at a higher risk of developing depressive symptoms and PTSD. Working in the Hubei province was associated with a higher risk of depressive symptoms, while those working in the Hubei province but residing in another province had a lower risk of depressive symptoms and PTSD. Being a nurse was associated with a higher risk of PTSD. INTERPRETATION: The findings suggest that targeted psychological interventions to promote the mental health of medical staff with psychological problems need to be immediately implemented. Special attention should be paid to local medical staff in Hubei.


title: COVID-19: Limiting the Risks for Eye Care Professionals

text: After the outbreak of the disease COVID-19, it has reached pandemic proportions within a very short time. It is mainly transmitted human-to-human through direct contact with secretions from an infected person or through inhalation of droplets containing SARS-CoV-2. It is controversial whether the virus may be transmitted via tears. Exposed ocular surface can serve as a gateway in transmission and acquiring respiratory diseases. Considering the reported cases on healthcare workers indicating nosocomial transmission and the anatomical and physiological aspects it is perceived that ophthalmic healthcare professionals are at higher risk of contracting the virus by virtue of their job. In this narrative review we discuss current evidence around detection of SARS-CoV-2 in human tears and forms of transmissions reported to date. We also provide a comprehensive approach that may be implemented in an ophthalmic care facility to protect healthcare personnel, as well as patients, from contracting the virus.


title: COVID-19 and people with intellectual disability: impacts of a pandemic

text: The impacts of the COVID-19 pandemic affect all groups in society. People with intellectual disability (ID) are especially vulnerable to the physical, mental and social effects of the pandemic. Cognitive impairments can limit understanding of information to protect them relying on carers to be vigilant on their behalf during quarantine. Restrictions on usual activities are likely to induce mental stress especially among those who are autistic leading to an escalation in challenging behaviours, risk of placement breakdown and increased the use of psychotropic medication. People with ID are vulnerable to exploitation by others where the usual community supports no longer function to protect them. In future pandemics, it is important that lessons are learned from the impacts COVID-19 have on people with ID. Collecting the evidence through a rigorous approach should help to empower people with ID and their carers to face future outbreaks of infectious diseases.


docid: bqyuugxl

title: Correccion a: Síntesis de evidencia relevante para COVID-19: protocolo común para múltiples revisiones sistemáticas y revisiones panorámicas./ [Correction to: Evidence synthesis relevant to COVID-19: a protocol for multiple systematic reviews and overviews of systematic reviews]


title: Up and about: Older adults' wellbeing during the COVID-19 pandemic in a Swedish longitudinal study

text: OBJECTIVES: To investigate early effects of the COVID-19 pandemic related to 1) levels of worry, risk perception, and social distancing; 2) longitudinal effects on wellbeing; and 3) effects of worry, risk perception, and social distancing on wellbeing. METHODS: We analyzed annual changes in four aspects of wellbeing over five years (2015-2020): life satisfaction, financial satisfaction, self-rated health, and loneliness in a subsample (n=1071, aged 60-71) from a larger survey of Swedish older adults. The 2020 wave, collected March 26-April 2, included measures of worry, risk perception, and social distancing in response to COVID-19. RESULTS: 1) In relation to COVID-19: 44.9% worried about health, 69.5% about societal consequences, 25.1% about financial consequences; 86.4% perceived a high societal risk, 42.3% a high risk of infection, and 71.2% reported high levels of social distancing. 2) Wellbeing remained stable (life satisfaction and loneliness) or even increased (self-rated health and financial satisfaction) in 2020 compared to previous years. 3) More worry about health and financial consequences was related to lower scores in all four wellbeing measures. Higher societal worry and more social distancing were related to higher wellbeing. DISCUSSION: In the early stage of the pandemic, Swedish older adults on average rated their wellbeing as high as, or even higher than, previous years. However, those who worried more reported lower wellbeing. Our findings speak to the resilience, but also heterogeneity, among older adults during the pandemic. Further research, on a broad range of health factors and long-term psychological consequences, is needed.


title: Association of ADH7 Gene Polymorphism with Schizophrenia in the Han Population of Northern China: a Case-Control Study

text: Schizophrenia is a serious neurodevelopmental disorder. Genetics is an important factor leading to schizophrenia, but its exact role is still unclear. Many studies have focused on neurotransmitters and regulators that participate in the processes mediated by these neurotransmitters. Alcohol dehydrogenase may not only catalyze the oxidation of retinol and ethanol but also be involved in a variety of neurotransmitter metabolic pathways. Therefore, our study investigated whether ADH7 gene variations in the Chinese Han population were associated with schizophrenia. Genomic DNA was extracted from a cohort of 275 schizophrenic patients (136 men and 139 women) and 313 healthy controls (160 men and 153 women) from the Northern Han Chinese population. The Hardy-Weinberg equilibrium test and linkage disequilibrium analysis were performed. Differences in genotypes, alleles, and haplotypes between the schizophrenic and control groups were determined using the chi-square test and correlation analysis. The distribution of the CC + TT genotype of rs284787 was statistically different between the case and control groups (p = 0.026, OR = 1.448); however, the difference disappeared after Bonferroni correction. Linkage analysis indicated that rs739147, rs284787, rs3805329, rs894369, rs3805331, and rs284786 were closely linked in one block. The haplotype analysis found no association between the composed haplotypes and the occurrence of schizophrenia. Our study showed that the ADH7 gene was not associated with the risk of schizophrenia. Additional studies with larger cohorts of different ethnicities are needed to validate our findings.


title: COVID-19 Epidemic and Public Health Measures in China

text: OBJECTIVES: The study aims to analyze the status quo of public health emergency measures taken in China in dealing with the spread of new coronavirus pneumonia (COVID-19), and to put forward policy suggestions for system construction and improvement. METHODS: According to the official data released by the National Health Commission, the epidemic data of infected people from 0:00 on January 24, 2020 to 24:00 on February 23, 2020 were quantitatively analyzed through statistical analysis. We used EXCEL software to draw the overall epidemic trend chart and Statistical Product and Service Solutions (SPSS) to carry out descriptive statistical analysis of mortality and cure rate. We made qualitative analysis on the emergency measures implemented by national administrative departments and provincial governments to work on controlling and monitoring COVID-19 nationwide spread. RESULTS: The number of patients diagnosed showed a linear increasing trend, with the slope increasing first and decreasing later. Suspected and new cases showed an inverted V pattern, with the peak occurring on February 8 and 12, respectively. There was a linear increase in the number of deaths and an exponential increase in the number of cures. Over the 31-day study period, the mortality rate fluctuated between 2.0% and 3.4%. The mean cure rate was 10.03%, the minimum value was 1.33%, and the maximum value was 32.05%. The quantitative and qualitative analysis shows that the public health emergency response system constructed in China plays a significant role in controlling the epidemic in a certain period of time. DISCUSSION: The four-tier emergency management system and the joint prevention mechanism established in China have provided various resources to control the epidemic, but there are still weakness in dealing with the spread of COVID-19. It is suggested to improve and strengthen the emergency management system, public health service system, health legal system, citizen health education, and international exchange and cooperation.


title: Weakness and elevated creatinine kinase as the initial presentation of coronavirus disease 2019 (COVID-19)

text: COVID-19 is a global public health emergency with more than one million positive cases across the globe. COVID-19 has a multifaceted presentation. We are herein to report two cases of SARS-CoV-2 induced rhabdomyolysis with an initial presentation of weakness and elevated creatinine kinase (CK). Both patients had no respiratory symptoms, they only complained of generalized weakness and were found to have elevated CK. Routine chest X-ray showed bilateral infiltrates in both cases and subsequently reverse-transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2 was positive. To the best of our knowledge, there was only one literature to date documented SARS-CoV-2 induced rhabdomyolysis as a late complication of COVID-19 patient. Our cases showed that elevated CK and rhabdomyolysis can be the sole initial presentation of patients with COVID-19 and total CK should be ordered in every patient on admission.


docid: fiaiwfke

title: Was there COVID-19 back in 2012? Challenge for AI in Diagnosis with Similar Indications

text: Purpose: Since the recent COVID-19 outbreak, there has been an avalanche of research papers applying deep learning based image processing to chest radiographs for detection of the disease. To test the performance of the two top models for CXR COVID-19 diagnosis on external datasets to assess model generalizability. Methods: In this paper, we present our argument regarding the efficiency and applicability of existing deep learning models for COVID-19 diagnosis. We provide results from two popular models - COVID-Net and CoroNet evaluated on three publicly available datasets and an additional institutional dataset collected from EMORY Hospital between January and May 2020, containing patients tested for COVID-19 infection using RT-PCR. Results: There is a large false positive rate (FPR) for COVID-Net on both ChexPert (55.3%) and MIMIC-CXR (23.4%) dataset. On the EMORY Dataset, COVID-Net has 61.4% sensitivity, 0.54 F1-score and 0.49 precision value. The FPR of the CoroNet model is significantly lower across all the datasets as compared to COVID-Net - EMORY(9.1%), ChexPert (1.3%), ChestX-ray14 (0.02%), MIMIC-CXR (0.06%). Conclusion: The models reported good to excellent performance on their internal datasets, however we observed from our testing that their performance dramatically worsened on external data. This is likely from several causes including overfitting models due to lack of appropriate control patients and ground truth labels. The fourth institutional dataset was labeled using RT-PCR, which could be positive without radiographic findings and vice versa. Therefore, a fusion model of both clinical and radiographic data may have better performance and generalization.


Cardio-oncology Care in the Time of COVID-19 and the Role of Telehealth


Comment on: Cutaneous manifestations in COVID-19: a first perspective. Safety concerns of clinical images and skin biopsies


title: Infection control measures of a Taiwanese hospital to confront the COVID-19 pandemic

text: The World Health Organization announced the coronavirus disease 2019 (COVID-19) outbreak a pandemic on 12 March 2020. Although being in proximity to China, the original epicenter of the COVID-19 outbreak, Taiwan has maintained a low number of COVID-19 cases despite its close social ties and heavy traffic between Taiwan and China. Containment strategies executed by the Taiwanese government have attracted global attention. Similarly, in-hospital settings, high alertness and swift responses to the changing outbreak situation are necessary to ensure hospital staff members' safety so they can continue to save patients' lives. Herein, we present infection control measures that can be adopted in hospital settings that were executed in a Taiwanese hospital to confront the COVID-19 pandemic, including emergency preparedness and responses from the hospital administration, education, surveillance, patient flow arrangement, the partition of hospital zones, and the prevention of a systemic shutdown by using the "divided cabin, divided flow" strategy. The measures implemented by a Taiwan hospital during the COVID-19 pandemic may not be universally applicable in every hospital. Nonetheless, the presented infection control methods have been practically executed and can be referenced or modified to fit each hospital's unique condition.


title: RNA genome conservation and secondary structure in SARS-CoV-2 and SARS-related viruses: a first look

text: As the COVID-19 outbreak spreads, there is a growing need for a compilation of conserved RNA genome regions in the SARS-CoV-2 virus along with their structural propensities to guide development of antivirals and diagnostics. Here we present a first look at RNA sequence conservation and structural propensities in the SARS-CoV-2 genome. Using sequence alignments spanning a range of betacoronaviruses, we rank genomic regions by RNA sequence conservation, identifying 79 regions of length at least 15 nucleotides as exactly conserved over SARS-related complete genome sequences available near the beginning of the COVID-19 outbreak. We then confirm the conservation of the majority of these genome regions across 739 SARS-CoV-2 sequences subsequently reported from the COVID-19 outbreak, and we present a curated list of 30 'SARS-related-conserved' regions. We find that known RNA structured elements curated as Rfam families and in prior literature are enriched in these conserved genome regions, and we predict additional conserved, stable secondary structures across the viral genome. We provide 106 'SARS-CoV-2-conserved-structured' regions as potential targets for antivirals that bind to structured RNA. We further provide detailed secondary structure models for the extended 5' UTR, frame-shifting element, and 3' UTR. Last, we predict regions of the SARS-CoV-2 viral genome that have low propensity for RNA secondary structure and are conserved within SARS-CoV-2 strains. These 59 'SARS-CoV-2-conserved-unstructured' genomic regions may be most easily targeted in primer-based diagnostic and oligonucleotide-based therapeutic strategies.


title: Association of particulate matter pollution and case fatality rate of COVID-19 in 49 Chinese cities

text: The COVID-19 epidemic, caused by the SARS-CoV-2 virus, has resulted in 3352 deaths in China as of April 12, 2020. This study aimed to investigate the associations between particulate matter (PM) concentrations and the case fatality rate (CFR) of COVID-19 in 49 Chinese cities, including the epicenter of Wuhan. We used the Global Moran's I to analyze spatial distribution and autocorrelation of CFRs, and then we used multivariate linear regression to analyze the associations between PM2.5 and PM10 concentrations and COVID-19 CFR. We found positive associations between PM pollution and COVID-19 CFR in cities both inside and outside Hubei Province. For every 10 µg/m3 increase in PM2.5 and PM10 concentrations, the COVID-19 CFR increased by 0.24% (0.01%-0.48%) and 0.26% (0.00%-0.51%), respectively. PM pollution distribution and its association with COVID-19 CFR suggests that exposure to such may affect COVID-19 prognosis.


title: Opening up while locking down: how an Irish independent sector mental health service is responding to the COVID-19 crisis?

text: The COVID-19 pandemic poses a particular set of challenges for health services. Some of these are common across all services (e.g. strategies to minimise infections; timely testing for patients and staff; and sourcing appropriate personal protective equipment (PPE)) and some are specific to mental health services (e.g. how to access general medical services quickly; how to safely deliver a service that traditionally depends on intensive face to face contact; how to isolate someone who does not wish to do so; and how to source sufficient PPE in the face of competing demands for such equipment). This paper describes how St Patrick's Mental Health Services (SPMHS) chose to address this unfolding and ever-changing crisis, how it developed its strategy early based on a clear set of objectives and how it adapted (and continues to adapt) to the constantly evolving COVID-19 landscape.


title: Nutrition habits of children and adolescents with type 1 diabetes changed in a 10 years span

text: BACKGROUND: Diet plays a key role in the treatment of type 1 diabetes (T1D). Dietary habits changed rapidly in the last decades and few data are available on recent dietary changes in children and adolescents with T1D. OBJECTIVE: To test the hypothesis that diet composition changed in a 10-year period in children and adolescents with T1D. METHODS: 229 T1D subjects (M/F:121/108) aged 6-16 years were recruited: 114 (group A) enrolled in 2009, not using CGM and/or CSII, and 115 (group B) enrolled in 2019. Anthropometric, biochemical (HbA1c, lipid profile), diet and insulin therapy parameters were compared between the two groups. Multivariate logistic regression analysis was performed with HbA1c as dependent variable (HbA1c > 58 mmol/mol = 1) and nutritional variables and technology use as independent ones. RESULTS: Energy intake of group A was not statistically different from that of group B. Group B had a significantly (p < 0.001) higher protein and lipids intake and lower total carbohydrate and fiber intake than group A. HbA1c was significantly (p < 0.01) lower in group B than in group A. Logistic regression analysis showed that MUFA (OR 0.83,95%CI:0.693-0.998), fiber intake (OR 0.82,95%CI:0.699-0.0969), and technology use (OR 0.15,95%CI:0.031-0.685), adjusted for age, gender, BMI, energy intake and diabetes duration, were were associated with a HbA1c higher than 58 mmol/mol) (R2 = 0.27, p < 0.05). CONCLUSIONS: In a 10-year period, diet composition of children and adolescents with T1D changed and glucometabolic control improved. Fiber and MUFA intake showed a positive effect on HbA1c, independent from technology use, supporting the importance of educating children with T1D and families to maintain healthy eating habits. This article is protected by copyright. All rights reserved.


Supportive Treatment with Tocilizumab for COVID-19: A Systematic Review


title: The peripheral lymphocyte count as a predictor of severe COVID-19 and the effect of treatment with ciclesonide

text: We investigated whether reduced lymphocyte count, could predict the development of severe COVID-19. We also examined whether ciclesonide could prevent the development of severe COVID-19 among patients with the predictors. This was a retrospective cohort study. Of the 30 included patients, 12, 14, and 4 were allocated to severe pneumonia, non-severe pneumonia, and non-pneumonia groups, respectively. The group of the low level of lymphocyte counts of the sixth day after onset was significantly intubated approximately three days later. The incidence of the severe pneumoniae requiring intubation are significantly lower in the patients treated with ciclesonide than without it (11.18 % vs 83.33%, p = 0.0033). The lymphocyte count after ciclesonide treatment in the non-severe pneumonia group was significantly higher (p = 0. 0156) than before. The lymphocyte count could be used to identify patients that may develop severe COVID-19. Treatment with ciclesonide may prevent the development of severe COVID-19.


Challenges and Concerns for Older Adults in India Regarding the COVID-19 Pandemic


title: Asymptomatic cases with SARS-CoV-2 infection

text: On 31 March 2020, Chinese Health Authorization announced that numbers of asymptomatic cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection will be made to the public daily. This was a very important step since different counties have different capacities for the detection of SARS-CoV-2 infection and control strategy for the Coronavirus Disease 2019 outbreak. We summarized the characteristics of asymptomatic SARS-CoV-2 infections and the transmission potential of asymptomatic cases. Then we provided guidelines for the management of asymptomatic cases through quarantine and nucleic acid/serology tests.


title: Massively multiplexed nucleic acid detection with Cas13

text: The great majority of globally circulating pathogens go undetected, undermining patient care and hindering outbreak preparedness and response. To enable routine surveillance and comprehensive diagnostic applications, there is a need for detection technologies that can scale to test many samples1-3 while simultaneously testing for many pathogens4-6. Here, we develop Combinatorial Arrayed Reactions for Multiplexed Evaluation of Nucleic acids (CARMEN), a platform for scalable, multiplexed pathogen detection. In the CARMEN platform, nanolitre droplets containing CRISPR-based nucleic acid detection reagents7 self-organize in a microwell array8 to pair with droplets of amplified samples, testing each sample against each CRISPR RNA (crRNA) in replicate. The combination of CARMEN and Cas13 detection (CARMEN-Cas13) enables robust testing of more than 4,500 crRNA-target pairs on a single array. Using CARMEN-Cas13, we developed a multiplexed assay that simultaneously differentiates all 169 human-associated viruses with at least 10 published genome sequences and rapidly incorporated an additional crRNA to detect the causative agent of the 2020 COVID-19 pandemic. CARMEN-Cas13 further enables comprehensive subtyping of influenza A strains and multiplexed identification of dozens of HIV drug-resistance mutations. The intrinsic multiplexing and throughput capabilities of CARMEN make it practical to scale, as miniaturization decreases reagent cost per test by more than 300-fold. Scalable, highly multiplexed CRISPR-based nucleic acid detection shifts diagnostic and surveillance efforts from targeted testing of high-priority samples to comprehensive testing of large sample sets, greatly benefiting patients and public health9-11.


title: Personal Protective Equipment and COVID-19: A Review for Surgeons

text: : There is a long history of personal protective equipment (PPE) used by the surgeon to minimize the transmission of various pathogens. In the context of the present coronavirus disease 2019 pandemic there is significant controversy as to what forms of PPE are appropriate or adequate. This review aims to describe the pathogenic mechanism and route of spread of the causative virus, severe acute respiratory syndrome coronavirus, as it pertains to accumulated published data from experienced centers globally. The various forms of PPE that are both available and appropriate are addressed. There are options in the form of eyewear, gloves, masks, respirators, and gowns. The logical and practical utilization of these should be data driven and evolve based on both experience and data. Last, situations specific to surgical populations are addressed. We aim to provide granular collective data that has thus far been published and that can be used as a reference for optimal PPE choices in the perioperative setting for surgical teams.


title: Emociones, preocupaciones y reflexiones frente a la pandemia del COVID-19 en Argentina./ [Emotions, concerns and reflections regarding the COVID-19 pandemic in Argentina]

text: The scope of this work is to explore the feelings and expectations that COVID-19 has generated in Argentina during the first stage of the pandemic. A survey of the World Health Organization adapted to the local context was applied. Open-ended questions were included to study people's feelings about COVID-19, and content analysis was subsequently conducted. In terms of results, it is revealed that the population surveyed feels uncertainty, fear and anguish, albeit a feeling of responsibility and care in the face of COVID-19 also emerges. Moreover, positive feelings regarding society stand out as an achievement of social interdependence. The results obtained show that the impact on mental health differs in accordance with gender, educational level, and perceived comfort in the home. The study concludes that the emotional and bonding dimensions of people are central to confronting the COVID-19 pandemic in Argentina. It is recommended that these dimensions, as well as their subjective and differential social impact among the different population groups, should be considered in the planning of policies to address the COVID-19 pandemic.


title: Exposure to Toxoplasma gondii in Marine Otters (Lontra felina) and Domestic Cats (Felis catus) in an Arid Environment in Chile

text: Toxoplasma gondii is a worldwide-distributed protozoon that infects warm-blooded animals. We determined T. gondii exposure in one marine otter (Lontra felina) and four domestic cats (Felis catus) along the northern and central coast of Chile, indicating a low seroprevalence of 5% (1/19) and 8% (4/50) respectively, likely related to arid environment.


title: Glass fragment injury to the craniocervical junction with inter-atlanto-occipital penetration to the subarachnoid space: Not-to-be-missed important aspects of craniocervical trauma even in the middle of the COVID-19 pandemic: a case report with a review of the literature

text: BACKGROUND: Non-missile penetrating injuries to the craniocervical junction caused by a glass fragment are rare, and a standard management strategy has not been established. CASE DESCRIPTION: A 75-year-old Japanese man was brought into our emergency department after receiving a left retroauricular stab wound by broken glass fragments. After spinal immobilization, a computed tomographic (CT) scan revealed glass fragments penetrating at the right craniocervical junction to the inter-atlanto-occipital subarachnoid space. CT angiography showed that both vertebral arteries (VAs) were not injured. Magnetic resonance imaging demonstrated that the glass fragments did not penetrate the cervical cord or medulla oblongata (MO). These glass fragments were removed via a midline incision from the external occipital protuberance to the C7 and with laminectomy without suboccipital craniectomy. Five of the glass fragments were found and removed in total. The dural defect was patched with a free fascia autograft. His postoperative course was uneventful. Postoperative CT angiography showed that both the vertebral arteries were intact as well as the complete removal of the glass fragments. CONCLUSIONS: CT graphical diagnosis is useful for the management of penetrating craniocervical junction trauma, and it should be considered in the evaluation of patients who have suffered craniocervical penetrating injury even in the absence of major wounds or bleeding. Spinal immobilization of patients with craniocervical penetrating injuries is crucial to avoid not only secondary neurological damage but also secondary critical vascular damage. Incomplete or inadequate assessment of craniocervical stab wounds results in unexpected hazards that are preventable.


The health of private insurance in the US during covid-19


Severe Bilateral Vision Loss in 2 Patients With Coronavirus Disease 2019


title: Hospital preparedness for mass critical care during SARS-CoV-2 pandemic

text: Mass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.


docid: ixasyqqu

title: Peça intermediária de espermatozoides bovinos: funções e anormalidades/ Midpiece of bovine spermatozoa: functions and abnormalities

text: O reprodutor tem grande importância na cadeia produtiva por possuir maior potencial de difusão do seu material genético dentro do rebanho do que as fêmeas que produzem apenas uma cria por ano, em manejo de monta natural. Entretanto, este potencial somente se torna real quando os machos apresentam boa qualidade seminal, resultando em menores taxas de retorno ao estro. No entanto, apesar das características reprodutivas apresentarem baixa herdabilidade, é consensual que algumas patologias espermáticas possam apresentar características hereditárias e neste caso podem permanecer disseminadas nos rebanhos. Entre as anomalias espermáticas identificadas nos ejaculados de bovinos, as patologias de peça intermediária são classificadas como defeitos espermáticos maiores, comprometendo a fertilidade dos reprodutores, porém estas têm recebido pouca atenção. O objetivo deste trabalho de revisão é apresentar os principais estudos sobre a formação da peça intermediária, sua importância e como esta pode sofrer anormalidades, visto que ejaculados com presença destas anomalias apresentam baixa motilidade espermática e fertilidade.(AU)


title: Adaptations to the British Society of Gastroenterology guidelines on the management of acute severe UC in the context of the COVID-19 pandemic: a RAND appropriateness panel

text: OBJECTIVE: Management of acute severe UC (ASUC) during the novel COVID-19 pandemic presents significant dilemmas. We aimed to provide COVID-19-specific guidance using current British Society of Gastroenterology (BSG) guidelines as a reference point. DESIGN: We convened a RAND appropriateness panel comprising 14 gastroenterologists and an IBD nurse consultant supplemented by surgical and COVID-19 experts. Panellists rated the appropriateness of interventions for ASUC in the context of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Median scores and disagreement index (DI) were calculated. Results were discussed at a moderated meeting prior to a second survey. RESULTS: Panellists recommended that patients with ASUC should be isolated throughout their hospital stay and should have a SARS-CoV-2 swab performed on admission. Patients with a positive swab should be discussed with COVID-19 specialists. As per BSG guidance, intravenous hydrocortisone was considered appropriate as initial management; only in patients with COVID-19 pneumonia was its use deemed uncertain. In patients requiring rescue therapy, infliximab with continuing steroids was recommended. Delaying colectomy because of COVID-19 was deemed inappropriate. Steroid tapering as per BSG guidance was deemed appropriate for all patients apart from those with COVID-19 pneumonia in whom a 4-6 week taper was preferred. Post-ASUC maintenance therapy was dependent on SARS-CoV-2 status but, in general, biologics were more likely to be deemed appropriate than azathioprine or tofacitinib. Panellists deemed prophylactic anticoagulation postdischarge to be appropriate in patients with a positive SARS-CoV-2 swab. CONCLUSION: We have suggested COVID-19-specific adaptations to the BSG ASUC guideline using a RAND panel.


The Ethics of COVID-19 Immunity-Based Licenses ("Immunity Passports")


title: A comprehensive analysis of genome composition and codon usage patterns of emerging coronaviruses

text: An outbreak of atypical pneumonia caused by a novel Betacoronavirus (ßCoV), named SARS-CoV-2 has been declared a public health emergency of international concern by the World Health Organization. In order to gain insight into the emergence, evolution and adaptation of SARS-CoV-2 viruses, a comprehensive analysis of genome composition and codon usage of ßCoV circulating in China was performed. A biased nucleotide composition was found for SARS-CoV-2 genome. This bias in genomic composition is reflected in its codon and amino acid usage patterns. The overall codon usage in SARS-CoV-2 is similar among themselves and slightly biased. Most of the highly frequent codons are A- and U-ending, which strongly suggests that mutational bias is the main force shaping codon usage in this virus. Significant differences in relative synonymous codon usage frequencies among SARS-CoV-2 and human cells were found. These differences are due to codon usage preferences.


From a Sprint to a Marathon in Hong Kong


docid: arsqibeh

title: The role of ACEIs/ARBs in COVID-19: Friend or foe?


title: GEICAM Guidelines for the Management of Patients with Breast Cancer During Spain's COVID-19 Pandemic

text: Breast cancer (BC) is the most common cancer in women in Spain. During the COVID-19 pandemic caused by the SARS-Cov-2 virus, patients with BC require timely treatment and follow-up. However, not only are hospitals overwhelmed with infected patients, some patients with BC are at higher risk for infection and for serious complications if infected. Thus, health care providers need to evaluate each BC treatment and in-hospital visit to minimize pandemic-associated risks while maintaining adequate treatment efficacy. Here we present a set of guidelines regarding available options for BC patient management and treatments by BC subtype in the context of the COVID-19 pandemic. Owing to the lack of evidence about COVID-19 infection, these recommendations are mainly based in expert opinion, medical organizations' and societies' recommendations, and some published evidence. We consider this a useful tool to facilitate medical decision making in this health crisis situation we are facing. IMPLICATIONS FOR PRACTICE: This work presents a set of guidelines regarding available options for breast cancer (BC) patient management and treatments by BC subtype in the context of the COVID-19 pandemic. Owing to the suddenness of this health crisis, specialists have to make decisions with little evidence at hand. Thus, these expert guidelines may be a useful tool to facilitate medical decision making in the context of a worldwide pandemic with no resources to spare.


title: Responding to the COVID-19 outbreak in Singapore: Staff Protection and Staff Temperature and Sickness Surveillance Systems

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by novel coronavirus (SARS-CoV-2), and first reported in Wuhan, China, in December 2019. Since the severe acute respiratory syndrome (SARS) outbreak in 2003, Tan Tock Seng Hospital (TTSH) in Singapore has routinely fit-tested staff for high filtration N95 respirators, and established web-based staff surveillance systems. The routine systems were enhanced in response to Singapore's first imported COVID-19 case on January 23,2020. METHODS: We conducted a cross-sectional study, from January 23,2020 to February 23,2020, among healthcare workers to evaluate the effectiveness of the staff protection and surveillance strategy in TTSH, a 1600-bed multidisciplinary acute-care hospital co-located with the 330-bed National Centre for Infectious Diseases (NCID). As of February 23,2020, TTSH/NCID has managed 76% of confirmed COVID-19 cases in Singapore. The hospital adopted a multi-pronged approach to protect and monitor staff with potential COVID-19 exposures:(1) Risk-based personal protective equipment, (2) Staff fever and sickness surveillance, and (3) Enhanced medical surveillance of unwell staff. RESULTS: A total of 10,583 staff were placed on hospital-wide fever and sickness surveillance, with 1,524 frontline staff working in COVID-19 areas under close surveillance. Among frontline staff, a median of eight staff illness episodes was seen per day, and almost 10% (n=29) resulted in hospitalization. None of the staff was found to be infected with COVID-19. CONCLUSIONS: A robust staff protection and health surveillance system that is routinely implemented during non-outbreak periods and enhanced during the COVID-19 outbreak is effective in protecting frontline staff from the infection.


title: Optimising benefits of testing key workers for infection with SARS-CoV-2: A mathematical modelling analysis

text: BACKGROUND: Internationally, key workers such as healthcare staff are advised to stay at home if they or household members experience coronavirus disease 2019 (COVID-19)-like symptoms. This potentially isolates / quarantines many staff without SARS-CoV-2, whilst not preventing transmission from staff with asymptomatic infection. We explored the impact of testing staff on absence durations from work and transmission risks to others. METHODS: We used a decision-analytic model for 1,000 key workers to compare the baseline strategy of (S0) no RT-PCR testing of workers to testing workers (S1) with COVID-19-like symptoms in isolation, (S2) without COVID-19-like symptoms but in household-quarantine, and (S3) all staff. We explored confirmatory re-testing scenarios of repeating all initial tests, initially-positive tests, initially-negative tests; or no re-testing. We varied all parameters, including the infection rate (0.1%-20%), proportion asymptomatic (10%-80%), sensitivity (60%-95%), and specificity (90%-100%). RESULTS: Testing all staff (S3) changes the risk of workplace transmission by -56.9 to +1.0 workers per 1,000 tests (with reductions throughout at RT-PCR sensitivity of ≥65%), and absences by 0.5 to +3.6 days per test but at heightened testing needs of 989.6-1995.9 tests per 1,000 workers. Testing workers in household-quarantine (S2) reduces absences the most by 3.0-6.9 days per test (at 47.0-210.4 tests per 1,000 workers), while increasing risk of workplace transmission by 0.02-49.5 infected workers per 1,000 tests (which can be minimised when re-testing initially-negative tests). DISCUSSION: Based on optimising absence durations or transmission risk our modelling suggests testing staff in household-quarantine or all staff, depending on infection levels and testing capacities.


docid: ianlqmeq

title: Staying in a Burning House: Perks and Perils of a Hotline in the Times of COVID-19


title: Probabilistic Model of Narratives Over Topical Trends in Social Media: A Discrete Time Model

text: Online social media platforms are turning into the prime source of news and narratives about worldwide events. However,a systematic summarization-based narrative extraction that can facilitate communicating the main underlying events is lacking. To address this issue, we propose a novel event-based narrative summary extraction framework. Our proposed framework is designed as a probabilistic topic model, with categorical time distribution, followed by extractive text summarization. Our topic model identifies topics' recurrence over time with a varying time resolution. This framework not only captures the topic distributions from the data, but also approximates the user activity fluctuations over time. Furthermore, we define significance-dispersity trade-off (SDT) as a comparison measure to identify the topic with the highest lifetime attractiveness in a timestamped corpus. We evaluate our model on a large corpus of Twitter data, including more than one million tweets in the domain of the disinformation campaigns conducted against the White Helmets of Syria. Our results indicate that the proposed framework is effective in identifying topical trends, as well as extracting narrative summaries from text corpus with timestamped data.


title: [Treatment experience of burn patients combined with inhalation injury during epidemic period of Corona Virus Disease 2019]

text: Objective: To introduce Treatment experience of burn patients combined with inhalation injury during epidemic period of Corona Virus Disease 2019 (COVID-19). Methods: Six burn patients combined with inhalation injury were hospitalized in Department of Burns of Tongren Hospital of Wuhan University& Wuhan Third Hospital from February 1 to March 1 in 2020duringhigh-incidence period of COVID-19, including 4 males and 2 females, aged 21-63 years, hospitalized for 2-4 hours, with total burn areas of 1%-20% TBSA and full-thickness burn areas of 1%-12% TBSA. Among them, 1 case was severe inhalation injury, 2 cases were mild inhalation injury, and 3 cases were moderate inhalation injury. The body temperatures of the patients were normal at admission without fever or cough in the past 2 weeks. At admission, chest CT of one patient showed double lower lobes and left upper lobes had multiple slices and slightly high-density shadow of nodules. Chest CT of two patients showed bilateral lung texture was thickening, and chest CT of other patients was normal. After admission, 6 patients were given routine treatment, the medical staffs paid attention to the protection and screened COVID-19 according to the diagnosis and treatment plan of COVID-19. On post injury day (PID) 1, 3, 6, and 9, vein blood of patients were collected for determination of white blood cell (WBC) count, neutrophil, lymphocyte absolute value. and level of procalcitonin (PCT). Nucleic acid of novel coronavirus was detected by real-time fluorescence reverse transcription polymerase chain reaction on PID 3 and 6. The temperatures of patients were recorded after admission. The results of chest CT within one week after injury and the prognosis of the patients were recorded. Measurement data distributed normally were expressed as x ± s, and measurement data distributed abnormally were expressed as M (P(25), P(75)). Results: (1) On PID1, 3, 6, and 9, WBC counts of patients were respectively (19.8±3.8)×10(9)/L, (17.2±3.4)×10(9)/L,(13.3±3.1)×10(9)/L, and (11.1±1.6)×10(9)/L, neutrophils of patients were respectively0.919±0.019,0.899±0.011, 0.855±0.034, and0.811±0.035, absolute values of lymphocytes of patients were respectively(0.65±0.18)×10(9)/L,(0.65±0.24)×10(9)/L,(0.91±0.34)×10(9)/L, and (1.23±0.42)×10(9)/L,and PCT values of patients were respectively0.49 (0.36, 1.64), 0.39 (0.26, 0.73), 0.28 (0.18, 0.33), and 0.12 (0.11, 0.20) ng/mL.The values of WBC and neutrophils of patients were higher than the normal value, showing a downward trend. The absolute values of lymphocyte of patients returned to the normal value gradually. The PCT values of patients were higher than the normal value. (2) Nucleic acid test results of novel coronavirus of 6 patients were negative on PID 3 and 6. The temperatures of patients were from 36.5 to 38.6 â. The typical imaging features of COVID-19 were not found in 6 patients within 1 week after injury by chest CT. After treatment for 14-32 days, 6 patients were cured and discharged. Conclusions: During the novel coronavirus, burn patients combined with inhalation injury should be treated under condition of good protection for COVID-19 among doctors and nurses. Meanwhile, virus should be actively screened to reduce the risk of COVID-19 infection among doctors and patients.


Palliative Radiotherapy for Oncologic Emergencies in the setting of COVID-19: Approaches to Balancing Risks and Benefits


title: Psychological and Ocular Surface State of Ophthalmologists and Ophthalmic Nurses Working With Patients With Coronavirus Disease 2019

text: Importance: The influence on the psychology and ocular surface of ophthalmologists and ophthalmic nurses in Wuhan, China, during the coronavirus disease 2019 (COVID-19) pandemic is not yet fully understood. Objective: To characterize mental state and ocular surface state of ophthalmologists and ophthalmic nurses in Wuhan, China, and similar areas during the COVID-19 outbreak. Design, Setting, and Participants: This survey study assessed ophthalmologists and ophthalmic nurses in Wuhan, China, and Jiangxi, China, a province approximately 300 km south of Wuhan. The Hospital Anxiety and Depression Scale, the Van Dream Anxiety Scale, and the Ocular Surface Disease Index were used to conduct questionnaire surveys via a messaging and social media app. Main Outcomes and Measures: Mean scores from the Hospital Anxiety and Depression Scale (0-10 points), the Van Dream Anxiety Scale (0-100 points), and the Ocular Surface Disease Index (0-100 points). Results: Of 126 individuals, there were 42 ophthalmologists (33.3%) and 21 ophthalmic nurses (16.7%) from Wuhan and 42 ophthalmologists (33.3%) and 21 nurses (16.7%) from Jiangxi. The mean (SD) age of ophthalmologists was 36.1 (7.6) years in Wuhan and 41.2 (8.8) years in Jiangxi. For ophthalmic nurses, the mean (SD) age was 35.2 (7.4) years in Wuhan and 33.4 (7.9) years in Jiangxi. The response rate for ophthalmologists was 90.3% (84 of 93) and for nurses was 91.3% (42 of 46). The participation rate of ophthalmologists and nurses in Wuhan was 0.06% (42 of 70â¯000) and 0.07% (21 of 30â¯000), respectively; the participation rate in Jiangxi was 0.06% (42 of 70â¯000; 21 of 35â¯000) for both groups. In Wuhan, the mean (SD) Hospital Anxiety and Depression Scale (anxiety and depression were counted as separate scores), Van Dream Anxiety Scale, and the Ocular Surface Disease Index scores were 6.90 (2.30), 7.38 (2.19), 24.52 (5.86), and 43.90 (3.74), respectively, in ophthalmologists and 8.67 (3.04), 9.38 (2.64), 21.48 (6.15), and 40.05 (6.67), respectively, in ophthalmic nurses. In Jiangxi, these scores were 5.67 (2.89), 4.90 (3.15), 12.76 (7.27), and 38.79 (7.78), respectively, in ophthalmologists and 4.67 (3.20), 4.33 (3.23), 10.10 (7.62), and 41.52 (5.92), respectively, in ophthalmic nurses. The difference (95% CI) between the 2 regions for these scores in ophthalmologists was 2.48 (95% CI, 1.30-3.65), 11.76 (95% CI, 8.90-14.63), 5.12 (95% CI, 2.45-7.79), and 5.12 (95% CI, 2.47-7.77), respectively, and in ophthalmic nurses was 4.16 (95% CI, 2.05-5.95), 5.05 (95% CI, 3.21-6.89), 11.38 (95% CI, 7.06-15.70), and -1.48 (95% CI, -5.41 to 2.25), respectively. Conclusions and Relevance: These findings suggest that ophthalmologists and ophthalmic nurses in Wuhan experienced more anxiety and depression and reported greater ocular surface abnormalities than counterparts outside of Wuhan, but the wide CIs preclude concluding confidently that there were differences.


COVID-19 and Financial Vulnerability: What Health Care Organizations and Society Owe Each Other


docid: nbolayox

title: Implications of Obesity for the Management of Severe Coronavirus Disease 2019 Pneumonia

text: OBJECTIVES: To investigate patients' characteristics, management, and outcomes in the critically ill population admitted to the ICU for severe acute respiratory syndrome coronavirus disease 2019 pneumonia causing an acute respiratory distress syndrome. DESIGN: Retrospective case-control study. SETTING: A 34-bed ICU of a tertiary hospital. PATIENTS: The first 44 coronavirus disease 2019 acute respiratory distress syndrome patients were compared with a historical control group of 39 consecutive acute respiratory distress syndrome patients admitted to the ICU just before the coronavirus disease 2019 crisis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Obesity was the most frequent comorbidity exhibited by coronavirus disease 2019 patients (n = 32, 73% vs n = 11, 28% in controls; p < 0.001). Despite the same severity of illness and level of hypoxemia at admission, coronavirus disease 2019 patients failed more high flow oxygen via nasal cannula challenges (n = 16, 100% vs n = 5, 45% in controls; p = 0.002), were more often intubated (n = 44, 100% vs n = 22, 56% in controls; p < 0.001) and paralyzed (n = 34, 77% vs n = 3, 14% in controls; p < 0.001), required higher level of positive end-expiratory pressure (15 vs 8 cm H2O in controls; p < 0.001), more prone positioning (n = 33, 75% vs n = 6, 27% in controls; p < 0.001), more dialysis (n = 16, 36% vs n = 3, 8% in controls; p = 0.003), more hemodynamic support by vasopressors (n = 36, 82% vs n = 22, 56% in controls; p = 0.001), and had more often a prolonged weaning from mechanical ventilation (n = 28, 64% vs n = 10, 26% in controls; p < 0.01) resulting in a more frequent resort to tracheostomy (n = 18, 40.9% vs n = 2, 9% in controls; p = 0.01). However, an intensive management requiring more staff per patient for positioning coronavirus disease 2019 subjects (6 [5-7] vs 5 [4-5] in controls; p < 0.001) yielded the same ICU survival rate in the two groups (n = 34, 77% vs n = 29, 74% in controls; p = 0.23). CONCLUSIONS: In its most severe form, coronavirus disease 2019 pneumonia striked preferentially the vulnerable obese population, evolved toward a multiple organ failure, required prolonged mechanical ventilatory support, and resulted in a high workload for the caregivers.


Covid-19, ocular manifestation and ophthalmic risks


Ethical standards for telemental health must be maintained during the COVID-19 pandemic


docid: ntyxgxrf

title: A new framework to identify dental emergencies in the COVID-19 era

text: In order to reduce the spread of COVID-19 (Coronavirus Disease 2019), it is crucial to take extraordinary prevention and safety measures in dental offices, and to defer all elective and non-urgent procedures. Dental emergencies are defined through oral symptoms but, the systemic and psychological conditions of each patient should be considered. The present short communication proposes a multilevel evaluation (oral, systemic and psychological) and risk assessment score for the management of dental emergencies following the SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) outbreak. A comprehensive categorization and score scale assessment for dental emergencies allows a better identification of patient's treatment needs and avoids unnecessary contact between dental health care providers and patients during the SARS-CoV-2 pandemic.


title: Disability, Urban Health Equity, and the Coronavirus Pandemic: Promoting Cities for All

text: Persons with disabilities (PWDs) living in cities during the COVID-19 pandemic response may be four times more likely to be injured or die than non-disabled persons, not because of their "vulnerable" position but because urban health policy, planning and practice has not considered their needs. In this article, the adverse health impacts on PWDs during the COVID-19 pandemic reveals the "everyday emergencies" in cities for PWDs and that these can be avoided through more inclusive community planning, a whole-of-government commitment to equal access, and implementation of universal design strategies. Importantly, COVID-19 can place PWDs at a higher risk of infection since some may already have compromised immune and respiratory systems and policy responses, such as social distancing, can lead to life-threatening disruptions in care for those that rely on home heath or personal assistants. Living in cities may already present health-damaging challenges for PWDs, such as through lack of access to services and employment, physical barriers on streets and transportation, and smart-city technologies that are not made universally accessible. We suggest that the current pandemic be viewed as an opportunity for significant urban health reforms on the scale of the sanitary and governance reforms that followed ninetieth century urban epidemics. This perspective offers insights for ensuring the twenty-first century response to COVID-19 focuses on promoting more inclusive and healthy cities for all.


Clinical Course and Outcomes of 344 Intensive Care Patients with COVID-19


title: Pharmacy administration and pharmaceutical care practice in a module hospital during the COVID-19 epidemic

text: OBJECTIVES: To describe the pharmacy administration and pharmaceutical care in a module hospital during the coronavirus disease 2019 (COVID-19) epidemic and provide reference for domestic and foreign pharmacists participating in the epidemic prevention and control. SETTING: The study was performed in a Jianghan module hospital constructed at the Wuhan Convention and Exhibition Center in Wuhan, China. This is 1 of the first 3 module hospitals. PRACTICE DESCRIPTION: One thousand eight hundred forty-eight patients were admitted to the Jianghan module hospital, and 1327 cases (71.81% of the total number) were cured and discharged. Pharmacists have successfully completed the tasks of purchase, storage, and free distribution of drugs worth ¥1.03 million (approximately $146,000), reviewed about 20,000 electronic orders, provided one-on-one online medication consultation for 484 patients, and held 5 lectures on rational drug use knowledge, which could help reduce irrational drug use and minimize the risk involved. PRACTICE INNOVATION: The new COVID-19 "module" pharmaceutical care model is equipped with new features such as pharmacy emergency command group, organizational structure for pharmacy administration, electronic control of drug prescription, and "zero contact" pharmaceutical care relying on the new media platform "WeChat." This platform provides relevant pharmaceutical care for patients, such as ensuring drug supply, setting up critical care drug trolleys, designing specific drug packaging bags, creating a module radio station to broadcast rational drug use information to the patients, and other aspects. EVALUATION: With the continuous improvement of the module hospital and the progress in in-depth knowledge about COVID-19, some aspects such as patient admission criteria and variety of drugs need to be adjusted depending on the actual situation. RESULTS: The pharmacists provided pharmaceutical care for 1848 patients with mild COVID-19 disease. They not only ensured the timely supply of the drugs but also reduced the incidence of drug-induced risks through medication review and guidance, thereby improving patient compliance and helping the patients rebuild their confidence in overcoming the disease. CONCLUSION: The new COVID-19 module pharmaceutical care model has played an important role in overcoming the epidemic situation of COVID-19 in China and thus can be implemented on a broader scale.


title: Transmission routes of 2019-nCoV and controls in dental practice

text: A novel ß-coronavirus (2019-nCoV) caused severe and even fetal pneumonia explored in a seafood market of Wuhan city, Hubei province, China, and rapidly spread to other provinces of China and other countries. The 2019-nCoV was different from SARS-CoV, but shared the same host receptor the human angiotensin-converting enzyme 2 (ACE2). The natural host of 2019-nCoV may be the bat Rhinolophus affinis as 2019-nCoV showed 96.2% of whole-genome identity to BatCoV RaTG13. The person-to-person transmission routes of 2019-nCoV included direct transmission, such as cough, sneeze, droplet inhalation transmission, and contact transmission, such as the contact with oral, nasal, and eye mucous membranes. 2019-nCoV can also be transmitted through the saliva, and the fetal-oral routes may also be a potential person-to-person transmission route. The participants in dental practice expose to tremendous risk of 2019-nCoV infection due to the face-to-face communication and the exposure to saliva, blood, and other body fluids, and the handling of sharp instruments. Dental professionals play great roles in preventing the transmission of 2019-nCoV. Here we recommend the infection control measures during dental practice to block the person-to-person transmission routes in dental clinics and hospitals.


Reductions in Heart Failure Hospitalizations During the COVID-19 Pandemic


The Equitable Distribution of COVID-19 Therapeutics and Vaccines


title: COVID-19 and the Heart

text: Infection with the severe acute respiratory syndrome novel coronavirus produces a clinical syndrome known as 2019 novel coronavirus disease (COVID-19). When severe, COVID-19 is a systemic illness characterized by hyperinflammation, cytokine storm, and elevations of cardiac injury biomarkers. Here, we review what is known about the pathophysiology of COVID-19, its cardiovascular manifestations, and emerging therapeutic prospects. In this rapidly moving field, this review was comprehensive as of April 3, 2020.


Epidemiological Assessment of Imported Coronavirus Disease 2019 (COVID-19) Cases in the Most Affected City Outside of Hubei Province, Wenzhou, China


COVID-19 heath crisis: less colorectal resections and yet no more peritonitis or bowel obstruction as a collateral effect?


title: Volatile compounds of a pumpkin (Cucurbita moschata) purée processed by high pressure thermal processing

text: BACKGROUND: The changes in the volatile profile of a pumpkin (Cucurbita moschata, Duch.) purée processed by high pressure thermal processing (HPT) at different pressure and initial temperature intensities (300, 600, 900 MPa and 60, 80 °C respectively) was evaluated. Headspace solid phase microextraction (HS-SPME) technique was used for the extraction and concentration of volatile compounds and the analysis was performed by gas chromatography-mass spectrometry (GC-MS). RESULTS: Alcohols were the volatile compounds most abundantly isolated in the headspace of pumpkin purée (control and processed purées had ranges between 43-56%), followed by aldehydes (14-28%), hydrocarbons (8-13%) and terpenes (7-10%). Lipid oxidation, Maillard reaction and carotenoids degradation were the main chemical routes of formation of volatile compounds after HPT processing. Initial temperature or pressure intensity of HPT processing, within the ranges tested in this study, did not affect the initial levels of volatile compounds of pumpkin purée. CONCLUSION: HPT processing is an effective technology for the preservation of the original aroma of low acid vegetables such as pumpkin. This article is protected by copyright. All rights reserved.


Covid-19: Remdesivir is recommended for authorisation by European Medicines Agency


title: The first case of COVID-19 treated with the complement C3 inhibitor AMY-101

text: Acute respiratory distress syndrome (ARDS) is a devastating clinical manifestation of COVID-19 pneumonia and is mainly based on an immune-driven pathology. Mounting evidence suggests that COVID-19 is fueled by a maladaptive host inflammatory response that involves excessive activation of innate immune pathways. While a "cytokine storm" involving IL-6 and other cytokines has been documented, complement C3 activation has been implicated as an initial effector mechanism that exacerbates lung injury in preclinical models of SARS-CoV infection. C3-targeted intervention may provide broader therapeutic control of complement-mediated inflammatory damage in COVID-19 patients. Herein, we report the clinical course of a patient with severe ARDS due to COVID-19 pneumonia who was safely and successfully treated with the compstatin-based complement C3 inhibitor AMY-101.


title: First Case of Rhinocerebral Mucormycosis Caused by Lichtheimia ornata, with a Review of Lichtheimia Infections

text: BACKGROUND: Lichtheimia species are emerging opportunistic fungal pathogens in the Mucorales, causing serious skin and respiratory infections in immunocompromised patients. Established agents are Lichtheimia corymbifera and L. ramosa, while L. ornata is a novel agent. Available data on a species-specific analysis of Lichtheimia infections are limited. METHODS: The first case of a fatal rhino-orbital-cerebral infection in a hematopoietic stem cell transplantation recipient caused by L. ornata is reported; the agent was identified by sequencing the ITS ribosomal region. We reviewed the literature on mucormycosis due to Lichtheimia species between 2009 and 2018, with an analysis of risk factors and epidemiological and clinical data. RESULTS: In addition to our Lichtheimia ornata case, 44 cases of human Lichtheimia were analyzed. Lichtheimia predominated in Europe (68.2%), followed by Asia (16%), and Africa (9%). The most common underlying condition was hematological malignancy (36.3%), followed by trauma/major surgery (27.3%), while diabetes mellitus was rare (11.4%). Site of infection was mostly skin and soft tissues (45.5%) and lung (25%), while relatively few cases were disseminated (13.6%) or rhinocerebral (11.4%). Mortality (36.4%) was mainly due to disseminated and rhinocerebral infections. CONCLUSION: In contrast to Rhizopus, the most common agent of mucormycosis recorded in patients with diabetes mellitus, Lichtheimia infections were primarily associated with hematological malignancies and major skin barrier damage. Given the fact that classical rhinocerebral mucormycosis remains difficult to treat, independent of causative species, timely application of amphotericin B accessory to debridement may be required for patient survival.


Respirators and surgical facemasks for COVID-19: implications for MRI


Coping with COVID-19: Perspectives of Student Radiographers


docid: fjzaoxiq

title: Drones keep an eye on people failing to social distance


title: Morphometry of pectoral muscle fiber and intestinal villi of Calidris pusilla during the wintering period in Brazil/ Morfometria da fibra muscular peitoral e das vilosidades intestinais de Calidris pusilla durante o período de invernada no Brasil

text: Migration is an event observed in several animals, such as shorebirds moving between the northern and southern hemispheres, during breeding and wintering intervals. Morphophysiological adaptations are necessary to allow the maintenance of migratory cycles and, therefore, studies with this focus can help clarify biological aspects related to migration. We analyzed the morphology variation in pectoral muscles and intestinal mucosa of Calidris pusilla, during different phases of the wintering period on the coast of Brazil. Fragments of pectoral muscles and duodenal were collected, fixed and processed for histology according to standard procedure, from specimens captured in a locality on the Brazilian coast. Modifications were found in the measured parameters among the three phases of wintering, arrival in Brazil (October, mid-period), January and departure to the Northern Hemisphere - May. The registered structural dynamism characterizes the growth of flight musculature and intestinal changes related to nutrition. Such changes occur temporarily due to the activities of preparation and migration between the northern and southern hemispheres.(AU)


title: Structure of Mpro from SARS-CoV-2 and discovery of its inhibitors

text: A new coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is the aetiological agent responsible for the 2019-2020 viral pneumonia outbreak of coronavirus disease 2019 (COVID-19)1-4. Currently, there are no targeted therapeutic agents for the treatment of this disease, and effective treatment options remain very limited. Here we describe the results of a programme that aimed to rapidly discover lead compounds for clinical use, by combining structure-assisted drug design, virtual drug screening and high-throughput screening. This programme focused on identifying drug leads that target main protease (Mpro) of SARS-CoV-2: Mpro is a key enzyme of coronaviruses and has a pivotal role in mediating viral replication and transcription, making it an attractive drug target for SARS-CoV-25,6. We identified a mechanism-based inhibitor (N3) by computer-aided drug design, and then determined the crystal structure of Mpro of SARS-CoV-2 in complex with this compound. Through a combination of structure-based virtual and high-throughput screening, we assayed more than 10,000 compounds-including approved drugs, drug candidates in clinical trials and other pharmacologically active compounds-as inhibitors of Mpro. Six of these compounds inhibited Mpro, showing half-maximal inhibitory concentration values that ranged from 0.67 to 21.4 µM. One of these compounds (ebselen) also exhibited promising antiviral activity in cell-based assays. Our results demonstrate the efficacy of our screening strategy, which can lead to the rapid discovery of drug leads with clinical potential in response to new infectious diseases for which no specific drugs or vaccines are available.


Immunosenescence exacerbates the COVID-19


Coronavirus disease 2019 (COVID-19) and anti-rheumatic drugs


Potential of chloroquine and hydroxychloroquine to treat COVID-19 causes fears of shortages among people with systemic lupus erythematosus


title: Combination of thrombolytic and immunosuppressive therapy for coronavirus disease 2019: A case report

text: In a proportion of patients, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a multisystem syndrome characterized by hyperinflammation, acute respiratory distress syndrome (ARDS), and hypercoagulability. A 68-year-old man with coronavirus disease 2019 (COVID-19) was admitted to the intensive care unit with respiratory failure, cytokine release syndrome (CRS), and skin ischemia - microthrombosis. Specific coagulation and inflammatory markers (D-dimer, ferritin, and C-reactive protein), along with the clinical picture, triggered the trial of recombinant tissue plasminogen activator (rt-PA) and tocilizumab. This was followed by resolution of the skin ischemia and CRS, while respiratory parameters improved. No major complications associated with rt-PA or tocilizumab occurred. The combination of rt-PA with targeted anti-inflammatory treatment could be a new therapeutic option for patients with COVID-19, ARDS, hyperinflammation, and increased blood viscosity.


title: Emerging novel coronavirus (2019-nCoV)-current scenario, evolutionary perspective based on genome analysis and recent developments

text: Coronaviruses are the well-known cause of severe respiratory, enteric and systemic infections in a wide range of hosts including man, mammals, fish, and avian. The scientific interest on coronaviruses increased after the emergence of Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) outbreaks in 2002-2003 followed by Middle East Respiratory Syndrome CoV (MERS-CoV). This decade's first CoV, named 2019-nCoV, emerged from Wuhan, China, and declared as 'Public Health Emergency of International Concern' on January 30th, 2020 by the World Health Organization (WHO). As on February 4, 2020, 425 deaths reported in China only and one death outside China (Philippines). In a short span of time, the virus spread has been noted in 24 countries. The zoonotic transmission (animal-to-human) is suspected as the route of disease origin. The genetic analyses predict bats as the most probable source of 2019-nCoV though further investigations needed to confirm the origin of the novel virus. The ongoing nCoV outbreak highlights the hidden wild animal reservoir of the deadly viruses and possible threat of spillover zoonoses as well. The successful virus isolation attempts have made doors open for developing better diagnostics and effective vaccines helping in combating the spread of the virus to newer areas.


title: Publisher Correction: Genome-wide association of polycystic ovary syndrome implicates alterations in gonadotropin secretion in European ancestry populations

text: An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Plastic surgery during the COVID-19 pandemic times


title: UK COVID-19 Lockdown: What are the impacts on air pollution

text: A country-wide `lock-down' imposed on the 23red March 2020 in the UK had a significant impact on the UK's anthropogenic movements. The closure of work-places and restrictions imposed on visiting friends and family has radically reduced the amount of traffic on the roads. In this short communication, we use data from UK air-quality sensors to quantify air pollution trends pre- and post-lock-down. While we detect large falls in nitrogen dioxide at levels not seen over the last decade, trends in other pollutants were mixed especially when compared to historical data. It suggests that the implication that lock-down was beneficial for the environment was not so obvious.


docid: chldjsja

title: Reshaping head and neck reconstruction policy during the COVID-19 pandemic peak: Experience in a front-line institution


title: Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: a retrospective cohort study

text: BACKGROUND: Rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, prompted heightened surveillance in Shenzhen, China. The resulting data provide a rare opportunity to measure key metrics of disease course, transmission, and the impact of control measures. METHODS: From Jan 14 to Feb 12, 2020, the Shenzhen Center for Disease Control and Prevention identified 391 SARS-CoV-2 cases and 1286 close contacts. We compared cases identified through symptomatic surveillance and contact tracing, and estimated the time from symptom onset to confirmation, isolation, and admission to hospital. We estimated metrics of disease transmission and analysed factors influencing transmission risk. FINDINGS: Cases were older than the general population (mean age 45 years) and balanced between males (n=187) and females (n=204). 356 (91%) of 391 cases had mild or moderate clinical severity at initial assessment. As of Feb 22, 2020, three cases had died and 225 had recovered (median time to recovery 21 days; 95% CI 20-22). Cases were isolated on average 4·6 days (95% CI 4·1-5·0) after developing symptoms; contact tracing reduced this by 1·9 days (95% CI 1·1-2·7). Household contacts and those travelling with a case were at higher risk of infection (odds ratio 6·27 [95% CI 1·49-26·33] for household contacts and 7·06 [1·43-34·91] for those travelling with a case) than other close contacts. The household secondary attack rate was 11·2% (95% CI 9·1-13·8), and children were as likely to be infected as adults (infection rate 7·4% in children <10 years vs population average of 6·6%). The observed reproductive number (R) was 0·4 (95% CI 0·3-0·5), with a mean serial interval of 6·3 days (95% CI 5·2-7·6). INTERPRETATION: Our data on cases as well as their infected and uninfected close contacts provide key insights into the epidemiology of SARS-CoV-2. This analysis shows that isolation and contact tracing reduce the time during which cases are infectious in the community, thereby reducing the R. The overall impact of isolation and contact tracing, however, is uncertain and highly dependent on the number of asymptomatic cases. Moreover, children are at a similar risk of infection to the general population, although less likely to have severe symptoms; hence they should be considered in analyses of transmission and control. FUNDING: Emergency Response Program of Harbin Institute of Technology, Emergency Response Program of Peng Cheng Laboratory, US Centers for Disease Control and Prevention.


COVID-19 suicides in Pakistan, dying off not COVID-19 fear but poverty? - The forthcoming economic challenges for a developing country


title: Back-projection of COVID-19 diagnosis counts to assess infection incidence and control measures: analysis of Australian data

text: Back-projection is an epidemiological analysis method that was developed to estimate HIV incidence using surveillance data on AIDS diagnoses. It was used extensively during the 1990s for this purpose as well as in other epidemiological contexts. Surveillance data on COVID-19 diagnoses can be analysed by the method of back-projection using information about the probability distribution of the time between infection and diagnosis, which is primarily determined by the incubation period. This paper demonstrates the value of such analyses using daily diagnoses from Australia. It is shown how back-projection can be used to assess the pattern of COVID-19 infection incidence over time and to assess the impact of control measures by investigating their temporal association with changes in incidence patterns. For Australia, these analyses reveal that peak infection incidence coincided with the introduction of border closures and social distancing restrictions, while the introduction of subsequent social distancing measures coincided with a continuing decline in incidence to very low levels. These associations were not directly discernible from the daily diagnosis counts, which continued to increase after the first stage of control measures. It is estimated that a one week delay in peak incidence would have led to a fivefold increase in total infections. Furthermore, at the height of the outbreak, half to three-quarters of all infections remained undiagnosed. Automated data analytics of routinely collected surveillance data are a valuable monitoring tool for the COVID-19 pandemic and may be useful for calibrating transmission dynamics models.


Les liaisons dangereuses and the danger of deductions: The interplay between cardiovascular disease and COVID-19


Letter to the Editor: The first Ramadan during COVID-19 pandemic: 1.8 billion Muslims should fast or not?


Elites can take care of themselves - Comment on COVID-19: the rude awakening for the political elite in low-income and middle-income countries


title: Impacts and strategies for the construction of the disease control and prevention system in the COVID-19 outbreak/ 上海预防医学

text: The outbreak of COVID-19 has exposed many shortcomings in disease control and prevention system (DCPS) of China. Resolving the problems and strengthening the DCPS became the top priority in China’s public policy agenda. This paper revealed the problems of the system regarding policy-making, regulations, operation mechanism and staff, and proposed several strategies from three aspects of legal construction, management system, and operation mechanism, including: 'Prevention first' should be incorporated into the national legal system, all the departments should be engaged in 'Healthy China 2030' initiative, laws and regulations should be amended, new disease prevention and control management institutions should be set up, a high-quality professional team should be retained, the regional health information exchange channels should be strengthened, the coordinated mechanism for disease prevention and control should be normalized, the long-term investment mechanism should be established, and the equipment renewal and reserve system should be improved.


title: Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: A prospective cohort study

text: OBJECTIVE: To describe differences in outcomes between pregnant women with and without COVID-19 DESIGN: Prospective cohort study of pregnant women consecutively admitted for delivery, and universally tested via nasopharyngeal (NP) swab for SARS-CoV-2 using reverse transcriptase polymerase chain reaction (RT-PCR). All infants of mothers with COVID-19 underwent SARS-CoV-2 testing. SETTING: Three New York City hospitals POPULATION: Pregnant women > 20 weeks' gestation admitted for delivery METHODS: Data were stratified by SARS-CoV-2 result and symptomatic status, and summarized using parametric and nonparametric tests. MAIN OUTCOME MEASURES: Prevalence and outcomes of maternal COVID-19; obstetric outcomes; neonatal SARS-CoV-2; placental pathology. RESULTS: Of 675 women admitted for delivery, 10.4% were positive for SARS-CoV-2, of whom 78.6% were asymptomatic. We observed differences in sociodemographics and comorbidities between women with symptomatic vs. asymptomatic vs. no COVID-19. Cesarean delivery rates were 46.7% in symptomatic COVID-19, 45.5% in asymptomatic COVID-19, and 30.9% without COVID-19 (p=0.044). Postpartum complications (fever, hypoxia, readmission) occurred in 12.9% of women with COVID-19 vs 4.5% of women without COVID-19 (p<0.001). No woman required mechanical ventilation, and no maternal deaths occurred. Among 71 infants tested, none were positive for SARS-CoV-2. Placental pathology demonstrated increased frequency of fetal vascular malperfusion, indicative of thrombi in fetal vessels, in women with vs. without COVID-19 (48.3% vs 11.3%, p <0.001). CONCLUSION: Among pregnant women with COVID-19 at delivery, we observed increased cesarean delivery rates and increased frequency of maternal complications in the postpartum period. Additionally, intraplacental thrombi may have maternal and fetal implications for COVID-19 infections remote from delivery.


Outcomes of extracorporeal membrane oxygenation support for patients with COVID-19: A pooled analysis of 331 cases


Doctors' deaths from covid-19 should be reported to the coroner


Long-acting injectable antipsychotics treatment during COVID-19 pandemic - A new challenge


Inpatient Management of COVID-19 Pneumonia: a Practical Approach from the Hospitalist Perspective


Covid-19: Public health agencies review whether vitamin D supplements could reduce risk


title: Herramientas de prevención en las unidades de endoscopia digestiva en época de pandemia

text: El pasado mes de diciembre surgió en Wuhan, China, el SARS-CoV-2, un nuevo coronavirus productor de la coronavirus disease (COVID-19), que al 15 de abril de 2020 ha infectado a más de 2 000 000 de personas y ha causado 128 833 muertes en el mundo Por la forma de transmisión del SARS-CoV-2, las salas de en-doscopia y los procedimientos endoscópicos son una fuente de fácil diseminación, debido a que cumple con las características de un ambiente contaminado para los pacientes y el personal asistencial que participa en los procedimientos endoscópicos Por esta razón, es de gran importancia establecer medidas dentro de las unidades de endoscopia para prevenir y disminuir el riesgo de propagación de esta infección, por medio de la creación de un entorno seguro que proteja a los pacientes y al personal de salud Se realizó una búsqueda en Pubmed con los siguientes términos: ("COVID-19"OR "coronavirus"OR "SARS-Cov-2") y ("gastrointesti-nal"OR "transmission"OR "intestinal"OR "digestive"OR "endoscopy"OR "esophagogastroduodenoscopy"OR "colonoscopy") El grupo de gastroenterología de nuestra institución considera que todos los pacientes llevados a procedimientos endoscópicos deben ser catalogados de alto riesgo, por lo cual presenta las re-comendaciones que todo el personal asistencial de las unidades de endoscopia debe tener en cuenta para disminuir el riesgo de contagio (AU)Last December, SARS-CoV-2 emerged in Wuhan, China, like a new coronavirus, producing the coronavirus disease (COVID-19), that as of April 15, 2020, it has infected more than 2,000,000 people worldwide and caused 128,833 deaths Due to the way SARS-CoV-2 is transmitted, endoscopy rooms and endoscopic pro-cedures are an easy source of dissemination, as they fulfill the different characteristics of a contaminated envi-ronment for patients and healthcare personnel involved in endoscopic procedures It is of great importance to establish measures within endoscopy units to prevent and reduce the risk of spreading this infection, creating a safe environment that protects patients and health personnel A Pubmed search was performed with the following terms: ("COVID-19"OR "coronavirus"OR "SARS-Cov-2") and ("gastrointestinal"OR "transmission"OR "intestinal"OR "digestive"OR "endoscopy "OR"esophagogastroduodenoscopy "OR"colonoscopy ") The gastroenterology team of our institution, considers that all patients brought to endoscopic procedures should be classified as high risk and presents the recommendations that all healthcare staff in endoscopy units, should take into account to reduce the risk of infection (AU)


Fibrinolysis in COVID-19 patients with hemodynamic unstable acute pulmonary embolism: yes or no?


Mental health treatment online during the COVID-19 outbreak


Physician-discretion DNIC (Do Not Initiate Compressions) in the COVID era


Get your obstetric inpatient and outpatient units ready for COVID-19


title: Supporting Real-Time COVID-19 Medical Management Decisions: The Transition Matrix Model Approach

text: Since the onset of the COVID-19 outbreak in Wuhan, China, numerous forecasting models have been proposed to project the trajectory of coronavirus infection cases. We propose a new discrete-time Markov chain transition matrix model that directly incorporates stochastic behavior and for which parameter estimation is straightforward from available data. Using such data from China's Hubei province (for which Wuhan is the provincial capital city), the model is shown to be flexible, robust, and accurate. As a result, it has been adopted by the first Shanghai assistance medical team in Wuhan's Jinyintan Hospital, which was the first designated hospital to take COVID-19 patients in the world. The forecast has been used for preparing medical staff, intensive care unit (ICU) beds, ventilators, and other critical care medical resources and for supporting real-time medical management decisions. Empirical data from China's first two months (January/February) of fighting COVID-19 was collected and used to enhance the model by embedding NPI efficiency into the model. We applied the model to forecast Italy, South Korea, and Iran on March 9. Later we made forecasts for Spain, Germany, France, US on March 24. Again, the model has performed very well, proven to be flexible, robust, and accurate for most of these countries/regions outside China.


title: Early experience with COVID-19 in kidney transplantation recipients: update and review

text: INTRODUCTION: little is known on the risk factors, clinical presentation, therapeutic protocols, and outcomes of kidney transplantation recipients (KTRs) who become infected by SARS-CoV-2. PURPOSE: to provide an updated view regarding the early experience obtained from the management of KTRs with COVID-19. MATERIALS AND METHODS: A narrative review was conducted using PubMed database to identify relevant articles written in English/Spanish, and published through May 15, 2020. Search terms included: "coronavirus", "severe acute respiratory syndrome coronavirus 2", "SARS-CoV-2", "COVID-19", "COVID", "renal transplantation", and "kidney transplantation". Case series were considered eligible, and case reports excluded. Thirty-four articles were included in the review. RESULTS: KTRs should be considered immunocompromised hosts: potential risk for infection, non-negligible comorbidity, and exposure to long-term immunosuppression. Only single center small retrospective experiences are still available regarding KTRs with COVID-19. SARS-CoV-2 symptoms in KTRs are similar to that observed for the general population, being fever and cough the most frequently observed. Mild-to-moderate symptomatic KTRs can be managed in an outpatient setting, while patients exhibiting severe symptoms must be addmited to hospital. More rapid clinical progression, and higher complication and death rates have been observed for hospitalized KTRs, requiring hemodyalisis or ventilatory support. Lymphopenia, elevated serum markers (C-reactive protein, procalcitonin, IL-6, D-dimer), and chest-X-ray findings consistent with pneumonia are linked to worse prognosis. A number of antiviral therapies have been used. However, it is difficult to draw meaningful conclusions regarding their efficacy at this point. Baseline immunosupression regimen should be adjusted in a case-by-case manner. However, it poses a significant challenge.


title: What we know so far: COVID-19 current clinical knowledge and research

text: In December 2019, health authorities in Wuhan, China, identified a cluster of pneumonia cases of unknown aetiology linked to the city's South China Seafood Market. Subsequent investigations revealed a novel coronavirus, SARS-CoV-2, as the causative agent now at the heart of a major outbreak. The rising case numbers have been accompanied by unprecedented public health action, including the wholesale isolation of Wuhan. Alongside this has been a robust scientific response, including early publication of the pathogen genome, and rapid development of highly specific diagnostics. This article will review the new knowledge of SARS-CoV-2 COVID-19 acute respiratory disease, and summarise its clinical features.


text: In December 2019, health authorities in Wuhan, China, identified a cluster of pneumonia cases of unknown aetiology linked to the city's South China Seafood Market Subsequent investigations revealed a novel coronavirus, SARS-CoV-2, as the causative agent now at the heart of a major outbreak The rising case numbers have been accompanied by unprecedented public health action, including the wholesale isolation of Wuhan Alongside this has been a robust scientific response, including early publication of the pathogen genome, and rapid development of highly specific diagnostics This article will review the new knowledge of SARS-CoV-2 COVID-19 acute respiratory disease, and summarise its clinical features , Copyright Notice (C) 2020 Royal College of Physicians


title: Prevalence, Severity and Mortality associated with COPD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is an evolving infectious disease that dramatically spread all over the world in the early part of 2020. No studies have yet summarized the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease (COPD), and we update information in smokers. METHODS: We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. We synthesized a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence rates and 95% confidence intervals (95%CI). RESULTS: In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 7.4%. The pooled prevalence rates of COPD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%. CONCLUSION: Although COPD prevalence in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.


title: The Potential Impact and Availability of Sexual Health Services During the COVID-19 Pandemic

text: As the COVID-19 pandemic causes upheaval in New York City (NYC), 1 consequence is the accessibility of sexual health services. The NYC STD Prevention Training Center at Columbia University administered an online provider survey to understand how the COVID-19 pandemic is affecting the availability of sexual health care services regionally.


title: The COVID-19 Outbreak and Affected Countries Stock Markets Response

text: This paper evaluates the short-term impact of the coronavirus outbreak on 21 leading stock market indices in major affected countries including Japan, Korea, Singapore, the USA, Germany, Italy, and the UK etc. The consequences of infectious disease are considerable and have been directly affecting stock markets worldwide. Using an event study method, our results indicate that the stock markets in major affected countries and areas fell quickly after the virus outbreak. Countries in Asia experienced more negative abnormal returns as compared to other countries. Further panel fixed effect regressions also support the adverse effect of COVID-19 confirmed cases on stock indices abnormal returns through an effective channel by adding up investors' pessimistic sentiment on future returns and fears of uncertainties.


title: COVID-19-related prejudice toward Asian medical students: A consequence of SARS-CoV-2 fears in Poland

text: The coronavirus disease 2019 (COVID-19) outbreak caused by SARS-CoV-2 has triggered global panic. We have conducted an anonymous online survey of Asian medical students in Poland to assess whether they experience any form of prejudice related to the ongoing pandemic. As demonstrated, the COVID-19 outbreak had triggered xenophobic reactions toward students of Asian-origin (n=85) before the first SARS-CoV-2 case was confirmed in Poland. Facing prejudice, including discrimination related to COVID-19, may add to feelings of isolation of students of Asian origin who study abroad, and affect career development, especially for students. We recommend that universities should proactively develop policies that support students, faculty, and staff affected by discriminatory behavior both during the current outbreak and in the future. However, preventing such behaviors should also be enforced by national authorities.


School Nurses: Living the Framework During COVID-19


A case of COVID-19 pneumonia with cerebral hemorrhage


EUS-guided gallbladder drainage during a pandemic crisis - How the COVID-19 outbreak could impact interventional endoscopy


Part of the Cure or Spreader of the Disease?


title: Social distancing and epidemic resurgence in agent-based Susceptible-Infectious-Recovered models

text: Once an epidemic outbreak has been effectively contained through non-pharmaceutical interventions, a safe protocol is required for the subsequent release of social distancing restrictions to prevent a disastrous resurgence of the infection. We report individual-based numerical simulations of stochastic susceptible-infectious-recovered model variants on four distinct spatially organized lattice and network architectures wherein contact and mobility constraints are implemented. We robustly find that the intensity and spatial spread of the epidemic recurrence wave can be limited to a manageable extent provided release of these restrictions is delayed sufficiently (for a duration of at least thrice the time until the peak of the unmitigated outbreak) and long-distance connections are maintained on a low level (limited to less than five percent of the overall connectivity).


title: Adaptive EMG-based hand gesture recognition using hyperdimensional computing

text: Accurate recognition of hand gestures is crucial to the functionality of smart prosthetics and other modern human-computer interfaces. Many machine learning-based classifiers use electromyography (EMG) signals as input features, but they often misclassify gestures performed in different situational contexts (changing arm position, reapplication of electrodes, etc.) or with different effort levels due to changing signal properties. Here, we describe a learning and classification algorithm based on hyperdimensional (HD) computing that, unlike traditional machine learning algorithms, enables computationally efficient updates to incrementally incorporate new data and adapt to changing contexts. EMG signal encoding for both training and classification is performed using the same set of simple operations on 10,000-element random hypervectors enabling updates on the fly. Through human experiments using a custom EMG acquisition system, we demonstrate 88.87% classification accuracy on 13 individual finger flexion and extension gestures. Using simple model updates, we preserve this accuracy with less than 5.48% degradation when expanding to 21 commonly used gestures or when subject to changing situational contexts. We also show that the same methods for updating models can be used to account for variations resulting from the effort level with which a gesture is performed.


title: A noncompeting pair of human neutralizing antibodies block COVID-19 virus binding to its receptor ACE2

text: Neutralizing antibodies could potentially be used as antivirals against the coronavirus disease 2019 (COVID-19) pandemic. Here, we report isolation of four human-origin monoclonal antibodies from a convalescent patient, all of which display neutralization abilities. The antibodies B38 and H4 block binding between the spike glycoprotein receptor binding domain (RBD) of the virus and the cellular receptor angiotensin-converting enzyme 2 (ACE2). A competition assay indicated different epitopes on the RBD for these two antibodies, making them a potentially promising virus-targeting monoclonal antibody pair for avoiding immune escape in future clinical applications. Moreover, a therapeutic study in a mouse model validated that these antibodies can reduce virus titers in infected lungs. The RBD-B38 complex structure revealed that most residues on the epitope overlap with the RBD-ACE2 binding interface, explaining the blocking effect and neutralizing capacity. Our results highlight the promise of antibody-based therapeutics and provide a structural basis for rational vaccine design.