title: Hepatitis C Virus Core Protein Promotes miR-122 Destabilization by Inhibiting GLD-2

text: The liver-specific microRNA miR-122, which has essential roles in liver development and metabolism, is a key proviral factor for hepatitis C virus (HCV). Despite its crucial role in the liver and HCV life cycle, little is known about the molecular mechanism of miR-122 expression regulation by HCV infection. Here, we show that the HCV core protein downregulates the abundance of miR-122 by promoting its destabilization via the inhibition of GLD-2, a non-canonical cytoplasmic poly(A) polymerase. The decrease in miR-122 expression resulted in the dysregulation of the known functions of miR-122, including its proviral activity for HCV. By high-throughput sequencing of small RNAs from human liver biopsies, we found that the 22-nucleotide (nt) prototype miR-122 is modified at its 3′ end by 3′-terminal non-templated and templated nucleotide additions. Remarkably, the proportion of miR-122 isomers bearing a single nucleotide tail of any ribonucleotide decreased in liver specimens from patients with HCV. We found that these single-nucleotide-tailed miR-122 isomers display increased miRNA activity and stability over the 22-nt prototype miR-122 and that the 3′-terminal extension is catalyzed by the unique terminal nucleotidyl transferase activity of GLD-2, which is capable of adding any single ribonucleotide without preference of adenylate to the miR-122 3′ end. The HCV core protein specifically inhibited GLD-2, and its interaction with GLD-2 in the cytoplasm was found to be responsible for miR-122 downregulation. Collectively, our results provide new insights into the regulatory role of the HCV core protein in controlling viral RNA abundance and miR-122 functions through miR-122 stability modulation.


title: Rapid discovery and optimization of therapeutic antibodies against emerging infectious diseases

text: Using a comprehensive set of discovery and optimization tools, antibodies were produced with the ability to neutralize SARS coronavirus (SARS-CoV) infection in Vero E6 cells and in animal models. These anti-SARS antibodies were discovered using a novel DNA display method, which can identify new antibodies within days. Once neutralizing antibodies were identified, a comprehensive and effective means of converting the mouse sequences to human frameworks was accomplished using HuFR™ (human framework reassembly) technology. The best variant (61G4) from this screen showed a 3.5–4-fold improvement in neutralization of SARS-CoV infection in vitro. Finally, using a complete site-saturation mutagenesis methodology focused on the CDR (complementarity determining regions), a single point mutation (51E7) was identified that improved the 80% plaque reduction neutralization of the virus by greater than 8-fold. These discovery and evolution strategies can be applied to any emerging pathogen or toxin where a causative agent is known.


Pneumopathie infiltrante subaiguë avec aspect radiologique en verre dépoli


title: Javamide-II Inhibits IL-6 without Significant Impact on TNF-alpha and IL-1beta in Macrophage-Like Cells

text: The main aim of this study is to find a therapeutic compound to inhibit IL-6, not TNF-alpha and IL-1beta, in macrophage-like cells, because the high-levels of IL-6 production by macrophages are reported to cause unfavorable outcomes under several disease conditions (e.g., autoimmune diseases, and acute viral infections, including COVID-19). In this study, the potential effects of javamide-II on IL-6, IL-1beta and TNF-alpha productions were determined using their ELISA kits in macrophage-like THP-1 cells. Western blots were also performed using the same cells, to determine its effects on signaling pathways (ERK, p38, JNK, c-Fos, ATF-2, c-Jun and NF-κB p65). At concentrations of 0.2–40 µM, javamide-II inhibited IL-6 production significantly in the THP-1 cells (IC(50) of 0.8 µM) (P < 0.02). However, javamide-II did not inhibit IL-1beta or TNF-alpha productions much at the same concentrations. In addition, the treatment of javamide-II decreased the phosphorylation of p38 without significant effects on ERK and JNK phosphorylations in the THP-1 cells. Furthermore, the p38 inhibition, followed by the reduction of ATF-2 phosphorylation (not c-Fos, c-Jun or NF-κB p65), led to the suppression of IL-6 mRNA expression in the cells (P < 0.02). The data indicate that javamide-II may be a potent compound to inhibit IL-6 production via suppressing the p38 signal pathway, without significant effects on the productions of TNF-alpha and IL-1beta in macrophage-like THP-1 cells.


title: Creating a Bundled Care Payment Model for Treatment of Pelvic Floor Disorders: Introducing Value into Urogynecology

text: Abstract Ineffective healthcare delivery and expenditures associated with traditional fee for service in-person models have turned attention towards alternative payment models as a means of enhancing healthcare quality in the United States. Bundled Care Payment Models are a form of alternate payment models that provide a single reimbursement for all services rendered for an episode of care and have been developed extensively in primary care settings with limited literature in urogynecology. We describe the process used to create a Bundled Care Payment Model for women seeking care in a pelvic floor disorders subspecialty clinic in partnership with our safety net insurer. The process included estimation of prior average spend, the design of an integrated practice unit, creation of pelvic floor pathways, approximation of utilization rates, and estimation of reimbursement and expenses.


title: Emerging, Novel, and Known Influenza Virus Infections in Humans

text: Influenza viruses continue to cause yearly epidemics and occasional pandemics in humans. In recent years, the threat of a possible influenza pandemic arising from the avian influenza A(H5N1) virus has prompted the development of comprehensive pandemic preparedness programs in many countries. The recent emergence of the pandemic influenza A(H1N1) 2009 virus from the Americas in early 2009, although surprising in its geographic and zoonotic origins, has tested these preparedness programs and revealed areas in which further work is necessary. Nevertheless, the plethora of epidemiologic, diagnostic, mathematical and phylogenetic modeling, and investigative methodologies developed since the severe acute respiratory syndrome outbreak of 2003 and the subsequent sporadic human cases of avian influenza have been applied effectively and rapidly to the emergence of this novel pandemic virus. This article summarizes some of the findings from such investigations, including recommendations for the management of patients infected with this newly emerged pathogen.


docid: zdcnvxht

title: COVID-19: A Time for Alternate Models in Cardiac Rehabilitation to Take Center Stage


title: Field Efficacy of an Attenuated Infectious Bronchitis Variant 2 Virus Vaccine in Commercial Broiler Chickens

text: Egyptian poultry suffer from frequent respiratory disease outbreaks associated with Infectious Bronchitis Virus (IBV) variant 2 strains (Egy/VarII). Different vaccination programs using imported vaccines have failed to protect the flocks from field challenge. Recent studies confirmed a successful protection using homologous strains as live attenuated vaccines. In this study, a newly developed live attenuated IB-VAR2 vaccine representing the GI-23 Middle East IBV lineage was evaluated in day-old commercial broilers in an IBV-endemic area. A commercial broiler flock was vaccinated with the IB-VAR2 vaccine at day-old age followed by IB-H120 at day 16. The vaccinated flock was monitored on a weekly basis till the slaughter age. The health status and growth performance were monitored, and selected viral pathogen real-time RT-PCR (rRT-PCR) detection was conducted on a weekly basis. Finally, the flock was compared to a nearby farm with only the classical IB-H120 vaccination program. Results showed that the IB-VAR2 vaccine was tolerable in day-old broiler chicks. The IBV virus rRT-PCR detection was limited to the trachea as compared to its nephropathogenic parent virus. Respiratory disease problems and high mortalities were reported in the IB-H120-only vaccinated flock. An exposure to a wild-type Egy/VarII strain was confirmed in both flocks as indicated by partial IBV S1 gene sequence. Even though the IB-VAR2-vaccinated flock performance was better than the flock that received only IB-H120, the IBV ELISA (enzyme-linked immunosorbent assay) and log2 Haemagglutination inhibition (HI) antibody mean titers remained high (3128 ± 2713 and ≥9 log2, respectively) until the 28th day of age. The current study demonstrates the safety and effectiveness of IB-VAR2 as a live attenuated vaccine in day-old commercial broilers. Also, the combination of IB-VAR2 and classical IBV vaccines confers a broader protective immune response against IBV in endemic areas.


title: The first complete genome sequences of clinical isolates of human coronavirus 229E

text: Human coronavirus 229E has been identified in the mid-1960s, yet still only one full-genome sequence is available. This full-length sequence has been determined from the cDNA-clone Inf-1 that is based on the lab-adapted strain VR-740. Lab-adaptation might have resulted in genomic changes, due to insufficient pressure to maintain gene integrity of non-essential genes. We present here the first full-length genome sequence of two clinical isolates. Each encoded gene was compared to Inf-1. In general, little sequence changes were noted, most could be attributed to genetic drift, since the clinical isolates originate from 2009 to 2010 and VR740 from 1962. Hot spots of substitutions were situated in the S1 region of the Spike, the nucleocapsid gene, and the non-structural protein 3 gene, whereas several deletions were detected in the 3′UTR. Most notable was the difference in genome organization: instead of an ORF4A and ORF4B, an intact ORF4 was present in clinical isolates.


title: Relating plaque morphology to respiratory syncytial virus subgroup, viral load, and disease severity in children

text: BACKGROUND: Viral culture plaque morphology in human cell lines are markers for growth capability and cytopathic effect, and have been used to assess viral fitness and select preattenuation candidates for live viral vaccines. We classified respiratory syncytial virus (RSV) plaque morphology and analyzed the relationship between plaque morphology as compared to subgroup, viral load and clinical severity of infection in infants and children. METHODS: We obtained respiratory secretions from 149 RSV-infected children. Plaque morphology and viral load was assessed within the first culture passage in HEp-2 cells. Viral load was measured by polymerase chain reaction (PCR), as was RSV subgroup. Disease severity was determined by hospitalization, length of stay, intensive care requirement, and respiratory failure. RESULTS: Plaque morphology varied between individual subjects; however, similar results were observed among viruses collected from upper and lower respiratory tracts of the same subject. Significant differences in plaque morphology were observed between RSV subgroups. No correlations were found among plaque morphology and viral load. Plaque morphology did not correlate with disease severity. CONCLUSION: Plaque morphology measures parameters that are viral-specific and independent of the human host. Morphologies vary between patients and are related to RSV subgroup. In HEp-2 cells, RSV plaque morphology appears unrelated to disease severity in RSV-infected children. SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1038/pr.2015.122) contains supplementary material, which is available to authorized users.


title: Virus infections, wheeze and asthma

text: Abstract Viral infections are the most frequent triggers of wheeze and asthma and yet their role in the development of symptoms remains controversial. Pre-existing airway abnormalities contribute to early virus-induced symptoms which usually remit in early childhood, whereas an interaction with airway inflammation causes exacerbations in asthma. However, the distinction between these two groups and the reason why some but not other children wheeze with viral infections is still debated. The effect of early infections on the developing immune system is also complex. The successful maturation of the T-cell response from a predominantly type 2 (atopic predisposition) at birth to a predominantly type 1 (optimal viral immunity) response, is influenced by genetic factors and the number of infections, as both are known to affect outcome. The relative parts played by predisposition and immunomodulation by early infections in later development of asthma are still controversial. These contentions are gradually being resolved by detailed prospective studies.


The response of microglia and astrocytes to the infected cortical neurons induced by a coronavirus


docid: uceukiie

title: Chapter 15 Exercise, Immunity, and Illness

text: Abstract It is generally accepted that moderate amounts of exercise improve immune system functions and hence reduce the risk of infection whereas athletes engaged in regular prolonged and/or intensive training have a higher than “normal” incidence of minor infections, especially of the upper respiratory tract (URT, e.g., common cold and influenza). This is likely related to regular acute (and possibly chronic) periods of exercise-induced changes in immune function. URT infections can compromise performance directly if suffered shortly before or during competition or indirectly if suffered at other times via effects on training and/or physiological adaptations. This chapter covers the effects of exercise (acute and chronic), both positive and negative, on immune function and consequent infection risk, and considers the current state-of-the-art for monitoring and assessing this in athletes.


title: Analyzing situational awareness through public opinion to predict adoption of social distancing amid pandemic COVID‐19

text: COVID‐19 pandemic has affected over 100 countries in a matter of weeks. People's response toward social distancing in the emerging pandemic is uncertain. In this study, we evaluated the influence of information (formal and informal) sources on situational awareness of the public for adopting health‐protective behaviors such as social distancing. For this purpose, a questionnaire‐based survey was conducted. The hypothesis proposed suggests that adoption of social distancing practices is an outcome of situational awareness which is achieved by the information sources. Results suggest that information sources, formal (P = .001) and informal (P = 0.007) were found to be significantly related to perceived understanding. Findings also indicate that social distancing is significantly influenced by situational awareness, P = .000. It can, therefore, be concluded that an increase in situational awareness in times of public health crisis using formal information sources can significantly increase the adoption of protective health behavior and in turn contain the spread of infectious diseases.


title: Rapid Development of an Outpatient‐To‐Inpatient Crash Curriculum for COVID Providers

text: The COVID‐19 pandemic has caused critical staff shortages and thus required innovative approaches to bring providers into the hospital workforce (1), including those who may not have performed inpatient general medicine care for many years. Our educational group felt an urgent need to create educational content to re‐familiarize these anxious providers with common inpatient scenarios. Our goal was to rapidly author and distribute high‐yield educational resources to non‐inpatient medical providers who could be pulled to cover inpatient general medicine services.


title: Sequence analysis of the membrane protein gene of human coronavirus 229E

text: Abstract Human coronaviruses (HCV) are ubiquitous pathogens which cause respiratory, gastrointestinal, and possibly neurological disorders. To better understand the molecular biology of the prototype HCV-229E strain, the complete nucleotide sequence of the membrane protein (M) gene was determined from cloned cDNA. The open reading frame is preceded by a consensus transcriptional initiation sequence UCUAAACU, identical to the one found upstream of the N gene. The M gene encodes a 225-amino acid polypeptide with a molecular weight (MW) of 25,822, slightly higher than the apparent MW of 19,000–22,000 observed for the unprocessed M protein obtained after in vitro translation and immunoprecipitation. The M amino acid sequence presents a significant degree of homology (38%) with its counterpart of transmissible gastroenteritis coronavirus (TGEV). The M protein of HCV-229E is highly hydrophobic and its hydropathicity profile shows a transmembranous region composed of three major hydrophobic domains characteristic of a typical coronavirus M protein. About 10% (20 amino acids) of the HCV-229E M protein constitutes a hydrophilic and probably external portion. One N-glycosylation and three potential O-glycosylation sites are found in this exposed domain.


eCAM benefits from diversity that derives from CAM


title: Mass Screening for SARS-CoV-2 Infection among Residents and Staff in Twenty-eight Long-term Care Facilities in Fulton County, Georgia

text: Mass screening for SARS-CoV-2 infection in long-term care facilities revealed significantly higher prevalence of infection in facilities that screened in response to a known infection compared to those that screened as a prevention measure. “Response” facilities had a SARS-CoV-2 prevalence of 28.9% while “preventive” facilities’ prevalence was 1.6% (p <0.001).


title: Caractéristiques microbiologiques et cliniques des patients hospitalisés pour suspicion d’infection à Middle East Respiratory Syndrome coronavirus (MERS-CoV) au cours de la période 2013–2016

text: Introduction Depuis 2012 dans le monde, l’infection due à MERS-CoV a été responsable de 1826 cas dont 649 décès. En France, 1568 patients ont été notifiés comme cas suspects dont 478 cas possibles. Seuls 2 cas ont été confirmé dont un décès. L’objectif de cette étude était d’évaluer les caractéristiques démographiques, cliniques et microbiologiques des patients cas possibles hospitalisés. Matériels et méthodes Étude rétrospective de tous les patients adultes hospitalisés dans les unités d’isolement de 2 services référents pour le MERS-CoV entre janvier 2013 et décembre 2016. Résultats Quatre-vingt treize patients ont été hospitalisés pour suspicion de MERS-CoV dont 10 (11 %) en unité de soins intensifs. L’âge médian était de 63,4 ans et 49 patients étaient des hommes (53 %). Quatre-vingt-deux revenaient d’Arabie saoudite (88 %) dont 75 (81) pour pèlerinage. L’examen clinique retrouvait un foyer pulmonaire chez 61 patients (66 %), une toux chez 89 (95 %) et une température médiane de 38,5°C. Des anomalies radiologiques étaient retrouvées initialement dans 73 cas (78 %). Les 93 patients étaient négatifs en PCR pour MERS-CoV. La documentation microbiologique était négative pour 21 (23 %) patients, mais a révélé 40 infections virales (43 %), 13 (14 %) infections bactériennes, 9 (10 %) co-infections bactérie-virus et 7 co-infections virus-virus (8 %). Les Rhinovirus étaient les principaux micro-organismes (26, 28 %), puis les virus influenza (25, 27 %), et les coronavirus non-MERS (5, 6 %). Sept (8 %) infections à Legionella pneumophilia et 7 (8 %) infections à Streptococcus pneumoniae ont été mises en évidence. Une antibiothérapie a été initié dans 81 (87 %) cas dont 63 bithérapie (68 %). La durée de bithérapie était inférieure à 48heures chez 34 patients (37 %) et l’antibiothérapie a été stoppée au cours des 48 premières heures pour 7 (8 %) patients. La durée médiane d’hospitalisation était de 3jours (1–33) et la durée médiane d’isolement était de 24heures (8–92). Deux patients sont décédés, l’un dû à une grippe maligne et l’autre à une endocardite infectieuse à S. aureus. Conclusion De 2013 à 2016 sur 93 patients hospitalisés pour suspicion de MERS-CoV, aucun nouveau cas d’infection à MERS-CoV n’a été confirmé. Les virus respiratoires saisonniers étaient la principale cause d’infection pulmonaire dans ce contexte bien que la pathogénicité de tous les virus identifiés ne puisse pas être confirmée. Les infections bactériennes et les co-infections bactérie-virus ont représenté 22 cas (24 %), plaidant pour l’instauration d’une antibiothérapie empirique efficace contre le pneumocoque et la légionnelle dans les premières heures de la prise en charge des cas suspects de MERS-CoV.


title: Telephone or Visit-Based Community Health Worker Care Management for Uncontrolled Diabetes Mellitus: A Longitudinal Study

text: Community health workers (CHWs) can reduce health disparities for low income patients but type of contact and outcomes has had limited study. Low-income Hispanic primary care patients with hemoglobin A1c [HbA1c] ≥ 9% received care managment (CM) over 6 months classified as: (CM1) telephone only; (CM2) clinic visit but no calls; (CM3) clinic visit with calls; and (CM4) ≥ 2 visits ± calls. Type of CM delivery and time to DM control (HbA1c < 9%) examined in Cox proportional hazards model and more rapid control within 6 months using logistic regression. Models adjusted for demographics, clinical, and health care variables. At baseline, 523 patients had mean HbA1c 10.9% (SD = 1.7%), mean age 57.9 years (SD = 10), 58.5% women, 87.6% Hispanic, and 55.5% uninsured. CM types for patients: 51 (9.8%) CM1; 192 (36.7%) CM2; 44 (8.4%) CM3; and 236 (45.4%) CM4. Median time to HbA1c control was 197 days (95% CI [71, 548]) and 41.5% achieved control within 6 months. Compared with CM1, control was more rapid for CM2 (Hazard ratio [HR] 1.45, 95% CI [1.01, 2.09], p = 0.043) and CM4 but not significant (HR [95% CI] 1.29 [0.91, 1.83], p = 0.15). Adjusted odds of more rapid control within 6 months were twofold higher for CM2 (p = 0.04) and CM4 (p = 0.055), respectively, versus CM1. CM2 did not differ from CM1. DM control was less likely for CM by telephone only than face-to-face in clinic. To benefit vulnerable patients with uncontrolled DM, in-person engagement may be required.


title: Human metapneumovirus pneumonia in patients with hematological malignancies

text: Abstract Background Human metapneumovirus (HMPV) has recently emerged as a cause of respiratory infections in hematological patients. Clinical data are lacking to guide the management of HMPV pneumonias. Objectives To characterize the clinical and radiographic presentation and outcome of HMPV pneumonias diagnosed in hematological patients. Study design We screened the patients with a positive HMPV respiratory test in two French teaching hospitals between 2007 and 2011. Among them, the medical charts from the hematological patients who presented with HMPV pneumonia were reviewed. Results Among the 54 patients with several underlying hematological conditions who were positive for HMPV, we found 13 cases of HMPV pneumonias. HMPV could be the cause of pneumonia as a single pathogen without associated upper respiratory infection. Centrilobular nodules were constant on lung computed tomography scans. No patients died despite the absence of administration of antiviral treatments. Conclusions Our data provide further insights in the diagnosis and management of HMPV pneumonias in this setting.


Reply to: Personal Protective Equipment Recommendations Based on COVID-19 Route of Transmission


Control of Nosocomial Methicillin-Resistant Staphylococcus aureus Infection


title: Physician and Nurse Practitioner Roles in Emergency, Trauma, Critical and Intensive Care

text: Abstract Importance The delivery of emergency, trauma, critical and intensive care services requires coordination among all members of the care team. Perceived teamwork and role clarity may vary among physicians (MDs) and nurse practitioners (NPs). Objective To examine differences in perceived roles and responsibilities of NPs and MDs practicing in emergency, trauma, critical and intensive care. Main Outcome(s) and Measure(s) Key clinical activities, perceptions of role clarity, teamwork and preparedness to function as a team in disaster Design Secondary Analysis of the National Survey of Emergency, Intensive and Critical Care Nurse Practitioners and Physicians, a 2015 cross-sectional national survey of clinicians. Setting Mail survey of randomly selected stratified cross-sectional samples of MDs and NPs drawn from national lists of clinicians in eligible specialties working in emergency, trauma, intensive and critical care units in the United States. Participants 814 clinicians (351 NPs and 463 MDs) recruited from national by postal mail survey. Our initial sample included n=2063 clinicians, n=1031 NPs and n=1032 MDs in eligible specialties. Of these, 63.5% of NPs and 70.1% of MDs completed and returned the survey excluding those who were ineligible due to lack of current practice in a relevant specialty Results NPs in ICU/CCU are more likely to be female and report working fewer hours than do MDs and provide direct care to more patients. 55% of NPs and 82% of MDs agree that their individual role in their unit is clear (p<.001); 34% of MDs and 42% of NPs agree that their unit is an example of excellent team work among professionals (p=0.021); 41% of MD and 37% of NP clinicians (p=0.061) agree that their teams are “prepared to provide outstanding care in a crisis or disaster”. Perceived role clarity was significantly associated with increased perceptions of excellent teamwork and disaster preparedness. Conclusion and Relevance Leaders of health organizations need to engage with one another and with their professional teams to assure that roles and responsibilities are clear and that teams are both prepared to provide the highest quality and efficient care in critical care and in disaster.


docid: upwsdgso

title: Identifying a Kidney Transplant Recipient COVID Phenotype to Aid Test Utilization in the Setting of Limited Testing Availability - Does One Exist?

text: Abstract: The high morbidity and mortality of COVID-19 in immunocompetent patients raises significant concern for immunosuppressed kidney transplant recipients (KTRs). This level of concern, both on the part of the KTRs and transplant professionals, is heightened by a lack of prior knowledge on how SARS-CoV-2 may manifest differently in immunosuppressed patients. Characterizing how KTRs may present differently than the general population would allow for more targeted and timely evaluation and treatment of KTRs with COVID-19 infection. Methods Without prior knowledge of how this virus would affect our transplant center’s delivery of care to KTRs who are SARS-CoV-2 positive or Patients Under Investigation (PUIs), and in the setting of limited testing availability, we initiated a Quality Assurance and Improvement Project (QAPI) to track KTRs followed at our transplant center through the SARS-CoV-2 testing process. Results Of the 53 symptomatic patients, 20 (38%) tested positive for SARS-CoV-2 either on presentation to the emergency department, or referral to a designated outpatient testing center. In addition, 16 (80%) of the 20 patients who tested positive required inpatient treatment. Intriguingly, patients with a history of polyoma BK viremia (BKV) had a higher incidence of testing positive for SARS-CoV-2 compared to patients without history of BKV (80% and 28%, respectively; p= 0.002). The Positive Predictive Value and Likelihood ratio was 80% and 6.6 for this association, respectively. Among our KTRs tested, those receiving belatacept had a lower likelihood of testing positive for SARS-CoV-2. This finding approached, but did not achieve, statistical significance (p=0.06).


title: Detection of canine kobuvirus RNA in diarrheic fecal samples of dogs with parvoviruses

text: Canine kobuvirus (CaKV) is a member of the Picornaviridae family and the Kobuvirus genus. CaKV was first described in fecal samples from diarrheic dogs in the USA in 2011, with subsequent reports in the UK, Italy, South Korea, China, Tanzania, and Japan. CaKV is frequently identified in feces of animals with or without clinical signs of gastroenteritis. The present study investigated the presence of CaKV in fecal samples from 53 diarrheic dogs from Londrina, southern Brazil. Using a RT-PCR assay, CaKV RNA was identified in three dogs, resulting in an overall occurrence rate of 5.7%. In addition, coinfection with canine parvovirus subtype 2b was detected in all CaKV-positive diarrheic fecal samples. Using a phylogenetic analysis based on the VP1 gene sequence, the Brazilian CaKV field strains were found to be very similar to a previously identified CaKV strain from Brazil that was found in the tissue of a puppy and were also found to be clustered with other CaKV strains detected worldwide and other kobuvirus strains identified in mouse, feline, and human hosts.


title: Deep Transfer Learning based Classification Model for COVID-19 Disease

text: Abstract The COVID-19 infection is increasing at a rapid rate, with the availability of limited number of testing kits. Therefore, the development of COVID-19 testing kits is still an open area of research. Recently, many studies have shown that chest Computed Tomography(CT) images can be used for COVID-19 testing, as chest CT images show a bilateral change in COVID-19 infected patients. However, the classification of COVID-19 patients from chest CT images is not an easy task as predicting the bilateral change is defined as an ill-posed problem. Therefore, in this paper, a deep transfer learning technique is used to classify COVID-19 infected patients. Additionally, a top-2 smooth loss function with cost-sensitive attributes is also utilized to handle noisy and imbalanced COVID-19 dataset kind of problems. Experimental results reveal that the proposed deep transfer learning-based COVID-19 classification model provides efficient results as compared to the other supervised learning models.


title: A computer based system for collection, storage, retrieval and reporting accession information in a veterinary medical diagnostic laboratory

text: Abstract Substantial data collected from large numbers of accessions, the need for comprehensive reporting of negative as well as positive laboratory findings, and the necessity for obtaining rapid diagnostic correlations prompted the development of a computer based system of accession data management for collection, storage, rapid retrieval, reporting, concording, and administrative compiling in a state-university Veterinary Medical Diagnostic Laboratory.


title: Anästhesie- und Intensivbeatmungsgeräte: Unterschiede und Nutzbarkeit bei COVID-19-Patienten

text: The current coronavirus disease 2019 (Covid-19) pandemia is a highly dynamic situation characterized by therapeutic and logistic uncertainties. Depending on the effectiveness of social distancing, a shortage of intensive care respirators must be expected. Concomitantly, many physicians and nursing staff are unaware of the capabilities of alternative types of ventilators, hence being unsure if they can be used in intensive care patients. Intensive care respirators were specifically developed for the use in patients with pathological lung mechanics. Nevertheless, modern anesthesia machines offer similar technical capabilities including a number of different modes. However, conceptual differences must be accounted for, requiring close monitoring and the presence of trained personnel. Modern transport ventilators are mainly for bridging purposes as they can only be used with 100% oxygen in contaminated surroundings. Unconventional methods, such as „ventilator-splitting“, which have recently received increasing attention on social media, cannot be recommended. This review intends to provide an overview of the conceptual and technical differences of different types of mechanical ventilators.


title: Disintermediation of travel agents in the hotel industry

text: The trend of massive disintermediation is threatening the livelihood of travel agents. This paper investigates the disintermediation of travel agents in the hospitality industry when hotels take distribution back into their own hands by setting up websites that allow guests to make bookings online. We analyze the factors affecting an agent's possible responses to a hotel's destructive acts, and put forward suggestions to agents to fight against the trend of disintermediation. We also point out what hotels can do to improve the quality of their relationship with their agents should they decide to launch their online channel.


title: Exercise against SARS-CoV-2 (COVID-19): Does workout intensity matter? (A mini review of some indirect evidence related to obesity)

text: ABSTRACT SARS-CoV-2 (COVID-19) is a new virus causing respiratory illness outbreak. Nowadays, COVID-19 has spread to several countries around the world and is presently a major global concern. It appears that no certain effective pharmaceutical agent is currently available for it. It seems that obesity is one of the biggest risk factors related to COVID-19 hospitalization and critical illness. The strengthening of the body systems by non-drug ways is very important especially in obese people. On the basis of some indirect evidence, it seems that moderate physical activity can be recommended as a non-pharmacological, inexpensive, and viable way to cope with corona. On the other hand, recommending higher intensity exercise needs further consideration to make final decision in this regard.


docid: qgefumxe

title: Myosins 1 and 6, myosin light chain kinase, actin and microtubules cooperate during antibody-mediated internalisation and trafficking of membrane-expressed viral antigens in feline infectious peritonitis virus infected monocytes

text: Monocytes infected with feline infectious peritonitis virus, a coronavirus, express viral proteins in their plasma membranes. Upon binding of antibodies, these proteins are quickly internalised through a new clathrin- and caveolae-independent internalisation pathway. By doing so, the infected monocytes can escape antibody-dependent cell lysis. In the present study, we investigated which kinases and cytoskeletal proteins are of importance during internalisation and subsequent intracellular transport. The experiments showed that myosin light chain kinase (MLCK) and myosin 1 are crucial for the initiation of the internalisation. With co-localisation stainings, it was found that MLCK and myosin 1 co-localise with antigens even before internalisation started. Myosin 6 co-localised with the internalising complexes during passage through the cortical actin, were it might play a role in moving or disintegrating actin filaments, to overcome the actin barrier. One minute after internalisation started, vesicles had passed the cortical actin, co-localised with microtubules and association with myosin 6 was lost. The vesicles were further transported over the microtubules and accumulated at the microtubule organising centre after 10 to 30 min. Intracellular trafficking over microtubules was mediated by MLCK, myosin 1 and a small actin tail. Since inhibiting MLCK with ML-7 was so efficient in blocking the internalisation pathway, this target can be used for the development of a new treatment for FIPV.


title: Effects of Yu-Ping-Feng polysaccharides (YPS) on the immune response, intestinal microbiota, disease resistance and growth performance of Litopenaeus vannamei

text: A 28-day feeding trial was conducted to investigate the effects of Yu-Ping-Feng polysaccharides (YPS) containing Astragalus polysaccharides (APS), Atractylodes macrocephala polysaccharides (AMP) and Saposhnikoviae polysaccharides (SPS) on the immune response, intestinal microbiota, disease resistance and growth performance of Litopenaeus vannamei. Seven hundred and twenty shrimp (3.04 ± 0.33 g) were fed the following diets: Control, YPS1 (0.13% APS + 0.0325% AMP + 0.0325% SPS), YPS2 (0.13% APS + 0.0325% AMP + 0.065% SPS) and YPS3 (0.13% APS + 0.0325% AMP+0.0975% SPS). After 14 and 28 days of feeding, the immune responses of hemocytes and intestine were measured. Intestinal microbiota and growth performance were measured after 28 days of feeding, after that, a 7-day challenge test against Vibrio harveyi was conducted. A significant (P < 0.05) increase of the total haemocyte count (THC), phagocytic activity, antibacterial activity and phenoloxidase (PO) activity was observed in shrimp fed YPS diets compared to the control. Also, dietary YPS supplementation particularly YPS3 group significantly increased the expressions of immune-related genes in the hemocytes and intestine. Regarding the intestinal microbiota, the microbial diversity and richness decreased and functional genes associated with short-chain fatty acids metabolism increased in YPS groups. After Vibrio harveyi challenge, the cumulative mortality in YPS groups was significantly lower than that of the control. Besides, dietary YPS had no significant effect on growth performance of shrimp (P > 0.05). The present results suggested that YPS could be considered as potential prebiotics for aquaculture farmed shrimp.


title: Cross sectional and longitudinal surveys of canine enteric coronavirus infection in kennelled dogs: A molecular marker for biosecurity

text: Abstract Previous studies have suggested that kennelled dogs are more likely to test positive for CECoV than household pets. Here we describe both cross sectional and longitudinal studies in two rescue kennels and two boarding kennels, together with molecular diagnostics, to provide a new insight into the epidemiology of CECoV. Prevalence of CECoV in the cross sectional studies tended to be higher in the rescue kennels (13.8% and 33.3%) than the boarding kennels (5.3% and 13.5%). In each kennel, type I CECoV was more prevalent than type 2 CECoV. The mean quantity of type I detected was equivalent to 6.3×108 gc/gm (range=5×106, 8.5×1011), compared to 1.3×108 gc/gm (range=3×106, 2.4×1010) for type II. In one rescue shelter where dogs were followed longitudinally, infection was significantly associated with accommodation block as well as the length of stay (increased risk of CECoV per week in residence of ×1.9). Of those animals sampled on two or more occasions, none tested positive on arrival, and 54.5% later shed CECoV, suggesting that infection may have been acquired within the kennel. Shedding patterns and sequence analysis suggested both types I and II CECoV were maintained in this population by a combination of introductions into the shelter and within-shelter transmission. The findings suggest that some kennel environments may be important in maintaining CECoV infection in the population. We also propose that the diversity of viruses like CECoV in these populations may provide a novel surrogate marker for the success of biosecurity.


title: Viral Fusion Peptides Induce Several Signal Transduction Pathway Activations That Are Essential for Interleukin-10 and Beta-Interferon Production

text: OBJECTIVES: The deciphering of intracellular signaling pathways that are activated by the interaction between viral fusion peptides and cellular membranes are important for the understanding of both viral replication strategies and host defense mechanisms. METHODS: Fusion peptides of several enveloped viruses belonging to different virus families were prepared by standard 9-fluorenylmethoxycarbonyl polyamine solid-phase synthesis and used to stimulate U937 cells in vitro to analyze the phosphorylation patterns of the signaling pathways (PKC, Src, Akt, and MAPK pathways). Immunoprecipitation and Western blotting were carried out by using phosphospecific antibodies. All samples were also assayed for the presence of IL-10 and IFN-β by ELISA and activation of nuclear factors (AP-1 and NF-κB). RESULTS: We have demonstrated that hydrophobic domains of fusion proteins are able to induce several transduction pathways that lead to cytokine (IFN-β and IL-10) production, an event that appears to be dependent on early activation of AP-1 and NF-κB. CONCLUSIONS: The results obtained on the signaling activity of fusion peptides from different viruses enabled us to shed some light on the complex mechanism of viral entry and more precisely we focused on the exact signaling event induced by hydrophobic domains characteristic of fusion peptides interacting with the cell membrane.


title: The challenges and experiences of psychotherapists working remotely during the coronavirus pandemic

text: The experiences and challenges of psychotherapists working remotely during the coronavirus pandemic were explored using a mixed‐methods approach. An online survey completed by 335 psychotherapists produced both quantitative and qualitative data with the latter being subject to a reflexive thematic analysis. Large numbers of therapists were using video‐link platforms and the telephone to conduct client sessions. A majority of therapists felt challenged by remote working, with reduced interpersonal cues, feelings of isolation and fatigue, and technical issues frequently cited concerns. At the same time, most therapists considered that remote working had been effective and that clients were comfortable with the process. Two‐thirds of therapists indicated that remote working would now become core business for them. The great majority of therapists thought that remote working skills should be part of formal therapy trainings.


title: Guías para el manejo de la neumonía comunitaria del adulto que precisa ingreso en el hospital

text: La neumonía adquirida en la comunidad (NAC) sigue siendo un problema sanitario de primer orden. En España, la incidencia de este tipo de infección es de 162 casos por cada 100.000 habitantes, lo que supone 53.000 hospitalizaciones al año y un coste de 115 millones de euros. Además, en los últimos años se han producido avances significativos en el conocimiento de la etiología y el diagnóstico de la enfermedad. Al mismo tiempo se está consiguiendo una mejor comprensión del problema derivado del aumento de las resistencias bacterianas, y han aparecido nuevas alternativas terapéuticas para el manejo de esta enfermedad. Por todo ello, un grupo de expertos pertenecientes a tres sociedades científicas de nuestro país (Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias - SEMICYUC; Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica - SEIMC; Sociedad Española de Neumología y Cirugía Torácica - SEPAR) se han reunido para, tras una revisión crítica de la literatura, elaborar las presentes Guías para el manejo de la NAC. En ellas se abordan aspectos de epidemiología, índices pronósticos, etiología, diagnóstico, tratamiento y prevención de la enfermedad. El objetivo que se persigue es ayudar a los clínicos en la toma de decisiones, sin olvidar destacar la importancia que tiene el conocer las características particulares de la NAC en cada zona. Community acquired pneumonia is still an important health problem. In Spain the year incidence is 162 cases per 100,000 inhabitants with 53,000 hospital admission costing 115 millions of euros per year. In the last years there have been significant advances in the knowledge of: aetiology, diagnostic tools, treatment alternatives and antibiotic resistance. The Spanish Societies of Intensive and Critical Care (SEMICYUC), Infectious Diseases and Clinical Microbiology (SEIMC) and Pulmonology and Thoracic Surgery (SEPAR) have produced these evidence-based Guidelines for the management of community acquired pneumonia in Adults. The main objective is to help physicians to make decisions about this disease. The different points that have been developed are: aetiology, diagnosis, treatment and prevention.


title: Respiratory syncytial virus in Brazilian infants – Ten years, two cohorts

text: Abstract Background Each year, a considerable amount of children will experience at least one episode of acute viral bronchiolitis (AVB) during their first year of life. About 10% of them will be hospitalized, with significant physical and economic burdens. Objectives To compare two cohorts of infants with AVB, from same region, in a ten-year interval, regarding epidemiologic factors and viral etiology. Study design Cohorts: 142 (2004) and 172 (2014) infants at ages zero to 12 months; clinical diagnosis of AVB; medical care in hospital and genetic screening of nasopharyngeal secretion for respiratory viruses. Results The comparative analysis showed a difference in the percentage of respiratory syncytial virus (RSV) positive patients [2004 (33.1%); 2014 (70.3%)] (p<0.01). No differences were noted regarding gender, breastfeeding, tobacco exposure, crowding and maternal education. There was a difference as to the month of incidence (seasonality) of AVB (higher in April 2014). There was a higher age at attendance in the first cohort, and lower birth weight and gestational age ratios in the second cohort (p<0.05). There were no differences in hospitalization time, need of mechanical ventilation and number of deaths, however a difference regarding co-morbidities was noted (higher in 2004) (p<0.001). Conclusion None of the analyzed variables had an impact on severity features. Virology and immunology must be considered in this kind of situation, by studying genetic variants and the maturation of the immune system in AVB by RSV or other viruses.


title: Recomendaciones para reumatólogos sobre el manejo farmacológico durante la emergencia sanitaria COVID-19: opinión grupo de expertos

text: Resumen La infección por Coronavirus 2019 (COVID-19) es una pandemia inesperada que ha provocado un estado de emergencia y generado cambios drásticos en los protocolos de atención clínica. Para su tratamiento se ha descrito el papel de algunos medicamentos usados habitualmente en artritis reumatoide, lupus eritematoso sistémico y otras enfermedades autoinmunes sistémicas. Debido a ello, existe un inminente riesgo de desabastecimiento, por lo cual el objetivo de esta revisión narrativa y opinión de expertos es formular recomendaciones generales clínicas y administrativas sobre el manejo de pacientes ambulatorios con enfermedad autoinmune o inflamatoria sistémica en el contexto de la pandemia por COVID-19. Abstract Coronavirus 2019 (COVID-19) is an unexpected pandemic that has caused a state of emergency, as well as generating drastic changes in clinical care protocols. Some drugs commonly used in rheumatoid arthritis, systemic lupus erythematosus, and other systemic autoimmune diseases have been described for its treatment. Therefore, there is an imminent risk of shortages. The aim of this narrative review and expert opinion is to present general recommendations on the clinical and administrative management of outpatients with autoimmune or systemic inflammatory disease, in the context of the COVID-19 pandemic.


title: Parainfluenza 3 Respiratory Infection Associated with Pericardial Effusion in a Very Low Birthweight Infant

text: Parainfluenza 3 virus is a frequent cause of respiratory infections in the pediatric population although it is uncommonly diagnosed in neonates, being usually reported as neonatal intensive care unit microepidemics. We report a case of parainfluenza 3 respiratory infection associated with pericardial effusion in a very low birthweight infant.


title: COVID‐19 patients benefit from early antiviral treatment: a comparative, retrospective study

text: BACKGROUND: The outbreak of COVID‐19, caused by SARS‐CoV‐2, started in December 2019, Wuhan, China. We aimed to figure out the time‐point and duration of using antiviral drugs for receiving the maximal effects in patients with COVID‐19. METHODS: In this study, we enrolled 129 confirmed COVID‐19 mild to moderate patients who had been treated with antiviral drugs during their hospitalization in Wuhan Union Hospital China. The patients were divided into early antiviral treatment group and late antiviral treatment group. The demographic data, laboratory tests, the virus clearance time, chest computed tomography (CT) scans, etc. were extracted, calculated and compared between two groups. RESULTS: Our data showed that the median time from illness onset to initiation of antiviral treatment was 6 days in all patients. The group with early antiviral treatment demonstrated 7 days shorter in the virus clearance time when compared to the group with late antiviral treatment. After virus clearance, the group with early antiviral treatment showed milder illness than the group with late antiviral treatment. CONCLUSIONS: Early antiviral treatment could effectively shorten the virus clearance time, and prevent the rapid progression of COVID‐19. Therefore, the COVID‐19 patients should receive combined therapies with antiviral treatment at early stage. This article is protected by copyright. All rights reserved.


title: Chapter 3 SARS coronavirus infections of the lower respiratory tract and their prevention

text: Abstract The Severe Acute Respiratory Syndrome (SARS) coronavirus was first identified in 2003 when it caused an epidemic of fatal human pneumonia cases that rapidly spread to multiple countries from an epicenter in Hong Kong. The outbreak was eventually controlled by quarantine measures but not before it had caused many fatalities. The original zoonotic source of the SARS virus that caused the outbreak is still unknown but is suspected to be bats. Attempts were made to develop a prophylactic vaccine but the SARS epidemic was over before any vaccines could be tested for human efficacy. As will be discussed in this chapter, coronavirus vaccines present many challenges including low and rapidly waning immunity and the fact that coronavirus vaccines, particularly when formulated with Th2-biased alum adjuvants, can exacerbate coronavirus infection-associated eosinophilic lung immunopathology. Fortunately, this problem can be avoided by formulation of coronavirus vaccines with Th1-type adjuvants that enhance T cell IFN-γ responses, such as, delta inulin or TLR agonists. Hence, appropriate adjuvant selection is vitally important for the development of safe and effective coronavirus vaccines. This chapter will describe the current state of development of SARS vaccines, the issue of coronavirus-associated eosinophilic lung immunopathology and how adjuvants can be used to reduce the risk of this complication.


title: Chapter 14 Nanoparticles in Antiviral Therapy

text: Abstract In addition to general unavailability of specific antiviral therapeutics for a variety of viral diseases, usage of most antiviral drugs is linked to their limited solubility in aqueous media, short half-life time, and inadequate penetration to specified anatomic compartments. Accordingly, there is continuous effort to improve physicochemical characteristics of existing antiviral drugs. Since nanomaterials display remarkable physical and chemical properties, high surface area to volume ratio, and increased reactivity, new approaches for antiviral therapies include combinations of nanomaterials and current antiviral agents. Multivalent nanostructures, polymers, dendrimers, and liposomes can establish multivalent binding interactions with many biological systems and thus can target pathogenic interactions. There are reports about anitiviral activities of different metal nanoparticles, especially silver nanoparticles and their potential for treatment, prophylaxis, and control of viral infections. Integration of classic antiviral drugs, in the form of multiple ligands, onto nanostructures provides the advantages by creating a high local concentration of active molecules. This article will summarize the antiviral activity of different nanoparticle-based approaches currently available for the treatment of viral infections, and it will discuss metal nanoparticles as possible future antiviral drugs.


La continuité pédagogique à l'épreuve du Covid-19


title: Rapid NK-cell activation in chicken after infection with infectious bronchitis virus M41

text: Abstract Natural killer (NK) cells are cytotoxic lymphocytes and play an important role in the early defence against viruses. In this study we focussed on NK cell and interferon (IFN) responses after infection with infectious bronchitis virus (IBV). Based on surface expression of CD107+, enhanced activation of lung NK cells was observed at 1dpi, whereas in blood prolonged NK-cell activation was found. IFN-α and IFN-β mRNA and proteins were not rapidly induced whereas IFN-γ production in lung, measured by Elispot assay, increased over time at 2 and 4dpi. In contrast, IFN-γ production in blood was highest at 1dpi and decreased over time down to levels comparable to uninfected birds at 4dpi. Collectively, infection with IBV-M41 resulted in activation of NK cells in the lung and blood and rapid production of IFN-γ and not IFN-α and IFN-β compared to uninfected birds.


title: Aetiology-Specific Estimates of the Global and Regional Incidence and Mortality of Diarrhoeal Diseases Commonly Transmitted through Food

text: BACKGROUND: Diarrhoeal diseases are major contributors to the global burden of disease, particularly in children. However, comprehensive estimates of the incidence and mortality due to specific aetiologies of diarrhoeal diseases are not available. The objective of this study is to provide estimates of the global and regional incidence and mortality of diarrhoeal diseases caused by nine pathogens that are commonly transmitted through foods. METHODS AND FINDINGS: We abstracted data from systematic reviews and, depending on the overall mortality rates of the country, applied either a national incidence estimate approach or a modified Child Health Epidemiology Reference Group (CHERG) approach to estimate the aetiology-specific incidence and mortality of diarrhoeal diseases, by age and region. The nine diarrhoeal diseases assessed caused an estimated 1.8 billion (95% uncertainty interval [UI] 1.1–3.3 billion) cases and 599,000 (95% UI 472,000–802,000) deaths worldwide in 2010. The largest number of cases were caused by norovirus (677 million; 95% UI 468–1,153 million), enterotoxigenic Escherichia coli (ETEC) (233 million; 95% UI 154–380 million), Shigella spp. (188 million; 95% UI 94–379 million) and Giardia lamblia (179 million; 95% UI 125–263); the largest number of deaths were caused by norovirus (213,515; 95% UI 171,783–266,561), enteropathogenic E. coli (121,455; 95% UI 103,657–143,348), ETEC (73,041; 95% UI 55,474–96,984) and Shigella (64,993; 95% UI 48,966–92,357). There were marked regional differences in incidence and mortality for these nine diseases. Nearly 40% of cases and 43% of deaths caused by these nine diarrhoeal diseases occurred in children under five years of age. CONCLUSIONS: Diarrhoeal diseases caused by these nine pathogens are responsible for a large disease burden, particularly in children. These aetiology-specific burden estimates can inform efforts to reduce diarrhoeal diseases caused by these nine pathogens commonly transmitted through foods.


title: Selection of adjuvants for vaccines targeting specific pathogens

text: Introduction: Adjuvants form an integral component in most of the inactivated and subunit vaccine formulations. Careful and proper selection of adjuvants helps in promoting appropriate immune responses against target pathogens at both innate and adaptive levels such that protective immunity can be elicited. Areas covered: Herein, we describe the recent progress in our understanding of the mode of action of adjuvants that are licensed for use in human vaccines or in clinical or pre-clinical stages at both innate and adaptive levels. Different pathogens have distinct characteristics, which require the host to mount an appropriate immune response against them. Adjuvants can be selected to elicit a tailor-made immune response to specific pathogens based on their unique properties. Identification of biomarkers of adjuvanticity for several candidate vaccines using omics-based technologies can unravel the mechanism of action of modern and experimental adjuvants. Expert opinion: Adjuvant technology has been revolutionized over the last two decades. In-depth understanding of the role of adjuvants in activating the innate immune system, combined with systems vaccinology approaches, have led to the development of next-generation, novel adjuvants that can be used in vaccines against challenging pathogens and in specific target populations.


Optimising SARS-CoV-2 pooled testing for low-resource settings


Heart Team meetings during COVID-19


docid: lrquaasd

title: Exopolysaccharides from probiotic bacteria and their health potential

text: Exopolysaccharides (EPS) are extracellular macromolecules excreted as tightly bound capsule or loosely attached slime layer in microorganisms. They play most prominent role against desiccation, phagocytosis, cell recognition, phage attack, antibiotics or toxic compounds and osmotic stress. In the last few decades, natural polymers have gained much attention among scientific communities owing to their therapeutic potential. In particular the EPS retrieved from probiotic bacteria with varied carbohydrate compositions possess a plenty of beneficial properties. Different probiotic microbes have unique behavior in expressing their capability to display significant health promoting characteristics in the form of polysaccharides. In this new era of alternative medicines, these polysaccharides are considered as substitutes for synthetic drugs. The EPS finds applications in various fields like textiles, cosmetics, bioremediation, food and therapeutics. The present review is focused on sources, chemical composition, biosynthetic pathways of EPS and their biological potential. More attention has been given to the scientific investigations on antimicrobial, antitumor, anti-biofilm, antiviral, anti-inflammatory and immunomodulatory activities.


title: Role of the microbiology laboratory in infectious disease surveillance, alert and response

text: ABSTRACT Surveillance is usually defined as the ongoing and systematic collection, analysis and interpretation of health data essential to the planning, implementation and evaluation of public health practice. During recent years, most of these programmes have been developed in the field of antimicrobial resistance and nosocomial infections, but efforts have also been made in other areas. Recent experiences of emerging microbial threats, including severe acute respiratory syndrome and new influenza variants affecting humans, the re-emergence of infectious disease problems and the possibility of bioterrorism have evidenced the need for implementation of infectious disease surveillance programmes. Clinical microbiology laboratories play a pivotal role in these programmes. They have the first opportunity to detect these problems and should participate in the design of reporting strategies and dissemination of this information. Policies for the flow of data to national and international authorities should be established using passive surveillance strategies. However, active surveillance programmes taking advantage of new methodologies, including virtual tools and mathematical programs, should be the goal for early detection of unusual patterns of microbial pathogens, outbreaks and healthcare-associated infections. In addition, early implementation of response strategies should be designed and performed with the cooperation of microbiology laboratories, and intervention and response protocols should be defined with the participation of clinical microbiologists.


title: Molecular cloning of the gene encoding the putative polymerase of mouse hepatitis coronavirus, strain A59

text: Abstract Complementary DNA (cDNA) libraries were constructed representing the genome RNA of the coronavirus mouse hepatitis virus, strain A59 (MHV-A59). From these libraries clones were selected to form a linear map across the entire gene A, the putative viral polymerase gene. This gene is approximately 23 kb in length, considerably larger than earlier estimates. Sequence analysis of the U terminal region of the genome indicates the presence of the 66-nucleotide leader that is found on all mRNAs. Secondary structure analysis of the 5′terminal region suggests that transcription of leader terminates in the region of nucleotide 66. The sequence of the first 2000 nucleotides is very similar to that reported for the closely related JHM strain of MHV and potentially encodes p28, a basic protein thought to be a component of the viral polymerase (L. Soe, C. K. Shieh, S. Baker, M. F. Chang, and M. M. C. Lai, 1987, J. Virol., 61, 3968–3976). Gene A contains two of the consensus sequences found in intergenic regions. One is adjacent to the 5′ leader sequence and the other is upstream from the initiation codon for translation of gene B.


title: Examination for a viral co-factor in postweaning multisystemic wasting syndrome (PMWS)

text: Abstract In order to test the hypothesis that a putative co-factor for the development of postweaning multisystemic wasting syndrome (PMWS) in pigs could be of viral origin, we performed extensive virological examinations on organ material from pigs diagnosed with PMWS originating from within a Danish PMWS-transmission study. Virus isolation attempts were carried out on a large panel of different cell types including primary pig kidney cells and lung macrophages, primary rabbit kidney cells and seven established cell lines (MARC-145, ST117, PK15, BHK21, HeLa, Vero, and MDCK). Although these represent cells with susceptibility to a wide range of known viruses, the results did not provide evidence for a specific virus other than PCV2 contributing to the development of PMWS. Furthermore, in order to test whether specific genotypes of PCV2 may trigger the switch from PCV2 infection to clinical disease, we compared complete DNA genome sequences of PCV2 derived from PMWS-positive as well as PMWS-negative pigs. On the basis of the DNA sequences, the PCV2 isolates were divided into two groups. Group 1 consisting of one isolate originating from a herd unaffected by PMWS, with group 2 consisting of nine isolates originating from four PMWS-affected herds, four PMWS-positive pigs plus one unaffected herd. The PCV2 genomes from the two groups showed 95.5% identity. Alignment analyses of the sequences encoding the replicase and capsid protein from group 1 and group 2 PCV2 isolates showed two amino acid differences encoded in the replicase protein, while 19 amino acid differences were predicted among the capsid protein sequences. The PCV2 DNA sequence analysis supports recent observations from studies in USA as well as Europe, which suggest that strain variations may influence the clinical outcome of PCV2 infection.


title: Spécificité d’hôte des virus et passages inter-espèces

text: Résumé Les virus possèdent habituellement une spécificité d’hôte et sont inféodés à une espèce animale. Cette spécificité est conditionnée par la sensibilité des cellules au virus et donc par la présence de récepteurs spécifiques sur la cellule hôte. La permissivité de la cellule, c’est-à-dire sa capacité à permettre la réplication du virus, peut également conditionner cette spécificité d’hôte. Toutefois, pour de nombreux virus, cette spécificité d’hôte n’est pas absolue et des passages inter-espèces sont possibles. Les virus provenant d’un réservoir animal pouvant infecter l’homme sont responsables de zoonoses. L’émergence de ces zoonoses est favorisée par les perturbations des équilibres naturels résultant de l’activité humaine. Des mutations peuvent permettre une meilleure adaptation des virus d’origine animale à l’espèce humaine et favoriser ainsi leur propagation épidémique. Summary Most viruses are host-specific and thus, they are closely associated to an animal species. This host specificity is conditioned by the cell susceptibility to the virus, given by the host cell receptors, and by the cell permissivity that relies on the availability of cellular factors required for viral replication. However, for many viruses, this host specificity is not absolute and inter-species transmissions are possible. Viruses which can be transmitted from an animal reservoir to humans are responsible for zoonotic diseases. Human activities and their impact on the natural environment dramatically contribute to emergence of zoonoses. Selection of viral mutations that confer better adaptation of animal viruses to humans may lead to epidemic spread of these diseases.


title: The value of China-Africa health development initiatives in strengthening “One Health” strategy

text: Abstract Implementing national to community-based “One Health” strategy for human, animal and environmental challenges and migrating-led consequences offer great opportunities, and its value of sustained development and wellbeing is an imperative. “One Health” strategy in policy commitment, partnership and financial investment are much needed in advocacy, contextual health human-animal and environmental development. Therefore, appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives. It is necessary to understand how to strengthen robust and sustainable “One Health” approach implementation in national and regional public health and disaster risk reduction programs. Understanding the foundation of “One Health” strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics. Building the value of China-Africa “One Health” strategy partnerships, frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives, but also, mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms. Further strengthen local infrastructure and workforce capacity, participatory accountability and transparency on “One Health” approach will benefit to set up infectious diseases of poverty projects, and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.


title: An Atypical Presentation of Acute Pulmonary Embolism With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pneumonia

text: Clinical presentation and severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) varies greatly amongst patients, as supported by recent literature. This poses an ongoing challenge in the diagnostic and therapeutic approach for managing these patients. Here, we would like to describe a case of acute bilateral pulmonary embolism (PE) presenting with atypical gastrointestinal symptoms in a patient with SARS-CoV-2 infection. This atypical presentation of PE is unique to our case and highlights the significance of a high index of clinical suspicion for SARS-CoV-2 and its associated thrombogenic effect, even in patients with atypical symptoms.


title: Coronavirus disease (COVID-19): A systematic review and meta-analysis to evaluate the impact of various comorbidities on serious events

text: BACKGROUND AND AIMS: Currently there is limited knowledge on medical comorbidities and COVID-19; we conducted a systematic review and meta-analysis to evaluate the impact of various morbidities on serious events in COVID 19. METHODS: PubMed, Cochrane Central Register of Clinical Trials were searched on April 28, 2020, to extract published articles that reported the outcomes of COVID-19 patients. The search terms were “coronavirus” and “clinical characteristics”. ICU admission, mechanical ventilation, ARDS, Pneumonia, death was considered serious events. The comorbidities assessed in the study were Hypertension (HTN), Diabetes mellitus (DM), Cardiovascular diseases (CVD), Chronic obstructive pulmonary disease (COPD) and Chronic Kidney disease (CKD). Subsequently, comparisons between comorbidity patient group and the non-comorbidity patient groups, in terms of serious events were made using the pooled estimates of odd’s ratio (OR) RESULTS: We identified 688 published results and 16 studies with 3994 patients were included in the systematic review. Serious events were seen in 526(13.16%) patients. Presence of hypertension with OR 2.95, diabetes mellitus with OR 3.07, Cardio vascular disease with OR 4.58, COPD with OR 6.66 and Chronic kidney disease with OR 5.32 had significant association in patients with COVID 19 on having serious events. Presence of diabetes mellitus (OR 2.78)) had a significant impact on death in COVID 19 patients with a p-value 0.004. CONCLUSIONS: Presence of medical comorbidities in COVID-19 leads to higher risk of developing serious events i.e. ICU admission, mechanical intubation and mortality. The presence of Diabetes mellitus has a significant impact on mortality rate in COVID-19 patients.


title: Identification of a new human coronavirus

text: Three human coronaviruses are known to exist: human coronavirus 229E (HCoV-229E), HCoV-OC43 and severe acute respiratory syndrome (SARS)-associated coronavirus (SARS-CoV). Here we report the identification of a fourth human coronavirus, HCoV-NL63, using a new method of virus discovery. The virus was isolated from a 7-month-old child suffering from bronchiolitis and conjunctivitis. The complete genome sequence indicates that this virus is not a recombinant, but rather a new group 1 coronavirus. The in vitro host cell range of HCoV-NL63 is notable because it replicates on tertiary monkey kidney cells and the monkey kidney LLC-MK2 cell line. The viral genome contains distinctive features, including a unique N-terminal fragment within the spike protein. Screening of clinical specimens from individuals suffering from respiratory illness identified seven additional HCoV-NL63-infected individuals, indicating that the virus was widely spread within the human population. SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1038/nm1024) contains supplementary material, which is available to authorized users.


title: Quantification of Torque Teno Virus and Epstein-Barr Virus Is of Limited Value for Predicting the Net State of Immunosuppression After Lung Transplantation

text: BACKGROUND: Major hurdles for survival after lung transplantation are rejections and infectious complications. Adequate methods for monitoring immune suppression status are lacking. Here, we evaluated quantification of torque teno virus (TTV) and Epstein-Barr virus (EBV) as biomarkers for defining the net state of immunosuppression in lung-transplanted patients. METHODS: This prospective single-center study included 98 patients followed for 2 years after transplantation. Bacterial infections, fungal infections, viral respiratory infections (VRTI), cytomegalovirus (CMV) viremia, and acute rejections, as well as TTV and EBV levels, were monitored. RESULTS: The levels of torque teno virus DNA increased rapidly after transplantation, likely due to immunosuppressive treatment. A modest increase in levels of Epstein-Barr virus DNA was also observed after transplantation. There were no associations between either TTV or EBV and infectious events or acute rejection, respectively, during follow-up. When Tacrolimus was the main immunosuppressive treatment, TTV DNA levels were significantly elevated 6–24 months after transplantation as compared with Cyclosporine treatment. CONCLUSIONS: Although replication of TTV, but not EBV, appears to reflect the functionality of the immune system, depending on the type of immunosuppressive treatment, quantification of TTV or EBV as biomarkers has limited potential for defining the net state of immune suppression.


title: Physical activity recommendations during the COVID-19 virus outbreak

text: • Confinement and prolonged periods of inactivity incure various health risks and increase levels of stress, depression, and anxiety. • Being physically active is a simple and effective way of addressing these negative effects. • Even in confinement and limited free movement people can remain physically active. • Prevention of COVID-19 infection should not increase other health risks. • Exercise professionals should encourage organizations, local authorities, and governments to promote PA during this period of mass quarantine.


title: More on COVID‐19 coagulopathy in Caucasian patients

text: We are grateful for the comments of Marrietta et al, [1] and welcome the opportunity to provide further details on the coagulopathy observed in our patients with COVID-19 infection [2]. The weight-adjusted low molecular weight heparin (LMWH) thromboprophylaxis used in the study is that routinely used for hospital in-patients in our institution, consistent with national recommendations [3,4] With respect to the cohort of patients with COVID-19 enrolled in our study, it is important to highlight that 74% of patients received enoxaparin 40mg (4000 IU) subcutaneously once daily.


title: An Overview of Transforming Changes at Mayo Clinic Proceedings During 2005

text: For the past 6 years, the Editorial Board and staff of Mayo Clinic Proceedings have dedicated ourselves to the progressive evolution of this journal. During this period, and for the foreseeable future, we have embraced change and improvement as themes for our daily efforts. As such, the changes identified in this communication are not a leap forward for the journal, they merely represent the next logical step in the growth of the journal. Given the momentum that has developed during the past few years, readers should expect to see further changes, all intended to better communicate with our principal readers, practicing physicians. In the final analysis, we are driven by a rededication of the journal to the primary value of Mayo Clinic: "The needs of the patient come first." While the journal's leadership has long looked to this statement for guidance, our approach to addressing this value in 2005 will require a considerable number of innovations. We look forward to sharing with you, our readers, these next steps in the journal's history. We trust that we will be able to learn and grow together so that, in the final analysis, the journal will build on its reputation as an authoritative and respected source of information.


COVID-19 infection prevention and control practices in Wuhan radiotherapy


title: Effect of COVID-19 pandemic on practice in european radiation oncology centers

text: ESTRO surveyed European radiation oncology department heads to evaluate the impact of COVID-19. Telemedicine was used in 78% of the departments, and 60% reported a decline in patient volume. Use of protective measures was implemented on a large scale, but shortages of personal protective equipment were present in more than half of the departments.


title: A Scorpion Defensin BmKDfsin4 Inhibits Hepatitis B Virus Replication in Vitro

text: Hepatitis B virus (HBV) infection is a major worldwide health problem which can cause acute and chronic hepatitis and can significantly increase the risk of liver cirrhosis and primary hepatocellular carcinoma (HCC). Nowadays, clinical therapies of HBV infection still mainly rely on nucleotide analogs and interferons, the usage of which is limited by drug-resistant mutation or side effects. Defensins had been reported to effectively inhibit the proliferation of bacteria, fungi, parasites and viruses. Here, we screened the anti-HBV activity of 25 scorpion-derived peptides most recently characterized by our group. Through evaluating anti-HBV activity and cytotoxicity, we found that BmKDfsin4, a scorpion defensin with antibacterial and Kv1.3-blocking activities, has a comparable high inhibitory rate of both HBeAg and HBsAg in HepG2.2.15 culture medium and low cytotoxicity to HepG2.2.15. Then, our experimental results further showed that BmKDfsin4 can dose-dependently decrease the production of HBV DNA and HBV viral proteins in both culture medium and cell lysate. Interestingly, BmKDfsin4 exerted high serum stability. Together, this study indicates that the scorpion defensin BmKDfsin4 also has inhibitory activity against HBV replication along with its antibacterial and potassium ion channel Kv1.3-blocking activities, which shows that BmKDfsin4 is a uniquely multifunctional defensin molecule. Our work also provides a good molecule material which will be used to investigate the link or relationship of its antiviral, antibacterial and ion channel–modulating activities in the future.


title: Why all COVID-19 Hospitals should have Mental Health Professionals: The importance of mental health in a worldwide crisis!

text: Abstract COVID-19 pandemic has led to a worldwide crisis. At present, everyone is focusing on the prevention of COVID-19 infection, preparing and discussing issues related to physical health consequences. However, it is important to understand that the life-threatening negative physical health consequences are going to be faced by a few, but everyone is going to face the negative mental health consequences of the pandemic. At various places COVID-19 hospitals are being established, to address the physical health consequences of the pandemic. However, mental health professionals have not been very actively involved in the management of people going through this pandemic. This viewpoint discusses the mental health consequences of the pandemic for the health care workers, people who are undergoing quarantine, people who are admitted to the COVID-19 hospitals, and those who have recovered from the infection. The article also highlights the mental health needs of people at different levels and the kind of interventions, which may be carried out.


title: Glycyrrhizic acid as a multifunctional drug carrier – From physicochemical properties to biomedical applications: A modern insight on the ancient drug

text: Abstract Glycyrrhizic acid is the main active component of Licorice root which has been known in traditional Chinese and Japanese medicine since ancient times. In these cultures glycyrrhizic acid (GA) is one of the most frequently used drugs. However, only in 21-st century a novel unusual property of the GA to enhance the activity of other drugs has been discovered. The review describes briefly the experimental evidences of wide spectrum of own biological activities of glycyrrhizic acid as well as discusses the possible mechanisms of the ability of GA to enhance the activity of other drugs. We have shown that due to its amphiphilic nature GA is able to form self-associates in aqueous and non-aqueous media, as well as water soluble complexes with a wide range of lipophilic drugs. The main purpose of our review is to focus reader's attention on physicochemical studies of the molecular mechanisms of GA activity as a drug delivery system (DDS). In our opinion, the most intriguing feature of glycyrrhizic acid which might be the key factor in its therapeutic activity is the ability of GA to incorporate into the lipid bilayer and to increase the membrane fluidity and permeability. The ability of biomolecules and their aggregates to change the properties of cell membranes is of great significance, from both fundamental and practical points of view.


title: Role of Viral Molecular Panels in Diagnosing the Etiology of Fever in Infants Younger Than 3 Months

text: As infants with proven viral infection present lower risk of bacterial infection, we evaluated how molecular methods detecting viruses on respiratory secretions could contribute to etiological diagnostic of these febrile episodes. From November 2010 to May 2011, we enrolled all febrile infants <90 days presenting to emergency room. Standard workup included viral rapid antigenic test and viral culture on nasopharyngeal aspirate. Samples negative by rapid testing were tested by molecular methods. From 208 febrile episodes (198 infants) with standard techniques, rate of documented microbiological etiology was 13% at emergency department, 47% during hospitalization, and 64% with viral cultures. Molecular methods increased microbiologically documented etiology rate by 12%, to 76%. Contribution of molecular methods was the highest in infants without clinical source of infection, increasing documentation by 18%, from 50% to 68%. Making viral molecular results rapidly available could help identifying a higher proportion of infants at low risk of serious bacterial infection.


title: Profile and quality of published reviews on COVID‐19

text: COVID‐19 has created the necessity to rapidly generate evidence to enlighten many blind spots encompassing the pandemic, from pathophysiology to management. Scientific journals have timely responded to this challenge by prioritizing COVID‐19 research, with proactive editorial efforts favoring open‐access to articles, launching calls for papers, implementing specific sections and special issues on COVID‐19, among others. However, the impact of all these measures on the overall quality and adequacy of research are largely unknown and several authors have shown concern in this regard.


Review of: “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial Gautret et al 2010, DOI:10.1016/j.ijantimicag.2020.105949


title: Novel rapid immunochromatographic test based on an enzyme immunoassay for detecting nucleocapsid antigen in SARS‐associated coronavirus

text: A novel severe acute respiratory syndrome‐associated coronavirus (SARS‐CoV) has been discovered. The detection of both antigens and antibodies in SARS‐CoV from human specimens with suspected SARS plays an important role in preventing infection. We developed a novel rapid immunochromatographic test (RICT) based on the sandwich format enzyme immunoassay (EIA) with an all‐in‐one device for detecting the native nucleocapsid antigen (N‐Ag) of SARS‐CoV using monoclonal antibodies (MoAbs), which we produced by immunizing recombinant N‐Ag to mice. RICT is a qualitative assay for respiratory aspirates and serum specimens. With this assay, a positive result can be judged subjectively by the appearance of a blue line on the device 15 min after the sample is applied. RICT with several pairs of MoAbs showed a high sensitivity for the detection of recombinant N‐Ag as well as viral N‐Ag of SARS‐CoV. rSN122 and rSN21‐2 were the best MoAbs for immobilized antibody and enzyme labeling, respectively. With regard to analytical sensitivity, RICT detected N‐Ag at 31 pg/mL for recombinant N‐Ag, and at 1.99×10(2) TCID(50)/mL for SARS‐CoV. The specificity of RICT was 100% when 150 human sera and 50 nasopharyngeal aspirates (NSPs) were used. RICT based on an EIA using the rSN122/rSN21‐2 pair is a sensitive, specific, and reliable rapid assay for detecting N‐Ag in SARS‐CoV treated with either heat or Triton X‐100. J. Clin. Lab. Anal. 19:150–159, 2005. © 2005 Wiley‐Liss, Inc.


title: Central Role of Ubiquitination in Genome Maintenance: DNA Replication and Damage Repair

text: Faithful transmission of genetic information through generations ensures genomic stability and integrity. However, genetic alterations occur every now and then during the course of genome duplication. In order to repair these genetic defects and lesions, nature has devised several repair pathways which function promptly to prevent the cell from accumulating permanent mutations. These repair mechanisms seem to be significantly impacted by posttranslational modifications of proteins like phosphorylation and ubiquitination. Protein ubiquitination is emerging as a critical regulatory mechanism of DNA damage response. Non-proteolytic, proteasome-independent functions of ubiquitin involving monoubiquitination and polyubiquitination of DNA repair proteins contribute significantly to the signaling of DNA repair pathways. In this paper, we will particularly highlight the work on ubiquitin-mediated signaling in the repair processes involving the Fanconi anemia pathway, translesional synthesis, nucleotide excision repair, and repair of double-strand breaks. We will also discuss the role of ubiquitin ligases in regulating checkpoint mechanisms, the role of deubiquitinating enzymes, and the growing possibilities of therapeutic intervention in this ubiquitin-conjugation system.


title: Post-vaccination encephalomyelitis: Literature review and illustrative case

text: Abstract Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system that is usually considered a monophasic disease. ADEM forms one of several categories of primary inflammatory demyelinating disorders of the central nervous system including multiple sclerosis, optic neuropathy, acute transverse myelitis, and neuromyelitis optica (Devic’s disease). Post-infectious and post-immunisation encephalomyelitis make up about three-quarters of cases, where the timing of a febrile event is associated with the onset of neurological disease. Post-vaccination ADEM has been associated with several vaccines such as rabies, diphtheria–tetanus–polio, smallpox, measles, mumps, rubella, Japanese B encephalitis, pertussis, influenza, hepatitis B, and the Hog vaccine. We review ADEM with particular emphasis on vaccination as the precipitating factor. We performed a literature search using Medline (1976–2007) with search terms including “ADEM”, “acute disseminated encephalomyelitis”, “encephalomyelitis”, “vaccination”, and “immunisation”. A patient presenting with bilateral optic neuropathies within 3 weeks of “inactivated” influenza vaccination followed by delayed onset of ADEM 3 months post-vaccination is described.


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title: Sars-CoV-2 et Kawasaki, rapprochement à risque


COVID-19: Una pandemia de valores


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title: Social determinants of health in Canada: Are healthy living initiatives there yet? A policy analysis

text: INTRODUCTION: Preventative strategies that focus on addressing the social determinants of health to improve healthy eating and physical activity have become an important strategy in British Columbia and Ontario for combating chronic diseases. What has not yet been examined is the extent to which healthy living initiatives implemented under these new policy frameworks successfully engage with and change the social determinants of health. METHODS: Initiatives active between January 1, 2006 and September 1, 2011 were found using provincial policy documents, web searches, health organization and government websites, and databases of initiatives that attempted to influence to nutrition and physical activity in order to prevent chronic diseases or improve overall health. Initiatives were reviewed, analyzed and grouped using the descriptive codes: lifestyle-based, environment-based or structure-based. Initiatives were also classified according to the mechanism by which they were administered: as direct programs (e.g. directly delivered), blueprints (or frameworks to tailor developed programs), and building blocks (resources to develop programs). RESULTS: 60 initiatives were identified in Ontario and 61 were identified in British Columbia. In British Columbia, 11.5% of initiatives were structure-based. In Ontario, of 60 provincial initiatives identified, 15% were structure-based. Ontario had a higher proportion of direct interventions than British Columbia for all intervention types. However, in both provinces, as the intervention became more upstream and attempted to target the social determinants of health more directly, the level of direct support for the intervention lessened. CONCLUSIONS: The paucity of initiatives in British Columbia and Ontario that address healthy eating and active living through action on the social determinants of health is problematic. In the context of Canada's increasingly neoliberal political and economic policy, the public health sector may face significant barriers to addressing upstream determinants in a meaningful way. If public health cannot directly affect broader societal conditions, interventions should be focused around advocacy and education about the social determinants of health. It is necessary that health be seen for what it is: a political matter. As such, the health sector needs to take a more political approach in finding solutions for health inequities.


title: The Change to Pass/Fail Scoring for Step 1 in the Context of COVID-19: Implications for the Transition to Residency Process

text: In this Invited Commentary, the author considers the February 2020 announcement that scoring on the United States Medical Licensing Examination (USMLE) Step 1 will change to pass/fail no sooner than January 2022 and its effects on the transition to residency process in the context of both the recommendations of the Invitational Conference on USMLE Scoring (InCUS) held in March 2019 and the disruptions caused by the COVID-19 pandemic in the spring of 2020. The author suggests that the medical education community must embrace any positive changes that come about as a result of the pandemic while continuing to systematically review the strengths and areas for improvement in the current transition to residency process. In its recommendations, InCUS provided a thoughtful set of action priorities and an effective process to work together, which can inform and guide the work ahead. The COVID-19 pandemic is dominating the educational and clinical environments and is now the biggest disruptor in all aspects of life, not just medical education. It is the responsibility of leaders in medical education to have a vision for and then implement an improved continuum of education that maintains the core values of the field and fits the health care delivery needs of today and the future.


title: Performance of oropharyngeal swab testing compared to nasopharyngeal swab testing for diagnosis of COVID-19 —United States, January-February 2020

text: Among 146 nasopharyngeal (NP) and oropharyngeal (OP) swab pairs collected ≤7 days since illness onset, CDC real-time RT-PCR SARS-CoV-2 assay diagnostic results were 95.2% concordant. However, NP swab Ct values were lower (indicating more virus) in 66.7% of concordant-positive pairs, suggesting NP swabs may more accurately detect amount of SARS-CoV-2.


title: Development and Validation of the Korean Version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire for Patients with Non-muscle Invasive Bladder Cancer: EORTC QLQ-NMIBC24

text: PURPOSE: We aimed to evaluate psychometric properties of the Korean version of the European Organization for Research and Treatment of Cancer (EORTC) QLQ-NMIBC24 when applied to Korean non-muscle invasive bladder cancer (NMIBC) patients. MATERIALS AND METHODS: A total of 249 patients who underwent curative transurethral resection of bladder tumor (TURBT) for primary or recurrent NMIBC were asked to complete the Korean version of EORTC QLQ-C30 and -NMIBC24 questionnaires three times (preoperative, post-TURBT 3 months and 6 months). Linguistic validation and psychometric evaluation of the questionnaire was conducted. RESULTS: Multitrait scaling analysis confirmed satisfactory construct validity in five scales except the malaise scale. Internal consistency was good (Cronbach’s alpha ≥ 0.70) for the five scales except the malaise scale at the all three time points. Known-group comparison analyses showed better quality-of-life (QOL) scores in patients with higher performance status as expected, and better sexual function in men than women (p < 0.05). Most of the scales had low correlations (< 0.40) with the scales in QLQ-C30 showing divergent validity, except for malaise scale which showed higher correlations (0.42 to 0.60). Responsiveness to change was consistent with clinical implications over time after TURBT. CONCLUSION: The Korean version of the EORTC QLQ-NMIBC24 has good reliability and cross-cultural validity for measuring various QOL aspects that can be self-administered to Korean NMIBC patients undergoing TURBT.


title: Section 3 Air and Gas Filtration

text: Abstract Our lives depend upon a constant supply of clean air to breathe, in the home, city, countryside or at our place of work. Air is also consumed in huge volumes for the production of power. Any particulate matter in this air will affect the efficiency and cleanliness of combustion and reduce the lifetime of engine or turbine parts. The off-gases downstream from combustion present a huge environmental problem, either in the local environment or in terms of their impact regionally or even globally. This section reviews the techniques and equipment used to purify air.


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title: THE IMPORTANCE OF PHYSICAL ACTIVITY TO CARE FOR FRAIL OLDER ADULTS DURING THE COVID-19 PANDEMIC

text: Summary COVID-19 restrictions could decreased physical and mental health. Simple, adapted and specific physical activities should be implemented and considered as the best solution to care for frail elderly during the COVID-19 pandemic.


title: Frequent detection of Saffold cardiovirus in adenoids

text: Saffold virus (SAFV) is classified into the Cardiovirus genus of the Picornaviridae family. Up to now, eleven genotypes have been identified however, their clinical significance remains unclear. Here, we investigated the presence of SAFV in asymptomatic patients admitted for adenoidectomy. A total of 70 adenoid tissue samples were collected from children with clinical symptoms caused by hypertrophy of adenoids but without symptoms of airway infection. Samples were investigated for SAFV by RT-nested PCR and sequence analysis. Eleven of 70 (15.7%) samples were positive for SAFV. Nasopharyngeal swabs were available from 45 children just before surgery. SAFV was rarely found and only in children with SAFV-positive adenoids 2/8. Our findings indicate that the presence of SAFV seems to be more frequent in adenoid tissue than expected. This could support the notion of a longer than previously anticipated persistence of SAFV nucleic acids in the respiratory tract and possibly a chronic infection. Further investigations are necessary to establish the role of SAFV infection in humans.


title: Exploiting plant virus‐derived components to achieve in planta expression and for templates for synthetic biology applications

text: [Table: see text] SUMMARY: This review discusses the varying roles that have been played by many plant‐viral regulatory sequences and proteins in the creation of plant‐based expression systems and virus particles for use in nanotechnology. Essentially, there are two ways of expressing an exogenous protein: the creation of transgenic plants possessing a stably integrated gene construction, or the transient expression of the desired gene following the infiltration of the gene construct. Both depend on disarmed strains of Agrobacterium tumefaciens to deliver the created gene construction into cell nuclei, usually through the deployment of virus‐derived components. The importance of efficient mRNA translation in the latter process is highlighted. Plant viruses replicate to sustain an infection to promote their survival. The major product of this, the virus particle, is finding increasing roles in the emerging field of bionanotechnology. One of the major products of plant‐viral expression is the virus‐like particle (VLP). These are increasingly playing a role in vaccine development. Similarly, many VLPs are suitable for the investigation of the many facets of the emerging field of synthetic biology, which encompasses the design and construction of new biological functions and systems not found in nature. Genetic and chemical modifications to plant‐generated VLPs serve as ideal starter templates for many downstream synthetic biology applications.


A roni‐like virus associated with mortalities of the freshwater crab, Eriocheir sinensis Milne Edwards, cultured in China, exhibiting ‘sighs disease’ and black gill syndrome


title: Emergency cesarean section in an epidemic of the middle east respiratory syndrome: a case report

text: Only a few reports have been published on women with an infectious respiratory viral pathogen, such as Middle East Respiratory Syndrome (MERS) Coronavirus delivering a baby. A laboratory confirmed case of MERS was reported during a MERS outbreak in the Republic of Korea in a woman at gestational week 35 + 4. She recovered, and delivered a healthy baby by emergency cesarean section (C-sec). We present the clinical course and the emergency C-sec in a pregnant woman with MERS.


Reflections on the Ebola Public Health Emergency of International Concern, Part 2: The Unseen Epidemic of Posttraumatic Stress among Health-care Personnel and Survivors of the 2014–2016 Ebola Outbreak


title: The effect of N-terminal acetylation and the inhibition activity of acetylated enkephalins on the aminopeptidase M-catalyzed hydrolysis of enkephalins☆()

text: High performance liquid chromatography and high performance liquid chromatography/electrospray ionization-mass spectrometry were used to study the effect of N-terminal acetylation and the inhibition activity of acetylated enkephalins on the aminopeptidase M (EC 3.4.11.2)-catalyzed hydrolysis of methionine (Met-enk) and leucine enkephalins (Leu-enk). Acetylation imparts a significant enhancement in the proteolytic stability of these two peptides. After 30 min of the reaction, <10% of both acetylated enkephalins was hydrolyzed. In an 8-h incubation period, only a maximum of 54% acetylated (Ac)-Met-enk and 38% Ac-Leu-enk was hydrolyzed. V(max) and K(m [infi]) for the degradation of Ac-Met-enk were 1.4 nmol/min/50 ng and 2.2 mM, respectively. The corresponding values for the reaction of Ac-Leu-enk were 0.5 nmol/min/50 ng and 0.9 mM. Also, the aminopeptidase M activity on Met-enk can be inhibited in the presence of Ac-Met-enk, which acts as a mixed-type inhibitor with the inhibition constant (K(i)) of 1 × 10(−3) M.


title: IFITM3: How genetics influence influenza infection demographically

text: The role of host genetics in influenza infection is unclear despite decades of interest. Confounding factors such as age, sex, ethnicity and environmental factors have made it difficult to assess the role of genetics without influence. In recent years a single nucleotide polymorphism, interferon-induced transmembrane protein 3 (IFITM3) rs12252, has been shown to alter the severity of influenza infection in Asian populations. In this review we investigate this polymorphism as well as several others suggested to alter the host's defence against influenza infection. In addition, we highlight the open questions surrounding the viral restriction protein IFITM3 with the hope that by answering some of these questions we can elucidate the mechanism of IFITM3 viral restriction and therefore how this restriction is altered due to the rs12252 polymorphism.