docid: xrglwbgn

title: People Behavior Changes in China during COVID-19 Pandemic

text: While most countries implemented measures to reduce people activities and gathering to contain the coronavirus, the outcome may vary significantly depending on how and to what extent people behaviors have been changed. We conducted a survey of 1,048 people in five major cities in China to track and quantify the behavior changes in different periods since the outbreak. It is found that there was nearly 80% reduction of out-of-home activities (working, eating, shopping, taking public transportation, and travelling) during the peak period. Such activities are gradually increasing after the easing of containment measures but still significantly below pre-outbreak level. The significant behavior changes have contributed to the rapid control of virus transmission in China. While countries are reopening the economies before the virus disappears, the system and capacity of testing and contact tracing should be carefully designed with the tracking of people behavior changes in the future.


title: EEG-triggered TMS reveals stronger brain state-dependent modulation of motor evoked potentials at weaker stimulation intensities

text: Background Corticospinal excitability depends on the current brain state. The recent development of real-time EEG-triggered transcranial magnetic stimulation (EEG-TMS) allows studying this relationship in a causal fashion. Specifically, it has been shown that corticospinal excitability is higher during the scalp surface negative EEG peak compared to the positive peak of µ-oscillations in sensorimotor cortex, as indexed by larger motor evoked potentials (MEPs) for fixed stimulation intensity. Objective We further characterize the effect of µ-rhythm phase on the MEP input-output (IO) curve by measuring the degree of excitability modulation across a range of stimulation intensities. We furthermore seek to optimize stimulation parameters to enable discrimination of functionally relevant EEG-defined brain states. Methods A real-time EEG-TMS system was used to trigger MEPs during instantaneous brain-states corresponding to µ-rhythm surface positive and negative peaks with five different stimulation intensities covering an individually calibrated MEP IO curve in 15 healthy participants. Results MEP amplitude is modulated by µ-phase across a wide range of stimulation intensities, with larger MEPs at the surface negative peak. The largest relative MEP-modulation was observed for weak intensities, the largest absolute MEP-modulation for intermediate intensities. These results indicate a leftward shift of the MEP IO curve during the µ-rhythm negative peak. Conclusion The choice of stimulation intensity influences the observed degree of corticospinal excitability modulation by µ-phase. Lower stimulation intensities enable more efficient differentiation of EEG µ-phase-defined brain states.


title: Prevalence and acceptance of glove wearing practice among general population when visiting high risk are during local COVID-19 outbreak .

text: Background Healthcare authorities have generally advised against wearing glove by the general population. However, the use of gloves has become a common sight in public places raising the question of the necessity of glove wearing practice by the general population Objective This study aims to investigate the prevalence and types of glove used as well as the acceptance of the glove practice by individuals visiting the high-risk area during Covid-19 pandemic. Setting This prospective observational study was conducted among individuals visiting a wet market and district specialist hospital During Covid-19 pandemic. The required data was recorded based on observation by trained data collectors who were stationed at the strategic entry point. Methods Individuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individuals entering the facilities from entry points without respiratory symptoms. Exclusion criteria for this study were individuals less than 2 years old, visiting the emergency department, facility staff, individuals who are suspected of multiple entry and individuals who are exiting the treatment facility entrance. Patients were categorized into two groups of acceptable and unacceptable glove practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting. Main outcome measure Prevalence, acceptance of glove wearing practice. Results A total of 75 individuals (2.3%) compromising of 45 (60.0%) individuals from hospitals and 30 (40.0%) individuals from wet markets were seen wearing glove amongst 3322 individuals observed during the data collection period. A higher proportion of individuals visiting wet market (30.0%) were observed with unacceptable glove practice compared to individuals visiting the hospital (8.9%), {chi}2 (1) = 5.60, p=.018. Similarly, a Higher proportion of glove use among non-Malay (53.3%) compared to Malay (46.7%) was observed in hospital compared to a higher proportion of glove use among Malay compared to non-Malay (16.7%) visiting wet market, {chi}2 (1) = 10.20, p=.001. As for glove use, we found that male were using more medical-grade glove (78.8%) compared to non-medical grade glove (21.2%) while an equal amount of medical (50.0%) and non-medical grade glove (50.0%) was used among female, {chi}2 (1) = 6.546, p=.011. Besides, we found that higher proportion of individual using medical-grade glove was using medical grade facemask (68.3%) which was similar to the proportion of individuals using non-medical glove was using non-medical facemask (66.7%), {chi}2 (1) = 5.25, p=.022. Conclusion We present the prevalence and characteristics of glove wearing practice in high-risk location during the current COVID-19 outbreak in Malaysia. Facing a worldwide public health emergency with limited effective clinical treatment, the role of glove-wearing in mitigating COVID-19 transmission is questionable. If needed, the compliance to proper glove-wearing could be improved through targeted public health education


title: Optimized pseudotyping conditions for the SARS-COV2 Spike glycoprotein

text: The SARS-COV2 Spike glycoprotein is solely responsible for binding to the host cell receptor and facilitating fusion between the viral and host membranes. The ability to generate viral particles pseudotyped with SARS-COV2 Spike is useful for many types of studies, such as characterization of neutralizing antibodies or development of fusion-inhibiting small molecules. Here we characterized the use of a codon-optimized SARS-COV2 Spike glycoprotein for the generation of pseudotyped HIV-1, MLV, and VSV particles. The full-length Spike protein functioned inefficiently with all three systems but was enhanced over 10-fold by deleting the last 19 amino acids of the cytoplasmic tail of Spike. Infection of 293FT target cells was only possible if the cells were engineered to stably express the human ACE-2 receptor, but stably introducing an additional copy of this receptor did not further enhance susceptibility. Stable introduction of the Spike activating protease TMPRSS2 further enhanced susceptibility to infection by 5-10 fold. Substitution of the signal peptide of the Spike protein with an optimal signal peptide did not enhance or reduce infectious particle production. However, modification of a single amino acid in the furin cleavage site of Spike (R682Q) enhanced infectious particle production another 10-fold. With all enhancing elements combined, the titer of pseudotyped particles reached almost 106 infectious particles/ml. Finally, HIV-1 particles pseudotyped with SARS-COV2 Spike was successfully used to detect neutralizing antibodies in plasma from COVID-19 patients, but not plasma from uninfected individuals. Importance When working with pathogenic viruses, it is useful to have rapid quantitative tests for viral infectivity that can be performed without strict biocontainment restrictions. A common way of accomplishing this is to generate viral pseudoparticles that contain the surface glycoprotein from the pathogenic virus incorporated into a replication-defective viral particle that contains a sensitive reporter system. These pseudoparticles enter cells using the glycoprotein from the pathogenic virus leading to a readout for infection. Conditions that block entry of the pathogenic virus, such as neutralizing antibodies, will also block entry of the viral pseudoparticles. However, viral glycoproteins often are not readily suited for generating pseudoparticles. Here we describe a series of modifications that result in the production of relatively high titer SARS-COV2 pseudoparticles that are suitable for detection of neutralizing antibodies from COVID-19 patients.


title: Lack of association between genetic variants at ACE2 and TMPRSS2 genes involved in SARS-CoV-2 infection and human quantitative phenotypes

text: Coronavirus disease 2019 (COVID-19) shows a wide variation in expression and severity of symptoms, from very mild or no symptomes, to flu-like symptoms, and in more severe cases, to pneumonia, acute respiratory distress syndrome and even death. Large differences in outcome have also been observed between males and females. The causes for this variability are likely to be multifactorial, and to include genetics. The SARS-CoV-2 virus responsible for the infection uses the human receptor angiotensin converting enzyme 2 (ACE2) for cell invasion, and the serine protease TMPRSS2 for S protein priming. Genetic variation in these two genes may thus modulate an individual's genetic predisposition to infection and virus clearance. While genetic data on COVID-19 patients is being gathered, we carried out a phenome-wide association scan (PheWAS) to investigate the role of these genes in other human phenotypes in the general population. We examined 178 quantitative phenotypes including cytokines and cardio-metabolic biomarkers, as well as 58 medications in 36,339 volunteers from the Lifelines population biobank, in relation to 1,273 genetic variants located in or near ACE2 and TMPRSS2. While none reached our threshold for significance, we observed a suggestive association of polymorphisms within the ACE2 gene with (1) the use of ARBs combination therapies (p=5.7x10-4), an association that is significantly stronger in females (pdiff=0.01), and (2) with the use of non-steroid anti-inflammatory and antirheumatic products (p=5.5x10-4). While these associations need to be confirmed in larger sample sizes, they suggest that these variants play a role in diseases such as hypertension and chronic inflammation that are often observed in the more severe COVID-19 cases. Further investigation of these genetic variants in the context of COVID-19 is thus promising for better understanding of disease variability. Full results are available at https://covid19research.nl.


title: Transmission Dynamics of 2019-nCoV in Malaysia

text: This paper focuses on the formulation of a deterministic 2019-nCov transmission model by considering the exposed and recovered populations with immunity. The scenario of the simulation is depicted based on the patient zero in Malaysia. The transmission model is found to be able to predict the next confirmed case given a single case introduced in a fully susceptible population. The mathematical model is developed based on the SEIR model which has susceptible, exposed, infectious and recovered populations. The system of equations which were obtained were solved numerically and the simulation results were analyzed. The analysis includes the impact of the disease if no control is taken.


docid: rvbefonz

title: SARS-CoV-2 / 2019-novel corona virus: An epidemic to pandemic

text: An unexpected outbreak of pneumonia of unfamiliar aetiology in Wuhan,Hubei, China was reported in December 2019. World Health Organization identified the pathogen and named it COVID-19. COVID-19 made the world go through a cisis. The impact of this viral disease is now an issue of major concern. Respiratory infections, dry cough with fever are the major symptoms which are due to beta coronavirus, namely Severe Acute Respiratory Syndrome corona virus 2 (SARS-CoV-2). Within a short spell, COVID-19 spread all over China. Since January to today 24 March 2020 this epidemic turned into pandemic with continuous rise of cases and deaths. Italy, Germany, Spain, USA, Iran, France are the countries where the disease is spreading in a community level and rest of the countries over the globe the positive cases are also coming in the report. As the disease is communicable, it is highly necessary to take measures before it starts spreading in countries like India where the population is very high. The treatment of this severe acute respiratory syndrome corona virus 2 is not clear so far. Prevention is the only way to stop spreading this fatal disease. In view of this, the total state of knowledge regarding COVID-19 and the suggestive prevention are discussed by considering countries (considering India) where the population is high and this pandemic just started spreading.


COVID-19 Infection in Cancer Patients: How Can Oncologists Deal With These Patients?


title: Mitigating the tsunami of COVID-19 through sustainable traceability

text: Many countries differed in its way of response and management to the fierce infectious COVID-19 outbreak Almost all the world countries agreed on the adequate verification and traceability of the suspected infected contacts, besides followed strict measures for containment and isolation However, life has to go on towards regular routines at a certain point, to fulfil many of the demanding socio-economic needs The literature does not have enough methods on how to do go back smoothly to life routines In contrast, the infected individuals or those who have a probability of spreading infections will not go without being identified This work focus on selective traceability that would be like a default system that would ensure the availability of sustainable community preparedness model Therefore, this paper focuses on developing a simple Yet, robust implementable scale and framework that help any public health authority, or organizations to take appropriate decision when to quarantine, direct for self-isolate, or consider the case to be safe;afterlife starts to go back to normal The framework helps to sustain the testing without disrupting the people life, based on evidence-based selective sampling The paper concludes with recommending the sustainable traceability framework be added to post-surveillance strategy as active case-finding technique The main implication of this paper is that it raises the competence of the community in mitigating the risks of virus tsunami, similar to the COVID-19, and closes its future vulnerability to any new outbreak The paper concludes with limitations and future research recommendations


title: Objective Olfactory Evaluation of Self-reported Olfactory Dysfunction in a Case Series of 86 COVID-19 Patients

text: Objective: To investigate olfactory dysfunction in patients with mild COVID-19 through patient-reported outcome questionnaires and objective psychophysical testing. Methods: Adult patients with COVID-19 and self-reported sudden-onset olfactory dysfunction were recruited through a public call for participation from the University of Mons. Demographic data, pathologic conditions, general and otolaryngological symptoms were collected, and general nasal complaints were evaluated with the sino-nasal outcome-22 (SNOT-22). Subjective olfactory and gustatory status was evaluated with the National Health and Nutrition Examination Survey (NHNES) and the short version of the Questionnaire of Olfactory Disorders-Negative Statements. Objective olfactory status was evaluated using an objective psychophysical test (Identification Sniffin Stick test). Results : 86 patients completed the study. The mean age was 42 + or - 12 years. The most common symptoms were fatigue (75%), headache (63%), nasal obstruction (58%), dysgeusia (51%), postnasal drip (49%), cough (49%) and myalgia (46%). On NHNES, total loss of taste and smell were reported by 51% and 74% of patients, respectively. 65% of patients reported a total loss of smell, while the remainder reported a partial loss. Objective olfactory testing found 41 anosmic (48%), 12 hyposmics (14%), and 33 normosmics (38%) patients. There was no correlation between the objective test results and subjective reports of nasal obstruction or postnasal drip, these complaints were absent in 69% of anosmic patients. Conclusion : A significant proportion of patients reporting olfactory dysfunction related to COVID-19 infection do not have olfactory dysfunction on objective testing. Furthermore, a majority of those with measured olfactory dysfunction did not have corresponding nasal obstruction.


title: Evaluation of a Novel Therapeutic Repetitive Transcranial Magnetic Stimulation Technique Optimized for Increased Accessibility in Major Depression

text: ABSTRACT BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) is effective in major depressive disorder (MDD). However, technical complexity and operational costs might have been barriers for its wide use and implementation in some jurisdictions, thereby decreasing accessibility. OBJECTIVE Our main goal was to test the feasibility of a novel rTMS protocol optimized for practicality, scalability and cost-effectiveness. We hypothesized that our novel rTMS protocol would be simple to implement and well-tolerated, but less costly and allow for more treatment capacity. METHODS Treatment was administered in an open-room setting, allowing a single technician to attend to multiple patients. Large non-focal parabolic coils held by custom-built arms allowed simple yet efficient and accurate placement. We employed a low-frequency (LF) 1 Hz stimulation protocol (360 pulses per session), delivered on the most affordable FDA-approved devices. MDD participants received an initial accelerated rTMS course (arTMS) of 6 sessions/day over 5 days (30 total), followed by a tapering course of daily sessions (up to 25) to decrease the odds of relapse. The self-reported Beck Depression Inventory II (BDI-II) was used to measure severity of depression. RESULTS Forty-eight (48) patients completed the arTMS course. No serious adverse events occurred, and all patients reported manageable pain levels. Response and remission rates were 35.4% and 27.1% on the BDI-II, respectively, at the end of the tapering course. CONCLUSION If rTMS could be delivered for lower cost at higher volume, while preserving efficacy, safety and tolerability, it could warrant further investigation of this treatment as a first-line intervention in MDD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04376697


title: Teleconsultation in a pandemic due to coronavirus: Challenges for telemedicine in the post-COVID-19 era/ Teleconsulta en la pandemia por coronavirus: Desafíos para la telemedicina pos-COVID-19

text: After being decreed, as of March 24, 2020, social isolation and mandatory confinement began in the national territory with the aim of stopping the transmission and preventing the spread of the coronavirus as it was declared a pandemic by the World Organization of Health (WHO). The Instituto de Coloproctología (ICO) designed and developed, together with its largest insurance company EPS SURA and through the available technologies of information, a teleconsultation program, with the aim of maintaining the activities of colorectal surgery and pelvic floor biofeedback and thus guaranteeing uninterrupted medical care and access for our patients. After twenty-five days, 626 consultations were scheduled (colorectal surgery 62 % and pelvic floor biofeedback 38 %) with a percentage of execution of 94 % and a resolution of 78%. This shows that telemedicine, like all teleworking activities, came to stay with high levels of satisfaction, in a world that will never be the same again.


title: Using real-world contact networks to quantify theeffectiveness of digital contact tracing and isolation strategies for Covid-19 pandemic

text: Contact tracing, both manual and potentially with digital apps, is considered a key ingredient in the control of infectious disease outbreaks, and in the strategies making it possible to alleviate the lock-down and to return to a quasi-normal functioning of society in the COVID-19 crisis. However, the current leading modeling framework for evaluating contact tracing is highly stylized, lacking important features and heterogeneities present in real-world contact patterns that are relevant for epidemic dynamics. Here, we fill this gap by considering a modeling framework extensively informed by real-world, high-resolution contact data to analyze the impact of digital (app-based) containment strategies for the COVID-19 pandemic. More specifically, we investigate how well contact tracing apps, coupled with the quarantine of identified contacts, can mitigate a spread in realistic scenarios such as a university campus, a workplace, or a high school. We find that restrictive policies are more effective in confining the epidemics but come at the cost of quarantining a large part of the population with a consequent social cost. It is possible to design less limiting policies, considering at risk only contacts with longer exposure and at shorter distance, in order to avoid this effect. Our results also show that isolation and tracing alone are unlikely to be sufficient to keep an outbreak under control, and additional measures need to be implemented simultaneously. Moreover, we confirm that a high level of app adoption is crucial to make digital contact tracing an effective measure. Finally, given the currently implemented infectiousness, we find that strategies focusing on long exposure times, even for weak links, perform better than approaches that emphasize close-range contacts for shorter time-periods. Our results have implications for the app-based contact tracing efforts currently being implemented across several countries worldwide.


title: Testing the effects of the timing of application of preventative procedures against COVID-19: An insight for future measures such as local emergency brakes.

text: As many countries plan to lift lockdown measures aimed at suppression of COVID-19, data from early regional epidemics in Italy were analysed to ascertain the effectiveness of the timing of preventative measures. The cumulative caseload data were extracted from regional epidemics in Italy. Epidemic features in regions where lockdown was applied early were compared to those where lockdown was applied later for statistical differences. There were statistically significant differences in the timing of the peak, the cumulative incidence at peak and the case/km2 at peak between regions where the lockdown had been applied early and those where it was applied late. The peak occurred 7 days earlier with four times less cases/km2 in regions where the lockdown was applied within 10 days of the start of the epidemic. Cumulative caseloads, cases/km2 and/or the number of days into an epidemic can be used to plan future localised suppression measures as part of a national postlockdown policy. There were 350 (95% confidence interval (CI) 203) cumulative cases and 2.4 (CI 1.1) cases/km2 on day 8 of the regional epidemics.


title: Improving Coronavirus (COVID-19) Diagnosis using Deep Transfer Learning

text: Background: Coronavirus disease (COVID-19) is an infectious disease caused by a new virus. Exponential growth is not only threatening lives, but also impacting businesses and disrupting travel around the world. Aim: The aim of this work is to develop an efficient diagnosis of COVID-19 disease by differentiating it from viral pneumonia, bacterial pneumonia and healthy cases using deep learning techniques. Method: In this work, we have used pre-trained knowledge to improve the diagnostic performance using transfer learning techniques and compared the performance different CNN architectures. Results: Evaluation results using K-fold (10) showed that we have achieved state of the art performance with overall accuracy of 98.75% on the perspective of CT and X-ray cases as a whole. Conclusion: Quantitative evaluation showed high accuracy for automatic diagnosis of COVID-19. Pre-trained deep learning models develop in this study could be used early screening of coronavirus, however it calls for extensive need to CT or X-rays dataset to develop a reliable application.


title: Forecasting COVID-19 Dynamics and Endpoint in Bangladesh: A Data-driven Approach

text: On December 31, 2019, the World Health Organization (WHO) was informed that atypical pneumonia-like cases have emerged in Wuhan City, Hubei province, China. WHO identified it as a novel coronavirus and declared a global pandemic on March 11th, 2020. At the time of writing this, the COVID-19 claimed more than 440 thousand lives worldwide and led to the global economy and social life into an abyss edge in the living memory. As of now, the confirmed cases in Bangladesh have surpassed 100 thousand and more than 1343 deaths putting startling concern on the policymakers and health professionals; thus, prediction models are necessary to forecast a possible number of cases in the future. To shed light on it, in this paper, we presented data-driven estimation methods, the Long Short-Term Memory (LSTM) networks, and Logistic Curve methods to predict the possible number of COVID-19 cases in Bangladesh for the upcoming months. The results using Logistic Curve suggests that Bangladesh has passed the inflection point on around 28-30 May 2020, a plausible end date to be on the 2nd of January 2021 and it is expected that the total number of infected people to be between 187 thousand to 193 thousand with the assumption that stringent policies are in place. The logistic curve also suggested that Bangladesh would reach peak COVID-19 cases at the end of August with more than 185 thousand total confirmed cases, and around 6000 thousand daily new cases may observe. Our findings recommend that the containment strategies should immediately implement to reduce transmission and epidemic rate of COVID-19 in upcoming days.


title: Conditional knockout of RAD51-related genes in Leishmania major reveals a critical role for homologous recombination during genome replication

text: Homologous recombination (HR) has an intimate relationship with genome replication, both during repair of DNA lesions that might prevent DNA synthesis and in tackling stalls to the replication fork. Recent studies led us to ask if HR might have a more central role in replicating the genome of Leishmania, a eukaryotic parasite. Conflicting evidence has emerged regarding whether or not HR genes are essential, and genome-wide mapping has provided evidence for an unorthodox organisation of DNA replication initiation sites, termed origins. To answer this question, we have employed a combined CRISPR/Cas9 and DiCre approach to rapidly generate and assess the effect of conditional ablation of RAD51 and three RAD51-related proteins in Leishmania major. Using this approach, we demonstrate that loss of any of these HR factors is not immediately lethal, but in each case growth slows with time and leads to DNA damage, accumulation of cells with aberrant DNA content, and genome-wide mutation. Despite these similarities, we show that only loss of RAD51 and RAD51-3 impairs DNA synthesis, and that the factors act in distinct ways. Finally, we reveal that loss of RAD51 has a profound effect on DNA replication, causing loss of initiation at the major origins and increased DNA synthesis at subtelomeres. Our work clarifies questions regarding the importance of HR to survival of Leishmania and reveals an unanticipated, central role for RAD51 in the programme of genome replication in a microbial eukaryote.


title: Knowledge syntheses in medical education: A bibliometric analysis

text: Purpose This bibliometric analysis maps the landscape of knowledge syntheses in medical education. It provides scholars with a roadmap for understanding where the field has been and where it might go in the future. In particular, this analysis details the venues in which knowledge syntheses are published, the types of syntheses conducted, citation rates they produce, and altmetric attention they garner. Method In 2020, the authors conducted a bibliometric analysis of knowledge syntheses published in 14 core medical education journals from 1999 to 2019. To characterize the studies, metadata was extracted from Pubmed, Web of Science, Altmetrics Explorer, and Unpaywall. Results The authors analyzed 963 knowledge syntheses representing 3.1% of total articles published (n=30,597). On average, 45.9 knowledge syntheses were published annually (SD=35.85, Median=33), and there was an overall 2,620% increase in the number of knowledge syntheses published from 1999 to 2019. The journals each published, on average, a total of 68.8 knowledge syntheses (SD=67.2, Median=41) with Medical Education publishing the most (n=189; 19%). Twenty-one knowledge synthesis types were identified; the most prevalent types were systematic reviews (n=341; 35.4%) and scoping reviews (n=88; 9.1%). Knowledge syntheses were cited an average of 53.80 times (SD=107.12, Median=19) and received a mean Altmetric Attention Score of 14.12 (SD=37.59, Median=6). Conclusions There has been considerable growth in knowledge syntheses in medical education over the past 20 years, contributing to medical education’s evidence base. Beyond this increase in volume, researchers have introduced methodological diversity in these publications, and the community has taken to social media to share knowledge syntheses. Implications for the field, including the impact of synthesis types and their relationship to knowledge translation, are discussed.


title: Donut PCR: a rapid, portable, multiplexed, and quantitative DNA detection platform with single-nucleotide specificity

text: Current platforms for molecular analysis of DNA markers are either limited in multiplexing (qPCR, isothermal amplification), turnaround time (microarrays, NGS), quantitation accuracy (isothermal amplification, microarray, nanopore sequencing), or specificity against single-nucleotide differences (microarrays, nanopore sequencing). Here, we present the Donut PCR platform that features high multiplexing, rapid turnaround times, single nucleotide discrimination, and precise quantitation of DNA targets in a portable, affordable, and battery-powered instrument using closed consumables that minimize contamination. We built a bread-board instrument prototype and three assays/chips to demonstrate the capabilities of Donut PCR: (1) a 9-plex mammal identification panel, (2) a 15-plex bacterial identification panel, and (3) a 30-plex human SNP genotyping assay. The limit of detection of the platform is under 10 genomic copies in under 30 minutes, and the quantitative dynamic range is at least 4 logs. We envision that this platform would be useful for a variety of applications where rapid and highly multiplexed nucleic acid detection is needed at the point of care.


Sport psychology services to professional athletes: working through COVID-19


title: What association do political interventions, environmental and health variables have with the number of Covid-19 cases and deaths? A linear modeling approach

text: Background: It is unclear which variables contribute to the variance in Covid-19 related deaths and Covid-19 cases. Method: We modelled the relationship of various predictors (health systems variables, population and population health indicators) together with variables indicating public health measures (school closures, border closures, country lockdown) in 40 European and other countries, using Generalized Linear Models and minimized information criteria to select the best fitting and most parsimonious models. Results: We fitted two models with log-linearly linked variables on gamma-distributed outome variables (CoV2 cases and Covid-19 related deaths, standardized on population). Population standardized cases were best predicted by number of tests, life-expectancy in a country, and border closure (negative predictor, i.e. preventive). Population standardized deaths were best predicted by time, the virus had been in the country, life expectancy, smoking (negative predictor, i.e. preventive), and school closures (positive predictor, i.e. accelerating). Model fit statistics and model adequacy were good. Discussion and Interpretation: Interestingly, none of the variables that code for the preparedness of the medical system, for health status or other population parameters were predictive. Of the public health variables only border closure had the potential of preventing cases and none were predictors for preventing deaths. School closures, likely as a proxy for social distancing, was associated with increased deaths. Conclusion: The pandemic seems to run its autonomous course and only border closure has the potential to prevent cases. None of the contributes to preventing deaths.


Editorial: Covid’s metamorphoses


title: Profiling COVID-19 pneumonia progressing into the cytokine storm syndrome: results from a single Italian Centre study on tocilizumab versus standard of care.

text: Background Approximately 5% of patients with coronavirus disease 2019 (COVID-19) develop a life-threatening pneumonia that often occurs in the setting of increased inflammation or "cytokine storm". Anti-cytokine treatments are being evaluated but optimal patient selection remains unclear. Methods Between February 29 to April 6, 2020, 111 consecutive hospitalized patients with COVID-19 pneumonia were evaluated in a single centre retrospective study. Patients were divided in two groups: 42 severe cases (TOCI) with adverse prognostic features including raised CRP and IL-6 levels, who underwent anti-cytokine treatments, mostly tocilizumab, and 69 standard of care patients (SOC). Findings In the TOCI group, all received anti-viral therapy and 40% also received glucocorticoids. In TOCI, 62% of cases were ventilated and there were 3 deaths (17.8+/-10.6 days, mean follow up) with 7/26 cases remaining on ventilators, without improvement, and 17/26 developed bacterial superinfection. One fatality occurred in the 15 TOCI cases treated on noninvasive ventilation and 1 serious bacterial superinfection. Of the 69 cases in SOC, there was no fatalities and no bacterial complications. The TOCI group had higher baseline CRP and IL-6 elevations (p<0.0001 for both) and higher neutrophils and lower lymphocyte levels (p= 0.04 and p=0.001, respectively) with the TOCI ventilated patients having higher markers than non-ventilated TOCI patients. Interpretation Higher inflammatory markers, more superimposed infections and worse outcomes characterized ventilated TOCI cases compared to ward based TOCI therapy. Despite the confounding factors, this study suggests that therapy time in anti-cytokine randomized clinical trials will be key.


title: Fractal kinetics of COVID-19 pandemic

text: We give an update to the original paper posted on 2/17/20 -- now (as of 3/1/20) the China deaths are rapidly decreasing, and we find an exponential decline to the power law similar to the that predicted by the network model of \citet{vazquez_polynomial_2006}. At the same time, we see non-China deaths increasing rapidly, and similar to the early behavior of the China statistics. Thus, we see three stages of the spread of the disease in terms of number of deaths: exponential growth, power-law behavior, and then exponential decline in the daily rate. (Original abstract) The novel coronavirus (COVID-19) continues to grow rapidly in China and is spreading in other parts of the world. The classic epidemiological approach in studying this growth is to quantify a reproduction number and infection time, and this is the approach followed by many studies on the epidemiology of this disease. However, this assumption leads to exponential growth, and while the growth rate is high, it is not following exponential behavior. One approach that is being used is to simply keep adjusting the reproduction number to match the dynamics. Other approaches use rate equations such as the SEIR and logistical models. Here we show that the current growth closely follows power-law kinetics, indicative of an underlying fractal or small-world network of connections between susceptible and infected individuals. Positive deviations from this growth law might indicate either a failure of the current containment efforts while negative deviations might indicate the beginnings of the end of the pandemic. We cannot predict the ultimate extent of the pandemic but can get an estimate of the growth of the disease.


title: COVID-19 and schooling in South Africa: Who should go back to school first?

text: The COVID-19 pandemic is the largest social and economic shock of our lifetimes. As governments grapple with their responses to the virus, more than half the world’s countries have closed their schools and severely limited almost all forms of public life. This will have a profound impact on children, both now and in the decade to come. As many countries start to send children back to school, a question arises: who should go back to school first? This Viewpoint addresses that question in the context of a middle-income country, South Africa. Based on a review of much of the evidence available at the time of publication, it concludes that the youngest children are least susceptible to harm from COVID-19, are less likely to spread the virus than adults, and also have the most to lose by being out of school. Hence, they should be the ones to return to school first.


title: Identification of five antiviral compounds from the Pandemic Response Box targeting SARS-CoV-2

text: With currently over 4 million confirmed cases worldwide, including more than 300’000 deaths, the current Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic has a major impact on the economy and health care system. Currently, a limited amount of prophylactic or therapeutic intervention options are available against SARS-CoV-2. In this study, we screened 400 compounds from the antimicrobial ‘Pandemic Response Box’ library for inhibiting properties against SARS-CoV-2. We identified sixteen compounds that potently inhibited SARS-CoV-2 replication, of which five compounds displayed equal or even higher antiviral activity compared to Remdesivir. These results show that five compounds should be further investigated for their mode of action, safety and efficacy against SARS-CoV-2. Highlights 400 compounds from the pandemic response box were tested for antiviral activity against SARS-CoV-2. 5 compounds had an equal or higher antiviral efficacy towards SARS-CoV-2, compared to the nucleoside analogue Remdesivir.


title: COVID-19 in Bangladesh: Measuring differences in individual precautionary behaviors among young adults

text: Aim: The novel coronavirus disease 2019 (COVID-19) has already hit Bangladesh, and various control measures have been taken to flatten the epidemic curve. Due to the current demographic distribution in Bangladesh, young adults are vital to the demography of the country. Therefore, their precautionary behavior is very important to ensure the success of preventive policies. This exploratory study examined the differences in the adoption of precautionary behaviors among young adults, and estimated and compared the predictors of precautionary behavior adoption among young adults living in the capital city Dhaka and a nearby district, Tangail. Subject and Methods: A total of 350 respondents from each district participated in the study. ANOVA and two-sample t-tests were utilized to detect differences in precautionary behavior across demographic groups of young adults, and quantile regression modeling was used to find the predictors of adopting precautionary behaviors and to compare these predictors between the two districts. Results: Individuals who had a postgraduate education and had good mental health tended to show better precautionary behaviors in Dhaka. Female respondents from Tangail who had no psychological distress took precautionary behaviors more often than their counterparts. However, no significant differences in the adoption of precautionary behaviors to prevent COVID-19 among young adults were found between the two districts. Better self-control ability, higher education, and good mental health emerged as factors that significantly shaped the precautionary behaviors of young adults in this study. Conclusion: Having better knowledge did not ensure better adoption of precautionary behaviors among the participants. In effect, strong intervention by the government to keep people at home and distant from each other and continued lockdown for several more days are probable immediate solutions. At the same time, the economic burden on lower-income people should be addressed.


title: Association of Cancer with Risk and Mortality of COVID-19: Results from the UK Biobank

text: Although cancer has been associated with COVID-19 risk and mortality in hospital-based studies, few population-based studies have been reported. Utilizing data from the UK Biobank (UKB), a population-based prospective cohort, we formally tested the association of over 44 different types of cancer with COVID-19 infection and mortality among 7,661 subjects who were tested by June 17, 2020. Compared to non-cancer subjects, cancer subjects (N=1,521) had significantly lower overall risk for COVID-19 infection [odds ratio (OR) and 95% confidence interval (CI): 0.79 (0.68-0.92), P=2.60E-03]. However, a trend of higher risk for COVID-19 mortality was found among 256 COVID-19 positive cancer patients, especially for hematologic cancers such as non-Hodgkin lymphoma [3.82 (1.17-12.01), P=0.02]. In cancer patients, while few demographic, lifestyle, genetic and comorbidity factors predicted risk for COVID-19 infection, older age, male sex, heart disease and hypertension significantly predicted COVID-19 mortality. The lower risk for COVID-19 infection is likely due to extra caution in COVID-19 prevention and more testing among cancer patients, an encouraging finding that demonstrates the feasibility of intervention. These results, if confirmed in future releases of UKB data and other independent populations, may provide guidance for COVID-19 prevention and treatment among cancer patients.


title: Is death from Covid-19 a multistep process?

text: Covid-19 death has a different relationship with age than is the case for other severe respiratory pathogens. The Covid-19 death rate increases exponentially with age, and the main risk factors are age itself, as well as having underlying conditions such as hypertension, diabetes, cardiovascular disease, severe chronic respiratory disease and cancer. Furthermore, the almost complete lack of deaths in children suggests that infection alone is not sufficient to cause death; rather, one must have gone through a number of changes, either as a result of undefined aspects of aging, or as a result of chronic disease. These characteristics of Covid-19 death are consistent with the multistep model of disease, a model which has primarily been used for cancer, and more recently for amyotrophic lateral sclerosis (ALS). We applied the multi-step model to data on Covid-19 case fatality rates (CFRs) from China, South Korea, Italy, Spain and Japan. In all countries we found that a plot of ln (CFR) against ln (age) was approximately linear with a slope of about 5. As a comparison, we also conducted similar analyses for selected other respiratory diseases. SARS showed a similar log-log age-pattern to that of Covid-19, albeit with a lower slope, whereas seasonal and pandemic influenza showed quite different age-patterns. Thus, death from Covid-19 and SARS appears to follow a distinct age-pattern, consistent with a multistep model of disease that in the case of Covid-19 is probably defined by comorbidities and age producing immune-related susceptibility. Identification of these steps would be potentially important for prevention and therapy for SARS-COV-2 infection.


title: Faculty satisfaction with online teaching: a comprehensive study with American faculty

text: The purpose of this research is to combine and extend the literature to determine which and to what extent various job-related factors influence faculty satisfaction with online teaching. A preliminary investigation was conducted to identify job-related factors that influence faculty satisfaction. An analytical study comprised of higher education faculty across the US was conducted for analyses. Herzberg’s two-factor theory is used as the framework for the factors being motivators or hygienes. An exploratory factor analysis was performed to identify the job-related factors based on the items determined from the preliminary investigation. Hierarchical linear regressions were conducted to determine the job-related factors’ influence on faculty satisfaction with online teaching. Crosstabulations were conducted for the item involving whether faculty are more satisfied with many or minimal interactions/relationships with students. The results indicate that most of the job-related factors significantly influence faculty satisfaction with online teaching. Overall, faculty are satisfied with online teaching.


docid: ealibraq

title: Simulation of Non-Pharmaceutical Interventions on COVID-19 with an Agent-based Model of Zonal Restraint

text: Non-Pharmaceutical Interventions (NPI) are currently the only mechanism governments can use to mitigate the impact of the COVID-19 epidemic. Similarly to the actual spread of the disease, the dynamics of the contention patterns emerging from the application of NPIs are complex and depend on interactions between people within a specific region as well as other stochastic factors associated to demographic, geographic, political and economical conditions. Agent-based models simulate microscopic rules of simultaneous spatial interactions between multiple agents within a population, in an attempt to reproduce the complex dynamics of the effect of the contention measures. In this way, it is possible to design individual behaviours along with NPI scenarios, measuring how the simulation dynamics is affected and therefore, yielding rapid insights to perform a broad assessment of the potential of composite interventions at different stages of the epidemic. In this paper we describe a model and a tool to experiment with such kind of analysis applied to a conceptual city, considering a number of widely-applied NPIs such as social distancing, case isolation, home quarantine, total lockdown, sentinel testing, mask wearing and a distinctive "zonal" enforcement measure, requiring these interventions to be applied gradually to separated enclosed districts (zones). We find that the model is able to capture emerging dynamics associated to these NPIs; besides, the zonal contention strategy yields an improvement on the mitigation impact across all scenarios of combination with individual NPIs. The model and tool are open to extensions to account for omitted or newer factors affecting the planning and design of NPIs intended to counter the late stages or forthcoming waves of the COVID-19 crisis.


title: Detection of Air and Surface Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in Hospital Rooms of Infected Patients

text: Understanding the particle size distribution in the air and patterns of environmental contamination of SARS-CoV-2 is essential for infection prevention policies. We aimed to detect SARS-CoV-2 surface and air contamination and study associated patient-level factors. 245 surface samples were collected from 30 airborne infection isolation rooms of COVID-19 patients, and air sampling was conducted in 3 rooms. Air sampling detected SARS-CoV-2 PCR-positive particles of sizes >4 μm and 1-4 μm in two rooms, which warrants further study of the airborne transmission potential of SARS-CoV-2. 56.7% of rooms had at least one environmental surface contaminated. High touch surface contamination was shown in ten (66.7%) out of 15 patients in the first week of illness, and three (20%) beyond the first week of illness (p = 0.01).


title: How urgent do intravitreal anti-VEGF injections need to be to justify the risk of transmitting COVID-19? Proof-of-concept calculations to determine the Health Adjusted Life-Year (HALY) trade-off.

text: Background: Clinical ophthalmological guidelines encourage the assessment of potential benefits and harms when deciding whether to perform elective ophthalmology procedures during the COVID-19 pandemic, in order to minimize the risk of disease transmission. Method: We performed probability calculations to estimate COVID-19 infection status and likelihood of disease transmission among neovascular age-related macular degeneration patients and health care workers during anti-VEGF procedures, at various community prevalence levels of COVID-19. We then applied the expected burden of COVID-19 illness and death expressed through health-adjusted life-years (HALYs) lost. We compared these results to the expected disease burden of severe visual impairment if sight protecting anti-VEGF injections were not performed. Results: Our calculations estimate for a single treatment, where the background rate of COVID-19 in the community is 1000 active cases per million population, and full personal protective equipment (PPE) is available, that the benefits of treatment are greater than the expected harms to the patient and immediate health care team, provided the probability of severe visual impairment without treatment is >0.001%. Without effective PPE, and with a COVID-19 prevalence of 200,000 per million, an 8.5% chance of severe visual impairment could still justify monthly injections for six months. Conclusion: In most cases analysed, the reduced disease burden from avoiding visual impairment outweighs the expected HALYs lost from COVID-19 transmission. This finding is driven by the fact that HALYs lost when someone suffers severe visual impairment for 5 years are equivalent to nearly 400 moderate cases of infectious disease lasting 2 weeks each.


title: NON-WHITE ETHNICITY, MALE SEX, AND HIGHER BODY MASS INDEX, BUT NOT MEDICATIONS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM ARE ASSOCIATED WITH CORONAVIRUS DISEASE 2019 (COVID-19) HOSPITALISATION: REVIEW OF THE FIRST 669 CASES FROM THE UK BIOBANK

text: Background: Cardiometabolic morbidity and medications, specifically Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), have been linked with adverse outcomes from coronavirus disease 2019 (COVID-19). This study aims to investigate factors associated with COVID-19 positivity for the first 669 UK Biobank participants; compared with individuals who tested negative, and with the untested, presumed negative, rest of the population. Methods: We studied 1,474 participants from the UK Biobank who had been tested for COVID-19. Given UK testing policy, this implies a hospital setting, suggesting at least moderate to severe symptoms. We considered the following exposures: age, sex, ethnicity, body mass index (BMI), diabetes, hypertension, hypercholesterolaemia, ACEi/ARB use, prior myocardial infarction (MI), and smoking. We undertook comparisons between: 1) COVID-19 positive and COVID-19 tested negative participants; and 2) COVID-19 tested positive and the remaining participants (tested negative plus untested, n=501,837). Logistic regression models were used to investigate univariate and mutually adjusted associations. Results: Among participants tested for COVID-19, non-white ethnicity, male sex, and greater BMI were independently associated with COVID-19 positive result. Non-white ethnicity, male sex, greater BMI, diabetes, hypertension, prior MI, and smoking were independently associated with COVID-19 positivity compared to the remining cohort (test negatives plus untested). However, similar associations were observed when comparing those who tested negative for COVID-19 with the untested cohort; suggesting that these factors associate with general hospitalisation rather than specifically with COVID-19. Conclusions: Among participants tested for COVID-19 with presumed moderate to severe symptoms in a hospital setting, non-white ethnicity, male sex, and higher BMI are associated with a positive result. Other cardiometabolic morbidities confer increased risk of hospitalisation, without specificity for COVID-19. Notably, ACE/ARB use did not associate with COVID-19 status.


title: Orthogonal genome-wide screenings in bat cells identify MTHFD1 as a target of broad antiviral therapy

text: Bats are responsible for the zoonotic transmission of several major viral diseases including the 2003 SARS outbreak and the ongoing COVID-19 pandemic. While bat genomic sequencing studies have revealed characteristic adaptations of the innate immune system, functional genomic studies are urgently needed to provide a foundation for the molecular dissection of the tolerance of viral infections in bats. Here we report the establishment and screening of genome-wide RNAi library and CRISPR library for the model megabat, Pteropus Alecto. We used the complementary RNAi and CRISPR libraries to interrogate Pteropus Alecto cells for infection with two different viruses, mumps virus and Influenza A virus, respectively. Screening results converged on the endocytosis pathway and the protein secretory pathway as required for both viral infections. Additionally, we revealed a general dependence of the C-1-tetrahydrofolate synthase gene, MTHFD1, for viral replication in bat cells as well as in human cells. MTHFD1 inhibitor carolacton potently blocked replication of several RNA viruses including SARS-CoV-2. Our studies provide a resource for systematic inquiry into the genetic underpinnings of bat biology and a potential target for developing broad spectrum antiviral therapy.


title: Increased serum levels of sCD14 and sCD163 indicate a preponderant role for monocytes in COVID-19 immunopathology

text: Background. Emerging evidence indicates a potential role for monocyte in COVID-19 immunopathology. We investigated two soluble markers of monocyte activation, sCD14 and sCD163, in covid19 patients with the aim of characterizing their potential role in monocyte-macrophage disease immunopathology. To the best of our knowledge, this is the first study of its kind. Methods. Fifty-nine SARS-Cov-2 positive hospitalized patients, classified according to ICU or non-ICU admission requirement, were prospectively recruited and analyzed by ELISA for levels of sCD14 and sCD163, along with other laboratory parameters, and compared to a healthy control group. Results. sCD14 and sCD163 levels were significantly higher among COVID-19 patients, independently of ICU admission requirement, compared to the control group. We found a significant correlation between sCD14 levels and other inflammatory markers, particularly Interleukin-6, in the non-ICU patients group. sCD163 showed a moderate positive correlation with the time at sampling from admission, increasing its value over time, independently of severity group. Conclusions. Monocyte-macrophage activation markers are increased and correlate with other inflammatory markers in SARS-Cov-2 infection, in association to hospital admission. These data suggest a potentially preponderant role for monocyte-macrophage activation in the development of immunopathology of covid19 patients.


title: Reduction in preterm births during the COVID-19 lockdown in Ireland: a natural experiment allowing analysis of data from the prior two decades.

text: Background: Aetiology of preterm birth (PTB) is heterogeneous and preventive strategies remain elusive. Socio-environmental measures implemented as Ireland s prudent response to the SARS-CoV-2 virus (COVID-19) pandemic represented, in effect, a national lockdown and have possibly influenced the health and wellbeing of pregnant women and unborn infants. Cumulative impact of such socio-environmental factors operating contemporaneously on PTB has never been assessed before. Methods: Regional PTB trends of very low birth weight (VLBW) infants in one designated health area of Ireland over two decades were analysed. Poisson regression and rate ratio analyses with 95% CI were conducted. Observed regional data from January to April 2020 were compared to historical regional and national data and forecasted national figures for 2020. Results: Poisson regression analysis found that the regional historical VLBW rate per 1000 live births for January to April, 2001 to 2019 was 8.18 (95% CI: 7.21, 9.29). During January to April 2020, an unusually low VLBW rate of just 2.17 per 1000 live births was observed. The rate ratio of 3.77 (95% CI: 1.21, 11.75), p = 0.022, estimates that for the last two decades there was, on average, 3.77 times the rate of VLBW, compared to the period January to April 2020 during which there is a 73% reduction. National Irish VLBW rate for 2020 is forecasted to be reduced to 400 per 60,000 births compared to historical 500 to 600 range. Conclusion: An unprecedented reduction in PTB of VLBW infants was observed in one health region of Ireland during the COVID-19 lockdown. Potential determinants of this unique temporal trend reside in the summative socio-environmental impact of the COVID-19 dictated lockdown. Our findings, if mirrored in other regions that have adopted similar measures to combat the pandemic, demonstrate the potential to evaluate these implicated interdependent behavioural and socio-environmental modifiers to positively influence PTB rates globally.


title: Global, Regional and National Incidence and Case-fatality rates of Novel Coronavirus (COVID-19) across 154 countries and territories: A systematic assessment of cases reported from January to March 16, 2020

text: Background: The 2019 novel coronavirus disease (COVID-19) outbreak turned into a pandemic, with hundreds of thousands of cases reported globally. The number of cases dramatically increased beginning in early March 2020. Aim: We assessed the cumulative change in the incidence and case-fatality rates of COVID-19 at the global, regional, and national levels from January to March 16, 2020, in 154 affected countries and territories globally. Methods: We collected data of COVID-19 cases using the GitHub repository, which provided real-time surveillance information developed by the Center for Systems Science and Engineering (CSSE), Johns Hopkins University (USA). Information such as confirmed COVID-19 cases, deaths, and recoveries reported across all affected countries was collected from January 22 to March 16, 2020. We estimated the change in the incidence rate, case-fatality rate, and recovery rate from January 22 to February 29 and from March 1 to March 16, 2020. Results: From January 22 to March 16, 2020, globally, the number of incident COVID-19 cases increased by 276.2%, and Europe recorded 65,281 new cases from March 1 to 16, 2020. Overall, the case-fatality rate was 3.92%, with a high COVID-19 fatality rate in Italy (7.7%), Iran (5.7%), China (4.2%) and the United Kingdom (3.6%). The estimated percentage change in COVID-19 cases from March 1 to 16, 2020, was highest in Belgium (105.8/100,000 population), followed by Qatar (439/100,000 population) and Portugal (331/100,000 population). The overall recovery rate of COVID-19 was 43%; China (35.5%) had the highest recovery rate, while the United States of America recorded a recovery rate of 0.3%. Conclusion: Overall, all the COVID-19-affected countries showed an upward trend in incidence, with little change in the incidence rate of -0.20% from January to Mid-March. The case-fatality rate was found to be 3.92%, and the recovery rate was observed to be less than half (43%) among COVID-19 patients. Italy, Iran, and Spain had the largest numbers of new cases of COVID-19 from March 1 to 16, 2020.


title: Inequality in acute respiratory infection outcomes in the United States: A review of the literature and its implications for public health policy and practice.

text: Seasonal and pandemic respiratory viruses such as influenza and the novel coronavirus (SARS-COV-2) currently sweeping the globe have often been described as 'equal opportunity infectors', implying little socioeconomic disparity in susceptibility. However, early data from the COVID-19 pandemic has underscored that the burden of respiratory viruses actually reflect and magnify existing socioeconomic inequalities. We review the literature on socioeconomic and racial disparities in acute respiratory infection (ARI), as well as ARI-associated hospitalization and mortality. Our goal is to identify key principles of the relationship between socioeconomic inequality and ARI outcomes, as well as highlighting poorly understood areas that need to be addressed by research and policy in the wake of the COVID-19 pandemic. We find that there has been descriptive work in this area, but that there is a distinct lack of cohesive methodology in the literature exploring social determinants and ARI. We propose the fundamental cause theory is a useful framework for guiding future research of disparities in ARI and for the design of interventions to alleviate these disparities.


title: Responding to a cardiac arrest: Keeping paramedics safe during the COVID-19 pandemic

text: This commentary aims to provide an overview of the current state and territory ambulance service cardiac arrest management recommendations to paramedics during the COVID-19 pandemic and highlight relevant risks to personnel.


docid: itbhorxo

title: Association of Poor Housing Conditions with COVID-19 Incidence and Mortality Across US Counties

text: Objective: Poor housing conditions have been linked with worse health outcomes and infectious spread in communities but its relationship with incidence and mortality of COVID19 is unknown. Therefore, we undertook this study to determine the association between poor housing condition and COVID19 incidence and mortality in US counties. Methods: We conducted cross sectional analysis of county level data from the US Centers for Disease Control, US Census Bureau and John Hopkins Coronavirus Resource Center for 3141 US counties. The exposure of interest was percentage of households with poor housing conditions (one or more of: overcrowding, high housing cost, incomplete kitchen facilities, or incomplete plumbing facilities). Outcomes were incidence rate ratios (IRR) and mortality rate ratios (MRR) of COVID19 across US counties through 4/21/2020. Multilevel generalized linear modeling was utilized with adjustment for population density and county characteristics including demographics, income, education, prevalence of medical comorbidities, access to healthcare insurance and emergency rooms, and state level COVID19 test density. Results: Across 3135 US counties, the mean percentage of households with poor housing conditions was 14.2% (range 2.7%, 60.2%). The mean (SD) incidence and mortality of COVID19 were 255.68 (2877.03) cases and 13.90 (272.22) deaths per county, respectively. In the fully adjusted models, with each 5% increase in percent households with poor housing conditions, there was a 50% higher risk of COVID19 incidence (IRR 1.50, 95% CI: 1.38,1.62) and a 42% higher risk of COVID19 mortality (MRR 1.42, 95% CI: 1.25,1.61). Results remained similar using earlier timepoints (3/31/2020 and 4/10/2020). Conclusions and Relevance: Counties with a higher percentage of households with poor housing had higher incidence of, and mortality associated with, COVID19. These findings suggest targeted health policies to support individuals living in poor housing conditions should be considered in further efforts to mitigate adverse outcomes associated with COVID19.


COVID-19 infection and death rates: the need to incorporate causal explanations for the data and avoid bias in testing


title: On Linear Growth in COVID-19 Cases

text: We present an elementary model of COVID-19 propagation that makes explicit the connection between testing strategies and rates of transmission and the linear growth in new cases observed in many parts of the world. An essential feature of the model is that it captures the population-level response to the infection statistics information provided by governments and other organisations. The conclusions from this model have important implications regarding benefits of wide-spread testing for the presence of the virus, something that deserves greater attention.


title: Mobile Learning in Higher Education: Structural Equation Model for Good Teaching Practices

text: Mobile learning is a methodology that involves the use of mobile devices to carry out the teaching-learning process. In exceptional situations such as that experienced during the COVID-19 pandemic in Spain, virtual training methods take on great importance, being the main route for the education of students. The purposes of this paper were to analyse the degree of implementation of the mobile learning methodology in Spanish universities and to check the sociodemographic factors that influence the development of good teaching practices in mobile learning. Ten hypothetical relationships were established and contrasted using a structural equation model. The sample was made up of 1544 university professors from 59 Spanish universities who were asked to complete a questionnaire designed to evaluate mobile learning practices. The results indicated that the degree of implementation of mobile devices was almost 73% of the population surveyed. While the sociodemographic factors that significantly influenced the development of good teaching practices were: teacher status; type of institution; educational technology research; implementing pedagogical innovations on a regular basis; agree that mobile devices are appropriate; belief in the expansion of mobile learning. Finally, the main findings and practical implications derived from the data obtained were discussed.


title: Evaluation of Knowledge, Practices, Attitude and Anxiety of Pakistans Nurses towards COVID-19 during the Current Outbreak in Pakistan

text: Since the emergence of novel corona virus the front line soldiers during this pandemic are the healthcare professionals because of their direct association with the patients. In the management of COVID-19 patient nurses play a significant role through proper care and preventive measures. Due to the contagious nature, fatality and no proper medicine, it is a risk to the health and life of nurses and has impact on their psychological health. In the current study we accessed the knowledge, attitude, practices and anxiety levels of the nurses who are directly involved in the management of COVID-19 patients. It was an online questionnaire based cross sectional survey targeted only those only nurses involved in the management of COVID-19 patients from different hospitals of Karachi, Pakistan. SPSS 21 was used for data analysis. Descriptive analysis, Chi Square and t-tests were applied. Value <0.05 was considered significant. Data of 78 nurses were analyzed .We observed that nurses possess good knowledge about COVID-19, its sources, symptoms, routes of transmission of virus and etc. The knowledge mean score was calculated 14.67 {+/-} 3.36. Health department /Hospital and social media are the main sources of information regarding COVID-19. We investigated that 92.3% of the nurses had mild to very severe anxiety and anxiety levels are significantly higher among the females (P<0.05). We conclude that the nurses performing their duties with COVID-19 positive patients have good knowledge and attitude. But their anxiety levels are high. Psychological interventions along with training should be given.


title: Regional differences in reported Covid-19 cases show genetic correlations with higher socio-economic status and better health, potentially confounding studies on the genetics of disease susceptibility

text: Background: In March 2020, England showed a rapid increase in Covid-19 cases. Susceptibility for infectious diseases like Covid-19 is likely to be partly genetic. Mapping the genetic susceptibility for Covid-19 outcomes may reveal biological mechanisms that could potentially aid in drug or vaccine developments. However, as the disease spreads unevenly across the country, regional allele frequency differences could become spuriously associated with disease prevalence. Methods: A regional genome-wide association study (RGWAS) was conducted in 396,042 individuals from England to investigate the association between 1.2 million genetic variants and regional differences in daily reported Covid-19 cases from March 1st to April 18th 2020. Results: The polygenic signal increases during the first weeks of March, peaking at March 13th with the measured genetic variants explaining ~3% of the variance, including two genome-wide significant loci. The explained variance starts to drop at the end of March and reaches almost zero on April 18th. The majority of this temporary polygenic signal is due to genes associated with higher educational attainment and better health. Conclusions: The temporary positive relationship between Covid-19 cases and regional socio-economic status (SES) at the beginning of the Covid-19 outbreak may reflect 1) a higher degree of international travelers, 2) more social contacts, and/or 3) better testing capacities in higher SES regions. These signals are in the opposite direction of expected disease risk increasing effects, which has the potential to cancel out signals of interest. Genetic association studies should be aware of the timing and location of cases as this can introduce interfering polygenic signals that reflect regional differences in genes associated with behavior.


title: Epidemiological characteristics of COVID-19 patients in Samarinda, East Kalimantan, Indonesia

text: Introduction. Coronavirus Disease (COVID-19) is caused by SARS-CoV-2 infection. Indonesia announced the first COVID-19 case on 2 March 2020. East Kalimantan has been determined as the new capital of Indonesia since 2019. This makes Samarinda as the capital of East Kalimantan has been focused for its capability of handling COVID-19 patients. We report the epidemiological characteristics and immunofluorescence assay results of these patients. Methods. All patients with positive confirmed COVID-19 by RT-PCR were admitted to hospitals and quarantine center in Samarinda. We retrospectively analyzed data from the daily report of the Samarinda City and East Kalimantan Health Office information system. Results. By June 25, 2020, 64 patients had been identified as having positive confirmed COVID-19. The mean age of the patients was 37.3 {+/-} 13.8 years. Most of the patients were men (57 [90.6%] patients). Thirty-nine COVID-19 patients were imported cases with a history of traveling from South Sulawesi. Most of the patients were admitted to the Quarantine Center of Samarinda City. The mean duration from the first hospital admission for isolation to discharge was 25.6 {+/-} 13.1 days. There was only one death case of COVID-19 patients in Samarinda. There were the highest confirmed cases of COVID-19 in Samarinda in early June 2020. There was a declining trend in the age of COVID-19 patients and the duration of isolation time in the hospital. Discussion. Imported cases still contributed to the increase of COVID-19 cases in Samarinda. Younger age of COVID-19 patients was more involved in frequent mobility which makes them cause the spread of the disease. Activation of the national reference laboratory for the COVID-19 examination in Samarinda has reduced the length of time patients treated in hospitals. Conclusion. The epidemiological characteristics of COVID-19 patients show the ability of local governments to deal with this pandemic. This can be seen from the low case fatality rate in Samarinda.


title: Changes in Solo and Partnered Sexual Behaviors during the COVID-19 Pandemic: Findings from a U.S. Probability Survey

text: Background: Research demonstrates that pandemics adversely impact sexual and reproductive health (SRH), but few have examined their impact on participation in sex. We examined self-reported changes in solo and sexual behaviors in U.S. adults during early stages of the public health response to COVID-19. Methods: We conducted an online, nationally representative, cross-sectional survey of U.S. adults (N=1010; aged 18-94 years; 62% response rate) from April 10-20, 2020. We used weighted multinomial logistic regression to examine past month self-reported changes (decreased, stable or increased) in ten solo and partnered sexual behaviors. Predictor variables included: having children at home, past month depressive symptoms, (ACHA 3-item scale), past month loneliness (UCLA 3-Item Loneliness scale), COVID-19 protection behaviors (adapted 12-item scale), perceived COVID-19 consequences (adapted 10-item scale) and COVID-19 knowledge (adapted 10-item scale). Findings: Nearly half of all adults reported some kind of change, most commonly, a decrease, in their sexual behavior in the past month. Having elementary aged children at home, past month depressive symptoms and loneliness and enacting more COVID-19 protective behaviors were associated with both reduced partnered bonding behaviors, such as hugging, cuddling, holding hands and kissing, as well as reduced partnered sexual behaviors, such as oral sex, partnered genital touching and vaginal sex. Greater COVID19 risk perception and greater COVID19 knowledge were associated with mixed effects in behavior outcomes. Interpretations: Our data illustrate the very personal ways in which different pandemic-associated factors may create or inhibit opportunities for solo and partnered sex. The centrality of sexuality to health and well-being, even during pandemics, means that a critical piece of public health prevention and management responses should is ensuring that services and resource that support positive sexual decision making remain open and available.


title: Linear regression analysis of COVID-19 outbreak and control in Henan province caused by the output population from Wuhan

text: Abstract Objectives: To observe outbreak of COVID-19 in Henan province caused by the output population from Wuhan, and high-grade control measures were proformed in Henan province, to study the phase of development and change of the epidemic in Henan province, and to make appropriate inferences about the influence of prevention and control measures and the phase of development of the epidemic. Methods: Linear regression analysis were used to establish a linear regression model with the number of Wuhan roaming people as the dependent variable and the cumulative number of COVID-19 cases in Henan province as the dependent variable, and to calculate and plot the regional distribution of the number of cases in 18 cities in Henan province in accordance with the criteria of whether the number of cases exceeded the expected number. Results: There was a linear correlation between the number of people Wuhan roaming and the number of cases, and the linear regression model equation was statistically significant. The cities that exceeded the expected number of cases had a clear spatio-temporal distribution. Geographically, these cities were roughly in the 1 o'clock and 2 o'clock directions in Nanyang, and in terms of time period, the first phase (10 days), the cities that exceeded the expected number of cases changed almost daily. In the second phase (5 days), cities that exceeded the expected number of cases were moderated, and in the third phase (15 days), cities that exceeded the expected number of cases entered the stabilization phase. Conclusions: The priority cities for COVID-19 prevention and control in Henan province should pay special attention to the cities that have exceeded the expected number of COVID-19 cases, and the implementation of high-level control measures can effectively control the spread of COVID-19 within 2-4 weeks during the early stage of the epidemic. Keywords: novel coronavirus; COVID-19; pneumonia; statistical map; epidemic


title: Predicting the COVID-19 positive cases in India with concern to Lockdown by using Mathematical and Machine Learning based Models

text: In this study, we analyze the number of infected positive cases of COVID-19 outbreak with concern to lockdown in India in the time window of February 11th 2020 to Jun 30th 2020. The first case in India was reported in Kerala on January 30th 2020. To break the chain of spreading, Government announced a nationwide lockdown on March 24th 2020, which is increased two times. The Ongoing lockdown 3.0 is over on May 18th, 2020. We derived how the lockdown relaxation is going to impact on containment of the outbreak. Here the Exponential Growth Model has been used to derive the epidemic curve based on the data collected from February 11th 2020, to May 11th 2020, and the Machine Learning based Linear Regression model that gives the epidemic curve to predict the cases with the continuous flow of the lockdown. We estimate that if the lockdown is continuing with more relaxation, then the estimated infected cases reach up to 1.16 crores by June 30th 2020, and the lockdown would persist with current restriction, then the expected predicted infected cases are 5.69 lacs. The Exponential Growth Model and the Linear Regression Model are advantageous to predict the number of affected cases of COVID-19. These models can be used for forecasting in long term intervals. It shows from our result that lockdown with certain restriction has a vital role in preventing the spreading of this epidemic in this current situation.


Commission or omission bias: COVID-19 makes you pick a side


title: The Unaddressed Behavioral Health Aspect During the Coronavirus Pandemic

text: The 2019 novel coronavirus (2019-nCoV) pneumonia has been declared a pandemic, citing more than 118,000 cases of the coronavirus illness in more than 110 countries and territories around the world. Public health emergencies have been demonstrated to have an impact on the behavioral health of the affected population as they may experience fear, anxiety, anger and post-traumatic stress disorder as consequences of their experiences. These effects may persist among affected individuals long after the outbreak has been controlled. To date, data on the behavioral distress and psychiatric morbidity of those suspected or diagnosed with the 2019-nCoV and their treating health professionals are lacking. Although the Centers for Disease Control and Prevention (CDC) has outlined some behavioral health guide for affected individuals, how best to respond to psychological challenges during the crisis is not known. There is an urgent need to provide robust and timely psychosocial support in the face of such an outbreak.


title: COVID-19 vaccines move toward clinic

text: Drug developers are moving their experimental vaccines for COVID-19 into clinical trials at a frenetic pace Trials for five such vaccines have begun in China Two are being tested in the US, with a third slated to start this month And trials of two more are due to begin in the UK and Australia in the coming weeks “Everything from basic science to clinical science is progressing at a pace faster than ever before—and very appropriately, given the grave nature of the current global crisis,” says Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center The World Health Organization says at least 70 COVID-19 vaccines are in development, while scientists at the Coalition for Epidemic Preparedness Innovations (CEPI) have counted 115 Moderna was the first to begin clinical testing of a COVID-19 vaccine, just 66 days after downloading the genome of SARS-CoV-2,


title: Molecules inhibit the enzyme activity of 3-chymotrypsin-like cysteine protease of SARS-CoV-2 virus: the experimental and theory studies

text: SARS-CoV-2 has emerged as a world public health threat. Herein, we report that the clinical approved auranofin could perfectly inhibit the activity of 3-chymotrypsin-like cysteine protease (Mpro or 3CLpro) of SARS-CoV-2. Gold cluster could significantly inhibit 3CLpro of SARS-COV-2. Phenyl isothiocyanate and Vitamin K3 could well suppress the activity of 3CLpro. For Mpro inhibition, IC50 of auranofin, Vitamin K3, phenyl isothiocyanate, gold cluster are about 0.51μM, 7.96μM, 10.13μM, 1.61μM, respectively. These compounds may be with potentials for treatment SARS-CoV-2 virus replication. Especially for FDA approved auranofin, it is an anti-inflammation drug in clinic, thus it may with strong potential to inhibit virus replication and suppress the inflammation damage in COVID-19 patients. Gold cluster is with better safety index and well anti-inflammation in vitro/vivo, therefore it is with potential to inhibit virus replication and suppress the inflammation damage caused by COVID-19 virus. As Au(I) ion is active metabolism specie derived from gold compounds or gold clusters in vivo, further computational studies revealed Au ion could tightly bind thiol group of Cys145 residue of 3CLpro thus inhibit enzyme activity. Also, phenyl isothiocyanate and Vitamin K3 may interact with thiol group of Cys145 via Michael addition reaction, molecular dynamic (MD) theory studied are applied to confirmed these small molecules are stable in the pocket and inhibit Mpro activity.


title: Let food be the medicine, but not for coronavirus: Nutrition and food science, telling myths from facts

text: The entire globe is facing a dangerous pandemic due to the coronavirus disease (COVID-19). The medical and scientific community is trying to figure out and adopt effective strategies that can lead to (i) preventing virus expansion; (ii) identifying medications for the management of critical care and reducing rates of mortality; and (iii) finally discovering the highly anticipated vaccine. Nutritional interventions have attained considerable scientific evidence in disease prevention and treatment. The main question, “What is the role of nutrition and food science in this scenario?” requires urgent answer as many theories suggesting that specific food or dietary supplements can fight coronavirus infection have received extensive coverage in most popular social media platforms. In this editorial, we focus on some frequent statements on the role of nutrition and food science in the battle against COVID-19, distinguishing between myths and facts. We highlight that social distancing and hygiene precautions are the best practices for reducing the risk of COVID-19 transmission. We further underline the importance of nutrition in its wholistic concept, pointing out the risk of unproven dietary options that could lead individuals to weaken effective precautionary measures.


docid: qrzjgzyk

title: Using HoloLensâ¢ to reduce staff exposure to aerosol generating procedures during a global pandemic

text: RATIONALE: COVID-19 poses a unique challenge; caring for patients with a novel, infectious disease whilst protecting staff. Some interventions used to give oxygen therapy are aerosol generating procedures. Staff delivering such interventions require PPE and are exposed to a significant viral load resulting in sick days and even death. We aim to reduce this risk using an augmented-reality communication device: The HoloLens by Microsoft. OBJECTIVES: In a tertiary centre in London we aim to implement HoloLens technology, allowing other medical staff to remotely join the consulting clinician when in a high-risk patient area delivering oxygen therapy. The study primary outcome was to reduce the exposure to staff and demonstrate non-inferiority staff satisfaction when compared to not using the device. Our secondary outcome was to reduce extrapolated PPE costs when using the device. METHODS: Our study was conducted in March and April 2020, within a respiratory unit delivering aerosolising oxygen therapies (High flow nasal oxygen, Continuous positive airway pressure and non-invasive ventilation) to patients with suspected or confirmed COVID-19 infection. MEASUREMENTS: Self-reported questionnaires to assess satisfaction in key areas of patient care. An infrared people counting device was also used to assess staff in and out of the unit. MAIN RESULTS: Mean self-reported time in the high-risk zone was less when using HoloLens (2.69 hours) compared to usual practice (3.96 hours) although this difference was not statistically significant (p = 0.3657). HoloLens showed non-inferiority when compared to usual practice in staff satisfaction score for all domains. Furthermore, mean staff satisfaction score encouragingly improved when using HoloLens. Self-reported PPE counts from this study showed 12 staff members changing PPE 25.8 times per shift, almost double the 13.5 times in the HoloLens count. CONCLUSIONS: We have demonstrated HoloLens can reduce the number of staff exposed to aerosol generating areas in a novel infectious disease. Our results show it did not impair communication, medical staff availability or end of life care. HoloLens technology may also reduce the use of PPE, which has equipment availability and cost benefits. This study provides grounding for further use of the HoloLens device by bringing a bedside experience to experts remote to the situation.


Decontamination and Reuse of N95 Respirators with Hydrogen Peroxide Vapor to Address Worldwide Personal Protective Equipment Shortages During the SARS-CoV-2 (COVID-19) Pandemic


title: A comparison study of SARS-CoV-2 IgG antibody between male and female COVID-19 patients: a possible reason underlying different outcome between gender.

text: Objective: To compare the difference of SARS-CoV-2 IgG antibody between male and female COVID-19 patients and figure out a possible explanation for different outcome between male and female patients. Methods: A total number of 331 patients confirmed SARS-CoV-2 infection were enrolled. The plasma of these patients were collected during hospitalization and were detected for SARS-CoV-2 IgG antibody. Afterwards, the difference of IgG antibody between male and female patients was analyzed. Results: The level of IgG antibody in mild, general and recovering patients showed on difference between male and female. In severe status, the average IgG antibody level in female patients tended to be higher than that of in male patients. Compared with male patients, most of the female patients generated a relatively high level of SARS-CoV-2 IgG antibody in severe status. In addition, the generation of IgG antibody in female tended to be stronger than male patients in disease early phase. Conclusions: The inconsistent of SARS-CoV-2 IgG antibody generation in male and female patients may account for the different outcome of COVID-19 between gender.


docid: ldeqvajo

title: Estimating the impact of physical distancing measures in containing COVID-19: an empirical analysis

text: Background Epidemic modelling studies predict that physical distancing is critical in containing COVID-19. However, few empirical studies have validated this finding. Our study evaluates the effectiveness of different physical distancing measures in controlling viral transmission. Methods We identified three distinct physical distancing measures with varying intensity and implemented at different times - international travel controls, restrictions on mass gatherings, and lockdown-type measures - based on the Oxford COVID-19 Government Response Tracker. We also estimated the time-varying reproduction number (Rt) for 142 countries and tracked Rt temporally for two weeks following the 100th reported case in each country. We regressed Rt on the physical distancing measures and other control variables (income, population density, age structure, and temperature) and performed several robustness checks to validate our findings. Findings Complete travel bans and all forms of lockdown-type measures have been effective in reducing average Rt over the 14 days following the 100th case. Recommended stay-at-home advisories and partial lockdowns are as effective as complete lockdowns in outbreak control. However, these measures have to be implemented early to be effective. Lockdown-type measures should be instituted two weeks before the 100th case and travel bans about a week before detection of the first case. Interpretation A combination of physical distancing measures, if implemented early, can be effective in containing COVID-19 - tight border controls to limit importation of cases, encouraging physical distancing, moderately stringent measures such as working from home, and a full lockdown in the case of a probable uncontrolled outbreak.


title: Musculoskeletal Consequences of COVID-19

text: Abstract: Coronavirus disease 2019 (COVID-19) is an emerging pandemic disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Although the majority of patients who become infected with SARS-CoV-2 are asymptomatic or have mild symptoms, some patients develop severe symptoms that can permanently detract from their quality of life SARS-CoV-2 is closely related to SARS-CoV-1, which causes severe acute respiratory syndrome (SARS) Both viruses infect the respiratory system, and there are direct and indirect effects of this infection on multiple organ systems, including the musculoskeletal system Epidemiological data from the SARS pandemic of 2002 to 2004 identified myalgias, muscle dysfunction, osteoporosis, and osteonecrosis as common sequelae in patients with moderate and severe forms of this disease Early studies have indicated that there is also considerable musculoskeletal dysfunction in some patients with COVID-19, although long-term follow-up studies have not yet been conducted The purpose of this article was to summarize the known musculoskeletal pathologies in patients with SARS or COVID-19 and to combine this with computational modeling and biochemical signaling studies to predict musculoskeletal cellular targets and long-term consequences of the SARS-CoV-2 infection Email address for C L Mendias: mendiasc@hss edu * Nathaniel P Disser, BS, and Andrea J De Micheli, PhD, contributed equally to this work Investigation performed at the Hospital for Special Surgery, New York, and Weill Cornell Medical College, New York, NY Disclosure: This study was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) grant R01-AR063649 On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links lww com/JBJS/F927) Copyright 2020 by The Journal of Bone and Joint Surgery, Incorporated


title: Author Correction: Respiratory virus shedding in exhaled breath and efficacy of face masks

text: In the version of this article initially published, in the first sentence of the third paragraph of the discussion, "for rhinovirus we detected virus in aerosols in 19 of 34 (56%) participants (compared to 4 of 10 (40%) for influenza and 8 of 23 (35%) for coronavirus)" should have read "for rhinovirus we detected virus in aerosols in 19 of 34 (56%) participants (compared to 4 of 10 (40%) for coronavirus and 8 of 23 (35%) for influenza)," with 'influenza' and 'coronavirus' transposed The error has been corrected in the HTML and PDF versions of the article Copyright © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc


Cardiovascular disease in the literature: A selection of recent original research papers


title: A Case of Coinfection with SARS-COV-2 and Cytomegalovirus in the Era of COVID-19

text: The World Health Organization has declared novel coronavirus disease 2019 (COVID-19) an international public health emergency. We describe the case of a 92-year-old woman who was admitted to our unit with fever and chills with laboratory evidence of coinfection with SARS-CoV-2 and cytomegalovirus. LEARNING POINTS: This is the first reported case of coinfection with SARS-CoV-2 and cytomegalovirus.


docid: rpmmadqc

title: Vitamin D deficiency as risk factor for severe COVID-19: a convergence of two pandemics

text: Importance: Vitamin D deficiency increases the incidence of respiratory virus infections. More than 1 billion people worldwide are vitamin D deficient. If vitamin D deficiency is associated to incidence or severity of SARS-CoV-2 infection, a global call could be made for vitamin D supplementation to mitigate the pandemic. Objective: to determine if lower serum 25-hydroxyvitamin D (25(OH)D) levels are correlated to the risk for COVID-19 and its severity as measured by CT Design: single-center observational study Setting: AZ Delta general hospital Participants: 186 consecutive patients with PCR-confirmed SARS-CoV-2 infection hospitalized for COVID-19 from March 1, 2020 to April 7, 2020 Main outcome and measures: comparative analysis of 25(OH)D levels in patients hospitalized for COVID-19 at various radiological stages and a season/age/sex-matched diseased control population Results: we report on 186 SARS-CoV-2 infected patients requiring hospitalization for severe COVID-19: 109 males (median age 68 years, IQR 53-79 years) and 77 females (median age 71 years, IQR 65-74 years). At admission patients were screened by CT to determine temporal changes of COVID-19 lung disease and classified as stage 1 (ground glass opacities), 2 (crazy paving pattern) and 3 (consolidation). At intake, 25(OH)D levels were measured and compared to a season-matched population of 2717 diseased controls, consisting of 999 males (median age 69 years, IQR 53-81 years) and 1718 females (median age 68 years, IQR 43-83 years). Male and female COVID-19 patients combined showed lower median 25(OH)D than controls (18.6 ng/mL, IQR 12.6-25.3, versus 21.5 ng/mL, IQR 13.9-30.8; P=0.0016) and a higher fraction of vitamin D deficiency (58.6% versus 45.2%, P=0.0005). A strong sexual dimorphism was found: female patients had comparable vitamin D status as control females. Male COVID-19 patients, however, showed markedly higher percentage of vitamin D deficiency than controls (67.0% versus 49.2%, P=0.0006) and this effect was more pronounced with advanced radiological stage ranging from 55.2% in stage 1 to 74% in stage 3. Conclusions and relevance: vitamin D deficiency is a possible risk factor for severe SARS-CoV-2 infection in males. Vitamin D supplementation might be an inexpensive, accessible and safe mitigation for the SARS-CoV-2 pandemic.


Making Wise Decisions During the Pandemic The Impact of COVID-19 on Clinical Research Trials Across Oncology


title: Socialising tourism for social and ecological justice after COVID-19

text: The COVID-19 pandemic of 2019–2020 has the potential to transform the tourism industry as well as the context in which it operates. This global crisis in which travel, tourism, hospitality and events have been shut down in many parts of the world, provides an opportunity to uncover the possibilities in this historic transformative moment. A critical tourism analysis of these events briefly uncovers the ways in which tourism has supported neoliberal injustices and exploitation. The COVID-19 pandemic crisis may offer a rare and invaluable opportunity to rethink and reset tourism toward a better pathway for the future. ‘Responsible’ approaches to tourism alone, however, will not offer sufficient capacity to enable such a reset. Instead, such a vision requires a community-centred tourism framework that redefines and reorients tourism based on the rights and interests of local communities and local peoples. Theoretically, such an approach includes a way tourism could be ‘socialised’ by being recentred on the public good. This is essential for tourism to be made accountable to social and ecological limits of the planet.


title: Is the psychological well-being of a population associated with COVID-19 related survival?

text: OBJECTIVE Immunological mind-body research suggests mental health may also be important in the COVID-19 pandemic. This study aimed to investigate the potential influence of mental health as a protective factor for COVID-19 related mortality in the general population. METHODS Data sources were the Global Burden of Disease report 2017 and publicly reported situational reports of COVID-19. We described variables; calculated the spearman's correlation coefficient, calculated the percentage of the variability of the data that is explained by the association. We explored inter-relationships among other variables: aged 70 or older, cardiovascular disease, obesity and diabetes. A correlation matrix with plotted scatter matrix diagrams was produced. RESULTS Across 181 countries, the mean total COVID-19 related survivors per million was 999,955 (sd=120), median=999,995. The variable had a lognormal distribution; the mean mentally healthy per 100,000 was 85,411 (sd=1,871), median=85,634. The test of normality resulted in p-value < 0.001. Correlation of mentally healthy per 100,0000 and totals of COVID-19 related survivors was s=0.29 (n=181, 95% CI 0.16-0.43). The variance explained by the relation between mental healthy and totals of COVID-19 related survivors was 8.4% (95% CI 2.6 -18.5). CONCLUSION A weak association was found between the psychological well-being of a population and COVID-19 related survival. This relationship explained between 2.6 and 18.5% of COVID-19 related survival.


title: Abstract Society in the Time of Plague

text: The global lockdown following the outbreak of the COVID-19 pandemic is likely to generate all sorts of consequences: psychological, social, economic, and political. To hypothesize about what will emerge from the present situation is at this point both premature and impossible. The impossibility comes primarily from the gravity and vastness of this emergency and from the lack of intellectual resources to deal with the challenge. At the same time, however, the need to get a grasp of the condition in which we have found ourselves is both understandable and irresistible. One way of responding, at least partially, to the demand and its possible consequences may be to refer to the concept of abstract society, an idea formulated 75 years ago by the Austrian-British philosopher Karl Popper.