title: A new approach to understanding tourism practices

text: In spite of renewed attention for practices in tourism studies, the analysis of practices is often isolated from theories of practice. This theoretical paper identifies the main strands of practice theory and their relevance and application to tourism research, and develops a new approach to applying practice theory in the study of tourism participation. We propose a conceptual model of tourism practices based on the work of Collins (2004), which emphasises the role of rituals in generating emotional responses. This integrated approach can focus on individuals interacting in groups, as well as explaining why people join and leave specific practices. Charting the shifting of individuals between practices could help to illuminate the dynamics and complexity of tourism systems.


docid: havpodzk

title: Inferring infection hazard in wildlife populations by linking data across individual and population scales

text: Our ability to infer unobservable disease‐dynamic processes such as force of infection (infection hazard for susceptible hosts) has transformed our understanding of disease transmission mechanisms and capacity to predict disease dynamics. Conventional methods for inferring FOI estimate a time‐averaged value and are based on population‐level processes. Because many pathogens exhibit epidemic cycling and FOI is the result of processes acting across the scales of individuals and populations, a flexible framework that extends to epidemic dynamics and links within‐host processes to FOI is needed. Specifically, within‐host antibody kinetics in wildlife hosts can be short‐lived and produce patterns that are repeatable across individuals, suggesting individual‐level antibody concentrations could be used to infer time since infection and hence FOI. Using simulations and case studies (influenza A in lesser snow geese and Yersinia pestis in coyotes), we argue that with careful experimental and surveillance design, the population‐level FOI signal can be recovered from individual‐level antibody kinetics, despite substantial individual‐level variation. In addition to improving inference, the cross‐scale quantitative antibody approach we describe can reveal insights into drivers of individual‐based variation in disease response, and the role of poorly understood processes such as secondary infections, in population‐level dynamics of disease.


title: The WHO global influenza surveillance and response system (GISRS)—A future perspective

text: In the centenary year of the devastating 1918‐19 pandemic, it seems opportune to reflect on the success of the WHO Global Influenza Surveillance and Response System (GISRS) initiated 70 years ago to provide early warning of changes in influenza viruses circulating in the global population to help mitigate the consequences of such a pandemic and maintain the efficacy of seasonal influenza vaccines. Three pandemics later and in the face of pandemic threats from highly pathogenic zoonotic infections by different influenza A subtypes, it continues to represent a model platform for global collaboration and timely sharing of viruses, reagents and information to forestall and respond to public health emergencies.


title: Pneumonia Pathogen Characterization Is an Independent Determinant of Hospital Readmission

text: BACKGROUND Hospital readmissions for pneumonia occur often and are difficult to predict. For fiscal year 2013, the Centers for Medicare & Medicaid Services readmission penalties have been applied to acute myocardial infarction, heart failure, and pneumonia. However, the overall impact of pneumonia pathogen characterization on hospital readmission is undefined. METHODS This was a retrospective 6-year cohort study (August 2007 to September 2013). RESULTS We evaluated 9,624 patients with a discharge diagnosis of pneumonia. Among these patients, 4,432 (46.1%) were classified as having culture-negative pneumonia, 1,940 (20.2%) as having pneumonia caused by antibiotic-susceptible bacteria, 2,991 (31.1%) as having pneumonia caused by potentially antibiotic-resistant bacteria, and 261 (2.7%) as having viral pneumonia. The 90-day hospital readmission rate for survivors (n = 7,637, 79.4%) was greatest for patients with pneumonia attributed to potentially antibiotic-resistant bacteria (11.4%) followed by viral pneumonia (8.3%), pneumonia attributed to antibiotic-susceptible bacteria (6.6%), and culture-negative pneumonia (5.8%) (P < .001). Multiple logistic regression analysis identified pneumonia attributed to potentially antibiotic-resistant bacteria to be independently associated with 90-day readmission (OR, 1.75; 95% CI, 1.56-1.97; P < .001). Other independent predictors of 90-day readmission were Charlson comorbidity score > 4, cirrhosis, and chronic kidney disease. Culture-negative pneumonia was independently associated with lower risk for 90-day readmission. CONCLUSIONS Readmission after hospitalization for pneumonia is relatively common and is related to pneumonia pathogen characterization. Pneumonia attributed to potentially antibiotic-resistant bacteria is associated with an increased risk for 90-day readmission, whereas culture-negative pneumonia is associated with lower risk for 90-day readmission.


title: Nebulized magnesium for moderate and severe pediatric asthma: A randomized trial

text: BACKGROUND: Intravenous magnesium sulfate, a rescue therapy added to bronchodilator and systemic steroid therapy for moderate and severe asthma, is uncommonly administered. We hypothesized that nebulized magnesium would confer benefit without undue risk. DESIGN AND METHODS: Patients aged 2 to 14 y with moderate and severe asthma (PRAM severity score ≥4) admitted to infirmary/observation unit care were randomized double‐blind on admission to receive 800 mg nebulized magnesium or normal saline placebo after all received intensive therapy with combined nebulized albuterol–ipratropium and intravenous methylprednisolone. Time to medical readiness for discharge was the primary outcome; sample size was chosen to detect a 15% absolute improvement. Improvement over time in PRAM severity score and other secondary outcomes were compared for the overall group and severe asthma subset. RESULTS: One hundred and ninety‐one magnesium sulfates and 174 placebo patients met criteria for analysis. The groups were similar with mean baseline PRAM scores >7. Blinded active therapy significantly increased blood magnesium level 2 hr post‐treatment completion compared to placebo, 0.85 vs 0.82 mmol/L, P = 0.001. There were no important adverse effects. Accelerated failure time analysis showed a non‐significantly shortened time to medical readiness for discharge of 14% favoring the magnesium sulfate group, OR = 1.14, 95% CI 0.93 to 1.40, P = 0.20. Mean times until readiness for discharge were 14.7 hr [SD 9.7] versuss 15.6 hr [SD 11.3] for the investigational and placebo groups, respectively, P = 0.41. CONCLUSIONS: Adding nebulized magnesium to combined nebulized bronchodilator and systemic steroid therapy failed to significantly shorten time to discharge of pediatric patients with moderate or severe asthma. Pediatr Pulmonol. 2015; 50:1191–1199. © 2015 Wiley Periodicals, Inc.


title: The origin and underlying driving forces of the SARS-CoV-2 outbreak

text: BACKGROUND: SARS-CoV-2 began spreading in December 2019 and has since become a pandemic that has impacted many aspects of human society. Several issues concerning the origin, time of introduction to humans, evolutionary patterns, and underlying force driving the SARS-CoV-2 outbreak remain unclear. METHOD: Genetic variation in 137 SARS-CoV-2 genomes and related coronaviruses as of 2/23/2020 was analyzed. RESULT: After correcting for mutational bias, the excess of low frequency mutations on both synonymous and nonsynonymous sites was revealed which is consistent with the recent outbreak of the virus. In contrast to adaptive evolution previously reported for SARS-CoV during its brief epidemic in 2003, our analysis of SARS-CoV-2 genomes shows signs of relaxation. The sequence similarity in the spike receptor binding domain between SARS-CoV-2 and a sequence from pangolin is probably due to an ancient intergenomic introgression that occurred approximately 40 years ago. The current outbreak of SARS-CoV-2 was estimated to have originated on 12/11/2019 (95% HPD 11/13/2019–12/23/2019). The effective population size of the virus showed an approximately 20-fold increase from the onset of the outbreak to the lockdown of Wuhan (1/23/2020) and ceased to increase afterwards, demonstrating the effectiveness of social distancing in preventing its spread. Two mutations, 84S in orf8 protein and 251 V in orf3 protein, occurred coincidentally with human intervention. The former first appeared on 1/5/2020 and plateaued around 1/23/2020. The latter rapidly increased in frequency after 1/23/2020. Thus, the roles of these mutations on infectivity need to be elucidated. Genetic diversity of SARS-CoV-2 collected from China is two times higher than those derived from the rest of the world. A network analysis found that haplotypes collected from Wuhan were interior and had more mutational connections, both of which are consistent with the observation that the SARS-CoV-2 outbreak originated in China. CONCLUSION: SARS-CoV-2 might have cryptically circulated within humans for years before being discovered. Data from the early outbreak and hospital archives are needed to trace its evolutionary path and determine the critical steps required for effective spreading.


title: Duplex real-time polymerase chain reaction assay for the detection of human KIPyV and WUPyV in nasopharyngeal aspirate pediatric samples

text: Abstract In this study, we describe a duplex real-time PCR assay for the simultaneous detection of KIPyV and WUPyV polyomaviruses based on TaqMan probes. This assay detected 500 copies/mL both for KIPyV and WUPyV in 100% of tested positive samples. We assessed this technique on 482 nasopharyngeal aspirate specimens from hospitalized pediatric patients with respiratory symptoms, previously analyzed with commercial multiplex assay for 16 major respiratory viruses. Our assay detected KIPyV genome in 15 out of 482 samples (3.1%) and WUPyV genome in 24 out of 482 samples (4.9%), respectively, and in three samples the coinfection of the two viruses was found. Interestingly, 29 out of 36 of samples with KIPyV and/or WUPyV infection exhibited a co-infection with one or more respiratory viruses confirming that KIPyV and WUPyV were often detected in association to other viral infections. Of note, KIPyV and WUPyV were detected singularly in 4 out of 15 cases and 3 out of 24 cases, respectively, suggesting a possible direct role of these viruses in the respiratory diseases. In conclusion, this method could be taken into account as an alternative technical approach to detect KIPyV and/or WUPyV in respiratory samples for epidemiological and diagnostic analyses.


title: Study on soybean potential productivity and food security assessment in China under the influence of the COVID-19 outbreak

text: Abstract The COVID-19 outbreak suddenly broke out globally in 2020. Pressure from the blockade and ban on food exports are starting to affect agricultural supply chains, it has led to a rapid rise in global food prices. As many grain exporting countries announced a ban on grain exports, food security issues in China have attracted great international attention. This study builds the Suitability Distribution Model and Soybean-Cereal Constraint Model to explore the relationship between soybean production potential and food security. As a result, the soybean potential planting area in China is 164.3 million ha. If the outbreak prevents China from importing soybeans, the soybean planting area will need to be increased by 6.9 times to satisfy the demands. In the meantime, the cereal self-sufficiency rate will drop to 63.4%, which will greatly affect food security. Each additional unit of soybean production will reduce 3.9 units of cereals, and 1% increase in the self-sufficiency rate of soybeans will result in a 0.63% drop in cereals. It is not sustainable to sacrifice cereal to grow soybeans and to rely heavily on imports. But to ensuring the cereal security, the self-sufficiency rate of soybeans is difficult to exceed 42%. China still need to import more than 68% of the original import volume of soybean. In the short term, the outbreak will not affect food security in China, but as soybean imports decrease, insufficient supply of soybeans will affect people's quality of life. To prevent the impact of the COVID-19 outbreak, China should increase soybean stocks and strengthen international cooperation in short term. In the long term, increasing the self-sufficiency rate is the fundamental solution to soybean problem, and the key to increasing soybean cultivation is to make soybean cultivation profitable and to build a sustainable soybean planting chain. So, China need to formulate a soybean cultivation strategy prudently.


title: Diagnostic et surveillance épidémiologique des infections grippales et à virus respiratoire syncytial: intérêt de la PCR multiplex

text: Résumé Objectif Le diagnostic étiologique des infections respiratoires nécessite d'être réalisé rapidement pour une prise en charge efficace des patients. Nous avons évalué une PCR multiplex pour le diagnostic et l'épidémiosurveillance des infections grippales et à virus respiratoire syncytial (VRS). Patients et méthodes Notre étude a porté sur 278 patients (âge moyen: 37,2±22,9 ans) présentant un syndrome grippal ou pseudogrippal, consultant des médecins vigies du GROG Poitou-Charentes ou hospitalisés au CHU de Poitiers. Une PCR multiplex détectant les virus grippaux A(H3), A(H1), B et les VRS A et B, a été réalisée en parallèle à un examen direct par immunofluorescence et une culture cellulaire. Résultats Nous avons mis en évidence une infection virale chez 139 (50,0%) patients: 99 cas de grippe A(H3), deux cas de grippe A(H1), 28 cas de grippe B et 11 cas d'infection à VRS. Le rendement diagnostique chez les patients du GROG (52,3%) était significativement plus élevé que celui observé chez les hospitalisés (34,5%) (p =0,04). Nous avons obtenu une concordance technique de 61%. La PCR multiplex a permis un gain de positivité de 22,3% par rapport aux techniques traditionnelles. Tous les prélèvements positifs par les techniques traditionnelles l'ont été également en PCR multiplex. Nous avons observé une parfaite corrélation entre les types et les sous-types viraux déterminés par PCR et par culture cellulaire. Conclusion La PCR multiplex est une technique sensible permettant un diagnostic efficace et rapide des infections respiratoires dues aux virus grippaux et au VRS. Abstract Objective Respiratory infections require a rapid etiological diagnosis for efficient management of cases. We evaluated multiplex PCR used for the diagnosis and the epidemiological surveillance of influenza and respiratory syncytial virus (RSV) infections. Patients and methods Our study included 278 patients (mean age: 37.2±22.9 years) with flu or flu-like syndromes, consulting physicians affiliated with the GROG Poitou-Charentes or hospitalized in the Poitiers teaching hospital. A multiplex PCR detecting A(H3), A(H1) and B influenza viruses, and RSV A and B, was performed with both a direct examination by immunofluorescence and cell-culture. Results We diagnosed a viral infection in 139 (50.0%) patients: 99 cases of influenza A(H3), 2 cases of influenza A(H1), 28 cases of influenza B and 11 cases of RSV infections. The diagnosis yield in GROG patients (52.3%) was significantly higher than that observed in hospitalized patients (34.5%) (P =0.04). All techniques were correlated in 61% of cases. The multiplex PCR yielded 22.3% more positive samples compared to the conventional techniques. All positive samples by conventional techniques were also positive by multiplex PCR. We observed a perfect correlation between viral types and subtypes determined by PCR and cell-culture. Conclusion Multiplex PCR is a sensitive technique allowing an efficient and rapid diagnosis of respiratory infections due to influenza and RSV.


title: Advancements in prophylactic and therapeutic nanovaccines

text: Abstract Vaccines activate suitable immune responses to fight against diseases but can possess limitations such as compromised efficacy and immunogenic responses, poor stability, and requirement of adherence to multiple doses. ‘Nanovaccines’ have been explored to elicit a strong immune response with the advantages of nano-sized range, high antigen loading, enhanced immunogenicity, controlled antigen presentation, more retention in lymph nodes and promote patient compliance by a lower frequency of dosing. Various types of nanoparticles with diverse pathogenic or foreign antigens can help to overcome immunotolerance and alleviate the need of booster doses as required with conventional vaccines. Nanovaccines have the potential to induce both cell-mediated and antibody-mediated immunity and can render long-lasting immunogenic memory. With such properties, nanovaccines have shown high potential for the prevention of infectious diseases such as acquired immunodeficiency syndrome (AIDS), malaria, tuberculosis, influenza, and cancer. Their therapeutic potential has also been explored in the treatment of cancer. The various kinds of nanomaterials used for vaccine development and their effects on immune system activation have been discussed with special relevance to their implications in various pathological conditions. Statement of Significance Interaction of nanoparticles with the immune system has opened multiple avenues to combat a variety of infectious and non-infectious pathological conditions. Limitations of conventional vaccines have paved the path for nanomedicine associated benefits with a hope of producing effective nanovaccines. This review highlights the role of different types of nanovaccines and the role of nanoparticles in modulating the immune response of vaccines. The applications of nanovaccines in infectious and non-infectious diseases like malaria, tuberculosis, AIDS, influenza, and cancers have been discussed. It will help the readers develop an understanding of mechanisms of immune activation by nanovaccines and design appropriate strategies for novel nanovaccines.


Use of recombinant virus technology to produce non-infectious, whole process controls for emerging viruses such as Ebola, Chikungunya, Dengue-2, Norovirus GII, MERS-CoV and Zika


title: COVID-19: INITIAL PERIOPERATIVE AND PERIANESTHESIA NURSING RESPONSE IN A MILITARY MEDICAL CENTER

text: Abstract Nurses have historically led efforts to improve the health of populations while simultaneously and unselfishly providing care during pivotal moments of national need. The COVID-19 pandemic has placed an unprecedented strain on the US healthcare system, including severe shortages of hospital beds, supplies, equipment, pharmaceuticals, and healthy frontline clinicians. Perioperative and perianesthesia leaders and clinicians have unique opportunities to provide patient care during the COVID-19 crisis. In this manuscript, we describe the initial changing roles and contributions of perioperative and perianesthesia registered nurses during the COVID-19 pandemic and share recent experiences from a military medical center. Perioperative and perianesthesia nurses are vital to the overall nursing viability of the healthcare system, as they possess the requisite knowledge and skills to provide expert clinical care in many hospital settings and meet the demands of a global pandemic.


Managing Uveitis During the COVID-19 Pandemic


title: The Burden of Influenza-Associated Hospitalizations in Oman, January 2008-June 2013

text: INTRODUCTION: Acute respiratory infections (ARI), including influenza, comprise a leading cause of morbidity and mortality worldwide. Influenza surveillance provides important information to inform policy on influenza control and vaccination. While the epidemiology of influenza has been well characterized in western countries, few data exist on influenza epidemiology in the Eastern Mediterranean Region. We describe the epidemiology of influenza virus in Oman. METHODS: Using syndromic case definitions and protocols, patients from four regional hospitals in Oman were enrolled in a descriptive prospective study to characterize the burden of severe acute respiratory infections (SARI) and influenza. Eligible patients provided demographic information as well as oropharyngeal (OP) and nasopharyngeal (NP) swabs. Specimens were tested for influenza A and influenza B; influenza A viruses were subtyped using RT-PCR. RESULTS: From January 2008 through June 2013, a total of 5,147 cases were enrolled and tested for influenza. Influenza strains were detected in 8% of cases for whom samples were available. Annual incidence rates ranged from 0.5 to 15.4 cases of influenza-associated SARI per 100,000 population. The median age of influenza patients was 6 years with children 0–2 years accounting for 34% of all influenza-associated hospitalizations. By contrast, the median age of non-influenza SARI cases was 1 year with children 0–2 years comprising 59% of SARI. Compared to non-influenza SARI cases, a greater proportion of influenza cases had pre-existing chronic conditions and underwent ventilation during hospitalization. CONCLUSIONS: Influenza virus is associated with a substantial proportion of SARI in Oman. Influenza in Oman approximately follows northern hemisphere seasonality, with major peaks in October to December and a lesser peak around April. The burden of influenza was greatest in children and the elderly. Future efforts should examine the burden of influenza in other potential risk groups such as pregnant women to inform interventions including targeted vaccination.


COVID-19-associated delayed posthypoxic leukoencephalopathy


Barrier System for Airway Management of COVID-19 Patients


Reply to letter to the editor ‘Lessons from COVID-19 to Future Evidence Synthesis Efforts: First Living Search Strategy and Out of Date Scientific Publishing and Indexing Industry


title: Cross-immunity between respiratory coronaviruses may limit COVID-19 fatalities

text: Of the seven coronaviruses associated with disease in humans, SARS-CoV, MERS-CoV and SARS-CoV-2 cause considerable mortality but also share significant sequence homology, and potentially antigenic epitopes capable of inducing an immune response. The degree of similarity is such that perhaps prior exposure to one virus could confer partial immunity to another. Indeed, data suggests a considerable amount of cross-reactivity and recognition by the hosts immune response between different coronavirus infections. While the ongoing COVID-19 outbreak rapidly overwhelmed medical facilities of particularly Europe and North America, accounting for 78% of global deaths, only 8% of deaths have occurred in Asia where the outbreak originated. Interestingly, Asia and the Middle East have previously experienced multiple rounds of coronavirus infections, perhaps suggesting buildup of acquired immunity to the causative SARS-CoV-2 that underlies COVID-19. This article hypothesizes that a causative factor underlying such low morbidity in these regions is perhaps (at least in part) due to acquired immunity from multiple rounds of coronavirus infections and discusses the mechanisms and recent evidence to support such assertions. Further investigations of such phenomenon would allow us to examine strategies to confer protective immunity, perhaps aiding vaccine development.


title: Topographical mapping of epitopes on the glycoproteins of murine hepatitis virus-4 (strain JHM): Correlation with biological activities

text: Abstract Monoclonal hybridoma antibodies (MAb) of defined polypeptide specificity and biological activity were used in a competition binding assay to identify antibody binding sites (epitopes) on the glycoproteins of murine hepatitis virus-4 strain JHM (MHV-4). Individual MAb were labeled with horseradish peroxidase (HRP) and used as probes in a competition enzyme immunoassay (EIA). Four topographically distinct antigenic sites were detected on the E2 glycoprotein of MHV-4. Antibodies reacting with these four determinants provisionally designated A(E2), B(E2), C(E2), and D(E2) had corresponding biological activities (M. J. Buchmeier, H. A. Lewicki, P. J. Talbot, and R. L. Knobler (1984) Virology 132, 261–270). Antibodies to sites A(E2) and B(E2) mediated virus neutralization in vitro and passively protected mice against lethal virus challenge in vivo. Antibody to site C(E2) neutralized virus efficiently in vitro but did not alter disease in vivo, while antibody to site D(E2) neither neutralized nor protected. Two major nonoverlapping antigenic sites were defined on the El glycoprotein. Overlapping epitopes A(El) and B(El) constituted one site and epitope C(E1) the other.


title: Comment on “Genetic variants and source of introduction of SARS‐CoV‐2 in South America”

text: I read with great interest a recent study by Poterico and Mestanza1 who described mutations in 30 SARS-CoV-2 genomes from South American countries (Argentina, Brazil, Chile, Colombia, Ecuador, and Peru) This article is protected by copyright. All rights reserved.


Myths and Facts on Vitamin D Amidst the COVID-19 Pandemic()


5 challenges in understanding the role of the virome in health and disease


title: Th2 Responses in OVA-Sensitized BALB/c Mice Are Down-Modulated By Mycobacterium bovis BCG Treatment

text: OBJECTIVE: This study aimed to determine whether Mycobacterium bovis Bacillus Calmette-Guérin (BCG) treatment can reverse an established allergic airway inflammation in a BALB/c mouse model of ovalbumin (OVA)-induced airway inflammation. METHODS: OVA sensitized BALB/c mice were challenged with aerosolized OVA on days 28 to 30, 34, 41 and 63. Mice were intranasal treated with BCG on days 35 and 42. Twenty-four hours after the last challenge, blood samples were collected to detect anti-OVA immunoglobulin isotypes, and bronchoalveolar lavage (BAL) was harvested for cell count. Additionally, lungs were collected for histological analysis, detection of the eosinophil peroxidase (EPO) activity and measurement of cytokines and CCL11. The expression of CTLA-4, Foxp3 and IL-10 was also determined in lung tissue by flow cytometry. RESULTS: BCG treatment was able to inhibit an established allergic Th2-response, by decreasing the allergen-induced eosinophilic inflammation, EPO activity, levels of CCL11 and IL-4, serum levels of IgE and IgG1. Mycobacteria treatment increased lung levels of IFN-γ, IL-10 and TGF-β, and expressions of Foxp3 and CTLA-4 in CD4(+)T cells. Additionally, an increased production of IL-10 by CD8(+) T cells was observed, even though no detectable changes in CD4(+)IL-10(+) was noticed. CONCLUSION: BCG treatment inhibits features of allergic airway inflammation and the results suggest that the mechanism underlying the down-regulatory effects of BCG on OVA-induced airway inflammation appear to be associated with the induction of both Th1 and T regulatory immune responses.


title: IFNL4 polymorphism as a predictor of chronic hepatitis C treatment efficiency in Ukrainian patients

text: The aim of this study was to examine association between IFNL4 gene ss469415590 and treatment efficiency in group of Ukrainian PEG-interferon/ribavirin-treated chronic hepatitis C patients. Study group consisted of 92 unrelated hepatitis C virus genotype 1 mono-infected patients: case group–29 patients with late or absent virological response; control group–63 patients with sustained virological response. Study material was genomic DNA. Genotyping was performed using amplification-refractory mutation system PCR. Statistical analysis was performed using GenePop and OpenEpi statistical packages. Obtained results show that ss469415590 ΔG/ΔG genotype is associated with poor virological response (OR = 3.62; CI 95%: 1.12–11.67) in PEG-interferon/ribavirin-treated chronic hepatitis C patients from Ukraine.


New clinical experiences and evaluation of clinical and paraclinical features of deceased patients with COVID-19 infection referred to Shahid Mostafa Khomeini Hospital of Ilam, Iranin


docid: qrcqorkd

title: Investigating the presence of human herpesvirus 7 and 8 in multiple sclerosis and normal control brain tissue

text: Abstract Multiple sclerosis (MS) is an important demyelinating disease of the central nervous system, the aetiology of which is thought to have a possible viral component. In this study we investigated the possible involvement in MS of two herpes viruses: the neurotropic human herpesvirus 7 (HHV-7) and the related human herpesvirus 8 (HHV-8). Utilising fluorescent in situ hybridisation (FISH) techniques, we examined human post mortem tissues for the presence of immediate early and late viral gene or protein expression in MS patient normal appearing white matter (NAWM), lesional tissue and normal control brain samples. HHV-7 and/or HHV-8 mRNA or protein was detected in some individuals in all three sample categories and was restricted to oligodendrocytes, as determined by double mRNA FISH analysis or immuno fluorescence (IF). No samples showed evidence of viral mRNA when subjected to RT-PCR on extracted ribonucleic acid. We therefore conclude that there is little evidence in our particular sample cohort to suggest involvement of either HHV-7 or HHV-8 in MS.


title: Safety and immunogenicity of an anti-Middle East respiratory syndrome coronavirus DNA vaccine: a phase 1, open-label, single-arm, dose-escalation trial

text: BACKGROUND: Middle East respiratory syndrome (MERS) coronavirus causes a highly fatal lower-respiratory tract infection. There are as yet no licensed MERS vaccines or therapeutics. This study (WRAIR-2274) assessed the safety, tolerability, and immunogenicity of the GLS-5300 MERS coronavirus DNA vaccine in healthy adults. METHODS: This study was a phase 1, open-label, single-arm, dose-escalation study of GLS-5300 done at the Walter Reed Army Institute for Research Clinical Trials Center (Silver Spring, MD, USA). We enrolled healthy adults aged 18–50 years; exclusion criteria included previous infection or treatment of MERS. Eligible participants were enrolled sequentially using a dose-escalation protocol to receive 0·67 mg, 2 mg, or 6 mg GLS-5300 administered by trained clinical site staff via a single intramuscular 1 mL injection at each vaccination at baseline, week 4, and week 12 followed immediately by co-localised intramuscular electroporation. Enrolment into the higher dose groups occurred after a safety monitoring committee reviewed the data following vaccination of the first five participants at the previous lower dose in each group. The primary outcome of the study was safety, assessed in all participants who received at least one study treatment and for whom post-dose study data were available, during the vaccination period with follow-up through to 48 weeks after dose 3. Safety was measured by the incidence of adverse events; administration site reactions and pain; and changes in safety laboratory parameters. The secondary outcome was immunogenicity. This trial is registered at ClinicalTrials.gov (number NCT02670187) and is completed. FINDINGS: Between Feb 17 and July 22, 2016, we enrolled 75 individuals and allocated 25 each to 0·67 mg, 2 mg, or 6 mg GLS-5300. No vaccine-associated serious adverse events were reported. The most common adverse events were injection-site reactions, reported in 70 participants (93%) of 75. Overall, 73 participants (97%) of 75 reported at least one solicited adverse event; the most common systemic symptoms were headache (five [20%] with 0·67 mg, 11 [44%] with 2 mg, and seven [28%] with 6 mg), and malaise or fatigue (five [20%] with 0·67 mg, seven [28%] with 2 mg, and two [8%] with 6 mg). The most common local solicited symptoms were administration site pain (23 [92%] with all three doses) and tenderness (21 [84%] with all three doses). Most solicited symptoms were reported as mild (19 [76%] with 0·67 mg, 20 [80%] with 2 mg, and 17 [68%] with 6 mg) and were self-limiting. Unsolicited symptoms were reported for 56 participants (75%) of 75 and were deemed treatment-related for 26 (35%). The most common unsolicited adverse events were infections, occurring in 27 participants (36%); six (8%) were deemed possibly related to study treatment. There were no laboratory abnormalities of grade 3 or higher that were related to study treatment; laboratory abnormalities were uncommon, except for 15 increases in creatine phosphokinase in 14 participants (three participants in the 0·67 mg group, three in the 2 mg group, and seven in the 6 mg group). Of these 15 increases, five (33%) were deemed possibly related to study treatment (one in the 2 mg group and four in the 6 mg group). Seroconversion measured by S1-ELISA occurred in 59 (86%) of 69 participants and 61 (94%) of 65 participants after two and three vaccinations, respectively. Neutralising antibodies were detected in 34 (50%) of 68 participants. T-cell responses were detected in 47 (71%) of 66 participants after two vaccinations and in 44 (76%) of 58 participants after three vaccinations. There were no differences in immune responses between dose groups after 6 weeks. At week 60, vaccine-induced humoral and cellular responses were detected in 51 (77%) of 66 participants and 42 (64%) of 66, respectively. INTERPRETATION: The GLS-5300 MERS coronavirus vaccine was well tolerated with no vaccine-associated serious adverse events. Immune responses were dose-independent, detected in more than 85% of participants after two vaccinations, and durable through 1 year of follow-up. The data support further development of the GLS-5300 vaccine, including additional studies to test the efficacy of GLS-5300 in a region endemic for MERS coronavirus. FUNDING: US Department of the Army and GeneOne Life Science.


title: Socio-demographic Predictors for Urban Community Disaster Health Risk Perception and Household Based Preparedness in a Chinese Urban City

text: Objectives: There is limited evidence on urban Asian communities' disaster risk perceptions and household level preparedness. Hong Kong is characterized by high population density, and is susceptible to large-scale natural disasters and health crises such as typhoons, fires and infectious disease outbreaks. This research paper investigates the rates and predictors of urban community disaster risk perception, awareness and preparedness, at individual and household levels. Methods: A randomized cross-sectional, population-based telephone survey study was conducted among the Cantonese-speaking population aged over 15 years in Hong Kong. Descriptive statistics were reported. A stepwise multivariate logistic regression analysis was conducted to determine the independent associations between risk perceptions, socioeconomic factors, household characteristics, and personal background. Findings: Final study sample comprised of 1002 respondents with a 63% response rate. The majority of respondents (82.3%) did not perceive Hong Kong as a disaster-susceptible city. Half (54.6%) reported beliefs that the local population had lower disaster awareness than other global cities. Infectious disease outbreak (72.4%), typhoon (12.6%), and fire (7.1%) were ranked as the most-likely-to-occur population-based disasters. Although over 77% believed that basic first aid training was necessary for improving individual disaster preparedness, only a quarter (26.1%) of respondents reported participation in training. Conclusion: Despite Hong Kong’s high level of risk, general public perceptions of disaster in Hong Kong were low, and little preparedness has occurred at the individual or household levels. This report has potential to inform the development of related policies and risk communication strategies in Asian urban cities.


title: Children of COVID-19: pawns, pathfinders or partners?

text: Countries throughout the world are counting the health and socioeconomic costs of the COVID-19 pandemic, including the strategies necessary to contain it. Profound consequences from social isolation are beginning to emerge, and there is an urgency about charting a path to recovery, albeit to a ‘new normal’ that mitigates them. Children have not suffered as much from the direct effects of COVID-19 infection as older adults. Still, there is mounting evidence that their health and welfare are being adversely affected. Closure of schools has been a critical component of social isolation but has a far broader impact than the diminution of educational opportunities, as important as these are. Reopening of schools is therefore essential to recovery, with some countries already tentatively implementing it. Children’s interests are vital considerations in any recovery plan, but the question remains as to how to address them within the context of how society views children; should they be regarded as pawns, pathfinders or partners in this enterprise?


title: The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A GRADE rapid review on the N95 respirators effectiveness

text: Protecting Health Care Workers (HCWs) during routine care of suspected or confirmed COVID-19 patients is of paramount importance to halt the SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) pandemic. The WHO, ECDC and CDC have issued conflicting guidelines on the use of respiratory filters (N95) by HCWs. We searched PubMed, Embase and The Cochrane Library from the inception to March 21, 2020 to identify randomized controlled trials (RCTs) comparing N95 respirators versus surgical masks for prevention of COVID-19 or any other respiratory infection among HCWs. The grading of recommendations, assessment, development, and evaluation (GRADE) was used to evaluate the quality of evidence. Four RCTs involving 8736 HCWs were included. We did not find any trial specifically on prevention of COVID-19. However, wearing N95 respirators can prevent 73 more (95% CI 46–91) clinical respiratory infections per 1000 HCWs compared to surgical masks (2 RCTs; 2594 patients; low quality of evidence). A protective effect of N95 respirators in laboratory-confirmed bacterial colonization (RR = 0.41; 95%CI 0.28–0.61) was also found. A trend in favour of N95 respirators was observed in preventing laboratory-confirmed respiratory viral infections, laboratory-confirmed respiratory infection, and influenza like illness. We found no direct high quality evidence on whether N95 respirators are better than surgical masks for HCWs protection from SARS-CoV-2. However, low quality evidence suggests that N95 respirators protect HCWs from clinical respiratory infections. This finding should be contemplated to decide the best strategy to support the resilience of healthcare systems facing the potentially catastrophic SARS-CoV-2 pandemic.


DOLOR TORÁCICO PERSISTENTE TRAS RESOLUCIÓN DE LA ENFERMEDAD POR CORONAVIRUS 2019 (COVID-19)


title: Budded Autographa californica NPV 64K protein: Further biochemical analysis and effects of postimmunoprecipitation sample preparation conditions

text: Abstract Previously it was shown that AcV1, a neutralizing monoclonal antibody of the Autographs californica nuclear polyhedrosis virus-budded phenotype reacted with a surface antigen present on infected cells during virus budding, and in the viral envelope (L. E. Volkman, P. A. Goldsmith, R. T. Hess, and P. Faulkner (1984), Virology 133, 354–362). Radioimmune precipitation of solubilized, [35S]methionine-labeled budded virus with AcV1 and analysis on SDS-PAGE revealed four bands consistently: one major band at 64,000 Da, and three minor bands at 127,000, 59,000, and 49,000 Da. The reason for the appearance of four bands instead of one was unclear. Data suggest that two of the bands, 49K and 59K, are aberrant, and are the products of sample preparation conditions. Further, evidence is presented that the 127K band is composed of dimers of the 64K protein, and that under nonreducing conditions, oligomers (trimers and tetramers) of 64K protein can also be detected. BVGP 64 is additionally shown to be phosphorylated and to have an isoelectric point of 3.15. The BVGP 64 epitope reactive with AcV1 is destroyed by interaction with SDS. This could account for the lack of neutralizing activity of antiserum made to the SDS-PAGE purified BVGP 64.


docid: icehbtkc

title: Pathogenic murine coronaviruses III. Biological and biochemical characterization of temperature sensitive mutants of JHMV

text: Abstract JHMV is a neurotropic member of the hepatoencephalitis group of murine coronaviridae. The characteristics of the biology and intracellular viral RNA synthesis and the intracellular viral protein synthesis of JHMV are discussed in the two previous papers, respectively. This paper describes the neuropathogenesis of JHMV and the isolation and characterization of 34 temperature-sensitive mutants of JHMV. These mutants were selected for their inability to induce syncytia formation after low multiplicity infection (m.o.i. = 0.1 iU) in BALB/c 17CL-1 cells at 38.5° as compared to the induction of syncytia at 33°. N-Methyl-N′-nitrosoguanidine (14 mutants) and 5-fluorouridine (20 mutants) were used as mutagens at a concentration that reduced infectivity by 90–95%. Characterization of these mutants included: induction of syncytia; synthesis of JHMV-specific intracellular RNA; progeny yields at 33, 37, and 38.5°; synthesis of JHMV-specific antigens as determined by indirect immunofluorescence and sodium dodecyl sulfate-polyacrylamide gel electrophoresis; virion thermostability; neuropathogenesis including isolation of virus from infected brain, immunofluorescence of infected brain, and histopathology of brain and spinal cord by light and transmission electron microscopy; ability to protect mice from a lethal JHMV infection; and complementation. RNA-minus ( 17 34 ), RNA-intermediate ( 14 34 ), and RNA-plus ( 3 34 ) groups were defined. One mutant, N3, produces chronic meningitis and demyelination without typical JHMV encephalitis in spite of the fact that neurons are infected as detected by immunofluorescence. This altered neuropathogenesis cannot be explained by “leakiness” or reversion. In addition, non-temperature-sensitive variants of JHMV have been selected for altered neuropathogenesis and are described.


title: Ocular manifestations and viral shedding in tears of pediatric patients with coronavirus disease 2019: a preliminary report

text: Abstract Purpose To evaluate ocular manifestations and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) prevalence in the tears of children with coronavirus disease 2019 (COVID-19). Methods A total of 27 pediatric patients with confirmed COVID-19 infection hospitalized from March 16 to April 15, 2020, at the Bambino Gesù Children’s Hospital were enrolled in the study. At admission, all patients showed ocular manifestations. Reverse transcriptase–polymerase chain reaction from nasopharyngeal and conjunctival swabs were performed every 2-3 days before discharge. Results Of the 27 patients, 4 (15%) were asymptomatic, 15 (56%) showed respiratory symptoms, and 8 (30%) had gastrointestinal symptoms. At admission, nasopharyngeal swabs were positive for COVID-19 in all patients; on the second swabs, 7 children (26%) tested negative, and 20 remained positive for COVID-19. Ocular manifestations consistent with mild viral conjunctivitis were observed in 4 patients (15%). At first conjunctival swab, 3 patients (11%), 1 symptomatic and 2 asymptomatic for ocular infection, had positive findings for COVID-19; 2 became negative on the second test and 1 on the third. Conclusions In our study cohort, ocular manifestations of COVID-19 seem to have had a milder clinical course in pediatric patients than in adults. Despite the low prevalence and rapid regression of viral presence in the conjunctiva, SARS-CoV-2 transmission through tears may be possible, even in patients without apparent ocular involvement.


title: The Role of Thailand in the International Trade in CITES-Listed Live Reptiles and Amphibians

text: BACKGROUND: International wildlife trade is one of the leading threats to biodiversity conservation. The Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) is the most important initiative to monitor and regulate the international trade of wildlife but its credibility is dependent on the quality of the trade data. We report on the performance of CITES reporting by focussing on the commercial trade in non-native reptiles and amphibians into Thailand as to illustrate trends, species composition and numbers of wild-caught vs. captive-bred specimens. METHODOLOGY/PRINCIPAL FINDINGS: Based on data in the WCMC-CITES trade database, we establish that a total of 75,594 individuals of 169 species of reptiles and amphibians (including 27 globally threatened species) were imported into Thailand in 1990–2007. The majority of individuals (59,895, 79%) were listed as captive-bred and a smaller number (15,699, 21%) as wild-caught. In the 1990s small numbers of individuals of a few species were imported into Thailand, but in 2003 both volumes and species diversity increased rapidly. The proportion of captive-bred animals differed greatly between years (from 0 to >80%). Wild-caught individuals were mainly sourced from African countries, and captive-bred individuals from Asian countries (including from non-CITES Parties). There were significant discrepancies between exports and imports. Thailand reports the import of >10,000 individuals (51 species) originating from Kazakhstan, but Kazakhstan reports no exports of these species. Similar discrepancies, involving smaller numbers (>100 individuals of 9 species), can be seen in the import of reptiles into Thailand via Macao. CONCLUSION/SIGNIFICANCE: While there has been an increase in imports of amphibian and reptiles into Thailand, erratic patterns in proportions of captive-bred specimens and volumes suggests either capricious markets or errors in reporting. Large discrepancies with respect to origin point to misreporting or possible violations of the rules and intentions of CITES.


title: Breastfeeding and coronavirus disease‐2019: Ad interim indications of the Italian Society of Neonatology endorsed by the Union of European Neonatal & Perinatal Societies

text: The recent COVID‐19 pandemic has spread to Italy with heavy consequences on public health and economics. Besides the possible consequences of COVID‐19 infection on a pregnant woman and the fetus, a major concern is related to the potential effect on neonatal outcome, the appropriate management of the mother–newborn dyad, and finally the compatibility of maternal COVID‐19 infection with breastfeeding. The Italian Society on Neonatology (SIN) after reviewing the limited scientific knowledge on the compatibility of breastfeeding in the COVID‐19 mother and the available statements from Health Care Organizations has issued the following indications that have been endorsed by the Union of European Neonatal & Perinatal Societies (UENPS). If a mother previously identified as COVID‐19 positive or under investigation for COVID‐19 is asymptomatic or paucisymptomatic at delivery, rooming‐in is feasible, and direct breastfeeding is advisable, under strict measures of infection control. On the contrary, when a mother with COVID‐19 is too sick to care for the newborn, the neonate will be managed separately and fed fresh expressed breast milk, with no need to pasteurize it, as human milk is not believed to be a vehicle of COVID‐19. We recognize that this guidance might be subject to change in the future when further knowledge will be acquired about the COVID‐19 pandemic, the perinatal transmission of SARS‐CoV‐2, and clinical characteristics of cases of neonatal COVID‐19.


title: Complete genomic sequence of turkey coronavirus

text: Abstract Turkey coronavirus (TCoV), one of the least characterized of all known coronaviruses, was isolated from an outbreak of acute enteritis in young turkeys in Ontario, Canada, and the full-length genomic sequence was determined. The full-length genome was 27,632 nucleotides plus the 3′ poly(A) tail. Two open reading frames, ORFs 1a and 1b, resided in the first two thirds of the genome, and nine additional downstream ORFs were identified. A gene for hemagglutinin-esterase was absent in TCoV. The region between the membrane (M) and nucleocapsid (N) protein genes contained three potential small ORFs: ORF-X, a previously uncharacterized ORF with an associated putative TRS within the M gene (apparently shared among all group III coronaviruses), and previously described ORFs 5a and 5b. The TCoV genome is organized as follows: 5′ UTR – replicase (ORFs 1a, 1b) – spike (S) protein – ORF3 (ORFs 3a, 3b) – small envelop (E or 3c) protein – membrane (M) protein – ORF5 (ORFs X, 5a, 5b) – nucleocapsid (N) protein −3′ UTR – poly(A). TCoV genome structure and sequence was most similar, but distinct from, avian infectious bronchitis virus (IBV). This is the first complete genome sequence for a TCoV and confirms that TCoV belongs to group III coronaviruses.


title: Characteristics Associated With Out-of-Hospital Cardiac Arrests and Resuscitations During the Novel Coronavirus Disease 2019 Pandemic in New York City

text: IMPORTANCE: Risk factors for out-of-hospital death due to novel coronavirus disease 2019 (COVID-19) are poorly defined. From March 1 to April 25, 2020, New York City, New York (NYC), reported 17 118 COVID-19–related deaths. On April 6, 2020, out-of-hospital cardiac arrests peaked at 305 cases, nearly a 10-fold increase from the prior year. OBJECTIVE: To describe the characteristics (race/ethnicity, comorbidities, and emergency medical services [EMS] response) associated with outpatient cardiac arrests and death during the COVID-19 pandemic in NYC. DESIGN, SETTING, AND PARTICIPANTS: This population-based, cross-sectional study compared patients with out-of-hospital cardiac arrest receiving resuscitation by the NYC 911 EMS system from March 1 to April 25, 2020, compared with March 1 to April 25, 2019. The NYC 911 EMS system serves more than 8.4 million people. EXPOSURES: The COVID-19 pandemic. MAIN OUTCOMES AND MEASURES: Characteristics associated with out-of-hospital arrests and the outcomes of out-of-hospital cardiac arrests. RESULTS: A total of 5325 patients were included in the main analysis (2935 men [56.2%]; mean [SD] age, 71 [18] years), 3989 in the COVID-19 period and 1336 in the comparison period. The incidence of nontraumatic out-of-hospital cardiac arrests in those who underwent EMS resuscitation in 2020 was 3 times the incidence in 2019 (47.5/100 000 vs 15.9/100 000). Patients with out-of-hospital cardiac arrest during 2020 were older (mean [SD] age, 72 [18] vs 68 [19] years), less likely to be white (611 of 2992 [20.4%] vs 382 of 1161 [32.9%]), and more likely to have hypertension (2134 of 3989 [53.5%] vs 611 of 1336 [45.7%]), diabetes (1424 of 3989 [35.7%] vs 348 of 1336 [26.0%]), and physical limitations (2259 of 3989 [56.6%] vs 634 of 1336 [47.5%]). Compared with 2019, the odds of asystole increased in the COVID-19 period (odds ratio [OR], 3.50; 95% CI, 2.53-4.84; P < .001), as did the odds of pulseless electrical activity (OR, 1.99; 95% CI, 1.31-3.02; P = .001). Compared with 2019, the COVID-19 period had substantial reductions in return of spontaneous circulation (ROSC) (727 of 3989 patients [18.2%] vs 463 of 1336 patients [34.7%], P < .001) and sustained ROSC (423 of 3989 patients [10.6%] vs 337 of 1336 patients [25.2%], P < .001), with fatality rates exceeding 90%. These associations remained statistically significant after adjustment for potential confounders (OR for ROSC, 0.59 [95% CI, 0.50-0.70; P < .001]; OR for sustained ROSC, 0.53 [95% CI, 0.43-0.64; P < .001]). CONCLUSIONS AND RELEVANCE: In this population-based, cross-sectional study, out-of-hospital cardiac arrests and deaths during the COVID-19 pandemic significantly increased compared with the same period the previous year and were associated with older age, nonwhite race/ethnicity, hypertension, diabetes, physical limitations, and nonshockable presenting rhythms. Identifying patients with the greatest risk for out-of-hospital cardiac arrest and death during the COVID-19 pandemic should allow for early, targeted interventions in the outpatient setting that could lead to reductions in out-of-hospital deaths.


title: Structural basis for potent neutralization of SARS-CoV-2 and role of antibody affinity maturation

text: SARS-CoV-2 is a betacoronavirus virus responsible for the COVID-19 pandemic. Here, we determined the X-ray crystal structure of a potent neutralizing monoclonal antibody, CV30, isolated from a patient infected with SARS-CoV-2, in complex with the receptor binding domain (RBD). The structure reveals CV30’s epitope overlaps with the human ACE2 receptor binding site thus providing the structural basis for its neutralization by preventing ACE2 binding.


title: The future of intensive medicine

text: Abstract Although Intensive Care Medicine is a young specialty compared with other medical disciplines, it currently plays a key role in the process of care for many patients. Experience has shown that professionals with specific training in Intensive Care Medicine are needed to provide high quality care to critically ill patients. In Europe, important steps have been taken towards the standardization of training programs of the different member states. However, it is now necessary to take one more step forward, that is, the creation of a primary specialty in Intensive Care Medicine. Care of the critically ill needs to be led by specialists who have received specific and complete training and who have the necessary professional competences to provide maximum quality care to their patients. The future of the specialty presents challenges that must be faced with determination, with the main objective of meeting the needs of the population.


title: Polymorphic genetic variation in immune system genes: a study of two populations of Espirito Santo, Brazil

text: Mapping single nucleotide polymorphisms (SNPs) in genes potentially involved in immune responses may help understand the pathophysiology of infectious diseases in specific geographical regions. In this context, we have aimed to analyze the frequency of immunogenetic markers, focusing on genes CD209 (SNP -336A/G), FCγRIIa (SNP -131H/R), TNF-α (SNP -308A/G) and VDR (SNP Taq I) in two populations of the Espirito Santo State (ES), Brazil: general and Pomeranian populations. Peripheral blood genomic DNA was extracted from one hundred healthy individuals of the general population and from 59 Pomeranians. Polymorphic variant identification was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP). SNP genotype frequencies were in Hardy–Weinberg Equilibrium. There was no statistically significant difference in allelic and genotypic distributions between the two populations studied. Statistically significant differences were observed for SNP genotype distribution in genes CD209, TNF-α and VDR when comparing the ES populations with other Brazilian populations. This is the first report of CD209, FcγRIIa, TNF-α and VDR allelic frequencies for the general and Pomeranian populations of ES.


title: Mega Regions and Pandemics

text: The ongoing COVID‐19 crisis has put the relationship between spatial structure and disease exposure into relief. Here, we propose that mega regions – clusters of metropolitan regions like the Acela Corridor in the United States are more exposed to diseases earlier in pandemics. We review standard accounts for the benefits and costs of locating in such regions before arguing that pandemic risk is higher there on average. We test this mega region exposure theory with a study of the US urban system. Our results indicate that American mega regions have born the early brunt of the disease, and that three mega regions are hotspots. From this standpoint, the extent more than the intensity of New York's urbanization may be implicated in its COVID‐19 experience. We conclude that early pandemic risk is a hitherto unrecognised diseconomy operating in mega regions.


title: Neutrophil-derived chemokines on the road to immunity

text: Abstract During recent years, it has become clear that polymorphonuclear neutrophils are remarkably versatile cells, whose functions go far beyond phagocytosis and killing. In fact, besides being involved in primary defense against infections–mainly through phagocytosis, generation of toxic molecules, release of toxic enzymes and formation of extracellular traps–neutrophils have been shown to play a role in finely regulating the development and the evolution of inflammatory and immune responses. These latter neutrophil-mediated functions occur by a variety of mechanisms, including the production of newly manufactured cytokines. Herein, we provide a general overview of the chemotactic cytokines/chemokines that neutrophils can potentially produce, either under inflammatory/immune reactions or during their activation in more prolonged processes, such as in tumors. We highlight recent observations generated from studying human or rodent neutrophils in vitro and in vivo models. We also discuss the biological significance of neutrophil-derived chemokines in the context of infectious, neoplastic and immune-mediated diseases. The picture that is emerging is that, given their capacity to produce and release chemokines, neutrophils exert essential functions in recruiting, activating and modulating the activities of different leukocyte populations.


Investigation of Viral Pathogen Profiles in Some Natural Hosts and Vectors in China


If Not Now, When? the Role of Geriatric Leadership as Covid-19 Brings the World to Its Knees


title: The impact of the SARS outbreak on Taiwanese hotel stock performance: An event-study approach

text: Abstract The severe acute respiratory syndrome (SARS) outbreak in 2003 weakened the Taiwanese economy. The tourism industry suffered the most, experiencing the highest stock price decline (approximately 29 percent) within a month of the SARS outbreak. This research examined the effect of the SARS epidemic on Taiwanese hotel stock price movements using an event-study approach. Seven publicly traded hotel companies experienced steep declines in earnings and stock price during the SARS outbreak period. On and after the day of the SARS outbreak, Taiwanese hotel stocks showed significantly negative cumulative mean abnormal returns, indicating a significant impact of the SARS outbreak on hotel stock performance. Empirical findings could be used to prepare businesses for the similar epidemics, such as a deadly bird-flu epidemic.


title: Oral lesions of herpes zoster in COVID‐19 patients or truly associated to the disease?

text: In response to the report of Carreras‐Presas et al. (2020) in which they present 3 cases with vesico‐bullous oral lesions associated with SARS‐Cov‐2 infection and with very interesting findings, however we cannot consider the possibility that findings be intrinsic related to COVID‐19 disease. The first two cases presented did not have laboratory confirmation of COVID‐19 infection, but the authors reported that these patients had compatible signs and symptoms.


title: Male genital damage in COVID-19 patients: Are available data relevant?

text: Over the past few weeks, we have observed increasing concern about the possible impact of coronavirus disease 2019 (COVID-19) which is caused by SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) on male fertility. Precise mechanisms of male reproductive damages are still unclear, but it seems that high temperature resulting from persistent fever and triggering a secondary autoimmune response leading to an autoimmune orchitis are the most likely involved mechanisms. Also, angiotensin conversion enzyme 2 (ACE2) plays a highly important role in cellular entry for SARS-CoV-2 and male genital system presents high ACE2 expression. All these preliminary findings suggest that COVID-19 could impact men's reproductive health. Thus, we examined available data including published and unpublished articles to assess the potential risk of COVID-19 in particular on the male reproductive system.


title: 5-Fluorouracil in combination with deoxyribonucleosides and deoxyribose as possible therapeutic options for the Coronavirus, COVID-19 infection

text: Abstract The recent global pandemic created by the Coronavirus SARS-CoV-2, started in Wuhan, China in December 2019, has generated panic, both in term of human death (4-5% of infected patients identified through testing) and the global economy. Human sufferings seem to be continuing, and it is not clear how long this will continue and how much more destruction it is going to cause until complete control is achieved. One of the most disturbing issues is Covid-19 treatment; although a large number of medications, previously used successfully with other viruses (including Chinese herbal medicines and anti-malaria drugs), are under consideration, there remain questions as to whether they can play a satisfactory role for this disease. Global attempts are ongoing to find the drugs for the treatment of this virus but none of the antiviral drugs used for treatment of other human viral infection is working and hence attempts to find new drugs are continuing. Here the author is proposing that 5-Fluorouracil (5-FU) which when used on its own is failing as an antiviral agent due to the removal of this compound by proof reading ability exceptionally found in Coronaviruses. The author here is proposing to test 5-FU in combination with a number of deoxynucleosides on animal models infected with this Covid-19. Should encouraging results ensue, therapies could then be tried on patients.


title: Strengthening Global Health Security Capacity — Vietnam Demonstration Project, 2013

text: Over the past decade, Vietnam has successfully responded to global health security (GHS) challenges, including domestic elimination of severe acute respiratory syndrome (SARS) and rapid public health responses to human infections with influenza A(H5N1) virus. However, new threats such as Middle East respiratory syndrome coronavirus (MERS-CoV) and influenza A(H7N9) present continued challenges, reinforcing the need to improve the global capacity to prevent, detect, and respond to public health threats. In June 2012, Vietnam, along with many other nations, obtained a 2-year extension for meeting core surveillance and response requirements of the 2005 International Health Regulations (IHR). During March-September 2013, CDC and the Vietnamese Ministry of Health (MoH) collaborated on a GHS demonstration project to improve public health emergency detection and response capacity. The project aimed to demonstrate, in a short period, that enhancements to Vietnam's health system in surveillance and early detection of and response to diseases and outbreaks could contribute to meeting the IHR core capacities, consistent with the Asia Pacific Strategy for Emerging Diseases. Work focused on enhancements to three interrelated priority areas and included achievements in 1) establishing an emergency operations center (EOC) at the General Department of Preventive Medicine with training of personnel for public health emergency management; 2) improving the nationwide laboratory system, including enhanced testing capability for several priority pathogens (i.e., those in Vietnam most likely to contribute to public health emergencies of international concern); and 3) creating an emergency response information systems platform, including a demonstration of real-time reporting capability. Lessons learned included awareness that integrated functions within the health system for GHS require careful planning, stakeholder buy-in, and intradepartmental and interdepartmental coordination and communication.


title: U.S. airport entry screening in response to pandemic influenza: Modeling and analysis

text: Summary Background A stochastic discrete event simulation model was developed to assess the effectiveness of passenger screening for Pandemic Influenza (PI) at U.S. airport foreign entry. Methods International passengers arriving at 18 U.S. airports from Asia, Europe, South America, and Canada were assigned to one of three states: not infected, infected with PI, infected with other respiratory illness. Passengers passed through layered screening then exited the model. 80% screening effectiveness was assumed for symptomatic passengers; 6% asymptomatic passengers. Results In the first 100 days of a global pandemic, U.S. airport screening would evaluate over 17M passengers with 800K secondary screenings. 11,570 PI infected passengers (majority asymptomatic) would enter the U.S. undetected from all 18 airports. Foreign airport departure screening significantly decreased the false negative (infected/undetected) passengers. U.S. attack rates: no screening (26.9%–30.9%); screening (26.4%–30.6%); however airport screening results in 800K–1.8M less U.S. PI cases; 16K–35K less deaths (2% fatality rate). Antiviral medications for travel contact prophylaxis (10 contacts/PI passenger) were high – 8.8M. False positives from all 18 airports: 100–200/day. Conclusions Foreign shore exit screening greatly reduces numbers of PI infected passengers. U.S. airport screening identifies 50% infected individuals; efficacy is limited by the asymptomatic PI infected. Screening will not significantly delay arrival of PI via international air transport, but will reduce the rate of new US cases and subsequent deaths.


docid: dchqfykq

title: COVID-19 outbreak: What should be done to avoid food shortages?


title: Picture of a pandemic: visual aids in the COVID-19 crisis

text: As a global crisis, COVID-19 has underscored the challenge of disseminating evidence-based public health recommendations amidst a rapidly evolving, often uncensored information ecosystem—one fueled in part by an unprecedented degree of connected afforded through social media. In this piece, we explore an underdiscussed intersection between the visual arts and public health, focusing on the use of validated infographics and other forms of visual communication to rapidly disseminate accurate public health information during the COVID-19 pandemic. We illustrate our arguments through our own experience in creating a validated infographic for patients, now disseminated through social media and other outlets across the world in nearly 20 translations. Visual communication offers a creative and practical medium to bridge critical health literacy gaps, empower diverse patient communities through evidence-based information and facilitate public health advocacy during this pandemic and the ‘new normal’ that lies ahead.


docid: uqznzewk

title: Middle East Respiratory Syndrome Coronavirus Efficiently Infects Human Primary T Lymphocytes and Activates the Extrinsic and Intrinsic Apoptosis Pathways

text: Middle East respiratory syndrome (MERS) is associated with a mortality rate of >35%. We previously showed that MERS coronavirus (MERS-CoV) could infect human macrophages and dendritic cells and induce cytokine dysregulation. Here, we further investigated the interplay between human primary T cells and MERS-CoV in disease pathogenesis. Importantly, our results suggested that MERS-CoV efficiently infected T cells from the peripheral blood and from human lymphoid organs, including the spleen and the tonsil. We further demonstrated that MERS-CoV infection induced apoptosis in T cells, which involved the activation of both the extrinsic and intrinsic apoptosis pathways. Remarkably, immunostaining of spleen sections from MERS-CoV–infected common marmosets demonstrated the presence of viral nucleoprotein in their CD3(+) T cells. Overall, our results suggested that the unusual capacity of MERS-CoV to infect T cells and induce apoptosis might partly contribute to the high pathogenicity of the virus.


title: Acute, subacute, and chronic cervical lymphadenitis in children

text: Lymphadenopathy refers to any disease process involving lymph nodes that are abnormal in size and consistency. Lymphadenitis specifically refers to lymphadenopathies that are caused by inflammatory processes. Cervical lymphadenopathy is a common problem in the pediatric age group and is largely inflammatory and infectious in etiology. Although most patients are treated successfully by their primary care physician, surgical consultation is frequently required for patients who fail to respond to initial therapy or for those in whom there is an index of suspicion for a neoplastic process. This article addresses current approaches to the diagnosis and management of cervical lymphadenitis in children.


title: Significant changes in the chemical compositions and sources of PM2.5 in Wuhan since the city lockdown as COVID-19

text: Abstract Wuhan was the first city to adopt the lockdown measures to prevent COVID-19 spreading, which improved the air quality accordingly. This study investigated the variations in chemical compositions, source contributions, and regional transport of fine particles (PM2.5) during January 23–February 22 of 2020, compared with the same period in 2019. The average mass concentration of PM2.5 decreased from 72.9 μg m−3 (2019) to 45.9 μg m−3 (2020), by 27.0 μg m−3. It was predominantly contributed by the emission reduction (92.0%), retrieved from a random forest tree approach. The main chemical species of PM2.5 all decreased with the reductions ranging from 0.85 μg m−3 (chloride) to 9.86 μg m−3 (nitrate) (p < 0.01). Positive matrix factorization model indicated that the mass contributions of seven PM2.5 sources all decreased. However, their contribution percentages varied from −11.0% (industrial processes) to 8.70% (secondary inorganic aerosol). Source contributions of PM2.5 transported from potential geographical regions showed reductions with mean values ranging from 0.22 to 4.36 μg m−3. However, increased contributions of firework burning, secondary inorganic aerosol, road dust and vehicle emissions from transboundary transport were observed. This study highlighted the complex and nonlinear response of chemical compositions and sources of PM2.5 to air pollution control measures, suggesting the importance of regional-joint control.


title: Rhinitis Subtypes, Endotypes, and Definitions

text: Rhinitis is often seen as posing a small burden. However, rhinitis is a complex disease that is underpinned by a plethora of different mechanisms and causes. Rhinitis is frequently associated with other comorbid conditions but, by itself, is a source of considerable morbidity for patients and creates a significant financial burden on health systems worldwide. This article approaches this condition from both a phenotypic and mechanistic standpoint, focusing on the complexity of characterizing these subtypes. Developing a clearer demarcation of the currently obscure rhinitis phenotypes and endotypes will substantially improve their future prevention and treatment.


Maternal Deaths with Covid19: a different outcome from mid to low resource countries?


title: How behavioural science data helps mitigate the COVID-19 crisis

text: In the current absence of medical treatment and vaccination, the unfolding COVID-19 pandemic can only be brought under control by massive and rapid behaviour change. To achieve this we need to systematically monitor and understand how different individuals perceive risk and what prompts them to act upon it, argues Cornelia Betsch.


Coronavirus-induced CNS disease: A model for virus-induced demyelination


Enterovirus cardiovascular infection and acute myocardial infarction


title: Enhancing the Teaching of Evolution in Public Health

text: SUMMARY: Public health courses are emerging as popular undergraduate offerings, especially at universities with schools of public health. It is important to note that evolution has shaped the burden of disease in the modern world in which we practice and educate for public health. Human cultures and technologies have modified life on Planet Earth and have co-evolved with myriad other species, including microorganisms, plant and animal sources of food, invertebrate vectors of disease, and intermediate bird, mammal, and primate hosts. Molecular mechanisms of evolution have produced differential resistance or susceptibility to infectious agents, including malaria, plague, smallpox, TB, measles, and diarrheal and respiratory diseases. The domestication of sheep and cattle led to natural selection in favor of human populations able to digest milk throughout life through persistence into adulthood of lactase enzyme expression in the intestine, a major story of anthropology. The emergence of a “Western diet” of dairy, refined cereal grains, refined sugars, vegetable oils, alcoholic beverages, salt, and omega-6-rich meats has dramatically altered glycemic load, fatty acid composition, macro-nutrients, acid-base balance, sodium/potassium ratio, and fiber content. This is a major story of nutrition and disease. The results include epidemics of atherosclerotic cardiovascular disease, obesity, diabetes, high blood pressure, osteoporosis, certain cancers, and bowel, inflammatory, and autoimmune disorders. Another interesting phenomenon is the selection of excessive hemostatic activity from platelets and the plasma clotting proteins; what was protective against death from bleeding after injuries among hunter-gatherers or from pregnancy-related hemorrhage now contributes to thrombosis underlying heart attacks and strokes. Conversely, there is little pressure against hemostasis and thrombosis since deaths from these causes occur mostly after the reproductive years of life. Learning about evolution over millennia for humans and over hours or days for microbes enlivens the experience of understanding evolutionary biology in public health context.


title: D-dimer as a biomarker for disease severity and mortality in COVID-19 patients: a case control study

text: BACKGROUND: Over 5,488,000 cases of coronavirus disease-19 (COVID-19) have been reported since December 2019. We aim to explore risk factors associated with mortality in COVID-19 patients and assess the use of D-dimer as a biomarker for disease severity and clinical outcome. METHODS: We retrospectively analyzed the clinical, laboratory, and radiological characteristics of 248 consecutive cases of COVID-19 in Renmin Hospital of Wuhan University, Wuhan, China from January 28 to March 08, 2020. Univariable and multivariable logistic regression methods were used to explore risk factors associated with in-hospital mortality. Correlations of D-dimer upon admission with disease severity and in-hospital mortality were analyzed. Receiver operating characteristic curve was used to determine the optimal cutoff level for D-dimer that discriminated those survivors versus non-survivors during hospitalization. RESULTS: Multivariable regression that showed D-dimer > 2.0 mg/L at admission was the only variable associated with increased odds of mortality [OR 10.17 (95% CI 1.10–94.38), P = 0.041]. D-dimer elevation (≥ 0.50 mg/L) was seen in 74.6% (185/248) of the patients. Pulmonary embolism and deep vein thrombosis were ruled out in patients with high probability of thrombosis. D-dimer levels significantly increased with increasing severity of COVID-19 as determined by clinical staging (Kendall’s tau-b = 0.374, P = 0.000) and chest CT staging (Kendall’s tau-b = 0.378, P = 0.000). In-hospital mortality rate was 6.9%. Median D-dimer level in non-survivors (n = 17) was significantly higher than in survivors (n = 231) [6.21 (3.79–16.01) mg/L versus 1.02 (0.47–2.66) mg/L, P = 0.000]. D-dimer level of > 2.14 mg/L predicted in-hospital mortality with a sensitivity of 88.2% and specificity of 71.3% (AUC 0.85; 95% CI = 0.77–0.92). CONCLUSIONS: D-dimer is commonly elevated in patients with COVID-19. D-dimer levels correlate with disease severity and are a reliable prognostic marker for in-hospital mortality in patients admitted for COVID-19.


title: The COVID-19 Pandemic and Implications for Gynaecologic Cancer Care

text: PURPOSE: The impact of the COVID-19 pandemic on world healthcare system and economy is unprecedented. Currently routine surgical procedures are at a halt globally, but whether one can delay cancer procedures remains an ethical issue, and still there is no clarity on how women with gynaecological cancers should be managed in these critical times. METHODS: Currently available literature on impact of COVID-19 on cancer was reviewed with special reference to its applicability to the Indian context. RESULTS: Cancer cases are more susceptible for COVID-19 infection and rapid deterioration if they get infected. A tumour board should plan their management with a “do no harm” approach as the guiding principle. Teleconsultation may be used to advise patients for therapy and symptom control measures, as well as to advise new patients regarding diagnostic tests. Surgical decision making may be stratified into three categories: patients with low (not life threatening) or intermediate (potential for future morbidity or mortality) acuity may be delayed; those with high acuity may be taken up for planned therapy after explaining the risks. Assessment of the severity of disease, comorbid conditions, and logistic challenges, along with COVID census in their area are important variables for informed and individualized decision making. Safety of healthcare personnel needs to be ensured at the same time. CONCLUSION: Currently available evidence is limited by small sample size, and full impact of this pandemic on cancer is yet to be seen. However, cancer care needs to be individualized taking all variables into consideration.


title: Safety and immunogenicity of an MF59™-adjuvanted subunit influenza vaccine in elderly Chinese subjects

text: BACKGROUND: The safety and immunogenicity of an MF59™-adjuvanted subunit influenza vaccine (Sub/MF59™; FLUAD(®), Novartis Vaccines) was evaluated among elderly Chinese subjects (≥ 60 years of age). After a preliminary Phase I, open-label study (n = 25) to assess safety 1–14 days post-vaccination, a comparative observer-blind, randomised, controlled clinical trial (n = 600) was performed to assess safety and immunogenicity versus a non-adjuvanted subunit influenza vaccine (Subunit; Agrippal(®), Novartis Vaccines). Subjects were randomised (2:1) to receive Sub/MF59™ or Subunit. RESULTS: Both vaccines were well tolerated, with no vaccine-related serious adverse events reported during the Phase I trial. During the observer-blind study, local and systemic reactions were generally similar for both vaccines 1–22 days post-vaccination; however, injection-site induration was more frequent among the Subunit group (P < 0.05), and mild pain at the injection site and fever were more frequent among Sub/MF59™ recipients (P ≤ 0.005). Both vaccines induced a significant (P < 0.001) increase in geometric mean titres (GMTs) for the three strains tested, versus baseline; GMTs against A/H1N1, A/H3N2 and B were significantly higher in the Sub/MF59™ group (P = 0.034, P < 0.001 and P = 0.005, respectively). GMT ratios against A/H1N1, A/H3N2 and B were also significantly higher in the Sub/MF59™ group (P = 0.038, P < 0.001 and P = 0.006, respectively). Similarly, the percentage of subjects achieving seroprotection or seroconversion on Day 22 was greater for Sub/MF59™ recipients, reaching significance for A/H3N2 (P < 0.001). CONCLUSION: MF59™-adjuvanted subunit influenza vaccine is well tolerated by elderly Chinese subjects and induces a higher level of immunogenicity than a non-adjuvanted subunit influenza vaccine in this population that is at high risk of influenza-related complications. CLINICAL TRIAL REGISTRY: , NCT00310648


title: Novel Virostatic Agents against Bluetongue Virus

text: Bluetongue virus (BTV), a member in the family Reoviridae, is a re-emerging animal disease infecting cattle and sheep. With its recent outbreaks in Europe, there is a pressing need for efficacious antivirals. We presented here the identification and characterization of a novel virostatic molecule against BTV, an aminothiophenecarboxylic acid derivative named compound 003 (C003). The virostatic efficacy of C003 could be improved via chemical modification, leading to a de novo synthesized compound 052 (C052). The 50% effective concentrations (EC(50)) of C003 and C052 were determined at 1.76±0.73 µM and 0.27±0.12 µM, respectively. The 50% cytotoxicity concentration (CC(50)) of C003 was over 100 µM and the CC(50) of C052 was at 82.69 µM. Accordingly, the 50% selective index (SI(50)) of C003 and C052 against BTV was over 57 and 306, respectively. The inhibitory effect of C003/C052 on BTV-induced apoptosis was also confirmed via the inhibition of caspase-3/-7 activation post BTV infection. C003/C052 could inhibit BTV induced CPE even when added as late as 24 h.p.i., indicating that they might act at late stage of viral life-cycle. C003/C052 could reduce over two-logs of both the progeny virus production and the number of genomic viral RNA copies. Interestingly, both the activation of host autophagy and viral protein expression were inhibited post BTV infection when cells were treated with C003 and C052, suggesting that C003/C052 might act as virostatic agents via inhibiting host autophagy activation. Although further investigations might be needed to pin down the exact mechanism of C003/C052, our finding suggested that these compounds might be potent lead compounds with potential novel mechanism of action against BTV.


title: Impact of genotype 1 and 2 of porcine reproductive and respiratory syndrome viruses on interferon-α responses by plasmacytoid dendritic cells

text: Porcine reproductive and respiratory syndrome (PRRS) virus (PRRSV) infections are characterized by prolonged viremia and viral shedding consistent with incomplete immunity. Type I interferons (IFN) are essential for mounting efficient antiviral innate and adaptive immune responses, but in a recent study, North American PRRSV genotype 2 isolates did not induce, or even strongly inhibited, IFN-α in plasmacytoid dendritic cells (pDC), representing “professional IFN-α-producing cells”. Since inhibition of IFN-α expression might initiate PRRSV pathogenesis, we further characterized PRRSV effects and host modifying factors on IFN-α responses of pDC. Surprisingly, a variety of type 1 and type 2 PRRSV directly stimulated IFN-α secretion by pDC. The effect did not require live virus and was mediated through the TLR7 pathway. Furthermore, both IFN-γ and IL-4 significantly enhanced the pDC production of IFN-α in response to PRRSV exposure. PRRSV inhibition of IFN-α responses from enriched pDC stimulated by CpG oligodeoxynucleotides was weak or absent. VR-2332, the prototype genotype 2 PRRSV, only suppressed the responses by 34%, and the highest level of suppression (51%) was induced by a Chinese highly pathogenic PRRSV isolate. Taken together, these findings demonstrate that pDC respond to PRRSV and suggest that suppressive activities on pDC, if any, are moderate and strain-dependent. Thus, pDC may be a source of systemic IFN-α responses reported in PRRSV-infected animals, further contributing to the puzzling immunopathogenesis of PRRS.


Bringing Nuance to “the Science” in Public Policy and Science Understanding


title: Acyclic nucleoside phosphonates containing the amide bond

text: ABSTRACT: To study the influence of a linker rigidity and donor–acceptor properties, the P–CH(2)–O–CHR– fragment in acyclic nucleoside phosphonates (e.g., acyclovir, tenofovir) was replaced by the P–CH(2)–HN–C(O)– residue. The respective phosphonates were synthesized in good yields by coupling the straight chain of ω-aminophosphonates and nucleobase-derived acetic acids with EDC. Based on the (1)H and (13)C NMR data, the unrestricted rotation within the methylene and 1,2-ethylidene linkers in phosphonates from series a and b was confirmed. For phosphonates containing 1,3-propylidene (series c) fragments, antiperiplanar disposition of the bulky O,O-diethylphosphonate and substituted amidomethyl groups was established. The synthesized ANPs P–X–HNC(O)–CH(2)B (X = CH(2), CH(2)CH(2), CH(2)CH(2)CH(2), CH(2)OCH(2)CH(2)) appeared inactive in antiviral assays against a wide variety of DNA and RNA viruses at concentrations up to 100 μM while marginal antiproliferative activity (L1210 cells, IC(50) = 89 ± 16 μM and HeLa cells, IC(50) = 194 ± 19 μM) was noticed for the analog derived from (5-fluorouracyl-1-yl)acetic acid and O,O-diethyl (2-aminoethoxy)methylphosphonate. GRAPHICAL ABSTRACT: [Image: see text]


Reply to ‘CORONA-steps for tracheotomy in COVID-19 patients: a staff-safe method for airway management’ by Ferreli F. et al


title: How you can help with COVID-19 modelling

text: Many physicists want to use their mathematical modelling skills to study the COVID-19 pandemic. Julia Gog, a mathematical epidemiologist, explains some ways to contribute.


Futuro de la neurorrehabilitación a partir de la pandemia por el SARS-CoV-2


title: Autophagy and Viral Infection

text: Autophagy is an intracellular recycling process that maintains cellular homeostasis by orchestrating immunity upon viral infection. Following viral infection, autophagy is often initiated to curtail infection by delivering viral particles for lysosomal degradation and further integrating with innate pattern recognition receptor signaling to induce interferon (IFN)-mediated viral clearance. However, some viruses have evolved anti-autophagy strategies to escape host immunity and to promote viral replication. In this chapter, we illustrate how autophagy prevents viral infection to generate an optimal anti-viral milieu, and then concentrate on how viruses subvert and hijack the autophagic process to evade immunosurveillance, thereby facilitating viral replication and pathogenesis. Understanding the interplays between autophagy and viral infection is anticipated to guide the development of effective anti-viral therapeutics to fight against infectious diseases.


title: Detection of bovine coronavirus in feces by reversed passive hemagglutination

text: A reversed passive hemagglutination (RPHA) method was developed for the detection of bovine coronavirus in fecal specimens. Sheep erythrocytes fixed with glutaraldehyde, and then treated with tannic acid were coated with anti-bovine coronavirus rabbit antibodies purified by affinity chromatography using bovine coronavirus linked to Sepharose 4B. The RPHA test was carried out by a microtiter method. Erythrocytes coated with purified specific antibodies were agglutinated by bovine coronavirus, but not by bovine rotavirus or enterovirus. The reaction was inhibited by antiserum to bovine coronavirus, confirming the specificity of the reaction. The RPHA test detected bovine coronavirus in 13 of 22 fecal specimens (59 per cent), from natural cases of diarrhea, while the positive rates were only 14 per cent (3/22) and 22 per cent (5/22) for immunofluorescent staining of primary cultures of calf kidney cells infected with the specimens, and immune electron microscopy respectively. The advantages of the RPHA method are its simplicity, high sensitivity and rapidity.


title: Effects of Triton X-100 on Properties of Hemoglobin and Controlled Release of Drug in Hemoglobin/Ribavirin/H2O System

text: Abstract Effects of Triton X-100 on the properties of hemoglobin (Hb) and on the controlled release of ribavirin were studied using the methods of UV-Vis spectrum, fluorescence spectrum, zeta potential, conductivity, high-performance liquid chromatographic (HPLC), and image morphology in Hb/ribavirin/H2O system. With the increase of concentration of Triton X-100 in the system, the intrinsic fluorescence intensity, synchronous fluorescence intensity, fluorescence polarization, zeta potential, and morphology of Hb all changed gradually, and the ribavirin located on the Hb surface was dissociated and released out. When the concentration of Triton X-100 was higher than 1×10−5 mol·L−1, the stronger interaction of Triton X-100 with Hb was predominant. Hb was unfolded and denaturized. A little Triton X-100 can protect Hb from the effects of ribavirin.


title: Mathematical modeling of infectious disease dynamics

text: Over the last years, an intensive worldwide effort is speeding up the developments in the establishment of a global surveillance network for combating pandemics of emergent and re-emergent infectious diseases. Scientists from different fields extending from medicine and molecular biology to computer science and applied mathematics have teamed up for rapid assessment of potentially urgent situations. Toward this aim mathematical modeling plays an important role in efforts that focus on predicting, assessing, and controlling potential outbreaks. To better understand and model the contagious dynamics the impact of numerous variables ranging from the micro host–pathogen level to host-to-host interactions, as well as prevailing ecological, social, economic, and demographic factors across the globe have to be analyzed and thoroughly studied. Here, we present and discuss the main approaches that are used for the surveillance and modeling of infectious disease dynamics. We present the basic concepts underpinning their implementation and practice and for each category we give an annotated list of representative works.


title: The need for urogenital tract monitoring in COVID-19

text: Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2, which invades a cell through binding to the ACE2 receptor and TMPRSS2 priming. Patients with severe disease predominantly present with pneumonia-related symptoms. However, evidence suggests that COVID-19 infection also has implications for the urogenital tract. Thus, urogenital organs should be considered when treating COVID-19.


Transverse leukonychia (Mees’ lines) nail alterations in a COVID‐19 patient


title: French West Indies castaway children as a result of the covid‐19 outbreak

text: I read with interest the submission of Haward et al. (1) dealing with the pediatrical ethics issues during this Covid‐19 outbreak. I was particularly sensitive to the chapter dedicated to neonatal which highlighted very clearly the indirect consequences of this pandemic on the paediatric population. I would like to insist on the situation in the West Indies. The numbers of adult's vital distress sharply increase the need for intensive care beds. Even the great majority of pediatric intensive care units have provided equipment and staff to support the adult units (2).


title: Risk of transmission via medical employees and importance of routine infection-prevention policy in a nosocomial outbreak of Middle East respiratory syndrome (MERS): a descriptive analysis from a tertiary care hospital in South Korea

text: BACKGROUND: In 2015, South Korea experienced an outbreak of Middle East respiratory syndrome (MERS), and our hospital experienced a nosocomial MERS infection. We performed a comprehensive analysis to identify the MERS transmission route and the ability of our routine infection-prevention policy to control this outbreak. METHODS: This is a case–cohort study of retrospectively analysed data from medical charts, closed-circuit television, personal interviews and a national database. We analysed data of people at risk of MERS transmission including 228 in the emergency department (ED) and 218 in general wards (GW). Data of personnel location and movement, personal protection equipment and hand hygiene was recorded. Transmission risk was determined as the extent of exposure to the index patient: 1) high risk: staying within 2 m; 2) intermediate risk: staying in the same room at same time; and 3) low risk: only staying in the same department without contact. RESULTS: The index patient was an old patient admitted to our hospital. 11 transmissions from the index patient were identified; 4 were infected in our hospital. Personnel in the ED exhibited higher rates of compliance with routine infection-prevention methods as observed objectively: 93% wore a surgical mask and 95.6% washed their hands. Only 1.8% of personnel were observed to wear a surgical mask in the GW. ED had a higher percentage of high-risk individuals compared with the GW (14.5% vs. 2.8%), but the attack rate was higher in the GW (16.7%; l/6) than in the ED (3%; 1/33). There were no transmissions in the intermediate- and low-risk groups in the ED. Otherwise 2 patients were infected in the GW among the low-risk group. MERS were transmitted to them indirectly by staff who cared for the index patient. CONCLUSIONS: Our study provide compelling evidence that routine infection-prevention policies can greatly reduce nosocomial transmission of MERS. Conventional isolation is established mainly from contact tracing of patients during a MERS outbreak. But it should be extended to all people treated by any medical employee who has contact with MERS patients. TRIAL REGISTRATION: NCT02605109, date of registration: 11th November 2015.


title: What do we know about the SARS-CoV-2 coronavirus in the environment?

text: Abstract In view of the current situation regarding the Covid-19 disease, a discussion is proposed on the need for research focusing on the presence and evolution of the SARS-CoV-2 virus in water, soils and other environmental compartments, reached through wastewater and sewage sludge spreading. Also, the evaluation of current treatments for wastewater and sewage sludge, as well as the eventual development of new specific techniques, based on sorption, nanotechnology, etc., would be of great interest for controlling the environmental dissemination of these viruses in the current and eventual future outbreaks.


title: Bariatric surgery during covid-19 pandemic from patients’ point of view—the results of a national survey

text: Introduction: The aim of the study was to investigate the impact of the COVID-19 pandemic on bariatric care from the patients’ point of view. The COVID-19 pandemic has perturbed the functioning of healthcare systems around the world and led to changes in elective surgical care, with bariatric procedures being postponed until the end of pandemic. There is no data in the literature about the effect of a new epidemiological situation on bariatric patients. Methods: The study was designed as an online survey containing multiple open questions about bariatric care during the COVID-19 pandemic. The survey was conducted among pre- and postoperative bariatric patients. Results: Out of 800 respondents, 74.53% felt anxiety about their health in regard to the present epidemiologic state. Some (72.25%) were aware of the fact that obesity was an important risk factor that could impair the course of the COVID-19 disease. Almost 30% of respondents admitted having put on weight, significantly more in the group of preoperative patients (43.8% vs 22.69%; p < 0.001). Only 20.92% of patients had a possibility of continuing direct bariatric care; 67.3% of patients had an opportunity of remote contact with a bariatric specialist, including online consultations, teleconsultations and social media meetings. Conclusions: Limited access to medical care and quarantine lockdown may result in a deterioration of long-time operation outcomes and lower weight losses. Patients should be encouraged to profit from online consultations with specialists and telemedicine to reduce the negative effects of the pandemic on their health.


title: Elucidating the Interacting Domains of Chandipura Virus Nucleocapsid Protein

text: The nucleocapsid (N) protein of Chandipura virus (CHPV) plays a crucial role in viral life cycle, besides being an important structural component of the virion through proper organization of its interactions with other viral proteins. In a recent study, the authors had mapped the associations among CHPV proteins and shown that N protein interacts with four of the viral proteins: N, phosphoprotein (P), matrix protein (M), and glycoprotein (G). The present study aimed to distinguish the regions of CHPV N protein responsible for its interactions with other viral proteins. In this direction, we have generated the structure of CHPV N protein by homology modeling using SWISS-MODEL workspace and Accelrys Discovery Studio client 2.55 and mapped the domains of N protein using PiSQRD. The interactions of N protein fragments with other proteins were determined by ZDOCK rigid-body docking method and validated by yeast two-hybrid and ELISA. The study revealed a unique binding site, comprising of amino acids 1–30 at the N terminus of the nucleocapsid protein (N1) that is instrumental in its interactions with N, P, M, and G proteins. It was also observed that N2 associates with N and G proteins while N3 interacts with N, P, and M proteins.


title: A high ATP concentration enhances the cooperative translocation of the SARS coronavirus helicase nsP13 in the unwinding of duplex RNA

text: Severe acute respiratory syndrome coronavirus nonstructural protein 13 (SCV nsP13), a superfamily 1 helicase, plays a central role in viral RNA replication through the unwinding of duplex RNA and DNA with a 5′ single-stranded tail in a 5′ to 3′ direction. Despite its putative role in viral RNA replication, nsP13 readily unwinds duplex DNA by cooperative translocation. Herein, nsP13 exhibited different characteristics in duplex RNA unwinding than that in duplex DNA. nsP13 showed very poor processivity on duplex RNA compared with that on duplex DNA. More importantly, nsP13 inefficiently unwinds duplex RNA by increasing the 5′-ss tail length. As the concentration of nsP13 increased, the amount of unwound duplex DNA increased and that of unwound duplex RNA decreased. The accumulation of duplex RNA/nsP13 complexes increased as the concentration of nsP13 increased. An increased ATP concentration in the unwinding of duplex RNA relieved the decrease in duplex RNA unwinding. Thus, nsP13 has a strong affinity for duplex RNA as a substrate for the unwinding reaction, which requires increased ATPs to processively unwind duplex RNA. Our results suggest that duplex RNA is a preferred substrate for the helicase activity of nsP13 than duplex DNA at high ATP concentrations.