title: Head and neck oncological ablation and reconstruction in the COVID-19 era – Our experience to date

text: The COVID-19 pandemic has caused unprecedented disruption to the routine operations of healthcare services across the world. As the potential duration of the pandemic remains uncertain, the need to develop strategies to continue urgent elective services has received increasing attention. A solution adopted in the Kent, Sussex and Surrey area of England has been to create COVID-19-protected cancer hubs. The Queen Victoria Hospital is the designated hub for head and neck cancer services in the area. We report on the evolution of the head and neck cancer care pathway and standard operating protocols put in place and how these have combined both national guidelines and local problem solving. It is hoped that our experience can help guide other centres as they re-establish head and neck cancer services during the ongoing pandemic.


title: The mediating effect of air quality on the association between human mobility and COVID-19 infection in China

text: BACKGROUND: Previous studies have found that human mobility restrictions could not only prevent the spread of COVID-19, but also improve the air quality because of the reduction of industrial production, transportation and traffic. It is noteworthy that air quality is also closely related to the risk of COVID-19 infection. Therefore, we aimed to assess the mediating role of air quality on the association between human mobility and the infection caused by this novel coronavirus. METHODS: We collected daily confirmed cases, human mobility data, air quality data and meteorological variables in 120 cities from China between January 23, 2020 and February 29, 2020. We applied the generalized additive model to examine the association of human mobility index with COVID-19 confirmed cases, and to assess the mediating effects of air quality index and each pollutant. RESULTS: We observed a significant positive relationship between human mobility index and the daily counts of COVID-19 confirmed cases. A unit increase in human mobility index (lag0–14) was associated with a 6.45% increase in daily COVID-19 confirmed cases, and air quality index significantly mediated 19.47% of this association. We also observed a positive relationship between human mobility index and air quality index. In the pollutant level analyses, we found significant mediating effects of PM(2.5), PM(10), and NO(2). CONCLUSIONS: Our study suggests that limiting human movements could reduce COVID-19 cases by improving air quality besides decreasing social contact.


title: Zn(2+) Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture

text: Increasing the intracellular Zn(2+) concentration with zinc-ionophores like pyrithione (PT) can efficiently impair the replication of a variety of RNA viruses, including poliovirus and influenza virus. For some viruses this effect has been attributed to interference with viral polyprotein processing. In this study we demonstrate that the combination of Zn(2+) and PT at low concentrations (2 µM Zn(2+) and 2 µM PT) inhibits the replication of SARS-coronavirus (SARS-CoV) and equine arteritis virus (EAV) in cell culture. The RNA synthesis of these two distantly related nidoviruses is catalyzed by an RNA-dependent RNA polymerase (RdRp), which is the core enzyme of their multiprotein replication and transcription complex (RTC). Using an activity assay for RTCs isolated from cells infected with SARS-CoV or EAV—thus eliminating the need for PT to transport Zn(2+) across the plasma membrane—we show that Zn(2+) efficiently inhibits the RNA-synthesizing activity of the RTCs of both viruses. Enzymatic studies using recombinant RdRps (SARS-CoV nsp12 and EAV nsp9) purified from E. coli subsequently revealed that Zn(2+) directly inhibited the in vitro activity of both nidovirus polymerases. More specifically, Zn(2+) was found to block the initiation step of EAV RNA synthesis, whereas in the case of the SARS-CoV RdRp elongation was inhibited and template binding reduced. By chelating Zn(2+) with MgEDTA, the inhibitory effect of the divalent cation could be reversed, which provides a novel experimental tool for in vitro studies of the molecular details of nidovirus replication and transcription.


title: Human Adenovirus Type 7 Outbreak in Police Training Center, Malaysia, 2011

text: In March 2011, an outbreak of acute respiratory disease was reported at the Kuala Lumpur (Malaysia) Police Training Centre. Approximately 100 trainees were hospitalized and 5 were admitted to the intensive care unit. Three of these 5 trainees died. Human adenovirus type 7 was identified as the etiologic agent.


title: Association of bacteria and viruses with wheezy episodes in young children: prospective birth cohort study

text: Objective To study the association between wheezy symptoms in young children and the presence of bacteria in the airways. Design Birth cohort study. Setting Clinical research unit in Copenhagen. Participants Children of asthmatic mothers, from age 4 weeks to 3 years, with planned visits and acute admissions to the research clinic. Main outcome measure Frequency of bacteria and virus carriage in airway aspirates during wheezy episodes and at planned visits without respiratory symptoms. Results 984 samples (361 children) were analysed for bacteria, 844 (299 children) for viruses, and 696 (277 children) for both viruses and bacteria. Wheezy episodes were associated with both bacterial infection (odds ratio 2.9, 95% confidence interval 1.9 to 4.3; P<0.001) and virus infection (2.8, 1.7 to 4.4; P<0.001). The associations of bacteria and viruses were independent of each other. Conclusion Acute wheezy episodes in young children were significantly associated with bacterial infections similar to but independent of the association with virus infections.


title: Epidemiology of viral respiratory tract infections in an outpatient haematology facility

text: Viral respiratory tract infections (VRTI) are an important cause of morbidity and mortality in haematology patients, particularly after haematopoietic stem cell transplantation (HSCT). The incidence, clinical presentation and outcome of symptomatic and asymptomatic VRTI in HSCT outpatient unit were prospectively evaluated during a single influenza season (January–March 2011). Pharyngeal swabs were performed at the first visit and if new symptoms were present. Molecular multiplex assay for 12 respiratory viruses was performed by the regional reference laboratory. Among 264 swabs from 193 outpatients, 58 (22 %) resulted positive for 61 viruses (influenza, n = 20; respiratory syncytial virus [RSV], n = 21; rhinovirus, n = 12; coronavirus, n = 4; adenovirus, n = 3; parainfluenza, n = 1). VRTI were detected more frequently in the presence of symptoms than in asymptomatic patients: 49 out of 162 (30 %) vs. 9 out of 102 (9 %), p < 0.001. Influenza-like illness syndrome (ILI) was significantly associated with a VRTI if compared to other presentations (42 %), while the European Centre for Disease Prevention and Control definition was not (30 %). Positive predictive value (PPV) of ILI for influenza was 17 %. Influenza and RSV peak periods were contemporary. Influenza prophylaxis was given to 25 patients following exposure. Low rate of progression from upper to lower respiratory tract infection (approximately 5 % for influenza and RSV), no nosocomial epidemics and no VRTI-related deaths were observed. VRTI are very frequent in high-risk haematology outpatients, but symptoms are aspecific and PPV of ILI is low. Symptoms of influenza and RSV overlap. Thus, microbiological diagnosis and contact preventive measures are crucial. Rather than universal influenza prophylaxis, prompt diagnosis and treatment of only documented infections could be pursued.


docid: jnwbodwm

title: Hotline Services in China during COVID-19 Pandemic

text: • Many countries are taking quarantine measures because of the globally spread transmission of the COVID-19, which may pose adverse psychological effects to people; • Hotline Services is a great choice to provide psychological services for people in need since face-to-face social interaction are limited; • Hotline service should cover more than regular working hours; • To increase the answering seats of existing hotlines; • Training including both crisis intervention skills and COVID-19 pandemic related knowledge for volunteers before providing hotline services is recommended.


title: MY COVID‐19 DIARY

text: Written in weekly instalments, Michelle Munyikwa's Covid‐19 diary reflects upon the experience of an unfolding pandemic from her dual role as a medical trainee and anthropologist living in the United States. Her observations centre on everyday encounters with scenes or objects that reflect the growing crisis, from the absence of masks outside patient rooms to emergent forms of care through telemedicine. The diary follows the author as she experiences grief, ambivalence and disorientation in the first weeks of the pandemic.


title: Epigenetic mechanisms in human adenovirus type 12 oncogenesis

text: Abstract For the past 30 years, my laboratory has concentrated its work on demonstrating that the epigenetic consequences of foreign DNA insertion into established mammalian genomes – de novo DNA methylation of the integrate and alterations of methylation patterns across the recipient genome – are essential elements in setting the stage towards oncogenic transformation. We have primarily studied human adenovirus type 12 (Ad12) which induces undifferentiated tumors in Syrian hamsters (Mesocricetus auratus) either at the site of subcutaneous Ad12 injection or intraperitoneally upon intramuscular injection. Up to 90% of the hamsters injected with Ad12 develop tumors within 3–6 weeks. Integration of foreign DNA, its de novo methylation, and the consequences of insertion on the cellular methylation and transcription profiles have been studied in detail. While viral infections are a frequent source of foreign genomes entering mammalian and other hosts and often their genomes, we have also pursued the fate of food-ingested foreign DNA in the mouse organism. The persistence of this DNA in the animals is transient and there is no evidence for the expression or germ line fixation of foreign DNA. Nevertheless, the occasional cell that carries integrated genomes from that foreign source deserves the oncologist's sustained interest.


title: Strain specific antibodies revealed by immunoabsorption studies with avian infectious bronchitis virus

text: Rabbit antisera prepared against the Massachusetts 41 (M41) strain of avian infectious bronchitis virus (IBV) and absorbed with chick embryo immunoabsorbent produced multiple precipitin lines in immunodouble-diffusion (IDD) tests with homologous or heterologous strains of virus. These precipitin lines were all removed by absorption with concentrated M41 virus preparations, but repeated absorption with concentrated, purified preparations of IBV strains: T, Holte, Connecticut, Beaudette or H120 failed to remove all precipitin lines produced to M41 virus, although all those to the heterologous viruses were removed. The remaining line(s) produced with M41 virus by sera absorbed with different heterologous viruses showed identity in IDD tests and was associated with the surface projections of the virus.


docid: tgjvvrmc

title: Biological risk and pollution history of polycyclic aromatic hydrocarbons (PAHs) in Nansha mangrove, South China

text: Abstract Chinese government has taken various measures to alleviate pollution caused by polycyclic aromatic hydrocarbons (PAHs) in the region of Pearl River Delta since the economic reform in 1978, but the effectiveness of these measures remains largely unknown. This study aimed to elucidate the biological risk and pollution history of PAHs by measuring the concentrations of 28 PAHs in the surface and core sediments, respectively, in Nansha mangrove. Results found that the biological risk of PAHs was low without obvious spatial variation. The PAH concentration along the depth gradient indicated that PAH pollution was stabilized since the early 1990s while the source of PAHs has gradually changed from combustion of coal to petroleum products. This implied that the mitigation measures taken by the Chinese government were effective. Compared to marine bottom sediment, we propose that using mangrove sediment can provide a more accurate and precise estimate of pollution history of PAHs.


title: Comment je fais: Prise en charge des patients en Radiologie Interventionnelle Oncologique en période de pandémie au SARS-CoV-2

text: Résumé Introduction: L’activité d’oncologie en radiologie interventionnelle (RI) doit rester une priorité parmi l’activité de RI en période de pandémie au SARS-CoV-2. Elle doit s’adapter aux ressources anesthésiques et capacité d’hospitalisation des patients. Elle doit assurer la sécurité et la protection des patients non suspects d’être atteints par le SARS-CoV-2 ainsi que du personnel quant à la transmission du COVID-19. Messages principaux: Les actes diagnostiques et thérapeutiques d’oncologie constituent une priorité en période de pandémie à COVID-19. L’état général du patient, ses comorbidités, les risques de contracter une forme grave de COVID-19, devront être pris en compte pour un éventuel report d’intervention ou un transfert du patient vers une structure moins sollicitée par les patients malades du COVID-19. Toutes les étapes du parcours oncologique en radiologie interventionnelle (réunion de concertation pluridisciplinaire, consultation pré et post-thérapeutique, imagerie pré et post-thérapeutique et intervention de RI) doivent être organisées dans le respect des mesures barrières (règles d’hygiène et de distanciation sociale) pour assurer la protection des patients et du personnel d’une contamination au SARS-CoV-2. Le dépistage des patients COVID-suspects doit être effectué scrupuleusement avant chaque étape du parcours de soin. Les téléconsultations doivent être favorisées, en dehors des consultations couplées à une échographie de faisabilité. Si un bilan scanographique est nécessaire avant une prise en charge, une exploration thoracique peut permettre de découvrir fortuitement des lésions suspectes de COVID-19. Les conditions d’anesthésie (curarisation) doivent être discutées avec l’équipe d’anesthésie-réanimation afin d’optimiser l’utilisation des drogues anesthésiques et diminuer le risque de contagion en salle. Les anesthésies loco-régionales doivent être favorisées. En cette période pandémique, les techniques mini-invasives de RIO doivent être favorisées aux dépens des traitements chirurgicaux pour diminuer les ressources anesthésiques (personnel et médicaments) en rapport avec les recommandations des sociétés savantes. Un protocole de prise en charge des patients avec un circuit « COVID-non suspect » d’une part et un circuit « COVID-suspect » et « COVID-confirmé » doit être mis en place en collaboration avec l’équipe d’hygiène et l’équipe d’anesthésie. Conclusion: Le patient oncologique doit être une priorité pour la RI en période de pandémie au COVID-19. Toutes les mesures doivent être mises en œuvre pour diminuer le risque de transmission aux patients et au personnel. La RI peut permettre d’optimiser les ressources anesthésiques (médecins et médicaments). Abstract Introduction: Interventional oncology should remain a priority among interventional radiology procedures during the SARS-CoV-2 global pandemic. It should be adapted to anesthetic resources and hospital beds capacity. Oncology patients not affected by COVID-19 should be treated in a safe environment to reduce the risk of exposure. Take-home points: Diagnostic and interventional radiology in oncology should remain a priority consideration during the SARS-CoV-2 global pandemic. Health status, comorbidities and risk of being severely affected by COVID-19 should be taken into consideration for post postponement of elective procedures or patient referral to a hospital not specialized in the fight against COVID-19. The different steps of the oncology clinical pathway including pluridisciplinary tumor board, pre and post-interventional office visits, pre and post-procedural imaging and interventional radiology procedures should be reorganized in order to provide appropriate services (hygiene practices and physical barriers) to reduce the risk of transmission of COVID-19 to patients et healthcare personnel. Phone calls to patients planned to be admitted the following days should be organized to ensure these patients do not present any symptoms suggestive of COVID-19. Telemedicine or phone calls should replace office visits unless an ultrasound examination is scheduled for the pre-intervention evaluation. If CT examination is necessary for the oncological evaluation, pulmonary lesions compatible with COVID-19 may be accidentally diagnosed. Careful attention should be paid to the indications and types of drugs used for general anesthesia in patients with COVID-19 because of medication shortage and to prevent cross-contamination of patients and medical staff. Locoregional anesthesia should be favored. Minimally-invasive interventional oncology procedures should be favored as an alternative to surgery to spare medical resources and medications in accordance with the recommendations of national oncological societies. Institutional healthcare policies and protocols must be organized with identification of dedicated COVID-19 transportation and care sections. Conclusion: Oncological procedures should be prioritized during the COVID-19 pandemic. Protective measures must be in place throughout the hospital and the radiology department to reduce the risks of exposure of the patients and the staff. Interventional radiology procedures offered as alternative treatments to surgery may optimize medical resources, anesthetic drugs and critical care unit beds.


docid: jetmocvk

title: Targeting N-Glycan Cryptic Sugar Moieties for Broad-Spectrum Virus Neutralization: Progress in Identifying Conserved Molecular Targets in Viruses of Distinct Phylogenetic Origins

text: Identifying molecular targets for eliciting broadly virus-neutralizing antibodies is one of the key steps toward development of vaccines against emerging viral pathogens. Owing to genomic and somatic diversities among viral species, identifying protein targets for broad-spectrum virus neutralization is highly challenging even for the same virus, such as HIV-1. However, viruses rely on host glycosylation machineries to synthesize and express glycans and, thereby, may display common carbohydrate moieties. Thus, exploring glycan-binding profiles of broad-spectrum virus-neutralizing agents may provide key information to uncover the carbohydrate-based virus-neutralizing epitopes. In this study, we characterized two broadly HIV-neutralizing agents, human monoclonal antibody 2G12 and Galanthus nivalis lectin (GNA), for their viral targeting activities. Although these agents were known to be specific for oligomannosyl antigens, they differ strikingly in virus-binding activities. The former is HIV-1 specific; the latter is broadly reactive and is able to neutralize viruses of distinct phylogenetic origins, such as HIV-1, severe acute respiratory syndrome coronavirus (SARS-CoV), and human cytomegalovirus (HCMV). In carbohydrate microarray analyses, we explored the molecular basis underlying the striking differences in the spectrum of anti-virus activities of the two probes. Unlike 2G12, which is strictly specific for the high-density Man(9)GlcNAc(2)Asn (Man9)-clusters, GNA recognizes a number of N-glycan cryptic sugar moieties. These include not only the known oligomannosyl antigens but also previously unrecognized tri-antennary or multi-valent GlcNAc-terminating N-glycan epitopes (Tri/m-Gn). These findings highlight the potential of N-glycan cryptic sugar moieties as conserved targets for broad-spectrum virus neutralization and suggest the GNA-model of glycan-binding warrants focused investigation.


title: Repurposing current therapeutics for treating COVID‐19: A vital role of prescription records data mining

text: Since its outbreak in late 2019, the SARS‐Cov‐2 pandemic already infected over 3.7 million people and claimed more than 250,000 lives globally. At least 1 year may take for an approved vaccine to be in place, and meanwhile millions more could be infected, some with fatal outcome. Over thousand clinical trials with COVID‐19 patients are already listed in ClinicalTrials.com, some of them for assessing the utility of therapeutics approved for other conditions. However, clinical trials take many months, and are typically done with small cohorts. A much faster and by far more efficient method for rapidly identifying approved therapeutics that can be repurposed for treating COVID‐19 patients is data mining their past and current electronic health and prescription records for identifying drugs that may protect infected individuals from severe COVID‐19 symptoms. Examples are discussed for applying health and prescription records for assessing the potential repurposing (repositioning) of angiotensin receptor blockers, estradiol, or antiandrogens for reducing COVID‐19 morbidity and fatalities. Data mining of prescription records of COVID‐19 patients will not cancel the need for conducting controlled clinical trials, but could substantially assist in trial design, drug choice, inclusion and exclusion criteria, and prioritization. This approach requires a strong commitment of health provides for open collaboration with the biomedical research community, as health provides are typically the sole owners of retrospective drug prescription records.


title: Scribes, EHRs, and Workflow Efficiencies in Allergy Practices

text: PURPOSE OF REVIEW: In the ever-changing healthcare system, along with new advancements in the field of allergy, the workflow for the allergist continues to evolve requiring more time spent doing non-clinical duties such as documentation and reviewing reimbursement challenges in the midst of busy clinics. The use of electronic medical records and medical scribes has emerged as tactics to aid the clinic’s workflow and efficiency in the modern allergy and immunology clinic. RECENT FINDINGS: The practicing allergist can implement various additional strategies in their office workflow to maximize and synthesize good medicine and good business. Optimal use of office staff, electronic health records, and various workflow efficiencies has been shown to improve job satisfaction and reduce physician burnout. SUMMARY: By utilizing these methods and integrating them into their practices, allergists will be able to meet the demands of the healthcare system and still provide patients with evidence based, compassionate, and cost-effective care.


title: Dynamics of a Cytokine Storm

text: Six volunteers experienced severe inflammatory response during the Phase I clinical trial of a monoclonal antibody that was designed to stimulate a regulatory T cell response. Soon after the trial began, each volunteer experienced a “cytokine storm”, a dramatic increase in cytokine concentrations. The monoclonal antibody, TGN1412, raised serum concentrations of both pro- and anti-inflammatory cytokines το very hiγh values during the first day, while lymphocyte and monocyte concentrations plummeted. Because the subjects were healthy and had no prior indications of immune deficiency, this event provided an unusual opportunity to study the dynamic interactions of cytokines and other measured parameters. Here, the response histories of nine cytokines have been modeled by a set of linear ordinary differential equations. A general search procedure identifies parameters of the model, whose response fits the data well during the five-day measurement period. The eighteenth-order model reveals plausible cause-and-effect relationships among the cytokines, showing how each cytokine induces or inhibits other cytokines. It suggests that perturbations in IL2, IL8, and IL10 have the most significant inductive effect, while IFN-γ and IL12 have the greatest inhibiting effect on other cytokine concentrations. Although TNF-α is a major pro-inflammatory factor, IFN-γ and three other cytokines have faster initial and median response to TGN1412 infusion. Principal-component analysis of the data reveals three clusters of similar cytokine responses: [TNF-α, IL1, IL10], [IFN-γ, IL2, IL4, IL8, and IL12], and [IL6]. IL1, IL6, IL10, and TNF-α have the highest degree of variability in response to uncertain initial conditions, exogenous effects, and parameter estimates. This study illuminates details of a cytokine storm event, and it demonstrates the value of linear modeling for interpreting complex, coupled biological system dynamics from empirical data.


title: Special issues raised by evolving areas of clinical research

text: Each study presents its own set of ethical considerations. Certain kinds of ethical issues are inherent in particular areas of clinical research, regardless of specific ethical questions associated with a specific study. In this chapter, some of the most common special areas of clinical research are presented, highlighting the ethical issues most frequently associated with each.


COVID-19 Pandemic: Greater Protection for Health Care Providers in the Hospital “Hot Zones”?


title: The basic reproduction number of SARS‐CoV‐2 in Wuhan is about to die out, how about the rest of the World?

text: The virologically confirmed cases of a new coronavirus disease (COVID‐19) in the world are rapidly increasing, leading epidemiologists and mathematicians to construct transmission models that aim to predict the future course of the current pandemic. The transmissibility of a virus is measured by the basic reproduction number (R(0)), which measures the average number of new cases generated per typical infectious case. This review highlights the articles reporting rigorous estimates and determinants of COVID‐19 R(0) for the most affected areas. Moreover, the mean of all estimated R(0) with median and interquartile range is calculated. According to these articles, the basic reproduction number of the virus epicentre Wuhan has now declined below the important threshold value of 1.0 since the disease emerged. Ongoing modelling will inform the transmission rates seen in the new epicentres outside of China, including Italy, Iran and South Korea.


title: COMPARISON BETWEEN THORACIC RADIOGRAPHIC FINDINGS AND POSTMORTEM DIAGNOSIS OF THORACIC DISEASES IN DYSPNEIC COMPANION RATS (RATTUS NORVEGICUS)

text: Companion rats are often presented to veterinarians for respiratory difficulties. Dyspnea in rats is most commonly due to infectious pneumonia, and thoracic neoplasia can go undiagnosed ante mortem due to a mistaken interpretation of pneumonia. In domestic carnivores, pulmonary nodular patterns have been shown to correlate with lung neoplastic diseases and infectious diseases. The main objective of this retrospective case series study was to determine whether certain radiographic criteria could be correlated with the presence of thoracic infectious disease and neoplastic disease in companion rats. A secondary objective was to determine whether the patient's sex and age were different between rats diagnosed with infectious versus neoplastic disease. Medical records and thoracic radiographs of dyspneic companion rats presented to the University of California at Davis, William R. Pritchard Veterinary Medical Teaching Hospital during the time period from January 2000 to December 2014 were reviewed. Rats with postmortem confirmation of thoracic lesions were included in the study. Thoracic radiographs were evaluated for positioning, lesion distribution, lung lobe involved, pulmonary pattern, mediastinal and pleural lesions by three observers blinded to diagnosis. Thirty rats were included in the study, including 23 rats with an infectious disease and seven with neoplasia. Mediastinal lesions were significantly more prevalent in the group diagnosed with thoracic neoplasia (P = 0.031), in particular cranially (P = 0.048). Although there was an overlap between the two groups, findings indicated that the presence of cranial mediastinal lesions may be helpful for differentiating neoplastic from infectious disease in rats.


title: Etiologie des gastroentérites du nouveau-né au centre hospitalier d'Amiens

text: Summary An epidemiological study has been carried on at the Amiens' Gynecology-Obstetrical center with the aim to determinate the aetiology of acute gastrointestinal disorders who affected part of the newborns over a two months period. Rotavirus was found in 16 babies (33 %) by electronmicroscopy and Enzyme-linked-Immuno-sorbent-Assay (ELISA). In one case, a « small round viruswas associated with the Rotavirus. Enteropathogenic bacteria were isolated only two times in this syndrom. The infection seem to releave of nosocomial contamination.


title: It’s F**ing Chaos: COVID-19’s Impact on Juvenile Delinquency and Juvenile Justice

text: An early examination of the impact of COVID-19 on juvenile delinquency and juvenile justice in America, this review provides initial scholarship to rapidly evolving areas of research. Our appraisals of these topics are made after nearly 2 months of national COVID-19 mitigation measures, like social distancing and limited “non-essential” movement outside the home but also as states are gradually lifting stricter directives and reopening economic sectors. We consider the impact of these pandemic-related changes on twenty-first century youths, their behaviors, and their separate justice system. To forecast the immediate future, we draw from decades of research on juvenile delinquency and the justice system, as well as from reported patterns of reactions and responses to an unprecedented and ongoing situation. As post-pandemic studies on juvenile delinquency and juvenile justice proliferate, we urge careful consideration as to how they might influence societal and the system responses to youths’ delinquency. Additional practical implications are discussed.


title: Receptor binding and proteolysis do not induce large conformational changes in the SARS-CoV spike

text: Severe acute respiratory syndrome coronavirus (SARS-CoV) emerged in 2002 as a highly transmissible pathogenic human betacoronavirus. The viral spike glycoprotein (S) utilizes angiotensin-converting enzyme 2 (ACE2) as a host protein receptor and mediates fusion of the viral and host membranes, making S essential to viral entry into host cells and host species tropism. As SARS-CoV enters host cells, the viral S undergoes two proteolytic cleavages at S1/S2 and S2’ sites necessary for efficient membrane fusion. Here, we present a cryo-EM analysis of the trimeric SARS-CoV S interactions with ACE2 and of the trypsin-cleaved S. Surprisingly, neither binding to ACE2 nor cleavage by trypsin at the S1/S2 cleavage site impart large conformational changes within S or expose the secondary cleavage site, S2’. These observations suggest that S2’ cleavage does not occur in the S prefusion conformation and that additional triggers may be required.


title: Interferon Status in Children during Acute Respiratory Infections. Therapy with Interferon

text: We studied interferon status in children during acute respiratory infections and found that it depends on etiology, course of the disease, and individual features of the organism. The efficiency of IFN inductor anaferon (pediatric formulation) and the possibility of its application in the therapy of children with acute respiratory infections were demonstrated.


title: Delivering Benefits at Speed Through Real-World Repurposing of Off-Patent Drugs: The COVID-19 Pandemic as a Case in Point

text: Real-world drug repurposing—the immediate “off-label” prescribing of drugs to address urgent clinical needs—is a widely overlooked opportunity. Off-label prescribing (ie, for a nonapproved indication) is legal in most countries and tends to shift the burden of liability and cost to physicians and patients, respectively. Nevertheless, health crises may mean that real-world repurposing is the only realistic source for solutions. Optimal real-world repurposing requires a track record of safety, affordability, and access for drug candidates. Although thousands of such drugs are already available, there is no central repository of off-label uses to facilitate immediate identification and selection of potentially useful interventions during public health crises. Using the current coronavirus disease (COVID-19) pandemic as an example, we provide a glimpse of the extensive literature that supports the rationale behind six generic drugs, in four classes, all of which are affordable, supported by decades of safety data, and targeted toward the underlying pathophysiology that makes COVID-19 so deadly. This paper briefly summarizes why cimetidine or famotidine, dipyridamole, fenofibrate or bezafibrate, and sildenafil citrate are worth considering for patients with COVID-19. Clinical trials to assess efficacy are already underway for famotidine, dipyridamole, and sildenafil, and further trials of all these agents will be important in due course. These examples also reveal the unlimited opportunity to future-proof our health care systems by proactively mining, synthesizing, cataloging, and evaluating the off-label treatment opportunities of thousands of safe, well-established, and affordable generic drugs.


title: Viral respiratory infections and the oropharyngeal bacterial microbiota in acutely wheezing children

text: Acute viral wheeze in children is a major cause of hospitalisation and a major risk factor for the development of asthma. However, the role of the respiratory tract microbiome in the development of acute wheeze is unclear. To investigate whether severe wheezing episodes in children are associated with bacterial dysbiosis in the respiratory tract, oropharyngeal swabs were collected from 109 children with acute wheezing attending the only tertiary paediatric hospital in Perth, Australia. The bacterial community from these samples was explored using next generation sequencing and compared to samples from 75 non-wheezing controls. No significant difference in bacterial diversity was observed between samples from those with wheeze and healthy controls. Within the wheezing group, attendance at kindergarten or preschool was however, associated with increased bacterial diversity. Rhinovirus (RV) infection did not have a significant effect on bacterial community composition. A significant difference in bacterial richness was observed between children with RV-A and RV-C infection, however this is likely due to the differences in age group between the patient cohorts. The bacterial community within the oropharynx was found to be diverse and heterogeneous. Age and attendance at day care or kindergarten were important factors in driving bacterial diversity. However, wheeze and viral infection were not found to significantly relate to the bacterial community. Bacterial airway microbiome is highly variable in early life and its role in wheeze remains less clear than viral influences.


title: COVID-19: Wissensstand, Risikowahrnehmung und Umgang mit der Pandemie

text: Zusammenfassung Hintergrund Für den Erfolg der Bemühungen zur Eindämmung einer Epidemie sind die großflächige Umsetzung der Maßnahmen und ihre Akzeptanz in der Bevölkerung wichtig. Diese Studie untersucht daher den Wissensstand und die Risikowahrnehmung in der frühen Phase der COVID-19-Pandemie und analysiert, wie empfohlene und vorgeschriebene Maßnahmen umgesetzt bzw. eingehalten wurden. Methode Im März 2020 wurden die im HeReCa-Online-Panel registrierten Teilnehmer/-innen aus Sachsen-Anhalt, Berlin und Schleswig-Holstein eingeladen, einen Fragebogen mit 65 Fragen zu beantworten. Ergebnisse 1 048 Teilnehmer/-innen beantworteten den Fragebogen. Dies entspricht einer Rücklaufquote von 3,5%. 83% der Befragten fühlten sich gut oder sehr gut über COVID-19 und das ursächliche Virus informiert. Die meisten Befragten gaben an, vor allem in Bezug auf die Gesundheit von Familienangehörigen (60%) und der Bevölkerung als Ganzes (45%) Angst vor der Pandemie zu haben und fürchteten negative Folgen für die Wirtschaft (79%). 79% der Befragten haben in Reaktion auf die Pandemie individuelle Maßnahmen ergriffen, z. B. das Einhalten von Mindestabständen zu anderen im öffentlichen Raum und Kontaktreduktion. Die staatlich verordneten Maßnahmen wurden überwiegend als sinnvoll und der Situation angemessen wahrgenommen. Schlussfolgerung In der Frühphase der Pandemie hat sich ein Großteil der Bevölkerung gezielt mit COVID-19 beschäftigt und setzte individuelle Maßnahmen zur Risikoreduktion um. Die Akzeptanz für die staatlichen Maßnahmen zur Eindämmung der Pandemie war hoch. Abstract Introduction In order to stem the spread of an epidemic, widespread adherence to safety measures and their acceptance within the German population are of key importance. This survey examines the levels of knowledge and the perception of risk within the population and analyses implementation and adherence to the recommended and legally mandated safety measures in the early phase of the COVID-19-pandemic. Methods In March 2020, participants registered on the HeReCa-Online-Panel from Saxony-Anhalt, Berlin and Schleswig Holstein were invited to complete a 65 question survey. Results 1 048 respondents answered the questionnaire, which amounts to a response of 3.5%. 83% of respondents stated that they felt themselves to be well-informed or very well-informed concerning COVID-19 and the coronavirus. The majority of respondents reported fears for the well-being of family members (60%) or the health of the German population as a whole (45%); 79% reported concerns regarding adverse economic impacts. 79% of respondents have implemented individual protective measures, such as reducing social contacts and maintaining the recommended physical distance in public spaces. Most respondents regarded the government mandated safety measures as predominantly reasonable and appropriate. Conclusions In the early phase of the pandemic, most people informed themselves of COVID-19 and started to take individual measures for risk reduction. Acceptance of governmental measures to stem the spread of the pandemic was high.


title: Comparative study on the antiviral activity of selected monoterpenes derived from essential oils

text: Essential oils are complex natural mixtures, their main constituents, e.g. terpenes and phenylpropanoids, being responsible for their biological properties. Essential oils from eucalyptus, tea tree and thyme and their major monoterpene compounds α‐terpinene, γ‐terpinene, α‐pinene, p‐cymene, terpinen‐4‐ol, α‐terpineol, thymol, citral and 1,8‐cineole were examined for their antiviral activity against herpes simplex virus type 1 (HSV‐1) in vitro. These essential oils were able to reduce viral infectivity by >96%, the monoterpenes inhibited HSV by about >80%. The mode of antiviral action has been determined, only moderate antiviral effects were revealed by essential oils and monoterpenes when these drugs were added to host cells prior to infection or after entry of HSV into cells. However, both essential oils and monoterpenes exhibited high anti‐HSV‐1 activity by direct inactivation of free virus particles. All tested drugs interacted in a dose‐dependent manner with herpesvirus particles thereby inactivating viral infection. Among the analysed compounds, monoterpene hydrocarbons were slightly superior to monoterpene alcohols in their antiviral activity, α‐pinene and α‐terpineol revealed the highest selectivity index. However, mixtures of different monoterpenes present in natural tea tree essential oil revealed a ten‐fold higher selectivity index and a lower toxicity than its isolated single monoterpenes. Copyright © 2009 John Wiley & Sons, Ltd.


Re: Testing recommendation for COVID-19 (SARS-CoV-2) in patients planned for surgery - continuing the service and ‘suppressing’ the pandemic


title: Impact of the Interactive e-Learning Instructions on Effectiveness of a Programming Course

text: The COVID-19 pandemic is forcing schools, universities and learning and development professionals to shift rapidly from in-person to online learning. It made providing of an effective e-learning contents more important. Consequently, the development of e-learning products and provision of e-learning opportunities is one of the most rapidly expanding areas of education and training. The growth of e-learning application is accelerating through both offline and online system. These innovative systems are changing the face of learning as we know it. However, what is known about these innovative approaches for learning and training has been limited by the shortage of scientifically evaluation. This study aims to assess the impact of using interactive instructions on e-learning to improve effectiveness of a programming course. This study develops a questionnaire based on usability evaluation method for an e-learning system. The method extends the current practice by focusing not only on cognitive but also affective considerations that may influence e-learning usability. This paper presents findings from a study of the impact of the learning systems. The study also describes designing evaluation sheet, data collection and analysis strategies of a case study on the evaluation of the e-learning system implemented for Programming Course in Ritsumeikan Asia Pacific University (APU), Japan.


Las revistas científicas ante la pandemia por Covid-19


title: Comparison of the AnyplexTM II RV16 and Seeplex® RV12 ACE assays for the detection of respiratory viruses

text: Abstract The AnyplexTM II RV16 detection kit (RV16; Seegene, Seoul, South Korea) is a multiplex real-time PCR assay based on tagging oligonucleotide cleavage extension. In this prospective study, we evaluated the RV16 assay by comparing with the Seeplex® RV12 ACE detection kit (RV12; Seegene), a multiplex end-point PCR kit. A total of 365 consecutive respiratory specimens were tested with both RV16 and RV12 assays in parallel and detected 140 (38.4%) and 89 (24.4%) positive cases, respectively. The positive percent agreement, negative percent agreement, and kappa values for the 2 assays were 95.6% (95% confidence interval [CI], 89.4–98.3%), 80.4% (95% CI, 75.3–84.6%), and 0.64 (95% CI, 0.56–0.72), respectively. The monoplex PCR and sequencing for the samples with discrepant results revealed that majority of the results were concordant with the results from RV16 assays. In conclusion, the RV16 assay produces results comparable to the RV12 assay.


title: Viral infection of the lung: Host response and sequelae

text: Because of its essential role in gas exchange and oxygen delivery, the lung has evolved a variety of strategies to control inflammation and maintain homeostasis. Invasion of the lung by pathogens (and in some instances exposure to certain noninfectious particulates) disrupts this equilibrium and triggers a cascade of events aimed at preventing or limiting colonization (and more importantly infection) by pathogenic microorganisms. In this review we focus on viral infection of the lung and summarize recent advances in our understanding of the triggering of innate and adaptive immune responses to viral respiratory tract infection, mechanisms of viral clearance, and the well-recognized consequences of acute viral infection complicating underlying lung diseases, such as asthma.


title: 2019 Novel Coronavirus Disease (COVID‐19) in patients with Inflammatory Bowel Diseases

text: BACKGROUND: Data on patients with inflammatory bowel diseases (IBD) who have had 2019 novel coronavirus (SARS‐CoV‐2) disease (COVID‐19) are lacking. AIM: To report the clinical characteristics, including gastrointestinal symptoms, of COVID‐19 in IBD patients, and to assess the risk of COVID‐19 in IBD. METHODS: This case series included consecutive IBD patients with laboratory‐confirmed COVID‐19. Age‐adjusted cumulative incidences were compared with the general population in the Madrid region. RESULTS: Through April 8, 12 patients of 1918 IBD patients were diagnosed of COVID‐19. The average age was 52 years, 75% of the patients were female, and 58.3% had Crohn’s disease. Seven patients (58%) were on maintenance treatment with immunomodulators/biologics, of these 4 with combined therapy (33%). Eight patients (66%) required hospitalization (1 intensive care unit admission, and 2 deaths), and 4 patients were isolated at home. Nine patients had diarrhoea ranging between 4‐10 loose stools per day (mean 5.4, SD 1.6). In 5 patients (42%) diarrhoea was a presenting symptom. In 2 patients, diarrhoea was the only symptom at debut. Cumulative incidence of COVID‐19 was 6.1 per 1000 IBD patients. IBD patients had a lower adjusted incidence ratio of COVID‐19 (OR 0.74, 95% CI 0.70‐0.77; p<0.001), and a similar associated mortality ratio (OR 0.95, 95% CI: 0.84‐1.06; p=0.36), compared with the general population. CONCLUSIONS: IBD patients do not have an increased risk of COVID‐19 and associated mortality compared with the general population. In many IBD patients diarrhoea was a presenting symptom, and sometimes, was the only symptom at onset of COVID‐19.


title: Point prevalence of Pneumocystis pneumonia in patients with non-Hodgkin lymphoma according to the number of cycles of R-CHOP chemotherapy

text: R-CHOP chemotherapy composed of rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone which might increase the risk of Pneumocystis pneumonia in patients with non-Hodgkin lymphoma. We estimated the point prevalence of Pneumocystis pneumonia in non-Hodgkin lymphoma patients according to the number of R-CHOP cycles and investigated whether cytoreduction by chemotherapy is associated with Pneumocystis pneumonia development. We retrospectively established a cohort of patients who received R-CHOP for non-Hodgkin lymphoma in our institution. Using this cohort, we estimated the incidence rate and point prevalence of definite and probable Pneumocystis pneumonia. To assess factors associated with Pneumocystis pneumonia development several clinical variables, including absolute neutrophil and lymphocyte count at the time of non-Hodgkin lymphoma diagnosis and when the last R-CHOP cycle was administered, were compared between patients with and without Pneumocystis pneumonia. Of 713 patients in the cohort, 14 and 18 patients were diagnosed with definite and probable Pneumocystis pneumonia, respectively. The overall incidence of definite and definite plus probable PCP in NHL patients receiving R-CHOP were 2.0 % (14/713; 95 % CI, 1.1–3.3 %) and 4.5 % (32/713; 95 % CI, 3.2–6.4 %), respectively. This corresponded to 3.8 (95 % CI, 2.2–6.4) and 8.4 (95 % CI, 5.9–11.9) per 1000 persons. Many cases of Pneumocystis pneumonia (22/32, 68.7 %) developed after administration of the fourth R-CHOP cycle. However, there was no statistical difference in Pneumocystis pneumonia prevalence between patients receiving four or more cycles of R-CHOP and fewer than. Higher absolute neutrophil count (4,742/mm(3) vs. 2,627/mm(3); p < 0.01) was associated with Pneumocystis pneumonia development at the last R-CHOP cycle, while absolute lymphocyte count at the time of NHL diagnosis was not. Contrary to expectations, Pneumocystis pneumonia is not a frequent complication of R-CHOP treatment for non-Hodgkin lymphoma. Cytoreduction of R-CHOP might not be a risk factor of Pneumocystis pneumonia development. Universal prophylaxis against Pneumocystis pneumonia during R-CHOP treatment could not be strongly recommended. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00277-012-1592-1) contains supplementary material, which is available to authorized users.


title: Lymphocyte Subset Counts in COVID‐19 Patients: A Meta‐Analysis

text: A reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized COVID‐19 patients. In this brief meta‐analysis, the reduction of lymphocyte subset counts in COVID‐19 patients was investigated across 20 peer‐reviewed studies meeting criteria for reporting lymphocyte subset counts and COVID‐19 disease severity. CD4+ T cell, CD8+ T cell, B cell, NK cell and total lymphocyte cell counts all showed statistically significant reduction in patients with severe/critical COVID‐19 disease compared to mild/moderate disease. T cell subsets showed the largest standardized magnitude of change. In some studies, multivariate analysis has shown that CD4 and/or CD8 T cells counts are independently predictive of patient outcomes.


OL-044 HAV seroprevalence among children with 10 24 month ages in Ulaanbaatar


title: Delivering dialysis during the COVID-19 outbreak: Strategies and outcomes

text: BACKGROUND: Haemodialysis (HD) patients are at increased risk of COVID-19 infection. Although all dialysis patients meet government criteria for shielding, only those on home treatment can comply. Patients attending incentre HD units represent a large and vulnerable group, who are unable to rigorously adhere to this advice. The need to adopt strategies to protect these patients is of great importance. We report our experience of delivering dialysis during the COVID-19 outbreak, describing the interventions taken to try to protect patients from virus transmission whilst maintaining optimal treatment. METHODS: We implemented measures, including use of; a system of active triage and isolation of suspected cases, separate transportation, a dedicated COVID-19 HD unit, personal protective equipment, active repatriation of patients back to base units. We collected data from all COVID-19 positive HD patients in our cohort, between 14/03/2020 - 20/04/2020. Data were compared to national reports of other units, and values obtained from a dialysis-specific Susceptible-Infectious-Removed model which predicted the impact of COVID-19 on our cohort. RESULTS: Results showed 76/670 (11.3%) tested positive for COVID-19. The majority were male (61.8%) and from a minority background (61.8%). 7/76 (9.2%) patients died following infection. The model projections overestimated the incidence of COVID-19, 221 vs 76 total number of infections by 20/4/20. Our incidence of COVID-19 and mortality are lower compared to other units across London. CONCLUSION: Implementation of measures to limit the spread of COVID-19, and optimise dialysis, could account for the low infection and mortality rates observed in our cohort of patients.


title: Evaluation of the implementation of occupational health, safety, and environment management systems in higher education laboratories

text: Laboratory researchers and students may expose to hazardous and toxic chemicals. Implementation of the Occupational Health, Safety, and Environment Management System (OHSEMS) has become a critical aspect in higher education. This study presents an overview of the evaluation of the implementation of the OHSEMS in higher education laboratories. The implementation of the OHSEMS is to prevent occupational accidents in the laboratory. The study design is a semiquantitative descriptive study. The aim of the study is to evaluate the implementation of the OHSEMS in higher education institution laboratories by evaluating the percentages of OHSEMS compliance in higher education laboratories. Five aspects are evaluated: occupational health, safety, and environment (OHSE) policy and commitment, planning, implementation, evaluation, and management review. The result shows that the average compliance with the OHSE policy and commitment aspect is 59.4% and for the planning, implementation, evaluation, and management review, the average compliance percentage are 33.0%, 65.3%, 26.0%, and 0.0%, respectively.


title: Covid-19 and Optimal Portfolio Selection for Investment in Sustainable Development Goals

text: The Covid-19 pandemic and global economic recession has shrunk global energy demand and collapsed fossil fuel prices. Therefore, renewable energy projects are losing their competitiveness. This endangers the achievement of several Sustainable Development Goals (SDGs) and the Paris Agreement on Climate Change. Various consulting companies define the SDGs differently. Institutional investors hire consulting companies and allocate their investment based on the consultants’ suggestions. This paper theoretically shows that the current allocation of investors by considering SDG based on various consulting companies will lead to distortion in the investment portfolio. The desired portfolio allocation can be achieved by taxing pollution and waste such as CO(2), NO(x), and plastics, globally with the same tax rate. Global taxation on pollution will lead to the desired portfolio allocation of assets.


title: Patient pathways of tuberculosis care-seeking and treatment: an individual-level analysis of National Health Insurance data in Taiwan

text: INTRODUCTION: Patients with tuberculosis (TB) often experience difficulties in accessing diagnosis and treatment. Patient pathway analysis identifies mismatches between TB patient care-seeking patterns and service coverage, but to date, studies have only employed cross-sectional aggregate data. METHODS: We developed an algorithmic approach to analyse and interpret patient-level routine data on healthcare use and to construct patients’ pathways from initial care-seeking to treatment outcome. We applied this to patients with TB in a simple random sample of one million patients’ records in the Taiwan National Health Insurance database. We analysed heterogeneity in pathway patterns, delays, service coverage and patient flows between different health system levels. RESULTS: We constructed 7255 pathways for 6258 patients. Patients most commonly initially sought care at the primary clinic level, where the capacity for diagnosing TB patients was 12%, before eventually initiating treatment at higher levels. Patient pathways are extremely heterogeneous prior to diagnosis, with the 10% most complex pathways accounting for 48% of all clinical encounters, and 55% of those pathways yet to initiate treatment after a year. Extended consideration of alternative diagnoses was more common for patients aged 65 years or older and for patients with chronic lung disease. CONCLUSION: Our study demonstrates that longitudinal analysis of routine individual-level healthcare data can be used to generate a detailed picture of TB care-seeking pathways. This allows an understanding of several temporal aspects of care pathways, including lead times to care and the variability in patient pathways.


title: A Survey of COVID-19 Preparedness Among Hospitals in Idaho

text: BACKGROUND: SARS-CoV-2 has been implicated in the largest recorded coronavirus outbreak to date. Initially, most COVID-19 cases were in China, but the virus has spread to more than 184 countries worldwide, and the United States currently has more cases than any other country. OBJECTIVE: With person-to-person spread expanding in the United States, we describe hospital preparedness for managing suspected and confirmed COVID-19 patients. DESIGN: Cross-sectional survey focused on various elements of respiratory disease preparedness. SETTING: Critical access hospitals (CAHs) and acute-care hospitals (ACHs) in Idaho. METHODS: The electronic survey was sent to infection preventionists (IPs) and nurse administrators in 44 hospitals in Idaho. RESULTS: Overall, 32 (73%) hospitals responded to the survey. Participating facilities reported their preparedness with respect to existing, formalized structures for managing infectious disease incidents—specifically COVID-19—as well as availability of resources, such as isolation rooms and personal protective equipment, for safely managing suspected and confirmed COVID-19 cases. CONCLUSIONS: Hospitals covered by the survey had varying levels of preparedness for managing COVID-19 cases, with differences across the various categories of interest in this study. Although the study reveals strengths, including in application of emergency management and infection control frameworks, it also suggests that other areas, such as consistent implementation of federal guidelines and requirements for infection prevention, are potential areas for strengthening preparedness for SARS-CoV-2 and other respiratory pathogens with pandemic potential.


title: The effect of massage on the quality of life in patients recovering from COVID-19: A systematic review protocol

text: BACKGROUND: There is a worldwide outbreak of covid-19, and as the number of patients increases, more and more patients are recovering. Massage is used as an alternative therapy. Currently, there are no relevant articles for systematic review. METHODS: We will search the randomized controlled trials related to acupuncture therapy and postoperative anorectal diseases from inception to January 2020. The following database is our focus area: the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wan-Fang Database. All published randomized controlled trials in English or Chinese related to massage for COVID-19 will be included. Primary outcome asthe influence of massage on the quality of life of convalescent patients. Secondary outcomes were accompanying symptoms (such as myalgia, expectoration, stuffiness, runny nose, pharyngalgia, anhelation, chest distress, dyspnea, crackles, headache, nausea, vomiting, anorexia, diarrhea) disappear rate, negative COVID-19 results rate on 2 consecutive occasions (not on the same day), average hospitalization time, clinical curative effect, and improved quality of life. RESULTS: The results will provide a high-quality synthesis of current evidence for researchers in this subject area. CONCLUSION: The conclusion of our study will provide evidence to judge whether massage is an effective intervention on the quality of life in patients recovering. PROSPERO REGISTRATION NUMBER: CRD42020181398


title: Rotavirus typing methods and algorithms

text: Vaccination is the current strategy for control and prevention of severe rotavirus infections, a major cause of acute, dehydrating diarrhoea in young children worldwide. Public health interventions aimed at improving water, food and sanitation are unlikely adequately to control the disease. The development of vaccines against severe rotavirus diarrhoea is based upon homotypic or heterotypic protection provided against either a single common G serotype (monovalent vaccines) or against multiple serotypes (multivalent vaccines). Rotavirus strain surveillance has a high priority in disease control programmes worldwide. The continued identification of the most common G and P serotypes for inclusion in vaccines is an important priority. And subsequent to the introduction of a vaccine candidate, not only monitoring of circulating strains is recommended, but also surveillance of potential reassortment of animal rotavirus genes from the vaccine into human rotavirus strains is critical. Conventional methods used in the characterisation of rotavirus strains, such as enzyme immunoassay serotyping and reverse‐transcription PCR‐based genotyping often fail to identify uncommon and newly appearing strains. The application of newer molecular approaches, including sequencing and oligonucleotide microarray hybridisation, may be required to characterise such strains. The present paper presents a brief overview of the variety of standard methods available, followed by suggestions for a systematic approach for routine rotavirus strain surveillance as well as for characterisation of incompletely typed rotavirus strains. Improved detection and characterisation of incompletely typed strains will help to develop a comprehensive strain surveillance that may be required for tailoring effective rotavirus vaccines. Published in 2004 by John Wiley & Sons, Ltd.


title: Electronic Personal Protective Equipment: A Strategy to Protect Emergency Department Providers in the Age of COVID-19

text: Emergent policy changes related to telemedicine and the Emergency Medical Treatment and Labor Act (EMTALA) during the novel coronavirus pandemic (COVID-19) have created opportunities for technology-based clinical evaluation, which serves to conserve personal protective equipment (PPE) and protect emergency providers. We define electronic personal protective equipment (ePPE) as an approach using telemedicine tools to perform electronic medical screening exams while satisfying EMTALA. We discuss the safety, legal, and technical factors necessary for implementing such a pathway. This approach has the potential to conserve PPE and protect providers while maintaining safe standards for medical screening exams in the ED for low risk patients in whom COVID-19 is suspected.


title: The Timing and Nature of Behavioural Responses Affect the Course of an Epidemic

text: During an epidemic, the interplay of disease and opinion dynamics can lead to outcomes that are different from those predicted based on disease dynamics alone. Opinions and the behaviours they elicit are complex, so modelling them requires a measure of abstraction and simplification. Here, we develop a differential equation model that couples SIR-type disease dynamics with opinion dynamics. We assume a spectrum of opinions that change based on current levels of infection as well as interactions that to some extent amplify the opinions of like-minded individuals. Susceptibility to infection is based on the level of prophylaxis (disease avoidance) that an opinion engenders. In this setting, we observe how the severity of an epidemic is influenced by the distribution of opinions at disease introduction, the relative rates of opinion and disease dynamics, and the amount of opinion amplification. Some insight is gained by considering how the effective reproduction number is influenced by the combination of opinion and disease dynamics.


The ‘Black Death’ and the physician at the time of COVID-19


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title: Clinical characteristics and factors predicting respiratory failure in adenovirus pneumonia

text: BACKGROUND AND OBJECTIVE: Limited data exist regarding factors predicting respiratory failure (RF) in non‐immunocompromised patients with adenovirus (AdV) pneumonia. METHODS: We described characteristics of AdV pneumonia (n = 91) versus non‐AdV pneumonia (n = 55) and compared clinico‐laboratory and radiological characteristics in patient groups categorized by RF. RESULTS: All 91 AdV pneumonia patients presented with acute respiratory symptoms and radiological infiltrations and had significantly lower levels of white blood cell counts and platelet counts compared with non‐AdV pneumonia. Of them, 67 patients had mild pneumonia without RF (non‐RF), 14 patients had no RF at admission but progressed to RF during hospitalization (progressed to RF) and 10 patients had RF at admission (initial RF). Initial monocyte percentage and absolute monocyte counts in RF patient groups (progressed to RF and initial RF) were significantly lower than those of non‐RF patients (both P < 0.001), and the differences among progressed to RF and initial RF patients were not significant. Chest computed tomography findings such as dominant pattern or distribution, clinical symptoms, and bacterial or viral co‐infections other than AdV were not discriminable between patients who had RF and those who did not. On univariate analysis, initial monocytopenia, multilobar infiltrations and pleural effusion were associated with RF. However, on multivariable analysis, only initial monocytopenia remained significant (P = 0.004) for predicting RF. CONCLUSION: Our data suggest that initial monocytopenia may help to predict RF during the course of AdV pneumonia in non‐immunocompromised patients.


title: Cloth Masks May Prevent Transmission of COVID-19: An Evidence-Based, Risk-Based Approach

text: As the COVID-19 pandemic progressed across the world, governments, international agencies, policymakers, and public health officials began recommending widespread use of nonmedical cloth masks to reduce the transmission of SARS-CoV-2. The authors of this article suggest that there is convincing evidence to support this recommendation.


title: A Novel Antiviral Strategy against MERS-CoV and HCoV-229E Using Binase to Target Viral Genome Replication

text: RNA viruses cause most of the dangerous communicable diseases. Due to their high mutation rates, RNA viruses quickly evade selective pressures and can adapt to a new host. Therefore, new antiviral approaches are urgently needed, which target more than one specific virus variant and which would optimally prevent development of viral resistance. Among the family of coronaviruses (CoV), several human pathogenic strains (HCoV) are known to cause respiratory diseases and are implied in enteric diseases. While most strains contribute to common cold-like illnesses, others lead to severe infections. One of these viruses is the newly emerged (2012), highly pathogenic Middle East respiratory syndrome coronavirus (MERS-CoV) of zoonotic origin. MERS-CoV causes a severe respiratory infection with a high mortality rate of 35 %. There is no specific treatment or infection prevention available. Here, we show that the bacterial ribonuclease Binase is able to inhibit the replication of MERS-CoV and of the low-pathogenic human coronavirus 229E (HCoV-229E) in cell culture. We demonstrate that at non-toxic concentrations, Binase decreased the titers of MERS-CoV and HCoV-229E. On a molecular level, Binase treatment reduced (i) the viral subgenomic RNAs and (ii) the viral nucleocapsidprotein (N) and non-structural protein 13 (nsp13) accumulation. Furthermore, we show that the quantity of the replication/transcription complexes within the infected cells is diminished. Thus, the data obtained might allow further development of new anti-coronaviral approaches affecting viral replication, independent of the specific virus strain.


title: The science commons in health research: structure, function, and value

text: The “science commons,” knowledge that is widely accessible at low or no cost, is a uniquely important input to scientific advance and cumulative technological innovation. It is primarily, although not exclusively, funded by government and nonprofit sources. Much of it is produced at academic research centers, although some academic science is proprietary and some privately funded R&D enters the science commons. Science in general aspires to Mertonian norms of openness, universality, objectivity, and critical inquiry. The science commons diverges from proprietary science primarily in being open and being very broadly available. These features make the science commons particularly valuable for advancing knowledge, for training innovators who will ultimately work in both public and private sectors, and in providing a common stock of knowledge upon which all players—both public and private—can draw readily. Open science plays two important roles that proprietary R&D cannot: it enables practical benefits even in the absence of profitable markets for goods and services, and its lays a shared foundation for subsequent private R&D. The history of genomics in the period 1992–2004, covering two periods when genomic startup firms attracted significant private R&D investment, illustrates these features of how a science commons contributes value. Commercial interest in genomics was intense during this period. Fierce competition between private sector and public sector genomics programs was highly visible. Seemingly anomalous behavior, such as private firms funding “open science,” can be explained by unusual business dynamics between established firms wanting to preserve a robust science commons to prevent startup firms from limiting established firms’ freedom to operate. Deliberate policies to create and protect a large science commons were pursued by nonprofit and government funders of genomics research, such as the Wellcome Trust and National Institutes of Health. These policies were crucial to keeping genomic data and research tools widely available at low cost.


title: Department of Homeland Security national planning scenarios: a spectrum of imaging findings to educate the radiologists

text: Following the events of the September 11th attack, there has been an increasing concern about the possibility of a future attack on our homeland. In response, the United States Department of Homeland Defense has planned for a future attack by formulating multiple scenarios which may occur in the event of such a disaster. Radiology will play a key role in each of these scenarios, assisting with triage, diagnosis, and therapy of the large populations which potentially could be involved. This article describes some of these scenarios as well the response which will be expected of the radiology community in the event of such a disaster.


title: Prioritization of Zoonotic Diseases in Kenya, 2015

text: INTRODUCTION: Zoonotic diseases have varying public health burden and socio-economic impact across time and geographical settings making their prioritization for prevention and control important at the national level. We conducted systematic prioritization of zoonotic diseases and developed a ranked list of these diseases that would guide allocation of resources to enhance their surveillance, prevention, and control. METHODS: A group of 36 medical, veterinary, and wildlife experts in zoonoses from government, research institutions and universities in Kenya prioritized 36 diseases using a semi-quantitative One Health Zoonotic Disease Prioritization tool developed by Centers for Disease Control and Prevention with slight adaptations. The tool comprises five steps: listing of zoonotic diseases to be prioritized, development of ranking criteria, weighting criteria by pairwise comparison through analytical hierarchical process, scoring each zoonotic disease based on the criteria, and aggregation of scores. RESULTS: In order of importance, the participants identified severity of illness in humans, epidemic/pandemic potential in humans, socio-economic burden, prevalence/incidence and availability of interventions (weighted scores assigned to each criteria were 0.23, 0.22, 0.21, 0.17 and 0.17 respectively), as the criteria to define the relative importance of the diseases. The top five priority diseases in descending order of ranking were anthrax, trypanosomiasis, rabies, brucellosis and Rift Valley fever. CONCLUSION: Although less prominently mentioned, neglected zoonotic diseases ranked highly compared to those with epidemic potential suggesting these endemic diseases cause substantial public health burden. The list of priority zoonotic disease is crucial for the targeted allocation of resources and informing disease prevention and control programs for zoonoses in Kenya.


Therapy for probable COVID‐19 associated erythema pernio‐like lesions in pediatric age. Case report


title: VI, 1. Epidemiology of toroviruses

text: Publisher Summary The discovery of the toroviruses, which comprise a genus of the family Coronaviridae, began with the serendipitous isolation of the morphologically unique Berne virus (ETV) in feces of a horse. This chapter discusses the epidemiology of toroviruses. ETV was first detected by the isolation of the virus in cell culture. Growth of ETV in cell culture allowed for the characterization of the virus, in terms of its morphology, morphogenesis, protein and nucleic acid composition, and facilitated investigations into its replication strategy. The successful propagation of ETV in cell cultures facilitated the development of a virus-neutralization assay that made it possible to gain an insight into the sero-epidemiology of this virus in various animal populations. Although ETV has been isolated, only once from a horse, there is evidence that antigenically related viruses are widespread in the equine population. The sero-prevalence of ETV-specific antibody as measured by virus neutralization test is very high in the horse population with 35% of randomly collected sera in Germany and 81% in Switzerland being positive.


title: Dwindling blood reserves: An ominous downside of COVID-19 pandemic

text: • Transfusion therapy is vital to ensure a healthy community. Thus, a safe and reliable reserve of blood is necessary, even in the face of widespread illness. • Since the outbreak of the novel coronavirus, a decline in blood supply has been noticed as hospitals and communities have switched to more pandemic-oriented operations. • Restricted mobility secondary to isolation and quarantine seems to be the major reason causing decline in number of donors. • Misinformation regarding transmission of coronavirus through blood along with the attitude of people towards hospitals and blood banks has also contributed to diminishing blood supplies.


title: Computer Vision Toolkit for Non-invasive Monitoring of Factory Floor Artifacts

text: Abstract Digitization has led to smart, connected technologies be an integral part of businesses, governments and communities. For manufacturing digitization, there has been active research and development with a focus on Cloud Manufacturing (CM) and the Industrial Internet of Things (IIoT). This work presents a computer vision toolkit (CV Toolkit) for non-invasive digitization of the factory floor in line with Industry 4.0 requirements for factory data collection. Currently, technical challenges persist towards digitization of legacy systems due to the limitation for changes in their design and sensors. This novel toolkit is developed to facilitate easy integration of legacy production machinery and factory floor artifacts with the digital and smart manufacturing environment with no requirement of any physical changes in the machines. The system developed is modular, and allows real-time monitoring of production machinery. The modularity aspect allows the incorporation of new software applications in the current framework of CV Toolkit. To allow connectivity of this toolkit with manufacturing floors in a simple, deployable and cost-effective manner, the toolkit is integrated with a known manufacturing data standard, MTConnect, to “translate” the digital inputs into data streams that can be read by commercial status tracking and reporting software solutions. The proposed toolkit is demonstrated using a mock-panel environment developed in house at the University of Cincinnati to highlight its usability.


title: Repeat Auditing of Primary Health-care Facilities Against Standards for Occupational Health and Infection Control: A Study of Compliance and Reliability

text: BACKGROUND: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. METHODS: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011–2012 were compared with follow-up internal audits in 2014–2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. RESULTS: At baseline, 25% of 60 facilities were “noncompliant” (audit score<50%), 48% “conditionally compliant” (score >50 < 80%), and only 27% “compliant” (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). CONCLUSION: Low baseline compliance with OHS–IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.


Preparing for a COVID-19 surge


docid: gsdvrtai

title: Personalized Nutrition and -Omics

text: With change in global concern toward food quality over food quantity, consumer concern and choice of healthy food has become a matter of prime importance. It gave rise to concept of “personalized or precision nutrition”. The theory behind personalization of nutrition is supported by multiple factors including advances in food analytics, nutrition based diseases and public health programs, increasing use of information technology in nutrition science, concept of gene-diet interaction and growing consumer capacity or concern by better and healthy foods. The advances in “omics” tools and related analytical techniques have resulted into tremendous scope of their application in nutrition science. As a consequence, a better understanding of underlying interaction between diet and individual is expected with addressing of key challenges for successful implementation of this science. In this chapter, the above aspects are discussed to get an insight into driving factors for increasing concern in personalized nutrition.


title: Suspension of ulipristal acetate for uterine fibroids during ongoing EMA’s review of liver injury risk: Unfortunate timing during the Covid-19 pandemic!

text: OBJECTIVE: EMA decided that with ulipristal acetate (UPA) treatment for uterine fibroids, should be discontinued due to the associated risk of hepatic failure, We analyzed whether the risk of recurrent symptoms due to fibroids may lead to an increased risk of Covid -19 infection and death, that would exceed the former risk of hepatic failure and transplantation. STUDY DESIGN, SIZE, DURATION: We used a Markov model to generate probabilities. PARTICIPANTS/MATERIALS, SETTING, METHODS: There are currently about 36250 treated patients in Europe. We estimated bleeding probabilities, while using or discontinuing UPA, which may induce a need of medical or surgical management in symptomatic patients, and increase the risk of acquiring a Covid-19 infection, and die from it. We also estimated the risk of suffering a hepatic failure and hepatic transplantation. MAIN RESULTS AND THE ROLE OF CHANCE: Based on our assumptions, ceasing UPA during a Covid 19 pandemic may be associated with a fatality ratio between 4 and 18, due to the Pandemic, whereas pursuing UPA would be associated with a fatality rate due to the pandemic between 1-2, and an added fatality rate due to hepatic impairment of 1. The added risk of stopping UPA may range between 2 and 15 additional deaths. Our calculations suggest that the decision to stop UPA in the middle of the Covid- 19 pandemic may be untimely, since it may result in an increased risk of Covid-19 infection, due to the recurrence of symptoms and the need for medical and surgical treatment. WIDER IMPLICATIONS OF THE FINDINGS: A decision, like the one EMA took need to be taken in a wider health context of a population, than simply analyzing its role as regulating agent for medications. STUDY FUNDING/COMPETING INTEREST(S): The study was not funded/ There are no competing interests.


title: System pharmacogenomics application in infectious diseases

text: The new era in systems pharmacology has revolutionized the human biology. Its applicability, precise treatment, adequate response and safety measures fit into all the paradigm of medical/clinical practice. The importance of mathematical models in understanding the disease pathology and epideomology is now being realized. The advent of high-throughput technologies and the emergence of systems biology have resulted in the creation of systems pharmacogenomics and the focus is now on personalized medicine. However, there are some regulatory issues that need to be addresssed; are we ready for this universal adoption? This article details some of the infectious disease pharmacogenomics to the developments in this area.


docid: aezrxysq

title: Psychosis spectrum disorders during and after the COVID-19 pandemic: Warning signs of “stress incubation”


docid: nfdplszh

title: A herbal formula for prevention of influenza-like syndrome: A double-blind randomized clinical trial

text: OBJECTIVE: To investigate the efficacy of a herbal formula in the prevention of influenza or influenza-like syndrome among elderies residing in old-people’s home in Hong Kong. The secondary objectives are to investigate the quality of life (QOL) and symptomology changes among the herbal users and to evaluate the safety of this formula. METHODS: In ten old people’s home or community centres in New Territories, Hong Kong, 740 eligible subjects agreed to join the study and were randomized to receive a herbal formula or a placebo on alternate days over 8 weeks. Among those 740 participants, 113 had provided blood samples for immunological assessments before and after the study drug. Assessments were done at 0, 4, 8 and 12 weeks. Participants were instructed to keep a daily record of body temperature and any symptoms as sore throat, myalgia, running nose or cough, and to report to assessor accordingly. Those reporting body temperature of 37.8 °C and above would be visited and a proper nasopharyngeal swab be taken for viral study. RESULTS: Seventy-two participants developed influenza-like-symptoms but none of them was proven influenza in their nasopharyngeal swabs, 40 of these patients belonged to the herbal group and 32 to the placebo group, without significant differences between groups. The difference on the changes in QOL between the two groups was not statistically significant. However, in the immunological study, the natural killer cell absolute count was significantly increased in the herbal group compared with the placebo group (463±253 vs 413±198, P<0.05). CONCLUSIONS: The herbal preparation was not effective compared with placebo in the prevention of influenza-like syndrome. It was however safe and possibly supporting immunological responses.


title: The U.S. Health Care System on the Eve of the Covid-19 Epidemic: A Summary of Recent Evidence on Its Impaired Performance

text: Four decades of neoliberal health policies have left the United States with a health care system that prioritizes the profits of large corporate actors, denies needed care to tens of millions, is extraordinarily fragmented and inefficient, and was ill prepared to address the COVID-19 pandemic. The payment system has long rewarded hospitals for providing elective surgical procedures to well-insured patients while penalizing those providing the most essential and urgent services, causing hospital revenues to plummet as elective procedures were cancelled during the pandemic. Before the recession caused by the pandemic, tens of millions of Americans were unable to afford care, compromising their physical and financial health; deep-pocketed corporate interests were increasingly dominating the hospital industry and taking over physicians’ practices; and insurers’ profits hit record levels. Meanwhile, yawning class-based and racial inequities in care and health outcomes remain and have even widened. Recent data highlight the failure of policy strategies based on market models and the need to shift to a nonprofit social insurance model.


title: Longitudinal analyses of the relationship between development density and the COVID-19 morbidity and mortality rates: Early evidence from 1,165 metropolitan counties in the United States

text: This longitudinal study aimed to investigative the impacts of development density on the spread and mortality rates of COVID-19 in metropolitan counties in the United States. Multilevel Linear Modeling (MLM) were employed to model the infection rate and the mortality rate of COVID-19, accounting for the hierarchical (two-level) and longitudinal structure of the data. This study found that large metropolitan size (measured in terms of population) lead to significantly higher COVID-19 infection rates and higher mortality rates. After controlling for metropolitan size and other confounding variables, county density leads to significantly lower infection rates and lower death rates. These findings recommend that urban planners and health professionals continue to advocate for compact development and continue to oppose urban sprawl for this and many other reasons documented in the literature, including the positive relationship between compact development and fitness and general health.


title: Utilización adecuada del lenguaje médico: principales problemas y soluciones

text: Resumen El lenguaje médico debe caracterizarse por su precisión, neutralidad emocional y estabilidad. La comunicación efectiva de los resultados de los trabajos científicos depende del cumplimiento de las normas vigentes de redacción y estilo, de manera que en un texto con defectos formales puede quedar mermado el interés de los hallazgos. En este trabajo se comentan algunos de los problemas y defectos más habituales del lenguaje médico; entre ellos, el abuso de siglas y de extranjerismos, la utilización de palabras impropias, los errores sintácticos o solecismos, los defectos más frecuentes en los títulos, y el abuso de mayúsculas y del gerundio. Frente a estos problemas, el investigador dispone de armas eficaces para superarlos, como la consulta de textos de calidad, los diccionarios críticos de dudas y dificultades de la lengua española y los manuales de redacción y estilo. Abstract Medical language should be characterized by its precision, emotional neutrality and stability. The effective communication of results of scientific studies depends on compliance with current standards of drafting and style; texts with defects can hinder interest in the findings. In this study, we discuss some of the most common problems and errors in medical language, including the abuse of abbreviations and foreign words, the use of improper words, syntax errors and solecisms, the most common errors in titles and the abuse of capital letters and the gerund. Investigators have effective tools for dealing with these problems, such as quality texts, critical dictionaries of questions and difficulties with the Spanish language and various drafting and style manuals.


title: Enterohaemorrhagic Escherichia coli: A new problem, an old group of organisms Inter faeces et urinam nascimur

text: All mammals are colonised by Escherichia coli generally at birth and these organisms become part of their intestinal flora for the rest of their lives. New types are acquired generally by an oral route. Some E coli are pathogenic and some may have a far more enhanced ability to colonise the human intestine than most others. Recently enterohaemorrhagic E coli have emerged. They can cause a number of intestinal illnesses in humans including bloody diarrhoea and haemolytic uraemic syndrome. These organisms produce a number of virulence factors particularly the Shiga‐like toxins (verotoxins). The intestines of animals may be the reservoir of these organisms for human infection, and cattle particularly have been shown to harbour them. Food, especially undercooked meat products, have been associated with a number of outbreaks throughout the world. While a certain serotype O157.H7 has been associated with many outbreaks throughout the world, other serotypes, particularly 0111.H‐, have also been reported. This latter serotype appears to be more common in Australia.


title: Neuropsychiatric aspects of COVID-19 Pandemic: A Selective Review

text: Corona virus disease (COVID-19) has been declared as a controllable pandemic by the World Health Organization (WHO). COVID-19 though is a predominantly respiratory illness; it can also affect brain and other organs like kidneys, heart and liver. Neuropsychiatric manifestations are common during viral pandemics but are not effectively addressed. Fever and cough are common symptoms only in infected individuals but headache and sleep disturbances are common even in uninfected general public. In this selective review, the authors report the available evidence of neuropsychiatric morbidity during the current COVID-19 crisis. The authors also discuss the postulated neuronal mechanisms of the corona virus infection sequelae.


title: Suitability evaluation on material specifications and edible methods of Dendrobii Officinalis Caulis based on holistic polysaccharide marker

text: Background: Dendrobii Officinalis Caulis (DC) is a well-known tonic herbal medicine worldwide and has favorable immunomodulatory activity. Various material specifications of DC are available in herbal markets, and DC is ingested by different edible methods. However, whether these specifications and edible methods are suitable or not remains unknown. Methods: In this study, we evaluated the suitability of four material specifications (fresh stem, dried stem, fengdou and powder) and three edible methods (making tea, soup and medicinal liquor) based on holistic polysaccharide marker (HPM), the major polysaccharide components in DC. First, the HPMs were extracted from the four specifications of DC by the three edible methods in different conditions. Second, qualitative and quantitative characterization of the extracted HPMs was performed using high performance gel permeation chromatography (HPGPC). Third, immunomodulatory activities of the extracted HPMs were evaluated in vivo. Results: The results showed that the HPMs were found to be quantitatively different from various specification of DC and edible methods. In vivo analysis indicated that the HPMs exerted positive effects on innate immune responses by increment in proliferation of splenocytes, secretion of IL-2 and cytotoxicity activity of NK cells. Moreover, the dosage amount of HPM should be defined as a certain range, but not the larger the better, for exerting strong immunological activities. Conclusion: According to the both chemical and biological results, fengdou by boiling with water for 4 h is the most recommended specification and edible method for DC.


title: Update on bacterial pathogens: virulence and resistance

text: The present article is an update of the literature on bacterial pathogens. Recognizing the interest and scientific and public health importance of infections produced by bacterial pathogens with new virulence mechanisms and/or new mechanisms of resistance to antimicrobial agents, a multidisciplinary group of Spanish physicians and microbiologists organized a joint session and revised the most important papers produced in the field during 2006. Each article was analyzed and discussed by one of the members of the panel. This paper focus on a variety of diseases that pose major clinical and public health challenges today; and include infections produced by community-acquired methicillin-resistant Staphylococcus aureus and S. aureus small colony variants, infections produced by multiply resistant coagulase-negative staphylococci, pneumococcal infections, human listeriosis, meningococcal disease, Haemophilus influenzae, pertussis, Escherichia coli, ESBL-producing organisms, and infections due to non-fermenters. After a review of the state of the art, papers selected in this field are discussed.


title: The Nucleocapsid Protein of Human Coronavirus NL63

text: Human coronavirus (HCoV) NL63 was first described in 2004 and is associated with respiratory tract disease of varying severity. At the genetic and structural level, HCoV-NL63 is similar to other members of the Coronavirinae subfamily, especially human coronavirus 229E (HCoV-229E). Detailed analysis, however, reveals several unique features of the pathogen. The coronaviral nucleocapsid protein is abundantly present in infected cells. It is a multi-domain, multi-functional protein important for viral replication and a number of cellular processes. The aim of the present study was to characterize the HCoV-NL63 nucleocapsid protein. Biochemical analyses revealed that the protein shares characteristics with homologous proteins encoded in other coronaviral genomes, with the N-terminal domain responsible for nucleic acid binding and the C-terminal domain involved in protein oligomerization. Surprisingly, analysis of the subcellular localization of the N protein of HCoV-NL63 revealed that, differently than homologous proteins from other coronaviral species except for SARS-CoV, it is not present in the nucleus of infected or transfected cells. Furthermore, no significant alteration in cell cycle progression in cells expressing the protein was observed. This is in stark contrast with results obtained for other coronaviruses, except for the SARS-CoV.


title: Role of viral coinfections in asthma development

text: BACKGROUND: Viral respiratory infections, especially acute bronchiolitis, play a key role in the development of asthma in childhood. However, most studies have focused on respiratory syncytial virus or rhinovirus infections and none of them have compared the long-term evolution of single versus double or multiple viral infections. OBJECTIVE: Our aim was to compare the frequency of asthma development at 6–8 years in children with previous admission for bronchiolitis associated with single versus double or multiple viral infection. PATIENTS & METHODS: A cross-sectional study was performed in 244 children currently aged 6–8 years, previously admitted due to bronchiolitis between September 2008 and December 2011. A structured clinical interview and the ISAAC questionnaire for asthma symptoms for 6-7-year-old children, were answered by parents by telephone. Specimens of nasopharyngeal aspirate for virological study (polymerase chain reaction) and clinical data were prospectively taken during admission for bronchiolitis. RESULTS: Median current age at follow-up was 7.3 years (IQR: 6.7–8.1). The rate of recurrent wheezing was 82.7% in the coinfection group and 69.7% in the single-infection group, p = 0.06. The number of wheezing-related admissions was twice as high in coinfections than in single infections, p = 0.004. Regarding the ISAAC questionnaire, 30.8% of coinfections versus 15% of single infections, p = 0.01, presented “wheezing in the last 12 months”, data that strongly correlate with current prevalence of asthma. “Dry cough at night” was also reported more frequently in coinfections than in single infections, p = 0.02. The strongest independent risk factors for asthma at 6–8 years of age were: age > 9 months at admission for bronchiolitis (OR: 3.484; CI95%: 1.459–8.317, p:0.005), allergic rhinitis (OR: 5.910; 95%CI: 2.622–13.318, p<0.001), and viral coinfection-bronchiolitis (OR: 3.374; CI95%: 1.542–7.386, p:0.01). CONCLUSIONS: Asthma at 6–8 years is more frequent and severe in those children previously hospitalized with viral coinfection-bronchiolitis compared with those with single infection. Allergic rhinitis and older age at admission seem also to be strong independent risk factors for asthma development in children previously hospitalised because of bronchiolitis.


title: Obesity and COVID‐19: an Italian snapshot

text: OBJECTIVE: The clinical manifestations of COVID‐19 run from asymptomatic disease to severe acute respiratory syndrome. Older age and comorbidities are associated to more severe disease. A role of obesity is suspected. METHODS: We enrolled patients hospitalized in the medical COVID‐19 ward with SARS‐CoV‐2 related pneumonia. Primary outcome of the study was to assess the relationship between the severity of COVID‐19 and obesity classes according to BMI. RESULTS: 92 patients (61.9% males; age 70.5±13.3 years) were enrolled. Patients with overweight and obesity were younger than normal‐weight patients (68.0±12.6 and 67.0±12.6 years vs. 76.1±13.0 years, p<0.01). A higher need for assisted ventilation beyond pure oxygen support (Invasive Mechanical Ventilation or Non‐Invasive Ventilation) and a higher admission to intensive or semi‐intensive care units was observed in patients with overweight and obesity (p<0.01 and p < 0.05, respectively) even after adjusting for sex, age and comorbidities (p<0.05 and p<0.001, respectively), or when patients with dementia or advanced cancer were removed from the analysis (p<0.05). CONCLUSION: Patients with overweight and obesity admitted in a medical ward for SARS‐CoV‐2 related pneumonia, despite their younger age, required more frequently assisted ventilation and access to intensive or semi‐intensive care units than normal weight patients.


docid: jejgkcql

title: Synthetic Biology and Personalized Medicine

text: Synthetic biology, application of synthetic chemistry to biology, is a broad term that covers the engineering of biological systems with structures and functions not found in nature to process information, manipulate chemicals, produce energy, maintain cell environment and enhance human health. Synthetic biology devices contribute not only to improve our understanding of disease mechanisms, but also provide novel diagnostic tools. Methods based on synthetic biology enable the design of novel strategies for the treatment of cancer, immune diseases metabolic disorders and infectious diseases as well as the production of cheap drugs. The potential of synthetic genome, using an expanded genetic code that is designed for specific drug synthesis as well as delivery and activation of the drug in vivo by a pathological signal, was already pointed out during a lecture delivered at Kuwait University in 2005. Of two approaches to synthetic biology, top-down and bottom-up, the latter is more relevant to the development of personalized medicines as it provides more flexibility in constructing a partially synthetic cell from basic building blocks for a desired task.


title: The Role of Medical Students During the COVID-19 Pandemic

text: In this commentary, the authors discuss multiple potential clinical roles for medical students during the coronavirus disease 2019 pandemic.