title: Large-scale survey of adverse reactions to canine non-rabies combined vaccines in Japan

text: Abstract Canine non-rabies combined vaccines are widely used to protect animals from infectious agents, and also play an important role in public health. We performed a large-scale survey to investigate vaccine-associated adverse events (VAAEs), including anaphylaxis, in Japan by distributing questionnaires on VAAEs to veterinary hospitals from April 1, 2006 through May 31, 2007. Valid responses were obtained for 57,300 vaccinated dogs at 573 animal hospitals; we obtained VAAEs information for last 100 vaccinated dogs in each veterinary hospital. We found that of the 57,300, 359 dogs showed VAAEs. Of the 359 dogs, death was observed in 1, anaphylaxis in 41, dermatological signs in 244, gastrointestinal signs in 160, and other signs in 106. Onset of VAAEs was mostly observed within 12h after vaccination (n =299, 83.3%). In this study, anaphylaxis events occurred within 60min after vaccination, and about half of these events occurred within 5min (n =19, 46.3%). Furthermore, where anaphylaxis was reported, additional information to support the diagnosis was obtained by reinvestigation. Our resurvey of dogs with anaphylaxis yielded responses on 31 dogs; 27 of these demonstrated collapse (87.1%), 24 demonstrated cyanosis (77.4%), and both signs occurred in 22 (71.0%). Higher rates of animal VAAEs, anaphylaxis, and death were found in Japan than in other countries. Further investigations, including survey studies, will be necessary to elucidate the interaction between death and vaccination and the risk factors for VAAEs, and thus develop safer vaccines. Moreover, it may also be necessary to continually update the data of VAAEs.


title: Immune responses against SARS-coronavirus nucleocapsid protein induced by DNA vaccine

text: Abstract The nucleocapsid (N) protein of SARS-coronavirus (SARS-CoV) is the key protein for the formation of the helical nucleocapsid during virion assembly. This protein is believed to be more conserved than other proteins of the virus, such as spike and membrane glycoprotein. In this study, the N protein of SARS-CoV was expressed in Escherichia coli DH5α and identified with pooled sera from patients in the convalescence phase of SARS. A plasmid pCI-N, encoding the full-length N gene of SARS-CoV, was constructed. Expression of the N protein was observed in COS1 cells following transfection with pCI-N. The immune responses induced by intramuscular immunization with pCI-N were evaluated in a murine model. Serum anti-N immunoglobulins and splenocytes proliferative responses against N protein were observed in immunized BALB/c mice. The major immunoglobulin G subclass recognizing N protein was immunoglobulin G2a, and stimulated splenocytes secreted high levels of gamma interferon and IL-2 in response to N protein. More importantly, the immunized mice produced strong delayed-type hypersensitivity (DTH) and CD8+ CTL responses to N protein. The study shows that N protein of SARS-CoV not only is an important B cell immunogen, but also can elicit broad-based cellular immune responses. The results indicate that the N protein may be of potential value in vaccine development for specific prophylaxis and treatment against SARS.


title: Inhibitory Effect of Resveratrol against Duck Enteritis Virus In Vitro

text: Duck viral enteritis (DVE) is an acute, contagious herpesvirus infection of ducks, geese, and swans of all ages and species. This disease has been responsible for significant economic losses in domestic and wild waterfowl as a result of mortality, and decreased egg production. Resveratrol is a naturally occurring phytoalexin in specific plants and exhibits inhibitory activity against many kinds of virus. In this paper, resveratrol was found to inhibit duck enteritis virus (DEV) replication in a dose-dependent manner, with a 50% inhibition concentration of 3.85 μg/mL. The inhibition in virus multiplication in the presence of resveratrol was not attributed to direct inactivation or inhibition of virus attachment to the host cells, but to the inhibition of viral multiplication in host cells. The assay of the time of addition limited the drug effect during the first 8 h of infection. This conclusion was supported by the ultrastructure images of the early stage of DEV infection, which showed that the replication of virus nucleic acid and the formation of the capsid in the cell nucleus were suppressed. In the indirect immunofluorescence assay, proteins expression in DEV infected duck embryo fibroblasts (DEFs) within 24 h post-infection (p.i.) was also effectively suppressed by resveratrol. In summary, the resveratrol has a good activity against DEV infection in vitro, which could be attributed to that fact that several essential immediate early viral proteins for virus replication were impacted by resveratrol.


Should, and how can, exercise be done during a coronavirus outbreak? An interview with Dr. Jeffrey A. Woods


title: Oncolytic Reovirus Infection Is Facilitated by the Autophagic Machinery

text: Mammalian reovirus is a double-stranded RNA virus that selectively infects and lyses transformed cells, making it an attractive oncolytic agent. Despite clinical evidence for anti-tumor activity, its efficacy as a stand-alone therapy remains to be improved. The success of future trials can be greatly influenced by the identification and the regulation of the cellular pathways that are important for reovirus replication and oncolysis. Here, we demonstrate that reovirus induces autophagy in several cell lines, evident from the formation of Atg5-Atg12 complexes, microtubule-associated protein 1 light chain 3 (LC3) lipidation, p62 degradation, the appearance of acidic vesicular organelles, and LC3 puncta. Furthermore, in electron microscopic images of reovirus-infected cells, autophagosomes were observed without evident association with viral factories. Using UV-inactivated reovirus, we demonstrate that a productive reovirus infection facilitates the induction of autophagy. Importantly, knock-out cell lines for specific autophagy-related genes revealed that the expression of Atg3 and Atg5 but not Atg13 facilitates reovirus replication. These findings highlight a central and Atg13-independent role for the autophagy machinery in facilitating reovirus infection and contribute to a better understanding of reovirus-host interactions.


title: Management von Patienten mit Tracheostoma während der COVID-19-Pandemie: Literaturüberblick und Demonstration

text: BACKGROUND: Since emergence of the new coronavirus in China in December 2019, many countries have been struggling to control skyrocketing numbers of infections, including among healthcare personnel. It has now been clearly demonstrated that SARS-CoV‑2 resides in the upper airways and transmits easily via aerosols and droplets, which significantly increases the risk of infection when performing upper airway procedures. Ventilated COVID-19 patients in a critical condition in the intensive care unit may require tracheotomy for long-term ventilation and to improve weaning. However, the risk of secondary infection of medical personnel performing subsequent tracheostomy care remains unclear. OBJECTIVE: This study aimed to evaluate the risk of droplet dispersion during tracheostomy tube change and overview tracheostomy tube change in COVID-19 patients. MATERIALS AND METHODS: The current literature was reviewed, quantitative and qualitative analyses of droplet formation during tracheostomy tube change in n = 8 patients were performed, and an overview of and checklist for tracheostomy tube change were compiled. RESULTS: This study demonstrates that tracheostomy tube change, in particular insertion of the new tube, may cause significant droplet formation. The aerosolization of particles smaller than 5 µm was not analyzed. CONCLUSION: Our data, together with the current literature, clearly emphasize that tracheostomy care is associated with a high infection risk and should only be performed by a small group of well-trained, maximally protected healthcare personnel.


title: A novel pipeline of 2-(benzenesulfonamide)-N-(4-hydroxyphenyl) acetamide analgesics that lack hepatotoxicity and retain antipyresis

text: Although acetaminophen (ApAP) is one of the most commonly used medicines worldwide, hepatotoxicity is a risk with overdose or in patients with compromised liver function. ApAP overdose is the most common cause of acute fulminant hepatic failure. Oxidation of ApAP to N-acetyl-p-benzoquinone imine (NAPQI) is the mechanism for hepatotoxicity. 1 is a non-hepatotoxic, metabolically unstable lipophilic ApAP analog that is not antipyretic. The newly synthesized 3 is a non-hepatotoxic ApAP analog that is stable, lipophilic, and retains analgesia and antipyresis. Intraperitoneal or po administration of the new chemical entities (NCEs), 3b and 3r, in concentrations equal to a toxic dose of ApAP did not result in the formation of NAPQI. Unlike livers from NCE-treated mice, the livers from ApAP-treated mice demonstrated large amounts of nitrotyrosine, a marker of mitochondrial free radical formation, and loss of hepatic tight junction integrity. Given the widespread use of ApAP, hepatotoxicity risk with overuse, and the ongoing opioid epidemic, these NCEs represent a novel, non-narcotic therapeutic pipeline.


title: Infectious diseases in large-scale cat hoarding investigations

text: Abstract Animal hoarders accumulate animals in over-crowded conditions without adequate nutrition, sanitation, and veterinary care. As a result, animals rescued from hoarding frequently have a variety of medical conditions including respiratory infections, gastrointestinal disease, parasitism, malnutrition, and other evidence of neglect. The purpose of this study was to characterize the infectious diseases carried by clinically affected cats and to determine the prevalence of retroviral infections among cats in large-scale cat hoarding investigations. Records were reviewed retrospectively from four large-scale seizures of cats from failed sanctuaries from November 2009 through March 2012. The number of cats seized in each case ranged from 387 to 697. Cats were screened for feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) in all four cases and for dermatophytosis in one case. A subset of cats exhibiting signs of upper respiratory disease or diarrhea had been tested for infections by PCR and fecal flotation for treatment planning. Mycoplasma felis (78%), calicivirus (78%), and Streptococcus equi subspecies zooepidemicus (55%) were the most common respiratory infections. Feline enteric coronavirus (88%), Giardia (56%), Clostridium perfringens (49%), and Tritrichomonas foetus (39%) were most common in cats with diarrhea. The seroprevalence of FeLV and FIV were 8% and 8%, respectively. In the one case in which cats with lesions suspicious for dermatophytosis were cultured for Microsporum canis, 69/76 lesional cats were culture-positive; of these, half were believed to be truly infected and half were believed to be fomite carriers. Cats from large-scale hoarding cases had high risk for enteric and respiratory infections, retroviruses, and dermatophytosis. Case responders should be prepared for mass treatment of infectious diseases and should implement protocols to prevent transmission of feline or zoonotic infections during the emergency response and when transferring the rescued cats to other shelters or to adopters.


Letter: Neurosurgical Patients’ Management During the COVID-19 Pandemic—An Institutional Report From an African Neurosurgical Center


docid: sonthitn

title: Interpretable Artificial Intelligence for COVID-19 Diagnosis from Chest CT Reveals Specificity of Ground-Glass Opacities

text: Background The use of CT imaging enhanced by artificial intelligence to effectively diagnose COVID-19, instead of or in addition to reverse transcription-polymerase chain reaction (RT-PCR), can improve widespread COVID-19 detection and resource allocation. Methods 904 axial lung window CT slices from 338 patients in 17 countries were collected and labeled. The data included 606 images from COVID-19 positive patients (confirmed via RT-PCR), 224 images of a variety of other pulmonary diseases including viral pneumonias, and 74 images of normal patients. We developed, trained, validated, and tested an object detection model which detects features in three categories: ground-glass opacities (GGOs) for COVID-19, GGOs for non-COVID-19 diseases, and features that are inconsistent with a COVID-19 diagnosis. These collected features are passed into an interpretable decision tree model to make a suggested diagnosis. Results On an independent test of 219 images from COVID-19 positive, a variety of pneumonia, and healthy patients, the model predicted COVID-19 diagnoses with an accuracy of 96.80 % (95% confidence interval [CI], 96.75 to 96.86) , AUC-ROC of 0.9664 (95% CI, 0.9659 to 0.9671) , sensitivity of 98.33% (95% CI, 98.29 to 98.40) , precision of 95.93% (95% CI, 95.83 to 95.99), and specificity of 94.95% (95% CI, 94.84 to 95.05). On an independent test of 34 images from asymptomatic COVID-19 positive patients, our model achieved an accuracy of 97.06% (95% CI, 96.81 to 97.06) and a sensitivity of 96.97% (95% CI, 96.71 to 96.97). Similarly high performance was also obtained for out-of-sample countries, and no significant performance difference was obtained between genders. Conclusion We present an interpretable artificial intelligence CT analysis tool to diagnose COVID-19 in both symptomatic and asymptomatic patients. Further, our model is able to differentiate COVID-19 GGOs from similar pathologies suggesting that GGOs can be disease-specific.


title: COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options

text: The novel coronavirus disease (COVID-19) outbreak, caused by SARS-CoV-2, represents the greatest medical challenge in decades. We provide a comprehensive review of the clinical course of COVID-19, its comorbidities, and mechanistic considerations for future therapies. While COVID-19 primarily affects the lungs, causing interstitial pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects multiple organs, particularly the cardiovascular system. Risk of severe infection and mortality increase with advancing age and male sex. Mortality is increased by comorbidities: cardiovascular disease, hypertension, diabetes, chronic pulmonary disease, and cancer. The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular fibrillation), cardiac injury [elevated highly sensitive troponin I (hs-cTnI) and creatine kinase (CK) levels], fulminant myocarditis, heart failure, pulmonary embolism, and disseminated intravascular coagulation (DIC). Mechanistically, SARS-CoV-2, following proteolytic cleavage of its S protein by a serine protease, binds to the transmembrane angiotensin-converting enzyme 2 (ACE2) —a homologue of ACE—to enter type 2 pneumocytes, macrophages, perivascular pericytes, and cardiomyocytes. This may lead to myocardial dysfunction and damage, endothelial dysfunction, microvascular dysfunction, plaque instability, and myocardial infarction (MI). While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis. Hence, patients should not discontinue their use. Moreover, renin–angiotensin–aldosterone system (RAAS) inhibitors might be beneficial in COVID-19. Initial immune and inflammatory responses induce a severe cytokine storm [interleukin (IL)-6, IL-7, IL-22, IL-17, etc.] during the rapid progression phase of COVID-19. Early evaluation and continued monitoring of cardiac damage (cTnI and NT-proBNP) and coagulation (D-dimer) after hospitalization may identify patients with cardiac injury and predict COVID-19 complications. Preventive measures (social distancing and social isolation) also increase cardiovascular risk. Cardiovascular considerations of therapies currently used, including remdesivir, chloroquine, hydroxychloroquine, tocilizumab, ribavirin, interferons, and lopinavir/ritonavir, as well as experimental therapies, such as human recombinant ACE2 (rhACE2), are discussed.


title: TRANSFUSION THRESHOLDS FOR ADULT RESPIRATORY EXTRACORPOREAL LIFE SUPPORT: AN EXPERT CONSENSUS DOCUMENT

text: Severe acute respiratory distress syndrome (ARDS) can complicate novel pandemic coronavirus disease (COVID-19). Extracorporeal life support (ECLS) represents the final possible rescue strategy. Variations in practice, combined with a paucity of rigorous guidelines, may complicate blood product resource availability and allocation during a pandemic. We conducted a literature review around venovenous extracorporeal membrane oxygenation (VV-ECMO) transfusion practices for platelets, packed red blood cells, fresh frozen plasma, prothrombin complex concentrate, and antithrombin. Pertinent society guidelines were examined, and the practice of Canadian ECLS experts was sampled through an environmental scan. This paper represents a synthesis of these explorations, combined with input from the Canadian Cardiovascular Critical Care (CANCARE) Society, Canadian Society of Cardiac Surgeons, and the Canadian Critical Care Society. We offer a pragmatic guidance document for restrictive transfusion thresholds in non-bleeding VV-ECMO patients, which may attenuate transfusion-related complications, and simultaneously shield national blood product inventory from strain during pandemic-induced activation of the National Plan for the Management of Shortages of Labile Blood Components.


title: Plasma citrulline, arginine, nitric oxide, and blood ammonia levels in neonatal calves with acute diarrhea

text: BACKGROUND: Plasma citrulline (CIT) concentration is considered to be a reliable marker of functional enterocyte mass, primarily in humans. However, information about CIT levels along with related metabolites, arginine (ARG), nitric oxide (NO), and ammonia in neonatal calves are lacking. OBJECTIVES: To compare plasma CIT, ARG, NO, and whole blood ammonia concentrations in neonatal calves with acute diarrhea with those in healthy calves and to assess their possible relationships with diarrhea‐related criteria. ANIMALS: Seventy neonatal calves (60 with acute diarrhea and 10 healthy). METHODS: Observational case‐control study. Diarrheic calves were classified into subgroups on the basis of etiology, severity of diarrhea, degree of dehydration, and systemic inflammatory response syndrome (SIRS) status. Plasma CIT and ARG concentrations were measured by liquid chromatography/tandem mass spectrometry. RESULTS: Plasma CIT (median [range]: 67.5 [61.9‐75.4] vs 30.1 [15.0‐56.1] μmol/L) and ARG (170.7 [148.5‐219.5] vs 106.1 [54.4‐190.7] μmol/L) were lower and plasma NO (4.42 [3.29‐5.58] vs 6.78 [5.29‐8.92] μM) and blood ammonia concentrations (28.7 [26.1‐36.9] vs 59.8 [34.6‐99.5] μmol/L) were higher in the neonatal calves with diarrhea (P < .001). Plasma CIT (β = −0.29, P = .02), ARG (β = −0.33, P = .01), NO (β = 0.55, P < .001), and blood ammonia (β = 0.63, P <.001) were affected by SIRS status. Except for ammonia (0.52), the effects sizes for severity of diarrhea and degree of dehydration were small (ηp2 ≤ 0.45) for CIT, ARG, and NO. CONCLUSIONS AND CLINICAL IMPORTANCE: The changes in these variables might have diagnostic, prognostic, and therapeutic value in diarrheic neonatal calves.


title: Well‐being and burnout: One size does not fit all

text: Well‐being and burnout are concepts that have become well described throughout emergency medicine. In the past, both well‐being and burnout have been defined and addressed as a singular phenomenon, similar for all physicians, regardless of career stage. However, unique stressors may exist for physicians, as a function of their work environment and stage. In this concepts article we present clinician well‐being as a dynamic and continuous process, subject to unique factors along the professional lifespan. Specific individual and system‐level factors are discussed, ranging from demographic variables, to evolving administrative and professional responsibilities depending on the career stage of a clinician. This detailed description of stressors spanning an emergency physician's professional career may help create more targeted physician well‐being and burnout interventions.


Editorial comment


title: Molecular testing for respiratory pathogens in sickle cell disease adult patients presenting with febrile acute chest syndrome

text: Abstract Background Differentiating acute chest syndrome (ACS) from community-acquired pneumonia (CAP) is challenging in adults presenting with major sickle cell disease (SCD) (semiological similarity, rare microbiological documentation). We aimed to assess the usefulness of nucleic acid amplification test (NAAT) for respiratory pathogens, in combination with standard bacteriological investigations, in febrile ACS adult patients presenting with major SCD. Methods We performed a prospective, monocentric, observational study of 61 SCD adults presenting with febrile ACS from February 2015 to April 2016. Systematic blood, urine, and respiratory specimens were collected, before antibiotic initiation, for culture, urinary antigen tests, serology, and NAAT for respiratory pathogens. Results A pathogen was detected in 12 febrile ACS (19.7%): four viruses (6.6%) (Rhinovirus; Influenza A/B), seven bacteria (11.4%) (S. aureus, S. pneumoniae, K. pneumoniae, L. pneumophila, M. pneumoniae), one mixed infection (1.6%) (S. aureus and Influenza B). NAAT only detected L. pneumophila in one case (serogroup 2). Apart from a significantly shorter antibiotic therapy duration (6.1 vs. 7.8 days, P =0.045), no difference was observed between undocumented and microbiologically-documented febrile ACS. Conclusion Using NAAT for the detection of respiratory pathogens in adults presenting with SCD slightly improved the microbiological diagnostic of febrile ACS, although respiratory infections are not the main etiological factor.


title: International Liaison Committee on Resuscitation: COVID-19 Consensus on Science, Treatment Recommendations and Task Force Insights

text: Summary Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.


docid: icahtjby

title: 2 Reviews of resilience theories and mathematical generalization

text: Abstract This chapter presents a comprehensive review of the resilience theories developed in three key fields of study or systems, namely, socioecological systems, sociotechnical systems and computer systems. Having thus clarified the nature of the resilience approach and its target function, a mathematical generalization of the resilience theories is established. A theoretical work on solving nonlinear dynamic problems using a two-step approach is also reviewed in order to expand the solution tools for studying system behaviors of complex dynamical systems, which are the targets of resilience studies. In order to reflect the latest research, several recent technical books and monographs on the subject are used as the basis of discussion. These are: Biggs et al., Principles for Building Resilience: Sustaining Ecosystem Services in Social–Ecological Systems, edited by Biggs et al. (2015), Resilience Engineering in Practice: A Guidebook, edited by Hollnagel, Paries, Woods and Wreathall (2011); and Resilient Computer System Design by Castano and Schagaev (2015). The following reviews are basically summaries and digests of the resilience theories and practices introduced in these books, with some comments by Z. Shi.


title: DNA Vaccine Encoding Middle East Respiratory Syndrome Coronavirus S1 Protein Induces Protective Immune Responses in Mice

text: The Middle East respiratory syndrome coronavirus (MERS-CoV), is an emerging pathogen that continues to cause outbreaks in the Arabian peninsula and in travelers from this region, raising the concern that a global pandemic could occur. Here, we show that a DNA vaccine encoding the first 725 amino acids (S1) of MERS-CoV spike (S) protein induces antigen-specific humoral and cellular immune responses in mice. With three immunizations, high titers of neutralizing antibodies (up to 1: 10(4)) were generated without adjuvant. DNA vaccination with the MERS-CoV S1 gene markedly increased the frequencies of antigen-specific CD4(+) and CD8(+) T cells secreting IFN-γ and other cytokines. Both pcDNA3.1-S1 DNA vaccine immunization and passive transfer of immune serum from pcDNA3.1-S1 vaccinated mice protected Ad5-hDPP4-transduced mice from MERS-CoV challenge. These results demonstrate that a DNA vaccine encoding MERS-CoV S1 protein induces strong protective immune responses against MERS-CoV infection.


title: Interferons and viruses: Signaling for supremacy

text: Interferon (IFN)-α and IFN-β are critical mediators of host defense against microbial challenges, directly interfering with viral infection and influencing both the innate and adaptive immune responses. IFNs exert their effects in target cells through the activation of a cell-surface receptor, leading to a cascade of signaling events that determine transcriptional and translation regulation. Understanding the circuitry associated with IFN-mediated signal transduction that leads to a specific biological outcome has been a major focus of our laboratory. Through the efforts of graduate students, postdoctoral fellows, a skilled research technologist, and important collaborations with investigators elsewhere, we have provided some insights into the complexity of the IFN system—and the elegance and simplicity of how protein-protein interactions define biological function.


title: Impact of microbial Aetiology on mortality in severe community-acquired pneumonia

text: BACKGROUND: The impact of different classes of microbial pathogens on mortality in severe community-acquired pneumonia is not well elucidated. Previous studies have shown significant variation in the incidence of viral, bacterial and mixed infections, with conflicting risk associations for mortality. We aimed to determine the risk association of microbial aetiologies with hospital mortality in severe CAP, utilising a diagnostic strategy incorporating molecular testing. Our primary hypothesis was that respiratory viruses were important causative pathogens in severe CAP and was associated with increased mortality when present with bacterial pathogens in mixed viral-bacterial co-infections. METHODS: A retrospective cohort study from January 2014 to July 2015 was conducted in a tertiary hospital medical intensive care unit in eastern Singapore, which has a tropical climate. All patients diagnosed with severe community-acquired pneumonia were included. RESULTS: A total of 117 patients were in the study. Microbial pathogens were identified in 84 (71.8%) patients. Mixed viral-bacterial co-infections occurred in 18 (15.4%) of patients. Isolated viral infections were present in 32 patients (27.4%); isolated bacterial infections were detected in 34 patients (29.1%). Hospital mortality occurred in 16 (13.7%) patients. The most common bacteria isolated was Streptococcus pneumoniae and the most common virus isolated was Influenza A. Univariate and multivariate logistic regression showed that serum procalcitonin, APACHE II severity score and mixed viral-bacterial infection were associated with increased risk of hospital mortality. Mixed viral-bacterial co-infections were associated with an adjusted odds ratio of 13.99 (95% CI 1.30–151.05, p = 0.03) for hospital mortality. CONCLUSIONS: Respiratory viruses are common organisms isolated in severe community-acquired pneumonia. Mixed viral-bacterial infections may be associated with an increased risk of mortality.


Epidemiologic Characteristics of Cases for Influenza A(H7N9) Virus Infections in China


docid: zocunore

title: Coronavirus phylogeny based on triplets of nucleic acids bases

text: Abstract We considered the fully overlapping triplets of nucleotide bases and proposed a 2D graphical representation of protein sequences consisting of 20 amino acids and a stop code. Based on this 2D graphical representation, we outlined a new approach to analyze the phylogenetic relationships of coronaviruses by constructing a covariance matrix. The evolutionary distances are obtained through measuring the differences among the two-dimensional curves.


title: Cysteine proteinases of microorganisms and viruses

text: This review considers properties of secreted cysteine proteinases of protozoa, bacteria, and viruses and presents information on the contemporary taxonomy of cysteine proteinases. Literature data on the structure and physicochemical and enzymatic properties of these enzymes are reviewed. High interest in cysteine proteinases is explained by the discovery of these enzymes mostly in pathogenic organisms. The role of the proteinases in pathogenesis of several severe diseases of human and animals is discussed.


title: Development of a multiplex one step RT-PCR that detects eighteen respiratory viruses in clinical specimens and comparison with real time RT-PCR

text: Abstract Rapid and accurate diagnosis of viral respiratory infections is crucial for patient management. Multiplex reverse transcriptase polymerase chain reaction (mRT-PCR) is used increasingly to diagnose respiratory infections and has shown to be more sensitive than viral culture and antigen detection. Objective of the present study was to develop a one-step mRT-PCR that could detect 18 respiratory viruses in three sets. The method was compared with real time RT-PCR (rRT-PCR) for its sensitivity and specificity. Clinical specimens from 843 pediatric patients with respiratory symptoms were used in the study. 503 (59.7%) samples were detected positive by mRT-PCR. Of these 462 (54.8%) exhibited presence of a single pathogen and 41 (4.9%) had multiple pathogens. rRT-PCR detected 439 (52.1%) positive samples, where 419 (49.7%) exhibited one virus and 20 (2.4%) showed co-infections. Concordance between mRT-PCR and rRT-PCR was 91.9% and kappa correlation 0.837. Sensitivity and specificity of mRT-PCR were 99.5% and 83.7% while that of rRT-PCR was 86.9% and 99.4% respectively. Rhinovirus (17.2%) was the most frequently detected virus followed by respiratory syncytial virus B (15.4%), H1N1pdm09 (8.54%), parainfluenza virus-3 (5.8%) and metapneumovirus (5.2%). In conclusion, mRT-PCR is a rapid, cost effective, specific and highly sensitive method for detection of respiratory viruses.


title: Bilateral anterior uveitis as a part of a multisystem inflammatory syndrome secondary to COVID‐19 infection

text: During the ongoing COVID‐19 pandemic, there is a global concern about patients presenting with inflammatory syndrome with variable clinical features. Colanfrancesco et al. described COVID‐19 systemic inflammatory reaction that are characterized by a life‐threatening hyper‐inflammation sustained by a cytokines storm which eventually leads to multi‐organ failure. This article is protected by copyright. All rights reserved.


title: Recommendations for detection, prioritization, and treatment of thoracic oncology patients during the COVID‐19 pandemic: The THOCOoP cooperative group

text: The world currently faces a pandemic due to SARS-CoV-2. Relevant information has emerged regarding the higher risk of poor outcomes in lung cancer patients. As such, lung cancer patients must be prioritized in terms of prevention, detection and treatment. On May 7th, 45 experts in thoracic cancers from 11 different countries were invited to participate. A core panel of experts regarding thoracic oncology care amidst the pandemic gathered virtually, and a total of 60 initial recommendations were drafted based on available evidence. By May 16th, 44 experts had agreed to participate, and voted on each recommendation using a Delphi panel on a live voting event. Consensus was reached regarding the recommendations (>66% strongly agree/agree) for 57 questions. Strong consensus (>80% strongly agree/agree) was reached for 45 questions. Patients with lung cancer represent a particularly vulnerable population during this time. Special care must be taken to maintain treatment while avoiding exposure.


title: Canine Coronavirus Highly Pathogenic for Dogs

text: Canine coronavirus (CCoV) is usually responsible for mild, self-limiting infections restricted to the enteric tract. We report an outbreak of fatal disease in puppies caused by a pathogenic variant of CCoV that was isolated from organs with severe lesions.


title: Multiplex PCR tests sentinel the appearance of pandemic influenza viruses including H1N1 swine influenza

text: BACKGROUND: Since the turn of the century seven new respiratory viruses have infected man and two of these have resulted in worldwide epidemics. Both SARS Coronavirus which quickly spread to 29 countries in February 2003 and H1N1 swine influenza that recently spread from Mexico to 30 countries in three weeks represent major pandemic threats for mankind. Diagnostic assays are required to detect novel influenza strains with pandemic potential. OBJECTIVE: In this report we evaluate the ability of a multiplex PCR test (xTAG(™)RVP) to detect new, “non-seasonal” influenza viruses including the H1N1 swine influenza A/swine/California/04/2009. STUDY DESIGN: Laboratory based study using retrospective and prospective specimens. RESULTS: This multiplex PCR test detected the present of non-seasonal (non-H1, non-H3) influenza in 20 of 20 patients infected with H1N1 swine flu virus. In addition to detecting the current swine flu the xTAG(™) RVP test detected the H5N1 A/Vietnam/1203/2004 high pathogenicity avian influenza virus that circulated in South East Asia in 2003 as well as 17 out of 17 influenza A viruses representing 11 HA subtypes isolated from birds, swine and horses not yet seen in the human population. CONCLUSION: Based on these results we believe that this molecular test can perform an important role as a sentinel test to detect novel non-seasonal influenza A viruses in patients presenting with influenza-like illness (ILI) and therefore act as an early warning system for the detection of future pandemic influenza threats.


title: PROTEINASE INHIBITORS | Cystatins

text: The cystatins comprise a superfamily of proteins related primarily by virtue of DNA and amino acid sequence homology. The superfamily consists so far of four distinct types of molecules ranging from the simpler low-molecular-weight type I and II cystatins, which function primarily to inhibit lysosomal cysteine proteinases (CPs), to the higher-molecular-weight type III and IV cystatins, which possess additional latent functions expressed only during episodes of injury and inflammation, or have evolved entirely novel inhibitory functions. The role cystatins play in respiratory diseases such as asthma and COPD is poorly understood. However, they do modulate the immune response by acting directly on neutrophils, macrophages, and antigen presenting cells. It is also clear that they do not function independently of other proteolytic pathways involved in remodeling of the lung. Limited proteolysis inactivates cystatins allowing lysosomal CP activity to directly contribute to lung tissue degradation and also liberates kinins which signal through G-protein-coupled receptors to cause both constriction and dilation of the bronchioles, pain via stimulation of sensory nerves, mucus secretion, cough, and edema.


title: Viral Etiology and the Impact of Codetection in Young Children Presenting With Influenza-Like Illness

text: BACKGROUND: Children with acute respiratory tract infection (ARTI) frequently exhibit virus-virus codetection, yet the clinical significance of ARTI remains contentious. Using data from a prospective cohort of children with influenza-like illness, we examined the virology of ARTI and determined the clinical impact of virus-virus codetection. METHODS: Children aged 6 to 59 months who presented to a tertiary pediatric hospital between influenza seasons 2008 and 2012 with fever and acute respiratory symptoms were enrolled, and nasal samples were collected. Respiratory viruses were identified by culture and polymerase chain reaction. We compared demographics, presenting symptoms, and clinical outcomes of children with a single-virus infection and those in whom 2 or more viruses were detected (virus-virus codetection). We used logistic regression models and estimated marginal means to calculate the adjusted odds ratios and probabilities of symptom presentation, prescription of antibiotics, and hospitalization. RESULTS: Of 2356 children, a virus was detected in 1630 (69.2%) of them; rhinovirus (40.8%), influenza (29.5%), and respiratory syncytial virus (26.4%) were detected most commonly. Two or more viruses were detected in 25% of these children. After we adjusted for demographic factors, children with virus-virus codetection had greater odds of presenting with cough (adjusted odds ratio [aOR], 1.9; 95% confidence interval [CI], 1.2–3.1) and rhinorrhea (aOR, 1.8; 95% CI, 1.1–2.9) than those with a single-virus infection, although both symptoms were common. Children with influenza and respiratory syncytial virus combined had the highest probability of hospitalization (55%; 95% CI, 35%–73%), which was significantly greater than for those with influenza infection alone (22%; 95% CI, 16%–29%). CONCLUSIONS: Overall, virus-virus codetection has limited impact on clinical severity among children with influenza-like illness. However, infection with specific pathogen pairs might be associated with more severe outcomes. Routine diagnostics to identify specific viruses should be restricted to common pathogens.


title: Dynamical modeling of viral spread in spatially distributed populations: stochastic origins of oscillations and density dependence

text: Abstract In order to understand the spatio-temporal structure of epidemics beyond that permitted with classical SIR (susceptible-infective-recovered)-type models, a new mathematical model for the spread of a viral disease in a population of spatially distributed hosts is described. The positions of the hosts are randomly generated in a rectangular habitat. Encounters between any pair of individuals are according to a Poisson process with a mean rate that declines exponentially as the distance between them increases. The contact rate allows the mean rates to be set at a certain number of encounters per day on average. The relevant state variables for each individual at any time are given by the solution of a pair of coupled differential equations for the viral load and the quantity of general immune system effectors which reduce the viral load. The parameters describing within-host viral-immune system dynamics are generated randomly to reflect variability across a population. Transmission is assumed to depend on the viral loads in donors and occurs with a probability p trans . The initial conditions are such that one randomly chosen individual carries a randomly chosen amount of the virus, whereas the rest of the population is uninfected. Simulations reveal local or whole-population responses. Whole-population disease spread may be in the form of isolated or multiple occurrences, the latter often being approximately periodic. The mechanisms of this oscillatory behaviour are analyzed in terms of several parameters and the distribution of critical points in the host dynamical systems. Increased contact rate, increased probability of transmission and decreased threshold for viral transmission, decreased immune strength and increased viral growth rate all increase the probability of multiple outbreaks and the distribution of the critical points also plays a role.


title: Diagnostic tests for SARS-CoV-2: Implications in head and neck oncology

text: • Screening is imperative to safeguard patients, practitioners and staff. • Various tests available for screening and diagnosing patients for SARS-CoV-2. • Rapid test can be used to screen patients before any surgical intervention. • Along with testing, clinical features should be corroborated. • Oral findings might aid in early diagnosis of COVID-19.


title: Epidemic in networked population with recurrent mobility pattern

text: The novel Coronavirus (COVID-19) has caused a global crisis and many governments have taken social measures, such as home quarantine and maintaining social distance. Many recent studies show that network structure and human mobility greatly influence the dynamics of epidemic spreading. In this paper, we utilize a discrete-time Markov chain approach and propose an epidemic model to describe virus propagation in the heterogeneous graph, which is used to represent individuals with intra social connections and mobility between individuals and common locations. There are two types of nodes, individuals and public places, and disease can spread by social contacts among individuals and people gathering in common areas. We give theoretical results about epidemic threshold and influence of isolation factor. Several numerical simulations are performed and experimental results further demonstrate the correctness of proposed model. Non-monotonic relationship between mobility possibility and epidemic threshold and differences between Erdös-Rényi and power-law social connections are revealed. In summary, our proposed approach and findings are helpful to analyse and prevent the epidemic spreading in networked population with recurrent mobility pattern.


title: Determination of the complete nucleotide sequence of a vaccine strain of porcine reproductive and respiratory syndrome virus and identification of the Nsp2 gene with a unique insertion

text: The complete nucleotide sequence of the genomic RNA of a vaccine strain (SP) of porcine reproductive and respiratory syndrome virus (PRRSV) was determined. It shares approximately 94% identity of nucleotide sequence with two recently reported North American strains, 16244B and VR2332, but only 78% with a European strain, Lelystad virus (LV). Its genome is the longest among the four published complete sequences of PRRSV, due to an insertion in the Nsp2-encoding region. Compared to Nsp2 of the North American strains and the European strain, the predicted Nsp2 of strain SP contains 36 and 155 amino acid insertions, respectively, near the C-terminus, in addition to several highly variable regions. The insertion shows no homology with any equivalent arterivirus proteins. This high sequence disparity of Nsp2 among different PRRSV isolates suggested that it could be used as a marker to differentiate PRRSV genotypes. The 5′ RACE and primer extension analysis of three North American strains demonstrated that the utmost 5′-end nucleotides are conserved among PRRSV strains isolated from two continents. The predicted polyprotein 1a/b contains conserved proteinase, polymerase and helicase domains responsible for polyprotein processing, RNA transcription and replication.


title: The daily computed weighted averaging basic reproduction number [Formula: see text] for MERS-CoV in South Korea

text: In this paper, we propose the daily computed weighted averaging basic reproduction number [Formula: see text] for Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea, May to July 2015. We use an SIR model with piecewise constant parameters [Formula: see text] (contact rate) and [Formula: see text] (removed rate). We use the explicit Euler’s method for the solution of the SIR model and a nonlinear least-square fitting procedure for finding the best parameters. In [Formula: see text] , the parameters [Formula: see text] , [Formula: see text] , and [Formula: see text] denote days from a reference date, the number of days in averaging, and a weighting factor, respectively. We perform a series of numerical experiments and compare the results with the real-world data. In particular, using the predicted reproduction number based on the previous two consecutive reproduction numbers, we can predict the future behavior of the reproduction number.


title: Teleneurology during the COVID-19 pandemic: A step forward in modernizing medical care

text: BACKGROUND: The COVID-19 pandemic mandated rapid transition from face-to-face encounters to teleneurology visits. While teleneurology is regularly used in acute stroke care, its application in other branches of neurology was limited. Here we review how the recent pandemic has created a paradigm shift in caring for patients with chronic neurological disorders and how academic institutions have responded to the present need. METHOD: Literature review was performed to examine the recent changes in health policies. Number of outpatient visits and televisits in the Department of Neurology was reviewed from Yale University School of Medicine and Johns Hopkins School of Medicine to examine the road to transition to televisit. RESULTS: The federal government and the insurance providers extended their supports during the COVID-19 pandemic. Several rules and regulations regarding teleneurology were revised and relaxed to address the current need. New technologies for video conferencing were incorporated. The transition to televisits went smoothly in both the institutions and number of face-to-face encounters reduced dramatically along with a rapid rise in televisits within 2 weeks of the declaration of national emergency. CONCLUSION AND RELEVANCE: The need for “social distancing” during the COVID-19 pandemic has created a major surge in the number of teleneurology visits, which will probably continue for the next few months. It may have initiated a more permanent transition to virtual technology incorporated medical care.


title: Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome

text: Abstract Objective This study was undertaken to evaluate the pregnancy and perinatal outcomes of pregnant women with severe acute respiratory syndrome (SARS). Study design All pregnant women (12) who presented with SARS in Hong Kong between February 1 and July 31, 2003, were included. The pregnancy and perinatal outcomes were collected. Evidence of perinatal transmission of virus was assessed with the SARS-associated coronavirus reverse-transcriptase polymerase chain reaction on cord blood, placenta tissue, and subsequent follow-up of the neonate on serology. Results Three deaths occurred among the 12 patients, giving a case fatality rate of 25%. Four of the 7 patients (57%) who presented in the first trimester had spontaneous miscarriage. Four of the 5 patients who presented after 24 weeks were delivered preterm. Two mothers recovered without delivery, but their ongoing pregnancies were complicated by intrauterine growth restriction. No newborn infant had clinical SARS and all investigations were negative for SARS. Conclusion SARS during pregnancy is associated with high incidences of spontaneous miscarriage, preterm delivery, and intrauterine growth restriction. There is no evidence of perinatal SARS infection among infants born to these mothers.


title: Empowering Health Workers to Protect their Own Health: A Study of Enabling Factors and Barriers to Implementing HealthWISE in Mozambique, South Africa, and Zimbabwe

text: Ways to address the increasing global health workforce shortage include improving the occupational health and safety of health workers, particularly those in high-risk, low-resource settings. The World Health Organization and International Labour Organization designed HealthWISE, a quality improvement tool to help health workers identify workplace hazards to find and apply low-cost solutions. However, its implementation had never been systematically evaluated. We, therefore, studied the implementation of HealthWISE in seven hospitals in three countries: Mozambique, South Africa, and Zimbabwe. Through a multiple-case study and thematic analysis of data collected primarily from focus group discussions and questionnaires, we examined the enabling factors and barriers to the implementation of HealthWISE by applying the integrated Promoting Action on Research Implementation in Health Services (i-PARiHS) framework. Enabling factors included the willingness of workers to engage in the implementation, diverse teams that championed the process, and supportive senior leadership. Barriers included lack of clarity about how to use HealthWISE, insufficient funds, stretched human resources, older buildings, and lack of incident reporting infrastructure. Overall, successful implementation of HealthWISE required dedicated local team members who helped facilitate the process by adapting HealthWISE to the workers’ occupational health and safety (OHS) knowledge and skill levels and the cultures and needs of their hospitals, cutting across all constructs of the i-PARiHS framework.


Reflections on the COVID-19 epidemic: The first 30 days in one of New York’s largest academic Departments of Surgery


title: Impact of Travel Between Patches for Spatial Spread of Disease

text: A multipatch model is proposed to study the impact of travel on the spatial spread of disease between patches with different level of disease prevalence. The basic reproduction number for the ith patch in isolation is obtained along with the basic reproduction number of the system of patches, ℜ(0). Inequalities describing the relationship between these numbers are also given. For a two-patch model with one high prevalence patch and one low prevalence patch, results pertaining to the dependence of ℜ(0) on the travel rates between the two patches are obtained. For parameter values relevant for influenza, these results show that, while banning travel of infectives from the low to the high prevalence patch always contributes to disease control, banning travel of symptomatic travelers only from the high to the low prevalence patch could adversely affect the containment of the outbreak under certain ranges of parameter values. Moreover, banning all travel of infected individuals from the high to the low prevalence patch could result in the low prevalence patch becoming diseasefree, while the high prevalence patch becomes even more disease-prevalent, with the resulting number of infectives in this patch alone exceeding the combined number of infectives in both patches without border control. Under the set of parameter values used, our results demonstrate that if border control is properly implemented, then it could contribute to stopping the spatial spread of disease between patches.


title: COVID-19 pandemic and associated lockdown as a “Global Human Confinement Experiment” to investigate biodiversity conservation

text: Efforts to curtail the spread of the novel coronavirus (SARS-CoV2) have led to the unprecedented concurrent confinement of nearly two-thirds of the global population. The large human lockdown and its eventual relaxation can be viewed as a Global Human Confinement Experiment. This experiment is a unique opportunity to identify positive and negative effects of human presence and mobility on a range of natural systems, including wildlife, and protected areas, and to study processes regulating biodiversity and ecosystems. We encourage ecologists, environmental scientists, and resource managers to contribute their observations to efforts aiming to build comprehensive global understanding based on multiple data streams, including anecdotal observations, systematic assessments and quantitative monitoring. We argue that the collective power of combining diverse data will transcend the limited value of the individual data sets and produce unexpected insights. We can also consider the confinement experiment as a “stress test” to evaluate the strengths and weaknesses in the adequacy of existing networks to detect human impacts on natural systems. Doing so will provide evidence for the value of the conservation strategies that are presently in place, and create future networks, observatories and policies that are more adept in protecting biological diversity across the world.


title: Selection on a Variant Associated with Improved Viral Clearance Drives Local, Adaptive Pseudogenization of Interferon Lambda 4 (IFNL4)

text: Interferon lambda 4 gene (IFNL4) encodes IFN-λ4, a new member of the IFN-λ family with antiviral activity. In humans IFNL4 open reading frame is truncated by a polymorphic frame-shift insertion that eliminates IFN-λ4 and turns IFNL4 into a polymorphic pseudogene. Functional IFN-λ4 has antiviral activity but the elimination of IFN-λ4 through pseudogenization is strongly associated with improved clearance of hepatitis C virus (HCV) infection. We show that functional IFN-λ4 is conserved and evolutionarily constrained in mammals and thus functionally relevant. However, the pseudogene has reached moderately high frequency in Africa, America, and Europe, and near fixation in East Asia. In fact, the pseudogenizing variant is among the 0.8% most differentiated SNPs between Africa and East Asia genome-wide. Its raise in frequency is associated with additional evidence of positive selection, which is strongest in East Asia, where this variant falls in the 0.5% tail of SNPs with strongest signatures of recent positive selection genome-wide. Using a new Approximate Bayesian Computation (ABC) approach we infer that the pseudogenizing allele appeared just before the out-of-Africa migration and was immediately targeted by moderate positive selection; selection subsequently strengthened in European and Asian populations resulting in the high frequency observed today. This provides evidence for a changing adaptive process that, by favoring IFN-λ4 inactivation, has shaped present-day phenotypic diversity and susceptibility to disease.


title: Multicenter Evaluation of the ePlex Respiratory Pathogen Panel for the Detection of Viral and Bacterial Respiratory Tract Pathogens in Nasopharyngeal Swabs

text: The performance of the new ePlex Respiratory Pathogen (RP) panel (GenMark Diagnostics) for the simultaneous detection of 19 viruses (influenza A virus; influenza A H1 virus; influenza A 2009 H1 virus; influenza A H3 virus; influenza B virus; adenovirus; coronaviruses [HKU1, OC43, NL63, and 229E]; human rhinovirus/enterovirus; human metapneumovirus; parainfluenza viruses 1, 2, 3, and 4; and respiratory syncytial virus [RSV] [RSV subtype A and RSV subtype B]) and 2 bacteria (Mycoplasma pneumoniae and Chlamydia pneumoniae) was evaluated. Prospectively and retrospectively collected nasopharyngeal swab (NPS) specimens (n = 2,908) were evaluated by using the ePlex RP panel, with the bioMérieux/BioFire FilmArray Respiratory Panel (BioFire RP) as the comparator method. Discordance analysis was performed by using target-specific PCRs and bidirectional sequencing. The reproducibility of the assay was evaluated by using reproducibility panels comprised of 6 pathogens. The overall agreement between the ePlex RP and BioFire RP results was >95% for all targets. Positive percent agreement with the BioFire RP result for viruses ranged from 85.1% (95% confidence interval [CI], 80.2% to 88.9%) to 95.1% (95% CI, 89.0% to 97.9%), while negative percent agreement values ranged from 99.5% (95% CI, 99.1% to 99.7%) to 99.8% (95% CI, 99.5% to 99.9%). Additional testing of discordant targets (12%; 349/2,908) confirmed the results of ePlex RP for 38% (131/349) of samples tested. Reproducibility was 100% for all targets tested, with the exception of adenovirus, for which reproducibilities were 91.6% at low virus concentrations and 100% at moderate virus concentrations. The ePlex RP panel offers a new, rapid, and sensitive “sample-to-answer” multiplex panel for the detection of the most common viral and bacterial respiratory pathogens.


title: Occupational Exposure to SARS-CoV-2 in Burns Treatment During the COVID-19 Epidemic: Specific Diagnosis and Treatment Protocol

text: ABSTRACT Epidemic prevention and control measures for the new coronavirus disease 2019 (COVID-19) has achieved significant results. As of 8 April 2020, 22,073 infection cases of COVID-19 among healthcare workers from 52 countries had been reported to WHO. COVID-19 has strong infectivity, high transmission speeds, and causes serious infection among healthcare worker. Burns are an acute-care condition, and burn treatment needs to be initiated before COVID-19 infection status can be excluded. The key step to infection prevention is to identify risk points of infection exposure, strengthen the protection against those risk points, and formulate an appropriate diagnosis and treatment protocol. Following an in-depth study of the latest literature on COVID-19 diagnosis and treatment, we reviewed the protocols surrounding hospitalization of patients with extensive burns (area≥50%) in our hospital from February 2009 to February 2019 and, in accordance with the epidemiological characteristics of COVID-19, developed an algorithm for protection during diagnosis and treatment of burns. Therefore, the aspects of medical protection and the diagnosis and treatment of burns appear to be particularly important during the prevention and control of the COVID-19. This algorithm was followed for 4 patients who received emergency treatment in February 2020 and were hospitalized. All healthcare worker were protected according to the three-tiered protective measures, and there was no nosocomial infection. During the COVID-19 epidemic, the early stages of emergency treatment for patients with extensive burns requiring the establishment of venous access for rehydration, endotracheal intubation or tracheostomy, wound treatment, and surgery are the risk points for exposure to infection. The implementation of effective, appropriate-grade protection and formulation of practical treatment protocols can increase protection of healthcare worke and reduce the risk of COVID-19 infection exposure.


title: Environmental perspective of COVID-19

text: Abstract The outbreak of COVID-19 has caused concerns globally. On 30 January WHO has declared it as a global health emergency. The easy spread of this virus made people to wear a mask as precautionary route, use gloves and hand sanitizer on a daily basis that resulted in generation of a massive amount of medical wastes in the environment. Millions of people have been put on lockdown in order to reduce the transmission of the virus. This epidemic has also changed the people's life style; caused extensive job losses and threatened the sustenance of millions of people, as businesses have shut down to control the spread of virus. All over the world, flights have been canceled and transport systems have been closed. Overall, the economic activities have been stopped and stock markets dropped along with the falling carbon emission. However, the lock down of the COVID-19 pandemic caused the air quality in many cities across the globe to improve and drop in water pollutions in some parts of the world.


title: Airways exudation of plasma macromolecules: Innate defense, epithelial regeneration, and asthma

text: This review discusses in vivo airway aspects of plasma exudation in relation to current views on epithelial permeability and epithelial regeneration in health and disease. Microvascular-epithelial exudation of bulk plasma proteins characteristically occurs in asthmatic patients, being especially pronounced in those with severe and exacerbating asthma. Healthy human and guinea pig airways challenged by noninjurious histamine-leukotriene–type autacoids also respond through prompt mucosal exudation of nonsieved plasma macromolecules. Contrary to current beliefs, epithelial permeability in the opposite direction (ie, absorption of inhaled molecules) has not been increased in patients with asthma and allergic rhinitis or in acutely exuding healthy airways. A slightly increased subepithelial hydrostatic pressure produces such unidirectional outward perviousness to macromolecules. Lack of increased absorption permeability in asthmatic patients can further be reconciled with occurrence of epithelial shedding, leaving small patches of denuded basement membrane. Counteracting escalating barrier breaks, plasma exudation promptly covers the denuded patches. Here it creates and sustains a biologically active barrier involving a neutrophil-rich, fibrin-fibronectin net. Furthermore, in the plasma-derived milieu, all epithelial cell types bordering the denuded patch dedifferentiate and migrate from all sides to cover the denuded basement membrane. However, this speedy epithelial regeneration can come at a cost. Guinea pig in vivo studies demonstrate that patches of epithelial denudation regeneration are exudation hot spots evoking asthma-like features, including recruitment/activation of granulocytes, proliferation of fibrocytes/smooth muscle cells, and basement membrane thickening. In conclusion, nonsieved plasma macromolecules can operate on the intact airway mucosa as potent components of first-line innate immunity responses. Exuded plasma also takes center stage in epithelial regeneration. When exaggerated, epithelial regeneration can contribute to the inception and development of asthma.


The COVID‐19 chemoprophylactic conundrum – Are we limiting available resources?


title: Coronavirus may cross placenta

text: Four months into the crisis, many questions remain over covid-19 in pregnancy


title: Are Sex Discordant Outcomes in COVID-19 Related to Sex Hormones?

text: COVID-19 has a clear sex disparity in clinical outcome. Globally, infection rates between men and women are similar; however, men are more likely to have more severe disease and are more likely to die. The causes for this disparity are currently under investigation and are most likely multifactorial. Sex hormones play an important role in the immune response with estrogen seen as immune boosting and testosterone as immunosuppressing. Additionally, an important protease involved in viral entry, TMPRSS2, is regulated by androgens. Many observational and prospective studies are ongoing or initiating to further examine the role of sex hormones in SARS-CoV-2 infection and if modulation of them is a realistic treatment option.


title: Experimental Piscine orthoreovirus infection mediates protection against pancreas disease in Atlantic salmon (Salmo salar)

text: Viral diseases are among the main challenges in farming of Atlantic salmon (Salmo salar). The most prevalent viral diseases in Norwegian salmon aquaculture are heart and skeletal muscle inflammation (HSMI) caused by Piscine orthoreovirus (PRV), and pancreas disease (PD) caused by Salmonid alphavirus (SAV). Both PRV and SAV target heart and skeletal muscles, but SAV additionally targets exocrine pancreas. PRV and SAV are often present in the same locations and co-infections occur, but the effect of this crosstalk on disease development has not been investigated. In the present experiment, the effect of a primary PRV infection on subsequent SAV infection was studied. Atlantic salmon were infected with PRV by cohabitation, followed by addition of SAV shedder fish 4 or 10 weeks after the initial PRV infection. Histopathological evaluation, monitoring of viral RNA levels and host gene expression analysis were used to assess disease development. Significant reduction of SAV RNA levels and of PD specific histopathological changes were observed in the co-infected groups compared to fish infected by SAV only. A strong correlation was found between histopathological development and expression of disease related genes in heart. In conclusion, experimentally PRV infected salmon are less susceptible to secondary SAV infection and development of PD. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13567-016-0389-y) contains supplementary material, which is available to authorized users.


title: GPI‐anchored aminopeptidase is involved in the acrosome reaction in sperm of the mussel mytilus edulis

text: The sperm of the mussel Mytilus had hydrolytic activities against substrates for aminopeptidase. Acrosome reaction (AR) was suppressed in the presence of aminopeptidase substrate, Phe‐4‐methylcoumaryl‐7‐amide (MCA), and an aminopeptidase inhibitor, bestatin. Treatment of sperm with phosphatidylinositol‐specific phospholipase C (PI‐PLC) released aminopeptidase activity from sperm and suppressed AR. These results suggest that the enzyme is located on the sperm surface via glycosylphosphatidylinositol (GPI)‐anchor and is involved in the AR. Immunoblot analysis showed that tyrosine residues of 40, 59, 68, and 72 kDa proteins were phosphorylated during induction of the AR. The 40 kDa protein was also recognized by anti‐c‐Src antibody by immunoblotting. The tyrosine phosphorylation of these proteins was inhibited when sperm were inseminated in the presence of Phe‐MCA, and by PI‐PLC treatment. Treatment of sperm with tyrosine kinase activator, 9,10‐dimethyl‐1,2‐benzanthracene, induced AR, and its inhibitor, genistein, suppressed AR. These results suggest that tyrosine phosphorylation of 40, 59, 68, and 72 kDa proteins, induced by the interaction of GPI‐anchored aminopeptidase with oocyte surface, triggers AR in Mytilus sperm. Mol. Reprod. Dev. 67: 465–471, 2004. © 2004 Wiley‐Liss, Inc.


title: TIGIT limits immune pathology during viral infections

text: Co-inhibitory pathways have a fundamental function in regulating T cell responses and control the balance between promoting efficient effector functions and restricting immune pathology. The TIGIT pathway has been implicated in promoting T cell dysfunction in chronic viral infection. Importantly, TIGIT signaling is functionally linked to IL-10 expression, which has an effect on both virus control and maintenance of tissue homeostasis. However, whether TIGIT has a function in viral persistence or limiting tissue pathology is unclear. Here we report that TIGIT modulation effectively alters the phenotype and cytokine profile of T cells during influenza and chronic LCMV infection, but does not affect virus control in vivo. Instead, TIGIT has an important effect in limiting immune pathology in peripheral organs by inducing IL-10. Our data therefore identify a function of TIGIT in limiting immune pathology that is independent of viral clearance.


title: Etiology of acute bronchiolitis and the relationship with meteorological conditions in hospitalized infants in China

text: Background/Purpose To investigate the prevalence of common viruses and Mycoplasma pneumoniae (MP) in hospitalized infants with acute bronchiolitis and study the relationship between bronchiolitis and meteorological conditions. Methods A 2-year prospective study was conducted on infants with a first episode of bronchiolitis admitted to Respiratory Department of Suzhou Children's Hospital. Demographic and clinical characteristics and meteorological conditions were obtained and analyzed. Results Pathogens were identified in 59.6% of 998 cases analyzed. The most frequent pathogen identified was respiratory syncytial virus (28.7%), followed by human bocavirus (11.6%), MP (9.0%), human parainfluenza virus-3 (7.8%), human metapneumovirus (6.6%), influenza A (3.5%), adenovirus (1.0%), and human parainfluenza virus-1 (0.3%). The clinical scores in children with MP or human metapneumovirus single infections, based on the assessment of severity of acute bronchiolitis, were significantly lower than in children with respiratory syncytial virus single infections. Respiratory syncytial virus had the strongest inverse correlation with mean temperature, followed by influenza A and human metapneumovirus. In addition, MP and human parainfluenza virus-3 showed positive correlations with mean temperature. Conclusion Although respiratory syncytial virus was the most frequent pathogen in patients in whom bronchiolitis was diagnosed, other pathogens, including newly identified viruses and MP, also play important roles in infants with bronchiolitis. Different respiratory pathogens have different traits in response to certain meteorological conditions.


title: Post-COVID-19 global health strategies: the need for an interdisciplinary approach

text: For survivors of severe COVID-19 disease, having defeated the virus is just the beginning of an uncharted recovery path. What follows after the acute phase of SARS-CoV-2 infection depends on the extension and severity of viral attacks in different cell types and organs. Despite the ridiculously large number of papers that have flooded scientific journals and preprint-hosting websites, a clear clinical picture of COVID-19 aftermath is vague at best. Without larger prospective observational studies that are only now being started, clinicians can retrieve information just from case reports and or small studies. This is the time to understand how COVID-19 goes forward and what consequences survivors may expect to experience. To this aim, a multidisciplinary post-acute care service involving several specialists has been established at the Fondazione Policlinico Universitario A. Gemelli IRCSS (Rome, Italy). Although COVID-19 is an infectious disease primarily affecting the lung, its multi-organ involvement requires an interdisciplinary approach encompassing virtually all branches of internal medicine and geriatrics. In particular, during the post-acute phase, the geriatrician may serve as the case manager of a multidisciplinary team. The aim of this article is to describe the importance of the interdisciplinary approach––coordinated by geriatrician––to cope the potential post-acute care needs of recovered COVID-19 patients.


title: Expression, crystallization and preliminary crystallographic study of human coronavirus HKU1 nonstructural protein 9

text: Human coronavirus HKU1 (HCoV-HKU1) belongs to coronavirus group II and encodes 16 nonstructural proteins (nsps) which mediate genome replication and transcription. Among these nsps, nsp9 has been shown to possess single-stranded DNA/RNA-binding properties. The gene that encodes HCoV-HKU1 nsp9 was cloned and expressed in Escherichia coli and the protein was subjected to crystallization trials. The crystals diffracted to 2.7 Å resolution and belonged to space group P2(1)2(1)2, with unit-cell parameters a = 83.5, b = 88.4, c = 31.2 Å, α = β = γ = 90° and two molecules per asymmetric unit.


title: Psychological distress in the shadow of the COVID-19 pandemic: preliminary development of an assessment scale

text: COVID-19 is now spreading worldwide, and poses some public mental health problems which requires close attention. This study aims to develop a scale of COVID-19 related psychological distress in healthy public (CORPD) to assess the severity of psychological distress in uninfected healthy populations. We compiled a 14-item scale which contains two dimensions— Anxiety & fear and Suspicion —using the classical measurement theory. 652 Chinese citizens consented and completed a survey through an online questionnaire APP. The reliability test showed that the scale had good internal consistency reliability and Split-Half reliability, and the validity test showed that it had good structure validity, content validity and criterion correlation validity. This scale can be used to assess the psychological distress of people in China and in other COVID-19-hit regions and countries. It also provides a reference for future studies on COVID-19 or other respiratory infectious diseases related public mental health.


title: Disentangling serology to elucidate henipa- and filovirus transmission in Madagascar fruit bats

text: 1. Bats are reservoirs for emerging human pathogens, including Hendra and Nipah henipaviruses and Ebola and Marburg filoviruses. These viruses demonstrate predictable patterns in seasonality and age structure across multiple systems; previous work suggests that they may circulate in Madagascar’s endemic fruit bats, which are widely consumed as human food. 2. We aimed to (a) document the extent of henipa- and filovirus exposure among Malagasy fruit bats, (b) explore seasonality in seroprevalence and serostatus in these bat populations and (c) compare mechanistic hypotheses for possible transmission dynamics underlying these data. 3. To this end, we amassed and analysed a unique dataset documenting longitudinal serological henipa-and filovirus dynamics in three Madagascar fruit bat species. 4. We uncovered serological evidence of exposure to Hendra-/Nipah-related henipaviruses in Eidolon dupreanum, Pteropus rufus and Rousettus madagascariensis, to Cedar-related henipaviruses in E. dupreanum and R. madagascariensis and to Ebola-related filoviruses in P. rufus and R. madagascariensis. We demonstrated significant seasonality in population-level seroprevalence and individual serostatus for multiple viruses across these species, linked to the female reproductive calendar. An age-structured subset of the data highlighted evidence of waning maternal antibodies in neonates, increasing seroprevalence in young and decreasing seroprevalence late in life. Comparison of mechanistic epidemiological models fit to these data offered support for transmission hypotheses permitting waning antibodies but retained immunity in adult-age bats. 5. Our findings suggest that bats may seasonally modulate mechanisms of pathogen control, with consequences for population-level transmission. Additionally, we narrow the field of candidate transmission hypotheses by which bats are presumed to host and transmit potentially zoonotic viruses globally.


title: Genetic Characterization of the Belgian Nephropathogenic Infectious Bronchitis Virus (NIBV) Reference Strain B1648

text: The virulent nephropathogenic infectious bronchitis virus (NIBV) strain B1648 was first isolated in 1984, in Flanders, Belgium. Despite intensive vaccination, B1648 and its variants are still circulating in Europe and North Africa. Here, the full-length genome of this Belgian NIBV reference strain was determined by next generation sequencing (NGS) to understand its evolutionary relationship with other IBV strains, and to identify possible genetic factors that may be associated with the nephropathogenicity. Thirteen open reading frames (ORFs) were predicted in the B1648 strain (5′UTR-1a-1b-S-3a-3b-E-M-4b-4c-5a-5b-N-6b-3′UTR). ORFs 4b, 4c and 6b, which have been rarely reported in literature, were present in B1648 and most of the other IBV complete genomes. According to phylogenetic analysis of the full-length genome, replicase transcriptase complex, spike protein, partial S1 gene and M protein, B1648 strain clustered with the non-Massachusetts type strains NGA/A116E7/2006, UKr 27-11, QX-like ITA/90254/2005, QX-like CK/SWE/0658946/10, TN20/00, RF-27/99, RF/06/2007 and SLO/266/05. Based on the partial S1 fragment, B1648 clustered with the strains TN20/00, RF-27/99, RF/06/2007 and SLO/266/05 and, further designated as B1648 genotype. The full-length genome of B1648 shared the highest sequence homology with UKr 27-11, Gray, JMK, and NGA/A116E7/2006 (91.2% to 91.6%) and was least related with the reference Beaudette and Massachusetts strains (89.7%). Nucleotide and amino acid sequence analyses indicated that B1648 strain may have played an important role in the evolution of IBV in Europe and North Africa. Further, the nephropathogenicity determinants might be located on the 1a, spike, M and accessory proteins (3a, 3b, 4b, 4c, 5a, 5b and 6b). Overall, strain B1648 is distinct from all the strains reported so far in Europe and other parts of the world.


docid: enluswvu

title: Herpes Simplex 1-2 in broncho alveolar fluid: A 5 years retrospective study


title: IL-21 optimizes T cell and humoral responses in the central nervous system during viral encephalitis

text: Acute coronavirus encephalomyelitis is controlled by T cells while humoral responses suppress virus persistence. This study defines the contribution of interleukin (IL)-21, a regulator of T and B cell function, to central nervous system (CNS) immunity. IL-21 receptor deficiency did not affect peripheral T cell activation or trafficking, but dampened granzyme B, gamma interferon and IL-10 expression by CNS T cells and reduced serum and intrathecal humoral responses. Viral control was already lost prior to humoral CNS responses, but demyelination remained comparable. These data demonstrate a critical role of IL-21 in regulating CNS immunity, sustaining viral persistence and preventing mortality.


title: Emesis in dogs: a review

text: Emesis is a common presenting sign in small animal practice. It requires a rational approach to management that is based upon a sound understanding of pathophysiology combined with logical decision making. This review, which assesses the weight of available evidence, outlines the physiology of the vomiting reflex, causes of emesis, the consequences of emesis and the approach to clinical management of the vomiting dog. The applicability of diagnostic testing modalities and the merit of traditional approaches to management, such as dietary changes, are discussed. The role and usefulness of both traditional and novel anti‐emetic drugs is examined, including in specific circumstances such as following cytotoxic drug treatment. The review also examines areas in which common clinical practice is not necessarily supported by objective evidence and, as such, highlights questions worthy of further clinical research.


title: Respiratory viral infections post-lung transplantation

text: Community-acquired respiratory viruses (CARVs) are common pathogens in lung transplant recipients. Infection due to these viruses is associated with multiple complications including: rhinitis, pharyngitis, bronchitis, pneumonia, respiratory failure and even death. CARVs have also become increasingly recognized as a risk factor for acute rejection (AR) and bronchiolitis obliterans syndrome (BOS). Newer diagnostic techniques have enhanced the accuracy of diagnosis, but proven treatment options for CARVs are limited. Further insight into the immune response and allograft dysfunction associated with CARV infections is needed in order to develop novel management strategies which can reduce the morbidity and mortality caused by these infectious agents.


title: Two adjacent mutations on the dimer interface of SARS coronavirus 3C-like protease cause different conformational changes in crystal structure

text: Abstract The 3C-like protease of SARS coronavirus (SARS-CoV 3CLpro) is vital for SARS-CoV replication and is a promising drug target. It has been extensively proved that only the dimeric enzyme is active. Here we discovered that two adjacent mutations (Ser139_Ala and Phe140_Ala) on the dimer interface resulted in completely different crystal structures of the enzyme, demonstrating the distinct roles of these two residues in maintaining the active conformation of SARS-CoV 3CLpro. S139A is a monomer that is structurally similar to the two reported monomers G11A and R298A. However, this mutant still retains a small fraction of dimer in solution, which might account for its remaining activity. F140A is a dimer with the most collapsed active pocket discovered so far, well-reflecting the stabilizing role of this residue. Moreover, a plausible dimerization mechanism was also deduced from structural analysis. Our work is expected to provide insight on the dimerization–function relationship of SARS-CoV 3CLpro.


Asthma, Biologics, Corticosteroids, and COVID-19


title: Rabbit models of heart disease

text: Human heart disease is a major cause of death and disability. A variety of animal models of cardiac disease have been developed to better understand the etiology, cellular and molecular mechanisms of cardiac dysfunction and novel therapeutic strategies. The animal models have included large animals (e.g. pig and dog) and small rodents (e.g. mouse and rat) and the advantages of genetic manipulation in mice have appropriately encouraged the development of novel mouse models of cardiac disease. However, there are major differences between rodent and human hearts that raise cautions about the extrapolation of results from mouse to human. The rabbit is a medium-sized animal that has many cellular and molecular characteristics very much like human, and is a practical alternative to larger mammals. Numerous rabbit models of cardiac disease are discussed, including pressure or volume overload, ischemia, rapid-pacing, doxorubicin, drug-induced arrhythmias, transgenesis and infection. These models also lead to the assessment of therapeutic strategies which may become beneficial in human cardiac disease. Section editors: Ju Chen – University of California, San Diego, Department of Medicine, La Jolla, CA, USA Robert Ross – University of California, San Diego, Cardiology Section, San Diego, CA, USA


title: Centers for Disease Control

text: Emerging from a small, wartime government program with a regional focus on malaria in 1946, the Centers for Disease Control and Prevention (CDC) has become a global public health agency that addresses the entire scope of public health, with over 10000 employees and contractors in nearly 200occupations. The CDC's expertise has expanded in direct correlation with the expanding view of public health needs: it is recognized globally for its ability to respond to urgent threat related to disease epidemics and the health consequences of disaster and war. CDC programs have contributed significantly to the eradication and reduction of diseases such as smallpox, polio, and guinea worm, as well as the control of health problems such as human immunodeficiency virus (HIV), childhood lead poisoning, breast and cervical cancer, diabetes, violence, and unintentional injuries. CDC contributions in applied epidemiology, public health surveillance, risk factor reduction, and environmental risk assessment also have been critical to the practice of public health in the United States and around the world. The emerging concerns of the new century – genomics, globalization, the built environment, information technology, global warming, emerging infections, violence, and so forth – will require not only the traditional disciplines but also new expertise and new global partners, both public and private.


Health security in 2014: building on preparedness knowledge for emerging health threats


title: Vitamin D3 in High-Quality Cow Milk: An Italian Case Study

text: The quality-labeling category of high-quality (HQ) milk defined by the Italian legislation must comply with specific requirements concerning rigorous breeder management, hygienic controls, fat and protein content, bacterial load, somatic cells, lactic acid content, and non-denatured soluble serum proteins. However, there is no specification for the vitamin D content of HQ milk. Moreover, the data on the vitamin D content of this milk category are very scarce. In the present study, the content of vitamin D3 was evaluated in HQ raw and pasteurized cow milk obtained from Italian cowsheds and supermarkets. The vitamin D3 content varied from not detected (less than 1 µg L(−1)) to 17.0 ± 2.0 µg L(−1) milk and was not related to the milk fat content. These results represent a case study including a significant although not exhaustive part of the contemporary Italian market of HQ milk. It was shown for the first time that HQ raw milk does not necessarily contain more vitamin D3, even though non-expert consumers likely to buy milk labeled as HQ could expect it. The vitamin D3 content in HQ pasteurized whole milk should be reported on the label of the milk package as a best practice of consumer information policy.


title: BRONCHIOLITIS

text: Bronchiolitis is a common respiratory tract infection usually affecting infants and young children during annual epidemics. It is characterized by wheeze, respiratory distress, and poor feeding. Respiratory syncytial virus (RSV) is the most common cause for bronchiolitis and is amongst the most important pathogens causing respiratory infection in infants worldwide. The healthcare burden of bronchiolitis is large, due to large numbers of hospitalized infants and the high risk of nosocomial spread during epidemics. Most children will suffer only mild, short-lived symptoms. A small proportion will need admission to hospital, where treatment is generally supportive until the illness resolves. Some will require ventilatory support for which mortality can be up to 10%. Infants at high risk of severe disease include those born prematurely, those with chronic lung disease, and immunocompromised infants. RSV infects ciliated epithelial cells, causing sloughing of the epithelium, cytokine and inflammatory mediator release, increases in mucus production, and interstitial edema. Clinical manifestations of bronchiolitis are a combined result of viral toxicity and the immune response to infection. Innate immune responses are important to the pathogenesis of bronchiolitis, as severe infection tends to occur after maternal antibody protection has waned and before the infant's adaptive immune responses have matured. Immunoprophylaxis, in the form of intramuscular anti-RSV IgG1, is effective in reducing rates of hospitalization for high-risk infants.


title: Quality of life and psychological status in survivors of severe acute respiratory syndrome at 3 months postdischarge

text: Abstract Background Little is known about the long-term consequence of severe acute respiratory syndrome (SARS). We carried out an assessment on SARS patients after their recovery from their acute illness. Method Postal survey comprising Health-Related Quality of Life (HRQoL) questionnaires and anxiety and depression measures was sent to them at 3 months' postdischarge. Results There was a significant impairment in both the HRQoL and mental functioning. Forty-one percent had scores indicative of a posttraumatic stress disorder (PTSD); about 30% had likely anxiety and depression. Conclusion SARS has significant impact on HRQoL and psychological status at 3 months.


title: Moral Obligation, Public Leadership, and Collective Action for Epidemic Prevention and Control: Evidence from the Corona Virus Disease 2019 (COVID-19) Emergency

text: To investigate the effect of villagers’ moral obligation and village cadres’ public leadership on villagers’ collective action for epidemic prevention and control, against the background of the corona virus disease 2019 (COVID-19) emergency in China, we constructed models based on the institutional analysis and development (IAD) framework and employed principal component analysis (PCA) and ordered probit regression, drawing on survey data from 533 villagers in Henan province adjacent to the COVID-19 origin province, Hubei, China. The results indicate that: (1) generally, both moral obligation and public leadership as well as their constituent indicators contributed positively to collective action for COVID-19 prevention and control; (2) moreover, moral obligation and public leadership can strengthen each other’s positive role in collective action for COVID-19 prevention and control. Based on the above findings, this paper suggests that villagers’ moral obligation can be perfected through internalizing epidemic prevention and control norms into the villagers’ moral norms by the way of villagers mastering the rural public health governance scheme. In addition, public leadership can be improved through professional training of village cadres and by motivating village elites to run for village cadres. With improved villagers’ moral obligation and village cadres’ public leadership, collective action for epidemic prevention and control could be more likely to be realized.


title: Chemotactic properties and absence of the formyl peptide receptor in ferret (Mustela putorius furo) neutrophils

text: Abstract This study describes a chemotaxis assay of ferret polymorphonuclear cells (PMNs). The optimal conditions for this chemotaxis assay were investigated for three chemoattractants: zymosan activated serum (ZAS), recombinant human interleukin-8 (rhIL-8) and N-formyl-Met-Leu- Phe (fMLF). In this study, ferret polymorphonuclear cells (PMNs) reacted to ZAS and rhIL-8, but not fMLF. The optimal concentration of ZAS and rhIL-8 were 5% and 100 ng/ml, respectively. The optimal incubation time of each reagent was 60 min. Due to the lack of response shown from fMLF, the existence of formyl peptide receptors (FPR) on ferret PMNs was investigated by evaluating FPR binding using flow cytometry. The receptor was not detected, implying that ferret neutrophils may lack FPR. This study confirms the fundamental experimental conditions for ferret PMNs chemotaxis and elucidates new findings concerning FPR in ferret neutrophils.


COVID-19: The Disease of the Anthropocene


title: Chapter 12 International Laws and Food-Borne Illness

text: Abstract This chapter begins by describing the food-borne illnesses including all food intoxications and infections with epidemiology, symptoms, pathogenesis, prophylaxis, and recent outbreaks. It is observed that one kind of disease which is prevalent in a particular area can now be transmitted with ease to another with export and import of food globally. It then explains the international laws, agreements, and standards to mitigate these food-borne diseases and to regulate the production, processing, and marketing of food all over the world.


Anxiety and depression in patients with confirmed and suspected COVID‐19 in Ecuador


title: Heparin‐induced Thrombocytopenia with Thrombosis in COVID‐19 Adult Respiratory Distress Syndrome

text: Early reports of COVID‐19 clinical features describe a hypercoagulable state, and recent guidelines recommend prophylactic anticoagulation for COVID‐19 patients with low molecular weight heparin, but this would be contraindicated in the presence of heparin‐induced thrombocytopenia (HIT). We address the key clinical question whether HIT is also present during COVID‐19. We report 3 cases of thrombocytopenia with anti‐platelet factor 4 antibodies among 16 intubated COVID‐19 patients with adult respiratory distress syndrome, a higher than expected incidence of 19%. Each patient had evidence of thrombosis (pulmonary embolism, upper extremity venous thromboses, and skin necrosis, respectively). The serotonin release assay confirmed HIT in one case, and two cases were negative. We believe this is the first reported case of HIT during the COVID‐19 pandemic. Recognition that the thrombocytopenia represented HIT in the confirmed case was delayed. We recommend clinicians monitor platelet counts closely during heparin therapy, with a low threshold to evaluate for HIT.


Man up


Chinese medical personnel against the 2019-nCoV


title: Spinal muscular atrophy care in the COVID‐19 pandemic era

text: The coronavirus disease 2019 (COVID‐19) pandemic has resulted in reorganization of healthcare settings affecting the delivery of clinical care to patients with spinal muscular atrophy (SMA). There is a concern that patients with SMA may be at increased risk of manifesting severe symptoms of COVID‐19. Currently approved therapies for SMA improve survival and motor function; however, their delivery requires an increased exposure to the health system and a dedicated healthcare team. In this study, we discuss consensus recommendations pertaining to care of SMA patients during the pandemic. We highlight that SMA treatments should not be perceived as elective. Decisions regarding the delay of treatments should be made with consideration of the potential risks of COVID‐19 exposure and the risk of that delay. We emphasize the importance of collaborative treatment decisions between the patient, family, and healthcare provider, considering any geographic‐ or institution‐specific policies and precautions for COVID‐19.


title: Is there a Link between Nursing Home Reported Quality and COVID-19 Cases? Evidence from California Skilled Nursing Facilities

text: Abstract Objectives During the COVID-19 outbreak in the U.S., nursing homes became the hotbed for the spread of COVID-19. States developed different policies to mitigate the COVID-19 risks at nursing homes, including limiting nursing home visitation and mandating staff screening. The purpose of this study is to examine whether COVID-19 cases and deaths are related to the nursing home reported quality. Design We combined the COVID-19 data reported by the California Department of Public Health (CDPH), quality ratings provided by Nursing Home Compare (NHC), and patient racial information from Long-term Care Focus to examine the association between nursing home reported quality and COVID-19 cases and deaths. Settings and Participants: Cross sectional data from 1,223 California Skilled Nursing Facilities with reported quality and longitudinal data of COVID-19 cases were used. Measures The dependent variable is COVID-19 residents’ cases and deaths. The main independent variable is nursing home reported quality. Nursing home ownership, size, years of operation, and patient race composition are also included. Results Nursing home star ratings and greater percentage of residents from different racial and ethnicity groups were significantly (p<.01) related to increased probability of having a COVID-19 residents’ case or death. Conclusion and Implications: Nursing homes with five-star ratings were less likely to have COVID-19 cases and deaths after adjusting for nursing home size and patient race proportion.


title: Genetic deficiency and polymorphisms of cyclophilin A reveal its essential role for Human Coronavirus 229E replication

text: Replication of coronaviruses is inhibited in vitro by cyclosporin A, a well-known immunosuppressive drug which binds to cellular cyclophilins thus inactivating their enzymatic cis-trans peptidyl-prolyl isomerase function. Latter is required for proper folding of cellular proteins and of proteins of several viruses. Here, we summarize present knowledge on the role of cyclophilin A during coronavirus replication. We present data on the effect of cyclophilin A single nucleotide polymorphism mutants on the replication of human CoV-229E demonstrating the requirement of proper cyclophilin A function for virus propagation. Results define cellular cyclophilin A as a host target for inhibition of coronaviruses ranging from relatively mild common cold to highly pathogenic SARS-CoV and MERS-CoV viruses with the perspective of disclosing non-immunosuppressive cyclosporin A analogs to broadly inactivate the coronavirus family.


docid: csgefliy

title: The disaster worker resiliency training program: a randomized clinical trial

text: OBJECTIVES: Disaster workers are at elevated risk for mental health problems as a result of trauma exposures during response efforts. One possible way to prevent mental health problems is to build-up coping resources that promote resilience to the effects of disaster work. The primary aim of this study was to evaluate the efficacy of a resilience building workshop, the Disaster Worker Resiliency Training Program (DWRT), in disaster workers previously exposed to Hurricane Sandy. METHODS: Disaster workers (N = 167) were randomly assigned to the DWRT workshop (n = 78) or a waitlist (n = 89). Workers completed self-report measures on healthy lifestyle behaviors, perceived stress, depression, and Posttraumatic Stress Disorder (PTSD) symptoms at baseline and 3-month follow-up. They also completed a measure assessing subsequent trauma-exposure between the baseline and 3-month post-intervention. RESULTS: Participants in the workshop condition, as compared to those in a waitlist control, reported significantly greater improvements from pre-intervention (T1) to 3-month follow-up (T2) in healthy lifestyle behaviors (η(2) = .03; p = .03), stress management (η(2) = .03, p = .04), and spiritual growth (η(2) = .03, p = .02). Among participants reporting subsequent trauma exposures between T1 and T2 (n = 101), participants in the waitlist condition, were more likely to report significant increases in perceived stress (η(2) = .07, p < .01), PTSD (η(2) = .05, p = .03), and depression (η(2) = .07, p < .01) symptoms. CONCLUSIONS: Participation in the resilience workshop promoted engagement in positive health behaviors and reduced the incidence of mental health symptoms, especially when administered prior to a repeat trauma exposure. Further research is needed to evaluate the long-term health effects of participation in the program.


title: Coronavirus disease 2019 (COVID-19): an evidence map of medical literature

text: BACKGROUND: Since the beginning of the COVID-19 outbreak in December 2019, a substantial body of COVID-19 medical literature has been generated. As of June 2020, gaps and longitudinal trends in the COVID-19 medical literature remain unidentified, despite potential benefits for research prioritisation and policy setting in both the COVID-19 pandemic and future large-scale public health crises. METHODS: In this paper, we searched PubMed and Embase for medical literature on COVID-19 between 1 January and 24 March 2020. We characterised the growth of the early COVID-19 medical literature using evidence maps and bibliometric analyses to elicit cross-sectional and longitudinal trends and systematically identify gaps. RESULTS: The early COVID-19 medical literature originated primarily from Asia and focused mainly on clinical features and diagnosis of the disease. Many areas of potential research remain underexplored, such as mental health, the use of novel technologies and artificial intelligence, pathophysiology of COVID-19 within different body systems, and indirect effects of COVID-19 on the care of non-COVID-19 patients. Few articles involved research collaboration at the international level (24.7%). The median submission-to-publication duration was 8 days (interquartile range: 4–16). CONCLUSIONS: Although in its early phase, COVID-19 research has generated a large volume of publications. However, there are still knowledge gaps yet to be filled and areas for improvement for the global research community. Our analysis of early COVID-19 research may be valuable in informing research prioritisation and policy planning both in the current COVID-19 pandemic and similar global health crises.


ISNI 2012 Abstracts B cells and antibodies