title: The COVID-19 epidemic, its mortality, and the role of non-pharmaceutical interventions

text: COVID-19 has developed into a pandemic, hitting hard on our communities. As the pandemic continues to bring health and economic hardship, keeping mortality as low as possible will be the highest priority for individuals; hence governments must put in place measures to ameliorate the inevitable economic downturn. The course of an epidemic may be defined by a series of key factors. In the early stages of a new infectious disease outbreak, it is crucial to understand the transmission dynamics of the infection. The basic reproduction number (R0), which defines the mean number of secondary cases generated by one primary case when the population is largely susceptible to infection ('totally naïve'), determines the overall number of people who are likely to be infected, or, more precisely, the area under the epidemic curve. Estimation of changes in transmission over time can provide insights into the epidemiological situation and identify whether outbreak control measures are having a measurable effect. For R0 > 1, the number infected tends to increase, and for R0 < 1, transmission dies out. Non-pharmaceutical strategies to handle the epidemic are sketched and based on current knowledge, the current situation is sketched and scenarios for the near future discussed.


title: Quantifying socioeconomic activities and weather effects on the global spread of COVID-19 epidemic

text: The COVID-19 has caused more than three million infections and over two hundred thousand deaths by April 20201. Limiting socioeconomic activities (SA) is among the most adopted governmental mitigating efforts to combat the transmission of the virus, though the degree varies dramatically among different regimes2. This study aims to quantify the contribution from the SA and weather conditions to the transmission of COVID-19 at global scale. Ruling out the unobservable factors including medical facilities and other control policies (MOC) through region-by-time fixed effects3,4, we show that the limiting SA has a leading contribution to lower the reproductive number by 18.3%, while weather conditions, including ultraviolet, relative humidity, and wind explain a smaller amount of variation. Temperature might have a non-monotonic impact on the transmission. We further show that in developed countries5 and China, the SA effect is more pronounced whereas the weather effect is significantly downplayed possibly because people tend to stay indoors most of the time with a controlled climate. We finally estimate the reduced reproductive number and the population spared from infections due to restricting SA at 40,964, 180,336, 174,494, in China, United States, and Europe respectively. From late January to mid-April, all regions, except for China, Australia, and south Korea show a steep upward trend of spared infections due to restricting SA. US and Europe, in particular, show far steeper upward trends of spared infections in the analyzed timeframe, signaling a greater risk of reopening the economy too soon.


title: Structural and molecular modelling studies reveal a new mechanism of action of chloroquine and hydroxychloroquine against SARS-CoV-2 infection

text: The recent emergence of the novel pathogenic SARS-coronavirus 2 (SARS-CoV-2) is responsible for a worldwide pandemic. Given the global health emergency, drug repositioning is the most reliable option to design an efficient therapy for infected patients without delay. The first step of the viral replication cycle [i.e. attachment to the surface of respiratory cells, mediated by the spike (S) viral protein] offers several potential therapeutic targets. The S protein uses the angiotension-converting enzyme-2 (ACE-2) receptor for entry, but also sialic acids linked to host cell surface gangliosides. Using a combination of structural and molecular modelling approaches, this study showed that chloroquine (CLQ), one of the drugs currently under investigation for SARS-CoV-2 treatment, binds sialic acids and gangliosides with high affinity. A new type of ganglioside-binding domain at the tip of the N-terminal domain of the SARS-CoV-2 S protein was identified. This domain (111-158), which is fully conserved among clinical isolates worldwide, may improve attachment of the virus to lipid rafts and facilitate contact with the ACE-2 receptor. This study showed that, in the presence of CLQ [or its more active derivative, hydroxychloroquine (CLQ-OH)], the viral S protein is no longer able to bind gangliosides. The identification of this new mechanism of action of CLQ and CLQ-OH supports the use of these repositioned drugs to cure patients infected with SARS-CoV-2. The in-silico approaches used in this study might also be used to assess the efficiency of a broad range of repositioned and/or innovative drug candidates before clinical evaluation.


title: Is pregnancy a risk factor of COVID-19?

text: This review evaluates whether pregnancy is a risk factor for COVID-19 by looking at the expression of immune markers such as immune cells and cytokines in order to have a better understanding on the pathophysiology of the disease, thus reducing maternal deaths. Pregnant women are more at risk of contracting COVID-19 due to their weakened immune system. Studies demonstrate that COVID-19 is an immune condition which is marked by reduced lymphocytes and elevated selected proinflammatory cytokines. Similar immune expression has been demonstrated in pregnancy by several studies. In addition, the placenta has been shown to possess ACE2 receptors on the villous cytotrophoblast and the syncytiotrophoblast and findings suggest that the coronavirus enters the host cells via these ACE2 receptors. The immune response in pregnancy increases the risk of contracting COVID-19. Both normal pregnancy and COVID-19 are marked by decreased lymphocytes, NKG2A inhibitory receptors, and increased ACE2, IL-8, IL-10, and IP-10 it therefore safer to conclude that pregnancy is a risk factor for COVID-19 development. Furthermore, the presence of the ACE2 receptors in the placenta may increase the risk of mother to baby transmission of the virus. Therefore, more studies investigating the link between pregnancy and COVID-19 are needed.


COVID-19, hypothalamo-pituitary-adrenal axis and clinical implications


Three lessons for the COVID-19 response from pandemic HIV


Global service-learning and COVID-19-What the future might look like?


Exercising Heart and Head in Managing Coronavirus Disease 2019 in Wuhan


title: Overview of therapeutic drug research for COVID-19 in China

text: Since the outbreak of novel coronavirus pneumonia (COVID-19) in December 2019, more than 2,500,000 people worldwide have been diagnosed with SARS-CoV-2 as of April 22. In response to this epidemic, China has issued seven trial versions of diagnosis and treatment protocol for COVID-19. According to the information that we have collected so far, this article provides an overview of potential therapeutic drugs and compounds with much attention, including favipiravir and hydroxychloroquine, as well as traditional Chinese medicine, which have been reported with good clinical treatment effects. Moreover, with further understanding of SARS-CoV-2 virus, new drugs targeting specific SARS-CoV-2 viral components arise and investigations on these novel anti-SARS-CoV-2 agents are also reviewed.


title: Anesthesia and COVID-19: What We Should Know and What We Should Do

text: Coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), was first reported in Wuhan, Hubei, China, and has spread to more than 200 other countries around the world. COVID-19 is a highly contagious disease with continuous human-to-human transmission. The origin of the virus is unknown. Airway manipulations and intubations, which are common during anesthesia procedures may increasingly expose anesthesia providers and intensive care unit team members to SARS-CoV-2. Through a comprehensive review of existing studies on COVID-19, this article presents the epidemiological and clinical characteristics of COVID-19, reviews current medical management, and suggests ways to improve the safety of anesthetic procedures. Owing to the highly contagious nature of the virus and the lack of therapeutic drugs or vaccines, precautions should be taken to prevent medical staff from COVID-19.


Covid-19 cases in a no-Covid-19 geriatric acute care setting. A sporadic occurrence?


Oxygen availability in sub-Saharan African countries: a call for data to inform service delivery


title: Acute respiratory failure in COVID-19: is it "typical" ARDS?

text: In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China. The World Health Organization (WHO) declared this outbreak a significant threat to international health. COVID-19 is highly infectious and can lead to fatal comorbidities especially acute respiratory distress syndrome (ARDS). Thus, fully understanding the characteristics of COVID-19-related ARDS is conducive to early identification and precise treatment. We aimed to describe the characteristics of COVID-19-related ARDS and to elucidate the differences from ARDS caused by other factors. COVID-19 mainly affected the respiratory system with minor damage to other organs. Injury to the alveolar epithelial cells was the main cause of COVID-19-related ARDS, and endothelial cells were less damaged with therefore less exudation. The clinical manifestations were relatively mild in some COVID-19 patients, which was inconsistent with the severity of laboratory and imaging findings. The onset time of COVID-19-related ARDS was 8-12 days, which was inconsistent with ARDS Berlin criteria, which defined a 1-week onset limit. Some of these patients might have a relatively normal lung compliance. The severity was redefined into three stages according to its specificity: mild, mild-moderate, and moderate-severe. HFNO can be safe in COVID-19-related ARDS patients, even in some moderate-severe patients. The more likely cause of death is severe respiratory failure. Thus, the timing of invasive mechanical ventilation is very important. The effects of corticosteroids in COVID-19-related ARDS patients were uncertain. We hope to help improve the prognosis of severe cases and reduce the mortality.


Research in the Time of Coronavirus: Continuing Ongoing Studies in the Midst of the COVID-19 Pandemic


Perioperative preparation in thoracic day surgery: Battle against COVID-19


title: Using Partial Differential Equation with Google Mobility Data to Model COVID-19 in Arizona

text: The outbreak of COVID-19 disrupts the life of many people in the world. The state of Arizona in the U.S. emerges as one of the country's newest COVID-19 hot spots. Accurate forecasting for COVID-19 cases will help governments to implement necessary measures and convince more people to take personal precautions to combat the virus. It is difficult to accurately predict the COVID-19 cases due to many human factors involved. This paper aims to provide a forecasting model for COVID-19 cases with the help of human activity data from the Google Community Mobility Reports. To achieve this goal, a specific partial differential equation (PDE) is developed and validated with the COVID-19 data from the New York Times at the county level in the state of Arizona in the U.S. The proposed model describes the combined effects of transboundary spread among county clusters in Arizona and human actives on the transmission of COVID-19. The results show that the prediction accuracy of this model is well acceptable (above 94\%). Furthermore, we study the effectiveness of human precautions such as wearing face masks and practicing social distancing on the decrease of COVID-19 cases at the local level. The localized analytical results can be used to help to slow down the spread of COVID-19 in Arizona. To the best of our knowledge, this work is the first attempt to apply PDE models on COVID-19 prediction with the Google Community Mobility Reports.


Radiation therapy during the coronavirus disease 2019 (covid-19) pandemic in Italy: a view of the nation's young oncologists


title: Forecast and evaluation of COVID-19 spreading in USA with reduced-space Gaussian process regression

text: In this report, we analyze historical and forecast infections for COVID-19 death based on Reduced-Space Gaussian Process Regression associated to chaotic Dynamical Systems with information obtained in 82 days with continuous learning, day by day, from January 21 th , 2020 to April 12 th . According last results, COVID-19 could be predicted with Gaussian models mean-field models can be meaning- fully used to gather a quantitative picture of the epidemic spreading, with infections, fatality and recovery rate. The forecast places the peak in USA around July 14 th 2020, with a peak number of 132,074 death with infected individuals of about 1,157,796 and a number of deaths at the end of the epidemics of about 132,800. Late on January, USA confirmed the first patient with COVID-19, who had recently traveled to China, however, an evaluation of states in USA have demonstrated a fatality rate in China (4%) is lower than New York (4.56%), but lower than Michigan (5.69%). Mean estimates and uncertainty bounds for both USA and his cities and other provinces have increased in the last three months, with focus on New York, New Jersey, Michigan, California, Massachusetts, ... (January e April 12 th ). Besides, we propose a Reduced-Space Gaussian Process Regression model predicts that the epidemic will reach saturation in USA on July 2020. Our findings suggest, new quarantine actions with more restrictions for containment strategies implemented in USA could be successfully, but in a late period, it could generate critical rate infections and death for the next 2 month.


title: Application of Lung Ultrasound during the COVID-19 Pandemic: A Narrative Review

text: This review highlights the ultrasound findings reported from a number of studies and case reports and discusses the unifying findings from COVID-19 patients as well as from the avian (H7N9) and H1N1 influenza epidemics. We discuss the potential role for portable point-of-care ultrasound (PPOCUS) as a safe and effective bedside option in the initial evaluation, management, and monitoring of disease progression in patients with confirmed or suspected COVID-19 infection.


title: Soins de fin de vie pour les patients atteints d'un virus respiratoire extrêmement transmissible : implications pour la COVID-19./ End-of-life care in patients with a highly transmissible respiratory virus: implications for COVID-19

text: Symptom management and end-of-life care are core skills for all physicians, although in ordinary times many anesthesiologists have fewer occasions to use these skills. The current coronavirus disease (COVID-19) pandemic has caused significant mortality over a short time and has necessitated an increase in provision of both critical care and palliative care. For anesthesiologists deployed to units caring for patients with COVID-19, this narrative review provides guidance on conducting goals of care discussions, withdrawing life-sustaining measures, and managing distressing symptoms.


title: Use of Tracheostomy During the COVID-19 Pandemic: American College of Chest Physicians/American Association for Bronchology and Interventional Pulmonology/Association of Interventional Pulmonology Program Directors Expert Panel Report

text: BACKGROUND: The role of tracheostomy during the COVID-19 pandemic remains unknown. The goal of this consensus statement is to examine the current evidence for performing tracheostomy in patients with respiratory failure from COVID-19 and offer guidance to physicians on the preparation, timing, and technique while minimizing the risk of infection to health care workers (HCWs). METHODS: A panel including intensivists and interventional pulmonologists from three professional societies representing 13 institutions with experience in managing patients with COVID-19 across a spectrum of health-care environments developed key clinical questions addressing specific topics on tracheostomy in COVID-19. A systematic review of the literature and an established modified Delphi consensus methodology were applied to provide a reliable evidence-based consensus statement and expert panel report. RESULTS: Eight key questions, corresponding to 14 decision points, were rated by the panel. The results were aggregated, resulting in eight main recommendations and five additional remarks intended to guide health-care providers in the decision-making process pertinent to tracheostomy in patients with COVID-19-related respiratory failure. CONCLUSION: This panel suggests performing tracheostomy in patients expected to require prolonged mechanical ventilation. A specific timing of tracheostomy cannot be recommended. There is no evidence for routine repeat reverse transcription polymerase chain reaction testing in patients with confirmed COVID-19 evaluated for tracheostomy. To reduce the risk of infection in HCWs, we recommend performing the procedure using techniques that minimize aerosolization while wearing enhanced personal protective equipment. The recommendations presented in this statement may change as more experience is gained during this pandemic.


Imported Novel Coronavirus Infections: Observation on Active and Passive Case Detection in Thailand


title: Estrategias para la práctica de la otorrinolaringología y cirugía de cabeza y cuello durante la fase de control de la COVID-19./ Estrategias para la práctica de la otorrinolaringología y cirugía de cabeza y cuello durante la fase de control de la COVID-19./ Strategies for the practice of otolaryngology and head and neck surgery during the monitoring phase of COVID-19

text: The appearance of a new coronavirus disease called COVID-19 at the end of 2019 and its pandemic expansion in the world has changed the usual practice of the specialty of Otorhinolaryngology (ENT). After a phase of exponential growth of infections, it has been possible to enter a phase of control of the spread of the disease in which the possibility of infection persists, and the appearance of new cases is considered acceptable by the health system. The aim of this document is to review the available evidence and propose strategies and recommendations for the medical-surgical practice of otorhinolaryngology and head and neck surgery, which allow establishing the usual activity, adapting the safety and efficacy standards to the current situation. Therefore, it is required to identify and classify patients according to criteria of infectious-immunological status, and to establish recommendations for protection in consultations, hospitalization and the operating room, which avoid the transmission of the disease to other users and healthcare personnel, in the specific context of the development of our specialty. This document is the result of the collaboration of all the scientific commissions and the SEORLCCC COVID-19 committee.


Reply: COVID-19, A and Hypersensitivity Pneumonitis


title: Factores relacionados con el contagio por SARS-CoV-2 en profesionales de la salud en España. Proyecto SANICOVI./ Factores relacionados con el contagio por SARS-CoV-2 en profesionales de la salud en España. Proyecto SANICOVI./ Factors related to SARS-CoV-2 infection in healthcare professionals in Spain. The SANICOVI project

text: OBJECTIVE: To describe the factors related to the situation of SARS-CoV-2 transmission identified by health professionals in Spain and to propose prevention strategies. METHOD: Cross-sectional descriptive study. The population were healthcare professionals working in institutions caring for COVID-19 patients and also confirmed cases of SARS-CoV-2 infection. A questionnaire with sociodemographic, occupational and epidemiological variables was used. Descriptive and bivariate analysis was performed according to the nature of the variables. RESULTS: A total of 2.230 questionnaires were analysed on a potential population of 41,239 (5.47%). The diagnosis was made based on a suspicious case (63.4%) and a probable case (12.3%). A study of contacts was carried out at 50.3%. The perception about the availability of protective measures as «always/frequently¼ were: FPP1 mask 57.3%, gloves 89.5%, soap 95% and hydroalcoholic solution 91.5%. In PPE, FPP2, FPP3 mask, goggles and disposable gowns at around 50%. The availability of protective measures, by field of work, presented significant differences. The average number of patients attended related to the performance of hand hygiene at moment4 and the perception of performing it correctly at moments4 and5. CONCLUSIONS: Preliminary data are presented, with variability in the response rate by Autonomous Region. Healthcare professionals infected by SARS-CoV-2 identified the management of the chain of infection transmission, the use and adequacy of protective equipment, as well as the effectiveness of handwashing as factors related to the transmission of the virus among professionals.


title: Diabetes management during Ramadan amid Covid-19 pandemic

text: Management of fasting patients with diabetes during Ramadan has always posed a great challenge on clinicians. This year, Ramadan has coincided with the Covid-19 pandemic which per se can complicate diabetes care. Although patients with diabetes should be generally discouraged from fasting, those who insist to fact during the current Covid-19 pandemic should undergo strict risk assessment and receive thorough education. In patients with type 2 diabetes, administered antidiabetics and their dose should be modified to minimize the risk of hypoglycemia and dehydration. In type 1 diabetic patients, insulin dose and it timing should be precisely calculated based on regular and rigorous blood glucose monitoring. Nonetheless, it would be prudent to generally discourage patients with diabetes form fasting this Ramadan to avoid the risk of life-threatening complications such severe dehydration and ensuing kidney damage.


title: Target Virus or Target Ourselves for COVID-19 Drugs Discovery?-Lessons learned from anti-influenzas virus therapies

text: The COVID-19 pandemic, after it was reported in December 2019, is a highly contagious and now spreading to over 190 countries, causing a severe public health burden. Currently, there is no vaccine or specific drug to treat COVID-19, which is caused by a novel coronavirus, SARS-2-CoV. For this emergency, the FDA has approved Remdesivir and Hydroxychloroquine for treatment of COVID-19 as Emergency Use Authorization. However, even after this pandemic, COVID-19 may still have a chance to come back. Therefore, we need to come out with new strategies for drug discovery for combating COVID-19 in the future.


title: While Stability Lasts: A Stochastic Model of Stablecoins

text: The `Black Thursday' crisis in cryptocurrency markets demonstrated deleveraging risks in over-collateralized lending and stablecoins. We develop a stochastic model of over-collateralized stablecoins that helps explain such crises. In our model, the stablecoin supply is decided by speculators who optimize the profitability of a leveraged position while incorporating the forward-looking cost of collateral liquidations, which involves the endogenous price of the stablecoin. We formally characterize stable and unstable domains for the stablecoin. We prove bounds on the probabilities of large deviations and quadratic variation in the stable domain and distinctly greater price variance in the unstable domain. The unstable domain can be triggered by large deviations, collapsed expectations, and liquidity problems from deleveraging. We formally characterize a deflationary deleveraging spiral as a submartingale that can cause such liquidity problems in a crisis. We also demonstrate `perfect' stability results in idealized settings and discuss mechanisms which could bring realistic settings closer to the idealized stable settings.


title: COVID-19 Respiratory Failure: Targeting Inflammation on VV-ECMO Support

text: The outbreak of novel coronavirus (SARS-CoV-2) that causes the respiratory illness COVID-19 has led to unprecedented efforts at containment due to its rapid community spread, associated mortality, and lack of immunization and treatment. We herein detail a case of a young patient who suffered life-threatening disease and multiorgan failure. His clinical course involved rapid and profound respiratory decompensation such that he required support with venovenous extracorporeal membrane oxygenation (VV-ECMO). He also demonstrated hyperinflammation (C-reactive protein peak 444.6 mg/L) with severe cytokine elevation (Interleukin-6 peak > 3000 pg/ml). Through treatment targeting hyperinflammation, he recovered from critical COVID-19 respiratory failure and required only 160 hours of VV-ECMO support. He was extubated 4 days after decannulation, had progressive renal recovery, and was discharged to home on hospital day 24. Of note, repeat SARS-CoV-2 test was negative 21 days after his first positive test. We present one of the first successful cases of VV-ECMO support to recovery of COVID-19 respiratory failure in North America.


Intubation boxes for managing the airway in patients with COVID-19


title: Position paper on the preparation of immune plasma to be used in the treatment of patients with COVID-19

text: Passive immunotherapy with plasma derived from convalescent patients recovering from SARS-CoV-2 infection can be a promising approach in the treatment of COVID-19 patients. It is important that blood establishments are ready to satisfy requests for immune plasma by defining the requirements applicable to plasma donors and the standards for preparation, qualification, storage, distribution, and control of product use. This Position paper aims to give recommendations on the biological characteristics of a plasma preparation from convalescent donors and to support the evaluation of this therapeutic approach in more rigorous investigations.


COVID-19 remedies


Diagnostik und Therapie schlafbezogener Atmungsstörungen im Zusammenhang mit der Corona-Pandemie


title: Coronavirus Disease 2019 (COVID-19) CT Findings: A Systematic Review and Meta-analysis

text: PURPOSE: To date, considerable knowledge gaps remain regarding the chest CT imaging features of coronavirus disease 2019 (COVID-19). We performed a systematic review and meta-analysis of results from published studies to date to provide a summary of evidence on detection of COVID-19 by chest CT and the expected CT imaging manifestations. METHODS: Studies were identified by searching PubMed database for articles published between December 2019 and February 2020. Pooled CT positive rate of COVID-19 and pooled incidence of CT imaging findings were estimated using a random-effect model. RESULTS: A total of 13 studies met inclusion criteria. The pooled positive rate of the CT imaging was 89.76% and 90.35% when only including thin-section chest CT. Typical CT signs were ground glass opacities (83.31%), ground glass opacities with mixed consolidation (58.42%), adjacent pleura thickening (52.46%), interlobular septal thickening (48.46%), and air bronchograms (46.46%). Other CT signs included crazy paving pattern (14.81%), pleural effusion (5.88%), bronchiectasis (5.42%), pericardial effusion (4.55%), and lymphadenopathy (3.38%). The most anatomic distributions were bilateral lung infection (78.2%) and peripheral distribution (76.95%). The incidences were highest in the right lower lobe (87.21%), left lower lobe (81.41%), and bilateral lower lobes (65.22%). The right upper lobe (65.22%), right middle lobe (54.95%), and left upper lobe (69.43%) were also commonly involved. The incidence of bilateral upper lobes was 60.87%. A considerable proportion of patients had three or more lobes involved (70.81%). CONCLUSIONS: The detection of COVID-19 chest CT imaging is very high among symptomatic individuals at high risk, especially using thin-section chest CT. The most common CT features in patients affected by COVID-19 included ground glass opacities and consolidation involving the bilateral lungs in a peripheral distribution.


title: Battle scars and resilience at the healthcare frontline

text: The COVID-19 pandemic has created an historic global crisis, resulting in unprecedented stressors on frontline healthcare systems. The population remains on edge, and hospitals are stretched to capacity. This is not our first pandemic. We have learned from prior outbreaks that, in addition to the sheer physical burden, there are also likely to be important but often unacknowledged behavioral and psychosocial costs.1 Frontline healthcare workers, may be particularly vulnerable to harmful psychological consequences.


title: COVID-Twitter-BERT: A Natural Language Processing Model to Analyse COVID-19 Content on Twitter

text: In this work, we release COVID-Twitter-BERT (CT-BERT), a transformer-based model, pretrained on a large corpus of Twitter messages on the topic of COVID-19. Our model shows a 10-30% marginal improvement compared to its base model, BERT-Large, on five different classification datasets. The largest improvements are on the target domain. Pretrained transformer models, such as CT-BERT, are trained on a specific target domain and can be used for a wide variety of natural language processing tasks, including classification, question-answering and chatbots. CT-BERT is optimised to be used on COVID-19 content, in particular social media posts from Twitter.


Australian Government releases face masks to protect against coronavirus


title: A COVID-19 Conundrum: Obstructive Sleep Apnea (OSA) and Non-Invasive Ventilation (NIV)

text: The challenges imposed by the COVID-19 pandemic become amplified in the setting of non-intubated patients with obstructive sleep apnea. Unlike the closed system that characterizes an intubated patient attached to a respiratory circuit, non-invasive ventilatory support threatens an increased risk of permeating the clinical workspace with airborne viral particles. Patients with sleep apnea may mandatorily require non-invasive ventilation strategies to see them through a respiratory illness. In this infographic, the considerations and general principles of managing non-invasive ventilation in such a scenario are outlined. The reader is encouraged to review the article in its entirety for a full depth of understanding.


Sharing Alcoholic Drinks and a COVID-19 Outbreak


title: Fast Graph Attention Networks Using Effective Resistance Based Graph Sparsification

text: The attention mechanism has demonstrated superior performance for inference over nodes in graph neural networks (GNNs), however, they result in a high computational burden during both training and inference. We propose FastGAT, a method to make attention based GNNs lightweight by using spectral sparsification to generate an optimal pruning of the input graph. This results in a per-epoch time that is almost linear in the number of graph nodes as opposed to quadratic. Further, we provide a re-formulation of a specific attention based GNN, Graph Attention Network (GAT) that interprets it as a graph convolution method using the random walk normalized graph Laplacian. Using this framework, we theoretically prove that spectral sparsification preserves the features computed by the GAT model, thereby justifying our FastGAT algorithm. We experimentally evaluate FastGAT on several large real world graph datasets for node classification tasks, FastGAT can dramatically reduce (up to 10x) the computational time and memory requirements, allowing the usage of attention based GNNs on large graphs.


COVID-19, microangiopathy, hemostatic activation, and complement


title: Conversion of positive-pressure cardiac catheterization and electrophysiology laboratories to a novel 2-zone negative-pressure system during COVID-19 pandemic

text: During coronavirus disease-2019 (COVID-19) pandemic, there continues to be a need to utilize cardiac catheterization and electrophysiology laboratories for emergent and urgent procedures. Per infection prevention guidelines and hospital codes, catheterization and electrophysiology laboratories are usually built as positive-pressure ventilation rooms to minimize the infection risk. However, patients with highly transmissible airborne diseases such as COVID-19 are best caredfor in negative ventilation rooms to minimize the risk of transmission. From a mechanical and engineering perspective, positive-pressure ventilation rooms cannot be readily converted to negative-pressure ventilation rooms. In this report, we describe a novel, quick, readily implantable, and resource-friendly approach on how to secure air quality in catheterization and electrophysiology laboratories by converting a positive-pressure ventilation room to a two-zone negative ventilation system to minimize the risk of transmission.


Protective Strategies in a Simulated Model When Performing Percutaneous Tracheostomies in the COVID-19 Era


Incidence of the COVID-19 in Iraq - Implications for travellers


Response to: Rethinking online mental health services in China during the COVID-19 epidemic


title: Dentists thoughts about COVID-19

text: Data sources Self-developed survey.Data extraction and synthesis This was a cross-sectional study using a self-administered online survey.Results Out of 700 randomly selected dentists in Jordan, 368 completed an online survey. Of those, 36% reported that the incubation period for COVID-19 is 1-14 days. The majority were aware of the symptoms of the disease and can identify affected patients. Nonetheless, 36.7% of dentists did not believe it to be a serious public health issue.Conclusions This group of Jordanian dentists was generally aware of COVID-19 symptoms and mode of transmission. Clinical practice guidelines should be made available to dentists by their associations during such crises.


title: A Rational Use of Clozapine Based on Adverse Drug Reactions, Pharmacokinetics, and Clinical Pharmacopsychology

text: Using Richardson and Davidson's model and the sciences of pharmacokinetics and clinical pharmacopsychology, this article reviewed the: (1) poor life expectancy associated with treatment-resistant schizophrenia (TRS), which may be improved in patients who adhere to clozapine; (2) findings that clozapine is the best treatment for TRS (according to efficacy, effectiveness and well-being); and (3) potential for clozapine to cause vulnerabilities, including potentially lethal adverse drug reactions such as agranulocytosis, pneumonia, and myocarditis. Rational use requires: (1) modification of the clozapine package insert worldwide to include lower doses for Asians and to avoid the lethality associated with pneumonia, (2) the use of clozapine levels for personalizing dosing, and (3) the use of slow and personalized titration. This may make clozapine as safe as possible and contribute to increased life expectancy and well-being. In the absence of data on COVID-19 in clozapine patients, clozapine possibly impairs immunological mechanisms and may increase pneumonia risk in infected patients. Psychiatrists should call their clozapine patients and families and explain to them that if the patient develops fever or flu-like symptoms, the psychiatrist should be called and should consider halving the clozapine dose. If the patient is hospitalized with pneumonia, the treating physician needs to assess for symptoms of clozapine intoxication since halving the dose may not be enough for all patients; consider decreasing it to one-third or even stopping it. Once the signs of inflammation and fever have disappeared, the clozapine dose can be slowly increased to the prior dosage level.


title: Engineered niches support the development of human dendritic cells in humanized mice

text: Classical dendritic cells (cDCs) are rare sentinel cells specialized in the regulation of adaptive immunity. Modeling cDC development is crucial to study cDCs and harness their therapeutic potential. Here we address whether cDCs could differentiate in response to trophic cues delivered by mesenchymal components of the hematopoietic niche. We find that mesenchymal stromal cells engineered to express membrane-bound FLT3L and stem cell factor (SCF) together with CXCL12 induce the specification of human cDCs from CD34+ hematopoietic stem and progenitor cells (HSPCs). Engraftment of engineered mesenchymal stromal cells (eMSCs) together with CD34+ HSPCs creates an in vivo synthetic niche in the dermis of immunodeficient mice driving the differentiation of cDCs and CD123+AXL+CD327+ pre/AS-DCs. cDC2s generated in vivo display higher levels of resemblance with human blood cDCs unattained by in vitro-generated subsets. Altogether, eMSCs provide a unique platform recapitulating the full spectrum of cDC subsets enabling their functional characterization in vivo.


title: Retrospective study of low-to-moderate dose glucocorticoids on viral clearance in patients with novel coronavirus pneumonia/ 中华临床感染病杂志

text: Objective@#To study the effect of low-to-moderate dose glucocorticoid therapy on viral clearance time in patients with COVID-19.@*Methods@#A total of 72 patients diagnosed with COVID-19 from January 19 to February 17, 2020 at the First Affiliated Hospital, School of Medicine, Zhejiang University were recruited. All patients received oral abidol and/or combined lopinavir/ritonavir, darunavir antiviral, and symptomatic supportive care. Among them, 51 patients received methylprednisolone (0.75-1.50 mg·kg-1·d-1) (glucocorticoid treatment group), and 21 patients who did not use glucocorticoid were the control group. The time of stable virologic conversion insputumand the time of radiologic recovery in lungsince onset were compared between the two groups and among the normal patients.The Kruskal-Wallis test or Fisher exact test was used to compare the difference between groups.@*Results@#The median ages of the glucocorticoid group and the control group were 52 [interquartile range (IQR):45, 62] years and 46 (IQR: 32, 56)years, and the differences were significant (P<0.05). The clinical conditions at hospital admission were different between the two groups (P<0.01). There were 52.0% critical ill patients in the glucocorticoid treatment group, compared to that of 71.4% normal patients in the control group. The median times from the onset tostable virologic conversion to negative in the two groups were 15 (IQR:13,20) days and 14 (IQR:12,20) days (P>0.05), and the difference was no statistically significant. The median times from onset to radiologic recovery were 13 (IQR: 11,15) days and 13 (IQR:12,17) days in the two groups, and there was no difference (P>0.05). In ordinary patients, the median timesfrom the onset tostable virologic conversion insputum were no difference (P>0.05), with 13 (IQR:11,18) days in the glucocorticoid group and 13 (IQR:12,15) days in the control group; The median times from onset to radiologic recovery in lungwere also no difference (P>0.05), with 12 (IQR: 10,15)days in the glucocorticoid group and 13 (IQR: 12,17) days inthe control group.@*Conclusions@#Low-to-moderate glucocorticoid treatment has no effect on the time of virus clearance in patients with different clinical types of COVID-19. The glucocorticoid is not recommended since no effectiveness on accelerating the improvement of radiologic recovery in lung has been observed.


Online Crowdfunding Response to Coronavirus Disease 2019


title: A Network Pharmacology Approach to Explore the Potential Mechanisms of Huangqin-Baishao Herb Pair in Treatment of Cancer

text: BACKGROUND The aim of this study was to identify the bioactive ingredients of Huangqin-Baishao herb pair and to reveal its anti-cancer mechanisms through a pharmacology approach. MATERIAL AND METHODS Detailed information on compounds in the HQ-BS herb pair was obtained from the Traditional Chinese medicine systems pharmacology (TCMSP) and screened by the criteria of OB ≥30% and DL ≥0.18. A systematic drug targeting model (SysDT) was used for compound targets prediction, and then the targets were analyzed for Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The protein-protein interaction (PPI) network of HQ-BS targets was constructed, after identifying core networks through Cytoscape plugins. RESULTS We found 47 bioactive compounds of HQ-BS and 107 human-derived targets. A compound target network and a target signal pathway network were constructed and used for topological analysis. Kaempferol, beta-sitosterol, stigmasterol, wogonin, and oroxylin-a were identified as core compounds and pathways in cancer. The calcium signaling pathway, PI3K-Akt signaling pathway, TNF signaling pathway, chemical carcinogenesis, estrogen signaling pathway, proteoglycans in cancer, HIF-1 signaling pathway, thyroid hormone signaling pathway, VEGF signaling pathway, small cell lung cancer, prostate cancer, colorectal cancer, NOD-like receptor signaling pathway, and T cell receptor signaling pathway were found to be potential signals of HQ-BS in treating cancer. Through PPI network analysis, TNF signaling pathway, tryptophan metabolism, proteoglycans in cancer, cell cycle, and chemical carcinogenesis sub-networks were obtained. CONCLUSIONS HQ-BS contains various bioactive compounds, including flavonoids, phytosterols, and other compounds, and these compounds can inhibit or activate multiple targets and pathways against cancer.


Challenges of pancreatic cancer chemotherapy in the COVID-19 era


The COVID-19 outbreak and its impact on hospitals in Italy: the model of cardiac surgery


title: Impacto de la COVID-19 en la mortalidad de la comunidad autónoma de Castilla y León./ [Impact of COVID-19 on mortality in the autonomous community of Castilla y León (Spain)]

text: OBJECTIVE: To estimate the increase in mortality associated with the SARS-CoV-2 coronavirus pandemic in the autonomous community of Castilla y León (Spain). METHOD: Ecological study based on population and death data for the months of March 2016 to 2020 in Castilla y León. The general and provincial standardized rates, the relative risks of the year 2020 with respect to previous years and the risks adjusted by sex, periods and province, using Poisson regression, were calculated. Trend analysis was performed using joinpoint linear regression. RESULTS: An increase in mortality was observed in March 2020 with respect to previous years, with an increase of 39% for men (relative risk [RR]: 1.39; 95% confidence interval [95%CI]: 1.32-1.47) and 28% for women (RR: 1.28; 95%CI: 1.21-1.35). The model predicts excess mortality of 775 deaths. In the trend analysis there is a significant turning point in 2019 in men, globally and for almost all provinces. The increase in mortality is general, although heterogeneous by sex, age group and province. CONCLUSIONS: Although the observed increase in mortality cannot be totally attributed to the disease, it is the best estimate we have of the real impact on deaths directly or indirectly related to it. The number of declared deaths only reaches two thirds of the increase in mortality observed.


American Society for Gastrointestinal Endoscopy: Guidance for trainees during the COVID-19 pandemic


Duration for carrying SARS-CoV-2 in COVID-19 patients


title: An infectious cDNA clone of SARS-CoV-2

text: The ongoing pandemic of COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), underscores the urgency to develop experimental systems for studying this virus and identifying countermeasures We report a reverse genetic system for SARS-CoV-2 Seven cDNA fragments spanning the SARS-CoV-2 genome were assembled into a full-genome cDNA RNA transcribed from the full-genome cDNA was highly infectious after electroporation into cells, producing 2 9×106 PFU/ml of virus Compared with a clinical isolate, the infectious clone-derived SARS-CoV-2 (icSARS-CoV-2) exhibited similar plaque morphology, viral RNA profile, and replication kinetics Additionally, icSARS-CoV-2 retained engineered molecular markers and did not acquire other mutations A stable mNeonGreen SARS-CoV-2 (icSARS-CoV2-mNG) was generated by introducing this reporter gene into OFR7 of the viral genome icSARSCoV-2-mNG was successfully used to evaluate the antiviral activities of interferon Collectively, the reverse genetic system and reporter virus provide key reagents to study SARS-CoV-2 and develop countermeasures


Incidence of coronavirus disease (COVID-19) and countries affected by malarial infections


title: Development of a lateral flow immunoassay strip for rapid detection of IgG antibody against SARS-CoV-2 virus

text: The ongoing worldwide SARS-CoV-2 epidemic clearly has a tremendous influence on public health. Molecular detection based on oral swabs was used for confirmation of SARS-CoV-2 infection. However, high false negative rates were reported. We describe here the development of a point-of-care (POC) serological assay for the detection of IgG antibody against SARS-CoV-2. The principle of a lateral flow immunoassay strip (LFIAs) consists of fixing SARS-CoV-2 nucleocapsid protein to the surface of the strip and coupling anti-human IgG with colloidal gold nanoparticles (Au NPs). A series of parameters of this method were optimized, including the concentration of coating antigen, BSA blocking concentration and pH value for conjugation. The entire detection process took 15-20 min with a volume of 80 µL of the analyte solution containing 10 µL of serum and 70 µL sample diluent. The performance of the established assay was evaluated using serum samples of the clinically diagnosed cases of Coronavirus Disease 2019 (COVID-19). Our results indicated that the LFIAs for SARS-CoV-2 had satisfactory stability and reproducibility. As a result, our fast and easy LFIAs could provide a preliminary test result for physicians to make the correct diagnosis of SARS-CoV-2 infections along with alternative testing methods and clinical findings, as well as seroprevalence determination, especially in low-resource countries.


Radiology Management and COVID-19 in Resource Limited Setting


NKG2A and COVID-19: another brick in the wall


title: REPLY: Factors Other Than Climate Are Likely to Influence Alcohol Consumption

text: We would like to thank Selck et al. for their letter. The issue they raise has both methodological and scientific interest. We clearly acknowledge in our discussion the limitations of our approach to estimate the causal impact of cold weather on alcoholic cirrhosis at a population level. In addition, as highlighted in the accompanying editorial, these associations at a population level might not hold at an individual level, and the causes of differences in alcohol intake between populations and individuals might not be the same.


title: Mathematical analysis of population migration and its effects to spread of epidemics

text: In this paper we study some mathematical models describing evolution of population density and spread of epidemics in population systems in which spatial movement of individuals depends only on the departure and arrival locations and does not have apparent connection with the population density. We call such models as population migration models and migration epidemics models, respectively. We first apply the theories of positive operators and positive semigroups to make systematic investigation to asymptotic behavior of solutions of the population migration models as time goes to infinity, and next use such results to study asymptotic behavior of solutions of the migration epidemics models as time goes to infinity. Some interesting properties of solutions of these models are obtained.


title: Geriatric mental health and COVID-19: An eye-opener to the situation of the Arab countries in the Middle East and North Africa Region

text: While the detrimental ramifications of the COVID-19 outbreak on the mental wellbeing of the general public continue to unravel, older adults seem to be at high risk. As the geriatric population continues to grow in the Middle East and North Africa (MENA) region, it is essential to explore the influence of this outbreak on geriatric mental health, a topic often neglected. In this review, we depict the status of geriatric psychiatry in the Arab countries of the MENA region, exploring the variations from one nation to another. While some have a null exposure to the field, resources and expertise in other countries range from very limited to extensive. Furthermore, we highlight the measures implemented in the Arab region to address mental health during the COVID-19 outbreak; these tend to be insufficient when targeting the geriatric population. Finally, we provide short- and long-term recommendations to stakeholders that aim at enhancing the mental healthcare of older adults in the Arab countries of the MENA region, particularly during this pandemic.


title: A new SEIR type model including quarantine effects and its application to analysis of Covid-19 pandemia in Poland in March-April 2020

text: Contact tracing and quarantine are well established non-pharmaceutical epidemic control tools. The paper aims to clarify the impact of these measures in COVID-19 epidemic. A new deterministic model is introduced (SEIRQ: susceptible, exposed, infectious, removed, quarantined) with Q compartment capturing individuals and releasing them with delay. We obtain a simple rule defining the reproduction number $\mathcal{R}$ in terms of quarantine parameters, ratio of diagnosed cases and transmission parameters. The model is applied to the epidemic in Poland in March - April 2020, when social distancing measures were in place. We investigate 3 scenarios corresponding to different ratios of diagnosed cases. Our results show that depending on the scenario contact tracing could have prevented from 50\% to over 90\% of cases. The effects of quarantine are limited by fraction of undiagnosed cases. Taking into account the transmission intensity in Poland prior to introduction of social restrictions it is unlikely that the control of the epidemic could be achieved without any social distancing measures.


title: Evaluating use cases for human challenge trials in accelerating SARS-CoV-2 vaccine development

text: Human challenge trials (HCTs) have been proposed as a means to accelerate SARS-CoV-2 vaccine development. We identify and discuss three potential use cases of HCTs in the current pandemic: evaluating efficacy, converging on correlates of protection, and improving understanding of pathogenesis and the human immune response. We outline the limitations of HCTs and find that HCTs are likely to be most useful for vaccine candidates currently in preclinical stages of development. We conclude that, while currently limited in their application, there are scenarios in which HCTs would be extremely beneficial. Therefore, the option of conducting HCTs to accelerate SARS-CoV-2 vaccine development should be preserved. As HCTs require many months of preparation, we recommend an immediate effort to (1) establish guidelines for HCTs for COVID-19; (2) take the first steps toward HCTs, including preparing challenge virus and making preliminary logistical arrangements; and (3) commit to periodically re-evaluating the utility of HCTs.


title: Withanone and Withaferin-A are predicted to interact with transmembrane protease serine 2 (TMPRSS2) and block entry of SARS-CoV-2 into cells

text: Coronavirus disease 2019 (COVID-19) initiated in December 2019 in Wuhan, China and became pandemic causing high fatality and disrupted normal life calling world almost to a halt. Causative agent is a novel coronavirus called Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2/2019-nCoV). While new line of drug/vaccine development has been initiated world-wide, in the current scenario of high infected numbers, severity of the disease and high morbidity, repurposing of the existing drugs is heavily explored. Here, we used a homology-based structural model of transmembrane protease serine 2 (TMPRSS2), a cell surface receptor, required for entry of virus to the target host cell. Using the strengths of molecular docking and molecular dynamics simulations, we examined the binding potential of Withaferin-A (Wi-A), Withanone (Wi-N) and caffeic acid phenethyl ester to TPMRSS2 in comparison to its known inhibitor, Camostat mesylate. We found that both Wi-A and Wi-N could bind and stably interact at the catalytic site of TMPRSS2. Wi-N showed stronger interactions with TMPRSS2 catalytic residues than Wi-A and was also able to induce changes in its allosteric site. Furthermore, we investigated the effect of Wi-N on TMPRSS2 expression in MCF7 cells and found remarkable downregulation of TMPRSS2 mRNA in treated cells predicting dual action of Wi-N to block SARS-CoV-2 entry into the host cells. Since the natural compounds are easily available/affordable, they may even offer a timely therapeutic/preventive value for the management of SARS-CoV-2 pandemic. We also report that Wi-A/Wi-N content varies in different parts of Ashwagandha and warrants careful attention for their use.Communicated by Ramaswamy H. Sarma.


Coronaviruses hijack the complement system


Neuraxial procedures in COVID-19 positive parturients: a review of current reports


Therapeutic Strategy for Patients with Coronavirus Disease 2019 During Left Ventricular Assist Device Supports


title: Données de vie réelle et Covid-19 : la troisième voie./ [Real-life data and Covid-19: The third avenue of reseach]

text: The analysis of real-life data from hospital information systems could make possible to decide on the efficacy and safety of Covid-19 treatments by avoiding the pitfalls of preliminary studies and randomized clinical trials. The different drugs tested in current clinical trials are already widely prescribed to patients by doctors in hospitals, and can therefore be immediately analysed according to validated methodological standards.


title: An Ethnographic Manifestation of Religious Life of Gadaba Tribe in Its Changing Dimensions

text: The captivating tribal communities living across the length and breadth of the state of Central India and mostly in Odisha have enriched the cultural heritage of the region by their cultural diversities. Gadaba's religious life reflected through their rich folk traditions of songs, dance, music, rituals and festivals celebrated round the year adds colourful dimensions to their very existence. The amazing conglomeration of traditions, beliefs, sorrows and philosophies that together constitute and vitalize the religion of tribes has descended from antiquity and has been preserved unimpaired to the present day. Every dimension of their life covering round the year activities is intimately connected with religion and the world view associated with it. It is these aspects of their culture that give meaning and depth to their lives and solidarity to their social structure. However, in recent days many changes have been taken place in traditional religious life of Gadaba tribe. Against this backdrop, this paper has tried to explore some of that core structure of Gadaba's religious life as well as the changing dimensions of their religious manifestation.


title: FiY101: A quick guide for newly qualified doctors

text: Final-year medical students in the UK have been allowed to voluntarily apply for early provisional registration in response to the COVID-19 pandemic, allowing these foundation interim year-1 (FiY1) doctors to assist in service provision in hospitals where resources and staffing may be strained. The authors, as recently qualified foundation year-1 (FY1) doctors, use this article to draw on their own experiences, and those of their colleagues, to provide advice on key topics that may not have been covered, or not covered sufficiently, in medical education, such as prescribing, rotas, wellbeing, and useful apps and websites.


COVID-19, nuclear war, and global warming: lessons for our vulnerable world


Laboring Alone?: Brief Thoughts on Ethics and Practical Answers During the COVID-19 Pandemic


COVID-19 Research in Brief: 16 May to 22 May, 2020


Primer for intensive care unit (ICU) redeployment of the noncritical care surgeon: Insights from the epicenter of the coronavirus disease 2019 (COVID-19) pandemic


title: No Reservations: A First Look at Amazon's Reserved Instance Marketplace

text: Cloud users can significantly reduce their cost (by up to 60\%) by reserving virtual machines (VMs) for long periods (1 or 3 years) rather than acquiring them on demand. Unfortunately, reserving VMs exposes users to \emph{demand risk} that can increase cost if their expected future demand does not materialize. Since accurately forecasting demand over long periods is challenging, users often limit their use of reserved VMs. To mitigate demand risk, Amazon operates a Reserved Instance Marketplace (RIM) where users may publicly list the remaining time on their VM reservations for sale at a price they set. The RIM enables users to limit demand risk by either selling VM reservations if their demand changes, or purchasing variable- and shorter-term VM reservations that better match their demand forecast horizon. Clearly, the RIM's potential to mitigate demand risk is a function of its price characteristics. However, to the best of our knowledge, historical RIM prices have neither been made publicly available nor analyzed. To address the problem, we have been monitoring and archiving RIM prices for 1.75 years across all 69 availability zones and 22 regions in Amazon's Elastic Compute Cloud (EC2). This paper provides a first look at this data and its implications for cost-effectively provisioning cloud infrastructure.


Wastewater monitoring and public health surveillance of SARS-CoV-2


title: Tracheotomy in the SARS-CoV-2 pandemic

text: The severe acute respiratory syndrome (SARS)-CoV-2 pandemic continues to produce a large number of patients with chronic respiratory failure and ventilator dependence. As such, surgeons will be called upon to perform tracheotomy for a subset of these chronically intubated patients. As seen during the SARS and the SARS-CoV-2 outbreaks, aerosol-generating procedures (AGP) have been associated with higher rates of infection of medical personnel and potential acceleration of viral dissemination throughout the medical center. Therefore, a thoughtful approach to tracheotomy (and other AGPs) is imperative and maintaining traditional management norms may be unsuitable or even potentially harmful. We sought to review the existing evidence informing best practices and then develop straightforward guidelines for tracheotomy during the SARS-CoV-2 pandemic. This communication is the product of those efforts and is based on national and international experience with the current SARS-CoV-2 pandemic and the SARS epidemic of 2002/2003.


title: Covid-19: Data analysis of the Lombardy region and the provinces of Bergamo and Brescia

text: The data analysis on deaths in the Lombardy Region and of both the provinces of Bergamo and Brescia shows a twofold aspect on the trend of the epidemic: - all the data show a bias linked to the event of March 10th (day for which the Lombardy region data is partial) and the subsequent change in the way in which positive cases and deaths are calculated; - following the containment measures of the Prime Minister's Decree of March 11th, the spread of the epidemic, although still exponential in nature, has a reduced multiplication coefficient. Our analysis concludes that the situation is not yet compatible with a plateau trend and allows us to predict the trend in the number of deaths in the Lombardy region. We therefore conclude that the containment measures put in place by the government on March 11th will allow a reduction in deaths from around 8000 to just over 6500 for March 27th.


COVID-19 and cancer: Looking for evidence


NSAIDs may increase the risk of thrombosis and acute renal failure in patients with COVID-19 infection


Transverse myelitis related to COVID-19 infection


Supporting children with autism spectrum disorder in the face of the COVID-19 pandemic


title: Unterricht an der Berufsfachschule für Notfallsanitäter der Landeshauptstadt München im Angesicht der COVID-19-Pandemie./ [Teaching at the paramedics school of the City of Munich during the COVID-19 pandemic]

text: The ongoing Coronavirus crisis forced both the Berufsfachschule für Notfallsanitäter (emergency paramedic vocational school) of the Munich fire department and all other German schools to quit classroom teaching within just a few days. Similarly, all practical trainings at clinics and on ambulances had to be put on hold. As the apprentices' training objective was acutely endangered by the expected lengthy teaching downtimes, it was of crucial importance to successfully establish homeschooling. While members of our teaching staff were additionally bound by support for the Munich crisis unit, the switch to virtual classroom teaching for all ongoing courses significantly increased the overall workload of the staff. In a first step, we established a fast video and communication platform via Microsoft Skype. All other issues had to be solved on the fly due to the lack of preparation time. Soon it became obvious that using only classic upfront teaching methods was not an option due to the resulting monotony of a full-time 35â¯h training week. Additionally, we had to ensure that exams would also be possible during homeschooling to avoid the accumulation of missing performance assessments. Within a few days, it became clear that almost all forms of social interactions and teaching methods could be integrated into the virtual classroom with minor limitations. A survey among students showed that while homeschooling cannot fully replace classroom teaching, it is considered a good alternative in emergency situations. Furthermore, many trainees think that homeschooling could be a valuable addition to normal classroom teaching. Maybe this crisis could turn out to be the beginning of a new complementary teaching strategy.


Using imaging to combat a pandemic: rationale for developing the UK National COVID-19 Chest Imaging Database


title: Role of respirators in controlling the spread of novel coronavirus (COVID-19) amongst dental healthcare providers: a review

text: During the ongoing COVID-19 pandemic, healthcare professionals are at the forefront of managing the highly infectious coronavirus. As the most common route of transmission is via aerosols and droplet inhalation, it is critical for healthcare workers to have the correct personal protective equipment (PPE) including gowns, masks and goggles. Surgical masks are not effective in preventing the influenza and SARS, so they are unlikely to be able to resist contaminated aerosols from entering the respiratory system. Therefore, it is vital to use respirators which have been proven to offer better protection against droplets, aerosols and fluid penetration and which form a tight seal around the mouth and nose. Various types of respirators are used in healthcare settings, such as half-mask filtering facepiece respirators (FFRs) and powered air-purifying respirators (PAPRs). The most commonly used FFR is the N95 disposable respirator, which is tight fitting and has a 95% or above particle filtering efficiency for a median particle size of 0.3 µm. This review discusses respirators, their purpose, types, clinical efficiency and proper donning and doffing techniques.


title: 3CL hydrolase-based multiepitope peptide vaccine against SARS-CoV-2 using immunoinformatics

text: The present study provides the first multiepitope vaccine construct using the 3CL hydrolase protein of SARS-CoV-2. The coronavirus 3CL hydrolase (Mpro) enzyme is essential for proteolytic maturation of the virus. This study was based on immunoinformatics and structural vaccinology strategies. The design of the multiepitope vaccine was built using helper T-cell and cytotoxic T-cell epitopes from the 3CL hydrolase protein along with an adjuvant to enhance immune response; these are joined to each other by short peptide linkers. The vaccine also carries potential B-cell linear epitope regions, B-cell discontinuous epitopes, and interferon-Î³-inducing epitopes. Epitopes of the constructed multiepitope vaccine were found to be antigenic, nonallergic, nontoxic, and covering large human populations worldwide. The vaccine construct was modeled, validated, and refined by different programs to achieve a high-quality three-dimensional structure. The resulting high-quality model was applied for conformational B-cell epitope selection and docking analyses with toll-like receptor-3 for understanding the capability of the vaccine to elicit an immune response. In silico cloning and codon adaptation were also performed with the pET-19b plasmid vector. The designed multiepitope peptide vaccine may prompt the development of a vaccine to control SARS-CoV-2 infection.


title: Convalescent plasma to treat coronavirus disease 2019 (COVID-19): considerations for clinical trial design

text: Case series studying convalescent plasma use in the treatment of COVID-19 have been promising, but additional, high-quality studies are needed to determine the efficacy of the treatment when applied for prophylaxis, for early phases of illness, and for severe illness. Previous studies of convalescent plasma in treating other viral diseases have identified factors to consider when designing treatment protocols, including timing of administration relative to onset of illness, timing of donation relative to resolution of symptoms, severity of illness of the donor, pretransfusion serology of the recipient, and antibody titers of the donor. There are many clinical trials studying treatment of, and prophylaxis against, COVID-19 using convalescent plasma. In addition to clinical trials, the FDA also allows treatment through two other pathways: the "Expanded Access to Convalescent Plasma for the Treatment of Patients with COVID-19" protocol, and emergency investigational new drug applications. The FDA also provides criteria for donation of convalescent plasma.


title: Epidemiological characteristics of the first 53 laboratory-confirmed cases of COVID-19 epidemic in Hong Kong, 13 February 2020

text: BackgroundCOVID-19, caused by SARS-CoV-2, first appeared in China and subsequently developed into an ongoing epidemic. Understanding epidemiological factors characterising the transmission dynamics of this disease is of fundamental importance.AimsThis study aimed to describe key epidemiological parameters of COVID-19 in Hong Kong.MethodsWe extracted data of confirmed COVID-19 cases and their close contacts from the publicly available information released by the Hong Kong Centre for Health Protection. We used doubly interval censored likelihood to estimate containment delay and serial interval, by fitting gamma, lognormal and Weibull distributions to respective empirical values using Bayesian framework with right truncation. A generalised linear regression model was employed to identify factors associated with containment delay. Secondary attack rate was also estimated.ResultsThe empirical containment delay was 6.39 days; whereas after adjusting for right truncation with the best-fit Weibull distribution, it was 10.4 days (95% CrI: 7.15 to 19.81). Containment delay increased significantly over time. Local source of infection and number of doctor consultations before isolation were associated with longer containment delay. The empirical serial interval was 4.58-6.06 days; whereas the best-fit lognormal distribution to 26 certain-and-probable infector-infectee paired data gave an estimate of 4.77 days (95% CrI: 3.47 to 6.90) with right-truncation. The secondary attack rate among close contacts was 11.7%.ConclusionWith a considerable containment delay and short serial interval, contact-tracing effectiveness may not be optimised to halt the transmission with rapid generations replacement. Our study highlights the transmission risk of social interaction and pivotal role of physical distancing in suppressing the epidemic.


title: The evaluation of sleep disturbances for Chinese frontline medical workers under the outbreak of COVID-19

text: OBJECTIVE: To evaluate sleep disturbances of Chinese frontline medical workers (FMW) under the outbreak of coronavirus disease 2019 (COVID-19), and make a comparison with non-FMW. METHODS: The medical workers from multiple hospitals in Hubei Province, China, volunteered to participate in this cross-sectional study. An online questionnaire, including Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS) and Visual Analogue Scale (VAS), was used to evaluate sleep disturbances and mental status. Sleep disturbances were defined as PSQI>6 points or/and AIS>6 points. We compared the scores of PSQI, AIS, anxiety and depression VAS, as well as prevalence of sleep disturbances between FMW and non-FMW. RESULTS: A total of 1306 subjects (801 FMW and 505 non-FMW) were enrolled. Compared to non-FMW, FMW had significantly higher scores of PSQI (9.3 ± 3.8 vs 7.5 ± 3.7; P < 0.001; Cohen's d = 0.47), AIS (6.9 ± 4.3 vs 5.3 ± 3.8; P < 0.001; Cohen's d = 0.38), anxiety (4.9 ± 2.7 vs 4.3 ± 2.6; P < 0.001; Cohen's d = 0.22) and depression (4.1 ± 2.5 vs 3.6 ± 2.4; P = 0.001; Cohen's d = 0.21), as well as higher prevalence of sleep disturbances according to PSQI > 6 points (78.4% vs 61.0%; relative risk [RR] = 1.29; P < 0.001) and AIS > 6 points (51.7% vs 35.6%; RR = 1.45; P < 0.001). CONCLUSION: FMW have higher prevalence of sleep disturbances and worse sleep quality than non-FMW. Further interventions should be administrated for FMW, aiming to maintain their healthy condition and guarantee their professional performance in the battle against COVID-19.


Is the type of diabetes treatment relevant to outcome of COVID-19?


[Novel coronavirus infection (COVID-19) and cytokine storms - treatment options based on inflammatory processes]


title: Diagnóstico De Neumonía Covid 19 En Pacientes Asintomáticos Tras La Realización De Un Pet-tc Oncológico

text: INTRODUCTION: On January 30, 2020, the World Health Organization (WHO) declared an international emergency due to the pandemic caused by a new coronavirus. There are some oncological indications that have special priority and studies are still being carried out despite the current situation. In these studies we have found suspicious findings of COVID-19 pneumonia in asymptomatic patients. The objective of this work is to assess the incidence of these findings, describe their characteristics and the evolution of suspected patients. MATERIAL AND METHODS: Oncological PET studies carried out in asymptomatic patients between March 18 and April 8, 2020 have been reviewed. Patients who presented findings suggestive of corresponding to an pulmonary infectious process were selected. Clinical findings have been reviewed to confirm or rule out SARS-CoV2 infection. RESULTS: During the specified period, a total of 129 PET-CT studies were performed. Of these, 11 (8.5%) found suspicious findings of a pulmonary infectious process. These were 8 men and 3 women aged between 30 and 79 years (mean 62.2). CONCLUSIONS: Patients with COVID 19 can present few symptoms of the disease, and in PET-CT studies both presymptomatic and almost asymptomatic patients can be detected, so nuclear medicine physicians should take special attention to the pulmonary evaluation of PET-CT studies.


Editorial: Obstetric anesthesia and COVID 19 times


title: Técnica de TightRope modificada no tratamento da doença do ligamento cruzado cranial em cães: resultados a longo prazo/ Modified TightRope technique for treatment of the cranial cruciate ligament disease in dogs: long term outcomes

text: O objetivo deste estudo foi descrever os resultados a longo prazo do uso da técnica extracapsular TightRope (TR) modificada no tratamento da doença do ligamento cruzado cranial (LCCr) em oito cães (10 articulações) com peso corporal variando entre 4kg e 28kg. Todos os animais selecionados foram submetidos aos exames ortopédicos específicos, sendo diagnosticada ruptura completa do LCCr pelos testes de gaveta e de compressão tibial. Realizaram-se exames radiográficos convencionais e em posição de estresse das articulações. A técnica TR foi modificada utilizando-se o fio de náilon substituindo o fio de fibra empregado na técnica original, facilitando a disponibilidade de obtenção do material. Houve também modificação na origem da perfuração do túnel tibial, sendo realizada imediatamente cranial ao sulco do tendão extensor digital longo. Todos os cães foram submetidos ao exame radiográfico tanto no pós-operatório imediato como no tardio. Aos 30 dias após a intervenção cirúrgica, os pacientes apresentavam claudicação nos membros pélvicos operados de grau discreto a moderado. Foi observado discreto movimento de gaveta cranial em 60% das articulações acometidas. Aos três meses após o procedimento cirúrgico, os animais apresentaram ausência de dor e discreta redução na amplitude dos movimentos articulares. Em duas articulações (20%) observou-se discreto deslocamento cranial da tíbia no teste de gaveta. Nesta fase, 80% dos membros avaliados apresentavam apoio normal. Um ano após a intervenção cirúrgica, observou-se ao exame radiográfico discreta progressão da doença articular degenerativa em 50% das articulações operadas. Das oito articulações avaliadas a longo prazo, em apenas um membro operado observou-se discreta claudicação com reduzida transferência de peso para o membro contralateral. Os demais membros pélvicos avaliados (87,5%) demonstraram ausência de claudicação e adequada recuperação da função articular. Concluiu-se que a técnica cirúrgica extracapsular TR modificada mostrou-se efetiva como opção de tratamento para doença do LCCr em cães de porte pequeno e médio, não apresentando complicações. As modificações do fio cirúrgico e da perfuração da tíbia na técnica TR parecem ter efeitos positivos na estabilização da articulação do joelho.(AU)


Mental health at the age of coronavirus: time for change


Proactive measures for the pandemic COVID-19 infection in outpatient clinics of Otolaryngology Department


title: Valve-in-valve transcatheter aortic valve replacement in a young patient with a suspected COVID-19 infection: a surgical dilemma in the era of the COVID-19 pandemic

text: We report on a case of a 57-year-old male patient, who underwent full root replacement in 2005 and now presented with high grade aortic insufficiency. On admission, the patient underwent a computed tomography scan which demonstrated interstitial infiltration in the left lung, highly suspicious for a COVID-19 infection that could not be confirmed by reverse transcription polymerase chain reaction (RT-PCR) testing. As there usually is a delay between infection and positive RT-PCR test results, the initial decision was to perform additional testing. However, the patient deteriorated quickly in spite of optimal medical therapy making urgent aortic valve replacement necessary. We decided to perform transcatheter aortic valve replacement to avoid cardiopulmonary bypass with shorter operative times, presumably shorter ventilation times and duration of intensive care unit stay, and thus a lesser risk for pulmonary complications.


title: Preventing nosocomial infections in resource-limited settings: An interventional approach in healthcare facilities in Burkina Faso

text: BACKGROUND: Nosocomial pathogens are transmitted by contamination of surfaces causing healthcare-associated infections (HAI). The impact of locally produced disinfectant with operational training as a means to improve hygiene in resource-limited healthcare facilities and prevent HAI was evaluated. METHOD: In Burkina Faso, 4 types of electro-chlorinator devices that convert salt and water into sodium hypochlorite through electrolysis were installed in 26 healthcare facilities distributed across 3 sanitary districts. The program was evaluated at 4 months and 11 months and performance compared with a control group. RESULTS: After 11 months, over 90% of the facilities applied 8 of the 11 essential hygiene practices defined by the Ministry of Health, compared to 20% in the control group. 61.5% of the healthcare facilities improved the chlorine concentration of their sodium hypochlorite solutions, reaching an average concentration of 5.1 g/L compared to an average of 2.1 g/L in the control group. Additionally, a cost-benefit analysis demonstrated that locally produced sodium hypochlorite led to daily savings ranging between 2.7 and 53 euros depending on the device compared with the purchase of chlorine tablets. CONCLUSION: Results, therefore, suggest that electro-chlorinator devices in addition to hygiene sensitization can be a simple, cost-effective and tailored intervention to reduce the prevalence of HAI in low-resource settings.


Low rate of severe acute respiratory syndrome coronavirus 2 spread among health-care personnel using ordinary personal protection equipment in a medium-incidence setting


title: The Italian coronavirus disease 2019 outbreak: recommendations from clinical practice

text: Novel coronavirus 2019 is a single-stranded, ribonucleic acid virus that has led to an international pandemic of coronavirus disease 2019. Clinical data from the Chinese outbreak have been reported, but experiences and recommendations from clinical practice during the Italian outbreak have not. We report the impact of the coronavirus disease 2019 outbreak on regional and national healthcare infrastructure. We also report on recommendations based on clinical experiences of managing patients throughout Italy. In particular, we describe key elements of clinical management, including: safe oxygen therapy; airway management; personal protective equipment; and non-technical aspects of caring for patients diagnosed with coronavirus disease 2019. Only through planning, training and team working will clinicians and healthcare systems be best placed to deal with the many complex implications of this new pandemic.


title: Graph Neural Network Based Coarse-Grained Mapping Prediction

text: The selection of coarse-grained (CG) mapping operators is a critical step for CG molecular dynamics (MD) simulation. It is still an open question about what is optimal for this choice and there is a need for theory. The current state-of-the art method is mapping operators manually selected by experts. In this work, we demonstrate an automated approach by viewing this problem as supervised learning where we seek to reproduce the mapping operators produced by experts. We present a graph neural network based CG mapping predictor called DEEP SUPERVISED GRAPH PARTITIONING MODEL(DSGPM) that treats mapping operators as a graph segmentation problem. DSGPM is trained on a novel dataset, Human-annotated Mappings (HAM), consisting of 1,206 molecules with expert annotated mapping operators. HAM can be used to facilitate further research in this area. Our model uses a novel metric learning objective to produce high-quality atomic features that are used in spectral clustering. The results show that the DSGPM outperforms state-of-the-art methods in the field of graph segmentation.


title: Projected Development of COVID-19 in Louisiana

text: At the time of writing, Louisiana has the third highest COVID-19 infection per capita in the United States. The state government issued a stay-at-home order effective March 23rd. We analyze the projected spread of COVID-19 in Louisiana without including the effects of the stay-at-home order. We predict that a large fraction of the state population would be infected without the mitigation efforts, and would certainly overwhelm the capacity of Louisiana health care system. We further predict the outcomes with different degrees of reduction in the infection rate. More than 70% of reduction is required to cap the number of infected to under one million.


title: Recent progress and challenges in drug development against COVID-19 coronavirus (SARS-CoV-2) - an update on the status

text: Coronaviruses are a large group of viruses known to cause illnesses that vary between the common cold and more severe diseases to include severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). A novel coronavirus was identified in December 2019 in Wuhan city, Hubei province, China. This virus represents a new strain that has not been previously identified in humans. The virus is now known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting disease is called coronavirus disease 2019 (COVID-19). The World Health Organization (WHO) declared the novel coronavirus outbreak a global pandemic in March 2020. Despite rigorous global containment and quarantine efforts, the incidence of COVID-19 continues to rise, with more than 1,948,617 laboratory-confirmed cases and over 121,846 deaths worldwide. Currently, no specific medication is recommended to treat COVID-19 patients. However, governments and pharmaceutical companies are struggling to quickly find an effective drug to defeat the coronavirus. In the current review, we summarize the existing state of knowledge about COVID-19, available medications, and treatment options. Favilavir is an antiviral drug that is approved in Japan for common influenza treatment and is now approved to treat symptoms of COVID-19 in China. Moreover, Chloroquine and hydroxychloroquine, drugs used to treat malaria and arthritis, respectively, were recommended by the National Health Commission of the People's Republic of China for treatment of COVID-19. Presently, chloroquine and hydroxychloroquine are under investigation by the US Food and Drug Administration (FDA) as a treatment for COVID-19. The first COVID-19 vaccine is not expected to be ready for clinical trials before the end of the year.


title: A preliminary systematic review and meta-analysis of randomized-controlled trials of cognitive remediation therapy for anorexia nervosa

text: Cognitive remediation therapy (CRT) for anorexia nervosa (AN) was developed as an adjuvant treatment to target set-shifting and central coherence inefficiencies important in AN and to ultimately improve clinical outcomes of those with AN. The primary aim of this preliminary systematic review and meta-analysis was to determine the effect of CRT for AN relative to control treatments in randomized-controlled trials (RCTs) on neuropsychological inefficiencies at end-of-treatment. Secondary aims were to assess the effect of CRT for AN on dropout, eating-disorder-related, and other psychological outcomes at end-of-treatment. Systematic review and meta-analytic procedures were conducted in accordance with PRISMA Guidelines. RCTs evaluating CRT for AN compared to a control treatment were identified via ProQuest, PsycINFO, PubMed, and SCOPUS. Seven RCTs and one quasi-RCT of CRT for AN were included. RCT quality ratings ranged from fair (n = 3) to good (n = 4). Random-effects meta-analysis was conducted using Hedge's g. Study heterogeneity was assessed using I2 and publication bias was assessed with Begg's adjusted-rank correlation and the trim-and-fill method. CRT was not associated with improvement in central coherence compared to control treatments at end-of-treatment (g = 0.25, 95% CI = -0.35, 0.85, k = 3). Set-shifting outcomes were mixed due to heterogeneity of set-shifting measures across studies. CRT may prevent dropout; yet, more studies are needed to draw conclusions. CRT did not confer advantage over control treatments for eating-disorder-related and other psychological outcomes at end-of-treatment. Future RCTs of CRT for AN should use precise measures to assess constructs (particularly for set shifting), increase sample size, and implement longitudinal follow-up. (Word Count: 247 words).


Covid-19: Risk of second wave is very real, say researchers


Role of doctors in epidemics: historical perspectives and implications for COVID-19


COVID-19: A Defining Moment for Clinical Pharmacology?


title: Ending the COVID-19 epidemic in the United Kingdom

text: Social distancing and lockdown are the two main non-pharmaceutical interventions being used by the UK government to contain and control the COVID-19 epidemic; these are being applied uniformly across the entire country, even though the results of the Imperial College report by Ferguson et al show that the impact of the infection increases sharply with age. This paper develops a variant of the workhorse SIR model for epidemics, where the population is classified into a number of age groups. This allows us to understand the effects of age-dependent controls on the epidemic, and explore possible exit strategies.


title: Phosphate and nitrate uptake dynamics in Palmaria palmata (Rhodophyceae): ecological and physiological aspects of nutrient availability

text: Uptake dynamics of dissolved inorganic phosphate (DIP) and dissolved inorganic nitrate (DIN) in young Palmaria palmata (n=49), cultivated in a range of DIP concentrations (0.0-6.0 µmol · L-1 ) and non-limiting DIN concentration (50 µmol · L-1 ) under fully controlled laboratory conditions, were quantified in a 'pulse-and-chase' approach over 5 weeks. Two different uptake rates were specified: (1) surge uptake (VS ) after starvation and (2) maintenance uptake with filled nutrient pools (VM ). VS for DIP of 1.57±0.29 µmol · cm-2 · d-1 and DIN of 15.6±4.3 µmol · cm-2 · d-1 , as well as VM for DIP of 0.57±0.22 µmol · cm-2 · d-1 and DIN of 5.6±2.1 µmol · cm-2 · d-1 were calculated. In addition, an absolute size of the internal storage capacity (ISC) for DIP of 22 µmol · cm2 and DIN of 222 µmol · cm2 was determined. A DIP to DIN uptake ratio of 1:10 under VM showed a weekly rhythmic uptake pattern, highlighted by a high correlation between DIP and DIN uptake (R=0.943). VS for DIN did not occur under DIP depletion, but uptake rates increased with increasing DIP availability. Hence, DIP availability limited access to DIN, which was also reflected by total dissolvable protein concentrations in sporophytes, which ranged from 10.2±2.5% to 24.6±8.0% dry weight depending on DIP availability. Similarly, total dissolvable carbohydrate concentration ranged from 22.1±3.6% to 54.3±12.3% dry weight. The data presented in this study opens further insight into ecological and physiological aspects of nutrient availability in P. palmata and allows for an optimization in cultivation.


title: Chest computed tomography findings of COVID-19 pneumonia: pictorial essay with literature review

text: Available information on chest Computed Tomography (CT) findings of the 2019 novel coronavirus disease (COVID-19) is constantly evolving. Ground glass opacities and consolidation with bilateral and peripheral distribution were reported as the most common CT findings, but also less typical features could be identified. All radiologists should be aware of the imaging spectrum of the COVID-19 pneumonia and imaging changes in the course of the disease. Our aim is to display the chest CT findings at first assessment and follow-up through a pictorial essay, to help in the recognition of these features for an accurate diagnosis.


Positive FIT or Cologuard in the Era of COVID-19 Pandemic


Impending Shortages of Kidney Replacement Therapy for COVID-19 Patients


What COVID-19 outbreak in Iran teaches us about virtual medical education


title: Ethical Challenges Arising in the COVID-19 Pandemic: An Overview from the Association of Bioethics Program Directors (ABPD) Task Force

text: The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing policies for pandemics differ by institution, health system, and applicable law. Most seem to agree that a patient's ability to benefit from treatment and to survive are first-order considerations. However, there is debate about what clinical measures should be used to make that determination and about other factors that might be ethically appropriate to consider. In this paper, we discuss resource allocation and several related ethical challenges to the healthcare system and society, including how to define benefit, how to handle informed consent, the special needs of pediatric patients, how to engage communities in these difficult decisions, and how to mitigate concerns of discrimination and the effects of structural inequities.


COVID-19: a time to reflect


title: Middle East Respiratory Syndrome Coronavirus and Severe Acute Respiratory Syndrome Coronavirus

text: Emerging infectious diseases continue to be of a significant importance worldwide with the potential to cause major outbreaks and global pandemics. In 2002, the world had witnessed the appearance of the severe acute respiratory syndrome coronavirus in China which disappeared abruptly within 6 months. About a decade later, a new and emerging novel coronavirus named the Middle East respiratory syndrome coronavirus (MERS-CoV) was described in a patient from Saudi Arabia. These two coronaviruses shared multiple similarities in the epidemiology, clinical presentations, and posed challenges in its prevention and management. Seven years since its discovery, MERS-CoV continues to be a lethal zoonotic pathogen capable of causing severe pneumonia with high case fatality rates and the ability to cause large health care-associated outbreaks.


VEGF-D: a novel biomarker for detection of COVID-19 progression


Corona-associated suicide - Observations made in the autopsy room


title: Measuring Human and Economic Activity from Satellite Imagery to Support City-Scale Decision-Making during COVID-19 Pandemic

text: The COVID-19 outbreak forced governments worldwide to impose lockdowns and quarantines over their population to prevent virus transmission. As a consequence, there are disruptions in human and economic activities all over the globe. The recovery process is also expected to be rough. Economic activities impact social behaviors, which leave signatures in satellite images that can be automatically detected and classified. Satellite imagery can support the decision-making of analysts and policymakers by providing a different kind of visibility into the unfolding economic changes. Such information can be useful both during the crisis and also as we recover from it. In this work, we use a deep learning approach that combines strategic location sampling and an ensemble of lightweight convolutional neural networks (CNNs) to recognize specific elements in satellite images and compute economic indicators based on it, automatically. This CNN ensemble framework ranked third place in the US Department of Defense xView challenge, the most advanced benchmark for object detection in satellite images. We show the potential of our framework for temporal analysis using the US IARPA Function Map of the World (fMoW) dataset. We also show results on real examples of different sites before and after the COVID-19 outbreak to demonstrate possibilities. Among the future work is the possibility that with a satellite image dataset that samples a region at a weekly (or biweekly) frequency, we can generate more informative temporal signatures that can predict future economic states. Our code is being made available at https://github.com/maups/covid19-satellite-analysis


title: Particulate multivalent presentation of the receptor binding domain induces protective immune responses against MERS-CoV

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is a WHO priority pathogen for which vaccines are urgently needed. Using an immune-focusing approach, we created self-assembling particles multivalently displaying critical regions of the MERS-CoV spike protein âfusion peptide, heptad repeat 2, and receptor binding domain (RBD) â and tested their immunogenicity and protective capacity in rabbits. Using a "plug-and-display" SpyTag/SpyCatcher system, we coupled RBD to lumazine synthase (LS) particles producing multimeric RBD-presenting particles (RBD-LS). RBD-LS vaccination induced antibody responses of high magnitude and quality (avidity, MERS-CoV neutralizing capacity, and mucosal immunity) with cross-clade neutralization. The antibody responses were associated with blocking viral replication and upper and lower respiratory tract protection against MERS-CoV infection in rabbits. This arrayed multivalent presentation of the viral RBD using the antigen-SpyTag/LS-SpyCatcher is a promising MERS-CoV vaccine candidate and this platform may be applied for the rapid development of vaccines against other emerging viruses such as SARS-CoV-2.


title: COVID-19 crisis in Jordan: Response, scenarios, strategies, and recommendations

text: UNSTRUCTURED: As of 12th April 2020, a total of 389 cases of COVID-19 were confirmed in Jordan. To control this imminent threat, Jordan has enforced public health infection prevention and control measures, called for social distancing, seized all forms of inbound and outbound movement/ international travel, and enacted the Defence Law that transferred the authority to Minister of Defence to work and formulate orders according to the situation. In an effort to support the government in anticipating the requirements of the health system in the upcoming period, an in-depth reflection and examination of different scenarios of the disease spread were developed. This viewpoint suggested different strategies and measures for case detection and contact tracing, clinical management of cases, public health system functioning, and civil society organizations contribution. It is necessary to accelerate containment of the disease to protect the economy and to maintain the continuity of some activities to mitigate the subsequent social, economic and financial impacts. This requires finding a coping mechanism for a period that may be prolonged until laboratories develop a vaccine. In specific, it is strongly recommended to promote community health awareness towards public health prevention and control measures, increase the efficiency and comprehensiveness of the epidemiological investigation/ active and passive surveillance, and employ technology and digital health solutions to track cases and contacts. It is also recommended to increase and expand resources of intensive care units including respirators, increase the capacity and the number of trained health staff in the area of public health and epidemiology, ensure continued provision of essential public health programs and mobilize the resources of non-governmental sector and donors to provide services for refugees and vulnerable populations.


Responding to the COVID-19 pandemic in complex humanitarian crises


Covid-19: Doctors are told not to perform CPR on patients in cardiac arrest


Thrombotic complications in critically ill patients with COVID 19


title: The problem of medical-psychiatric illness in the homeless and its occurrence in the midst of a viral pandemic: A commentary

text: This article has the purpose of examining the problem of getting help for the medical-psychiatric-substance use group of "homeless" people on the streets of our cities, who refuse treatment. The problem has gradually worsened since closure of state hospitals and subsequent lack of community resources. It has been stalemated, in part, by advocates, who argue for personal autonomy and freedom rather than involuntary diagnosis and treatment over the life of these people. It has reached a crisis situation secondary to such potential patients being imprisoned and/or sick with COVID-19 being potential health and legal threats. We review A) the nature of the problem, B) the current social-legal availability of treatment and long-term management (or lack of one) in the context of societal rejection of these potential patients, and C) suggest what might be done, locally and nationally. Mandating scientifically-based medical orders to citizens regardless of personal freedom - are now being implemented to manage the COVID-19 pandemic. We argue for creating a similar med-psych short- and long-term system as a new approach to help this group. They are now mostly being ignored "to die on the streets."


Is the conclusion available? Letter to the Editor concerning the study of Prof. Jin titled "Clinical features and outcomes of pregnant women suspected of coronavirus disease 2019"


Cardiovascular phenotypes in ventilated patients with COVID-19 acute respiratory distress syndrome


The COVID-19 pandemonium continues: (Withdrawal of published clinical studies in Lancet and N Engl J Med, 2020)


title: Investigating the Determinants of High Case-Fatality Rate for Coronavirus Disease 2019 in Italy

text: Case-Fatality Rate (CFR) for COVID-19 in Italy is apparently much higher than in other countries. Using data from Italy and other countries we evaluated the role of different determinants of this phenomenon. We found that the Italian testing strategy could explain an important part of the observed difference in CFR. In particular, the majority of patients that are currently tested in Italy have severe clinical symptoms that usually require hospitalization and this translates to a large CFR. We are confident that, once modifications in the testing strategy leading to higher population coverage are consistently adopted in Italy, CFR will realign with the values reported worldwide.


title: COVID-19. La historia se repite y seguimos tropezando con la misma piedra./ [COVID-19. History repeats itself and we keep stumbling on the same stone]

text: The COVID-19 pandemic has caused a mismatch in all health systems. Most countries had forgotten how to behave in the face of such an epidemic without adequate resources. We need to take stock of everything that has happened, instruct the population and generate a new knowledge that allows us to face new epidemics.