title: “Slit-Lamp Infection Protector Cover for COVID-19”

text: Supplemental Digital Content is Available in the Text.


title: Involvement of the renin-angiotensin system in the progression of severe hand-foot-and-mouth disease

text: BACKGROUND: Hand-foot-and-mouth disease (HFMD) is generally considered as a mild exanthematous disease to infants and young children worldwide. HFMD cases are usually mild and self-limiting but for few cases leads to complicated severe clinical outcomes, and even death. Previous studies have indicated that serum Ang II levels in patients with H7N9 infection were related to the severity of infection. However, the mechanisms underlying the pathogenesis of severe HFMD remain unclear. This study was undertaken to clarify the role of the renin-angiotensin system (RAS) in the progression of severe HFMD. METHODS: In the present study, 162 children including HFMD patients and healthy controls were recruited. The data was analyzed by time-series fashion. Concentrations of angiotensin II (Ang II) and noradrenaline (NA) in serum of patients were measured with ELISA. We established a mouse model for enterovirus 71 (EV71) infection and determined concentrations of Ang II, NA in tissue lysates at 3, 5 and 7 days post infection (dpi). RESULTS: The concentrations of Ang II and NA in serum of the HFMD patients with mild or severe symptoms were significantly higher than that in healthy controls. Additionally, the concentrations of Ang II and NA in serum of severe cases were significantly higher than those mild cases and the increased concentrations of Ang II and NA showed the same time trend during the progression of HFMD in the severe cases. Furthermore, the concentrations of Ang II and NA in target organs of EV71-infected mice including brains, skeletal muscle, and lungs were increased with the progression of EV71 infection in mice. Histopathological alterations were observed in the brains, skeletal muscle and lungs of EV71-infected mice. CONCLUSION: Our study suggested that activation of the RAS is implicated in the pathogenesis of severe HFMD.


title: Immunogenicity of a malaria parasite antigen displayed by Lactococcus lactis in oral immunisations

text: A putative protective protein from Plasmodium falciparum merozoites, MSA2, was expressed in two different ways on the cell surface of the Gram-positive food-grade bacterium, Lactococcus lactis. The first display format exploits an LPXTG-type anchoring motif of the lactococcal proteinase PrtP to covalently anchor MSA2 to the genetically modified producer cells. In a second display format, MSA2 was fused to the peptidoglycan-binding domain (Protein Anchor) of the lactococcal cell wall hydrolase AcmA and was non-covalently rebound to the surface of non-genetically modified, non-living high-binder L. lactis cells, termed Gram-positive enhancer matrix (GEM) particles. The L. lactis recombinants carrying covalently bound MSA2 were used to immunise rabbits through nasal and oral routes. The highest levels of IgG antibodies reacting with near-native MSA2 on merozoites was elicited by oral administration. Intestinal antibodies to MSA2 were produced only after oral immunisation. MSA2-specific T(h)-cell activation could be demonstrated. Based on these results, the immunogenicity in oral immunisations of MSA2, bound non-covalently to non-genetically modified L. lactis GEM particles, was compared with MSA2 that was bound covalently to genetically modified L. lactis. These two forms elicited similar titres of serum antibodies. The results illustrate the potential of using non-genetically modified L. lactis as a safe vaccine delivery vehicle to elicit systemic antibodies, thereby avoiding the dissemination of recombinant DNA into the environment.


Response letter


title: CLEC4M is associated with poor prognosis and promotes cisplatin resistance in NSCLC patients

text: Cisplatin-based chemotherapy is the foundation of treatment for major non-small cell lung cancer (NSCLC) patients. However, cisplatin resistance is still a challenging issue, and the molecular mechanisms underlying this resistance remain to be fully explored. CLEC4M, a Ca(2+)-dependent C-type lectin, has recently been found to correlate with tumourigenesis. This study mainly focused on whether CLEC4M impacts clinical prognosis and how CLEC4M contributes to cisplatin resistance in NSCLC. Our results found that CLEC4M was correlated with poor prognosis in patients with lung cancer. In addition, a positive association between CLEC4M expression and the IC50 values of cisplatin was found, which suggests that CLEC4M may impact cisplatin sensitivity. In vitro results from cultured A549 and H1299 cells confirmed that CLEC4M could enhance cisplatin resistance, while CLEC4M knockdown led to higher sensitivity to cisplatin in these cells. Further experiments showed that the underlying mechanisms included inhibition of cisplatin-induced cell apoptosis by CLEC4M and improved DNA repair capacity by upregulating XPA and ERCC1 expression. In addition, CLEC4M was able to promote cell migration with or without cisplatin treatment. Collectively, these findings suggest the potential clinical significance of CLEC4M inhibition in overcoming cisplatin resistance in NSCLC patients.


title: Apoptosis in astrovirus-infected CaCo-2 cells

text: Abstract Cell death processes during human astrovirus replication in CaCo-2 cells and their underlying mechanisms were investigated. Morphological and biochemical alterations typical of apoptosis were analyzed in infected cells using a combination of techniques, including DAPI staining, the sub-G0/G1 technique and the TUNEL assay. The onset of apoptosis was directly proportional to the virus multiplicity of infection. Transient expression experiments showed a direct link between astrovirus ORF1a encoded proteins and apoptosis induction. A computer analysis of the astrovirus genome revealed the presence of a death domain in the nonstructural protein p38 of unknown function, encoded in ORF1a. Apoptosis inhibition experiments suggested the involvement of caspase 8 in the apoptotic response, and led to a reduction in the infectivity of the virus progeny released to the supernatant. We conclude that apoptotic death of host cells seems necessary for efficient human astrovirus replication and particle maturation.


title: Wuhan and Hubei COVID-19 mortality analysis reveals the critical role of timely supply of medical resources

text: • COVID-19 mortality rates in Wuhan and Hubei decay exponentially. • COVID-19 mortality rates outside Hubei and Wuhan are nearly constant. • COVID-19 recovery rates in Wuhan and Hubei grow exponentially. • Over 40,000 aided health workers help Hubei to effectively treat patients. • Newly supplied beds allow over 38,000 patients in Wuhan to be treated in hospitals.


title: Searching for safe-haven assets during the COVID-19 pandemic

text: Abstract The ongoing COVID-19 pandemic has shaken the global financial system and caused great turmoil. Facing unprecedented risks in the markets, people have increasing needs to find a safe haven for their investments. Given that the nature of this crisis is a combination of multiple problems, it is substantially different from all other financial crises known to us. It is therefore urgent to re-evaluate the safe-haven role of some traditional asset types, namely, gold, cryptocurrency, foreign exchange and commodities. This paper introduces a sequential monitoring procedure to detect changes in the left-quantiles of asset returns, and to assess whether a tail change in the equity index can be offset by introducing a safe-haven asset into a simple mean-variance portfolio. The sample studied covers a training period between August–December 2019 and a testing period of December 2019–March 2020. Furthermore, we calculate the cross-quantilogram between pair-wise asset returns and compare their directional predictability on left-quantiles in both normal market conditions and the COVID-19 period. The main results show that the role of safe haven becomes less effective for most of the assets considered in this paper, while gold and soybean commodity futures remain robust as safe-haven assets during this pandemic.


title: Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study

text: Summary Background A new betacoronavirus—Middle East respiratory syndrome coronavirus (MERS-CoV)—has been identified in patients with severe acute respiratory infection. Although related viruses infect bats, molecular clock analyses have been unable to identify direct ancestors of MERS-CoV. Anecdotal exposure histories suggest that patients had been in contact with dromedary camels or goats. We investigated possible animal reservoirs of MERS-CoV by assessing specific serum antibodies in livestock. Methods We took sera from animals in the Middle East (Oman) and from elsewhere (Spain, Netherlands, Chile). Cattle (n=80), sheep (n=40), goats (n=40), dromedary camels (n=155), and various other camelid species (n=34) were tested for specific serum IgG by protein microarray using the receptor-binding S1 subunits of spike proteins of MERS-CoV, severe acute respiratory syndrome coronavirus, and human coronavirus OC43. Results were confirmed by virus neutralisation tests for MERS-CoV and bovine coronavirus. Findings 50 of 50 (100%) sera from Omani camels and 15 of 105 (14%) from Spanish camels had protein-specific antibodies against MERS-CoV spike. Sera from European sheep, goats, cattle, and other camelids had no such antibodies. MERS-CoV neutralising antibody titres varied between 1/320 and 1/2560 for the Omani camel sera and between 1/20 and 1/320 for the Spanish camel sera. There was no evidence for cross-neutralisation by bovine coronavirus antibodies. Interpretation MERS-CoV or a related virus has infected camel populations. Both titres and seroprevalences in sera from different locations in Oman suggest widespread infection. Funding European Union, European Centre For Disease Prevention and Control, Deutsche Forschungsgemeinschaft.


title: Camouflage and interception: how pathogens evade detection by intracellular nucleic acid sensors

text: Intracellular DNA and RNA sensors play a vital part in the innate immune response to viruses and other intracellular pathogens, causing the secretion of type I interferons, cytokines and chemokines from infected cells. Pathogen RNA can be detected by retinoic‐acid inducible gene I‐like receptors in the cytosol, whereas cytosolic DNA is recognized by DNA sensors such as cyclic GMP‐AMP synthase (cGAS). The resulting local immune response, which is initiated within hours of infection, is able to eliminate many pathogens before they are able to establish an infection in the host. For this reason, all viruses, and some intracellular bacteria and protozoa, need to evade detection by nucleic acid sensors. Immune evasion strategies include the sequestration and modification of nucleic acids, and the inhibition or degradation of host factors involved in innate immune signalling. Large DNA viruses, such as herpesviruses, often use multiple viral proteins to inhibit signalling cascades at several different points; for instance herpes simplex virus 1 targets both DNA sensors cGAS and interferon‐γ‐inducible protein 16, as well as the adaptor protein STING (stimulator of interferon genes) and other signalling factors in the pathway. Viruses with a small genome encode only a few immunomodulatory proteins, but these are often multifunctional, such as the NS1 protein from influenza A virus, which inhibits RNA sensing in multiple ways. Intracellular bacteria and protozoa can also be detected by nucleic acid sensors. However, as the type I interferon response is not always beneficial for the host under these circumstances, some bacteria subvert, rather than evade, these signalling cascades for their own gain.


title: International aviation emissions to 2025: Can emissions be stabilised without restricting demand?

text: International aviation is growing rapidly, resulting in rising aviation greenhouse gas emissions. Concerns about the growth trajectory of the industry and emissions have led to calls for market measures such as emissions trading and carbon levies to be introduced to restrict demand and prompt innovation. This paper provides an overview of the science on aviation's contribution to climate change, analyses key trends in the industry since 1990, projects international civil aviation emissions to 2025 and analyses the emission intensity improvements that are necessary to offset rising international demand. The findings suggest international aviation carbon dioxide (CO(2)) emissions will increase by more than 110 per cent between 2005 and 2025 (from 416 Mt to between 876 and 1013 Mt) and that it is unlikely emissions could be stabilised at levels consistent with risk averse climate targets without restricting demand.


title: Balancing evidence and frontline experience in the early phases of the COVID-19 pandemic: current position of the Italian Society of anti-infective therapy (SITA) and the Italian Society of Pulmonology (SIP)

text: Abstract Background SARS-CoV-2 is the causative agent of coronavirus disease 2019 (COVID-19), which has rapidly become epidemic in Italy and other European countries. The disease spectrum ranges from asymptomatic/mildly symptomatic presentations to acute respiratory failure. At the present time the absolute number of severe cases requiring ventilator support is reaching or even surpassing the intensive care unit bed capacity in the most affected regions and countries. Objectives To narratively summarize the available literature on the management of COVID-19, in the attempt to combine current evidence and frontline opinions and provide balanced answers to pressing clinical questions. Sources Inductive PubMed search for publications relevant to the topic. Content The available literature and the authors’ frontline-based opinion are summarized in brief narrative answers to selected clinical questions, plus a conclusive statement for each answer. Implications Many off-label antiviral and anti-inflammatory drugs are currently being administered to patients with COVID-19. Physicians must be aware that, being not supported by high-level evidence, these treatments may often be ethically justifiable only in those worsening patients unlikely to improve only with supportive care, and who cannot be enrolled in randomized clinical trials (RCT). Access to well-designed RCT should be expanded as much as possible, being the most secure way to change for the better our approach to COVID-19 patients.


title: Interrupting transmission of COVID-19: lessons from containment efforts in Singapore

text: Despite multiple importations resulting in local chains of transmission, Singapore has been able to control the COVID-19 outbreak without major disruption to daily living. In this article, we describe the combination of measures taken by Singapore to contain COVID-19 and share some early lessons learnt from the experience.


title: Combined effects of spray‐drying conditions and postdrying storage time and temperature on Salmonella choleraesuis and Salmonella typhimurium survival when inoculated in liquid porcine plasma

text: The objective of this study was to determine the effectiveness of the spray‐drying process on the inactivation of Salmonella choleraesuis and Salmonella typhimurium spiked in liquid porcine plasma and to test the additive effect of immediate postdrying storage. Commercial spray‐dried porcine plasma was sterilized by irradiation and then reconstituted (1:9) with sterile water. Aliquots of reconstituted plasma were inoculated with either S. choleraesuis or S. typhimurium, subjected to spray‐drying at an inlet temperature of 200°C and an outlet temperature of either 71 or 80°C, and each spray‐drying temperature combinations were subjected to either 0, 30 or 60 s of residence time (RT) as a simulation of residence time typical of commercial dryers. Spray‐dried samples were stored at either 4·0 ± 3·0°C or 23·0 ± 0·3°C for 15 days. Bacterial counts of each Salmonella spp., were completed for all samples. For both Salmonella spp., spray‐drying at both outlet temperatures reduced bacterial counts about 3 logs at RT 0 s, while there was about a 5·5 log reduction at RT 60 s. Storage of all dried samples at either 4·0 ± 3·0°C or 23·0 ± 0·3°C for 15 days eliminate all detectable bacterial counts of both Salmonella spp. SIGNIFICANCE AND IMPACT OF THE STUDY: Safety of raw materials from animal origin like spray‐dried porcine plasma (SDPP) may be a concern for the swine industry. Spray‐drying process and postdrying storage are good inactivation steps to reduce the bacterial load of Salmonella choleraesuis and Salmonella typhimurium. For both Salmonella spp., spray‐drying at 71°C or 80°C outlet temperatures reduced bacterial counts about 3 log at residence time (RT) 0 s, while there was about a 5.5 log reduction at RT 60 s. Storage of all dried samples at either 4.0 ± 3.0°C or 23.0 ± 0.3°C for 15 days was effective for eliminating detectable bacterial counts of both Salmonella spp.


title: Launching a public statewide tele(oral)medicine service in Brazil during COVID‐19 pandemic

text: The State of Santa Catarina is located in the South of Brazil, covering an area of 95,730 km2 , and is divided into 295 municipalities, with an estimated population of 7.164.788 inhabitants. Specialised medical facilities are centralised in urban centres. The State has 39 registered Oral Medicine (OM) specialists (one per 183,700 inhabitants).


The anesthesiologist and COVID-19


title: Inhibitors of SARS-CoV Entry - Identification using an Internally-Controlled Dual Envelope Pseudovirion Assay

text: Severe acute respiratory syndrome-associated coronavirus (SARS-CoV) emerged as the causal agent of an endemic atypical pneumonia, infecting thousands of people worldwide. Although a number of promising potential vaccines and therapeutic agents for SARS-CoV have been described, no effective antiviral drug against SARS-CoV is currently available. The intricate, sequential nature of the viral entry process provides multiple valid targets for drug development. Here, we describe a rapid and safe cell-based high-throughput screening system, Dual Envelope Pseudovirion (DEP) Assay, for specifically screening inhibitors of viral entry. The assay system employs a novel dual envelope strategy, using lentiviral pseudovirions as targets whose entry is driven by the SARS-CoV Spike glycoprotein. A second, unrelated viral envelope is used as an internal control to reduce the number of false positives. As an example of the power of this assay a class of inhibitors is reported with the potential to inhibit SARS-CoV at two steps of the replication cycle, viral entry and particle assembly. This assay system can be easily adapted to screen entry inhibitors against other viruses with the careful selection of matching partner virus envelopes.


title: Gut microbiota: Implications in Parkinson's disease

text: Abstract Gut microbiota (GM) can influence various neurological outcomes, like cognition, learning, and memory. Commensal GM modulates brain development and behavior and has been implicated in several neurological disorders like Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, anxiety, stress and much more. A recent study has shown that Parkinson's disease patients suffer from GM dysbiosis, but whether it is a cause or an effect is yet to be understood. In this review, we try to connect the dots between GM and PD pathology using direct and indirect evidence.


COVID-19 online surveys need to follow standards and guidelines: Comment on “Does COVID-19 pandemic affect sexual behaviour? A cross-sectional, cross-national online survey” and “Binge watching behavior during COVID 19 pandemic: A cross-sectional, cross-national online survey”- Authors’ reply


title: Bats and Coronaviruses

text: Bats are speculated to be reservoirs of several emerging viruses including coronaviruses (CoVs) that cause serious disease in humans and agricultural animals. These include CoVs that cause severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), porcine epidemic diarrhea (PED) and severe acute diarrhea syndrome (SADS). Bats that are naturally infected or experimentally infected do not demonstrate clinical signs of disease. These observations have allowed researchers to speculate that bats are the likely reservoirs or ancestral hosts for several CoVs. In this review, we follow the CoV outbreaks that are speculated to have originated in bats. We review studies that have allowed researchers to identify unique adaptation in bats that may allow them to harbor CoVs without severe disease. We speculate about future studies that are critical to identify how bats can harbor multiple strains of CoVs and factors that enable these viruses to “jump” from bats to other mammals. We hope that this review will enable readers to identify gaps in knowledge that currently exist and initiate a dialogue amongst bat researchers to share resources to overcome present limitations.


title: COVID-19 pandemic and mental health consequences: systematic review of the current evidence

text: BACKGROUND: During the COVID-19 pandemic general medical complications have received the most attention, whereas only few studies address the potential direct effect on mental health of SARS-CoV-2 and the neurotropic potential. Furthermore, the indirect effects of the pandemic on general mental health are of increasing concern, particularly since the SARS-CoV-1 epidemic (2002-2003) was associated with psychiatric complications. METHODS: We systematically searched the database Pubmed including studies measuring psychiatric symptoms or morbidities associated with COVID-19 among infected patients and among none infected groups the latter divided in psychiatric patients, health care workers and non-health care workers. RESULTS: A total of 43 studies were included. Out of these, only two studies evaluated patients with confirmed COVID-19 infection, whereas 41 evaluated the indirect effect of the pandemic (2 on patients with preexisting psychiatric disorders, 20 on medical health care workers, and 19 on the general public). 18 of the studies were case-control studies/compared to norm, while 25 of the studies had no control groups. The two studies investigating COVID-19 patients found a high level of post-traumatic stress symptoms (PTSS) (96.2%) and significantly higher level of depressive symptoms (p=0.016). Patients with preexisting psychiatric disorders reported worsening of psychiatric symptoms. Studies investigating health care workers found increased depression/depressive symptoms, anxiety, psychological distress and poor sleep quality. Studies of the general public revealed lower psychological well-being and higher scores of anxiety and depression compared to before COVID-19, while no difference when comparing these symptoms in the initial phase of the outbreak to four weeks later. A variety of factors were associated with higher risk of psychiatric symptoms and/or low psychological well-being including female gender, poor-self-related health and relatives with COVID-19. CONCLUSION: Research evaluating the direct neuropsychiatric consequences and the indirect effects on mental health is highly needed to improve treatment, mental health care planning and for preventive measures during potential subsequent pandemics.


title: COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study

text: BACKGROUND: Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer. METHODS: In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission. FINDINGS: From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9·42 [95% CI 6·56–10·02]; p<0·0001), being male (1·67 [1·19–2·34]; p=0·003), and the presence of other comorbidities such as hypertension (1·95 [1·36–2·80]; p<0·001) and cardiovascular disease (2·32 [1·47–3·64]). 281 (35%) patients had received cytotoxic chemotherapy within 4 weeks before testing positive for COVID-19. After adjusting for age, gender, and comorbidities, chemotherapy in the past 4 weeks had no significant effect on mortality from COVID-19 disease, when compared with patients with cancer who had not received recent chemotherapy (1·18 [0·81–1·72]; p=0·380). We found no significant effect on mortality for patients with immunotherapy, hormonal therapy, targeted therapy, radiotherapy use within the past 4 weeks. INTERPRETATION: Mortality from COVID-19 in cancer patients appears to be principally driven by age, gender, and comorbidities. We are not able to identify evidence that cancer patients on cytotoxic chemotherapy or other anticancer treatment are at an increased risk of mortality from COVID-19 disease compared with those not on active treatment. FUNDING: University of Birmingham, University of Oxford.


title: Comparison of eMAG™ versus NucliSENS® EasyMAG® performance on clinical specimens

text: Abstract Background eMAG™ (bioMerieux) is a new nucleic acid extraction platform based on magnetic silica technology, like its predecessor, NucliSENS® easyMAG® (bioMerieux). Using the same reagents and disposables, eMAG™ adds further automation, allowing simultaneous extraction of 48 samples directly from primary tubes, and distribution of nucleic acid extracts on PCR strips or in tubes at the end of the extraction process. Objective To compare the performance of eMAG™ and easyMAG® on various clinical specimens. Study design Respiratory (n=199), whole blood (n=50), plasma (n=25) and urine (n=25) specimens were extracted in parallel on both platforms. Both qualitative (respiratory virus, cell control, CMV, EBV, HHV6 and BKV detection) and quantitative (respiratory virus and cell control cycle thresolds, and CMV, EBV, HHV6 and BKV viral loads) results were compared. Results Detection of qualitative targets showed good agreement, ranging from 84.6% for whole blood to 95.9% for respiratory specimens. Correlations between quantitative results were good, with R2 ranging from 0.802 to 0.995. Quantitative results showed average overall differences below 0.10 log10 copies/mL between eMAG™ and easyMAG®. Conclusions The two platforms showed comparable performance on the types of clinical specimen tested. With higher automation and throughput than easyMAG®, the eMAG™ platform is likely to be advantageous for laboratories performing a large number of molecular analyses.


title: Vector-delivered artificial miRNA effectively inhibited replication of Chikungunya virus

text: Abstract Chikungunya virus (CHIKV) has emerged as one of the most significant arboviral threats in many parts of the world. In spite of large scale morbidity, and long lasting polyarthralgia, no licensed vaccine or antivirals are available for the clinical management of CHIKV infection. In this study, a novel RNA interference based strategy has been adopted for effective inhibition of CHIKV. Four artificial microRNAs (amiRNAs) were designed to target different regions of CHIKV genome. These amiRNAs significantly inhibited CHIKV replication in Vero cells at both RNA and protein levels as assessed by qRT-PCR, immunoblotting and immunofluorescence techniques. Further inhibition of the infectious CHIKV up to 99.8% was demonstrated by plaque reduction assay. Concatemerization of amiRNA resulted in higher inhibition of CHIKV than individual amiRNAs. In addition, we studied the effect of combination of RNAi based therapy with other classical antivirals like chloroquine, ribavirin and mycophenolic acid, that helped in understanding the rational selection of RNAi based combination therapy. These findings provide a promising avenue for the development of novel amiRNA or combination based therapeutics against emerging CHIKV.


title: Visiting a sauna: does inhaling hot dry air reduce common cold symptoms? A randomised controlled trial

text: Objective: Design, setting and participants: A randomised single‐blind controlled trial with a treatment duration of 3 days and a follow‐up period of 4 days was conducted at a sauna in Berlin, Germany. Between November 2007 and March 2008 and between September 2008 and April 2009, 157 patients with symptoms of the common cold were randomly assigned to an intervention group (n = 80) and a control group (n = 77). Interventions: Participants in the intervention group inhaled hot dry air within a hot sauna, dressed in a winter coat, whereas participants in the control group inhaled dry air at room temperature within a hot sauna, also dressed in a winter coat. Main outcome measures: Area under the curve (AUC) summarising symptom severity over time (Days 2, 3, 5 and 7), symptom severity scores for individual days, intake of medication for the common cold and general ill feeling. Results: No significant difference between groups was observed for AUC representing symptom severity over time (intervention group mean, 31.2 [SEM, 1.8]; control group mean, 35.1 [SEM, 2.3]; group difference, − 3.9 [95% CI, − 9.7 to 1.9]; P = 0.19). However, significant differences between groups were found for medication use on Day 1 (P = 0.01), symptom severity score on Day 2 (P = 0.04), and participants’ ratings of the effectiveness of the therapy on Day 7 (P = 0.03). Conclusion: Inhaling hot air while in a sauna has no significant impact on overall symptom severity of the common cold. Trial registration: ClinicalTrials.gov identifier NCT00552981.


title: A novel fast vector method for genetic sequence comparison

text: With sharp increasing in biological sequences, the traditional sequence alignment methods become unsuitable and infeasible. It motivates a surge of fast alignment-free techniques for sequence analysis. Among these methods, many sorts of feature vector methods are established and applied to reconstruction of species phylogeny. The vectors basically consist of some typical numerical features for certain biological problems. The features may come from the primary sequences, secondary or three dimensional structures of macromolecules. In this study, we propose a novel numerical vector based on only primary sequences of organism to build their phylogeny. Three chemical and physical properties of primary sequences: purine, pyrimidine and keto are also incorporated to the vector. Using each property, we convert the nucleotide sequence into a new sequence consisting of only two kinds of letters. Therefore, three sequences are constructed according to the three properties. For each letter of each sequence we calculate the number of the letter, the average position of the letter and the variation of the position of the letter appearing in the sequence. Tested on several datasets related to mammals, viruses and bacteria, this new tool is fast in speed and accurate for inferring the phylogeny of organisms.


title: Lysosomes as a therapeutic target

text: Lysosomes are membrane-bound organelles with roles in processes involved in degrading and recycling cellular waste, cellular signalling and energy metabolism. Defects in genes encoding lysosomal proteins cause lysosomal storage disorders, in which enzyme replacement therapy has proved successful. Growing evidence also implicates roles for lysosomal dysfunction in more common diseases including inflammatory and autoimmune disorders, neurodegenerative diseases, cancer and metabolic disorders. With a focus on lysosomal dysfunction in autoimmune disorders and neurodegenerative diseases — including lupus, rheumatoid arthritis, multiple sclerosis, Alzheimer disease and Parkinson disease — this Review critically analyses progress and opportunities for therapeutically targeting lysosomal proteins and processes, particularly with small molecules and peptide drugs.


title: MOOC’s impact on higher education

text: Abstract The Massive Open Online Course has exerted a significant influence on adult learning. MOOC’s has been discussed in all previous literature. However, the current study tries to investigate the MOOC’s effect on higher education systems. This study investigates the impact of MOOCs on Higher Education in the Kingdom of Saudi Arabia (KSA). Its main objective is to examine the essential aspects of developing the teaching and learning mechanisms used in Saudi universities by employing open-source courses (MOOCs) in university education. This research adopted a descriptive and analytical approach. A quantitative survey was used to collect the necessary data. The study population included all professors at King Saud University (KSU). The results of the analysis reveal that MOOCs have a significant direct impact on higher education as it improves education outcomes (t = 23.46, p ≤ 0.001), which supports H1. Also, MOOCs accounted for a 65% improvement in education outcomes. The findings show MOOC’s classes have a positive influence on the kingdom’s higher education System.


title: Hypertension, the renin–angiotensin system, and the risk of lower respiratory tract infections and lung injury: implications for COVID-19: European Society of Hypertension COVID-19 Task Force Review of Evidence

text: Systemic arterial hypertension (referred to as hypertension herein) is a major risk factor of mortality worldwide, and its importance is further emphasized in the context of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection referred to as COVID-19. Patients with severe COVID-19 infections commonly are older and have a history of hypertension. Almost 75% of patients who have died in the pandemic in Italy had hypertension. This raised multiple questions regarding a more severe course of COVID-19 in relation to hypertension itself as well as its treatment with renin–angiotensin system (RAS) blockers, e.g. angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). We provide a critical review on the relationship of hypertension, RAS, and risk of lung injury. We demonstrate lack of sound evidence that hypertension per se is an independent risk factor for COVID-19. Interestingly, ACEIs and ARBs may be associated with lower incidence and/or improved outcome in patients with lower respiratory tract infections. We also review in detail the molecular mechanisms linking the RAS to lung damage and the potential clinical impact of treatment with RAS blockers in patients with COVID-19 and a high cardiovascular and renal risk. This is related to the role of angiotensin-converting enzyme 2 (ACE2) for SARS-CoV-2 entry into cells, and expression of ACE2 in the lung, cardiovascular system, kidney, and other tissues. In summary, a critical review of available evidence does not support a deleterious effect of RAS blockers in COVID-19 infections. Therefore, there is currently no reason to discontinue RAS blockers in stable patients facing the COVID-19 pandemic.


title: Transmission identification of Escherichia coli aerosol in chicken houses to their environments using ERIC-PCR

text: In order to study E. coli aerosol spreading from chicken houses to their surrounding air, air samples, including indoor and outdoor air (upwind 10 and 50 m as well as downwind 10, 50, 100, 200 and 400 m away) of 5 chicken houses were collected using six-stage Andersen microbial samplers and Reuter-Centrifugal samplers (RCS). E. coli concentrations (CFU/m(3) air) collected from different sampling sites were calculated. E. coli strains from chicken feces samples were also isolated. Furthermore, the enterobacterial repetitive intergenic consensus (ERIC)-PCR method was applied to amplify the isolated E. coli strain DNA samples. Through the genetic similarity analyses of the E. coli obtained from different sampling sites, the spreading of bioaerosol from animal houses to the ambient air was characterized. The results showed that the isolated E. coli concentrations in indoor air (9–63 CFU/m(3)) in 5 chicken houses were higher than those in upwind and downwind air, but there were no significant differences between the indoor and downwind sites 10 m away from all the 5 houses (P>0.05). The phylogenetic tree indicated that a part of the E. coli (34.1%) isolated from indoor air had 100% similarity with those isolated from feces, and that most of E. coli isolated (54.5%) from downwind at 10, 50, 100 or even 200 m had 100% similarity with those isolated from indoor air or feces too. But those isolated from upwind air had a lower similarity (73%–92%) with corresponding strains isolated from indoor air or feces. Our results suggested that some strains isolated from downwind air and indoor air originated in the chicken feces, but most of isolates obtained from upwind air samples did not come from the chicken feces or indoor air. Effective hygienic measures should be taken in animal farms to prevent or minimize downwind spreading of microorganism aerosol.


title: Cryptosporidium parvum infection in cattle: are current perceptions accurate?

text: The perception that cattle are major reservoirs for Cryptosporidium parvum infections in humans and that C. parvum is a major cause of diarrhea and production loss in cattle might not reflect the whole situation. Numerous management factors influence the epidemiological and clinical picture associated with C. parvum infections in cattle. Whereas C. parvum is highly prevalent in young dairy calves and confined beef calves, it occurs rarely in calves on range and in adult cattle. In well-managed herds, clinical disease due to C. parvum is also rare. Therefore, C. parvum infections in cattle might not be as important as current perceptions would indicate.


title: Pain Management Best Practices from Multispecialty Organizations during the COVID-19 Pandemic and Public Health Crises

text: BACKGROUND: It is nearly impossible to overestimate the burden of chronic pain, which is associated with enormous personal and socioeconomic costs. Chronic pain is the leading cause of disability in the world, is associated with multiple psychiatric co-morbidities, and has been causally linked for the opioid crisis. Access to pain treatment has been called a fundamental human right by numerous organizations. The current COVID-19 pandemic has strained medical resources, creating a dilemma for physicians charged with a responsibility to limit spread of the contagion, and their responsibility to treat the patients they are entrusted to care for. METHODS: To address these issues, an expert panel was convened that included pain management experts from the military, Veterans Health Administration, and academia. Endorsement from stakeholder societies was sought upon completion of the document, with a 1-week suspense period. RESULTS: In these guidelines, we provide a framework for pain practitioners and institutions to balance the often-conflicting goals of risk mitigation for health care providers, risk mitigation for patients, conservation of resources, and access to pain management services. Specific issues discussed include general and interventional-specific risk mitigation, patient flow issues and staffing plans, telemedicine options, triaging recommendations, strategies to reduce psychological sequelae in health care providers, and resource utilization. CONCLUSIONS: The COVID-19 public health crisis has strained health care systems, creating a conundrum for patients, pain medicine practitioners, hospital leaders, and regulatory officials. Although this document provides a framework for pain management services, systems-wide and individual decisions must take into account clinical considerations, regional health conditions, government and hospital directives, resource availability, the welfare of health care providers. Video-Abstract link: https://youtu.be/m_P17TvZQNA


title: Betacoronavirus 1 in alpacas (Vicugna pacos) in the High Peruvian Andes

text: Abstract Genetic sequences highly related to Bovine coronavirus (BCoV) were detected in fecal samples from Peruvian 1–3 week old alpaca crias located on six farms in Puno department, some of which shared pastures with cattle. A total of 60 samples were screened for coronavirus using a nested PCR amplification of a fragment of the RNA-dependent RNA polymerase (RdRp) gene. Sequences from 11 positive samples were highly similar to the Kakegawa, Quebec and Mebus BCoV strains (99.5–100.0%) and 99.2% identical to an alpaca Coronavirus (CoV) previously detected in the USA. The detection of genetic sequences related to BCoV from Peruvian alpaca crias suggests possible role of this virus on enteric disorders etiology in the High Andes.


title: Molecular and antigenic characterization of bovine Coronavirus circulating in Argentinean cattle during 1994–2010

text: Abstract Bovine coronavirus (BCoV) is an important viral pathogen associated with neonatal calf diarrhea. Our aim was to investigate the incidence of BCoV in diarrhea outbreaks in beef and dairy herds from Argentina during 1994–2010. A total of 5.365 fecal samples from diarrheic calves were screened for BCoV diagnosis by ELISA. The virus was detected in 1.71% (92/5365) of the samples corresponding to 5.95% (63/1058) of the diarrhea cases in 239 beef and 324 dairy farms. The detection rate of BCoV was significantly higher in dairy than in beef herds: 12.13% (29/239) vs. 4.32% (14/324) respectively. Phylogenetic analysis of the hypervariable S1 region of seven representative samples (from different husbandry systems, farm locations and years of sampling) indicated that BCoV strains circulating in Argentinean beef and dairy herds formed a cluster distinct from other geographical regions. Interestingly, Argentinean strains are distantly related (at both the nucleotide and amino acid levels) with the Mebus historic reference BCoV strain included in the vaccines currently available in Argentina. However, Mebus-induced antibodies were capable of neutralizing the BCoV Arg95, a field strain adapted to grow in vitro, and vice versa, indicating that both strains belong to the same CoV serotype reported in cattle. This work represents the first large survey describing BCoV circulation in Argentinean cattle.


title: Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome

text: Severe acute respiratory syndrome (SARS) is a recently emerged infectious disease caused by a novel coronavirus, but its immunopathological mechanisms have not yet been fully elucidated. We investigated changes in plasma T helper (Th) cell cytokines, inflammatory cytokines and chemokines in 20 patients diagnosed with SARS. Cytokine profile of SARS patients showed marked elevation of Th1 cytokine interferon (IFN)-γ, inflammatory cytokines interleukin (IL)-1, IL-6 and IL-12 for at least 2 weeks after disease onset, but there was no significant elevation of inflammatory cytokine tumour necrosis factor (TNF)-α, anti-inflammatory cytokine IL-10, Th1 cytokine IL-2 and Th2 cytokine IL-4. The chemokine profile demonstrated significant elevation of neutrophil chemokine IL-8, monocyte chemoattractant protein-1 (MCP-1), and Th1 chemokine IFN-γ-inducible protein-10 (IP-10). Corticosteroid reduced significantly IL-8, MCP-1 and IP-10 concentrations from 5 to 8 days after treatment (all P < 0·001). Together, the elevation of Th1 cytokine IFN-γ, inflammatory cytokines IL-1, IL-6 and IL-12 and chemokines IL-8, MCP-1 and IP-10 confirmed the activation of Th1 cell-mediated immunity and hyperinnate inflammatory response in SARS through the accumulation of monocytes/macrophages and neutrophils.


title: The impact of epidemics on labor market: identifying victims of the Middle East Respiratory Syndrome in the Korean labor market

text: BACKGROUND: The vulnerability approach suggests that disasters such as epidemics have different effects according not only to physical vulnerability but also to economic class (status). This paper examines the effect of the Middle East Respiratory Syndrome epidemic on the labor market to investigate whether vulnerable groups become more vulnerable due to an interaction between the socio-economic structure and physical risk. METHODS: This paper examines the effect of the Middle East Respiratory Syndrome epidemic on the labor market by considering unemployment status, job status, working hours, reason for unemployment and underemployment status. In particular, the study investigates whether the U-shaped curve becomes a J-shaped curve due to the interaction between medical vulnerability and labor market vulnerability after an outbreak, assuming that the relative vulnerability in the labor market by age shows a U curve with peaks for the young group and middle aged and old aged groups using the Economically Active Population Survey. We use the difference in difference approach and also conduct a falsification check and robustness check. RESULTS: The results suggest that older workers faced a higher possibility of unemployment after the Middle East Respiratory Syndrome outbreak. In particular, they experienced higher involuntary unemployment and underemployment status as well as decreased working hours. It was confirmed that the relative vulnerability of the labor market for older workers was higher than for the other age groups after the epidemic outbreak due to the double whammy of vulnerability in the medical and labor market. The vulnerability in the young group partially increased compared to the 30s and 40s age groups due to their relative vulnerability in the labor market despite being healthy. We find that assuming the relative vulnerability in the existing labor market shows a U shape with age increase, the U-shaped curve became J-shaped after the outbreak. CONCLUSIONS: Disasters like epidemics can occur unexpectedly and affect certain groups more than other. Therefore, medical protection should be enhanced for groups vulnerable to disease and economic measures are also required for the protection of their livelihoods in the labor market to prevent unemployment stemming from inequality.


title: Home-Based Primary Care Led-Outbreak Mitigation in Assisted Living Facilities in the First One Hundred Days of COVID-19

text: Abstract Residents of congregate care settings have been severely impacted by the current COVID-19 pandemic. In this report, we describe the methods our home-based primary care (HBPC) practice has developed to mitigate the spread of COVID-19 in assisted living facilities (ALFs) and we present an initial evaluation of this innovation. Shortly after the first COVID-19 case was reported in the U.S., our organization assembled an outbreak committee, designed to support the 1,794 ALF residents and the 101 communities in which they reside. The committee led the development and deployment of a comprehensive COVID-19 prevention and suppression strategy. The average age of the cohort was 83 + 11 years and 74% were female. Seven individuals (0.4% of census) tested positive for SARS-CoV-2. The positive individuals were located in three ALFs, representing 3% of our total number of ALFs. There has been one death. HBPC-led outbreak mitigation may be an enabler to suppress COVID-19 in ALFs.


title: Acquisition of respiratory and gastrointestinal pathogens among health care workers during the 2015 Hajj season

text: BACKGROUND: Data on the risk of transmission of infection to health care workers (HCWs) serving ill pilgrims during the Hajj is scarce. METHODS: Two cohorts of HCWs, the first serving Hajj pilgrims in Mecca and the second serving patients in Al-Ahsa, were investigated for respiratory and gastrointestinal symptoms and pathogen carriage using multiplex polymerase chain reaction before and after the 2015 Hajj. RESULTS: A total of 211 HCWs were enrolled of whom 92 were exposed to pilgrims (Mecca cohort), whereas 119 were not exposed (Al-Ahsa cohort). Symptoms were observed only in HCWs from the Mecca cohort, with 29.3% experiencing respiratory symptoms during the Hajj period or in the subsequent days and 3.3% having gastrointestinal symptoms. Acquisition rates of at least 1 respiratory virus were 14.7% in the Mecca cohort and 3.4% in the Al-Ahsa cohort (P = .003). Acquisition rates of at least 1 respiratory bacterium were 11.8% and 18.6% in the Mecca and Al-Ahsa cohorts, respectively (P = .09). Gastrointestinal pathogens were rarely isolated in both cohorts of HCWs and acquisition of pathogens after the Hajj was documented in only a few individuals. CONCLUSIONS: HCWs providing care for pilgrims both acquire pathogens and present symptoms (especially respiratory symptoms) more frequently than those not working during Hajj.


title: Podocyte ACE2 protects against diabetic nephropathy

text: As new components of the renin–angiotensin system (RAS) are elucidated, our understanding of the complexities of their interactions also advances. Previous studies have determined that podocytes possess a local RAS that can generate angiotensin II. Podocytes have also been shown to express angiotensin-converting enzyme 2 (ACE2), which can decrease angiotensin II levels by generation of angiotensin-(1–7). Nadarajah et al. now show that increased podocyte ACE2 activity can attenuate the development of diabetic nephropathy.


PSGE Statement on Minimally Invasive Gynecologic Surgeries (MIGS) during the COVID-19 Pandemic in the Philippines. March 30, 2020


title: New perspectives on the pathogenesis of rheumatoid arthritis

text: Abstract In the pathogenesis of rheumatoid arthritis, locally produced antibodies complex with an inciting antigen, yet to be identified, within the joint and activate the complement system, resulting in articular inflammation mediated primarily by polymorphonuclear leukocytes and their products. Chronic inflammatory cells then produce soluble factors that induce both tissue destruction and inflammation. A major issue is how and why apparently normal immune responses in the acute stage progress to chronic inflammation in subsequent months to years. Although it is often assumed that the initial etiologic agent, persisting in the joint or at an extra-articular site, is responsible for continued synovitis, this need not be the case. It is possible that once the inciting agent is cleared from the joint through a normal immune response, the presence of activated cells rich in surface class II histocompatibility (Ia) antigens could, under the influence of multiple genetic or environmental factors, become the target of autoimmune attack. Alternatively, the process might result from the interactions of synovial lining cells and their products with T cells assuming a secondary role. Further research into the relative contributions of soluble products, T helper and suppressor subsets, synoviocytes, and antigen determine which model is correct.


title: Characterisation of the Virome of Tonsils from Conventional Pigs and from Specific Pathogen-Free Pigs

text: Porcine respiratory disease is a multifactorial disease that can be influenced by a number of different microorganisms, as well as by non-infectious factors such as the management and environment of the animals. It is generally believed that the interaction between different infectious agents plays an important role in regard to respiratory diseases. Therefore, we used high-throughput sequencing combined with viral metagenomics to characterise the viral community of tonsil samples from pigs coming from a conventional herd with lesions in the respiratory tract at slaughter. In parallel, samples from specific pathogen-free pigs were also analysed. This study showed a variable co-infection rate in the different pigs. The differences were not seen at the group level but in individual pigs. Some viruses such as adenoviruses and certain picornaviruses could be found in most pigs, while others such as different parvoviruses and anelloviruses were only identified in a few pigs. In addition, the complete coding region of porcine parvovirus 7 was obtained, as were the complete genomes of two teschoviruses. The results from this study will aid in elucidating which viruses are circulating in both healthy pigs and in pigs associated with respiratory illness. This knowledge is needed for future investigations into the role of viral-viral interactions in relation to disease development.


title: Detection of diarrheal viruses circulating in adult patients in Thailand

text: A total of 332 fecal specimens collected during January-December 2008 from adult patients with diarrhea were screened for group A and C rotaviruses, noroviruses GI and GII, sapovirus, Aichi virus, human parechovirus, enterovirus, adenovirus and astrovirus by RT-multiplex PCR. The detection rate for diarrheal viruses was 4.2 %. Adenovirus and enterovirus were equally detected as the most predominant viruses, with prevalence of 1.2 %, followed by Aichi virus (0.9 %) and norovirus GII (0.6 %). Mixed infection with norovirus GII and human parechovirus was also detected (0.3 %). This study provides epidemiological data for a wide variety of diarrheal viruses circulating in adult patients with diarrhea in Chiang Mai, Thailand.


title: Giving the Genes a Shuffle: Using Natural Variation to Understand Host Genetic Contributions to Viral Infections

text: The laboratory mouse has proved an invaluable model to identify host factors that regulate the progression and outcome of virus-induced disease. The paradigm is to use single-gene knockouts in inbred mouse strains or genetic mapping studies using biparental mouse populations. However, genetic variation among these mouse strains is limited compared with the diversity seen in human populations. To address this disconnect, a multiparental mouse population has been developed to specifically dissect the multigenetic regulation of complex disease traits. The Collaborative Cross (CC) population of recombinant inbred mouse strains is a well-suited systems-genetics tool to identify susceptibility alleles that control viral and microbial infection outcomes and immune responses and to test the promise of personalized medicine.


Parallel epidemics, or nearly so: certainties and uncertainties about sars-cov-2 in italy


title: Clinical findings in a patient with haemophilia A affected by COVID‐19

text: At the end of 2019, a cluster of pneumonia patients were confirmed to be infected with a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Wuhan, Hubei Province, China. This infectious disease was designated as coronavirus disease 2019 (COVID-19). It rapidly spreads throughout the world. More than 80,000 cases have been reported in China and epidemics have grown in other countries.


title: Effects of patients’ motives in choosing a provider on determining the type of medical institution

text: BACKGROUND: Primary care is relatively weak in the Republic of Korea. As the referral system is not well established, patients can freely choose from among clinics, hospitals, and tertiary hospitals. This study was conducted to determine the factors influencing patients’ choice of providers. METHODS: A survey was conducted of 999 Korean adults aged 19–59 years. An exploratory factor analysis was performed on nine factors influencing their motives in choosing a medical provider. The factors derived from this analysis and the types of medical institutions were used as the independent and dependent variables, respectively, in logistic regression analysis. Adjustments were made for region, gender, age, educational level, income, type of insurance, and chronic diseases. RESULTS: The results showed that patients preferred clinics when considering the importance of accessibility, staff kindness, and patient-centeredness; they preferred hospitals when considering cleanliness; and tertiary hospitals when considering the reputation and structural factors. When considering structural factors, clinics and hospitals were less preferred; however tertiary hospitals were less preferred when considering accessibility, staff kindness, and patient-centeredness. CONCLUSION: It is necessary to provide more accessible and patient-centered services in order to strengthen the primary health care role of clinics. In addition, efforts are needed to improve the quality of health care of tertiary hospitals in order to meet patient expectations.


ESICM LIVES 2019: Berlin, Germany. 28 September - 2 October 2019


title: UV-C irradiation is able to inactivate pathogens found in commercially collected porcine plasma as demonstrated by swine bioassay

text: Abstract Liquid porcine plasma is an animal origin raw material for the manufacturing process of spray-dried porcine plasma that is used in pig nutrition worldwide. In previous studies we found that the application of ultraviolet light C (UV-C) in liquid plasma that was inoculated with a variety of bacteria or viruses of importance in the swine industry can be considered as redundant safety steps because in general achieve around 4 logs reduction for most of these pathogens. However, the final validation of the UV-C light as safety feature should be conducted with commercial liquid plasma and using the pig bioassay model. As a first objective, the potential infectivity of a raw liquid plasma product collected from an abattoir was tested by means of a swine bioassay. We used Porcine circovirus 2 (PCV-2), a ubiquitous virus that has been systematically detected by PCR in porcine plasma at abattoirs as selection criteria for commercial liquid plasma lot. As a second aim of the study, the effects of different doses of UV-C irradiation on the selected raw liquid plasma were assayed in the animal bioassay. Moreover, other swine infecting agents, including Porcine reproductive and respiratory syndrome virus (PRRSV), were also determined in the original plasma and monitored in the inoculated animals. Pigs negative for PCV-2 and PRRSV genome and antibodies were allotted to one of five groups (6 to 8 pigs/ group) and injected intra-peritoneally with 10 mL of their assigned inoculum at 50 d of age. Negative control pigs (group 1) were injected with PBS. Positive control pigs (group 5) were injected with a PCV-2 inoculum. Groups 2, 3 and 4 were injected with liquid porcine plasma that had been subjected to 0 (raw plasma), 3000 or 9000 J/L UV-C irradiation, respectively. Group 2 pigs (0 J/L UV-C) got infection by PRRSV but no PCV-2 infection or seroconversion. However, one pig from group 2 seroconverted to Rotavirus A (RVA) and Hepatitis E virus (HEV) and three group 2 pigs seroconverted to Porcine parvovirus (PPV). Groups 1, 3 and 4 pigs showed no evidence of infection or seroconversion associated with the tested viruses or any other pathogens found in the liquid plasma before UV-C irradiation. Group 5 pigs developed PCV-2 infectivity as expected. UV-C irradiation of liquid plasma at 3000 and 9000 J/L was effective in preventing PRRSV and other pathogens transmission. Moreover, raw liquid plasma was non-infectious for PCV-2 in naïve pigs.


title: Épidémiologie de l'asthme grave

text: Summary Prevalence of severe acute asthma can be evaluated through mortality statistics, hospitalization rates and epidemiological studies. Risk factors include personnal characteristics (age, socio-economic status, disease denial, depression, medical features associated with increased severity), environment factors as life events and exposure to specific (allergens) and as non-specific factors (viral or microbial infections, passive smoking, air polluants) and the health care system (care delivery, quality of medical management). Such factors are inter-related. Their knowledge should allow a better management leading to a lower incidence of severe acute asthma attacks.


title: Herd‐level prevalence and incidence of porcine epidemic diarrhoea virus (PEDV) and porcine deltacoronavirus (PDCoV) in swine herds in Ontario, Canada

text: Porcine epidemic diarrhoea virus (PEDV) and porcine deltacoronavirus (PDCoV) were first identified in Canada in 2014. Surveillance efforts have been instrumental in controlling both diseases. In this study, we provide an overview of surveillance components for the two diseases in Ontario (Canada), as well as PEDV and PDCoV incidence and prevalence measures. Swine herds located in the Province of Ontario, of any type, whose owners agreed to participate in a voluntary industry‐led disease control programme (DCP) and with associated diagnostic or epidemiological information about the two swine coronaviruses, were eligible to be included for calculation of disease frequency at the provincial level. PEDV and PDCoV data stored in the industry DCP database were imported into the R statistical software and analysed to produce weekly frequency of incidence counts and prevalence counts, in addition to yearly herd‐level incidence risk and prevalence between 2014 and 2016. The yearly herd‐level incidence risk of PEDV, based on industry data, was 13.5%, 3.0% and 1.4% (95% CI: 11.1–16.2, 2.0–4.2, 0.8–2.3), while the yearly herd‐level incidence risk of PDCoV was 1.1%, 0.3%, and 0.1% (95% CI: 0.5–2.2, 0.1–0.9, 0.0–0.5), for 2014, 2015 and 2016, respectively. Herd‐level prevalence estimates for PEDV in the last week of 2014, 2015 and 2016 were 4.4%, 2.3% and 1.4%, respectively (95% CI: 3.1–6.0, 1.5–3.3, 0.8–2.2), while herd‐level prevalence estimates for PDCoV in the last week of 2014, 2015 and 2016 were 0.5%, 0.2% and 0.2%, respectively (95% CI: 0.1–1.2, 0.0–0.6, 0.0–0.6). Collectively, our results point to low and decreasing incidence risk and prevalence for PEDV and PDCoV in Ontario, making both diseases possible candidates for disease elimination at the provincial level.


title: The Impact of COVID-19 on Anxiety in Chinese University Students

text: COVID-19 had become a pandemic raising concerns of widespread panic and increasing anxiety and stress in individuals all over the world (World Health Organization, 2020a). Lots of countries had closed their schools. As the first country to do so, Chinese colleges and universities were making use of different modes of learning, including online-learning based on different platforms to achieve the goal suggested by Ministry of Education in China, “suspending classes without suspending learning,” since middle February. This paper is the first one which aims to investigate the anxiety of Chinese university students after the outbreak of COVID-19 right before the start of new spring term. 3611 university students (female: male = 1.48:1) aged between 18 to 24 from all over China were enrolled to this study from a top university in China. The Self-Rating Anxiety Scale – SAS (Zung, 1971) was used to assess anxiety 2 days before the start of new spring term in middle February. All four-year undergraduate students were included in the study. The mean SAS score was 40.53 (SD = 10.15), significantly higher than the national norm (Mean = 29.78, SD = 10.07, and p ≤ .001), and there were still 557 (15.43%, Mean = 58.75, and SD = 8.9) students met the cutoff of 50 and were screened positive. Comparisons among sexes, grades and majors were also conducted. Significant differences were found between all males and all female (p ≤ .001), and between all students majoring arts and sciences in the anxiety sample (n = 557, p = 0.05). The results also showed that the mean SAS scores were not correlated with the regions they came from/lived in. This study concluded that the Chinese university students showed higher anxiety for COVID-19.


title: The impact of a pathogenic bacterium on a social carnivore population

text: 1. The long‐term ecological impact of pathogens on group‐living, large mammal populations is largely unknown. We evaluated the impact of a pathogenic bacterium, Streptococcus equi ruminatorum, and other key ecological factors on the dynamics of the spotted hyena Crocuta crocuta population in the Ngorongoro Crater, Tanzania. 2. We compared key demographic parameters during two years when external signs of bacterial infection were prevalent (‘outbreak’) and periods of five years before and after the outbreak when such signs were absent or rare. We also tested for density dependence and calculated the basic reproductive rate R (0) of the bacterium. 3. During the five pre‐outbreak years, the mean annual hyena mortality rate was 0·088, and annual population growth was relatively high (13·6%). During the outbreak, mortality increased by 78% to a rate of 0·156, resulting in an annual population decline of 4·3%. After the outbreak, population size increased moderately (5·1%) during the first three post‐outbreak years before resuming a growth similar to pre‐outbreak levels (13·9%). We found no evidence that these demographic changes were driven by density dependence or other ecological factors. 4. Most hyenas showed signs of infection when prey abundance in their territory was low. During the outbreak, mortality increased among adult males and yearlings, but not among adult females – the socially dominant group members. These results suggest that infection and mortality were modulated by factors linked to low social status and poor nutrition. During the outbreak, we estimated R (0) for the bacterium to be 2·7, indicating relatively fast transmission. 5. Our results suggest that the short‐term ‘top–down’ impact of S. equi ruminatorum during the outbreak was driven by ‘bottom–up’ effects on nutritionally disadvantaged age–sex classes, whereas the longer‐term post‐outbreak reduction in population growth was caused by poor survival of juveniles during the outbreak and subsequent poor recruitment of breeding females. These results suggest synergistic effects of ‘bottom–up’ and ‘top–down’ processes on host population dynamics.


title: Selected Viruses Detected on and in our Food

text: PURPOSE OF REVIEW: The purpose of this review is to provide an update on recent literature and findings concerning selected foodborne viruses. Two groups of viruses were selected: (a) the most important viruses contaminating food, based on numbers of publications in the last 5 years and (b) viruses infecting sources of food that might have an impact on human health. RECENT FINDINGS: Important foodborne viruses such as norovirus, hepatitis A and rotavirus are usually “only” contaminating food and are detected on the surface of foodstuffs. However, they are threats to human public health and make up for the majority of cases. In contrast, the meaning of viruses born from within the food such as natural animal and plant viruses is still in many cases unknown. An exception is Hepatitis E virus that is endemic in pigs, transmitted via pork meat and is recognised as an emerging zoonosis in industrialised countries. SUMMARY: Even though the clinical meaning of “new” foodborne viruses, often detected by next generation sequencing, still needs clarification, the method has great potential to enhance surveillance and detection particularly in view of an increasingly globalised food trade.


title: Noncutaneous considerations of COVID‐19 for dermatology practices

text: COVID‐19 presents many pressing challenges to the global dermatological community and our patients with ongoing skin needs, which must be considered by every dermatology provider. Many of these are logistical and administrative, distinct from physical manifestations, and could be summarized by the acronym COVID (Consultations, Operations, Videoconferencing, Immunosuppressive medications, Drug and equipment shortages). While the pandemic may represent a threat to many parts of our existence, dermatologists can help the patients we care for by considering noncutaneous implications of COVID‐19 upon our practice.


title: Mannheimia haemolytica biofilm formation on bovine respiratory epithelial cells

text: Abstract Mannheimia haemolytica is the most important bacterial agent associated with the bovine respiratory disease complex (BRDC), which causes worldwide economic losses to the cattle industry. M. haemolytica cells initially colonize the tonsillar crypts in the upper respiratory tract of cattle, from where they can subsequently descend into the lungs to cause disease. Many bacteria exist as biofilms inside their hosts. We hypothesize that M. haemolytica colonization of cattle during its commensal state may include biofilm formation. To begin to assess this possibility, we developed an in vitro system to study biofilm formation directly on bovine respiratory epithelial cells. Using fixed primary bovine bronchial epithelial cells, we observed M. haemolytica biofilm formation after a 48h incubation period at 37°C. Addition of mucin, the main component of mucus present in the upper respiratory tract, decreased M. haemolytica biofilm formation on bovine epithelial cells. We investigated the effects of prior viral infection of the epithelial cells on subsequent biofilm formation by M. haemolytica and found negligible effects. Utilization of this model system will provide new insights into the potential role of biofilm formation by M. haemolytica in the pathogenesis of BRDC.


title: Nasal microbiota and symptom persistence in acute respiratory tract infections in infants

text: Acute respiratory tract infections (ARI) in infancy have been implicated in the development of chronic respiratory disease, but the complex interplay between viruses, bacteria and host is not completely understood. We aimed to prospectively determine whether nasal microbiota changes occur between the onset of the first symptomatic ARI in the first year of life and 3 weeks later, and to explore possible associations with the duration of respiratory symptoms, as well as with host, environmental and viral factors. Nasal microbiota of 167 infants were determined at both time-points by 16S ribosomal RNA-encoding gene PCR amplification and subsequent pyrosequencing. Infants were clustered based on their nasal microbiota using hierarchical clustering methods at both time-points. We identified five dominant infant clusters with distinct microbiota at the onset of ARI but only three clusters after 3 weeks. In these three clusters, symptom persistence was overrepresented in the Streptococcaceae-dominated cluster and underrepresented in the cluster dominated by “Others” (p<0.001). Duration of symptoms was not associated with the type of respiratory virus. Infants with prolonged respiratory symptoms after their first ARI tend to exhibit distinct microbial compositions, indicating close microbiota–host interactions that seem to be of importance for symptom persistence and recovery.


title: COVID-19: Melatonin as a potential adjuvant treatment

text: Abstract This article summarizes the likely benefits of melatonin in the attenuation of COVID-19 based on its putative pathogenesis. The recent outbreak of COVID-19 has become a pandemic with tens of thousands of infected patients. Based on clinical features, pathology, the pathogenesis of acute respiratory disorder induced by either highly homogenous coronaviruses or other pathogens, the evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients. Additional experiments and clinical studies are required to confirm this speculation.


The Need to Adapt the Rescue Chain for Out-of-Hospital Cardiac Arrest during the COVID-19 Pandemic: Experience from the Paris Fire Brigade Basic Life Support and Advanced Life Support Teams


Foreward: Molecular epidemiology of viral infection in Asia


title: Discovery of alliin as a putative inhibitor of the main protease of SARS-CoV-2 by molecular docking

text: The outbreak of viral pneumonia caused by the novel coronavirus SARS-CoV-2 that began in December 2019 caused high mortality. It has been suggested that the main protease (Mpro) of SARS-CoV-2 may be an important target to discover pharmaceutical compounds for the therapy of this life-threatening disease. Remdesivir, ritonavir and chloroquine have all been reported to play a role in suppressing SARS-CoV-2. Here, we applied a molecular docking method to study the binding stability of these drugs with SARS-CoV-2 Mpro. It appeared that the ligand–protein binding stability of the alliin and SARS-CoV-2 Mpro complex was better than others. The results suggested that alliin may serve as a good candidate as an inhibitor of SARS-CoV-2 Mpro. Therefore, the present research may provide some meaningful guidance for the prevention and treatment of SARS-CoV-2.


title: Direct comparison of dietary portfolio vs statin on C-reactive protein

text: BACKGROUND: 3-Hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) markedly reduce serum cholesterol and have anti-inflammatory effects. The effect of cholesterol-lowering diets on inflammatory biomarkers is less well known. OBJECTIVE: To compare the efficacy of a dietary combination (portfolio) of cholesterol-lowering foods vs a statin in reducing C-reactive protein (CRP) as a biomarker of inflammation linked to increased cardiovascular disease risk. METHODS: In all, 34 hyperlipidemic subjects completed three 1-month treatments as outpatients in random order: a very low-saturated fat diet (control); the same diet with 20 mg lovastatin (statin); and a diet high in plant sterols (1.0 g/1000 kcal), soy protein (21.4 g/1000 kcal), viscous fibers (9.8 g/1000 kcal), and almonds (14 g/1000 kcal) (portfolio). Fasting blood samples were obtained at weeks 0, 2, and 4. RESULTS: Using the complete data, no treatment reduced serum CRP. However, when subjects with CRP levels above the 75th percentile for previously reported studies (>3.5 mg/l) were excluded, CRP was reduced similarly on both statin, −16.3±6.7% (n=23, P=0.013) and dietary portfolio, −23.8±6.9% (n=25, P=0.001) but not the control, 15.3±13.6% (n=28, P=0.907). The percentage CRP change from baseline on the portfolio treatment (n=25) was greater than the control (n=28, P=0.004) but similar to statin treatment (n=23, P=0.349). Both statin and portfolio treatments were similar in reducing CRP and numerically more effective than control but only the change in portfolio was significant after the Bonferroni adjustment. CONCLUSIONS: A combination of cholesterol-lowering foods reduced C-reactive protein to a similar extent as the starting dose of a first-generation statin.


title: Airway management strategies for the Covid 19 patients: A brief narrative review

text: • Airway management of patients with Covid-19 is a high risk procedure. • There is an international attention to develop recommendations for the strategies. • The airway should be considered as potentially difficult and complicated. • Triaging, personal protective equipment and isolation areas may cause challenges.


title: Development of a Sensitive Real-Time Fast-qPCR Based on SYBR(®) Green for Detection and Quantification of Chicken Parvovirus (ChPV)

text: Many viruses have been associated with runting and stunting syndrome (RSS). These viral infections mainly affect young chickens, causing apathy, depression, ruffled feathers, cloacal pasting, and diarrhea. Chicken Parvovirus (ChPV) is such an infection and has been detected in chickens showing signs of enteric diseases worldwide. Therefore, the present study aims to develop a sensitive real-time fast-qPCR assay based on SYBR(®) Green for detection and quantification of ChPV. A 561-bp non-structural (NS) gene was amplified and cloned, and a pair of primers was designed based on conserved nucleotide sequences on the NS gene of ChPV, the intercalating DNA reagent SYBR(®) Green was employed, and the Fast mode of a thermocycler was used. The assay detects 10(9) to 10(1) copies of the genome (CG). The limit of detection (LoD) was estimated to five CG, and the limit of quantification (LoQ) was estimated at ten CG. The standard curve efficiency was 101.94%, and the melting curve showed a unique clean peak and a melting temperature of 79.3 °C. The assay was specific to amplify the ChPV NS gene, and no amplification was shown from other viral genomes or in the negative controls. A total of 141 samples were tested using the assay, of which 139 samples were found positive. The highest CG value of ChPV was 5.7 × 10(6) CG/uL of DNA without apparent clinical signs of enteric disturbance, and 4.6 × 10(6) CG/uL DNA were detected in chickens with RSS.


title: Antivirus-built environment: lessons learned from covid-19 pandemic

text: Before developing medications for an epidemic, one solution is to go back to the physical and built environment to reduce its impact. Epidemics have transformed our built environment because of the fear of infection. Consequently, architecture and urbanism after the Covid-19 epidemic will never be the same. Although the current global epidemic poses a challenge at all levels in the built environment, it will take time to develop an antivirus-enabled paradigm to reduce the potential risks or stop the virus from spreading. This study imagines what the antivirus-built environment looks like based on the lessons learned and the importance of designing a healthy and sustainable built environment. Many unanswered questions require further multidisciplinary studies. We aim to search for answers and learn from this forced experiment to add additional security layers to overcome future virus-like attacks.


title: A snapshot of radiology training during the early COVID-19 pandemic

text: PURPOSE: The COVID-19 pandemic transformed the personal and professional lives of radiology trainees. The purpose of this study was to broadly summarize the impact COVID-19 on radiology trainees and their training programs via data collected during the early pandemic. MATERIALS AND METHODS: : An online survey was distributed to radiology chief residents in residencies throughout North America with responses collected between March 20th, 2020 and May 15th, 2020, which coincided with the development of initial COVID-19 peaks in North America. A subset of COVID-19 pandemic questions included resident wellness, imaging opinions, residency infrastructure change, and opinions regarding the Core Exam delay. RESULTS: : 140 chief residents from 86 institutions responded to COVID-19-related questions. Nearly all responding programs (99%; 85/86) reported institutional positive cases of COVID-19. Most residents (94%; 132/140) thought laboratory testing provided more value than imaging. 57% of respondents (80/140) would use COVID-19-related terminology when encountering chest CT findings supportive of viral pneumonia in symptomatic patients. There was little reported change in the number of residents on call (no change reported in >80% of programs). 59% of residents (83/140) reported increased stress related to the COVID-19 pandemic. The majority of programs (93%) had fewer residents on service (80/86 responding programs). CONCLUSIONS: : COVID-19 dramatically affected radiology residencies during the early pandemic period. As we enter future phases of the COVID-19 pandemic, careful thought should also be given to rebuilding the radiology resident experience.


title: Unusual Influenza A Viruses in Bats

text: Influenza A viruses infect a remarkably diverse number of hosts. Two completely new influenza A virus subtypes were recently discovered in bats, dramatically expanding the host range of the virus. These bat viruses are extremely divergent from all other known strains and likely have unique replication cycles. Phylogenetic analysis indicates long-term, isolated evolution in bats. This is supported by a high seroprevalence in sampled bat populations. As bats represent ~20% of all classified mammals, these findings suggests the presence of a massive cryptic reservoir of poorly characterized influenza A viruses. Here, we review the exciting progress made on understanding these newly discovered viruses, and discuss their zoonotic potential.


title: Development and Validation of a S1 Protein-Based ELISA for the Specific Detection of Antibodies against Equine Coronavirus

text: Equine coronavirus (ECoV) is considered to be involved in enteric diseases in foals. Recently, several outbreaks of ECoV infection have also been reported in adult horses from the USA, France and Japan. Epidemiological studies of ECoV infection are still limited, and the seroprevalence of ECoV infection in Europe is unknown. In this study, an indirect enzyme-linked immunosorbent assay (ELISA) method utilizing ECoV spike S1 protein was developed in two formats, and further validated by analyzing 27 paired serum samples (acute and convalescent sera) from horses involved in an ECoV outbreak and 1084 sera of horses with unknown ECoV exposure. Both formats showed high diagnostic accuracy compared to virus neutralization (VN) assay. Receiver-operating characteristic (ROC) analyses were performed to determine the best cut-off values for both ELISA formats, assuming a test specificity of 99%. Employing the developed ELISA method, we detected seroconversion in 70.4% of horses from an ECoV outbreak. Among the 1084 horse sera, seropositivity varied from 25.9% (young horses) to 82.8% (adult horses) in Dutch horse populations. Further, sera of Icelandic horses were included in this study and a significant number of sera (62%) were found to be positive. Overall, the results demonstrated that the ECoV S1-based ELISA has reliable diagnostic performance compared to the VN assay and is a useful assay to support seroconversion in horses involved with ECoV outbreaks and to estimate ECoV seroprevalence in populations of horses.


Renin–angiotensin system and SARS-CoV-2 infection: there is a before and after


title: Concomitant brain arterial and venous thrombosis in a COVID‐19 patient

text: COVID‐19 infection can cause a severe pneumonia which, in some cases, can lead to admission in intensive care unit for respiratory support.(1) In severe cases, systemic thrombotic complication has been described, including cerebrovascular disease (5.7‐23% of cases).(2,3)


title: Letter: low population mortality from COVID‐19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity

text: The recent editorial by Rhodes et al considered latitude and mentioned one mechanism that vitamin D is important in regulating and suppressing the inflammatory response of cytokines of respiratory epithelial cells and macrophages to various pathogens, including respiratory viruses and preventing cytokine storm and the subsequent acute respiratory distress syndrome (RDS) (1).


title: Inhibition of SARS-CoV replication cycle by small interference RNAs silencing specific SARS proteins, 7a/7b, 3a/3b and S

text: Abstract The severe acute respiratory syndrome coronavirus (SARS CoV) genome has 14 potential open reading frames (ORFs). The first ORF is translated from the full-length genomic mRNA while the remaining ORFs are translated from eight subgeomic RNAs (sgRNAs). In this study, we designed small interference RNAs (siRNAs) targeting sgRNA 2, 3 and 7 and tested their efficiency and specificity in silencing the protein translated from the targeted sgRNA. Our results demonstrated that siRNA 7 could inhibit sgRNA 7, which showed 19/19 nucleotides (nt) matching, and sgRNA 8, which showed 18/19nt matching; but, it did not inhibit the full-length genomic mRNA which showed 17/19nt matching. Overall, each of the siRNAs can inhibit the targeted sgRNA without affecting the full-length genomic mRNA or the other sgRNAs that showed mismatch of two or more nt. Thus, siRNA could be designed so as to knockdown the expression of viral protein(s) from a targeted sgRNA during viral infection, thereby allowing the contribution of individual viral proteins to viral infection to be delineated. When Vero E6 cells expressing siRNA 2, 3 or 7 were infected with SARS-CoV, a significant reduction in the yield of progeny virus was observed. Indirect immunofluorescence assays showed that in the infected cells expressing each of the siRNAs, there was aspecific silencing of S, 3a and 7a, respectively, but the expression of nucleocapsid protein was not affected. Thus, our data suggests that the accessory proteins, i.e. 3a and 7a, could play an important role during the replication cycle of the SARS-CoV.


title: The prevalence of Cryptosporidium/Giardia in the trail horse population utilizing public lands in Colorado

text: Summary Cryptosporidium and Giardia spp. are small coccidian parasites that infect the intestinal tract of birds, reptiles and mammals including humans. Oocysts of Cryptosporidium parvum and cysts of Giardia duodenalis are shed in the feces of infected animals and directly infect subsequent hosts following ingestion. The broad host range, resistant nature, and small size of the parasites in the environment may potentially contribute to contamination of water supplies. The perception that recreational riding horses may increase the prevalence of Cryptosporidium and Giardia in large watersheds adjacent to common trails, indirectly infecting humans, has resulted in banning recreational riding horses from some trails. However, there is currently no scientific data linking the recreational trail horse to the incidence or increased risk of human cryptosporidiosis or giardiasis. This survey was conducted to determine the prevalence of Cryptosporidium and Giardia spp. in recreational horses utilizing trails located near large watershed areas in Colorado. At the trail heads, approximately 10 g of fresh feces were collected from recreational horses (n=300) that were utilizing the trails on the day they were sampled. Fecal samples were mixed with 10% formalin at a dilution rate of 1 part feces to 4 parts formalin and were transported to the Veterinary Diagnostic Laboratory at Colorado State University. Samples were evaluated using the Merifluor™ Cryptosporidium/Giardia Direct Immunofluorescent Detection Procedure. One horse (0.33%) was detected positive for Cryptosporidium and two horses (0.66%) were positive for Giardia. The low prevalence of Cryptosporidia and Giardia in the trial horse population surveyed indicates that the adult recreational trail horse population is not likely to be a significant source of Cryptosporidium and Giardia environmental contamination in watershed areas.


Please cite this paper as: Khandaker et al. (2012) Comparing the use of, and considering the need for, lumbar puncture in children with influenza or other respiratory virus infections. Influenza and Other Respiratory Viruses DOI:10.1111/irv.12039. Background The clinical presentation of influenza in infancy may be similar to serious bacterial infection and be investigated with invasive procedures like lumbar puncture (LP), despite very limited evidence that influenza occurs concomitantly with bacterial meningitis, perhaps because the diagnosis of influenza is very often not established when the decision to perform LP is being considered. Methods A retrospective medical record review was undertaken in all children presenting to the Children’s Hospital at Westmead, Sydney, Australia, in one winter season with laboratory‐confirmed influenza or other respiratory virus infections (ORVIs) but excluding respiratory syncytial virus, to compare the use of, and reflect on the need for, the performance of invasive diagnostic procedures, principally LP, but also blood culture, in influenza and non‐influenza cases. We also determined the rate of concomitant bacterial meningitis or bacteraemia. Findings Of 294 children, 51% had laboratory‐confirmed influenza and 49% had ORVIs such as parainfluenza viruses (34%) and adenoviruses (15%). Of those with influenza, 18% had a LP and 71% had a blood culture performed compared with 6·3% and 55·5% in the ORVI group (for both P < 0·01). In multivariate analysis, diagnosis of influenza was a strong independent predictor of both LP (P = 0·02) and blood culture (P = 0·05) being performed, and, in comparison with ORVIs, influenza cases were almost three times more likely to have a LP performed on presentation to hospital. One child with influenza (0·9%) had bacteraemia and none had meningitis. Interpretation Children with influenza were more likely to undergo LP on presentation to hospital compared with those presenting with ORVIs. If influenza is confirmed on admission by near‐patient testing, clinicians may be reassured and less inclined to perform LP, although if meningitis is clinically suspected, the clinician should act accordingly. We found that the risk of bacterial meningitis and bacteraemia was very low in hospitalised children with influenza and ORVIs. A systematic review should be performed to investigate this across a large number of settings.


title: Chapter 7 Indoor Environmental Quality (IEQ)

text: Abstract From the outset, Chapter 7 tries to explain what is understood by indoor environmental quality (IEQ) and the various factors that impact it, as well as the best current approaches employed to achieving optimum IEQ. The causes of building-related illness (BRI) and sick building syndrome (SBS), which appear to be on the increase, are explained and analyzed. The chapter also focuses on the need for a building’s interior air quality, as this is one of the most pivotal factors in maintaining building occupants’ safety, productivity, and well-being. Other important factors that are focused on are ventilation and filtration, including air cleaners and ventilation systems. The leading inorganic indoor contaminants are discussed such as asbestos, radon, and lead, exposure to which can create significant health risks. Likewise, organic contaminants including aldehydes, volatile organic compounds/semivolatile organic compounds, and pesticides are examined and analyzed. Several combustion-generated contaminates such as carbon dioxide, water, carbon monoxide, and nitrogen oxides are also looked into. Toward the end of the chapter, the best practices for IEQ are outlined and discussed.


title: Reprint of bioaerosol: A bridge and opportunity for many scientific research fields

text: Abstract Bioaerosol is a concept that is used to describe all biological materials suspended in the air, including bacteria, fungi, viruses, pollen, and their derivatives such as allergens, endotoxin, mycotoxins and etc. In some studies, primary biological aerosol particle (PBAP) is also coined to refer to intact microbes in the air. Bioaerosol is a multidisciplinary research subject, involving many different fields such as microbiology, mechanical engineering, air pollution, medical science, epidemiology, immunological science, biochemistry, physics, nanotechnologies and etc. The bioaerosol field has undergone about 200 years' research history since 1833 when mold spores were first detected in the air by Charles Darwin on the Cape Verde Islands. In recent decades, there has been a research boom in bioaerosol field, thus triggering many outstanding research opportunities. Visible progress has already been made in understanding bioaerosol roles in human health, atmospheric and ecological impacts as well as their respective technologies: bioaerosol capture, monitoring and also inactivation. Most recently, researchers from different fields start to bridge together for solving bioaerosol challenges and addressing key scientific problems, e.g., bioaerosol spread, real-time detection, indoor microbes, human bioaerosol emissions, and bio-defense. Toward this effort, a “Bioaerosol Xiangshan Science Conference-the 600th” has been successfully held in the summer in Beijing, China. A total of 47 scientists and funding agency officials including leading bioaerosol experts from overseas were invited and two-day long extensive discussions on bioaerosol progress and problems were carried out. Future bioaerosol directions have been outlined by the attendees during the conference. Some of the participants have also contributed to this bioaerosol special issue. This special issue consists of a total of 20 bioaerosol articles from eight countries including one review, and contributes to the advances in bioaerosol emission, transmission, health effects, ambient bioaerosols, method development and instrumentation, and control. Through this special issue, the bioaerosol community has obtained a better understanding of bioaerosol health risks and developed the corresponding strategies to confront the threats. This special issue might serve as a starting point to not only link bioaerosol scientists from different continents, but also bring together people from various fields yet with an interest in bioaerosol to collectively advance the field further.


title: Alpha/Beta Interferon (IFN-α/β) Signaling in Astrocytes Mediates Protection against Viral Encephalomyelitis and Regulates IFN-γ-Dependent Responses

text: The contribution of distinct central nervous system (CNS) resident cells to protective alpha/beta interferon (IFN-α/β) function following viral infections is poorly understood. Based on numerous immune regulatory functions of astrocytes, we evaluated the contribution of astrocyte IFN-α/β signaling toward protection against the nonlethal glia- and neuronotropic mouse hepatitis virus (MHV) strain A59. Analysis of gene expression associated with IFN-α/β function, e.g., pattern recognition receptors (PRRs) and interferon-stimulated genes (ISGs), revealed lower basal mRNA levels in brain-derived astrocytes than in microglia. Although astrocytes poorly induced Ifnβ mRNA following infection, they upregulated various mRNAs in the IFN-α/β pathway to a higher extent than microglia, supporting effective IFN-α/β responsiveness. Ablation of the IFN-α/β receptor (IFNAR) in astrocytes using mGFAPcre IFNAR(fl/fl) mice resulted in severe encephalomyelitis and mortality, coincident with uncontrolled virus replication. Further, virus spread was not restricted to astrocytes but also affected microglia and neurons, despite increased and sustained Ifnα/β and ISG mRNA levels within the CNS. IFN-γ, a crucial mediator for MHV control, was not impaired in infected mGFAPcre IFNAR(fl/fl) mice despite reduced T cell CNS infiltration. Unexpectedly however, poor induction of IFN-γ-dependent major histocompatibility complex (MHC) class II expression on microglia supported that defective IFN-γ signaling contributes to uncontrolled virus replication. A link between sustained elevated IFN-α/β and impaired responsiveness to IFN-γ supports the novel concept that temporally limited early IFN-α/β responses are critical for effective antiviral IFN-γ function. Overall, our results imply that IFN-α/β signaling in astrocytes is not only critical in limiting early CNS viral spread but also promotes protective antiviral IFN-γ function. IMPORTANCE An antiviral state established by IFN-α/β contains initial viral spread as adaptive immunity develops. While it is apparent that the CNS lacks professional IFN-α/β producers and that resident cells have distinct abilities to elicit innate IFN-α/β responses, protective interactions between inducer and responder cells require further investigation. Infection with a glia- and neuronotropic coronavirus demonstrates that astrocytes mount a delayed but more robust response to infection than microglia, despite their lower basal mRNA levels of IFN-α/β-inducing components. Lethal, uncontrolled viral dissemination following ablation of astrocyte IFN-α/β signaling revealed the importance of IFN-α/β responses in a single cell type for protection. Sustained global IFN-α/β expression associated with uncontrolled virus did not suffice to protect neurons and further impaired responsiveness to protective IFN-γ. The results support astrocytes as critical contributors to innate immunity and the concept that limited IFN-α/β responses are critical for effective subsequent antiviral IFN-γ function.


title: COVID‐19 in a patient with pre‐existing acute lymphoblastic leukaemia

text: Coronavirus disease 2019 (COVID-19) is a novel respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), newly discovered since December 2019(Chen et al, 2020; Guan et al, 2020; Lu et al, 2020). According to WHO situation report (<https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports>) on 1 April, 2020, a total of 823626 cases and over 40000 death had been documented globally, rapidly evolving into a pandemic. As reported by previous studies, patients with pre-existing health conditions are more likely to progress to severe COVID-19 pneumonia(Guan et al, 2020; Huang et al, 2020; Yang et al, 2020; Zhao et al, 2020b). Here we report a COVID-19 case with pre-existing acute lymphoblastic leukemia(ALL).