title: Can N95 Respirators Be Reused after Disinfection? How Many Times?

text: The coronavirus disease 2019 (COVID-19) pandemic has led to a major shortage of N95 respirators, which are essential for protecting healthcare professionals and the general public who may come into contact with the virus. Thus, it is essential to determine how we can reuse respirators and other personal protective equipment in these urgent times. We investigated multiple commonly used disinfection schemes on media with particle filtration efficiency of 95%. Heating was recently found to inactivate the virus in solution within 5 min at 70 °C and is among the most scalable, user-friendly methods for viral disinfection. We found that heat (≤85 °C) under various humidities (≤100% relative humidity, RH) was the most promising, nondestructive method for the preservation of filtration properties in meltblown fabrics as well as N95-grade respirators. At 85 °C, 30% RH, we were able to perform 50 cycles of heat treatment without significant changes in the filtration efficiency. At low humidity or dry conditions, temperatures up to 100 °C were not found to alter the filtration efficiency significantly within 20 cycles of treatment. Ultraviolet (UV) irradiation was a secondary choice, which was able to withstand 10 cycles of treatment and showed small degradation by 20 cycles. However, UV can potentially impact the material strength and subsequent sealing of respirators. Finally, treatments involving liquids and vapors require caution, as steam, alcohol, and household bleach all may lead to degradation of the filtration efficiency, leaving the user vulnerable to the viral aerosols.


title: Exploring Lifestyle Habits, Physical Activity, Anxiety and Basic Psychological Needs in a Sample of Portuguese Adults during COVID-19

text: This cross-sectional study aimed to characterize the lifestyle habits, anxiety levels and basic psychological needs (BPN), in Portuguese adults during the Coronavirus Disease 2019 (COVID-19) pandemic, including a comparison between genders and age groups. In total, 1404 adults (36.4 ± 11.7 years; 69.6% female) answered sociodemographic data and three instruments: the International Physical Activity Questionnaire, the Basic Need General Satisfaction Scale and the State-Trait Anxiety Inventory. Males revealed higher values for the total energy expenditure (z = -2.26; p = 0.024; Î· 2 = 0.004) and for the level of satisfaction of competence (z = -2.62; p = 0.009; Î· 2 = 0.005). Females showed higher scores for the anxiety state (z = -7.87; p ≤ 0.001; Î· 2 = 0.044) and anxiety trait (z = -6.49; p ≤ 0.001; Î· 2 = 0.030). Regarding age, higher values for the anxiety trait (p ≤ 0.001; Î· H 2 = 0.030) were found in the 18-34 years-old group compared to all the other age groups, also presenting significantly higher values of total energy expenditure (χ² = 13.93; p = 0.008; Î· H 2 = 0.007) when compared to the 35-44 years-old group. Significant differences were observed between the 18-34 years-old group and the other age groups for the satisfaction of competence (χ² = 40.97; p ≤ 0.001; Î· H 2 = 0.026), except for the >65 years-old group. Strategies for promoting well-being during periods of social isolation should consider the role of psychological dimensions and lifestyle habits according to the gender or age group.


COVID-19 infection associated with autoimmune hemolytic anemia


Pertinence of Telehealth in a Rush Conversion to Virtual Allergy Practice during the COVID-19 Outbreak


title: Manejo de pacientes oncológicos en la pandemia por COVID-19

text: El documento contiene las estrategias para la reducción de riesgo de infección por COVID-19 en pacientes oncológicos y sus cuidadores


title: Natural-like products as potential SARS-CoV-2 Mpro inhibitors: in-silico drug discovery

text: In December 2019, a COVID-19 epidemic was discovered in Wuhan, China, and since has disseminated around the world impacting human health for millions. Herein, in-silico drug discovery approaches have been utilized to identify potential natural products (NPs) as Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) main protease (Mpro) inhibitors. The MolPort database that contains over 100,000 NPs was screened and filtered using molecular docking techniques. Based on calculated docking scores, the top 5,000 NPs/natural-like products (NLPs) were selected and subjected to molecular dynamics (MD) simulations followed by molecular mechanics-generalized Born surface area (MM-GBSA) binding energy calculations. Combined 50 ns MD simulations and MM-GBSA calculations revealed nine potent NLPs with binding affinities (ΔGbinding ) > -48.0 kcal/mol. Interestingly, among the identified NLPs, four bis([1,3]dioxolo)pyran-5-carboxamide derivatives showed ΔGbinding > -56.0 kcal/mol, forming essential short hydrogen bonds with HIS163 and GLY143 amino acids via dioxolane oxygen atoms. Structural and energetic analyses over 50 ns MD simulation demonstrated NLP-Mpro complex stability. Drug-likeness predictions revealed the prospects of the identified NLPs as potential drug candidates. The findings are expected to provide a novel contribution to the field of COVID-19 drug discovery. Communicated by Ramaswamy H. Sarma.


title: Epidemic analysis of COVID-19 in Brazil by a generalized SEIR model

text: We shall apply a generalized SEIR model to study the outbreak of COVID-19 in Brazil. In particular, we would like to explain the projections of the increase in the level of infection over a long period of time, overlapping large local outbreaks in the most populous states in the country. A time-dependent dynamic SEIR model inspired in a model previously used during the outbreak in China was used to analyses the time trajectories of infected, recovered, and deaths. The model has parameters that vary with time and are fitted considering a nonlinear least-squares method. The simulations starting from April 8, 2020, concluded that the time for a peak in Brazil will be in July 21, 2020 with total cumulative infected cases around 982K people; in addition, an estimated total death case will reach to 192K in the end. Besides that, Brazil will reach a peak in terms of daily new infected cases and death cases around the middle of July with 50K cases of infected and almost 6.0K daily deaths.


title: Failure in initial stage containment of global COVID-19 epicenters

text: With multiple virus epicenters, COVID-19 has been declared a pandemic by the World Health Organization. Consequently, many countries have implemented different policies to manage this crisis including curfew and lockdown. However, the efficacy of individual policies remains unclear with respect to COVID-19 case development. We analyzed available data on COVID-19 cases of eight majorly affected countries, including China, Italy, Iran, Germany, France, Spain, South Korea, and Japan. Growth rates and doubling time of cases were calculated for the first 6 weeks after the initial cases were declared for each respective country and put into context with implemented policies. Although the growth rate of total confirmed COVID-19 cases in China has decreased, those for Japan have remained constant. For European countries, the growth rate of COVID-19 cases considerably increased during the second time interval. Interestingly, the rates for Germany, Spain, and France are the highest measured in the second interval and even surpass the numbers in Italy. Although the initial data in Asian countries are encouraging with respect to case development at the initial stage, the opposite is true for European countries. Based on our data, disease management in the 2 weeks following the first reported cases is of utmost importance.


Glove-Wall System for Respiratory Specimen Collection and COVID-19 Mass Screening


Reply: COVID-19 and human reproduction: hypothesis need to be investigated


Reply: COVID-19 and human reproduction: hypothesis needs to be investigated


title: A war of attrition against antibiotic resistance: Current strategies try to keep antibiotic resistance at bay and further encourage research to produce genuinely novel antibacterials

text: To fight antibiotic resistance, novel drugs are urgently needed. Regulatory agencies are addressing the economic problems and offer new incentives for developing new antibiotics.


Disproportionate impact of COVID-19 pandemic on head and neck cancer survivors


Clinical features and outcomes of coronavirus disease 2019 (COVID-19) patients with chronic Hepatitis B virus infection


Impact of Covid-19 on the treatment of acute myeloid leukemia


title: Conserved High Free Energy Sites in Human Coronavirus Spike Glycoprotein Backbones

text: Methods previously developed by the author are applied to uncover several sites of interest in the spike glycoproteins of all known human coronaviruses (hCoVs), including SARS-CoV-2 that causes COVID-19. The sites comprise three-dimensional neighborhoods of peptides characterized by four key properties: (1) they pinpoint regions of high free energy in the backbone whose obstruction might interrupt function; (2) by their very definition, they occur rarely in the universe of all gene-encoded proteins that could obviate host response to compounds designed for their interference; (3) they are common to all known hCoV spikes, possibly retaining activity in light of inevitable viral mutation; and (4) they are exposed in the molecular surface of the glycoprotein. These peptides in SARS-CoV-2 are given by the triples of residues (131, 117, 134), (203, 227, 228), and (1058, 730, 731) in its spike.


title: Evolution of Chinese airport network

text: With the rapid development of economy and the accelerated globalization process, the aviation industry plays more and more critical role in today's world, in both developed and developing countries. As the infrastructure of aviation industry, the airport network is one of the most important indicators of economic growth. In this paper, we investigate the evolution of Chinese airport network (CAN) via complex network theory. It is found that although the topology of CAN remains steady during the past several years, there are many dynamic switchings inside the network, which changes the relative relevance of airports and airlines. Moreover, we investigate the evolution of traffic flow (passengers and cargoes) on CAN. It is found that the traffic keeps growing in an exponential form and it has evident seasonal fluctuations. We also found that cargo traffic and passenger traffic are positively related but the correlations are quite different for different kinds of cities.


title: SAGES and EAES recommendations for minimally invasive surgery during COVID-19 pandemic

text: The unprecedented pandemic of COVID-19 has impacted many lives and affects the whole healthcare systems globally. In addition to the considerable workload challenges, surgeons are faced with a number of uncertainties regarding their own safety, practice, and overall patient care. This guide has been drafted at short notice to advise on specific issues related to surgical service provision and the safety of minimally invasive surgery during the COVID-19 pandemic. Although laparoscopy can theoretically lead to aerosolization of blood borne viruses, there is no evidence available to confirm this is the case with COVID-19. The ultimate decision on the approach should be made after considering the proven benefits of laparoscopic techniques versus the potential theoretical risks of aerosolization. Nevertheless, erring on the side of safety would warrant treating the coronavirus as exhibiting similar aerosolization properties and all members of the OR staff should use personal protective equipment (PPE) in all surgical procedures during the pandemic regardless of known or suspected COVID status. Pneumoperitoneum should be safely evacuated via a filtration system before closure, trocar removal, specimen extraction, or conversion to open. All emergent endoscopic procedures performed during the pandemic should be considered as high risk and PPE must be used by all endoscopy staff.


Chloroquine and hydroxychloroquine as available weapons to fight COVID-19


Perspectives on vascular surgical practice change due to COVID-19 at a nonacademic tertiary care center


title: Orf Virus VIR Antagonizes p53-Mediated Antiviral Effects to Facilitate Viral Replication

text: As a zoonotic disease, ovine contagious pustular dermatitis (Orf) is a serious threat to sheep as well as humans. Orf virus (ORFV) interferon resistance protein (VIR) is the principal virulence protein that encodes a dsRNA-binding protein to inhibit host antiviral response. p53 is one of the key proteins of the host antiviral innate immunity. It not only enhances type I interferon secretion but also induces apoptosis in infected cells, and plays a crucial role in the immune response against various viral infections. However, it remains to be elucidated what role p53 plays in ORFV replication and whether ORFV's own protein VIR regulates p53 expression to promote self-replication. In this study, we showed that p53 has an antiviral effect on ORFV and can inhibit ORFV replication. In addition, ORFV nonstructural protein VIR interacts with p53 and degrades p53, which inhibits p53-mediated positive regulation of downstream antiviral genes. This study provides new insight into the immune evasion mediated by ORFV and identifies VIR as an antagonistic factor for ORFV to evade the antiviral response.


The increasing impact of Chinese innovative drug research on the global stage with a focus on drug discovery


title: Atypical presentations of coronavirus disease 2019 in a patient with acute obstructive suppurative cholangitis

text: During the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak in Wuhan, China, we experienced a case of SARS-CoV-2 infection with atypical presentations in a patient with acute obstructive suppurative cholangitis (AOSC), who was initially admitted with jaundice and fever. The patient had no other typical symptoms of COVID-19 such as cough, dyspnea, nausea, vomiting, abdominal pain and diarrhea except for fever, but her epidemiological history was clear. COVID-19 was finally confirmed by repeated viral nucleic acid testing, but her repetitive lungs CT imaging findings had been atypical. After endoscopic-related operations and antiviral treatment, the patient was subsequently recovered and discharged. This particular case is being reported to provide a reference and guidance for the diagnosis and management of COVID-19 in AOSC.


title: Special report: Early use of ICD-10-CM code "U07.1, COVID-19" to identify 2019 novel coronavirus cases in Military Health System administrative data

text: This report describes early exploratory analysis of ICD-10-CM code U07.1 (2019-nCoV acute respiratory disease [COVID-19]) to assess the use of administrative data for case ascertainment, syndromic surveillance, and future epidemiological studies. Out of the 2,950 possible COVID-19 cases identified between 1 April 2020 and 4 May 2020, 600 (20.3%) were detected in the Defense Medical Surveillance System (DMSS) and not in the Disease Reporting System internet (DRSi) or in Health Level 7 laboratory data from the Composite Health Care System. Among the 150 out of 600 cases identified exclusively in the DMSS and selected for Armed Forces Health Longitudinal Technology Application (AHLTA) review, 16 (10.7%) had a certified positive lab result in AHLTA, 17 (11.3%) met Council of State and Territorial Epidemiologists (CSTE) criteria for a probable case, 46 (30.7%) were not cases based on CSTE criteria, and 71 (47.3%) had evidence of a positive lab result from an outside source. Lack of full capture of lab results may continue to be a challenge as the variety of available tests expands. Administrative data may provide an important stopgap measure for detecting lab positive cases, pending incorporation of new COVID-19 tests and standardization of test and result nomenclature.


Aerosol treatments for childhood asthma in the era of COVID-19


title: Royal Flying Doctor Service COVID-19 activity and surge modelling in Australia

text: Introduction: There is a COVID-19 pandemic. We aimed to describe the characteristics of patients transported by the Royal Flying Doctor Service (RFDS) for confirmed or suspected Coronavirus disease 2019 (COVID-19), and to investigate surge capacity of, and operational implications for, the RFDS in dealing with COVID-19. Methods: Prospective cohort study. To determine the characteristics of patients transported for confirmed or suspected COVID-19, we included patient data from 02 February 2020 to 06 May 2020. To investigate surge capacity and operational implications for RFDS in dealing with COVID-19, we built, and validated, an interactive operations area level discrete-event simulation decision support model, underpinned by RFDS aeromedical activity data from 2015 to 2019 (4-years). This model was subsequently used in a factorial in silico experiment to systematically investigate both the supply of RFDS aeromedical services and the increased rates of demand for these services, for diseases of the respiratory system. Results: The RFDS conducted 291 patient episodes of care for confirmed or suspected COVID-19. This included 288 separate patients, including 136 males and 119 females (gender missing=33), with a median age of 62.0 years (IQR=43.5-74.9). The simulation decision support model we developed is capable of providing dynamic and real-time support for RFDS decision-makers in understanding the system's performance under uncertain COVID-19 demand. With increased COVID-19 related demand, the ability of the RFDS to cope will be driven by the number of aircraft available. The simulation model provided each aviation section with estimated numbers of aircraft required to meet a range of anticipated demands. Conclusion: Despite the lack of certainty in the actual level of COVID-19 related demand for RFDS services, modelling demonstrates that robustness of meeting such demand increases with the number of operational and medically staffed aircraft.


title: Interventions improving health professionals' practice for addressing patients' weight management behaviours: systematic review of reviews

text: Health professionals require education and training to implement obesity management guidelines and ultimately impact on the health outcomes experienced by their patients. Therefore, a systematic review of systematic reviews that evaluated interventions designed to change the practice of health professionals when addressing diet and physical activity with their patients was conducted. MEDLINE Complete; Cochrane database of systematic reviews; PsycINFO; CINAHL Complete; Global Health; Embase; INFORMIT: Health Subset; Health System Evidence and RX for change were searched in March 2019, with no date or language limits. Identified references underwent screening, full-text analyses and data extraction in duplicate. The search identified 15 230 references. Five systematic reviews that provided a narrative syntheses of a combined 38 studies were included. Health professional participants generally reported being satisfied with the training interventions. Heterogeneity between and within included reviews, non-controlled designs of individual studies and low quality of evidence at an individual study level and review level made it difficult to draw firm conclusions regarding what interventions are most effective in changing health professionals' knowledge, skills, self-efficacy, attitudes and practice. However, similar gaps in the literature were identified across included reviews. Key areas that could be addressed in future interventions including organization and system-level barriers to providing advice, health professionals' attitudes and motivation and weight stigma have been highlighted. Health professionals and patients could be more involved in the planning and development of interventions that work towards improving diet and physical activity advice and support provided in healthcare.


Pain Management During COVID-19 and Steroids: Striking a Balance


Firearms or SARS-Cov-2: what is the most lethal?


title: Mitochondria and Microbiota dysfunction in COVID-19 pathogenesis

text: The COVID-19 pandemic caused by the coronavirus (SARS-CoV-2) has taken the world by surprise into a major crisis of overwhelming morbidity and mortality. This highly infectious disease is associated with respiratory failure unusual in other coronavirus infections. Mounting evidence link the accelerated progression of the disease in COVID-19 patients to the hyper-inflammatory state termed as the "cytokine storm" involving major systemic perturbations. These include iron dysregulation manifested as hyperferritinemia associated with disease severity. Iron dysregulation induces reactive oxygen species (ROS) production and promotes oxidative stress. The mitochondria are the hub of cellular oxidative homeostasis. In addition, the mitochondria may circulate "cell-free" in non-nucleated platelets, in extracellular vesicles and mitochondrial DNA is found in the extracellular space. The heightened inflammatory/oxidative state may lead to mitochondrial dysfunction leading to platelet damage and apoptosis. The interaction of dysfunctional platelets with coagulation cascades aggravates clotting events and thrombus formation. Furthermore, mitochondrial oxidative stress may contribute to microbiota dysbiosis, altering coagulation pathways and fueling the inflammatory/oxidative response leading to the vicious cycle of events. Here, we discuss various cellular and systemic incidents caused by SARS-CoV-2 that may critically impact intra and extracellular mitochondrial function, and contribute to the progression and severity of the disease. It is crucial to understand how these key modulators impact COVID-19 pathogenesis in the quest to identify novel therapeutic targets that may reduce fatal outcomes of the disease.


Plea for multitargeted interventions for severe COVID-19


Dynamics of faecal SARS-CoV-2 in infected children during the convalescent phase


title: The psycho-social effects of COVID-19 on Italian adolescents' attitudes and behaviors

text: BACKGROUND: COVID-19 is an emerging issue that has significant consequences on psycho-social well-being. METHODS: In this regard, a survey was conducted on a large group of adolescents in Italy. The survey investigated four items: concerns and fears, information on the pandemic, provisions of public authorities (e.g., lockdown), and impact on everyday life. RESULTS: Adolescents actively participated in the survey. COVID-19 affected emotions and lifestyle. COVID-19 influenced relationships with peers and parents. There were regional differences. CONCLUSIONS: The current research highlighted the remarkable, healthy, and certainly unexpected, emotional balance of the new generations in the face of a sudden, unpredictable phenomenon capable of jeopardizing life itself. While understanding the gravity of the phenomenon and willingly adapting to all the necessary precautions, the adolescents still seemed to express an excellent ability to manage situations of insecurity and to deal with unfavorable and adverse conditions by adapting to the new routine and finding alternative and innovative means of meeting their social and psychological needs.


Navigating Nonessential Research Trials During COVID-19: The Push We Needed for Using Digital Technology to Increase Access for Rural Participants?


title: Prophylaxie post-exposition ou traitement préventif pour le syndrome respiratoire aigu sévère du coronavirus 2 (SARS-CoV-2) : protocole d'étude pour une étude randomisée contrôlée pragmatique./ Post-exposure prophylaxis or pre-emptive therapy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): study protocol for a pragmatic randomized-controlled trial

text: BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 causing the coronavirus disease (COVID-19) pandemic. Currently, there is a lack of evidence-based therapies to prevent COVID-19 following exposure to the virus, or to prevent worsening of symptoms following confirmed infection. We describe the design of a clinical trial of hydroxychloroquine for post-exposure prophylaxis (PEP) and pre-emptive therapy (PET) for COVID-19. METHODS: We will conduct two nested multicentre international double-blind randomized placebo-controlled clinical trials of hydroxychloroquine for: 1) PEP of asymptomatic household contacts or healthcare workers exposed to COVID-19 within the past four days, and 2) PET for symptomatic outpatients with COVID-19 showing symptoms for less than four days. We will recruit 1,500 patients each for the PEP and PET trials. Participants will be randomized 1:1 to receive five days of hydroxychloroquine or placebo. The primary PEP trial outcome will be the incidence of symptomatic COVID-19. The primary PET trial outcome will be an ordinal scale of disease severity (not hospitalized, hospitalized without intensive care, hospitalization with intensive care, or death). Participant screening, informed consent, and follow-up will be exclusively internet-based with appropriate regulatory and research ethics board approvals in Canada and the United States. DISCUSSION: These complementary randomized-controlled trials are innovatively designed and adequately powered to rapidly answer urgent questions regarding the effectiveness of hydroxychloroquine to reduce virus transmission and disease severity of COVID-19 during a pandemic. In-person participant follow-up will not be conducted to facilitate social distancing strategies and reduce risks of exposure to study personnel. Innovative trial approaches are needed to urgently assess therapeutic options to mitigate the global impact of this pandemic. TRIALS REGISTRATION: clinicaltrials.gov (NCT04308668); registered 16 March, 2020.


title: SARS-CoV-2 orf1b Gene Sequence in the NTNG1 Gene on Human Chromosome 1

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a positive-sense single-stranded RNA virus. It is contagious in humans and is the cause of the coronavirus disease 2019 (COVID-19) pandemic. In the current analysis, we searched for SARS-CoV-2 sequences within the human genome. To compare the SARS-CoV-2 genome to the human genome, we used the blast-like alignment tool (BLAT) of the University of California, Santa Cruz Genome Browser. BLAT can align a user sequence of 25 bases or more to the genome. BLAT search results revealed a 117-base pair SARS-CoV-2 sequence in the human genome with 94.6% identity. The sequence was in chromosome 1p within an intronic region of the netrin G1 (NTNG1) gene. The sequence matched a sequence in the SARS-CoV-2 orf1b (open reading frames) gene. The SARS-CoV-2 human sequence lies within non-structural proteins 14 and 15 (NSP14 and NSP15), and is quite close to the viral spike sequence, separated only by NSP16, a 904-base pair sequence. The mechanism for SARS-CoV-2 infection is the binding of the virus spike protein to the membrane-bound form of angiotensin-converting enzyme 2 and internalization of the complex by the host cell. It is probably no accident that a sequence from the SARS-CoV-2 orf1b gene is found in the human NTNG1 gene, implicated in schizophrenia, and that haloperidol, used to treat schizophrenia, may also be a treatment for COVID-19. We suggest, therefore, that it is important to investigate other haloperidol analogs. Among them are benperidol, bromperidol, bromperidol decanoate, droperidol, seperidol hydrochloride, and trifluperidol. These analogs might be valuable in the treatment of COVID-19 and other coronavirus infections.


CT screening for early diagnosis of SARS-CoV-2 infection - Authors' reply


Caution when linking COVID-19 to mental health consequences


On Tuberculosis and COVID-19 co-infection


title: Management of used personal protective equipment and wastes related to COVID-19 in South Korea

text: With the rapid spread of coronavirus disease 2019 (COVID-19), the amount of used personal protective equipment (PPE) including face masks and protective clothes has significantly increased. This used PPE in a hospital can lead to the indirect infection by COVID-19. Accordingly, it has been recognized that the management of used PPE is very important to prevent the spread of COVID-19. Through the experience of spreading some infectious diseases such as severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola virus in South Korea (Republic of Korea), a safe management method of waste related to infectious diseases has been developed. In addition, regarding waste related to COVID-19, the Ministry of Environment, SK, proposed special measures to strengthen the management process of waste related to COVID-19 based on principles such as sustainability, transparency and safety.


title: A Putative Role of de-Mono-ADP-Ribosylation of STAT1 by the SARS-CoV-2 Nsp3 Protein in the Cytokine Storm Syndrome of COVID-19

text: As more cases of COVID-19 are studied and treated worldwide, it had become apparent that the lethal and most severe cases of pneumonia are due to an out-of-control inflammatory response to the SARS-CoV-2 virus. I explored the putative causes of this specific feature through a detailed genomic comparison with the closest SARS-CoV-2 relatives isolated from bats, as well as previous coronavirus strains responsible for the previous epidemics (SARS-CoV and MERS-CoV). The high variability region of the nsp3 protein was confirmed to exhibit the most variations between closest strains. It was then studied in the context of physiological and molecular data available in the literature. A number of convergent findings suggest de-mono-ADP-ribosylation (de-MARylation) of STAT1 by the SARS-CoV-2 nsp3 as a putative cause of the cytokine storm observed in the most severe cases of COVID-19. This may suggest new therapeutic approaches and help in designing assays to predict the virulence of naturally circulating SARS-like animal coronaviruses.


title: Perspective of Medical Students on the COVID-19 Pandemic: Survey of Nine Medical Schools in Uganda

text: BACKGROUND: The coronavirus disease (COVID-19) pandemic is a global public health concern affecting over 5 million people and posing a great burden on health care systems worldwide. OBJECTIVE: The aim of this study is to determine the knowledge, attitude, and practices of medical students in Uganda on the COVID-19 pandemic. METHODS: We conducted an online, descriptive cross-sectional study in mid-April 2020, using WhatsApp Messenger. Medical students in 9 of the 10 medical schools in Uganda were approached through convenience sampling. Bloom's cut-off of 80% was used to determine good knowledge (≥12 out of 15), positive attitude (≥20 out of 25), and good practice (≥12 out of 15). RESULTS: The data of 741 first- to fifth-year medical students, consisting of 468 (63%) males with a mean age of 24 (SD 4) years, were analyzed. The majority (n=626, 84%) were pursuing Bachelor of Medicine and Bachelor of Surgery degrees. Overall, 671 (91%) had good knowledge, 550 (74%) had a positive attitude, and 426 (57%) had good practices. Knowledge was associated with the 4th year of study (adjusted odds ratio [aOR] 4.1, 95% CI 1.6-10.3; P<.001). Attitude was associated with the female sex (aOR 0.7, 95% CI 0.5-1; P=.04) and TV or radio shows (aOR 1.1, 95% CI 0.6-2.1; P=.01). Practices were associated with the ≥24 years age category (aOR 1.5, 95% CI 1.1-2.1; P=.02) and online courses (aOR 1.8, 95% CI 1.1-3.2; P=.03). In total, 592 (80%) medical students were willing to participate in frontline care if called upon. CONCLUSIONS: Medical students in Uganda have sufficient knowledge of COVID-19 and will be a large reservoir for health care response when the need arises.


title: Chronology of COVID-19 Cases on the Diamond Princess Cruise Ship and Ethical Considerations: A Report From Japan

text: The Diamond Princess cruise ship has been anchored at the Yokohama port in Japan since February 3, 2020. A total of 691 cases of the coronavirus disease 2019 (COVID-19) infection had been confirmed as of February 23. The government initially assumed that the infection was not spreading aboard and therefore indicated that any persons who either tested negative for the virus or were asymptomatic should immediately disembark. However, on February 5, the government set a 14-day health observation period because of the severity of the infection. Passengers confirmed to be free from infection began disembarking on Day 15 (February 19) of the quarantine. The effectiveness and validity of infection control, justification for the timing of inspections, and even the nature of COVID-19 itself now are all in question. The ethical considerations related to cruise ship infection control include the reasonable justification for isolation, the psychological fragility and quality of life of the isolated passengers and crew members, the procedural justice inherent in a forced quarantine, and the optimization of control measures.The international coordination framework and the global ramifications of such outbreaks should be reevaluated by the international community. Denying a ship's entry based on local politics is incompatible with global justice. Events such as these require an international response and global regulations that seek to reduce disparities.


title: Abnormal liver function tests predict transfer to intensive care unit and death in COVID-19

text: BACKGROUND: The pandemic of coronavirus disease 2019 (COVID-19) has emerged as a relevant threat for humans worldwide. Abnormality in liver function tests (LFTs) has been commonly observed in patients with COVID-19, but there is controversy on its clinical significance. The aim of this study was to assess the prevalence, the characteristics and the clinical impact of abnormal LFTs in hospitalized, non-critically ill patients with COVID-19. METHODS: In this multicentre, retrospective study, we collected data about 565 inpatients with COVID-19. Data on LFTs were collected at admission and every 7 ± 2 days during the hospitalization. The primary outcome was a composite endpoint of death or transfer to intensive care unit (ICU). RESULTS: Upon admission 329 patients (58%) had LFTs abnormality. Patients with abnormal LFTs had more severe inflammation and higher degree of organ dysfunction than those without. During hospitalization, patients with abnormal LFTs had a higher rate of transfer to ICU (20% vs 8%; P < .001), acute kidney injury (22% vs 13%, P = .009), need for mechanical ventilation (14% vs 6%; P = .005) and mortality (21% vs 11%; P = .004) than those without. In multivariate analysis, patients with abnormal LFTs had a higher risk of the composite endpoint of death or transfer to ICU (OR = 3.53; P < .001). During the hospitalization, 86 patients developed de novo LFTs abnormality, which was associated with the use of tocilizumab, lopinavir/ritonavir and acetaminophen and not clearly associated with the composite endpoint. CONCLUSIONS: LFTs abnormality is common at admission in patients with COVID-19, is associated with systemic inflammation, organ dysfunction and is an independent predictor of transfer to ICU or death.


Think national, act local: the role of the physician and the RCP


A SARS-Cov2-negative corona victim


Impact of the COVID-19 Pandemic on Paediatric Urology Practice in Europe: A Reflection from the European Association of Urology Young Academic Urologists


Urgent digestive surgery, a collateral victim of the COVID-19 crisis?


title: Controlled human infection with SARS-CoV-2 to study COVID-19 vaccines and treatments: bioethics in Utopia

text: A number of papers have appeared recently arguing for the conclusion that it is ethically acceptable to infect healthy volunteers with severe acute respiratory syndrome coronavirus 2 as part of research projects aimed at developing COVID-19 vaccines or treatments. This position has also been endorsed in a statement by a working group for the WHO. The papers generally argue that controlled human infection (CHI) is ethically acceptable if (1) the risks to participants are low and therefore acceptable, (2) the scientific quality of the research is high, (3) the research has high social value, (4) participants give full informed consent, and (5) there is fair selection of participants. All five conditions are necessary premises in the overall argument that such research is ethically acceptable. The arguments concerning risk and informed consent have already been critically discussed in the literature. This paper therefore looks specifically at the arguments relating to condition 3 'high social value' and condition 5 'fair selection of participants' and shows that whereas they may be valid, they are not sound. It is highly unlikely that the conditions that are necessary for ethical CHI trials to take place will be fulfilled. Most, if not all, CHI trials will thus be well intentioned but unethical.


The indispensable role of emergency medicine in national preparedness for high consequence infectious diseases (HCIDs)


Covid-19 is no worse in immunocompromised children, says NICE


title: A hypothesis on the role of the human immune system in covid-19

text: The COVID-19 pandemic has not spared any continent. The disease has affected more than 7,500,000 individuals globally and killed approximately 450,000 individuals. The disease is caused by a very small virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is an enveloped single-stranded RNA virus with a spike-like structure on its envelope that can interact with the angiotensin-converting enzyme 2 (ACE2) receptor after cleavage. ACE2 receptors are present in the human lungs and other organs. SARS-CoV-2 is a new virus that belongs to the subgenus Sarbecovirus; viruses in this subgenus have spread widely in the previous years and caused outbreaks of severe acute respiratory syndromes.


title: Quick Thinking Turns out Low-Cost Ventilators

text: As the number of coronavirus 2019 disease (COVID-19) cases in the United States began mounting in the early weeks of March, health care workers raised the alarm about a looming shortage of ventilators to treat patients. On March 30, 2020, Ford Motor Company announced plans to produce 50,000 ventilators in 100 days [1], and General Motors followed suit on April 8, stating that it would deliver out 6,000 ventilators by the end of May and another 24,000 by August [2].


Comment on "Beware of Too Aggressive Approach in Children With Acute Abdomen During COVID-19 Outbreak!"


title: The Technique and Justification for Minimally Invasive Surgery in COVID-19 Pandemic: Laparoscopic Anterior Resection for Near Obstructed Rectal Carcinoma

text: Introduction: The recent COVID-19 pandemic outbreak has made surgeons change and take on newer strategies and safe exercises. All elective cases have been put off, but oncology cases need to be done to prevent progression of the disease. There is concern about minimally invasive surgery due to aerosol formation. Here we discuss how we have dealt with this in our colorectal surgery department taking into account current evidence about the danger of viral transmission during laparoscopic surgery. Discussion: We report a case of 28 years old female patient with carcinoma rectum. The patient had near total intestinal obstruction. She was operated on utilizing laparoscopic anterior resection. The air seal (CONMED, Utica, NY) and high-efficiency particulate air (HEPA) filter was utilized for safe gas evacuation. There is no evidence against laparoscopic surgery, which suggest viral transmission. One should take utmost precautions using N95 masks and personal protective equipment (PPE). Air filtration products like aerosol, HEPA filters will be of great aid in safe evacuation of gases. Conclusion: At present, there is no solid evidence to suggest viral transmission through surgical smoke. We believe due to effective smoke containment, less blood loss, and less postoperative stay, laparoscopy will be a non-inferior option than open surgical procedure. We advise taking all precautions for operating room staff to lessen the danger of transmission.


title: COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study

text: BACKGROUND: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. METHODS: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. FINDINGS: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68·0 years (61·8-75·0) and the majority had an Eastern Cooperative Oncology Group performance status of 0-1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1·88, 95% 1·00-3·62), being a current or former smoker (4·24, 1·70-12·95), receiving treatment with chemotherapy alone (2·54, 1·09-6·11), and the presence of any comorbidities (2·65, 1·09-7·46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3·18, 95% CI 1·11-9·06) was associated with increased risk of death. INTERPRETATION: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference. FUNDING: None.


title: [Fungal Infections]

text: In cancer patients, fungal diseases are rare but remains an important complication. Chemotherapy or surgery procedures are often delayed or postponed in patients with fungal disease which might lead to impaired overall survival. Candida, Aspergillus, Cryptococcus and Pneumocystis jirovecii have accounted for most of yeast and mold infections reported in cancer patients. We have to know each risk factor and clinical picture. Early diagnosis strategies improve cancer outcomes. Recently immune checkpoint inhibitors(ICIs)-anti-PD-1(nivolumab, pembrolizumab), anti-PD-L1(atezolizumab, avelumab), anti- CTLA-4(ipilimumab)-have improved outcomes for several malignancies. Use of these drugs is associated with immunerelated adverse effects, requirement for immunosuppressive therapy. Prolonged immunosuppressive therapies may increase fungal diseases.


title: A note on blind contact tracing at scale with applications to the COVID-19 pandemic

text: The current COVID-19 pandemic highlights the utility of contact tracing, when combined with case isolation and social distancing, as an important tool for mitigating the spread of a disease [1]. Contact tracing provides a mechanism of identifying individuals with a high likelihood of previous exposure to a contagious disease, allowing additional precautions to be put in place to prevent continued transmission. Here we consider a cryptographic approach to contact tracing based on secure two-party computation (2PC). We begin by considering the problem of comparing a set of location histories held by two parties to determine whether they have come within some threshold distance while at the same time maintaining the privacy of the location histories. We propose a solution to this problem using pre-shared keys, adapted from an equality testing protocol due to Ishai et al [2]. We discuss how this protocol can be used to maintain privacy within practical contact tracing scenarios, including both app-based approaches and approaches which leverage location history held by telecoms and internet service providers. We examine the efficiency of this approach and show that existing infrastructure is sufficient to support anonymised contact tracing at a national level.


title: Fiducial displacements with improved accuracy for the global network of gravitational wave detectors

text: As sensitivities improve and more detectors are added to the global network of gravitational wave observatories, calibration accuracy and precision are becoming increasingly important. Photon calibrators, relying on power-modulated auxiliary laser beams reflecting from suspended interferometer optics, enable continuous calibration by generating displacement fiducials proportional to the modulated laser power. Developments in the propagation of laser power calibration via transfer standards to on-line power sensors monitoring the modulated laser power have enabled generation of length fiducials with improved accuracy. Estimated uncertainties are almost a factor of two smaller than the lowest values previously reported. This is partly due to improvements in methodology that have increased confidence in the results reported. Referencing the laser power calibration standards for each observatory to a single transfer standard enables reducing relative calibration errors between elements of the detector network. Efforts within the national metrology institute community to realize improved laser power sensor calibration accuracy are ongoing.


title: Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic

text: The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available.


title: Using integrated computational approaches to identify safe and rapid treatment for SARS-CoV-2

text: SARS-CoV-2 is a new generation of coronavirus, which was first determined in Wuhan, China, in December 2019. So far, however, there no effective treatment has been found to stop this new generation of coronavirus but discovering of the crystal structure of SARS-CoV-2 main protease (SARS-CoV-2 Mpro) may facilitate searching for new therapies for SARS-COV-2. The aim was to assess the effectiveness of available FDA approved drugs which can construct a covalent bond with Cys145 inside binding site SARS-CoV-2 main protease by using covalent docking screening. We conducted the covdock module MMGBSA module in the Schrodinger suite 2020-1, to examine the covalent bonding utilizing. Besides, we submitted the top three drugs to molecular dynamics simulations via Gromacs 2018.1. The covalent docking showed that saquinavir, ritonavir, remdesivir, delavirdine, cefuroxime axetil, oseltamivir and prevacid have the highest binding energies MMGBSA of -72.17, -72.02, -65.19, -57.65, -54.25, -51.8, and -51.14 kcal/mol, respectively. The 50 ns molecular dynamics simulation was conducted for saquinavir, ritonavir and remdesivir to evaluate the stability of these drugs inside the binding pocket of SARS-CoV-2 main protease. The current study provides a powerful in silico results, means for rapid screening of drugs as anti-protease medications and recommend that the above-mentioned drugs can be used in the treatment of SARS-CoV-2 in combined or sole therapy.Communicated by Ramaswamy H. Sarma.


Healthcare Resource Management and Pandemic Preparedness for COVID-19: A Single Centre Experience From Jodhpur, India


title: Visualizing the invisible: class excursions to ignite children's enthusiasm for microbes

text: We have recently argued that, because microbes have pervasive - often vital - influences on our lives, and that therefore their roles must be taken into account in many of the decisions we face, society must become microbiology-literate, through the introduction of relevant microbiology topics in school curricula (Timmis et al. 2019. Environ Microbiol 21: 1513-1528). The current coronavirus pandemic is a stark example of why microbiology literacy is such a crucial enabler of informed policy decisions, particularly those involving preparedness of public-health systems for disease outbreaks and pandemics. However, a significant barrier to attaining widespread appreciation of microbial contributions to our well-being and that of the planet is the fact that microbes are seldom visible: most people are only peripherally aware of them, except when they fall ill with an infection. And it is disease, rather than all of the positive activities mediated by microbes, that colours public perception of 'germs' and endows them with their poor image. It is imperative to render microbes visible, to give them life and form for children (and adults), and to counter prevalent misconceptions, through exposure to imagination-capturing images of microbes and examples of their beneficial outputs, accompanied by a balanced narrative. This will engender automatic mental associations between everyday information inputs, as well as visual, olfactory and tactile experiences, on the one hand, and the responsible microbes/microbial communities, on the other hand. Such associations, in turn, will promote awareness of microbes and of the many positive and vital consequences of their actions, and facilitate and encourage incorporation of such consequences into relevant decision-making processes. While teaching microbiology topics in primary and secondary school is key to this objective, a strategic programme to expose children directly and personally to natural and managed microbial processes, and the results of their actions, through carefully planned class excursions to local venues, can be instrumental in bringing microbes to life for children and, collaterally, their families. In order to encourage the embedding of microbiology-centric class excursions in current curricula, we suggest and illustrate here some possibilities relating to the topics of food (a favourite pre-occupation of most children), agriculture (together with horticulture and aquaculture), health and medicine, the environment and biotechnology. And, although not all of the microbially relevant infrastructure will be within reach of schools, there is usually access to a market, local food store, wastewater treatment plant, farm, surface water body, etc., all of which can provide opportunities to explore microbiology in action. If children sometimes consider the present to be mundane, even boring, they are usually excited with both the past and the future so, where possible, visits to local museums (the past) and research institutions advancing knowledge frontiers (the future) are strongly recommended, as is a tapping into the natural enthusiasm of local researchers to leverage the educational value of excursions and virtual excursions. Children are also fascinated by the unknown, so, paradoxically, the invisibility of microbes makes them especially fascinating objects for visualization and exploration. In outlining some of the options for microbiology excursions, providing suggestions for discussion topics and considering their educational value, we strive to extend the vistas of current class excursions and to: (i) inspire teachers and school managers to incorporate more microbiology excursions into curricula; (ii) encourage microbiologists to support school excursions and generally get involved in bringing microbes to life for children; (iii) urge leaders of organizations (biopharma, food industries, universities, etc.) to give school outreach activities a more prominent place in their mission portfolios, and (iv) convey to policymakers the benefits of providing schools with funds, materials and flexibility for educational endeavours beyond the classroom.


title: COVID-19 Surface Persistence: A Recent Data Summary and Its Importance for Medical and Dental Settings

text: Recently, due to the coronavirus pandemic, many guidelines and anti-contagion strategies continue to report unclear information about the persistence of coronavirus disease 2019 (COVID-19) in the environment. This certainly generates insecurity and fear in people, with an important psychological component that is not to be underestimated at this stage of the pandemic. The purpose of this article is to highlight all the sources currently present in the literature concerning the persistence of the different coronaviruses in the environment as well as in medical and dental settings. As this was a current study, there are still not many sources in the literature, and scientific strategies are moving towards therapy and diagnosis, rather than knowing the characteristics of the virus. Such an article could be an aid to summarize virus features and formulate new guidelines and anti-spread strategies.


Establishing and Managing a Temporary Coronavirus Disease 2019 Specialty Hospital in Wuhan, China


title: Practice of Pharmaceutical Care in Designated Hospital under the Condition of Novel Coronavirus Pneumonia Epidemic/ 中国药房

text: OBJECTIVE：To shar e the experienc e of pharmaceutical care in Wuhan Jinyintan Hospital （herein after refers to “our hospital ”）under the condition of novel coronavirus pneumonia （COVID-19）epidemic，and to provide reference for other hospitals to deal with public health emergencies. METHODS ：The situation of pharmaceutical care in our hospital under the condition of COVID- 19 epidemic was summarized and shared ，including the epidemic prevention and control management （regional division ，disinfection management ，pharmacy personnel training ），supply of drugs and disinfection products ，the monitoring and education of rational drug use by information technology. RESULTS ：The pharmacy department of our hospital divided the activity scope into clean area ，potential pollution risk area ，semi pollution area ，and implement different disinfection management. All pharmacists received training ，involving personal health protection ，prevention and control knowledge of COVID-19，health status monitoring ，etc. For supply and guarantee of drugs and disinfectants ，the epidemic drug list of our hospital was formulated ，drugs and disinfectants were purchased accurately and stored in a standardized way. 24 h response telephone was set up in the clinical pharmacy room to receive consultation from clinicians on drug use at any time. The drugs mentioned in the COVID- 19 diagnosis scheme were compared in terms of the mechanism of action and the medication of special populations to form a tablet ，so as to help clinical rational choice treatment drug. CONCLUSIONS ：The pharmaceutical care in the designated hospital of COVID- 19 is a professional and complicated work ，involving a wide range of aspects. Pharmacy department must respond actively and adjust the strategy in time so as to play an important role in improving the ability of medical treatment.


Remdesivir as a possible therapeutic option for the COVID-19


title: Deep Learning for Portfolio Optimisation

text: We adopt deep learning models to directly optimise the portfolio Sharpe ratio. The framework we present circumvents the requirements for forecasting expected returns and allows us to directly optimise portfolio weights by updating model parameters. Instead of selecting individual assets, we trade Exchange-Traded Funds (ETFs) of market indices to form a portfolio. Indices of different asset classes show robust correlations and trading them substantially reduces the spectrum of available assets to choose from. We compare our method with a wide range of algorithms with results showing that our model obtains the best performance over the testing period, from 2011 to the end of April 2020, including the financial instabilities of the first quarter of 2020. A sensitivity analysis is included to understand the relevance of input features and we further study the performance of our approach under different cost rates and different risk levels via volatility scaling.


Old Age Psychiatry Services in the UK responding to COVID-19


Return to the lab: scientists face shiftwork, masks and distancing as coronavirus lockdowns ease


title: Clinical concepts might be included in health-related mathematic models

text: The construction of mathematical models that allow comprehensive approach of decision-making in situations of absence of robust evidence is important. While it is interesting to use models that are easy to understand, using values of direct interpretation, we analized a published index (COVID-19 Burden Index) and found it seems to be oversimplified. It is possible that the proposed index, with current data, could be useful in geographically and administratively narrowed places. But it is inaccurate to be applied throughout the process and in places as broad as American countries. It would be ideal to correct and refine the referred model, bearing in mind clinical concepts described, to take advantage of the proposal and generate a more accurate response, which can serve as an input both in the implementation of measures and in the prediction of the behavior of a pandemic like the current one. However, what we propose is to improve the accuracy of the model in terms of quantities and applicability, agreeing with the concept of"stay at home". The approach between complementary areas of knowledge should be the door that we must open to generate the new evidence we need. Mathematics should not dispense clinical sciences.


title: Minimizing contagion risks of COVID-19 during Trans Oral Robotic Surgery

text: In this communication we would like to share our experience in managing TORS patients during COVID-19 pandemia.


title: Coronavirus Disease-19 (COVID-19) associated with severe acute pancreatitis: Case report on three family members

text: BACKGROUND/OBJECTIVES: Abdominal pain is one of the known symptoms associated with coronavirus disease 2019. Little is known about the development of acute pancreatitis as a complication of severe acute respiratory syndrome coronavirus 2 infection. This case report describes the presentation of acute pancreatitis in two of three family members with severe COVID-19 infection. METHODS: Data were collected from three family members admitted with COVID-19 to the intensive care unit in March 2020. This study was reviewed and approved by the local data and ethics committee (31-1521-253). RESULTS: Two of the three family members were diagnosed with acute pancreatitis associated with SARS-CoV-2. Other causes of acute pancreatitis were excluded for both patients (including alcohol, biliary obstruction/gall stones, drugs, trauma, hypertriglyceridemia, hypercalcemia, and hypotension). CONCLUSIONS: These cases highlight acute pancreatitis as a complication associated with COVID-19 and underlines the importance of measuring pancreas-specific plasma amylase in patients with COVID-19 and abdominal pain.


Delivery Room Preparedness and Early Neonatal Outcomes During COVID19 Pandemic in New York City


title: Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study

text: OBJECTIVE: To delineate the clinical characteristics of patients with coronavirus disease 2019 (covid-19) who died. DESIGN: Retrospective case series. SETTING: Tongji Hospital in Wuhan, China. PARTICIPANTS: Among a cohort of 799 patients, 113 who died and 161 who recovered with a diagnosis of covid-19 were analysed. Data were collected until 28 February 2020. MAIN OUTCOME MEASURES: Clinical characteristics and laboratory findings were obtained from electronic medical records with data collection forms. RESULTS: The median age of deceased patients (68 years) was significantly older than recovered patients (51 years). Male sex was more predominant in deceased patients (83; 73%) than in recovered patients (88; 55%). Chronic hypertension and other cardiovascular comorbidities were more frequent among deceased patients (54 (48%) and 16 (14%)) than recovered patients (39 (24%) and 7 (4%)). Dyspnoea, chest tightness, and disorder of consciousness were more common in deceased patients (70 (62%), 55 (49%), and 25 (22%)) than in recovered patients (50 (31%), 48 (30%), and 1 (1%)). The median time from disease onset to death in deceased patients was 16 (interquartile range 12.0-20.0) days. Leukocytosis was present in 56 (50%) patients who died and 6 (4%) who recovered, and lymphopenia was present in 103 (91%) and 76 (47%) respectively. Concentrations of alanine aminotransferase, aspartate aminotransferase, creatinine, creatine kinase, lactate dehydrogenase, cardiac troponin I, N-terminal pro-brain natriuretic peptide, and D-dimer were markedly higher in deceased patients than in recovered patients. Common complications observed more frequently in deceased patients included acute respiratory distress syndrome (113; 100%), type I respiratory failure (18/35; 51%), sepsis (113; 100%), acute cardiac injury (72/94; 77%), heart failure (41/83; 49%), alkalosis (14/35; 40%), hyperkalaemia (42; 37%), acute kidney injury (28; 25%), and hypoxic encephalopathy (23; 20%). Patients with cardiovascular comorbidity were more likely to develop cardiac complications. Regardless of history of cardiovascular disease, acute cardiac injury and heart failure were more common in deceased patients. CONCLUSION: Severe acute respiratory syndrome coronavirus 2 infection can cause both pulmonary and systemic inflammation, leading to multi-organ dysfunction in patients at high risk. Acute respiratory distress syndrome and respiratory failure, sepsis, acute cardiac injury, and heart failure were the most common critical complications during exacerbation of covid-19.


title: COVID-19: establishing an oral surgery-led urgent dental care hub

text: COVID-19 has changed the face of dentistry in the UK and around the world. The potential for aerosol generation, the presence of the virus within saliva and the fact that dental professionals work with the oral-pharyngeal environment determines that dental treatment poses a risk of viral transmission. At the start of the pandemic, the cessation of routine dental care across the country necessitated the rapid establishment of an emergency dental service at King's College Hospital. This paper describes its evolution to date and the challenges encountered along the way.


Preliminary reflections of CAMHS in COVID-19 lockdown


Reply to "Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19)"


title: Recommendations for the measurement of the QT interval during the use of drugs for COVID-19 infection treatment. Updatable in accordance with the availability of new evidence

text: COVID-19 infection has shown rapid growth worldwide, and different therapies have been proposed for treatment, in particular, the combination of immune response modulating drugs such as chloroquine and hydroxychloroquine (antimalarials) alone or in combination with azithromycin. Although the clinical evidence supporting their use is scarce, the off label use of these drugs has spread very quickly in face of the progression of the epidemic and the high mortality rate in susceptible populations. However, these medications can pathologically prolong the QT interval and lead to malignant ventricular arrhythmias such that organized guidance on QT evaluation and management strategies are important to reduce morbidity associated with the potential large-scale use.


title: Enhanced chitosan effects on cell membrane models made with lipid raft monolayers

text: Langmuir monolayers have been used as cell membrane models, where lipid composition is normally varied to mimic distinct types of membranes. For eukaryotic membranes, for instance, rather than using only zwitterionic phospholipids there is now a trend to employ mixtures to simulate the lipid rafts known to be relevant for various cellular processes. In this study, we demonstrate that effects from chitosans on Langmuir monolayers are considerably higher if lipid raft compositions (ternary mixtures of dipalmitoyl phosphatidyl choline (DPPC), sphingomyelin (SM) and cholesterol) are used. Significantly, measurable effects on the surface pressure isotherms start at 10-6 mg mL-1 for chitosans in lipid rafts, to be compared with 10-2 mg mL-1 for neat dipalmitoyl phosphatidylcholine (DPPC). This applies to both a commercial chitosan and chitosans soluble at physiological pH. Incorporation of these chitosans in the raft monolayers was confirmed in polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS) experiments, where both the tail groups and headgroups were found to interact with chitosan. Since the effects on membrane models may be observed at such small concentrations for chitosans and probably other molecules, some studies may have to be revisited where neat phospholipids should be replaced by lipid raft compositions.


COVID-19: a major cause of cachexia and sarcopenia?


title: [Visual analysis of coronavirus disease 2019 (COVID-19) studies based on bibliometrics]

text: To analyze the development of coronavirus disease 2019(COVID-19), this study systematically retrieved relevant Chinese and English literatures from both CNKI and Web of Science database platforms by bibliometric research method and CiteSpace 5.5.R2 software to obtain information and visualize relevant literatures. A total of 695 Chinese and 446 English literatures were included in this paper. Statistics showed that China had published most of the literatures and established close cooperation with the United States and the United Kingdom. Through the analysis, Tongji Medical College of Huazhong University of Science and Technology and its affiliated hospitals published the largest number of the publications. Moreover, the highly productive journals including Journal of Traditional Chinese Medicine and The Lancet covered eight major fields, such as medicine, medical virology, radiation medicine, infectious disease, and traditional Chinese medicine. Besides, a total of 35 special COVID-19 funds were recently established to subsidize these studies. The key words and themes analysis indicated that protein structure of COVID-19, receptor targets and mechanisms of action, integration of traditional Chinese and Western medicine, screening and development of antiviral drugs from traditional Chinese medicine and Western medicine, vaccine research as well as epidemiological characteristics and prediction are current study hotspots. This study provides a reference for researchers to rapidly master main study directions of COVID-19 and screen out relevant literatures.


title: SOFFCO-MM guidelines for the resumption of bariatric and metabolic surgery during and after the Covid-19 pandemic

text: Bariatric/metabolic surgery was paused during the Covid-19 pandemic. The impact of social confinement and the interruption of this surgery on the population with obesity has been underestimated, with weight gain and worsened comorbidities. Some candidates for this surgery are exposed to a high risk of mortality linked to the pandemic. Obesity and diabetes are two major risk factors for severe forms of Covid-19. The only currently effective treatment for obesity is metabolic surgery, which confers prompt, lasting benefits. It is thus necessary to resume such surgery. To ensure that this resumption is both gradual and well-founded, we have devised a priority ranking plan. The flow charts we propose will help centres to identify priority patients according to a benefit/risk assessment. Diabetes holds a central place in the decision tree. Resumption patterns will vary from one centre to another according to human, physical and medical resources, and will need adjustment as the epidemic unfolds. Specific informed consent will be required. Screening of patients with obesity should be considered, based on available knowledge. If Covid-19 is suspected, surgery must be postponed. Emphasis must be placed on infection control measures to protect patients and healthcare professionals. Confinement is strongly advocated for patients for the first month post-operatively. Patient follow-up should preferably be by teleconsultation.


title: Coexistence of COVID-19 and acute ischemic stroke report of four cases

text: Coronaviruses are revealed to target the human respiratory system mainly. However, they also have neuro-invasive abilities and might spread from the respiratory system to the central nervous system. Herein, we report four patients with COVID-19 simultaneously diagnosed with acute ischemic stroke. There were four stroke cases with simultaneously diagnosis of Covid-19 till the April 14, 2020 in the city of Sakarya, Turkey. They were aged between 45 and 77 years. All four cases were likely to have contracted the virus in Sakarya. The patients had all commonly reported symptoms of Covid-19. Three patients have elevated D-dimer levels, and two of them had high C-reactive protein (CRP) levels. They were managed symptomatically for both the infection and the stroke. Our findings suggest that ischemic cerebrovascular diseases may simultaneously develop in the course of Covid-19 independently of the critical disease process. Increased inflammation predicted by CRP and D-dimer levels may play a role in the formation of ischemia. In particular, elder patients with prothrombotic risk factors should also be considered for the signs of cerebrovascular events in addition to infectious symptoms.


Management of Neurosurgical Patients During the COVID-19 Pandemic


title: Contact Tracing: Beyond the Apps

text: As pandemic wide spread results in locking down vital facilities, digital contact tracing is deemed as a key for re-opening. However, current efforts in digital contact tracing, running as mobile apps on users' smartphones, fall short in being effective. This paper lays out the vision and guidelines for the next era of digital contact tracing, where the contact tracing functionality is moved from being personal responsibility to be the responsibility of facilities that users visit daily. A privacy-preserving architecture is proposed, which can be mandated as a prerequisite for any facility to re-open during or after the pandemic.


Safety of dupilumab in severe atopic dermatitis and infection of Covid-19: two case reports


title: COVID-19 Related Mobility Reduction: Heterogenous Effects on Sleep and Physical Activity Rhythms

text: Mobility restrictions imposed to suppress coronavirus transmission can alter physical activity (PA) and sleep patterns. Characterization of response heterogeneity and their underlying reasons may assist in tailoring customized interventions. We obtained wearable data covering baseline, incremental movement restriction and lockdown periods from 1824 city-dwelling, working adults aged 21 to 40 years, incorporating 206,381 nights of sleep and 334,038 days of PA. Four distinct rest activity rhythms (RARs) were identified using k-means clustering of participants' temporally distributed step counts. Hierarchical clustering of the proportion of time spent in each of these RAR revealed 4 groups who expressed different mixtures of RAR profiles before and during the lockdown. Substantial but asymmetric delays in bedtime and waketime resulted in a 24 min increase in weekday sleep duration with no loss in sleep efficiency. Resting heart rate declined 2 bpm. PA dropped an average of 38%. 4 groups with different compositions of RAR profiles were found. Three were better able to maintain PA and weekday/weekend differentiation during lockdown. The least active group comprising 51 percent of the sample, were younger and predominantly singles. Habitually less active already, this group showed the greatest reduction in PA during lockdown with little weekday/weekend differences. Among different mobility restrictions, removal of habitual social cues by lockdown had the largest effect on PA and sleep. Sleep and resting heart rate unexpectedly improved. RAR evaluation uncovered heterogeneity of responses to lockdown and can identify characteristics of persons at risk of decline in health and wellbeing.


ST-elevation myocardial infarction in the COVID-19 era


Proposal of the French Society of Vascular Medicine for the prevention, diagnosis and treatment of venous thromboembolic disease in outpatients with COVID-19


Screening for Covid-19 in Skilled Nursing Facilities. Reply


title: Hyperglycemia, hydroxychloroquine, and the COVID-19 pandemic

text: Coronavirus disease-2019 (COVID-19) infection and its severity can be explained by the concentration of glycosylated severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) viral particles in the lung epithelium, the concentration of glycosylated angiotensin-converting enzyme receptor 2 (ACE2) in the lung epithelium, and the degree and control of the pulmonary immune response to the SARS-CoV-2 spike protein at approximately day 8 to 10 after symptom onset, which may be related to both. Binding of ACE2 by SARS-CoV-2 in COVID-19 also suggests that prolonged uncontrolled hyperglycemia, and not just a history of diabetes mellitus, may be important in the pathogenesis of the disease. It is tempting to consider that the same mechanism acts in COVID-19 as in SARS, where an overactive macrophage M1 inflammatory response, as neutralizing antibodies to the SARS-CoV-2 spike protein form at day 7 to 10, results in acute respiratory distress syndrome (ARDS) in susceptible patients. It also allows consideration of agents, such as hydroxychloroquine, which may interfere with this overly brisk macrophage inflammatory response and perhaps influence the course of the disease, in particular, those that blunt but do not completely abrogate the M1 to M2 balance in macrophage polarization, as well as viral load, which in SARS appears to be temporally related to the onset of ARDS.


Letter in response to the article "Enhancing immunity in viral infections, with special emphasis on COVID-19: A review" (Jayawardena et al.)


title: A Chinese Case of COVID-19 Did Not Show Infectivity During the Incubation Period: Based on an Epidemiological Survey

text: Controversy remains over whether the novel coronavirus 2019 (COVID-19) virus may have infectivity during the incubation period before the onset of symptoms. The author had the opportunity to examine the infectivity of COVID-19 during the incubation period by conducting an epidemiological survey on a confirmed patient who had visited Jeju Island during the incubation period. The epidemiological findings support the claim that the COVID-19 virus does not have infectivity during the incubation period.


When the Dust Settles: Preventing a Mental Health Crisis in COVID-19 Clinicians


title: Challenges and solutions in meeting up the urgent requirement of ventilators for COVID-19 patients

text: BACKGROUND: Severely affected patients in the COVID-19 pandemic need Ventilators, we chart the challenges faced by the health care systems in procuring these machines and the role of 3-D printing technology in building ventilators. AIMS: We tried to find the current role, availability and need of ventilators in the COVID-19 pandemic and the role of applied innovative technologies is assessed. METHODS: We have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the second week of April 2020. RESULTS: We found in our review that there is an acute shortage of the ventilators and the manpower to operate these sophisticated machines. There is significant deficiency in the production and supply chain of the ventilators. Many of the seriously ill patients who require hospitalization may need ventilator support. Non-invasive ventilation is not recommended in these patients. CONCLUSION: As the respiratory illness due to COVID-19 pandemic spreads worldwide, health care systems are facing the tough challenges of acquiring ventilators to support patients. All steps involved in the supply chain management of ventilators are being escalated to produce more ventilators for the coronavirus frontline. Innovative applications of Additive medicine like 3-D printer technology may play key role in delivering sufficient ventilators.


title: My Coronavirus Experience

text: A nurse-midwife describes her experience being ill with COVID-19.


title: Personal Protective Equipment: Current Best Practices for Orthopedic Teams

text: The coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome (SARS-CoV-2) virus is challenging healthcare providers across the world. Current best practices for personal protective equipment (PPE) during this time are rapidly evolving and fluid due to the novel and acute nature of the pandemic and the dearth of high-level evidence. Routine infection control practices augmented by airborne precautions are paramount when treating the COVID-19-positive patient. Best practices for PPE use in patients who have unknown COVID-19 status are a highly charged and emotional issue. The variables to be considered include protection of patients and healthcare providers, accuracy and availability of testing, and responsible use of PPE resources. This article also explores the concerns of surgeons regarding possible transmission to their own family members as a result of caring for COVID-19 patients.


Autoimmune haemolytic anaemia associated with COVID-19 infection


Deaths in healthcare workers due to COVID-19: the need for robust data and analysis


title: SARS-CoV-2/COVID-19: Viral Genomics, Epidemiology, Vaccines, and Therapeutic Interventions

text: The COVID-19 pandemic is due to infection caused by the novel SARS-CoV-2 virus that impacts the lower respiratory tract. The spectrum of symptoms ranges from asymptomatic infections to mild respiratory symptoms to the lethal form of COVID-19 which is associated with severe pneumonia, acute respiratory distress, and fatality. To address this global crisis, up-to-date information on viral genomics and transcriptomics is crucial for understanding the origins and global dispersion of the virus, providing insights into viral pathogenicity, transmission, and epidemiology, and enabling strategies for therapeutic interventions, drug discovery, and vaccine development. Therefore, this review provides a comprehensive overview of COVID-19 epidemiology, genomic etiology, findings from recent transcriptomic map analysis, viral-human protein interactions, molecular diagnostics, and the current status of vaccine and novel therapeutic intervention development. Moreover, we provide an extensive list of resources that will help the scientific community access numerous types of databases related to SARS-CoV-2 OMICs and approaches to therapeutics related to COVID-19 treatment.


Dor lombar em equinos - Parte 1: anatomia estrutural


title: Informational Space of Meaning for Scientific Texts

text: In Natural Language Processing, automatic extracting the meaning of texts constitutes an important problem. Our focus is the computational analysis of meaning of short scientific texts (abstracts or brief reports). In this paper, a vector space model is developed for quantifying the meaning of words and texts. We introduce the Meaning Space, in which the meaning of a word is represented by a vector of Relative Information Gain (RIG) about the subject categories that the text belongs to, which can be obtained from observing the word in the text. This new approach is applied to construct the Meaning Space based on Leicester Scientific Corpus (LSC) and Leicester Scientific Dictionary-Core (LScDC). The LSC is a scientific corpus of 1,673,350 abstracts and the LScDC is a scientific dictionary which words are extracted from the LSC. Each text in the LSC belongs to at least one of 252 subject categories of Web of Science (WoS). These categories are used in construction of vectors of information gains. The Meaning Space is described and statistically analysed for the LSC with the LScDC. The usefulness of the proposed representation model is evaluated through top-ranked words in each category. The most informative n words are ordered. We demonstrated that RIG-based word ranking is much more useful than ranking based on raw word frequency in determining the science-specific meaning and importance of a word. The proposed model based on RIG is shown to have ability to stand out topic-specific words in categories. The most informative words are presented for 252 categories. The new scientific dictionary and the 103,998 x 252 Word-Category RIG Matrix are available online. Analysis of the Meaning Space provides us with a tool to further explore quantifying the meaning of a text using more complex and context-dependent meaning models that use co-occurrence of words and their combinations.


title: The impact of COVID-19 on small business outcomes and expectations

text: To explore the impact of coronavirus disease 2019 (COVID-19) on small businesses, we conducted a survey of more than 5,800 small businesses between March 28 and April 4, 2020. Several themes emerged. First, mass layoffs and closures had already occurred-just a few weeks into the crisis. Second, the risk of closure was negatively associated with the expected length of the crisis. Moreover, businesses had widely varying beliefs about the likely duration of COVID-related disruptions. Third, many small businesses are financially fragile: The median business with more than $10,000 in monthly expenses had only about 2 wk of cash on hand at the time of the survey. Fourth, the majority of businesses planned to seek funding through the Coronavirus Aid, Relief, and Economic Security (CARES) Act. However, many anticipated problems with accessing the program, such as bureaucratic hassles and difficulties establishing eligibility. Using experimental variation, we also assess take-up rates and business resilience effects for loans relative to grants-based programs.


title: Health equity and COVID-19: global perspectives

text: The COVID-19 is disproportionally affecting the poor, minorities and a broad range of vulnerable populations, due to its inequitable spread in areas of dense population and limited mitigation capacity due to high prevalence of chronic conditions or poor access to high quality public health and medical care. Moreover, the collateral effects of the pandemic due to the global economic downturn, and social isolation and movement restriction measures, are unequally affecting those in the lowest power strata of societies. To address the challenges to health equity and describe some of the approaches taken by governments and local organizations, we have compiled 13 country case studies from various regions around the world: China, Brazil, Thailand, Sub Saharan Africa, Nicaragua, Armenia, India, Guatemala, United States of America (USA), Israel, Australia, Colombia, and Belgium. This compilation is by no-means representative or all inclusive, and we encourage researchers to continue advancing global knowledge on COVID-19 health equity related issues, through rigorous research and generation of a strong evidence base of new empirical studies in this field.


title: Colchicina: una herramienta terapéutica potencial frente a COVID-19. Experiencia en 5 pacientes./ [Colchicine: a potential therapeutic tool against COVID-19. Experience of 5 patients]

text: COVID-19 is a newly emerged disease that has become a global public health challenge. Due to a lack of knowledge about the virus, a significant number of potential targets for using a particular drug have been proposed. Five cases with a clinical history of biopolymers in the gluteal region that developed iatrogenic allogenosis (IA) are presented here. The 5 cases were put under colchicine treatment for IA crisis and had non-specific symptoms (headache, cough without dyspnoea, and arthralgias) with a positive SARS-CoV-2 test. Their close contacts had mild to severe symptoms and three of them died. In the SARS-CoV-2 infection different inflammatory pathways are altered where colchicine reduces cytokine levels as well as the activation of macrophages, neutrophils, and the inflammasome. The possible mechanisms that colchicine may use to prevent acute respiratory distress syndrome (ARDS) in patients with COVID-19 infection are also reviewed in this article.


title: The urgent need for integrated science to fight COVID-19 pandemic and beyond

text: The COVID-19 pandemic has become the leading societal concern. The pandemic has shown that the public health concern is not only a medical problem, but also affects society as a whole; so, it has also become the leading scientific concern. We discuss in this treatise the importance of bringing the world's scientists together to find effective solutions for controlling the pandemic. By applying novel research frameworks, interdisciplinary collaboration promises to manage the pandemic's consequences and prevent recurrences of similar pandemics.


title: Prevention of thrombotic risk in hospitalized patients with COVID-19 and hemostasis monitoring

text: COVID-19 is an infection induced by the SARS-CoV-2 coronavirus, and severe forms can lead to acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) management. Severe forms are associated with coagulation changes, mainly characterized by an increase in D-dimer and fibrinogen levels, with a higher risk of thrombosis, particularly pulmonary embolism. The impact of obesity in severe COVID-19 has also been highlighted.In this context, standard doses of low molecular weight heparin (LMWH) may be inadequate in ICU patients, with obesity, major inflammation, and hypercoagulability. We therefore urgently developed proposals on the prevention of thromboembolism and monitoring of hemostasis in hospitalized patients with COVID-19.Four levels of thromboembolic risk were defined according to the severity of COVID-19 reflected by oxygen requirement and treatment, the body mass index, and other risk factors. Monitoring of hemostasis (including fibrinogen and D-dimer levels) every 48 h is proposed. Standard doses of LMWH (e.g., enoxaparin 4000 IU/24 h SC) are proposed in case of intermediate thrombotic risk (BMI < 30 kg/m2, no other risk factors and no ARDS). In all obese patients (high thrombotic risk), adjusted prophylaxis with intermediate doses of LMWH (e.g., enoxaparin 4000 IU/12 h SC or 6000 IU/12 h SC if weight > 120 kg), or unfractionated heparin (UFH) if renal insufficiency (200 IU/kg/24 h, IV), is proposed. The thrombotic risk was defined as very high in obese patients with ARDS and added risk factors for thromboembolism, and also in case of extracorporeal membrane oxygenation (ECMO), unexplained catheter thrombosis, dialysis filter thrombosis, or marked inflammatory syndrome and/or hypercoagulability (e.g., fibrinogen > 8 g/l and/or D-dimers > 3 µg/ml). In ICU patients, it is sometimes difficult to confirm a diagnosis of thrombosis, and curative anticoagulant treatment may also be discussed on a probabilistic basis. In all these situations, therapeutic doses of LMWH, or UFH in case of renal insufficiency with monitoring of anti-Xa activity, are proposed.In conclusion, intensification of heparin treatment should be considered in the context of COVID-19 on the basis of clinical and biological criteria of severity, especially in severely ill ventilated patients, for whom the diagnosis of pulmonary embolism cannot be easily confirmed.


title: Pathogenicity and transmissibility of 2019-nCoV-A quick overview and comparison with other emerging viruses

text: A zoonotic coronavirus, tentatively labeled as 2019-nCoV by the World Health Organization (WHO), has been identified as the causative agent of the viral pneumonia outbreak in Wuhan, China, at the end of 2019. Although 2019-nCoV can cause a severe respiratory illness like SARS and MERS, evidence from clinics suggested that 2019-nCoV is generally less pathogenic than SARS-CoV, and much less than MERS-CoV. The transmissibility of 2019-nCoV is still debated and needs to be further assessed. To avoid the 2019-nCoV outbreak turning into an epidemic or even a pandemic and to minimize the mortality rate, China activated emergency response procedures, but much remains to be learned about the features of the virus to refine the risk assessment and response. Here, the current knowledge in 2019-nCoV pathogenicity and transmissibility is summarized in comparison with several commonly known emerging viruses, and information urgently needed for a better control of the disease is highlighted.


title: Incidental Finding of COVID-19 Lung Infection in 18F-FDG PET/CT: What Should We Do?

text: We report the case of an asymptomatic (no fever, no cough, no dyspnea) 80-year-old woman who had an F-FDG PET/CT scan for initial staging of Lieberkühnian adenocarcinoma located on anal canal. Chest analysis incidentally revealed bilateral diffuse patchy ground-glass opacity with mild increasing F-FDG uptake, consistent with incidental COVID-19 infection finding during the March 2020 pandemic. The infection was confirmed by reverse transcription-polymerase chain reaction. It led us to improve patient flow and to undertake broader measures to avoid patient clinical issues and potential disease spreading.


Rational Perspectives on Risk and Certainty for Dentistry During the COVID-19 Pandemic


title: Financial Burden of Hospitalization of Children with Coronavirus Disease 2019 under the National Health Insurance Service in Korea

text: Coronavirus disease 2019 (COVID-19) has resulted in an ongoing pandemic; however, the socioeconomic burden of COVID-19 treatment in the pediatric population remains unclear. Thus, the aim of this study was to determine the hospitalization periods and medical costs among children with COVID-19. In total, 145 billing statements for pediatric patients receiving healthcare services because of COVID-19 from February 1, 2020 to March 31, 2020 were used. The study showed that individual treatment costs for children with COVID-19 are approximately USD 2,192 under the Korean National Health Insurance Service System. This study revealed the differences in cost among age groups, determined by the type of hospital wherein admission occurred, as a trend of increasing age, increasing hospitalization time, and increasing cost was observed. Tailored COVID-19 treatment strategies by age group may lower costs and increase the effectiveness of resource allocation.


title: Exploring the Relevance of Senotherapeutics for the Current SARS-CoV-2 Emergency and Similar Future Global Health Threats

text: The higher death rate caused by COVID-19 in older people, especially those with comorbidities, is a challenge for biomedical aging research. Here we explore the idea that an exacerbated inflammatory response, in particular that mediated by IL-6, may drive the deleterious consequences of the infection. Data shows that other RNA viruses, such as influenza virus, can display enhanced replication efficiency in senescent cells, suggesting that the accumulation of senescent cells with aging and age-related diseases may play a role in this phenomenon. However, at present, we are completely unaware of the response to SARS-CoV and SARS-COV-2 occurring in senescent cells. We deem that this is a priority area of research because it could lead to the development of several therapeutic strategies based on senotherapeutics or prevent unsuccessful attempts. Two of these senotherapeutics, azithromycin and ruxolitinib, are currently undergoing testing for their efficacy in treating COVID-19. The potential of these strategies is not only for ameliorating the consequences of the current emergence of SARS-CoV-2, but also for the future emergence of new viruses or mutated ones for which we are completely unprepared and for which no vaccines are available.


Pediatric Surgery in the Time of COVID-19


Introducing the Percent, Number, Availability, and Capacity [PNAC] Spatial Approach to Identify Priority Rural Areas Requiring Targeted Health Support in Light of COVID-19: A Commentary and Application


title: Pathologies cardiovasculaires et Covid-19 : particularités chez les personnes âgées./ COVID-19 and cardiovascular diseases: viewpoint for older patients

text: The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. The link between cardiovascular disease and COVID-19 appears to be twofold. First, some reports of data indicate that certain groups of patients are more at risk of COVID-19. This includes patients with cardiovascular risk factors or pre-existing cardiovascular conditions and older patients. In addition, these patients incur disproportionately worse outcome. Second, SARS-CoV2 infection can be complicated by life-threatening cardiovascular acute diseases. Despite the rapid evolution of data on this pandemic, this review aims to highlight the cardiovascular considerations related to COVID-19 whether as comorbidities including concerns and uncertainty regarding the effect of renin-angiotensin-aldosterone system (RAAS) inhibitors on angiotensin conversion enzyme 2 or related to acute cardiovascular complications.


title: Outbreak of neonatal diarrhea caused by multiple genotypes of rotavirus A in a beef calves herd/ Surto de diarreia neonatal por múltiplos genótipos de rotavírus A em um rebanho de bovinos de corte

text: Calf diarrhea causes substantial economic losses to beef cattle production worldwide. It is a complex multifactorial pathological condition influenced by infectious, nutritional and environmental factors. The present study focused on analyzing the pathological and molecular characterization of bovine rotavirus A (BoRVA) during a diarrhea outbreak in a beef cattle herd located in the state of Mato Grosso, central-western region, Brazil. The outbreak caused high morbidity (80%) and mortality (12%) among 1,100 calves up to 30 days of age. The BoRVA was identified in 53.3% (16/30) of the diarrheic fecal samples analyzed using the silver-stained polyacrylamide gel electrophoresis (ss-PAGE) technique. The nucleotide sequence analysis of VP7 (G genotype) and VP4 (P genotype) via RT-PCR from eight BoRVA-positive fecal samples showed the genotypes G6P[5] (n = 6), G6P[11] (n = 1) and G6P[X] (n = 1). Three calves were necropsied and the gross findings included edema and thickened, wrinkled bowel mucosa in the small intestine. Microscopic lesions were confined to the villi of the small intestine, characterized mainly by villus fusion and moderate multifocal lymphoplasmacytic enteritis. Immunohistochemical examination of three cases was positive for BoRVA. The 53.3% of the diarrheic fecal samples that were positive for BoRVA in this study suggested that RV was the etiological agent involved in this neonatal calf diarrhea outbreak.(AU)


title: Liver transplantation during the COVID-19 epidemic : recommendations from the Belgian Liver Intestine Transplant Committee (BeLIAC)

text: Since January 2020, the Novel Coronavirus Disease 2019 (COVID-19) pandemic has dramatically impacted the world. In March 2020, the COVID-19 epidemic reached Belgium creating uncertainty towards all aspects of life. There has been an impressive capacity and solidarity of all healthcare professionals to acutely reconvert facilities to treat these patients. In the context of liver transplantation (LTx), concerns are raised about organ donation shortage and safety, the ethics of using limited healthcare resources for LTx, selection criteria for LTx during the epidemic and the risk of de novo COVID-19 infection on the waiting list and after LTx. BeLIAC makes several recommendations to try to mitigate the deleterious effect that this epidemic has/will have on donation and LTx, taking into account the available resources, and trying to maximize patients and healthcare professionals' safety.