title: Reference gene selection for quantitative real-time PCR analysis in virus infected cells: SARS corona virus, Yellow fever virus, Human Herpesvirus-6, Camelpox virus and Cytomegalovirus infections

text: Ten potential reference genes were compared for their use in experiments investigating cellular mRNA expression of virus infected cells. Human cell lines were infected with Cytomegalovirus, Human Herpesvirus-6, Camelpox virus, SARS coronavirus or Yellow fever virus. The expression levels of these genes and the viral replication were determined by real-time PCR. Genes were ranked by the BestKeeper tool, the GeNorm tool and by criteria we reported previously. Ranking lists of the genes tested were tool dependent. However, over all, β-actin is an unsuitable as reference gene, whereas TATA-Box binding protein and peptidyl-prolyl-isomerase A are stable reference genes for expression studies in virus infected cells.


title: A pilot study on nurses' attitudes toward perinatal bereavement support: a cluster analysis

text: Aim: Nurses' attitudes towards perinatal bereavement care are explored by identifying profiles of nurses working in a Hong Kong Obstetrics and Gynaecology (OAG) unit. Relationships between nurses' attitudes towards bereavement support, need for bereavement training and hospital policy are explored. Research method: 110 nurses recruited from the OAG unit of a large Hong Kong public hospital completed a structured questionnaire. Outcome measures: Attitudes towards perinatal bereavement support; required support and training needs for nurses on bereavement care. Results: Two-step cluster analysis yielded two clusters. Cluster A consisted of 55.5% (n=61) and cluster B consisted of 44.5% (n=49) of nurses. Cluster A nurses were younger, had less OAG experience, more junior ranking and less education than cluster B nurses. Cluster B nurses had additional midwifery and bereavement care training, personal grieving experiences and experience handling grieving clients. The majority held positive bereavement care attitudes. Significant differences towards perinatal bereavement support were found. Only 25.5% (n=28) had bereavement related training. Attitudes towards bereavement care were positively correlated with training needs (r(s)=0.59) and hospital policy support (r(s)=0.60). Conclusion: Hong Kong nurses emphasized need for increased bereavement care knowledge and experience, improved communication skills, and greater hospital and team members' support. Findings may be used to improve support of nurses, to ensure sensitive bereavement care in perinatal settings, and to enhance nursing curricula.


title: COVID-19 Clinical Research

text: INTRODUCTION: While the global COVID-19 pandemic has challenged the entire humanity and health systems, it also triggered researchers to urgently perform clinical trials to assess the safety and efficacy of many agents and modalities to combat COVID-19. As of April 22, over 650 clinical studies have been registered both in USA and internationally. Results from these studies are also coming at a brisk pace in this unprecedented emergency. AREAS COVERED: We searched the NCI website and Medline and summarize various national and international clinical trials and summarize few of the pivotal ones in this paper, including those specific to oncology population. Two hundred and eighty four studies are actively recruiting adults and children with confirmed COVID-19, including 25 are early-phase I/phase I, 72 phase II, 58 phase III, 12 phase IV, and 31 other trials. They can be categorized into four groups: drugs that combat SARS-CoV-2, immunomodulatory agents to counteract cytokine storm, convalescence plasma therapies and vaccines trials. EXPERT OPINION: It is hoped that these efforts will results in a successful treatment to COVID-19, especially in a timely fashion before the second pandemic expected in fall. It is essential to acknowledge the devotion and hard work of the clinical research team and clinical research volunteers.


title: COVID-19-related conspiracy beliefs and their relationship with perceived stress and pre-existing conspiracy beliefs

text: Previous studies have down that erroneous Conspiracy Theory (CT) beliefs develop more strongly in people who have underlying conspiratorial reasoning styles and psychopathological traits and particularly when they are faced with stressful external events (Swami et al., 2013; van Prooijen, 2018). In this study, we test this proposition by examining the individual differences associated with the development of COVID-19-related CT beliefs during the pandemic. A total of 660 adults completed a survey that captured COVID–related CT beliefs and broader conspiracy beliefs, education, perceived stress and attitudes towards government responses. The results showed that COVID-19 related CT beliefs were: strongly related to broader CT beliefs, higher in those with lower levels of education; and, positively (although weakly) correlated with more negative attitudes towards government responses. However, no relationship was found between COVID-19 beliefs and self-reported stress. These findings hold implications for why some people are more likely to be resistant to public health interventions relating to COVID-19. The findings encourage more detailed exploration of the causes and sources of CTs and, in particular, the role of social media use and other information sources in the development and perpetuation of health-related CT beliefs.


Contamination risk in urology operating room during the COVID-19 pandemic


title: Prediction and Analysis of COVID-19 Positive Cases using Deep Learning Models:A Descriptive Case Study of India

text: In this paper, Deep Learning-based models are used for predicting the number of novel coronavirus (COVID-19) positive reported cases for 32 states and union territories of India. Recurrent neural network (RNN) based long-short term memory (LSTM) variants such as Deep LSTM, Convolutional LSTM and Bi-directional LSTM are applied on Indian data-set to predict the number of positive cases. LSTM model with minimum error is chosen for predicting daily and weekly cases. It is observed that the proposed method yields high accuracy for short term prediction with error less than 3 % for daily predictions and less than 8 % for weekly predictions. Indian states are categorised into different zones based on the spread of positive cases and daily growth rate for easy identification of novel coronavirus hot-spots. Preventive measures to reduce the spread in respective zones are also suggested.A website is created where the state-wise predictions are updated using the proposed model for authorities,researchers and planners.This study can be applied by other countries for predicting COVID-19 cases at the state or national level.


title: A SARS-CoV-2 familial cluster infection reveals asymptomatic transmission to children

text: Information on SARS-CoV-2 asymptomatic infection and infectivity in children is limited. In this study, we aimed to report the epidemiological and clinical characteristics of a familial cluster infection including children with SARS-CoV-2. On February 1, 2020, two children(case 1 and case 2), an 8-year-old girl and a 9-year-old boy, were admitted to the isolation ward in Xiangyang Central Hospital, Hubei province, China, with the diagnosis of COVID-19. Before admission, they had been staying at home with their father and never contacted with any confirmed patients except their mother (case 3) who returned from Wuhan on January 22. Both case 1 and case 2 got mild symptoms. Case 3 didn’t develop any symptoms until February 6, 2020, with an asymptomatic period of 15 days. She was transferred to ICU and administered multiple treatment according to the disease progression and chest CT manifestations. Her nucleic acid test turned positive until Feb 21, 2020, 15 days after symptoms onset, 30 days after her return from Wuhan. Our data showed that patients with SARS-CoV-2 may have the ability to transmit during their asymptomatic period even with the negative of viral nucleic acid in pharyngeal swabs.


title: Bench-to-bedside review: Outcome predictions for critically ill patients in the emergency department

text: The escalating number of emergency department (ED) visits, length of stay, and hospital overcrowding have been associated with an increasing number of critically ill patients cared for in the ED. Existing physiologic scoring systems have traditionally been used for outcome prediction, clinical research, quality of care analysis, and benchmarking in the intensive care unit (ICU) environment. However, there is limited experience with scoring systems in the ED, while early and aggressive intervention in critically ill patients in the ED is becoming increasingly important. Development and implementation of physiologic scoring systems specific to this setting is potentially useful in the early recognition and prognostication of illness severity. A few existing ICU physiologic scoring systems have been applied in the ED, with some success. Other ED specific scoring systems have been developed for various applications: recognition of patients at risk for infection; prediction of mortality after critical care transport; prediction of in-hospital mortality after admission; assessment of prehospital therapeutic efficacy; screening for severe acute respiratory syndrome; and prediction of pediatric hospital admission. Further efforts at developing unique physiologic assessment methodologies for use in the ED will improve quality of patient care, aid in resource allocation, improve prognostic accuracy, and objectively measure the impact of early intervention in the ED.


Frequent handwashing amidst the COVID‐19 outbreak: prevention of hand irritant contact dermatitis and other considerations


title: Pandemia del SARS-CoV-2 y reproducción asistida

text: Abstract The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies. In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of ACE2 in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements.


title: Transmissibility of 1918 pandemic influenza

text: The 1918 influenza pandemic killed 20–40 million people worldwide(1), and is seen as a worst-case scenario for pandemic planning. Like other pandemic influenza strains, the 1918 A/H1N1 strain spread extremely rapidly. A measure of transmissibility and of the stringency of control measures required to stop an epidemic is the reproductive number, which is the number of secondary cases produced by each primary case(2). Here we obtained an estimate of the reproductive number for 1918 influenza by fitting a deterministic SEIR (susceptible-exposed-infectious-recovered) model to pneumonia and influenza death epidemic curves from 45 US cities: the median value is less than three. The estimated proportion of the population with A/H1N1 immunity before September 1918 implies a median basic reproductive number of less than four. These results strongly suggest that the reproductive number for 1918 pandemic influenza is not large relative to many other infectious diseases(2). In theory, a similar novel influenza subtype could be controlled. But because influenza is frequently transmitted before a specific diagnosis is possible and there is a dearth of global antiviral and vaccine stores, aggressive transmission reducing measures will probably be required. SUPPLEMENTARY INFORMATION: The online version of this article (doi:10.1038/nature03063) contains supplementary material, which is available to authorized users.


title: The history of vaccination and current vaccination policies in Korea

text: There may be many reasons for the significant decrease in the incidence of the pediatric infectious diseases in modern Korea; this could be due to the improvement of sanitary facilities, significant growth of Korean economy, improvement of nutrition, development and dissemination of antibiotics and implantation of vaccination, and overall improvement of medical technology. The development of vaccination has been highlighted as a striking achievement of the modern medical sciences with new technologies in many fields of medicine. Since 1876, the method for vaccination has opened its new era by Suk-Young Jee, known as the Jenner in Korea who wrote a book about smallpox vaccination, and it led an opportunity to propagate the needs for the vaccination in Korea. There was a time when pediatric wards were full of patients with parasitic diseases and many vaccine-preventable diseases such as diphtheria, pertussis, Japanese B encephalitis, and poliomyelitis in 1950s-1960s. We do not see those infectious diseases that often any more in recent years. However, we still have patients with water-borne diseases and other communicable diseases related to increasing international travels. We just experienced the first pandemic influenza of the 21st century in 2009 and avian influenza is still a threat to humans in other parts of the world with an unpredictable potential of pandemicity. In addition, we have tough battles with emerging antibiotic resistance in many strains of bacteria and increased opportunistic infections due to improvement of medical technology involving more aggressive treatment modality and use of medical devices. Researches in many areas are under way and we hope that some of them may be preventable and decreased with a development of new vaccines in the future.


title: Trends in malaria cases in Japan

text: Abstract Just after World War II, more than 10,000 malaria cases per year were reported in Japan, including indigenous, imported and induced malaria. Malaria has been successfully eradicated since 1961 in Japan and now only imported malaria cases are encountered. However, as the number of Japanese people who are going abroad and also the number of foreigners who are visiting Japan increases (about 16 and 5 millions, respectively, in 2001), so does the chance for Japanese doctors to see imported malaria or transfusion-transmitted malaria cases. In fact, the total number of the patients with acute malaria in Japan has been around 100–150 annually for the last 10 years. Of those, about 75% are Japanese and 25% are foreigners, and about 75% are male and 25% are female. The peak age is in the 20s. Recently, about 45% of patients are Plasmodium falciparum and another 45% Plasmodium vivax infections. The former species is likely to be seen in travelers coming back from African countries and the latter is mainly from Asian countries. The important issue is that patients in Japan have not been diagnosed promptly nor treated properly because doctors in Japan are no longer familiar with tropical medicine. Therefore, some patients are dying from severe malaria as a consequence. As it is, most of the effective medicines for drug-resistant malaria or severe malaria have not been registered in Japan. There is now a need for medical practitioners to focus on travel medicine in Japan.


title: Neutralizing antibody against severe acute respiratory syndrome (SARS)‐coronavirus spike is highly effective for the protection of mice in the murine SARS model

text: We evaluated the efficacy of three SARS vaccine candidates in a murine SARS model utilizing low‐virulence Pp and SARS‐CoV coinfection. Vaccinated mice were protected from severe respiratory disease in parallel with a low virus titer in the lungs and a high neutralizing antibody titer in the plasma. Importantly, the administration of spike protein‐specific neutralizing monoclonal antibody protected mice from the disease, indicating that the neutralization is sufficient for protection. Moreover, a high level of IL‐6 and MCP‐1 production, but not other 18 cytokines tested, on days 2 and 3 after SARS‐CoV infection was closely linked to the virus replication and disease severity, suggesting the importance of these cytokines in the lung pathogenicity of SARS‐CoV infection.


title: Middle East respiratory syndrome coronavirus: current situation and travel-associated concerns

text: The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012 brought back memories of the occurrence of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002. More than 1500 MERS-CoV cases were recorded in 42 months with a case fatality rate (CFR) of 40%. Meanwhile, 8000 cases of SARS-CoV were confirmed in six months with a CFR of 10%. The clinical presentation of MERS-CoV ranges from mild and non-specific presentation to progressive and severe pneumonia. No predictive signs or symptoms exist to differentiate MERS-CoV from community-acquired pneumonia in hospitalized patients. An apparent heterogeneity was observed in transmission. Most MERS-CoV cases were secondary to large outbreaks in healthcare settings. These cases were secondary to community-acquired cases, which may also cause family outbreaks. Travel-associated MERS infection remains low. However, the virus exhibited a clear tendency to cause large outbreaks outside the Arabian Peninsula as exemplified by the outbreak in the Republic of Korea. In this review, we summarize the current knowledge about MERS-CoV and highlight travel-related issues.


title: Travellers give wings to novel coronavirus (2019-nCoV)

text: A novel coronavirus, probably of bat origin, has caused an outbreak of severe respiratory infection in humans in Wuhan, China and has been dispersed globally by travelers. The WHO has declared the spread of the infection a Public Health Emergency of International Concern.


title: Impact of COVID‐19 pandemic on ST‐elevation myocardial infarction in a non‐COVID‐19 epicenter

text: OBJECTIVES: We sought to study the impact of COVID‐19 pandemic on the presentation delay, severity, patterns of care, and reasons for delay among patients with ST‐elevation myocardial infarction (STEMI) in a non‐hot‐spot region. BACKGROUND: COVID‐19 pandemic has significantly reduced the activations for STEMI in epicenters like Spain. METHODS: From January 1, 2020, to April 15, 2020, 143 STEMIs were identified across our integrated 18‐hospital system. Pre‐ and post‐COVID‐19 cohorts were based on March 23rd, 2020, whenstay‐at‐home orders were initiated in Ohio. We used presenting heart rate, blood pressure, troponin, new Q‐wave, and left ventricle ejection fraction (LVEF) to assess severity. Duration of intensive care unit stay, total length of stay, door‐to‐balloon (D2B) time, and radial versus femoral access were used to assess patterns of care. RESULTS: Post‐COVID‐19 presentation was associated with a lower admission LVEF (45 vs. 50%, p = .015), new Q‐wave, and higher initial troponin; however, these did not reach statistical significance. Among post‐COVID‐19 patients, those with >12‐hr delay in presentation 31(%) had a longer average D2B time (88 vs. 53 min, p = .033) and higher peak troponin (58 vs. 8.5 ng/ml, p = .03). Of these, 27% avoided the hospital due to fear of COVID‐19, 18% believed symptoms were COVID‐19 related, and 9% did not want to burden the hospital during the pandemic. CONCLUSIONS: COVID‐19 has remarkably affected STEMI presentation and care. Patients' fear and confusion about symptoms are integral parts of this emerging public health crisis.


title: Die Rolle der Augenheilkunde in der COVID-19-Pandemie

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 19 (COVID-19) has led to a worldwide pandemic. This pandemic presents a huge challenge for the healthcare system and also for ophthalmologists. Previous studies and case reports indicated that SARS-CoV‑2 also infects the conjunctiva resulting in conjunctivitis. In addition, infectious virus particles in the tear fluid can be potential sources of infection; however, the detection of SARS-CoV‑2 RNA in the tear fluid has rarely been successful. Although isolated conjunctival involvement is highly unlikely, at the current point in time of the COVID-19 pandemic, practically every patient examined by an ophthalmologist could be infected with SARS-CoV‑2. Therefore, protective and hygiene measures should currently be consistently followed to minimize the risk of spreading the virus. Currently, there are no treatment recommendations for conjunctivitis associated with COVID-19. Tear substitutes might be helpful for symptom relief but there is no evidence for a topical antiviral therapy. In the future ophthalmologists could play a decisive role in the screening of maculopathies that might occur during COVID-19 treatment using chloroquine or hydroxychloroquine.


Maintaining zero COVID-19 infection among long term care facility residents in Hong Kong


title: Bovine Respiratory Syncytial Virus Decreased Pasteurella multocida Adherence by Downregulating the Expression of Intercellular Adhesion Molecule-1 on the Surface of Upper Respiratory Epithelial Cells

text: The synergistic infection of bovine respiratory syncytial virus (BRSV) and Pasteurella multocida (PM) may predispose cattle to develop severe pneumonia. Previously, we reported that BRSV infection significantly decreased PM adherence to the upper respiratory epithelial cells. It may allow bacteria to invade into the lower respiratory tract and lead to severe pneumonia. To investigate whether BRSV infection regulates the cell surface adherence receptor on bovine trachea epithelial cells (bTECs), we performed proteomic and functional analyses. BRSV infection decreased the expression of intercellular adhesion molecule-1 (ICAM1) on bTECs. Inhibition and knockdown experiments using anti-ICAM1 antibody and siRNAs targeting ICAM1 indicated that PM adherence to bTECs was dependent on ICAM1 expression. These data suggest that under normal conditions bTECs may capture PM in the upper respiratory tract, while BRSV infection reverses this mechanism. The proposed gateway function of bTECs is disrupted by BRSV infection that may facilitate bacterial invasion into the lower respiratory tract and lead to secondary or more severe respiratory infection.


title: CT characteristics and diagnostic value of COVID-19 in pregnancy

text: OBJECTIVE: To investigate the computed tomography (CT) characteristics and diagnostic value of novel coronavirus pneumonia (NCP or COVID-19) in pregnancy. METHODS: This study included ten pregnant women infected with COVID-19, treated in the Zhongnan Hospital of Wuhan University from January 20, 2020 to February 6, 2020. Clinical and chest CT data were collected and clinical symptoms, laboratory indicators, and CT images were analyzed to explore CT characteristics and diagnostic value for COVID-19 during pregnancy. RESULTS: Laboratory examination showed that white blood cell count was normal in nine patients, and slightly higher in one patient (10.23 × 109). The lymphocyte ratio decreased in two patients by 12% and 14%, respectively. The levels of C-reactive protein was elevated in seven patients (range, 21.16–60.3 mg/L) and the levels of D-dimer was increased in eight patients (range, 507–2141 ng/mL). Six patients had low levels of total protein (range, 35.3–56.5 mg/L). Two patients showed small patchy ground glass opacity (GGO) involving single lung, while eight patients showed multilobe GGO in both the lungs, with partial consolidation. Peripheral and non-peripheral lesion distributions were seen in ten (100%) and four (40%) patients, respectively. There were four patients who had signs of intra-bronchial air-bronchogram, six patients had small bilateral pleural effusions, while none had lymphadenopathy. Dynamic observations were performed in four patients after COVID-19 treatment. Among these four patients, one patient showed normal on the initial examination, and new lesions were observed after 3 days; 1 patient showed progression after 7 days of treatment, with expansion of the lesion area; and the other 2 patients showed improvement after 14 days of treatment, with reduction in the density and area of lesions and appearance of linear opacity. CONCLUSIONS: The CT characteristics of COVID-19 in pregnancy were mainly observed in early and progressive stages, and multiple new lesions were common. And there were consolidations of varying sizes and degrees within the lesion. Moreover, the original ground glass lesions could be fused or partially absorbed. Six patients had small bilateral pleural effusion. In summary, CT scans can play an important role in early screening, dynamic observation, and efficacy evaluation of suspected or confirmed cases of pregnant women with COVID-19.


title: Prevalence of Cryptosporidia, Eimeria, Giardia, and Strongyloides in pre-weaned calves on smallholder dairy farms in Mukurwe-ini district, Kenya

text: AIM: Gastrointestinal diseases are among the leading causes of calf morbidity and mortality in Kenya and elsewhere. This study was undertaken to determine the prevalence of Cryptosporidia, Eimeria, Giardia, and Strongyloides in calves on smallholder dairy farms (SDF) in Mukurwe-ini District, Nyeri County, Kenya. These infections have been associated with economic losses by decreased growth rates, decreased productivity, and increased susceptibility to other diseases. MATERIALS AND METHODS: An observational study was conducted on 109 farms in Mukurwe-ini District, Nyeri County, Kenya, where 220 calf fecal samples (each calf at 4 and 6 weeks of age) from 110 calves (1 set of twins) were collected and analyzed for Cryptosporidia, Eimeria, Giardia, and helminth parasites. RESULTS: Eimeria oocysts, Cryptosporidia oocysts, and Strongyloides eggs were detected in the fecal samples examined, but no Giardia cysts were found. The overall period prevalence of Eimeria, Cryptosporidia, and Strongyloides was 42.7% (47/110), 13.6% (15/110), and 5.4% (6/110), respectively. The prevalence at 4 weeks of age for Eimeria, Cryptosporidia, and Strongyloides was 30.0% (33/110), 8.2% (9/110), and 3.7% (4/109), respectively, while the prevalence at 6 weeks of age was 20.2% (22/109), 6.5% (7/107), and 2.7% (3/110), respectively. There was, however, no significant difference in the prevalence at 4 and 6 weeks (p>0.05). CONCLUSION: Findings from this study show that Eimeria, Cryptosporidia, and Strongyloides, are prevalent in the study area and indicate the need to adopt optimal management practices to control infections in calves.


Nepal’s First Case of COVID-19 and public health response


title: Priapism in a patient with coronavirus disease 2019 (COVID-19): A case report

text: Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability. Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state. Emergency management consisted on an intracavernosal injection of the sympathomimetic agent ethylephrine and cavernosal blood aspiration. The patient experienced no recurrences under thromboprophylaxis by enoxaparin 40 mg twice daily.


title: In silico vaccine design against Chlamydia trachomatis infection

text: Chlamydia trachomatis, a gram-negative bacterium known to infect the genital sites mainly columnar epithelial cells of the cervix, urethra and rectum in women and causes acute epididymitis, urinary tract inflammation and DNA damage to the sperms in men, hence considered to be one of the major sexually transmitted infections. The infection is asymptomatic in many people and remains untreated leading to serious health complications, including pelvic inflammatory disease, ectopic pregnancy and infertility. The current treatment options include antibiotics, but the pathogen has gained resistance against many antibiotics. The present work involves an in silico reverse vaccinology approach for identifying the immunogens as vaccine candidates that can be effective against reinfections and should be capable of inducing long-term protective immunity against Chlamydial infections. This study identifies the putative vaccine candidates that are membrane bound with high antigenicity properties; antigenicity induces the immunogenicity which involves identification of T-cell and B-cell epitopes that induce both humoral and cell-mediated immunity. The epitopes ‘LSWEMELAY’, ‘LSNTEGYRY’, ‘TSDLGQMEY’, ‘FIDLLQAIY’ and ‘FSNNFSDIY’ were predicted as core sequences for class I MHC molecules. The identified epitopes showed promising ability to interact with the human leukocyte antigens (HLA). These epitopes showed maximum population coverage with epitope conservancy above 80%. Molecular docking was performed to test the binding affinities of the identified epitopes with the HLA molecule to study the binding cleft interactions. The vaccine candidate thus identified from this study showed to possess the potential to activate the B- and T-cell immune responses which are more specific and make the body stronger against infections and effective for reinfections. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13721-020-00243-w) contains supplementary material, which is available to authorized users.


title: How to Target Viral and Bacterial Effector Proteins Interfering with Ubiquitin Signaling

text: Ubiquitination is a frequently occurring and very diverse posttranslational modification influencing a wide scope of cellular processes. Ubiquitin (Ub) has the unique ability to form eight different lysine-linked polymeric chains, mixed chains and engages with ubiquitin-like (Ubl) molecules. The distinct signals evoked by specific enzymes play a crucial role in, for instance, proteasome-mediated protein degradation, cell cycle regulation, and DNA damage responses. Due to the large variety of cellular functions that this posttranslational modification influences, the enzymes that construct such Ub modifications, and subsequently controle and degrade these signals, is enormous. In this chapter, we will discuss the current state-of-the-art of activity-based probes, reporter substrates, and other relevant tools based on Ub as recognition element, to study the enzymes involved in the complex system of ubiquitination.


title: Molecular mechanisms of primary and secondary mucosal immunity using avian infectious bronchitis virus as a model system

text: Abstract Although mucosal immune responses are critical for protection of hosts from clinical illness and even mortality caused by mucosal pathogens, the molecular mechanism of mucosal immunity, which is independent of systemic immunity, remains elusive. To explore the mechanistic basis of mucosal protective immunity, gene transcriptional profiling in mucosal tissues was evaluated after the primary and secondary immunization of animals with an attenuated avian infectious bronchitis virus (IBV), a prototype of Coronavirus and a well-characterized mucosal pathogen. Results showed that a number of innate immune factors including toll-like receptors (TLRs), retinoic-acid-inducible gene-1 (RIG-1), type I interferons (IFNs), complements, and interleukin-1 beta (IL-1β) were activated locally after the primary immunization. This was accompanied or immediately followed by a potent Th1 adaptive immunity as evidenced by the activation of T-cell signaling molecules, surface markers, and effector molecules. A strong humoral immune response as supported by the significantly up-regulated immunoglobulin (Ig) gamma chain was observed in the absence of innate, Th1 adaptive immunity, or IgA up-regulation after the secondary immunization, indicating that the local memory response is dominated by IgG. Overall, the results provided the first detailed kinetics on the molecular basis underlying the development of primary and secondary mucosal immunity. The key molecular signatures identified may provide new opportunities for improved prophylactic and therapeutic strategies to combat mucosal infections.


title: COVID-19 et Chirurgie ORL

text: RESUME En ORL, l’examen clinique et les gestes invasifs sur les voies respiratoires et leurs annexes exposent à la transmission directe du SARS-CoV-2 par inhalation ou projection oculaire de gouttelettes contaminées, ou indirecte manuportée ou par l’intermédiaire d’objets ou de surfaces contaminés. L’estimation d’un R0 de la Covid-19 à environ 3 a justifié de reporter les rendez-vous des consultations présentielles non urgentes et de développer la téléconsultation afin de limiter les risques d'infection par le SARS-CoV-2 des patients ou des agents de santé et de participer au respect du confinement. L’autorité sanitaire a recommandé de déprogrammer toute activité ORL chirurgicale ou médicale non urgente et sans préjudice de perte de chance pour les patients. Cette déprogrammation a eu pour objectif d’augmenter très significativement la capacité de soins critiques, prioriser l’accueil de malades de patients Covid-19, prioriser l’affectation des personnels et la mise à disposition des matériels nécessaires à leur fonctionnement, contribuer à la fluidité de l’aval des soins critiques au sein de leur établissement. Il s’agissait également de ne pas exposer les malades concernés à un risque d’exposition infectieuse. Cet article propose des orientations concernant les indications et modalités de réalisation de la chirurgie ORL et la gestion des reports d’intervention dans le contexte pandémique actuel. Il ne s’agit que de conseils de bonne pratique qui doivent naturellement être modulés dans chaque région en fonction de l’évolution de l’épidémie et des organisations préexistantes, et ce dans le cadre de concertations entre les équipes ORL, les unités opérationnelles d’hygiène et toutes les autres spécialités concernées.


title: Chapter 13 Economic and Political Impact of Ebola Virus Disease

text: We are at a dangerous moment in these three West African countries, all fragile states that have had strong economic growth in recent years after decades of wars and poor governance. It would be scandalous to let this crisis escalate further when we have the knowledge, tools, and resources to stop it. Tens of thousands of lives, the future of the region, and hard-won economic and health gains for millions hang in the balance. Jim Yong Kim and Paul Farmer, World Bank Group President and Harvard University Professor, The Washington Post


title: Change of influenza pandemics because of climate change: Complex network simulations

text: Introduction Airborne influenza virus transmission is depending on climate. Infected individuals are able to travel to any country in the world within one day. In this study we combine these two insights to investigate the influence of climate change on pandemic spreading patterns of airborne infectious diseases, like influenza. Well-known recent examples for pandemics are severe acute respiratory syndrome (SARS, 2002/2003) and H1N1 (Influenza A virus subtype, 2009), which have demonstrated the vulnerability of a strongly connected world. Methods Our study is based on a complex network approach including the following datasets: –global air traffic data (from openflights.org) with information on airports, direct flight connections, and airplane types; –global population grid [from Socioeconomic Data and Applications Center (SEDAC), NASA]; –WATCH-Forcing-Data-ERA-Interim (WFDEI) climate reanalysis data (1980–2015) and RCP6.0 climate projection data (2016–2040): temperature, specific humidity, surface air pressure, water vapour pressure. We use the dependency between water vapour pressure and influenza transmission rate to give every location around the globe a unique transmission rate time series from 1980 until 2040. Local disease development is simulated with a stochastic SEIR compartmental model. All individuals (including infectious ones) are able to migrate from location to location via air traffic to simulate global dissemination of the virus. Results Our results show which regions are most vulnerable to climate change in terms of influenza pandemics towards key target locations (defined by highest degree, highest population, highest betweenness centrality). Furthermore, we point out the influence of climate change on pandemics from 1980 until 2040. A significant trend in the pandemic rate of spreading can be seen on a global scale. Climate change causes an influenza pandemic to proceed 5 days slower (global average) in the year 2040 compared to the year 1980. This trend varies from country to country. For example, pandemics originating from Chad show an accelerated (6 days faster) spread. Conclusion The presented results focus on the effect that climate change has on spreading patterns of airborne infectious diseases. The change from 1980 until 2040 of important influencing variables like population distribution, varying air traffic, vaccine research, hygiene, and healthcare are neglected to separate the impact of climate change.


Universal public use of surgical mask and respiratory viral infection


title: Role of modelling in COVID-19 policy development

text: Models have played an important role in policy development to address the COVID-19 outbreak from its emergence in China to the current global pandemic. Early projections of international spread influenced travel restrictions and border closures. Model projections based on the virus’s infectiousness demonstrated its pandemic potential, which guided the global response to and prepared countries for increases in hospitalisations and deaths. Tracking the impact of distancing and movement policies and behaviour changes has been critical in evaluating these decisions. Models have provided insights into the epidemiological differences between higher and lower income countries, as well as vulnerable population groups within countries to help design fit-for-purpose policies. Economic evaluation and policies have combined epidemic models and traditional economic models to address the economic consequences of COVID-19, which have informed policy calls for easing restrictions. Social contact and mobility models have allowed evaluation of the pathways to safely relax mobility restrictions and distancing measures. Finally, models can consider future end-game scenarios, including how suppression can be achieved and the impact of different vaccination strategies.


title: Catalysts for implementation of One Health in Kenya

text: The recent Zika outbreak in the Americas, Ebola epidemic in West Africa and the increased frequency and impact of emerging and re-emerging infections of animal origin have increased the calls for greater preparedness in early detection and responses to public health events. One-Health approaches that emphasize collaborations between human health, animal health and environmental health sectors for the prevention, early detection and response to disease outbreaks have been hailed as a key strategy. Here we highlight three main efforts that have progressed the implementation of One Health in Kenya.


title: The Role of Epithelial Integrin Receptors in Recognition of Pulmonary Pathogens

text: Integrins are a large family of heterodimeric transmembrane cell adhesion receptors. During the last decade, it has become clear that integrins significantly participate in various host-pathogen interactions involving pathogenic bacteria, fungi, and viruses. Many bacteria possess adhesins that can bind either directly or indirectly to integrins. However, there appears to be an emerging role for integrins beyond simply adhesion molecules. Given the conserved nature of integrin structure and function, and the diversity of the pathogens which use integrins, it appears that they may act as pattern recognition receptors important for the innate immune response. Several clinically significant bacterial pathogens target lung epithelial integrins, and this review will focus on exploring various structures and mechanisms involved in these interactions.


title: RLadyBug—An R package for stochastic epidemic models

text: Abstract RLadyBug is an S4 package for the simulation, visualization and estimation of stochastic epidemic models in R. Maximum likelihood and Bayesian inference can be performed to estimate the parameters in a susceptible-exposed-infectious-recovered (SEIR) model, which is a stochastic model for describing a single outbreak of an infectious disease. The package is thus one step towards statistical software supporting parameter estimation, calculation of confidence intervals and hypothesis testing for transmission models.


title: Nursing When the World is Upside Down

text: Nurses are at the forefront of the COVID-19 pandemic.


title: Structuring for innovative responses to human resource challenges: A skunk works approach

text: Abstract Increasingly, organizations find that they need to be more flexible and innovative in responding to unexpected and emergent human resource (HR) issues affecting their members, such as outbreaks of infectious diseases (e.g., COVID-19) forcing massive transition to remote work, changes in industry landscape altering learning and development, and politically-driven global mobility regulations restricting people flow. Organizations have long utilized informal structures known as “skunk works”, flexible groups empowered to work rapidly with minimal management constraints, to address technological challenges. In this article, we aim to better understand when and how organizations similarly employ skunk works-like structures to help them deal with rapidly evolving HR-related challenges. We discuss three examples of organizations that have utilized this approach. We then integrate the learning insights from these examples to develop a framework supported by a set of research questions to guide future scholarship into HR skunk works. We emphasize that there are both benefits and drawbacks of innovative organizational structures for addressing HR challenges alongside regular, established ways of working.


title: Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody

text: The newly identified 2019 novel coronavirus (2019-nCoV) has caused more than 800 laboratory-confirmed human infections, including 25 deaths, posing a serious threat to human health. Currently, however, there is no specific antiviral treatment or vaccine. Considering the relatively high identity of receptor binding domain (RBD) in 2019-nCoV and SARS-CoV, it is urgent to assess the cross-reactivity of anti-SARS-CoV antibodies with 2019-nCoV spike protein, which could have important implications for rapid development of vaccines and therapeutic antibodies against 2019-nCoV. Here, we report for the first time that a SARS-CoV-specific human monoclonal antibody, CR3022, could bind potently with 2019-nCoV RBD (KD of 6.3 nM). The epitope of CR3022 does not overlap with the ACE2 binding site within 2019-nCoV RBD. Therefore, CR3022 has the potential to be developed as candidate therapeutics, alone or in combination with other neutralizing antibodies, for the prevention and treatment of 2019-nCoV infections. Interestingly, some of the most potent SARS-CoV-specific neutralizing antibodies (e.g., m396, CR3014) that target the ACE2 binding site of SARS-CoV failed to bind 2019-nCoV spike protein, indicating that the difference in the RBD of SARS-CoV and 2019-nCoV has a critical impact for the cross-reactivity of neutralizing antibodies, and that it is still necessary to develop novel monoclonal antibodies that could bind specifically to 2019-nCoV RBD.


title: AI Surveillance during Pandemics: Ethical Implementation Imperatives

text: Artificial intelligence surveillance can be used to diagnose individual cases, track the spread of Covid‐19, and help provide care. The use of AI for surveillance purposes (such as detecting new Covid‐19 cases and gathering data from healthy and ill individuals) in a pandemic raises multiple concerns ranging from privacy to discrimination to access to care. Luckily, there exist several frameworks that can help guide stakeholders, especially physicians but also AI developers and public health officials, as they navigate these treacherous shoals. While these frameworks were not explicitly designed for AI surveillance during a pandemic, they can be adapted to help address concerns regarding privacy, human rights, and due process and equality. In a time where the rapid implementation of all tools available is critical to ending a pandemic, physicians, public health officials, and technology companies should understand the criteria for the ethical implementation of AI surveillance.


„SARS als Folge der Traditionellen Chinesischen Medizin?”


title: Astragalus polysaccharides inhibit avian infectious bronchitis virus infection by regulating viral replication

text: Abstract The avian coronavirus causes infectious bronchitis (IB), which is one of the most serious diseases affecting the avian industry worldwide. However, there are no effective strategies for controlling the IB virus (IBV) at present. Therefore, development of novel antiviral treatment strategies is urgently required. As reported, astragalus polysaccharides (APS) have potential antiviral effects against several viruses; however, the antiviral effect of APS against IBV remains unclear. In this study, we explored whether APS had the potential to inhibit IBV infectionby utilizing several in vitro experimental approaches. To this end, the effect of APS on the replication of IBV was examined in chicken embryo kidney (CEK) cells. Viral titers were calculated by using the plaque formation assay, and the cytotoxicity of APS was tested by utilizing a Cell Counting Kit-8 assay. The expression of viral mRNA and cytokine (IL-1β, IL-6, IL-8 and TNF-α) mRNA transcripts was determined by real-time quantitative RT-PCR(qRT-PCR). IBV titers in infected CEK cells treated with APS were significantly reduced in a dose-dependent manner, indicating that APS inhibited IBV replication in vitro. We also found that the decreased viral replication after APS treatment was associated with reduced mRNA levels of the cytokines IL-1B, IL-6, IL-8 and TNF-α. In conclusion, these results suggest that APS exhibit antiviral activities against IBV and it may represent a potential therapeutic agent for inhibiting the replication of IBV.


title: Genomic screening of new putative antiviral lectins from Amazonian cyanobacteria based on a bioinformatics approach

text: Lectins are proteins of nonimmune origin, which are capable of recognizing and binding to glycoconjugate moieties. Some of them can block the interaction of viral glycoproteins to the host cell receptors acting as antiviral agents. Although cyanobacterial lectins have presented broad biotechnological potential, little research has been directed to Amazonian Cyanobacterial diversity. In order to identify new antiviral lectins, we performed genomic analysis in seven cyanobacterial strains from Coleção Amazônica de Cianobactérias e Microalgas (CACIAM). We found 75 unique CDS presenting one or more lectin domains. Since almost all were annotated as hypothetical proteins, we used homology modeling and molecular dynamics simulations to evaluate the structural and functional properties of three CDS that were more similar to known antiviral lectins. Nostoc sp. CACIAM 19 as well as Tolypothrix sp. CACIAM 22 strains presented cyanovirin‐N homologues whose function was confirmed by binding free energy calculations. Asn, Glu, Thr, Lys, Leu, and Gly, which were described as binding residues for cyanovirin, were also observed on those structures. As for other known cyanovirins, those residues in both our models also made favorable interactions with dimannose. Finally, Alkalinema sp. CACIAM 70d presented one CDS, which was identified as a seven‐bladed beta‐propeller structure with binding sites predicted for sialic acid and N‐acetylglucosamine. Despite its singular structure, our analysis suggested this molecule as a new putative antiviral lectin. Overall, the identification and the characterization of new lectins and their homologues are a promising area in antiviral research, and Amazonian cyanobacteria present biotechnological potential to be explored in this regard.


title: Undersampling in action and at scale: application to the COVID-19 pandemic

text: It is the purpose of this short communication to analyze the possible caveats in the statistical interpretation of collected data, particularly in the light of decision-making concerning the current COVID-19 coronavirus pandemic. A mitigation of undersampling is proposed, based on re-scaling of statistics that can be considered reliable, such as deaths, and epidemic properties like mortality, that may be considered comparable between countries with similar levels of health care, which would not have reached a saturation level.


title: Potential implications of COVID‐19 in non‐alcoholic fatty liver disease

text: COVID-19 burdens all areas of healthcare, and the relationship between COVID-19 and liver injury is being examined. The recently published papers by Xu et al and Xie et al nicely describe liver injury resulting from COVID-191,2 . As with many papers the focus lies on patients without pre-existing liver disease, even though it has been suggested that pre-existing conditions affect COVID-19.


Risk and resilience in the time of the COVID-19 crisis


title: Detection of viruses in weekly stool specimens collected during the first 2 years of life: A pilot study of five healthy Australian infants in the rotavirus vaccine era

text: Several viruses are associated with gastroenteritis in infants. This pilot study, nested within a larger community‐based project of early childhood infections, collected daily symptom data and 511 weekly stool samples from five healthy, fully vaccinated, term infants from birth until their second birthday. Real‐time PCR assays were used to detect six enteric viruses. Frequent, silent shedding of one or more of the six viruses was observed, particularly involving adenovirus where shedding could be for up to 3 months without gastrointestinal symptoms. These pilot data demonstrate that a positive PCR result for enteric viruses may not always indicate the cause of childhood gastroenteritis. J. Med. Virol. 89:917–921, 2017. © 2016 Wiley Periodicals, Inc.


title: Trends in IoT based solutions for health care: moving AI to the Edge

text: In recent times, we assist to an ever growing diffusion of smart medical sensors and Internet of things devices that are heavily changing the way healthcare is approached worldwide. In this context, a combination of Cloud and IoT architectures is often exploited to make smart healthcare systems capable of supporting near realtime applications when processing and performing Artificial Intelligence on the huge amount of data produced by wearable sensor networks. Anyway, the response time and the availability of cloud based systems, together with security and privacy, still represent critical issues that prevents Internet of Medical Things (IoMT) devices and architectures from being a reliable and effective solution to the aim. Lately, there is a growing interest towards architectures and approaches that exploit Edge and Fog computing as an answer to compensate the weaknesses of the cloud. In this paper, we propose a short review about the general use of IoT solutions in health care, starting from early health monitoring solutions from wearable sensors up to a discussion about the latest trends in fog/edge computing for smart health.


title: A bioinformatic filter for improved base-call accuracy and polymorphism detection using the Affymetrix GeneChip® whole-genome resequencing platform

text: DNA resequencing arrays enable rapid acquisition of high-quality sequence data. This technology represents a promising platform for rapid high-resolution genotyping of microorganisms. Traditional array-based resequencing methods have relied on the use of specific PCR-amplified fragments from the query samples as hybridization targets. While this specificity in the target DNA population reduces the potential for artifacts caused by cross-hybridization, the subsampling of the query genome limits the sequence coverage that can be obtained and therefore reduces the technique's resolution as a genotyping method. We have developed and validated an Affymetrix Inc. GeneChip® array-based, whole-genome resequencing platform for Francisella tularensis, the causative agent of tularemia. A set of bioinformatic filters that targeted systematic base-calling errors caused by cross-hybridization between the whole-genome sample and the array probes and by deletions in the sample DNA relative to the chip reference sequence were developed. Our approach eliminated 91% of the false-positive single-nucleotide polymorphism calls identified in the SCHU S4 query sample, at the cost of 10.7% of the true positives, yielding a total base-calling accuracy of 99.992%.


title: Nicotinamide Riboside—The Current State of Research and Therapeutic Uses

text: Nicotinamide riboside (NR) has recently become one of the most studied nicotinamide adenine dinucleotide (NAD(+)) precursors, due to its numerous potential health benefits mediated via elevated NAD(+) content in the body. NAD(+) is an essential coenzyme that plays important roles in various metabolic pathways and increasing its overall content has been confirmed as a valuable strategy for treating a wide variety of pathophysiological conditions. Accumulating evidence on NRs’ health benefits has validated its efficiency across numerous animal and human studies for the treatment of a number of cardiovascular, neurodegenerative, and metabolic disorders. As the prevalence and morbidity of these conditions increases in modern society, the great necessity has arisen for a rapid translation of NR to therapeutic use and further establishment of its availability as a nutritional supplement. Here, we summarize currently available data on NR effects on metabolism, and several neurodegenerative and cardiovascular disorders, through to its application as a treatment for specific pathophysiological conditions. In addition, we have reviewed newly published research on the application of NR as a potential therapy against infections with several pathogens, including SARS-CoV-2. Additionally, to support rapid NR translation to therapeutics, the challenges related to its bioavailability and safety are addressed, together with the advantages of NR to other NAD(+) precursors.


title: Correction: Reversal of the Progression of Fatal Coronavirus Infection in Cats by a Broad-Spectrum Coronavirus Protease Inhibitor

text: [This corrects the article DOI: 10.1371/journal.ppat.1005531.].


title: A Minimally Replicative Vaccine Protects Vaccinated Piglets Against Challenge With the Porcine Epidemic Diarrhea Virus

text: Porcine epidemic diarrhea virus (PEDV), is an economically important enteric coronavirus, with over a 90% mortality rate in neonatal piglets. The virus emerged in the US in 2013, resulting in severe production losses. Effective vaccine development against PEDV is a challenge. Inactivated vaccines are of questionable efficacy. Attenuated vaccines, while more effective, require a relatively long lead development time, are associated with safety concerns and are also unable to prevent new field outbreaks. To combine the safety and efficacy advantages of inactivated and attenuated PEDV vaccines, respectively, in this study, we tested the hypothesis that subjecting PEDV virions to heat treatment at 44°C for 10 min to reversibly unfold structural proteins, followed by exposure to RNAse to fragment the genome, would result in a vaccine preparation with intact viral structure/antigenicity but highly diminished replicative abilities. We expected the vaccine to be both safe and effective in a piglet challenge model. Following the heat and RNAse treatment, PEDV virions had an intact electron microscopic ultrastructure and were amplified only in the 3rd passage in Vero cells, indicating that diminished replication was achieved in vitro. Strong PEDV spike-protein specific and virus neutralizing antibody responses were elicited in vaccinated piglets. Upon challenge, all vaccinated pigs were protected against fecal viral shedding and intestinal pathology, while the unvaccinated controls were not. The vaccine virus was not detected in the fecal matter of vaccinated pigs prior to challenge; nor did they develop intestinal lesions. Thus, the described approach has significant promise in improving current approaches for PEDV immunization.


title: Cell mediated innate responses of cattle and swine are diverse during foot-and-mouth disease virus (FMDV) infection: A unique landscape of innate immunity

text: Abstract Pathogens in general and pathogenic viruses in particular have evolved a myriad of mechanisms to escape the immune response of mammalian species. Viruses that cause acute disease tend to bear characteristics that make them very contagious, as survival does not derive from chronicity of infection, but spread of disease throughout the herd. Foot-and-mouth disease virus (FMDV) is one of the most contagious viruses known. Upon infection of susceptible species, cloven-hoofed animals, the virus proliferates rapidly and causes a vesicular disease within 2–4 days. Disease symptoms resolve by 10 days to 2 weeks and in most cases, virus can no longer be detected. Periods of fever and viremia are usually brief, 1–3 days. In vivo control of virus infection and clearance of the virus during and following acute infection is of particular interest. The interaction of this virus with cells mediating the early, innate immune response has been analyzed in a number of recent studies. In most reports, the virus has a distinct inhibitory effect on the response of cells early in infection. Here we review these new data and discuss the dynamics of the interaction of virus with different cell types mediating the immune response to infection.


title: Use of transparent curtains on bedside of patients with COVID‐19

text: The pandemic of COVID-19 has brought day to day life at a standstill. During such difficult times, safety of medical staff becomes more important as they are on the frontlines in tackling the disease. Despite aggressive safety measures and use of personal protective equipment (PPE), infections and deaths have been reported among HCP's.1 This has led to a panic and stigma in the medical community.


title: COVID-19: is there a link between the course of infection and pharmacological agents in diabetes?

text: BACKGROUND: The Coronavirus disease 2019 (COVID-19) and type 2 diabetes (T2D) are two pandemics that share the dramatic impact on global mortality and economic resources. COVID-19 largely exhibits mild to moderate clinical manifestations. However, severe pneumonia with high fatality rate may occur, especially in the elderly and in patients with underlying conditions, such as diabetes and cardiovascular disease. SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) binds to the angiotensin-converting enzyme 2 (ACE2), a ubiquitous trans-membrane carboxypeptidase, to enter the cells. AIMS: This short review discusses some open questions about the link between COVID-19 and diabetes, principally focusing on the possible effects of commonly used drugs in patients with diabetes. RESULTS: Preclinical studies have reported that angiotensin receptor blockers (ARBs) and ACE inhibitors might increase ACE2 expression in several cell types. Hence, it has been speculated that the treatment with these agents might influence the course of the infection, and both harmful and beneficial effects have been supposed. Other pharmacological agents are thought to increase ACE2 expression, including statins and proliferator-activated receptor gamma (PPAR-γ) agonists. All these drug classes are broadly adopted in T2D. Besides ACE2, other unknown co-factors might be involved in cell infection. It has been recently observed that dipeptidyl peptidase-4 (DPP4), the receptor for MERS-CoV (Middle East respiratory syndrome-related coronavirus) and ACE2 have similar expression profiles in the lung. DPP4 has important metabolic and immune functions and is a target for commonly used therapies in T2D. CONCLUSIONS: Although clinical data supporting an influence of all these drugs on the course of the disease are limited, this is an interesting background for further research that might help unravel the complex mechanisms underlying the link between COVID-19 and diabetes.


title: The untapped cell biology of neglected tropical diseases

text: The World Health Organization lists a constellation of 17 tropical diseases that afflict approximately one in six individuals on the planet and, until recently, few resources have been devoted to the treatment and eradication of those diseases. They are often referred to as the diseases of the “bottom billion,” because they are most prevalent among the poorest individuals in impoverished tropical nations. However, the few studies that have been performed reveal an extraordinary world of molecular and cellular adaptations that facilitate the pathogens’ survival in hosts ranging from insects to humans. A compelling case can be made that even a modest investment toward understanding the basic molecular and cell biology of these neglected pathogens has a high probability of yielding exciting new cellular mechanisms and insights into novel ways of combating these diseases.


title: Endocrine and metabolic link to coronavirus infection

text: Type 2 diabetes mellitus and hypertension are the most common comorbidities in patients with coronavirus infections. Emerging evidence demonstrates an important direct metabolic and endocrine mechanistic link to the viral disease process. Clinicians need to ensure early and thorough metabolic control for all patients affected by COVID-19.


title: Limonoids isolated from Toona sinensis and their radical scavenging, anti-inflammatory and cytotoxic activities

text: Abstract A phytochemical investigation of the ethanol extract of Toona sinensis (A. Juss.) Roem resulted in the isolation of ten new limonoids, toonasinenines A–J (1–10), together with two known compounds, toonafolin (11) and toonacilianin D (12). Their structures were determined by spectroscopic analyses. The isolated components were evaluated in vitro for radical scavenging potential using ABTS⋅+ and DPPH test, anti-inflammatory activities for Cox-1 and Cox-2, and cytotoxicies against nine tumour cell lines (A549, BGC-823, CHG-5, HCT15, HeLa, HepG2, MDA-MB-231, SHG-44 and SGC-7901 cells). As a result, 4, 5 and 7–10 showed potent radical scavenging activities, while limonoids 1–4 and 11 exhibited significant anti-inflammatory and cytotoxic potential.


title: Villains or heroes? The raison d'être of viruses

text: The relationship between humans and viruses has a long history. Since the first identification of viruses in the 19th century, we have considered them to be ‘pathogens’ and have studied their mechanisms of replication and pathogenicity to combat the diseases that they cause. However, the relationships between hosts and viruses are various and virus infections do not necessarily cause diseases in their hosts. Rather, recent studies have shown that viral infections sometimes have beneficial effects on the biological functions and/or evolution of hosts. Here, we provide some insight into the positive side of viruses.


title: ‘Policing’ a pandemic: Garda wellbeing and COVID-19

text: In response to the global pandemic COVID-19, the Irish government has called upon the Garda Síochána to implement an unparalleled mode of policing to mitigate and contain the spread of the Coronavirus. Studies investigating smaller scale epidemics, such as Severe Acute Respiratory Syndrome (SARS), indicate that staff at the frontlines of an outbreak are exposed to an insuperable amount of stress and experience increased psychological morbidities as a result. Furthermore, research not only indicates that heighted levels of psychological distress are an occupational hazard associated with the law enforcement profession, but that members of the Garda Síochána feel their mental health needs are largely unmet by their organisation. Given the pandemic’s propensity to expose officers to indeterminate echelons of physical and psychological threat; there has never been a more appropriate time to explore the potential burdens associated with ‘policing’ a pandemic, question the governments capacity to address the psychological support needs of frontline professionals, and plan future research for best practice.


title: Altered Taste in Patients with COVID‐19: The Potential Role of Salivary Glands

text: The novel coronavirus disease (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) constitutes a public health emergency of international concern. Taste and smell disorders have been reported along with various other clinical problems. In some studies (Fitzgerald, 2020; Machado & Gutierrez, 2020; Parma et al., 2020; Yan, Faraji, Prajapati, Boone, & DeConde, 2020), smell and taste disturbances have been reported in COVID‐19‐positive subjects, suggesting that chemosensory dysfunction should be considered when screening for this disease. In this manuscript, the possible influence of salivary gland dysfunction and hyposalivation in the chemosensory disorders observed in COVID‐19 patients is briefly discussed.


title: Oral delivery of maize-produced porcine epidemic diarrhea virus spike protein elicits neutralizing antibodies in pigs

text: Porcine Epidemic Diarrhea Virus (PEDV) causes severe diarrhea and mortality in piglets. Robust immunity may break the transmission cycle. Expression of antigens in maize grains is a promising method for producing low-cost vaccines. As a first step, we expressed maize constructs containing PEDV S1 spike protein targeted to various cellular locations including the cell wall, endoplasmic reticulum, and vacuole, and fused to carrier proteins E. coli heat labile subunit (LTB) and a dendritic cell (DC) binding peptide, and obtained sufficient antigen for oral immunization. Constructs targeting S1 to the ER or fused to carrier proteins produced high levels of antigen of greater than 20 mg/kg. Oral administration to pigs elicited serum neutralizing antibodies, supporting oral immunization as a practical and cost-effective PEDV vaccine. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11240-020-01835-0) contains supplementary material, which is available to authorized users.


title: Data-Driven Dynamic Clustering Framework for Mitigating the Adverse Economic Impact of Covid-19 Lockdown Practices

text: The COVID-19 disease has once again reiterated the impact of pandemics beyond a biomedical event with potential rapid, dramatic, sweeping disruptions to the management, and conduct of everyday life. Not only the rate and pattern of contagion that threaten our sense of healthy living but also the safety measures put in place for containing the spread of the virus may require social distancing. Three different measures to counteract this pandemic situation have emerged, namely: i) vaccination, ii) herd immunity development, and iii) lockdown. As the first measure is not ready at this stage and the second measure is largely considered unreasonable on the account of the gigantic number of fatalities, a vast majority of countries have practiced the third option despite having a potentially immense adverse economic impact. To mitigate such an impact, this paper proposes a data-driven dynamic clustering framework for moderating the adverse economic impact of COVID-19 flare-up. Through an intelligent fusion of healthcare and simulated mobility data, we model lockdown as a clustering problem and design a dynamic clustering algorithm for localized lockdown by taking into account the pandemic, economic and mobility aspects. We then validate the proposed algorithms by conducting extensive simulations using the Malaysian context as a case study. The findings signify the promises of dynamic clustering for lockdown coverage reduction, reduced economic loss, and military unit deployment reduction, as well as assess potential impact of uncooperative civilians on the contamination rate. The outcome of this work is anticipated to pave a way for significantly reducing the severe economic impact of the COVID-19 spreading. Moreover, the idea can be exploited for potentially the next waves of corona virus-related diseases and other upcoming viral life-threatening calamities.


title: Assessment of YouTube as an Educational Tool in Teaching Key Indicator Cases in Otolaryngology During the COVID-19 Pandemic and Beyond: Neck Dissection

text: OBJECTIVES: YouTube has become the preferred resource for trainees in otolaryngology to prepare for surgery. This study aimed to compare the evaluation by 2 attending physicians and 2 resident physicians of the quality of videos on YouTube on neck dissection, a key indicator case in head and neck surgery. The authors aimed to assess the quality and quantity of YouTube videos available for development of a virtual surgical educational curriculum for trainees in otolaryngology. METHODS: Using the YouTube search feature, the top 10 videos by relevance and view count were compiled using the following search terms: radical neck dissection, selective neck dissection, modified radical neck dissection, lateral neck dissection, levels I-III neck dissection, levels II-IV, left neck dissection, right neck dissection, cervical nodal dissection, and supraomohyoid neck dissection. A total of 37 videos on neck dissection were identified and analyzed using the LAP-VEGaS criteria as well as author-specific modified LAP-VEGaS criteria. RESULTS: The mean comprehensive LAP-VEGaS score was 8.74 (SD 3.10). The majority of videos (24/37) were designated as medium quality; 10 of 37 videos were low quality and 3 of 37 videos were high quality. In the total group analysis, there was excellent inter-rater reliability between attending physicians (Cohen's kappa coefficient of 0.84) and good inter-rater reliability between resident physicians (Cohen's kappa coefficient of 0.58). There was no correlation between total view count, video age, or number of likes/dislikes and the overall LAP-VEGaS score. The presence of audio or written commentary had a moderate positive correlation with LAP-VEGaS score (adjusted R(2) of 0.36). There was no statistically significant difference in video quality between videos posted by US and non-US based physicians (95% confidence interval −0.10 to 4.10; p = 0.06). However, videos made by an otolaryngology-trained physician had a LAP-VEGaS score that was 3.93 points higher (95% confidence interval 2.34-5.52; p < 0.001) than that of videos made by a nonotolaryngology-trained physician. CONCLUSIONS: Online videos of neck dissection represent an increasingly ubiquitous and appropriate resource for trainees in learning otolaryngology key indicator cases. While free-to-access video repositories, such as YouTube, have become increasingly popular among trainees as a primary resource for learning and preparing for surgical cases, they lack consistent quality and as such, global efforts should be taken to improve the breadth and depth of educational video content in otolaryngology. LEVEL OF EVIDENCE: N/A


title: Vimentin in Bacterial Infections

text: Despite well-studied bacterial strategies to target actin to subvert the host cell cytoskeleton, thus promoting bacterial survival, replication, and dissemination, relatively little is known about the bacterial interaction with other components of the host cell cytoskeleton, including intermediate filaments (IFs). IFs have not only roles in maintaining the structural integrity of the cell, but they are also involved in many cellular processes including cell adhesion, immune signaling, and autophagy, processes that are important in the context of bacterial infections. Here, we summarize the knowledge about the role of IFs in bacterial infections, focusing on the type III IF protein vimentin. Recent studies have revealed the involvement of vimentin in host cell defenses, acting as ligand for several pattern recognition receptors of the innate immune system. Two main aspects of bacteria-vimentin interactions are presented in this review: the role of vimentin in pathogen-binding on the cell surface and subsequent bacterial invasion and the interaction of cytosolic vimentin and intracellular pathogens with regards to innate immune signaling. Mechanistic insight is presented involving distinct bacterial virulence factors that target vimentin to subvert its function in order to change the host cell fate in the course of a bacterial infection.


title: Association of radiologic findings with mortality of patients infected with 2019 novel coronavirus in Wuhan, China

text: Radiologic characteristics of 2019 novel coronavirus (2019-nCoV) infected pneumonia (NCIP) which had not been fully understood are especially important for diagnosing and predicting prognosis. We retrospective studied 27 consecutive patients who were confirmed NCIP, the clinical characteristics and CT image findings were collected, and the association of radiologic findings with mortality of patients was evaluated. 27 patients included 12 men and 15 women, with median age of 60 years (IQR 47–69). 17 patients discharged in recovered condition and 10 patients died in hospital. The median age of mortality group was higher compared to survival group (68 (IQR 63–73) vs 55 (IQR 35–60), P = 0.003). The comorbidity rate in mortality group was significantly higher than in survival group (80% vs 29%, P = 0.018). The predominant CT characteristics consisted of ground glass opacity (67%), bilateral sides involved (86%), both peripheral and central distribution (74%), and lower zone involvement (96%). The median CT score of mortality group was higher compared to survival group (30 (IQR 7–13) vs 12 (IQR 11–43), P = 0.021), with more frequency of consolidation (40% vs 6%, P = 0.047) and air bronchogram (60% vs 12%, P = 0.025). An optimal cutoff value of a CT score of 24.5 had a sensitivity of 85.6% and a specificity of 84.5% for the prediction of mortality. 2019-nCoV was more likely to infect elderly people with chronic comorbidities. CT findings of NCIP were featured by predominant ground glass opacities mixed with consolidations, mainly peripheral or combined peripheral and central distributions, bilateral and lower lung zones being mostly involved. A simple CT scoring method was capable to predict mortality.


title: A review on the antagonist Ebola: A prophylactic approach

text: Abstract Ebola virus (EBOV), a member of Filoviridae virus family under the genus Ebolavirus, has emerged as a dangerous and potential threat to human health globally. It causes a severe and deadly hemorrhagic fever in humans and other mammals, called Ebola Virus Disease (EVD). In recent outbreaks of EVD, there has been loss of large numbers of individual’s life. Therefore, EBOV has attracted researchers and increased interests in developing new models for virus evolution, and therapies. The EBOV interacts with the immune system of the host which led to understand how the virus functions and effects immune system behaviour. This article presents an exhaustive review on Ebola research which includes EVD illness, symptoms, transmission patterns, patho-physiology conditions, development of antiviral agents and vaccines, resilient health system, dynamics and mathematical model of EBOV, challenges and prospects for future studies.


Mitigating lockdown challenges in the response to COVID-19 in Sub-Saharan Africa


title: Community Calls: Lessons and Insights Gained from a Medical–Religious Community Engagement During the COVID-19 Pandemic

text: During the pandemic caused by the severe acute respiratory syndrome coronavirus-2, public health instructions were issued with the hope of curbing the virus’ spread. In an effort to assure accordance with these instructions, equitable strategies for at-risk and vulnerable populations and communities are warranted. One such strategy was our community conference calls, implemented to disseminate information on the pandemic and allow community leaders to discuss struggles and successes. Over the first 6 weeks, we held 12 calls, averaging 125 (standard deviation 41) participants. Participants were primarily from congregations and faith-based organizations that had an established relationship with the hospital, but also included school leaders, elected officials, and representatives of housing associations. Issues discussed included reasons for quarantining, mental health, social isolation, health disparities, and ethical concerns regarding hospital resources. Concerns identified by the community leaders as barriers to effective quarantining and adherence to precautions included food access, housing density, and access to screening and testing. Through the calls, ways to solve such challenges were addressed, with novel strategies and resources reaching the community. This medical–religious resource has proven feasible and valuable during the pandemic and warrants discussions on reproducing it for other communities during this and future infectious disease outbreaks.


COVID-19, containment and addictions


title: Role of anesthesia nurses in the treatment and management of patients with COVID-19

text: Abstract As the backbone for the treatment of patients with coronavirus disease 2019 (COVID-19), nurses have been actively playing key roles in cabin hospitals, isolation wards, and intensive care units (ICUs) for critical cases. Anesthesia nurses have their own professional specialties, such as airway management, the use and maintenance of life support equipment, including ventilators, and the use of high-flow oxygen equipment. With rich experience in emergency responses and nursing, anesthesia nurses, along with emergency nurses and critical care nurses, play important roles during the treatment of COVID-19 patients. In our hospital, 27 of 34 anesthesia nurses participated in the front-line fight against COVID-19 and did an excellent job. Anesthesia care by nurses is relatively new in China, and the role of anesthesia nurses during a disaster response has not been fully appreciated. Given their specialty, anesthesia nurses have played important roles in the treatment of COVID-19 patients. We hope that authorities will consider including anesthesia nurses in national disaster response medical rescue teams.


Fecal‐oral transmission of COVID‐19


title: Impact of Severe Acute Respiratory Syndrome (SARS) Outbreaks on the Use of Emergency Department Medical Resources

text: Background The impact of the severe acute respiratory syndrome (SARS) outbreak in 2003 on the emergency department (ED) medical needs of adult patients has not been elucidated. The purpose of this study was to investigate the demographic and clinical characteristics of ED adult patients before, during and after the SARS epidemic in a SARS-dedicated hospital. Methods A retrospective, ED chart review was conducted, and demographic data were obtained from a computer database, for a total of 17,586 patients. Patient information, including age, gender, mode of arrival, triage category, time of visit, main diagnosis, use of ED services, and status after the ED visit, were collected and compared for pre-, early-, peak-, late-, and post-SARS epidemic stages. Results Demographic data demonstrated a significant decrease in patient attendances per day, with a mean reduction of 92.5 ± 8.3 patients (43.7 ± 3.9% reduction in rate; p < 0.01) during peak-versus pre-epidemic stages, but revealed no differences in patient age and gender. The numbers of patients with ambulance transport, inter-hospital referral, and critical illnesses, including DOA, categorized as triage 1, or admitted to a ward or intensive care unit after the ED visit, were not influenced by the SARS epidemic. The number of patients with upper airway infections and suicide attempts from drug overdoses increased, but not statistically significantly. The number of patients with other diagnoses decreased progressively from early- to peak-epidemic stages, but returned to their earlier levels at the post-epidemic stage. Statistically significant decreases (p < 0.05) were noted in mean attendance at peak-versus pre- and early-epidemic stages for patients with cardiovascular disease, inflammatory or functional bowel disease, endocrine disease, dizziness or vertigo, or trauma. Conclusion The SARS outbreak did not eliminate the need of critically ill patients for advanced medical support. However, besides an overall decrease in patient numbers, the SARS epidemic markedly altered demographic information, clinical characteristics, and the use of medical services by adult patients in the ED of a SARS-dedicated hospital.


title: Red Cell Transfusions and Guidelines: A Work in Progress

text: Blood transfusion utilization continues to rise, yet it has never undergone prospective safety and efficacy testing. Recent data regarding oxygen delivery, microcirculation, and inflammation all point toward potential problems with allogeneic transfusion. Outcome data from retrospective data bases are sobering, calling to question the present practices of red cell transfusion.


title: Prospective monitoring of adenovirus infection and type analysis after allogeneic hematopoietic cell transplantation: A single‐center study in Korea

text: BACKGROUND: Epidemiologic studies of human adenovirus (HAdV) in allogeneic hematopoietic cell transplantation (HCT) recipients have been conducted mostly in European countries where HAdV 2 (species C) has been most prevalent in the community. The main objective of this study was to investigate the epidemiology and the characteristics of HAdV infection in Korean allogeneic HCT recipients (<19 years). METHODS: In a prospective study from April 2012 to September 2015, HAdV in blood, urine, and stool specimens were monitored weekly from transplantation to day 100 or after if clinically suspected. HAdV infection was defined as positive HAdV PCR result in any specimens regardless of symptoms. RESULTS: A total of 1734 specimens were collected from 57 consecutively enrolled recipients. The cumulative incidence of HAdV infection at day 100, and 1 year was 10%, and 20%, and the incidence of viremia was 2% and 6%, respectively. The median onset time from HCT to viremia was 221 days (range, 7‐596 days). All viremia cases were caused by only HAdV 3 (species B), whereas several types were detected in stool. Among patients with HAdV infection, lower absolute lymphocyte counts and extensive chronic graft‐vs‐host disease were associated with viremia (P = .028 and P = .006, respectively). CONCLUSIONS: Compared to western studies, this study demonstrated a lower incidence and delayed onset of HAdV infections and HAdV 3 was most prevalent in Korea.


title: The implications of high-speed railways on air passenger flows in China

text: Abstract The High-speed Railway (HSR) network in China is the largest in the world, competing intensively with airlines for inter-city travel. Panel data from 2007 to 2013 for 138 routes with HSR-air competition were used to identify the ex-post impacts of the entry of HSR services, the duration of operating HSR services since entry, and the specific impacts of HSR transportation variables such as travel time, frequency, and ticket fares on air passenger flows in China. The findings show that the entry of new HSR services in general leads to a 27% reduction in air travel demand. After two years of operating HSR services, however, the negative impact of HSR services on air passenger flows tends to further increase. The variations of the frequency in the temporal dimension and the travel time in the spatial dimension significantly affect air passenger flows. Neither in the temporal nor spatial dimensions are HSR fares strongly related to air passenger flows in China, due to the government regulation of HSR ticket prices during the period of analysis. The impacts of different transportation variables found in this paper are valuable to consider by operational HSR companies in terms of scheduling and planning of new routes to increase their competitiveness relative to airlines.


title: Impacto de la pandemia covid-19 en la organización asistencial del ictus. Plan ictus madrid

text: Resumen Introducción: La sobrecarga asistencial y los cambios organizativos frente a la pandemia COVID-19 podrían estar repercutiendo en la atención al ictus agudo en la Comunidad de Madrid (CM). Métodos: Encuesta estructurada en bloques: características del hospital, cambios en infraestructura y recursos, circuitos de código ictus, pruebas diagnósticas, rehabilitación y atención ambulatoria. Análisis descriptivo según el nivel de complejidad en la atención del ictus (disponibilidad o no de unidad de ictus-UI y de trombectomía mecánica-TM). Resultados: De los 26 hospitales del SERMAS que atienden urgencias en adultos, 22 cumplimentaron la encuesta entre el 16 y 27 de abril. El 95% han cedido neurólogos para atender a pacientes afectados por COVID-19. Se han reducido camas de neurología en el 89,4%, modificado los circuitos en urgencias para ictus en el 81%, con circuitos específicos para sospecha de infección COVID-19 en el 50%, y en el 42% de los hospitales los pacientes con ictus agudo COVID-19 positivos no ingresan en camas de neurología. Ha mejorado el acceso al tratamiento con TM 24h/7d en el propio hospital en 10 hospitales, reduciéndose los traslados interhospitalarios secundarios. Se ha evitado el ingreso de pacientes con AIT o ictus leve (45%) y se han incorporado consultas telefónicas para seguimiento en el 100%. Conclusiones: los cambios organizativos de los hospitales de la CM frente a la pandemia COVID-19 han modificado la dedicación de recursos humanos e infraestructuras de las unidades de neurología y los circuitos de atención del ictus, realización de pruebas diagnósticas, ingreso de los pacientes y seguimiento. Abstract Introduction: The overload of the healthcare system and the organisational changes made in response to the COVID-19 pandemic may be having an impact on acute stroke care in the Region of Madrid. Methods: We conducted a survey with sections addressing hospital characteristics, changes in infrastructure and resources, code stroke clinical pathways, diagnostic testing, rehabilitation, and outpatient care. We performed a descriptive analysis of results according to the level of complexity of stroke care (availability of stroke units and mechanical thrombectomy). Results: The survey was completed by 22 of the 26 hospitals in the Madrid Regional Health System that attend adult emergencies, between 16 and 27 April 2020. Ninety-five percent of hospitals had reallocated neurologists to care for patients with COVID-19. The numbers of neurology ward beds were reduced in 89.4% of hospitals; emergency department stroke care pathways were modified in 81%, with specific pathways for suspected COVID-19 infection established in 50% of hospitals; and COVID-19–positive patients with acute stroke were not admitted to neurology wards in 42%. Twenty-four hour on-site availability of mechanical thrombectomy was improved in 10 hospitals, which resulted in a reduction in the number of secondary hospital transfers. The admission of patients with transient ischaemic attack or minor stroke was avoided in 45% of hospitals, and follow-up through telephone consultations was implemented in 100%. Conclusions: The organisational changes made in response to the COVID-19 pandemic in hospitals in the Region of Madrid have modified the allocation of neurology department staff and infrastructure, stroke units and stroke care pathways, diagnostic testing, hospital admissions, and outpatient follow-up.


title: Comparison of Porcine Epidemic Diarrhea Viruses from Germany and the United States, 2014

text: Since 2013, highly virulent porcine epidemic diarrhea virus has caused considerable economic losses in the United States. To determine the relation of US strains to those recently causing disease in Germany, we compared genomes and found that the strain from Germany is closely related to variants in the United States.


title: Identification and characterization of GLDC as host susceptibility gene to severe influenza

text: Glycine decarboxylase (GLDC) was prioritized as a candidate susceptibility gene to severe influenza in humans. The higher expression of GLDC derived from genetic variations may confer a higher risk to H7N9 and severe H1N1 infection. We sought to characterize GLDC as functional susceptibility gene that GLDC may intrinsically regulate antiviral response, thereby impacting viral replication and disease outcome. We demonstrated that GLDC inhibitor AOAA and siRNA depletion boosted IFNβ‐ and IFN‐stimulated genes (ISGs) in combination with PolyI:C stimulation. GLDC inhibition and depletion significantly amplified antiviral response of type I IFNs and ISGs upon viral infection and suppressed the replication of H1N1 and H7N9 viruses. Consistently, GLDC overexpression significantly promoted viral replication due to the attenuated antiviral responses. Moreover, GLDC inhibition in H1N1‐infected BALB/c mice recapitulated the amplified antiviral response and suppressed viral growth. AOAA provided potent protection to the infected mice from lethal infection, comparable to a standard antiviral against influenza viruses. Collectively, GLDC regulates cellular antiviral response and orchestrates viral growth. GLDC is a functional susceptibility gene to severe influenza in humans.


title: Factors influencing the adherence of nurses to standard precautions in South Korea hospital settings

text: BACKGROUND: Standard precautions (SPs) serve as the first line of defense against exposure to blood and body fluids. The objective of this study was to explore the adherence of nurses to SPs and to identify factors influencing adherence to SPs. METHODS: This study was an exploratory cross-sectional survey. A total of 339 nurses from 9 general hospitals and 3 tertiary hospitals located in 3 South Korean cities were selected. Hierarchical regression was used to examine the effects of sociodemographic, individual, and institutional factors. RESULTS: A higher, or positive, attitude was the strongest influencing factor in adherence to SPs in the final model, followed by administrative support, hospital types, and safety climate, in descending order. These 4 variables accounted for 26.0% of the variance in adherence to SPs. CONCLUSIONS: The attitudes of nurses toward SPs is important for increasing the adherence to SP best practices. The adherence of nurses to SPs will improve if safe environments are created in different hospital types and if managerial support and administrative efforts are supportive and sustained.


title: An Overview of the Most Significant Zoonotic Viral Pathogens Transmitted from Animal to Human in Saudi Arabia

text: Currently, there has been an increasing socioeconomic impact of zoonotic pathogens transmitted from animals to humans worldwide. Recently, in the Arabian Peninsula, including in Saudi Arabia, epidemiological data indicated an actual increase in the number of emerging and/or reemerging cases of several viral zoonotic diseases. Data presented in this review are very relevant because Saudi Arabia is considered the largest country in the Peninsula. We believe that zoonotic pathogens in Saudi Arabia remain an important public health problem; however, more than 10 million Muslim pilgrims from around 184 Islamic countries arrive yearly at Makkah for the Hajj season and/or for the Umrah. Therefore, for health reasons, several countries recommend vaccinations for various zoonotic diseases among preventive protocols that should be complied with before traveling to Saudi Arabia. However, there is a shortage of epidemiological data focusing on the emerging and reemerging of zoonotic pathogens transmitted from animal to humans in different densely populated cities and/or localities in Saudi Arabia. Therefore, further efforts might be needed to control the increasing impacts of zoonotic viral disease. Also, there is a need for a high collaboration to enhance the detection and determination of the prevalence, diagnosis, control, and prevention as well as intervention and reduction in outbreaks of these diseases in Saudi Arabia, particularly those from other countries. Persons in the health field including physicians and veterinarians, pet owners, pet store owners, exporters, border guards, and people involved in businesses related to animal products have adopted various preventive strategies. Some of these measures might pave the way to highly successful prevention and control results on the different transmission routes of these viral zoonotic diseases from or to Saudi Arabia. Moreover, the prevention of these viral pathogens depends on socioeconomic impacts, available data, improved diagnosis, and highly effective therapeutics or prophylaxis.


title: Adenovirus-mediated expression of the C-terminal domain of SARS-CoV spike protein is sufficient to induce apoptosis in Vero E6 cells

text: The pro-apoptotic properties of severe acute respiratory syndrome coronavirus (SARS-CoV) structural proteins were studied in vitro. By monitoring apoptosis indicators including chromatin condensation, cellular DNA fragmentation and cell membrane asymmetry, we demonstrated that the adenovirus-mediated over-expression of SARS-CoV spike (S) protein and its C-terminal domain (S2) induce apoptosis in Vero E6 cells in a time- and dosage-dependent manner, whereas the expression of its N-terminal domain (S1) and other structural proteins, including envelope (E), membrane (M) and nucleocapsid (N) protein do not. These findings suggest a possible role of S and S2 protein in SARS-CoV induced apoptosis and the molecular pathogenesis of SARS.


title: Avian Influenza: Recent Epidemiology, Travel-Related Risk, and Management

text: H5N1 influenza continues to smolder in Southeast Asia over the past 5 years, but the emergence of H7N9 in China in 2012 raised concerns for a new avian influenza threat. In contrast with H5N1 with over 650 confirmed cases over 11 years, H7N9 has infected over 450 persons within 2 years. The case fatality rate for H7N9 (35 %) is lower than for H5N1 (60 %) or H10N8 (67 %) but is comparable to that for the Middle East respiratory syndrome coronavirus (MERS CoV), another emerging zoonosis with travel-associated importations. Exposure to poultry and fomites are considered the likely sources of infection for H7N9, H5N1, and H10N8, with limited human-to-human transmission in close contacts. Most cases have occurred in local populations of affected countries, and travel-related risk can be mitigated by avoiding exposure. Vaccines, antivirals, and other therapeutics remain in development stage or of modest benefit for dangerous infections carrying high morbidity and mortality.


title: COVID‐19 Infection in Early Post‐Operative Period after Liver Transplantation

text: We read the recently published article by Drs. Agopian, Verna and Goldberg (1) with great interest. The authors have provided an important assessment of liver transplant volumes across the United Network for Organ Sharing (UNOS) regions from February to March of 2019 and 2020. The study revealed a significant center‐based difference in volume of transplant particularly among centers located in the same metropolitan areas including New York City.


title: Angiotensin II Receptors ‐ Impact for COVID‐19 Severity

text: COVID‐19 is an outbreak of viral pneumonia which became a global health crisis, and the risk of morbidity and mortality of people with obesity are higher. SARS‐CoV‐2, the pathogen of COVID‐19, enters into cells through binding to the Angiotensin Converting Enzyme (ACE) homolog‐2 (ACE2). ACE2 is a regulator of two contrary pathways in renin angiotensin system (RAS): ACE‐Ang‐II‐AT1R axis and ACE2‐Ang 1‐7‐Mas axis. Viral entry process eventuate in downregulation of ACE2 and subsequent activation of ACE‐Ang‐II‐AT1R axis. ACE‐Ang II‐AT1R axis increases lipid storage, reduces white‐to‐beige fat conversion and plays role in obesity. Conversely, adipose tissue is an important source of angiotensin, and obesity results in increased systemic RAS. ACE‐Ang‐II‐AT1R axis, which has proinflammatory, profibrotic, prothrombotic and vasoconstrictive effects, is potential mechanism of more severe SARS‐CoV‐2 infection. The link between obesity and severe COVID‐19 may be attributed to ACE2 consumption and subsequent ACE‐Ang‐II‐AT1R axis activation. Therefore, patients with SARS‐CoV‐2 infection may benefit from therapeutic strategies that activate ACE2‐Ang 1‐7‐Mas axis, such as Ang II reseptor blockers (ARBs), ACE inhibitors (ACEIs), Mas receptor agonists and ACE2. This article is protected by copyright. All rights reserved.


title: Mechanical thrombectomy for acute ischaemic stroke during the COVID-19 pandemic: changes to UK practice and lessons learned

text: Abstract Aim To describe evolving practices in the provision of mechanical thrombectomy (MT) services across the UK during the COVID-19 pandemic, the responses of and impact on MT teams, and the effects on training. Materials and methods The UK Neurointerventional Group (UKNG) and the British Society of Neuroradiologists (BSNR) sent out a national survey on 1 May 2020 to all 28 UK neuroscience centres that have the potential capability to perform MT. Results Responses were received from 27/28 MT-capable centres (96%). Three of the 27 centres do not currently provide MT services. There was a 27.7% reduction in MTs performed during April 2020 compared with the first 3 months of the year. All MT patients in 20/24 centres that responded were considered as COVID-19 suspicious/positive unless or until proven otherwise. Twenty-two of the 24 centres reported delays to the patient pathway. Seventeen of the 24 centres reported that the COVID-19 pandemic had reduced training opportunities for specialist registrars (SpR). Fourteen of the 24 centres reported that the pandemic had hampered their development plans for their local or regional MT service. Conclusion The present survey has highlighted a trend of decreasing cases and delays in the patient pathway during the early stages of the COVID-19 pandemic across UK centres.