title: Dying with SARS-CoV-2 infection—an autopsy study of the first consecutive 80 cases in Hamburg, Germany

text: Autopsies of deceased with a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can provide important insights into the novel disease and its course. Furthermore, autopsies are essential for the correct statistical recording of the coronavirus disease 2019 (COVID-19) deaths. In the northern German Federal State of Hamburg, all deaths of Hamburg citizens with ante- or postmortem PCR-confirmed SARS-CoV-2 infection have been autopsied since the outbreak of the pandemic in Germany. Our evaluation provides a systematic overview of the first 80 consecutive full autopsies. A proposal for the categorisation of deaths with SARS-CoV-2 infection is presented (category 1: definite COVID-19 death; category 2: probable COVID-19 death; category 3: possible COVID-19 death with an equal alternative cause of death; category 4: SARS-CoV-2 detection with cause of death not associated to COVID-19). In six cases, SARS-CoV-2 infection was diagnosed postmortem by a positive PCR test in a nasopharyngeal or lung tissue swab. In the other 74 cases, SARS-CoV-2 infection had already been known antemortem. The deceased were aged between 52 and 96 years (average 79.2 years, median 82.4 years). In the study cohort, 34 deceased were female (38%) and 46 male (62%). Overall, 38% of the deceased were overweight or obese. All deceased, except for two women, in whom no significant pre-existing conditions were found autoptically, had relevant comorbidities (in descending order of frequency): (1) diseases of the cardiovascular system, (2) lung diseases, (3) central nervous system diseases, (4) kidney diseases, and (5) diabetes mellitus. A total of 76 cases (95%) were classified as COVID-19 deaths, corresponding to categories 1–3. Four deaths (5%) were defined as non-COVID-19 deaths with virus-independent causes of death. In eight cases, pneumonia was combined with a fulminant pulmonary artery embolism. Peripheral pulmonary artery embolisms were found in nine other cases. Overall, deep vein thrombosis has been found in 40% of the cases. This study provides the largest overview of autopsies of SARS-CoV-2-infected patients presented so far.


title: Current and Potential Applications of Bismuth-Based Drugs

text: Bismuth compounds have been used extensively as medicines and in particular for the treatment of gastrointestinal ailments. In addition to bismuth’s well known gastroprotective effects and efficacy in treating H. pylori infection it also has broad anti-microbial, anti-leishmanial and anti-cancer properties. Aspects of the biological chemistry of bismuth are discussed and biomolecular targets associated with bismuth treatment are highlighted. This review strives to provide the reader with an up to date account of bismuth-based drugs currently used to treat patients and discuss potential medicinal applications of bismuth drugs with reference to recent developments in the literature. Ultimately this review aims to encourage original contributions to this exciting and important field.


title: Genome Sequences of Human Coronavirus OC43 and NL63, Associated with Respiratory Infections in Kilifi, Kenya

text: Coding-complete genomes of two human coronavirus OC43 strains and one NL63 strain were obtained by metagenomic sequencing of clinical samples collected in 2017 and 2018 in Kilifi, Kenya. Maximum likelihood phylogenies showed that the OC43 strains were genetically dissimilar and that the NL63 strain was closely related to NL63 genotype B viruses.


title: Phylogenetic analysis of VP1 and RdRP genes of Brazilian aichivirus B strains involved in a diarrhea outbreak in dairy calves

text: Aichivirus B has been reported worldwide in calves and adult cattle with and without diarrhea. The aim of this study was to describe the molecular characteristics of the RdRP and VP1 genes of aichivirus B strains identified as the most frequent etiologic agent in a neonatal diarrhea outbreak in a high-production Brazilian dairy cattle herd. Preliminary laboratory analysis ruled out important enteropathogens (Cryptosporidium spp; Eimeria spp., E. coli F5, and bovine coronavirus). Fecal samples from diarrheic (n = 24) and asymptomatic (n = 5) calves up to 30 days old were collected for virological analysis. RT-PCR assays were performed for the detection of aichivirus B RdRP and VP1 genes and for rotavirus A VP7 and VP4 genes in fecal samples. Asymptomatic calves (control group) were negative for both viruses. Aichivirus B and rotavirus A G10P[11] genotypes were found in 54.2% (13/24) and 25% (6/24) of the diarrheic fecal samples, respectively. Aichivirus B was only identified (83.3%, 10/12) in calves up to two weeks old. Phylogenetic analysis based on the RdRP gene grouped the Brazilian strains in a new branch within the aichivirus B group. Comparative analysis of the nucleotide sequence of the VP1 gene of Brazilian and Chinese aichivirus B strains allowed the strains identified in this study to be classified in the putative lineage 1. This is the first description of a high rate of aichivirus B detection in a diarrhea outbreak in dairy calves, and the first phylogenetic study of the VP1 gene of aichivirus B wild-type strains performed in South America.


Asymptomatic transmission of SARS‐CoV‐2 and implications for mass gatherings


title: Severe Acute Respiratory Syndrome (SARS)

text: Severe acute respiratory syndrome (SARS) is a new human disease caused by an animal coronavirus that adapted to efficient human-to-human transmission. The disease first emerged in November 2002 in Guangdong Province, China and spread globally within months. The SARS coronavirus (SARS CoV) affects multiple organ systems with severe viral pneumonia as its main clinical manifestation but with diarrhea, lymphopenia, and mild liver dysfunction being common extra-pulmonary manifestations. Increasing age and the presence of underlying respiratory diseases worsens the prognosis. Unlike other respiratory viral infections, transmission of SARS was less frequent in the first 5days of illness and correlated with low viral load in the upper respiratory tract at this stage of the illness. This fortuitous feature of the disease allowed the public health measures of case detection and patient isolation to interrupt virus transmission in the community and abort the SARS outbreak. Bats are a reservoir of a virus closely related to SARS CoV and this may be the likely precursor from which the human-adapted SARS CoV emerged. Small mammals such as ‘civet-cats’ (Paguma larvata) within live animal markets in southern China serve as amplifiers of infection and these markets were the likely interface where zoonotic transmission occurred. The viral spike protein is necessary and sufficient for inducing protective antibody responses and has been a key target in the development of candidate vaccines.


title: CoViD‐19 epidemic follows the “kinetics” of enzymes with cooperative substrate binding

text: The Hill equation, which models the cooperative ligand‐receptor binding equilibrium, turns out to be useful in modeling the progression of infectious disease outbreaks such as CoViD‐19. The equation fits well the data for total and daily case numbers, allows tentative predictions for the half‐point and end point of the epidemic, and presents a mathematical characterization of how social interventions “flatten the curve” of the disease progression.


title: Clinical course of Coronavirus Disease‐2019 (COVID‐19) in pregnancy

text: INTRODUCTION: The aim of this study is to report our clinical experience in the management of pregnant women infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) during the first thirty days of the Coronavirus disease (COVID‐19) pandemic. MATERIAL AND METHODS: We reviewed clinical data from the first 60 pregnant women with COVID‐19 whose care was managed at Puerta de Hierro University Hospital, Madrid, Spain from March 14(th) to April 14(th), 2020. Demographic data, clinical findings, laboratory test results, imaging findings, treatment received, and outcomes were collected. An analysis of variance (Kruskal‐Wallis test) was performed to compare the medians of laboratory parameters. Fisher's exact test was used to evaluate categorical variables. A correspondence analysis was used to explore associations between variables. RESULTS: A total of 60 pregnant women were diagnosed with COVID‐19. The most common symptoms were fever and cough (75.5%, each) followed by dyspnea (37.8%). Forty‐one patients (68.6%) required hospital admission (18 due to disease worsening and 23 for delivery) of whom 21 patients (35%) underwent pharmacological treatment, including hydroxychloroquine, antivirals, antibiotics and tocilizumab. No renal or cardiac failures or maternal deaths were reported. Lymphopenia (50%), thrombocytopenia (25%), and elevated C‐reactive protein (CRP) (59%) were observed in the early stages of the disease. Median CRP, D‐dimer and the neutrophil/lymphocyte ratio were elevated. High CRP and D‐dimer levels were the parameters most frequently associated with severe pneumonia. The Neutrophil/lymphocyte ratio was found to be the most sensitive marker for disease improvement (relative risk: 6.65; 95% CI: 4.1‐5.9). During the study period, 18 of the women (78%) delivered vaginally. All newborns tested negative for SARS‐CoV‐2 and none of them were infected during breastfeeding. No SARS‐CoV‐2 was detected in placental tissue. CONCLUSIONS: Most of the pregnant COVID‐19 positive patients had a favorable clinical course. However, one‐third of them developed pneumonia, of whom 5% presented a critical clinical status. CRP and D‐dimer levels positively correlated with severe pneumonia and the neutrophil/lymphocyte ratio decreased as the patients improved clinically. Seventy‐eight percent of patients had a vaginal delivery. No vertical or horizontal transmissions were diagnosed in the neonates during labor or breastfeeding.


title: Intrahost selection pressures drive rapid dengue virus microevolution in acute human infections

text: Dengue, caused by four dengue virus serotypes (DENV-1–DENV-4), is a highly-prevalent mosquito-borne viral disease in humans. Yet, selection pressures driving DENV microevolution within human hosts (‘intrahost’) remain unknown. We employed a whole-genome segmented amplification approach coupled with deep sequencing to profile DENV-3 intrahost diversity in peripheral blood mononuclear cell (PBMC) and plasma samples from 77 dengue patients. DENV-3 intrahost diversity appears to be driven by immune pressures as well as replicative success in PBMCs and potentially other replication sites. Hotspots for intrahost variation were detected in 59–78% of patients in the viral Envelope and pre-Membrane/Membrane proteins, which together form the virion surface. Dominant variants at the hotspots arose via convergent microevolution, appear to be immune-escape variants, and were evolutionarily constrained at the macro-level due to viral replication defects. Dengue is thus an example of an acute infection in which selection pressures within infected individuals drive rapid intrahost virus microevolution.


title: A novel Chimpanzee serotype-based adenoviral vector as delivery tool for cancer vaccines

text: The use of adenovirus (Ad) as vaccine vectors is hindered by pre-existing immunity to human Ads in most of the human population. In order to overcome this limitation, uncommon alternative Ad serotypes need to be utilized. In this study, an E1–E3 deleted recombinant Ad based on the chimpanzee serotype 3 (ChAd3) was engineered to express human carcinoembryonic antigen (CEA) protein or rat neu extracellular/transmembrane domains (ECD.TM). ChAd3 vectors were tested in CEA transgenic (CEA.Tg) and BALB/NeuT mice, which show immunologic tolerance to these antigens. ChAd3 is capable of inducing an immune response comparable to that of hAd5 serotype-based vectors, thus breaking tolerance to tumor associated antigens (TAAs) and achieving anti-tumor effects. Of importance is that ChAd3 can overcome hAd5 pre-existing immunity and work in conjunction with DNA electroporation (DNA-EP) and other Ad vaccines based on common human serotypes.


title: Airports, localities and disease: Representations of global travel during the H1N1 pandemic

text: Abstract During summer 2009, the UK experienced one of the highest incidences of H1N1 infection outside of the Americas and Australia. Building on existing research into biosecurity and the spread of infectious disease via the global airline network, this paper explores the biopolitics of public health in the UK through an in-depth empirical analysis of the representation of H1N1 in UK national and regional newspapers. We uncover new discourses relating to the significance of the airport as a site for control and the ethics of the treatment of the traveller as a potential transmitter of disease. We conclude by highlighting how the global spread of infectious diseases is grounded in particular localities associated with distinctive notions of biosecurity and the traveller.


title: Cytokine storm intervention in the early stages of COVID-19 pneumonia

text: Abstract Clinical intervention in patients with corona virus disease 2019 (COVID-19) has demonstrated a strong upregulation of cytokine production in patients who are critically ill with SARS-CoV2-induced pneumonia. In a retrospective study of 41 patients with COVID-19, most patients with SARS-CoV-2 infection developed mild symptoms, whereas some patients later developed aggravated disease symptoms, and eventually passed away because of multiple organ dysfunction syndrome (MODS), as a consequence of a severe cytokine storm. Guidelines for the diagnosis and treatment of SARS-CoV-2 infected pneumonia were first published January 30th, 2020; these guidelines recommended for the first time that cytokine monitoring should be applied in severely ill patients to reduce pneumonia related mortality. The cytokine storm observed in COVID-19 illness is also an important component of mortality in other viral diseases, including SARS, MERS and influenza. In view of the severe morbidity and mortality of COVID-19 pneumonia, we review the current understanding of treatment of human coronavirus infections from the perspective of a dysregulated cytokine and immune response.


title: Antiviraux chez l’enfant en pratique de ville : infections herpétiques, varicelle, grippe

text: Résumé Les infections liées à l'herpès virus humain (HSV), au virus de la varicelle et du zona (VZV) et au virus de la grippe (Influenza A et B) sont très fréquentes en pédiatrie et sont le plus souvent bénignes avec une guérison spontanée. L'utilisation des antiviraux antigrippaux (inhibiteurs de neuraminidase) a été étudiée dans de larges essais randomisés et fait l'objet de recommandations nationales et internationales. Celle des anti-HSV et anti-VZV n’a pas fait l’objet d’études de la même ampleur et de ce fait, leur prescription est plus discutée avec des bénéfices moins bien définis et variables (à l'exception des infections néonatales et/ou neuro-méningées). L'objectif de cette mise au point est donc de proposer une synthèse des données disponibles dans la littérature concernant les indications des antiviraux en pratique de ville pour les infections liées à l'HSV (gingivostomatite, herpès récurrent, faux panaris herpétique), au VZV (varicelle, zona) et à la grippe. Abstract Human herpes virus (HSV), varicella-zoster virus (VZV), and the flu (influenza A and B) are very common in pediatrics and most often cause mild disease with spontaneous recovery. The use of influenza antivirals (neuraminidase inhibitors) has been studied in large randomized trials and is the focus of national and international recommendations. The use of anti-HSV and VZV compounds has not been the subject of large studies and is often more controversial (except for neonatal infection and/or meningoencephalitis). The objective of this review is therefore to offer an overview of the available data in the literature on the indications for antivirals for HSV-related infections (gingivostomatitis, recurrent herpes, herpetic whitlow), VZV (chickenpox, herpes zoster), and influenza in a pediatric outpatient setting.


title: Evaluating the effectiveness of an emergency preparedness training programme for public health staff in China

text: Summary Background The severe acute respiratory syndrome (SARS) crisis of 2003 provided a new urgency in China in terms of preparing public health staff to respond effectively to public health emergencies. Although the Chinese Government has already carried out a series of emergency education and training programmes to improve public health staff's capability of emergency preparedness, it remains unclear if these training programmes are effective and feasible. The purpose of this research was to evaluate an emergency preparedness training programme and to develop a participatory training approach for emergency response. Methods Seventy-six public health staff completed the emergency preparedness training programme. The effectiveness of the training was evaluated by questionnaire before training, immediately after training and 12 months after training (follow-up). Additionally, semi-structured interviews were conducted throughout the training period. Results The emergency preparedness training improved the knowledge levels and increased attitudinal and behavioural intention scores for emergency preparedness (P<0.01). The results at follow-up showed that the knowledge levels and attitudinal/behavioural intention scores of participants decreased slightly (P>0.05) compared with levels immediately after training (P<0.01). However, there was a significant increase compared with before training (P<0.01). Moreover, more than 80% of participants reported that the training process and resources were scientific and feasible. Conclusions The emergency preparedness training programme met its aims and objectives satisfactorily, and resulted in positive shifts in knowledge and attitudinal/behavioural intentions for public health staff. This suggests that this emergency training strategy was effective and feasible in improving the capability of emergency preparedness.


title: Early-warning health and process indicators for sentinel surveillance in Madagascar 2007-2011

text: Background: Epidemics pose major threats in resource-poor countries, and surveillance tools for their early detection and response are often inadequate. In 2007, a sentinel surveillance system was established in Madagascar, with the aim of rapidly identifying potential epidemics of febrile or diarrhoeal syndromes and issuing alerts. We present the health and process indicators for the five years during which this system was constructed, showing the spatiotemporal trends, early-warning sign detection capability and process evaluation through timely analyses of high-quality data. Methods: The Malagasy sentinel surveillance network is currently based on data for fever and diarrhoeal syndromes collected from 34 primary health centres and reported daily via the transmission of short messages from mobile telephones. Data are analysed daily at the Institut Pasteur de Madagascar to make it possible to issue alerts more rapidly, and integrated process indicators (timeliness, data quality) are used to monitor the system. Results: From 2007 to 2011, 917,798 visits were reported. Febrile syndromes accounted for about 11% of visits annually, but the trends observed differed between years and sentinel sites. From 2007 to 2011, 21 epidemic alerts were confirmed. However, delays in data transmission were observed (88% transmitted within 24 hours in 2008; 67% in 2011) and the percentage of forms transmitted each week for validity control decreased from 99.9% in 2007 to 63.5% in 2011. Conclusion: A sentinel surveillance scheme should take into account both epidemiological and process indicators. It must also be governed by the main purpose of the surveillance and by local factors, such as the motivation of healthcare workers and telecommunication infrastructure. Permanent evaluation indicators are required for regular improvement of the system.


title: Antiviral Strategies Against Chikungunya Virus

text: In the last few decades the Chikungunya virus (CHIKV) has evolved from a geographically isolated pathogen to a virus that is widespread in many parts of Africa, Asia and recently also in Central- and South-America. Although CHIKV infections are rarely fatal, the disease can evolve into a chronic stage, which is characterized by persisting polyarthralgia and joint stiffness. This chronic CHIKV infection can severely incapacitate patients for weeks up to several years after the initial infection. Despite the burden of CHIKV infections, no vaccine or antivirals are available yet. The current therapy is therefore only symptomatic and consists of the administration of analgesics, antipyretics, and anti-inflammatory agents. Recently several molecules with various viral or host targets have been identified as CHIKV inhibitors. In this chapter, we summarize the current status of the development of antiviral strategies against CHIKV infections.


title: Caring in the age of COVID-19: lessons from science and society Cuidar em tempos da COVID-19: lições aprendidas entre a ciência e a sociedade/ Cuidar en tiempos del COVID-19: lecciones aprendidas entre la ciencia y la sociedad Caring in the age of CO

text: Abstract: This paper focuses on our research and intervention in health promotion with patients and communities affected by various infectious diseases, in the project Knowledge-Sharing Platform This project is developed at the National Institute of Infectious Diseases Evandro Chagas in the Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, and promotes the continuing involvement of health researchers and professionals in the collaborative production of knowledge on health with patients and community groups and in their training as community health promoters The new epidemic scenario created the demand for a space of dialogue and knowledge-sharing on the prevention of COVID-19 transmission Due to the interruption of regular activities in the Knowledge-Sharing Platform, a strategy was launched to serve as a link between science and society and help overcome the social isolation imposed by the COVID-19 pandemic The WhatsApp group allowed project members to participate by addressing questions (audio) on COVID-19 through mediation by community group leaders The main questions by participants related to risk factors, transmission, immunity to the novel coronavirus, care related to prevention, symptoms, and treatment;and COVID-19 and influenza vaccine The educational material Caring in the Age of COVID-19 was produced and shared with community leaders and distributed to the respective groups and was eventually shared in their communities as a response to a demand for knowledge that responds to the concerns of people already exposed to structural vulnerability


title: Pediatric anesthetic implications of COVID‐19—A review of current literature

text: Pediatric anesthetists have an important role to play in the management of patients suspected or confirmed to have COVID‐19. In many institutions, the COVID‐19 intubation teams are staffed with anesthetists as the proceduralists working throughout the hospitals also in the ICU and Emergency Departments. As practitioners who perform aerosol generating procedures involving the airway, we are at high risk of exposure to the virus SARS‐CoV‐2 and need to ensure we are well prepared and trained to manage such cases. This article reviews the relevant pediatric literature surrounding COVID‐19 and summarizes the key recommendations for anesthetists involved in the care of children during this pandemic.


title: Un corps étranger hors du commun. À propos d'un cas d'emphysème sous-cutané lors d'une crise d'asthme

text: Summary Pneumomediastinum is an uncommon complication after an asthma attack. The essential clinical sign is the presence of subcutaneous emphysema. In the great majority of cases, the treatment of pneumomediastinum corresponds to that of asthma, with resorption over several days. The situation is very different when the development of pneumomediastinum and subcutaneous emphysema is secondary to an aspiration syndrome.


title: Bioactive paper provides a low-cost platform for diagnostics

text: Abstract Bioactive paper includes a range of potential paper-based materials that can perform analytical functions normally reserved for multi-well plates in the laboratory or for portable electronic devices. Pathogen detection is the most compelling application. Simple paper-based detection, not requiring hardware, has the potential to have impacts in society, ranging from the kitchen to disasters in the developing world. Bioactive-paper research is an emerging field with significant efforts in Canada, USA (Harvard), Finland and Australia. Following a brief introduction to the material and surface properties of paper, I review the literature. Some of the early work exploits the porosity of paper to generate paper-based microfluidics (“paperfluidics”) devices. I exclude from this review printed electronic devices and plastics-supported devices.


title: Japanese encephalitis virus counteracts BST2 restriction via its envelope protein E

text: Abstract It has been well documented that BST2 restricts the release of enveloped viruses by cross-linking newly produced virions to the cell membrane. However, it is less clear whether and how BST2 inhibits the release of enveloped viruses which bud via the secretory pathway. Here, we demonstrated that BST2 restricts the release of Japanese encephalitis virus (JEV) whose budding occurs at the ER-Golgi intermediate compartment, and in turn, JEV infection downregulates BST2 expression. We further found that the JEV envelope protein E, but not other viral components, significantly downregulates BST2 with the viral protein M playing an auxiliary role in the process. Envelope protein E-mediated BST2 downregulation appears to undergo lysosomal degradation pathway. Additional study revealed that the transmembrane domain and the coiled-coil domain (CC) of BST2 are the target domains of viral protein E and that the N- and C-terminal membrane anchors and the CC domain of BST2 are essential for blocking JEV release. Our results together indicate that the release of enveloped viruses whose budding take place in an intracellular compartment can be restricted by BST2.


title: Emerging Zoonoses: the "One Health Approach"

text: Zoonoses represent a public health risk recently pointed out by the spreading of previously unknown human infectious diseases emerging from animal reservoirs such as severe acute respiratory syndrome and avian influenza caused by H5N1-virus. These outbreaks have shown that animal breeding activities can pose a significant public health risk. Until now, the risk of zoonoses has probably been underestimated, particularly in occupational settings. The emergence or re-emergence of bacterial (Mycobacterium bovis and Brucella spp) or viral (hepatitis E virus) infections shows that zoonoses should be considered as emerging risks in agricultural and animal breeding and should be addressed by specific preventive interventions. Close cooperation and interaction between veterinarians, occupational health physicians and public health operators is necessary, for a worldwide strategy to expand interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment. This is what the One Health Approach was intended to be.


title: Trends in Tuberculosis in Taiwan, 2002–2008

text: Background/Purpose Tuberculosis (TB) remains an important infectious disease in Taiwan. To control TB effectively, the Taiwan Centers for Disease Control implemented the National Tuberculosis Program (NTP) in 2006, modeled on the World Health Organization global TB control program. The goal of the program was to reduce the number of TB cases by half within a decade. This study was designed to describe the epidemiology of TB in Taiwan, and to evaluate the preliminary effectiveness of the NTP. Methods We conducted a retrospective study of data from the National Tuberculosis Registry System collected between 2002 and 2008. Demographics, geographic distribution of disease, and change in rates of TB incidence and mortality were analyzed. Results From 2002 to 2008, new TB cases declined from 16,758 to 14,265, and incidence decreased from 75 per 100,000 population to 62 per 100,000 population. More than 50% of new cases occurred among elderly adults. Over the study period, TB mortality decreased from 5.7 per 100,000 population to 3.3 per 100,000 population, with over half of TB deaths occurring among patients aged ≥ 65 years. Since the NTP was implemented, from 2005 to 2008, TB incidence and mortality declined by 14% and 23%, respectively. Conclusion TB-associated incidence and mortality decreased over the course of the study. Nevertheless, there continue to be high-incidence areas that show the opposite trend; these areas should strive to improve case management and consultation. In the most populous districts, rigorous surveillance is necessary to track incidence and mortality rate fluctuations.


title: A Rational Approach to Estimating the Surgical Demand Elasticity Needed to Guide Manpower Reallocation during Contagious Outbreaks

text: BACKGROUND: Emerging infectious diseases continue to pose serious threats to global public health. So far, however, few published study has addressed the need for manpower reallocation needed in hospitals when such a serious contagious outbreak occurs. AIM: To quantify the demand elasticity of the major surgery types in order to guide future manpower reallocation during contagious outbreaks. MATERIALS AND METHODS: Based on a nationwide research database in Taiwan, we extracted the monthly volumes of major surgery types for the period 1998–2003, which covered the SARS period, in order to carry out a time series analysis. The demand elasticity of each surgery type was then estimated by autoregressive integrated moving average (ARIMA) analysis. RESULTS: During the study period, the surgical volumes of most selected surgery types either increased or remained steady. We categorized these surgery types into low-, moderate- and high-elastic groups according to their demand elasticity. Appendectomy, ‘open reduction of fracture with internal fixation’ and ‘free skin graft’ were in the low demand elasticity group. Transurethral prostatectomy and extracorporeal shockwave lithotripsy (ESWL) were in the high demand elasticity group. The manpower of the departments carrying out the surgeries with low demand elasticity should be maintained during outbreaks. In contrast, departments in charge of surgeries mainly with high demand elasticity, like urology departments, may be in a position to have part of their staff reallocated. CONCLUSIONS: Taking advantage of the demand variation during the SARS period in 2003, we adopted the concept of demand elasticity and used a time series approach to figure out an effective index of demand elasticity for various types of surgery that could be used as a rational reference to carry out manpower reallocation during contagious outbreak situations.


title: Quantification of mRNA encoding cytokines and chemokines and assessment of ciliary function in canine tracheal epithelium during infection with canine respiratory coronavirus (CRCoV)

text: Abstract One of the first lines of defence against viral infection is the innate immune response and the induction of antiviral type I interferons (IFNs). However some viruses, including the group 2 coronaviruses, have evolved mechanisms to overcome or circumvent the host antiviral response. Canine respiratory coronavirus (CRCoV) has previously been shown to have a widespread international presence and has been implicated in outbreaks of canine infectious respiratory disease (CIRD). This study aimed to quantify pro-inflammatory cytokine mRNAs following infection of canine air-interface tracheal cultures with CRCoV. Within this system, immunohistochemistry identified ciliated epithelial and goblet cells as positive for CRCoV, identical to naturally infected cases, thus the data obtained would be fully transferable to the situation in vivo. An assay of ciliary function was used to assess potential effects of CRCoV on the mucociliary system. CRCoV was shown to reduce the mRNA levels of the pro-inflammatory cytokines TNF-α and IL-6 and the chemokine IL-8 during the 72h post-inoculation. The mechanism for this is unknown, however the suppression of a key antiviral strategy during a period of physiologic and immunological stress, such as on entry to a kennel, could potentially predispose a dog to further pathogenic challenge and the development of respiratory disease.


title: Development of a TaqMan-based real-time RT-PCR assay for the detection of SADS-CoV associated with severe diarrhea disease in pigs

text: Abstract Swine acute diarrhea syndrome coronavirus (SADS-CoV) is a novel coronavirus which was first reported in southern China in 2017. It can cause severe diarrhea disease in pigs. In order to detect this new emerging virus rapidly and reliably, a TaqMan-based real-time RT-PCR assay was established in this study. Specific primers and probe were designed and synthesized based on the conserved region within the N gene of the viral genome. Results showed that the lowest limit of detection was 3.0 × 101 copies/μL. This approach was specific for SADS-CoV, and there were no cross-reaction observed against other 15 swine viruses. It was 10 times more sensitive than the conventional PCR and gave higher SADS-CoV positive detection rate (70.69%, 123/174) than the conventional PCR (51.15%, 89/174) from clinical samples. These data indicated that the TaqMan-based real-time RT-PCR assay established here was an effective method with high sensitivity, specificity and reproducibility for faster and more accurate detection and quantification of SADS-CoV.


title: Inhibition of feline (FIPV) and human (SARS) coronavirus by semisynthetic derivatives of glycopeptide antibiotics

text: Abstract Various semisynthetic derivatives of glycopeptide antibiotics including vancomycin, eremomycin, teicoplanin, ristocetin A and DA-40926 have been evaluated for their inhibitory activity against feline infectious peritonitis virus (FIPV) and human (SARS-CoV, Frankfurt-1 strain) coronavirus in cell culture in comparison with their activity against human immunodeficiency virus (HIV). Several glycopeptide derivatives modified with hydrophobic substituents showed selective antiviral activity. For the most active compounds, the 50% effective concentrations (EC50) were in the lower micromolar range. In general, removal of the carbohydrate parts of the molecules did not affect the antiviral activity of the compounds. Some compounds showed inhibitory activity against both, whereas other compounds proved inhibitory to either, FIPV or SARS-CoV. There was no close correlation between the EC50 values of the glycopeptide derivatives for FIPV or SARS-CoV.


title: Spatial-temporal characteristics of epidemic spread in-out flow—Using SARS epidemic in Beijing as a case study

text: For better detecting the spatial-temporal change mode of individual susceptible-infected-symptomatic-treated-recovered epidemic progress and the characteristics of information/material flow in the epidemic spread network between regions, the epidemic spread mechanism of virus input and output was explored based on individuals and spatial regions. Three typical spatial information parameters including working unit/address, onset location and reporting unit were selected and SARS epidemic spread in-out flow in Beijing was defined based on the SARS epidemiological investigation data in China from 2002 to 2003 while its epidemiological characteristics were discussed. Furthermore, by the methods of spatial-temporal statistical analysis and network characteristic analysis, spatial-temporal high-risk hotspots and network structure characteristics of Beijing outer in-out flow were explored, and spatial autocorrelation/heterogeneity, spatial-temporal evolutive rules and structure characteristics of the spread network of Beijing inner in-out flow were comprehensively analyzed. The results show that (1) The outer input flow of SARS epidemic in Beijing concentrated on Shanxi and Guangdong provinces, but the outer output flow was disperse and mainly includes several north provinces such as Guangdong and Shandong. And the control measurement should focus on the early and interim progress of SARS breakout. (2) The inner output cases had significant positive autocorrelative characteristics in the whole studied region, and the high-risk population was young and middle-aged people with ages from 20 to 60 and occupations of medicine and civilian labourer. (3) The downtown districts were main high-risk hotspots of SARS epidemic in Beijing, the northwest suburban districts/counties were secondary high-risk hotspots, and northeast suburban areas were relatively safe. (4) The district/county nodes in inner spread network showed small-world characteristics and information/material flow had notable heterogeneity. The suburban Tongzhou and Changping districts were the underlying high-risk regions, and several suburban districts such as Shunyi and Huairou were the relatively low-risk safe regions as they carried out minority information/material flow. The exploration and analysis based on epidemic spread in-out flow help better detect and discover the potential spatial-temporal evolutive rules and characteristics of SARS epidemic, and provide a more effective theoretical basis for emergency/control measurements and decision-making.


title: Improved capacity for influenza surveillance in the WHO Eastern Mediterranean Region: Progress in a challenging setting

text: Abstract Background The World Health Organization Regional Office for Eastern Mediterranean has partnered with the United States Centers for Disease Control and Prevention (CDC) to strengthen pandemic influenza preparedness and response in the Region since 2006. This partnership focuses on pandemic preparedness planning, establishing and enhancing influenza surveillance systems, improving laboratory capacity for detection of influenza viruses, estimating the influenza disease burden, and providing evidence to support policies for the introduction and increased use of seasonal influenza vaccines. Methods Various published and unpublished data from public and WHO sources, programme indicators of the CDC cooperative agreement and Pandemic Influenza Preparedness Framework were reviewed and analysed. Analyses and review of the programme indicators and published articles enabled us to generate information that was unavailable from only WHO sources. Results Most (19/22) countries of the Region have established influenza surveillance system; 16 countries in the Region have designated National Influenza Centres. The Region has seen considerable improvement in geographic coverage of influenza surveillance and influenza detection. Virus sharing has improved and almost all of the participating laboratories have achieved a 100% efficiency score in the WHO external quality assessment programme. At least seven countries have estimated their influenza disease burden using surveillance data and at least 17 are now using seasonal influenza vaccines as a control strategy for influenza illness. Conclusion The Region has achieved substantial progress in surveillance and response to seasonal influenza, despite the adverse effects to the health systems of many countries due to acute and protracted emergencies and other significant challenges.


title: Then Tell Me What You Think About Morality: A Freedom of Expression Perspective on the CJEU’s Decision in FACK JU GÖHTE (C-240/18 P)

text: This case note on the CJEU’s decision in Fack Ju Göhte focuses on morality bars and freedom of expression in EU trade mark law. Based on the presumption that a refusal to register a trade mark for being contrary to accepted principles of morality interferes with freedom of expression, an empirical concept of morality appears incompatible with freedom of expression. However, the test for morality developed by the CJEU seems to employ such an empirical concept at least partially. In addition, the test seems to lack legal certainty. In light of freedom of expression, both represent a potential shortcoming of the decision.


Position Statement of Transplant Activity in the Middle East in Era of COVID-19 Pandemic


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


title: LILRA3 Binds Both Classical and Non-Classical HLA Class I Molecules but with Reduced Affinities Compared to LILRB1/LILRB2: Structural Evidence

text: Structurally, Group 1 LILR (Leukocyte Immunogloblin (Ig)-Like Receptor, also known as Ig-like transcripts, ILT; Leukocyte Ig-like receptor, LIR; and CD85) members are very similar in terms of the HLAIs (human leukocyte antigen class I molecules) binding region and were hypothesized that they all bind to HLAIs. As one of the Group 1 LILRs, LILRA3 is the only secretory LILR and may greatly control the inhibitory immune response induced by LILRB1, LILRB2, and other HLA-binding LILR molecules like LILRA1. Nevertheless, little was known about the binding of LILRA3 to HLAIs. In this report, we present the crystal structure of the LILRA3 domain 1 (D1) and evaluate the D1 and D1D2 (domain 1 and domain 2) binding to classical and non-classical HLAIs using BIAcore® surface plasmon resonance analysis (SPR). We found that LILRA3 binds both classical HLA-A*0201 and non-classical HLA-G1 but with reduced affinities compared to either LILRB1 or LILRB2. The polymorphic amino acids and the LILRA3 D1 structure support this notion.


Appearance of skin rash in pediatric patients with COVID‐19: Three case presentations


title: Genotype shift in human coronavirus OC43 and emergence of a novel genotype by natural recombination

text: Summary Background Human coronavirus (HCoV) OC43 is the most prevalent HCoV in respiratory tract infections. Its molecular epidemiological characterization, particularly the genotyping, was poorly addressed. Methods The full-length spike (S), RNA-dependent RNA polymerase (RdRp), and nucleocapsid (N) genes were amplified from each respiratory sample collected from 65 HCoV-OC43-positive patients between 2005 and 2012. Genotypes were determined by phylogenetic analysis. Recombination was analyzed based on full-length viral genome sequences. Clinical manifestations of each HCoV genotype infection were compared by reviewing clinical records. Results Sixty of these 65 samples belong to genotypes B, C and D. The remaining five strains had incongruent positions in the phylogenetic trees of the S, RdRp and N genes, suggesting a novel genotype emerging, designated as genotype E. Whole genome sequencing and bootscan analysis indicated that genotype E is generated by recombination between genotypes B, C and D. Temporal analysis revealed a sequential genotype replacement of C, B, D and E over the study period with genotype D being the dominant genotype since 2007. The novel genotype E was only detected in children younger than three years suffering from lower respiratory tract infections. Conclusions Our results suggest that HCoV-OC43 genotypes are evolving. Such genotype shift may be an adapting mechanism for HCoV-OC43 maintaining its epidemic.


title: Containing the accidental laboratory escape of potential pandemic influenza viruses

text: BACKGROUND: The recent work on the modified H5N1 has stirred an intense debate on the risk associated with the accidental release from biosafety laboratory of potential pandemic pathogens. Here, we assess the risk that the accidental escape of a novel transmissible influenza strain would not be contained in the local community. METHODS: We develop here a detailed agent-based model that specifically considers laboratory workers and their contacts in microsimulations of the epidemic onset. We consider the following non-pharmaceutical interventions: isolation of the laboratory, laboratory workers’ household quarantine, contact tracing of cases and subsequent household quarantine of identified secondary cases, and school and workplace closure both preventive and reactive. RESULTS: Model simulations suggest that there is a non-negligible probability (5% to 15%), strongly dependent on reproduction number and probability of developing clinical symptoms, that the escape event is not detected at all. We find that the containment depends on the timely implementation of non-pharmaceutical interventions and contact tracing and it may be effective (>90% probability per event) only for pathogens with moderate transmissibility (reproductive number no larger than R(0) = 1.5). Containment depends on population density and structure as well, with a probability of giving rise to a global event that is three to five times lower in rural areas. CONCLUSIONS: Results suggest that controllability of escape events is not guaranteed and, given the rapid increase of biosafety laboratories worldwide, this poses a serious threat to human health. Our findings may be relevant to policy makers when designing adequate preparedness plans and may have important implications for determining the location of new biosafety laboratories worldwide.


title: Strategies for successful recombinant expression of disulfide bond-dependent proteins in Escherichia coli

text: Bacteria are simple and cost effective hosts for producing recombinant proteins. However, their physiological features may limit their use for obtaining in native form proteins of some specific structural classes, such as for instance polypeptides that undergo extensive post-translational modifications. To some extent, also the production of proteins that depending on disulfide bridges for their stability has been considered difficult in E. coli. Both eukaryotic and prokaryotic organisms keep their cytoplasm reduced and, consequently, disulfide bond formation is impaired in this subcellular compartment. Disulfide bridges can stabilize protein structure and are often present in high abundance in secreted proteins. In eukaryotic cells such bonds are formed in the oxidizing environment of endoplasmic reticulum during the export process. Bacteria do not possess a similar specialized subcellular compartment, but they have both export systems and enzymatic activities aimed at the formation and at the quality control of disulfide bonds in the oxidizing periplasm. This article reviews the available strategies for exploiting the physiological mechanisms of bactera to produce properly folded disulfide-bonded proteins.


title: Membrane-Active Sequences within gp41 Membrane Proximal External Region (MPER) Modulate MPER-Containing Peptidyl Fusion Inhibitor Activity and the Biosynthesis of HIV-1 Structural Proteins

text: The membrane proximal external region (MPER) is a highly conserved membrane-active region located at the juxtamembrane positions within class I viral fusion glycoproteins and essential for membrane fusion events during viral entry. The MPER in the human immunodeficiency virus type I (HIV-1) envelope protein (Env) interacts with the lipid bilayers through a cluster of tryptophan (Trp) residues and a C-terminal cholesterol-interacting motif. The inclusion of the MPER N-terminal sequence contributes to the membrane reactivity and anti-viral efficacy of the first two anti-HIV peptidyl fusion inhibitors T20 and T1249. As a type I transmembrane protein, Env also interacts with the cellular membranes during its biosynthesis and trafficking. Here we investigated the roles of MPER membrane-active sequences during both viral entry and assembly, specifically, their roles in the design of peptidyl fusion inhibitors and the biosynthesis of viral structural proteins. We found that elimination of the membrane-active elements in MPER peptides, namely, penta Trp→alanine (Ala) substitutions and the disruption of the C-terminal cholesterol-interacting motif through deletion inhibited the anti-viral effect against the pseudotyped HIV-1. Furthermore, as compared to C-terminal dimerization, N-terminal dimerization of MPER peptides and N-terminal extension with five helix-forming residues enhanced their anti-viral efficacy substantially. The secondary structure study revealed that the penta-Trp→Ala substitutions also increased the helical content in the MPER sequence, which prompted us to study the biological relevance of such mutations in pre-fusion Env. We observed that Ala mutations of Trp664, Trp668 and Trp670 in MPER moderately lowered the intracellular and intraviral contents of Env while significantly elevating the content of another viral structural protein, p55/Gag and its derivative p24/capsid. The data suggest a role of the gp41 MPER in the membrane-reactive events during both viral entry and budding, and provide insights into the future development of anti-viral therapeutics.


title: Career Prospects of Young Dentists in Switzerland

text: The observational cross-sectional study was aimed to obtain information on the promotion and development of young professionals in Switzerland. An online survey with 20 questions was sent out. Data was collected on participants’ demographic data, including age, gender, level of qualification, place of work, information on employment, future perspectives, and career prospects. The survey was sent out to 1920 practitioners, of which 440 (22.9%) responded (37.1% males and 62.9% females). Of them, 76.6% were members of the Swiss Dental Association (SSO) 15.9% students, and 7.5% non-SSO members. Most participants had parents with a dental education (80.9%), and 19.8% did not. Young dentists in Switzerland most often saw their career prospects as neutral (39.8%) or rather positive (39.3%). Whereas significantly fewer dentists had a negative view of their professional future (16.8%), including more women than men, the fewest dentists of both sexes (4.1%) saw their career prospects as positive by far. The majority of young dentists were satisfied with their career prospects. Within the limitations of the current study, the reasons for this need further investigation. Despite good career prospects, there is a desire among young colleagues for cantonal practice assistance and mentoring programs, as well as support in finding a job and in taking the plunge into self-employment.


The Forgotten Fallen: painful reality of a pandemic


title: Emerging Infections and Pregnancy

text: A key component of the response to emerging infections is consideration of special populations, including pregnant women. Successful pregnancy depends on adaptation of the woman's immune system to tolerate a genetically foreign fetus. Although the immune system changes are not well understood, a shift from cell-mediated immunity toward humoral immunity is believed to occur. These immunologic changes may alter susceptibility to and severity of infectious diseases in pregnant women. For example, pregnancy may increase susceptibility to toxoplasmosis and listeriosis and may increase severity of illness and increase mortality rates from influenza and varicella. Compared with information about more conventional disease threats, information about emerging infectious diseases is quite limited. Pregnant women's altered response to infectious diseases should be considered when planning a response to emerging infectious disease threats.


title: Closing the Gap in Global Neurosurgical Education via Online Conference: A Pre-Covid Survey

text: Introduction A reliable network for peer review and feedback can lead to an increase in knowledge and improving patient care. As opportunities to participate in online continuing medical education (CME) increase, there is a reduction in the worldwide knowledge gap often due to a lack of resources to attend conferences and advanced training in person. Methods A total of 64 participants completed a 10-item anonymous online questionnaire to assess how their knowledge and applied practical skills improved by participating in online conferences, and whether this education modality adequately addresses challenges for countries with limited access to conferences or training. Results While an overall positive response toward this mode of neurosurgical education was expected, interesting insights were gained from the short-answer section, demonstrating a direct influence on clinical practice through online conference participation. Conclusion While limited in size, the study results support the expectation of a positive attitude toward neurosurgical e-learning, which translates directly to improving patient care and lessening the worldwide gap in neurosurgical education.


title: Home Self-Collection of Nasal Swabs for Diagnosis of Acute Respiratory Virus Infections in Children With Cystic Fibrosis

text: BACKGROUND: Understanding the importance of respiratory viruses in children with cystic fibrosis (CF) has been limited because of challenges using clinic- or hospital-based diagnostic testing. We conducted a pilot study to assess feasibility of home self- (or parent-) collection of nasal swabs (NS). METHODS: Cystic fibrosis patients aged 6–18 years with new respiratory illness participated. In clinic, a deep nasal flocked swab was collected by research staff and compared with an anterior foam NS obtained after instillation of saline spray. At home, up to 2 self-collections of paired foam NS (with and without saline) were collected and mailed for real-time polymerase chain reaction (PCR) testing. RESULTS: Paired swabs were collected from 28 patients: 18 sets in clinic (deep nasal vs saline foam NS) and 43 sets at home (saline vs dry foam NS) with 9 (50%) and 35 (81%) virus detections, respectively. Home-collected NS were obtained closer to illness onset, with a mean difference in symptom days of −2.3 between home and clinic collections (95% confidence interval [CI] −3.5, −1.2; P < .001). Rhinovirus comprised 73% of virus detections; the difference in mean PCR cycle threshold values for rhinovirus between swabs collected at home versus clinic was −3.8 (95% CI −6.8, −0.9; P = .014), indicating significantly higher viral load for home-collected swabs. CONCLUSIONS: Home-collected foam NS had a higher positivity rate compared with clinic-collected swabs, likely because collection was closer to illness onset. Home self-collection is feasible and well tolerated for timely respiratory virus diagnosis and provides a novel approach for clinical diagnostics and surveillance of respiratory virus infections among CF patients.


title: IFITM3 inhibits virus-triggered induction of type I interferon by mediating autophagosome-dependent degradation of IRF3

text: Interferon-induced transmembrane protein 3 (IFITM3) is a restriction factor that can be induced by viral infection and interferons (IFNs). It inhibits the entry and replication of many viruses, which are independent of receptor usage but dependent on processes that occur in endosomes. In this study, we demonstrate that IFITM3 plays important roles in regulating the RNA-virus-triggered production of IFN-β in a negative-feedback manner. Overexpression of IFITM3 inhibited Sendai virus-triggered induction of IFN-β, whereas knockdown of IFITM3 had the opposite effect. We also showed that IFITM3 was constitutively associated with IRF3 and regulated the homeostasis of IRF3 by mediating the autophagic degradation of IRF3. These findings suggest a novel inhibitory function of IFITM3 on the RNA-virus-triggered production of type I IFNs and cellular antiviral responses.


title: An ELISA optimized for porcine epidemic diarrhoea virus detection in faeces

text: Abstract Monoclonal antibodies to porcine epidemic diarrhoea virus (PEDV) membrane protein M were prepared and used for the comparative assessment of three blocking ELISA variants to detect PEDV. The competitive blocking ELISA (CB-ELISA) format showed the highest sensitivity, allowing detection of 102.5 plaque-forming units of PEDV/ml in culture medium. Its specificity was verified by inclusion of control samples containing transmissible gastroenteritis virus (TGEV) and rotavirus A in each analysis. Eighty porcine field samples of faeces obtained from 38 herds affected with diarrhoea were examined, and PEDV was found in 15 (19%) samples from 6 (16%) herds. The suitability of the CB-ELISA for the screening herds in epizootiologic situations is discussed.


title: Infectious diseases of the central nervous system

text: Neurologic disease is seen commonly in cats, with infectious causes accounting for 30-45% of cases. However, since a specific infection cannot be identified in 12-40% of these cases, it is essential that we try to understand these cases better in the hope that we can eventually identify the cause(s), and so determine how best to treat and/or prevent them.


title: Chapter 8 Bismarck and the Long Road to Universal Health Coverage

text: Abstract The 2015 Sustainable Development Goals (SDGs) state that All United Nations Member States have agreed to try to achieve Universal Health Coverage by 2030. This includes financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all. Universal health coverage (UHC) means inclusion and empowerment for all people to access medical care, including treatment and prevention services. UHC exists in all the industrial nations except the US, which has a mixed public-private system and struggles with closing the gap between the insured and the uninsured population. Middle- and low-income countries face many challenges for UHC achievement, including low levels of funding, lack of personnel, weak health management, and issues of availability of services favoring middle- and upper-class communities. Community health services for preventive and curative health services for needs in populations at risk for poor health in low-income countries must be addressed with proactive health promotion initiatives for the double burden of infectious and noncommunicable diseases. Each nation will develop its own unique approach to national health systems, but there are models used by a number of countries based on principles of national responsibility for health, social solidarity for providing funding, and for effective ways of providing care with comprehensiveness, efficiency, quality, and cost containment. Universal access does not eliminate social inequalities in health by itself, including a wide context of reducing social inequities. Understanding national health systems requires examining representative models of different systems. Health reform is necessarily a continuing process as all countries must adapt to face challenges of cost constraints, inequalities in access to care, aging populations, emergence of new disease conditions and advancing technology including the growing capacity of medicine, public health and health promotion. The growing stress of increasing obesity, diabetes, and other chronic diseases, requires nations to modify their health care systems. Learning from the systems developed in different countries helps to learn from the processes of change in other countries.


title: The science commons in life science research: structure, function, and value of access to genetic diversity

text: Innovation in the life sciences depends on how much information is produced as well as how widely and easily it is shared. Policies governing the science commons – or alternative, more restricted informational spaces – determine how widely and quickly information is distributed. The purpose of this paper is to highlight why the science commons matters and to analyse its structure and function. The main lesson from our analysis is that both the characteristics of the physical resources (from genes to microbes, plants and animals) and the norms and beliefs of the different research communities – think of the Bermuda rules in the human genome case or the Belem declaration for bioprospecting – matter in the institutional choices made when organising the science commons. We also show that the science commons contributes to solving some of the collective action dilemmas that arise in the production of knowledge in Pasteur's Quadrant, when information is both scientifically important and practically applicable. We show the importance of two of these dilemmas for the life sciences, which we call respectively the diffusion–innovation dilemma (how readily innovation diffuses) and the exploration–exploitation dilemma (when application requires collective action).


title: Actualités sur le syndrome respiratoire aigu sévère

text: Résumé Propos et points forts. – Le syndrome respiratoire aigu sévère (SRAS) a récemment été reconnu comme étant associé à une infection virale émergente, hautement contagieuse et pouvant être mortelle. Actualités. – À fin juin 2003, plus de 8500 cas d’infections humaines et 800 décès ont été rapportés dans 30 pays. L’agent responsable de cette infection a été identifié comme étant un nouveau coronavirus. La présentation clinique, les anomalies biologiques et radiologiques, ainsi que l’évolution et le traitement des patients infectés par ce virus sont décrits dans cet article. Perspectives et projets. – La recherche de thérapeutiques efficaces et de vaccins est en cours d’évaluation. Abstract Introduction. – The severe acute respiratory syndrome (SARS) has recently been recognised as a new clinical entity and a new emerging infectious disease that is highly contagious with significant mortality. Current knowledge and key points. – By the end of 17 June 2003, a total of 8500 cases included 800 deaths had been reported from 30 countries. The cause of SARS has been identified as a new corona virus. In this manuscript, we describe the clinical features, biological findings, virological tests, radiological assessment, outcome and treatments of this infection. Future. – Research on specific therapies and vaccines is on-going.


title: Human bocavirus (HBoV) in Thailand: Clinical manifestations in a hospitalized pediatric patient and molecular virus characterization

text: Summary Objective Human bocavirus (HBoV), a novel virus, which based on molecular analysis has been associated with respiratory tract diseases in infants and children have recently been studied worldwide. To determine prevalence, clinical features and perform phylogenetic analysis in HBoV infected Thai pediatric patients. Methods HBoV was detected from 302 nasopharyngeal (NP) suctions of pediatric patients with acute lower respiratory tract illness and sequenced applying molecular techniques. Results The incidence of HBoV infection in pediatric patients amounted to 6.62% with 40% co-infected with other respiratory viruses. There were no clinical specific manifestations for HBoV; however, fever and productive cough were commonly found. Generalized rales and wheezing were detected in most of the patients as well as perihilar infiltrates. The alignment and phylogenetic analysis of partial VP1 genes showed minor variations. Conclusion Our results indicated that HBoV can be detected in nasopharyngeal aspirate specimens from infants and children with acute lower respiratory tract illness.


The National Disability Insurance Scheme and COVID‐19: a collision course


Re-appearance of the SARS-CoV-2 virus nucleic acid in patients recovering from COVID-19


Quis custodiet ipsos custodes: are we taking care of healthcare workers in the Italian Covid-19 outbreak?


title: Chest CT manifestations of new coronavirus disease 2019 (COVID-19): a pictorial review

text: Coronavirus disease 2019 (COVID-19) outbreak, first reported in Wuhan, China, has rapidly swept around the world just within a month, causing global public health emergency. In diagnosis, chest computed tomography (CT) manifestations can supplement parts of limitations of real-time reverse transcription polymerase chain reaction (RT-PCR) assay. Based on a comprehensive literature review and the experience in the frontline, we aim to review the typical and relatively atypical CT manifestations with representative COVID-19 cases at our hospital, and hope to strengthen the recognition of these features with radiologists and help them make a quick and accurate diagnosis. Key Points • Ground glass opacities, consolidation, reticular pattern, and crazy paving pattern are typical CT manifestations of COVID-19. • Emerging atypical CT manifestations, including airway changes, pleural changes, fibrosis, nodules, etc., were demonstrated in COVID-19 patients. • CT manifestations may associate with the progression and prognosis of COVID-19.


title: A simplified math approach to predict ICU beds and mortality rate for hospital emergency planning under Covid-19 pandemic

text: The different stages of Covid-19 pandemic can be described by two key-variables: ICU patients and deaths in hospitals. We propose simple models that can be used by medical doctors and decision makers to predict the trends on both short-term and long-term horizons. Daily updates of the models with real data allow forecasting some key indicators for decision-making (an Excel file in the Supplemental material allows computing them). These are beds allocation, residence time, doubling time, rate of renewal, maximum daily rate of change (positive/negative), halfway points, maximum plateaus, asymptotic conditions, and dates and time intervals when some key thresholds are overtaken. Doubling time of ICU beds for Covid-19 emergency can be as low as 2-3 days at the outbreak of the pandemic. The models allow identifying the possible departure of the phenomenon from the predicted trend and thus can play the role of early warning systems and describe further outbreaks.


title: Primary structure of the membrane and nucleocapsid protein genes of feline infectious peritonitis virus and immunogenicity of recombinant vaccinia viruses in kittens

text: Abstract Feline infectious peritonitis virus (FIPV) causes a mostly fatal, immunologically mediated disease in cats. Previously, we demonstrated that immunization with a recombinant vaccinia virus expressing the FIPV spike protein (S) induced early death after challenge with FIPV (Vennema et al., 1990, J. Virol. 64, 1407–1409). In this paper we describe similar immunizations with the FIPV membrane (M) and nucleocapsid (N) proteins. The genes encoding these proteins were cloned and sequenced. Comparison of the amino acid sequences with the corresponding sequences of porcine transmissible gastroenteritis virus revealed 84.7 and 77% identity for M and N, respectively. Vaccinia virus recombinants expressing the cloned genes induced antibodies in immunized kittens. Immunization with neither recombinant induced early death after challenge with FIPV, strongly suggesting that antibody-dependent enhancement is mediated by antibodies against S only. Immunization with the N protein recombinant had no apparent effect on the outcome of challenge. However, three of eight kittens immunized with the M protein recombinant survived the challenge, as compared to one of eight kittens of the control group.


title: International Law and Public Health Policy

text: The field of international public health and the contribution of international organizations to its development is described. The growth and elaboration of the field of international public health law in the last decade and a half is one of the most notable developments in global health policy. In this new era of global health governance, international law has an important, albeit limited, role to play in promoting and coordinating international cooperation and national action to protect and promote global health. Particular attention is paid to the global health impact of international law developed under the auspices of the World Health Organization and the World Trade Organization.


Year in review in Intensive Care Medicine 2014: III. Severe infections, septic shock, healthcare-associated infections, highly resistant bacteria, invasive fungal infections, severe viral infections, Ebola virus disease and paediatrics


title: A combination of epitope prediction and molecular docking allows for good identification of MHC class I restricted T-cell epitopes

text: Abstract In silico identification of T-cell epitopes is emerging as a new methodology for the study of epitope-based vaccines against viruses and cancer. In order to improve accuracy of prediction, we designed a novel approach, using epitope prediction methods in combination with molecular docking techniques, to identify MHC class I restricted T-cell epitopes. Analysis of the HIV-1 p24 protein and influenza virus matrix protein revealed that the present approach is effective, yielding prediction accuracy of over 80% with respect to experimental data. Subsequently, we applied such a method for prediction of T-cell epitopes in SARS coronavirus (SARS-CoV) S, N and M proteins. Based on available experimental data, the prediction accuracy is up to 90% for S protein. We suggest the use of epitope prediction methods in combination with 3D structural modelling of peptide-MHC-TCR complex to identify MHC class I restricted T-cell epitopes for use in epitope based vaccines like HIV and human cancers, which should provide a valuable step forward for the design of better vaccines and may provide in depth understanding about activation of T-cell epitopes by MHC binding peptides.


title: Single-nucleotide variants in human CD81 influence hepatitis C virus infection of hepatoma cells

text: An estimated number of 71 million people are living with chronic hepatitis C virus (HCV) infection worldwide and 400,000 annual deaths are related to the infection. HCV entry into the hepatocytes is complex and involves several host factors. The tetraspanin human CD81 (hCD81) is one of the four essential entry factors and is composed of one large extracellular loop, one small extracellular loop, four transmembrane domains, one intracellular loop and two intracellular tails. The large extracellular loop interacts with the E2 glycoprotein of HCV. Regions outside the large extracellular loop (backbone) of hCD81 have a critical role in post-binding entry steps and determine susceptibility of hepatocytes to HCV. Here, we investigated the effect of five non-synonymous single-nucleotide variants in the backbone of hCD81 on HCV susceptibility. We generated cell lines that stably express the hCD81 variants and infected the cells using HCV pseudoparticles and cell culture-derived HCV. Our results show that all the tested hCD81 variants support HCV pseudoparticle entry with similar efficiency as wild-type hCD81. In contrast, variants A54V, V211M and M220I are less supportive to cell culture-derived HCV infection. This altered susceptibility is HCV genotype dependent and specifically affected the cell entry step. Our findings identify three hCD81 genetic variants that are impaired in their function as HCV host factors for specific viral genotypes. This study provides additional evidence that genetic host variation contributes to inter-individual differences in HCV infection and outcome. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00430-020-00675-1) contains supplementary material, which is available to authorized users.


title: Clinical characteristics and outcomes of severe rhinovirus-associated pneumonia identified by bronchoscopic bronchoalveolar lavage in adults: Comparison with severe influenza virus-associated pneumonia

text: Abstract Background Rhinoviruses (RVs) may cause pneumonia, but the characteristics of RV-associated pneumonia have not been adequately evaluated. Objective We aimed to compare characteristics, complications, and outcomes between severe RV- and influenza virus (IFV)-associated pneumonia in adults. Study design We used prospective cohort data of adult patients with severe pneumonia who had been admitted to the medical intensive care unit of a tertiary care hospital over a 4-year period. The clinical features and outcomes of 27 patients with RV-positive bronchoscopic bronchoalveolar lavage (BAL) fluid were compared to those of 51 pneumonia patients with IFV-positive BAL fluid or IFV-positive nasopharyngeal specimens. Results Of 356 patients who underwent bronchoscopic BAL and respiratory virus polymerase chain reaction (PCR), RV was the most commonly identified virus (8.1%) from BAL fluid. Patients with RV-associated pneumonia were more likely to be immunocompromised than patients with IFV-associated pneumonia (81.5% vs. 33.3%, p <0.001). Bacterial coinfection tended to be less common in the RV group (18.5% vs. 37.3%, p =0.09). Although septic shock was less common in the RV group (29.6% vs. 54.9%, p =0.03), other clinical manifestations, laboratory findings, and radiologic patterns were similar between the groups. The 28-day mortality of patients with severe RV- and IFV-associated pneumonia was similarly high (29.6% vs. 35.3% respectively, p =0.61). Conclusions Severe RV-associated pneumonia patients were more likely to be immunocompromised and less likely to present septic shock. Overall clinical features were similar and mortalities of both groups were comparably high. Studies of larger cohorts encompassing mild to moderate pneumonia patients are needed.


title: RIG-I in RNA virus recognition

text: Abstract Antiviral immunity is initiated upon host recognition of viral products via non-self molecular patterns known as pathogen-associated molecular patterns (PAMPs). Such recognition initiates signaling cascades that induce intracellular innate immune defenses and an inflammatory response that facilitates development of the acquired immune response. The retinoic acid-inducible gene I (RIG-I) and the RIG-I-like receptor (RLR) protein family are key cytoplasmic pathogen recognition receptors that are implicated in the recognition of viruses across genera and virus families, including functioning as major sensors of RNA viruses, and promoting recognition of some DNA viruses. RIG-I, the charter member of the RLR family, is activated upon binding to PAMP RNA. Activated RIG-I signals by interacting with the adapter protein MAVS leading to a signaling cascade that activates the transcription factors IRF3 and NF-κB. These actions induce the expression of antiviral gene products and the production of type I and III interferons that lead to an antiviral state in the infected cell and surrounding tissue. RIG-I signaling is essential for the control of infection by many RNA viruses. Recently, RIG-I crosstalk with other pathogen recognition receptors and components of the inflammasome has been described. In this review, we discuss the current knowledge regarding the role of RIG-I in recognition of a variety of virus families and its role in programming the adaptive immune response through cross-talk with parallel arms of the innate immune system, including how RIG-I can be leveraged for antiviral therapy.


Occupational Hazards in Nursing


title: A Basic Strategy to Manage Global Health with Reference to Livestock Production in Asia

text: Newly emerging infectious diseases (nEIDs) have increased rapidly presenting alarming challenges to global health. We argue that for effective management of global health a basic strategy should include at least three essential tactical forms: actions of a directly focused nature, institutional coordination, and disciplinary integration in approaches to health management. Each level of action is illustrated with examples from the livestock sector in Asia. No clear example of all three tactical forms in place can be found from developing countries where food security is a significant threat although Vietnam is developing a comprehensive strategy. Finally, an ecosystem health approach to global health management is advocated; such an approach moves away from the traditional single disciplinary approach. Stronger guidance is needed to direct ecohealth research and application in the management of global health.


title: Respiratory Infections, Acute

text: Acute respiratory tract infections are an extremely common and important source of morbidity and mortality. Despite advances in our understanding of microbial pathogens and the development of novel antimicrobial agents, acute respiratory tract infections continue to place an enormous burden on global health expenditure. Acute respiratory tract infections can be divided into infections that predominantly affect the upper respiratory tract above the vocal cords and those that affect the lower respiratory tract. The clinical features, causative pathogens, and therapies of common acute respiratory tract infections are detailed in this article.


title: Sixty‐eight consecutive patients assessed for COVID‐19 infection: Experience from a UK Regional infectious diseases Unit

text: BACKGROUND: Assessment of possible infection with SARS‐CoV‐2, the novel coronavirus responsible for COVID‐19 illness, has been a major activity of infection services since the first reports of cases in December 2019. OBJECTIVES: We report a series of 68 patients assessed at a Regional Infection Unit in the UK. METHODS: Between 29 January 2020 and 24 February 2020, demographic, clinical, epidemiological and laboratory data were collected. We compared clinical features between patients not requiring admission for clinical reasons or antimicrobials with those assessed as needing either admission or antimicrobial treatment. RESULTS: Patients assessed were aged from 0 to 76 years; 36/68 were female. Peaks of clinical assessments coincided with updates to the case definition for suspected COVID‐19. Microbiological diagnoses included SARS‐CoV‐2, mycoplasma pneumonia, influenza A, non‐SARS/MERS coronaviruses and rhinovirus/enterovirus. Nine of sixty‐eight received antimicrobials, 15/68 were admitted, 5 due to inability to self‐isolate. Patients requiring admission on clinical grounds or antimicrobials (14/68) were more likely to have fever or raised respiratory rate compared to those not requiring admission or antimicrobials. CONCLUSIONS: The majority of patients had mild illness, which did not require clinical intervention. This finding supports a community testing approach, supported by clinicians able to review more unwell patients. Extensions of the epidemiological criteria for the case definition of suspected COVID‐19 lead to increased screening intensity; strategies must be in place to accommodate this in time for forthcoming changes as the epidemic develops.


title: Computational modelling of flavivirus dynamics: the ins and outs

text: Enveloped viruses such as the flaviviruses represent a significant burden to human health around the world, with hundreds of millions of people each year affected by dengue alone. In an effort to improve our understanding of the molecular basis for the infective mechanisms of these viruses, extensive computational modelling approaches have been applied to elucidate their conformational dynamics. Multiscale protocols have been developed to simulate flavivirus envelopes in close accordance with biophysical data, in particular derived from cryo-electron microscopy, enabling high-resolution refinement of their structures and elucidation of the conformational changes associated with adaptation both to host environments and to immunological factors such as antibodies. Likewise, integrative modelling efforts combining data from biophysical experiments and from genome sequencing with chemical modification are providing unparalleled insights into the architecture of the previously unresolved nucleocapsid complex. Collectively, this work provides the basis for the future rational design of new antiviral therapeutics and vaccine development strategies targeting enveloped viruses.


title: Simultaneously inhibition of HIV and HBV replication through a dual small interfering RNA expression system

text: Abstract Human immunodeficiency virus (HIV) is often acquired in individuals already infected with hepatitis B virus (HBV) as a result of shared routes of transmission. Since current options for the treatment of HIV and HBV infections are limited, there is an essential need for the development of effective therapies against HIV/HBV co-infections. RNA interference (RNAi) has been used as a powerful tool to silence genes in cells and animals. In this study, we developed a small interfering RNA generation system that expressed two different siRNAs to target the HBs gene of HBV and the gp120 gene of HIV in Bel-7402 and HEK293T cells, respectively. Our results demonstrated that the two siRNA molecules could simultaneously inhibit the expression of HBs and gp120 by 81% and 89%, respectively. In addition, dual siRNA molecules significantly decreased the production of HBs, and simultaneously inhibited the replication of HBV and HIV. This dual siRNA generation system not only proved to be a novel approach for studying functions of multiple genes simultaneously, but also provides a potential approach for the treatment and prevention of HIV and HBV co-infection.


title: Characterizing replication kinetics and plaque production of type I feline infectious peritonitis virus in three feline cell lines

text: Abstract Investigating type I feline coronaviruses (FCoVs) in tissue culture is critical for understanding the basic virology, pathogenesis, and virus-host interactome of these important veterinary pathogens. This has been a perennial challenge as type I FCoV strains do not easily adapt to cell culture. Here we characterize replication kinetics and plaque formation of a model type I strain FIPV Black in Fcwf-4 cells established at Cornell University (Fcwf-4 CU). We determined that maximum virus titers (>107 pfu/mL) were recoverable from infected Fcwf-4 CU cell-free supernatant at 20 h post-infection. Type I FIPV Black and both biotypes of type II FCoV formed uniform and enumerable plaques on Fcwf-4 CU cells. Therefore, these cells were employable in a standardized plaque assay. Finally, we determined that the Fcwf-4 CU cells were morphologically distinct from feline bone marrow-derived macrophages and were less sensitive to exogenous type I interferon than were Fcwf-4 cells purchased from ATCC.


title: Chapter 7 IFN Inducibility of Major Histocompatibility Antigens in Tumors

text: Interferons represent a protein family with pleiotropic functions including immunomodulatory, cytostatic, and cytotoxic activities. Based on these effects, interferons are involved in innate as well as adaptive immunity, thereby shaping the tumor host immune responses. These cytokines, alone or in combination, have been successfully implemented for the treatment of some malignancies. However, it has been recently demonstrated that tumor cells could be resistant to interferon treatment, which may be associated with an escape of tumor cells from immune surveillance. Therefore, the aim of this chapter is to summarize the frequency of impaired interferon signal transduction, their underlying molecular mechanisms, and their clinical relevance.


title: Neonatal Immunology

text: The field of neonatal immunology and calf vaccination is going through a revolution in veterinary medicine. The purpose of this article is to give an overview of basic neonatal immunology and principles of vaccination as they relate to beef and dairy calves. Opinions on when and what to vaccinate calves for vary widely among experts; therefore, this article focuses primarily on the documented literature. It is likely that vaccination approaches that might be effective or economic for one herd may not work for another.


The Impact of the COVID-19 Pandemic on Head and Neck Cancer Patients


title: A creature with a hundred waggly tails: intrinsically disordered proteins in the ribosome

text: Intrinsic disorder (i.e., lack of a unique 3-D structure) is a common phenomenon, and many biologically active proteins are disordered as a whole, or contain long disordered regions. These intrinsically disordered proteins/regions constitute a significant part of all proteomes, and their functional repertoire is complementary to functions of ordered proteins. In fact, intrinsic disorder represents an important driving force for many specific functions. An illustrative example of such disorder-centric functional class is RNA-binding proteins. In this study, we present the results of comprehensive bioinformatics analyses of the abundance and roles of intrinsic disorder in 3,411 ribosomal proteins from 32 species. We show that many ribosomal proteins are intrinsically disordered or hybrid proteins that contain ordered and disordered domains. Predicted globular domains of many ribosomal proteins contain noticeable regions of intrinsic disorder. We also show that disorder in ribosomal proteins has different characteristics compared to other proteins that interact with RNA and DNA including overall abundance, evolutionary conservation, and involvement in protein–protein interactions. Furthermore, intrinsic disorder is not only abundant in the ribosomal proteins, but we demonstrate that it is absolutely necessary for their various functions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00018-013-1446-6) contains supplementary material, which is available to authorized users.


title: Corticosteroids for Urological Cancer Care During Coronavirus Disease 2019. Treat or Not to Treat?

text: Currently, the official World Health Organization guidance is not to start corticosteroids, but there is no robust evidence of risk in patients with cancer and coronavirus disease 2019. A risk-benefit analysis should be performed for each patient on the use of steroids in cancer care.


Paleovirology—Modern Consequences of Ancient Viruses


title: Response of major air pollutants to COVID-19 lockdowns in China

text: Abstract COVID-19 suddenly struck Wuhan at the end of 2019 and soon spread to the whole country and the rest of world in 2020. To mitigate the pandemic, China authority has taken unprecedentedly strict measures across the country. That provides a precious window to study how the air quality response to quick decline of anthropogenic emissions in terms of national scale, which would be critical basis to make atmospheric governance policies in the future. In this work, we utilized observations from both remote sensing and in-situ measurements to investigate impacts of COVID-19 lockdown on different air pollutions in different regions of China. It is witnessed that the PM2.5 concentrations exhibited distinct trends in different regions, despite of plunges of NO2 concentrations over the whole country. The steady HCHO concentration in urban area provides sufficient fuels for generations of tropospheric O3, leading to high concentrations of O3, especially when there is not enough NO to consume O3 via the titration effect. Moreover, the SO2 concentration kept steady at a low level regardless of cities. As a conclusion, the COVID-19 lockdown indeed helped reduce NO2 concentration. However, the atmospheric quality in urban areas of China has not improved overall due to lockdown measures. It underscores the significance of comprehensive control of atmospheric pollutants in cleaning air. Reducing VOCs (volatile organic compounds) concentrations in urban areas would be a critical mission for better air quality in the future.


title: Combining X-Ray Crystallography and Electron Microscopy

text: The combination of cryo-electron microscopy to study large biological assemblies at low resolution with crystallography to determine near atomic structures of assembly fragments is quickly expanding the horizon of structural biology. This technique can be used to advantage in the study of large structures that cannot be crystallized, to follow dynamic processes, and to “purify” samples by visual selection of particles. Factors affecting the quality of cryo-electron microscopy maps and limits of accuracy in fitting known structural fragments are discussed.


Cancer patients in covid-19 era: swimming against the tide


title: Relevance of signaling molecules for apoptosis induction on influenza A virus replication

text: Abstract Apoptosis is an important mechanism to maintain homeostasis in mammals, and disruption of the apoptosis regulation mechanism triggers a range of diseases, such as cancer, autoimmune diseases, and developmental disorders. The severity of influenza A virus (IAV) infection is also closely related to dysfunction of apoptosis regulation. In the virus infected cells, the functions of various host cellular molecules involved in regulation of induction of apoptosis are modulated by IAV proteins to enable effective virus replication. The modulation of the intracellular signaling pathway inducing apoptosis by the IAV infection also affects extracellular mechanisms controlling apoptosis, and triggers abnormal host responses related to the disease severity of IAV infections. This review focuses on apoptosis related molecules involved in IAV replication and pathogenicity, the strategy of the virus propagation through the regulation of apoptosis is also discussed.


title: L’infection par SRAS-CoV-2 peut se traduire par un syndrome appendiculaire : tomodensitométrie thoracique avant appendicectomie

text: Court résumé La présentation clinique initiale d’une maladie de la Covid-19 peut être un syndrome appendiculaire. La réalisation d’une tomodensitométrie abdominale permet d’infirmer le diagnostic d’appendicite et la tomodensitométrie thoracique de poser le diagnostic d’infection par le SRAS-CoV-2. La réalisation d’un scanner est nécessaire avant d’envisager une chirurgie d’urgence pour appendicite aiguë. Short Abstract The initial clinical presentation of CoronaVirus Disease 2019 may be appendicular syndrome. An abdominal CT scan ruled out a diagnosis of appendicitis and a chest CT scan yielded a diagnosis of SARS-CoV-2 infection. CT scan is required before considering emergency surgery for acute appendicitis.


title: The replication of a mouse adapted SARS-CoV in a mouse cell line stably expressing the murine SARS-CoV receptor mACE2 efficiently induces the expression of proinflammatory cytokines

text: Infection of conventional mice with a mouse adapted (MA15) severe acute respiratory syndrome (SARS) coronavirus (CoV) reproduces many aspects of human SARS such as pathological changes in lung, viremia, neutrophilia, and lethality. However, established mouse cell lines highly susceptible to mouse-adapted SARS-CoV infection are not available. In this work, efficiently transfectable mouse cell lines stably expressing the murine SARS-CoV receptor angiotensin converting enzyme 2 (ACE2) have been generated. These cells yielded high SARS-CoV-MA15 titers and also served as excellent tools for plaque assays. In addition, in these cell lines, SARS-CoV-MA15 induced the expression of proinflammatory cytokines and IFN-β, mimicking what has been observed in experimental animal models infected with SARS-CoV and SARS patients. These cell lines are valuable tools to perform in vitro studies in a mouse cell system that reflects the species used for in vivo studies of SARS-CoV-MA15 pathogenesis.


Perioperative Echocardiography during the Coronavirus Crisis – considerations in pediatrics and congenital heart disease


title: Restructured society and environment: A review on potential technological strategies to control the COVID-19 pandemic

text: Abstract The emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in China at December 2019 had led to a global outbreak of coronavirus disease 2019 (COVID-19) and the disease started to spread all over the world and became an international public health issue. The entire humanity has to fight in this war against the unexpected and each and every individual role is important. Healthcare system is doing exceptional work and the government is taking various measures that help the society to control the spread. Public, on the other hand, coordinates with the policies and act accordingly in most state of affairs. But the role of technologies in assisting different social bodies to fight against the pandemic remains hidden. The intention of our study is to uncover the hidden roles of technologies that ultimately help for controlling the pandemic. On investigating, it is found that the strategies utilizing potential technologies would yield better benefits and these technological strategies can be framed either to control the pandemic or to support the confinement of the society during pandemic which in turn aids in controlling the spreading of infection. This study enlightens the various implemented technologies that assists the healthcare systems, government and public in diverse aspects for fighting against COVID-19. Furthermore, the technological swift that happened during the pandemic and their influence in the environment and society is discussed. Besides the implemented technologies, this work also deals with untapped potential technologies that have prospective applications in controlling the pandemic circumstances. Alongside the various discussion, our suggested solution for certain situational issues is also presented.


title: CDC issues COVID‐19 guidelines for law enforcement personnel

text: In the wake of COVID‐19, law enforcement personnel need to be aware of important facts about the spread of the virus so that they can help keep community spaces safe. The Centers for Disease Control and Prevention posted guidelines for law enforcement personnel directly related to public safety.


title: Cell cycle control (and more) by programmed −1 ribosomal frameshifting: implications for disease and therapeutics

text: Like most basic molecular mechanisms, programmed –1 ribosomal frameshifting (−1 PRF) was first identified in viruses. Early observations that global dysregulation of −1 PRF had deleterious effects on yeast cell growth suggested that −1 PRF may be used to control cellular gene expression, and the cell cycle in particular. Collection of sufficient numbers of viral −1 PRF signals coupled with advances in computer sciences enabled 2 complementary computational approaches to identify −1 PRF signals in free living organisms. The unexpected observation that almost all −1 PRF events on eukaryotic mRNAs direct ribosomes to premature termination codons engendered the hypothesis that −1 PRF signals post-transcriptionally regulate gene expression by functioning as mRNA destabilizing elements. Emerging research suggests that some human diseases are associated with global defects in −1 PRF. The recent discovery of −1 PRF signal-specific trans-acting regulators may provide insight into novel therapeutic strategies aimed at treating diseases caused by changes in gene expression patterns.


title: COVID‐19 infection in patients with sickle cell disease

text: Severe acute respiratory syndrome coronavirus 2, also known as COVID-19, has spread to 184 countries with almost 1.5 million cases as of mid-April 2020 since first reported (1). The clinical features of this disease are not completely understood, however severe illness is thought to predominantly occur in adults with advanced age and those with underlying comorbidities (2). Sickle cell disease (SCD), an immunocompromised condition, puts patients at higher risk for respiratory infections and subsequent pulmonary complications such as acute chest syndrome (ACS) (3).


title: Early chest CT features of patients with 2019 novel coronavirus (COVID-19) pneumonia: relationship to diagnosis and prognosis

text: OBJECTIVE: To determine the consistency between CT findings and real-time reverse transcription–polymerase chain reaction (RT-PCR) and to investigate the relationship between CT features and clinical prognosis in COVID-19. METHODS: The clinical manifestations, laboratory parameters, and CT imaging findings were analyzed in 34 COVID-19 patients, confirmed by RT-PCR from January 20 to February 4 in Hainan Province. CT scores were compared between the discharged patients and the ICU patients. RESULTS: Fever (85%) and cough (79%) were most commonly seen. Ten (29%) patients demonstrated negative results on their first RT-PCR. Of the 34 (65%) patients, 22 showed pure ground-glass opacity. Of the 34 (50%) patients, 17 had five lobes of lung involvement, while the 23 (68%) patients had lower lobe involvement. The lesions of 24 (71%) patients were distributed mainly in the subpleural area. The initial CT lesions of ICU patients were distributed in both the subpleural area and centro-parenchyma (80%), and the lesions were scattered. Sixty percent of ICU patients had five lobes involved, while this was seen in only 25% of the discharged patients. The lesions of discharged patients were mainly in the subpleural area (75%). Of the discharged patients, 62.5% showed pure ground-glass opacities; 80% of the ICU patients were in the progressive stage, and 75% of the discharged patients were at an early stage. CT scores of the ICU patients were significantly higher than those of the discharged patients. CONCLUSION: Chest CT plays a crucial role in the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. The initial features in CT may be associated with prognosis. KEY POINTS: • Chest CT is valuable for the early diagnosis of COVID-19, particularly for those patients with a negative RT-PCR. • The early CT findings of COVID-19 in ICU patients differed from those of discharged patients.