title: The Australasian COVID-19 Trial (ASCOT) to assess clinical outcomes in hospitalised patients with SARS-CoV-2 infection (COVID-19) treated with lopinavir/ritonavir and/or hydroxychloroquine compared to standard of care: A structured summary of a study protocol for a randomised controlled trial

text: OBJECTIVES: To determine if lopinavir/ritonavir +/- hydroxychloroquine will reduce the proportion of participants who survive without requiring ventilatory support, 15 days after enrolment, in adult participants with non-critically ill SARS-CoV-2 infection. TRIAL DESIGN: ASCOT is an investigator-initiated, multi-centre, open-label, randomised controlled trial. Participants will have been hospitalised with confirmed COVID-19, and will be randomised 1:1:1:1 to receive lopinavir /ritonavir, hydroxychloroquine, both or neither drug in addition to standard of care management. PARTICIPANTS: Participants will be recruited from >80 hospitals across Australia and New Zealand, representing metropolitan and regional centres in both public and private sectors. Admitted patients will be eligible if aged ≥ 18 years, have confirmed SARS-CoV-2 by nucleic acid testing in the past 12 days and are expected to remain an inpatient for at least 48 hours from the time of randomisation. Potentially eligible participants will be excluded if admitted to intensive care or requiring high level respiratory support, are currently receiving study drugs or their use is contraindicated due to allergy, drug interaction or comorbidities (including baseline QTc prolongation of 470ms for women or 480ms for men), or death is anticipated imminently. INTERVENTION AND COMPARATOR: Participants will be randomised 1:1:1:1 to: Group 1: standard of care; Group 2: lopinavir (400mg) / ritonavir (100mg) twice daily for 10 days in tablet form; Group 3: hydroxychloroquine (800mg) 4x200mg administered 12 hours apart on Day 1, followed by 400mg twice a day for 6 days; Group 4: lopinavir /ritonavir plus hydroxychloroquine. MAIN OUTCOMES: Proportion of participants alive and not having required intensive respiratory support (invasive or non-invasive ventilation) at 15 days after enrolment. A range of clinical and virological secondary outcomes will also be evaluated. RANDOMISATION: The randomisation schedule will be generated by an independent statistician. Randomisation will be stratified by site and will be in permuted blocks of variable block size. The randomised sequence allocation will only be accessible to the data management group, and site investigators will have individual participant allocation provided through a web-based trial enrolment platform. BLINDING (MASKING): This is an open-label study, with researchers assessing the laboratory outcomes blinded to treatment allocation. No unblinding procedures relating to potential adverse effects are therefore required. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): We assumed that 5% of participants receiving standard of care would meet the primary outcome, aimed to evaluate whether interventions could lead to a relative risk of 0.5, assuming no interaction between intervention arms. This corresponds to a required sample size of 610 per arm, with a 5% two-sided significance level (alpha) and 80% power. The total sample size therefore is planned to be 2440. TRIAL STATUS: ASCOT protocol version 3, May 5, 2020. Recruitment opened April 4, 2020 and is ongoing, with planned completion of enrolment July 31, 2021. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12620000445976). Prospectively registered April 6, 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.


The use of a novel smartphone app for monitoring male luts treatment during the COVID-19 outbreak


The emotional impact of COVID-19 outbreak in amyotrophic lateral sclerosis patients: evaluation of depression, anxiety and interoceptive awareness


title: Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia

text: BACKGROUND: Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP). METHODS: This retrospective multicenter study was conducted in four French university hospitals. Respiratory samples were obtained from patients with clinical and radiological signs of pneumonia and simultaneously tested using conventional microbiological methods and the rm-PCR. A committee composed of an intensivist, a microbiologist, and an infectious diseases specialist retrospectively assessed all medical files and agreed on the most appropriate antimicrobial therapy for each pneumonia episode, according to the results of rm-PCR and blinded to the culture results. The rm-PCR-guided antimicrobial regimen was compared to the empirical treatment routinely administered to the patient in standard care. RESULTS: We included 159 pneumonia episodes. Most patients were hospitalized in intensive care units (n = 129, 81%), and episodes were HAP (n = 68, 43%), CAP (n = 54, 34%), and VAP (n = 37, 23%). Conventional culture isolated ≥ 1 microorganism(s) at significant level in 95 (60%) patients. The syndromic rm-PCR detected at least one bacteria in 132 (83%) episodes. Based on the results of the rm-PCR, the multidisciplinary committee proposed a modification of the empirical therapy in 123 (77%) pneumonia episodes. The modification was a de-escalation in 63 (40%), an escalation in 35 (22%), and undetermined in 25 (16%) patients. In microbiologically documented episodes (n = 95), the rm-PCR increased appropriateness of the empirical therapy to 83 (87%), as compared to 73 (77%) in routine care. CONCLUSIONS: Use of a syndromic rm-PCR test has the potential to reduce unnecessary antimicrobial exposure and increase the appropriateness of empirical antibiotic therapy in adult patients with pneumonia.


title: The significance of case detection ratios for predictions on the outcome of an epidemic - a message from mathematical modelers

text: In attempting to predict the further course of the novel coronavirus disease (COVID-19) pandemic caused by SARS-CoV-2, mathematical models of different types are frequently employed and calibrated to reported case numbers. Among the major challenges in interpreting these data is the uncertainty about the amount of undetected infections, or conversely: the detection ratio. As a result, some models make assumptions about the percentage of detected cases among total infections while others completely neglect undetected cases. Here, we illustrate how model projections about case and fatality numbers vary significantly under varying assumptions on the detection ratio. Uncertainties in model predictions can be significantly reduced by representative testing, both for antibodies and active virus RNA, to uncover past and current infections that have gone undetected thus far.


title: GVHD-free, relapse-free survival provides novel clues for optimizing allogeneic-HSCT for adult T-cell leukemia/lymphoma

text: The outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for adult T-cell leukemia/lymphoma (ATL) is still unsatisfactory. To illustrate the advantages and disadvantages of each donor source, we performed a nationwide retrospective study of graft-versus-host disease (GVHD)-free, relapse-free survival (GRFS) of patients with allo-HSCT-treated ATL. One-year GRFS did not significantly differ between patients who received related bone marrow transplantation (R-BMT; 26%, n = 117), related peripheral blood stem cell transplantation (R-PBSCT; 22%, n = 225), unrelated bone marrow transplantation (UR-BMT; 26%, n = 619), and cord blood transplantation (CBT; 21%, n = 359; p = 0.09). This was attributable to a low incidence of systemically-treated chronic GVHD after CBT (9% at 1 year) and reduced non-GVHD/relapse mortality after R-PBSCT (9% at 1 year). Among patients transplanted in complete remission (CR), 1-year overall survival after CBT (52%, n = 132) was not inferior to that after R-BMT (55%, n = 51), R-PBSCT (57%, n = 79), and UR-BMT (58%, n = 280; p = 0.15), and relapse rates were equivalent among the four sources (p = 0.19). Our results suggest that all donor sources are feasible for CR patients and that GRFS provides important clues toward optimizing allo-HSCT for ATL.


title: Russia between east and west, and the future of Eurasian order

text: This article introduces the special issue by going beyond the traditional debates about geopolitics and great power rivalry. Instead, it examines the emergent and highly complex world of Central Eurasia, in its transformative effort to reorder itself in response to both global and local change. In particular, the paper (and the volume) focuses on two interrelated themes: one of a changing Russia, that is anxiously trying to adapt to the uncertain dynamics within and beyond the wider Eurasian space; and the other—of an emerging complexity of new order-making regional (integration) initiatives that are poised to reshape the future of international and global order. The overarching intention of this paper and the volume is to advance the need to focus on ‘the local’, to gain a more holistic understanding of the present-day challenges and the kind of global response needed to stay attuned to the increasingly complex world.


Covid19, Brexit and much more in 2020: A Bad Year for Animal Welfare?


title: Germany’s first COVID-19 deceased: a 59-year-old man presenting with diffuse alveolar damage due to SARS-CoV-2 infection

text: Clinical characterization of COVID-19 (Corona Virus Disease 2019) is being performed worldwide to gain insights into the pathogenesis and course of the disease. Little is known regarding morphological findings, which are essential to understanding the unique features and pathomechanisms of the disease, from which one can identify possible new treatments. It has been shown that diffuse alveolar damage, signifying acute respiratory distress syndrome, is present together with atypical multinucleated cells in reported cases of the disease by Tian et al. (J Thorac Oncol 15:700–704, 2020). Macroscopic morphological findings in COVID-19 remain elusive to this day. Here, we report the case of the first German to die due to COVID-19. A detailed examination consisting of full-body computed tomography, autopsy, histology assessment, and viral assessment has been performed. The lungs of the deceased contained high concentrations of SARS-CoV-2 RNA and displayed the typical radiological signatures of COVID-19. Furthermore, a morphological pattern was found displaying hyperaemic areas interspersed by normally perfused areas affecting the whole lung. We also report a finding suggestive of micro-thrombotic events in the lung, which is compatible with the recently described coagulation changes and increased incidence of pulmonary artery embolisms seen in COVID-19 patients as reported by Wichmann et al. (Ann Intern Med, 2020). A broader study is needed to confirm these findings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00428-020-02872-y) contains supplementary material, which is available to authorized users.


title: In-office endoscopic nasal polypectomy: prospective analysis of patient tolerability and efficacy

text: PURPOSE: In-office rhinologic procedures have become popularised in the last decade, especially in North America. Endoscopic nasal polypectomy under local anaesthesia offers instant relief in selected patients with obstructive chronic rhinosinusitis with nasal polyps. We aimed to analyse patient tolerability during the procedure while measuring its effectiveness. METHODS: A prospective study of patients who underwent in-office microdebrider-assisted polypectomy under local anaesthetic from September 2018 to November 2019 in a Spanish tertiary hospital was performed. The tolerability was measured by monitoring vital signs during the procedure and using a visual analogue scale posteriorly. The effectiveness was calculated through patient-reported outcomes (SNOT-22) and endoscopic evaluation 1 and 6 months follow-up. RESULTS: Forty-four patients were included, with a mean age of 60.7 years. The mean visual analogue scale score was 2.76 out of 10 points. Vital signs were steady overall, with a statistically significant reduction (p < 0.001) in systolic pressure during the procedure. Presyncope and epistaxis were among the few mild complications. However, we registered one major complication that required intensive care admission. There was a 64% reduction in the SNOT-22 score in the first month, with a maintained effect after 6 months. Patients with asthma and a higher polyp load were the subgroups that required more time to achieve significant improvement. CONCLUSIONS: In-office polypectomy is a very effective technique that alleviates obstructive symptoms in patients with nasal polyposis, and it is generally safe and well tolerated when performed by an expert. However, rhinologists must be aware of potentially severe complications.


The spectrum of pathological findings in coronavirus disease (COVID-19) and the pathogenesis of SARS-CoV-2


title: COVID-19 and type 1 diabetes: dealing with the difficult duo

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) has aroused global health concerns, particularly in relation to diabetes where it has been associated with poorer outcomes. The bulk of the evolving evidence in diabetes and COVID-19 relates to type 2 diabetes (T2D). Since there are a significant number of patients with type 1 diabetes (T1D) with unique concerns and challenges during the ongoing COVID-19 pandemic, we reviewed existing literature, relevant websites, and related guidelines to form this narrative review to help address key questions in this area. METHODS: We systematically searched the PubMed database up to May 31, 2020, and retrieved all the articles published on T1D and COVID-19. RESULTS: We found 18 relevant articles, each of which carried a part of the evidence regarding the risk of contracting COVID-19 in patients with T1D, effect of COVID-19 on development of T1D, outcomes in T1D with COVID-19, and special management issues in T1D in the light of COVID-19. These have been documented in the present review. CONCLUSION: COVID-19 with T1D presents special challenges. While the available evidence does shed some light, we need more evidence to deal with this difficult duo.


Social Distancing


title: The mevalonate pathway is an actionable vulnerability of t(4;14)-positive multiple myeloma

text: Multiple myeloma (MM) is a plasma cell malignancy that is often driven by chromosomal translocations. In particular, patients with t(4;14)-positive disease have worse prognosis compared to other MM subtypes. Herein, we demonstrated that t(4;14)-positive cells are highly dependent on the mevalonate (MVA) pathway for survival. Moreover, we showed that this metabolic vulnerability is immediately actionable, as inhibiting the MVA pathway with a statin preferentially induced apoptosis in t(4;14)-positive cells. In response to statin treatment, t(4;14)-positive cells activated the integrated stress response (ISR), which was augmented by co-treatment with bortezomib, a proteasome inhibitor. We identified that t(4;14)-positive cells depend on the MVA pathway for the synthesis of geranylgeranyl pyrophosphate (GGPP), as exogenous GGPP fully rescued statin-induced ISR activation and apoptosis. Inhibiting protein geranylgeranylation similarly induced the ISR in t(4;14)-positive cells, suggesting that this subtype of MM depends on GGPP, at least in part, for protein geranylgeranylation. Notably, fluvastatin treatment synergized with bortezomib to induce apoptosis in t(4;14)-positive cells and potentiated the anti-tumor activity of bortezomib in vivo. Our data implicate the t(4;14) translocation as a biomarker of statin sensitivity and warrant further clinical evaluation of a statin in combination with bortezomib for the treatment of t(4;14)-positive disease.


Perspectiva de los pacientes sobre el uso de la telemedicina en las consultas urológicas ambulatorias: aprendiendo de la pandemia del COVID-19


Telehealth and Nutrition Support During the Covid-19 Pandemic


Introduction of Telemedicine During the COVID-19 Pandemic: A Challenge for Now, an Opportunity for the Future


Fatal Post-Infarction Late Left Ventricular Free Wall Rupture in the Era of COVID-19


Be the Change You Wish to See


Vindicating the general ophthalmologist. Tribute to Dr. Li Wenliang (1986â2020)()


Transport and mobility justice: Evolving discussions


COVID-19 Pandemic and Ageism: A Call for Humanitarian Care


Corrigendum to A novel covid-19 mathematical model with fractional derivatives: singular and nonsingular kernels [Chaos Solitons & Fractals 139(2020)110060]


The Invisible Epidemic: Neglected Chronic Disease Management During COVID-19


Nursing Homes, the Pandemic, and Caring Enough


COVID-19 infection: mitohormetic concept of immune response


title: Covid-19 and diabesity: when a pandemia cross another pandemia

text: The Covid-19 epidemic is having a strong impact on the population with pre-existing chronic diseases. The collision between the Covid-19 pandemic and the current diabesity epidemic has highlighted that obese and diabetic patients have a worse prognosis due to the impairment of the immune response to infections and due to the mechanical limits that make the management of the hospitalized patients with severe obesity more difficult. The limitations imposed on accessibility to non-urgent care during the lockdown of "phase 1" of this pandemic have created the need to revolutionize clinical practice to meet the health demands of chronic and high-risk diseases such as obesity and diabetes. The use of technology and risk stratification to establish the priority of access to the treatments that we have been forced to undertake will be useful tools for a new phase of a more efficient and successful treatment of diabesity.


Current concepts in ophthalmology (1(st) edition) (2020) Editor: Andrzej Grzybowski e-book, ISBN: 978-3-030-25389-9 Publisher: SpringerNature


title: Vitamin D and COVID-19

text: Epidemiological data report that several countries with a high prevalence of hypovitaminosis D may have increased susceptibility to complications and mortality due to COVID-19 infection. These reports, however, have limitations given that they derive from observational studies. Nevertheless, while awaiting more robust data, clinicians should treat patients with vitamin D deficiency irrespective of whether or not it has a link with respiratory infections.


The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angiotensin II receptor blocker-based antihypertensive therapies—reply


title: Molecular epidemiology of enteroviruses associated with severe hand, foot and mouth disease in Shenzhen, China, 2014-2018

text: In this study, we investigated the epidemiology and molecular characteristics of enteroviruses associated with severe hand, foot and mouth disease (HFMD) in Shenzhen, China, during 2014-2018. A total of 137 fecal specimens from patients with severe HFMD were collected. Enterovirus (EV) types were determined using real-time reverse transcription polymerase chain reaction (RT-PCR), RT nested PCR, and sequencing. Sequences were analyzed using bioinformatics programs. Of 137 specimens tested, 97 (70.8%), 12 (8.8%), and 10 (7.3%) were positive for EV-A71, coxsackievirus A6 (CVA6), and CVA16, respectively. Other pathogens detected included CVA2 (2.9%, 4/137), CVA10 (2.9%, 4/137), CVA5 (0.7%, 1/137), echovirus 6 (E6) (0.7%, 1/137) and E18 (0.7%, 1/137). The most frequent complication in patients with proven EV infections was myoclonic jerk, followed by aseptic encephalitis, tachypnea, and vomiting. The frequencies of vomiting and abnormal eye movements were higher in EV-A71-infected patients than that in CVA6-infected or CVA16-infected patients. Molecular phylogeny based on the complete VP1 gene revealed no association between the subgenotype of the virus and disease severity. Nevertheless, 12 significant mutations that were likely to be associated with virulence or the clinical phenotype were observed in the 5’UTR, 2A(pro), 2C, 3A, 3D(pol) and 3’UTR of CVA6. Eight significant mutations were observed in the 5’UTR, 2B, 3A, 3D(pol) and 3’UTR of CVA16, and 10 significant mutations were observed in the 5’UTR, VP1, 3A and 3C(pro) of CVA10. In conclusion, EV-A71 is still the main pathogen causing severe HFMD, although other EV types can also cause severe complications. Potential virulence or phenotype-associated sites were identified in the genomes of CVA6, CVA16, and CVA10. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00705-020-04734-z) contains supplementary material, which is available to authorized users.


title: Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment

text: The coronavirus disease-2019 (COVID-19) pandemic is likely to pose new challenges to the rheumatology community in the near and distant future. Some of the challenges, like the severity of COVID-19 among patients on immunosuppressive agents, are predictable and are being evaluated with great care and effort across the globe. A few others, such as atypical manifestations of COVID-19 mimicking rheumatic musculoskeletal diseases (RMDs) are being reported. Like in many other viral infections, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can potentially lead to an array of rheumatological and autoimmune manifestations by molecular mimicry (cross-reacting epitope between the virus and the host), bystander killing (virus-specific CD8 + T cells migrating to the target tissues and exerting cytotoxicity), epitope spreading, viral persistence (polyclonal activation due to the constant presence of viral antigens driving immune-mediated injury) and formation of neutrophil extracellular traps. In addition, the myriad of antiviral drugs presently being tried in the treatment of COVID-19 can result in several rheumatic musculoskeletal adverse effects. In this review, we have addressed the possible spectrum and mechanisms of various autoimmune and rheumatic musculoskeletal manifestations that can be precipitated by COVID-19 infection, its therapy, and the preventive strategies to contain the infection.


title: Genealogies of Resilience: From Conservation to Disaster Adaptation

text: The concept of ‘resilience’ was first adopted within systems ecology in the 1970s, where it marked a move away from the homeostasis of Cold War resource management towards the far-from-equilibrium models of second-order cybernetics (or complex systems theory). Resilience as an operational strategy of risk management has more recently been taken up in financial, urban, and environmental security discourses, where it reflects a general consensus about the necessity of adaptation through endogenous crisis. The generalisation of complex systems theory as a methodology of power has ambivalent sources. While, on the one hand, the redefinition of the concept can be directly traced to the work of the ecologist Crawford S. Holling, on the other hand, the deployment of complex systems theory is perfectly in accord with the later philosophy of the Austrian neoliberal Friedrich Hayek. This ambivalence is reflected in the trajectory of resilience theory itself, from the ecological critique of orthodox fossil-fuelled growth economics to a methodology of power deployed in its service, in a time of planetary heating and ecosystem collapse in which all long-term expectations of equilibrium have been abandoned.


High Prevalence of SARS-CoV-2 Infection Among the Uninsured Hispanic/Latino Population: a Retrospective Cohort Study


Letter to the Editor in Response to: COVID-19: Magnifying the Effect of Health Disparities


Older Adults with COVID-19 Can Choose Care at Home: Lessons Learned from New York City


title: Ethical Algorithms in Autonomous Vehicles: Reflections on a Workshop

text: This chapter summarizes and expands on the breakout session at the 2019 Autonomous Vehicles Symposium in Orlando, FL, titled “Ethical Algorithms in Autonomous Vehicles.” First, the content of the workshop presentations is summarized, covering technical and nontechnical detail. Second, the discussion during, and on the margins of the workshop is summarized from the perspective of the authors, consistent with the Chatham House Rule. Conclusions are posed for industry, academia, and government readers.


title: Societal Expectations from Automated Road Mobility: Results of a Survey in Germany

text: This chapter summarizes the results of a survey among 1,000 interviewed persons that was conducted in Germany. The aim was to obtain a current picture of the population’s expectations from self-driving (automated) vehicles. Twelve questions were asked to get an overview of the participants’ opinions on the potential of self-driving vehicles regarding climate impact, time and monetary savings, the willingness to use automated vehicles, as well as their safety and risks. The results are compared to the current state of expert knowledge. The main finding is that the German population is skeptical towards self-driving vehicles. In comparison to a scientific perspective, the population is underestimating the potential and possible benefits of automated vehicles, while the risks are assessed similarly. In the conclusions, the findings of the studyare assessed in view of the COVID-19 pandemic.


title: COVID-19, Brachytherapy, and Gynecologic Cancers: a Moroccan Experience

text: The treatment of gynecological cancers is the main activity of brachytherapy units. However, during COVID-19 pandemic, precautions should be done in order to reduce the spread of the virus while maintaining all chances to recovery for all patients (Radiother Oncol 148, 227-228, 2020). Despite the extent of the pandemic in our country, limited data are available to establish recommendations with a sufficient level of evidence (Radiother Oncol 148, 227-228, 2020). More recently, the American Brachytherapy Society published some clarifications in this regard and international expert consensus recommendations of radiation therapy for gynecologic malignancies during the COVID-19 pandemic were published (https://www.americanbrachytherapy.org/about-abs/abs-news/abs-statement-on-coronavirus/, Gynecol Oncol 15, 2020). In this commentary, we sought to share the procedures adopted for the management of gynecological cancer patients during COVID-19 pandemic in our brachytherapy unit.


title: Bin it or pin it? Which professional ethical guidance on managing COVID-19 should I follow?

text: BACKGROUND: As the COVID-19 (coronavirus) pandemic develops, healthcare professionals are looking for support with, and guidance to inform, the difficult decisions they face. In the (current) absence of an authoritative national steer in England, professional bodies and local organisations have been developing and disseminating their own ethical guidance. Questions inevitably arise, some of which are particularly pressing during the pandemic, as events are unfolding quickly and the field is becoming crowded. My central question here is: which professional ethical guidance should the professional follow? MAIN BODY: Adopting a working definition of “professional ethical guidance”, I offer three domains for a healthcare professional to consider, and some associated questions to ask, when determining whether – in relation to any guidance document – they should “bin it or pin it”. First, the professional should consider the source of the guidance: is the issuing body authoritative or, if not, at least sufficiently influential that its guidance should be followed? Second, the professional should consider the applicability of the guidance, ascertaining whether the guidance is available and, if so, whether it is pertinent. Pertinence has various dimensions, including whether the guidance applies to this professional, this patient and/or this setting, whether it is up-to-date, and whether the guidance addresses the situation the professional is facing. Third, the professional should consider the methodology and methods by which the guidance was produced. Although the substantive quality of the guidance is important, so too are the methods by which it was produced. Here, the professional should ask whether the guidance is sufficiently inclusive – in terms of who has prepared it and who contributed to its development – and whether it was rigorously developed, and thus utilised appropriate processes, principles and evidence. CONCLUSION: Asking and answering such questions may be challenging, particularly during a pandemic. Furthermore, guidance will not do all the work: professionals will still need to exercise their judgment in deciding what is best in the individual case, whether or not this concerns COVID-19. But such judgments can and should be informed (and constrained) by guidance, and hopefully these preliminary observations will provide some useful pointers for time-pressed professionals.


title: The angiotensin-converting enzyme 2 (ACE2) receptor in the prevention and treatment of COVID-19 are distinctly different paradigms

text: There is current debate concerning the use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin II type 1 receptor blockers (ARBs), for hypertension management, during COVID-19 infection. Specifically, the suggestion has been made that ACE inhibitors or ARBs could theoretically contribute to infection via increasing ACE2 receptor expression and hence increase viral load. The ACE2 receptor is responsible for binding the SAR-CoV2 viral spike and causing COVID-19 infection. What makes the argument somewhat obtuse for ACE inhibitors or ARBs is that ACE2 receptor expression can be increased by compounds that activate or increase the expression of SIRT1. Henceforth common dietary interventions, vitamins and nutrients may directly or indirectly influence the cellular expression of the ACE2 receptor. There are many common compounds that can increase the expression of the ACE2 receptor including Vitamin C, Metformin, Resveratrol, Vitamin B3 and Vitamin D. It is important to acknowledge that down-regulation or blocking the cellular ACE2 receptor will likely be pro-inflammatory and may contribute to end organ pathology and mortality in COVID-19. In conclusion from the perspective of the ACE2 receptor, COVID-19 prevention and treatment are distinctly different. This letter reflects on this current debate and suggests angiotensin-converting enzyme inhibitors and ARBs are likely beneficial during COVID-19 infection for hypertensive and normotensive patients.


title: Could hemophagocytic lymphohistiocytosis be the core issue of severe COVID-19 cases?

text: BACKGROUND: COVID-19, a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly presents as fever, cough, dyspnea, and myalgia or fatigue. Although the majority of patients with COVID-19 have mild symptoms, some are more prone to serious outcomes, including pneumonia, acute respiratory distress syndrome (ARDS), and even death. Hemophagocytic lymphohistiocytosis (HLH) is a severe, life-threatening inflammatory syndrome associated with intense cytokine release (also known as a “cytokine storm”). Similar to COVID-19, HLH is characterized by aggressive course leading to multi-organ failure. MAIN TEXT: The purpose of this review article is to draw attention to the possibility of the complication of HLH in patients with the severe course of COVID-19. Indeed, some of the clinical characteristics observed in the more severe cases of COVID-19 are reminiscent of secondary HLH (which can be triggered by infections, malignancies, rheumatological diseases, or autoimmune/immunodeficiency conditions). The pathogenesis of SARS-CoV-2 infection also suggests that HLH or a similar hyperinflammatory syndrome is the cause of the severe course of the infection. CONCLUSION: The pathogenesis and clinical symptoms of severe COVID-19 indicate that an increased inflammatory response corresponding to HLH is occurring. Therefore, patients with severe COVID-19 should be screened for hyperinflammation using standard laboratory tests to identify those for whom immunosuppressive therapy may improve outcomes.


title: Proceedings from the 2(nd) Next Gen Therapies for Systemic Juvenile Idiopathic Arthritis and Macrophage Activation Syndrome symposium held on October 3-4, 2019

text: For reasons poorly understood, and despite the availability of biological medications blocking IL-1 and IL-6 that have markedly improved overall disease control, children with Systemic Juvenile Idiopathic Arthritis (SJIA) are now increasingly diagnosed with life-threatening chronic complications, including hepatitis and lung disease (SJIA-LD). On October 3–4, 2019, a two-day meeting, NextGen Therapies for Systemic Juvenile Idiopathic Arthritis (SJIA) & macrophage activation syndrome (MAS) organized by the Systemic JIA Foundation (www.systemicjia.org/) in Washington, DC brought together scientists, clinicians, parents and FDA representatives with the objectives (1) to integrate clinical and research findings in MAS and SJIA-LD, and (2) to develop a shared understanding of this seemingly new pulmonary complication of SJIA. The current manuscript summarizes discussions and conclusions of the meeting.


title: Early epidemiological assessment of the transmission potential and virulence of coronavirus disease 2019 (COVID-19) in Wuhan City, China, January–February, 2020

text: BACKGROUND: Since the first cluster of cases was identified in Wuhan City, China, in December 2019, coronavirus disease 2019 (COVID-19) rapidly spreads globally. Scientists have made strides in estimating key transmission and epidemiological parameters. In particular, accumulating evidence points to a substantial fraction of asymptomatic or subclinical infections, which influences our understanding of the transmission potential and severity of this emerging disease. In this study, we derive estimates of the transmissibility and virulence of COVID-19 in Wuhan City, China, by reconstructing the underlying transmission dynamics using multiple data sources. METHODS: We employ statistical methods and publicly available epidemiological datasets to jointly derive estimates of transmissibility and severity associated with the novel coronavirus. For this purpose, the daily series of laboratory-confirmed COVID-19 cases and deaths in Wuhan City together with epidemiological data of Japanese repatriated from Wuhan City on board government-chartered flights were integrated into our analysis. RESULTS: Our posterior estimates of basic reproduction number (R) in Wuhan City, China, in 2019–2020 reached values at 3.49 (95% CrI 3.39–3.62) with a mean serial interval of 6.0 days, and the enhanced public health intervention after January 23 in 2020 was associated with a significantly reduced R at 0.84 (95% CrI 0.81–0.88), with the total number of infections (i.e., cumulative infections) estimated at 1,906,634 (95% CrI 1,373,500–2,651,124) in Wuhan City, elevating the overall proportion of infected individuals to 19.1% (95% CrI 13.5–26.6%). We also estimated the most recent crude infection fatality ratio (IFR) and time–delay adjusted IFR at 0.04% (95% CrI 0.03–0.06%) and 0.12% (95% CrI 0.08–0.17%), respectively, estimates that are substantially smaller than the crude CFR estimated at 4.06%. CONCLUSIONS: We have estimated key epidemiological parameters of the transmissibility and virulence of COVID-19 in Wuhan, China, during January–February 2020 using an ecological modeling approach that is suitable to infer epidemiological parameters with quantified uncertainty from partial observations collected by surveillance systems. Our estimate of time–delay adjusted IFR falls in the range of the median IFR estimates based on multiple serological studies conducted in several areas of the world.


In Kürze | Aktuelles


title: Employment impact of Covid-19 crisis: from short term effects to long terms prospects

text: We contribute to the assessment of the employment implications of the COVID crisis by classifying economic sectors according to the confinement decrees of three European countries (Germany, Spain and Italy). The analysis of these decrees can be used to make a first assessment of the implications of the COVID crisis on labour markets, and also to speculate on mid and long-term developments, since the most and least affected sectors are probably going to continue to operate differently until a vaccine or other long-term solution is found. Using an ad-hoc extraction of EU-LFS data, we apply this classification to the analysis of employment in Germany, Italy and Spain but also UK, Poland and Sweden, in order to cover the whole spectrum of institutional labour market settings within Europe. Our results, in line with recent literature, show that the employment impact is asymmetric within and between countries. In particular, the countries that are being hardest hit by the pandemic itself (Spain and Italy, and also the UK) are the countries more likely to suffer the worst employment implications of the confinement, because of their productive specialisation and labour market institutions. Indeed, these were also the labour markets that were more vulnerable before the crisis: characterised by high unemployment and precarious work (especially temporary contracts).


title: Projected geographic disparities in healthcare worker absenteeism from COVID-19 school closures and the economic feasibility of child care subsidies: a simulation study

text: BACKGROUND: School closures have been enacted as a measure of mitigation during the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been shown that school closures could cause absenteeism among healthcare workers with dependent children, but there remains a need for spatially granular analyses of the relationship between school closures and healthcare worker absenteeism to inform local community preparedness. METHODS: We provide national- and county-level simulations of school closures and unmet child care needs across the USA. We develop individual simulations using county-level demographic and occupational data, and model school closure effectiveness with age-structured compartmental models. We perform multivariate quasi-Poisson ecological regressions to find associations between unmet child care needs and COVID-19 vulnerability factors. RESULTS: At the national level, we estimate the projected rate of unmet child care needs for healthcare worker households to range from 7.4 to 8.7%, and the effectiveness of school closures as a 7.6% and 8.4% reduction in fewer hospital and intensive care unit (ICU) beds, respectively, at peak demand when varying across initial reproduction number estimates by state. At the county level, we find substantial variations of projected unmet child care needs and school closure effects, 9.5% (interquartile range (IQR) 8.2–10.9%) of healthcare worker households and 5.2% (IQR 4.1–6.5%) and 6.8% (IQR 4.8–8.8%) reduction in fewer hospital and ICU beds, respectively, at peak demand. We find significant positive associations between estimated levels of unmet child care needs and diabetes prevalence, county rurality, and race (p<0.05). We estimate costs of absenteeism and child care and observe from our models that an estimated 76.3 to 96.8% of counties would find it less expensive to provide child care to all healthcare workers with children than to bear the costs of healthcare worker absenteeism during school closures. CONCLUSIONS: School closures are projected to reduce peak ICU and hospital demand, but could disrupt healthcare systems through absenteeism, especially in counties that are already particularly vulnerable to COVID-19. Child care subsidies could help circumvent the ostensible trade-off between school closures and healthcare worker absenteeism.


title: New insights into genetic susceptibility of COVID-19: an ACE2 and TMPRSS2 polymorphism analysis

text: BACKGROUND: Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has now been confirmed worldwide. Yet, COVID-19 is strangely and tragically selective. Morbidity and mortality due to COVID19 rise dramatically with age and co-existing health conditions, including cancer and cardiovascular diseases. Human genetic factors may contribute to the extremely high transmissibility of SARS-CoV-2 and to the relentlessly progressive disease observed in a small but significant proportion of infected individuals, but these factors are largely unknown. MAIN BODY: In this study, we investigated genetic susceptibility to COVID-19 by examining DNA polymorphisms in ACE2 and TMPRSS2 (two key host factors of SARS-CoV-2) from ~ 81,000 human genomes. We found unique genetic susceptibility across different populations in ACE2 and TMPRSS2. Specifically, ACE2 polymorphisms were found to be associated with cardiovascular and pulmonary conditions by altering the angiotensinogen-ACE2 interactions, such as p.Arg514Gly in the African/African-American population. Unique but prevalent polymorphisms (including p.Val160Met (rs12329760), an expression quantitative trait locus (eQTL)) in TMPRSS2, offer potential explanations for differential genetic susceptibility to COVID-19 as well as for risk factors, including those with cancer and the high-risk group of male patients. We further discussed that polymorphisms in ACE2 or TMPRSS2 could guide effective treatments (i.e., hydroxychloroquine and camostat) for COVID-19. CONCLUSION: This study suggested that ACE2 or TMPRSS2 DNA polymorphisms were likely associated with genetic susceptibility of COVID-19, which calls for a human genetics initiative for fighting the COVID-19 pandemic.


Systems and implementation science should be part of the COVID-19 response in low resource settings


"Ein guter Vertriebler braucht Gespür für das Machbare"


title: Polycystic ovary syndrome (PCOS) and COVID-19: an overlooked female patient population at potentially higher risk during the COVID-19 pandemic

text: BACKGROUND: In women of reproductive age, polycystic ovary syndrome (PCOS) constitutes the most frequent endocrine disorder. Women with PCOS are considered to typically belong to an age and sex group which is at lower risk for severe COVID-19. MAIN BODY: Emerging data link the risk of severe COVID-19 with certain factors such as hyper-inflammation, ethnicity predisposition, low vitamin D levels, and hyperandrogenism, all of which have known direct associations with PCOS. Moreover, in this common female patient population, there is markedly high prevalence of multiple cardio-metabolic conditions, such as type 2 diabetes, obesity, and hypertension, which may significantly increase the risk for adverse COVID-19-related outcomes. This strong overlap of risk factors for both worse PCOS cardio-metabolic manifestations and severe COVID-19 should be highlighted for the clinical practice, particularly since women with PCOS often receive fragmented care from multiple healthcare services. Comprehensively informing women with PCOS regarding the potential risks from COVID-19 and how this may affect their management is also essential. CONCLUSION: Despite the immense challenges posed by the COVID-19 outbreak to the healthcare systems in affected countries, attention should be directed to maintain a high standard of care for complex patients such as many women with PCOS and provide relevant practical recommendations for optimal management in the setting of this fast moving pandemic.


"Viele sind gut aufgestellt im Wettbewerb"


title: Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

text: BACKGROUND: The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. METHODS: In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug–drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. RESULTS: All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. CONCLUSIONS: The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.


title: Umsetzbarkeit und Erleben: Erste Erfahrungen mit einer Kurzform der anwendungsorientierten Parcoursprüfung im MSc-Studiengang Psychologie

text: EINLEITUNG: Voraussetzung für die Approbation im Rahmen der neuen Psychotherapeutenausbildung ist u.a. das Bestehen einer anwendungsorientierten Parcoursprüfung. Da diese Prüfung von Lehrenden und Studierenden als Herausforderung angesehen wird, wurde eine Kurzform der Parcoursprüfung im Rahmen einer Modulprüfung des MSc-Studiengangs Psychologie eingeführt und evaluiert. METHODE: Für die 15-minütige Parcoursprüfung wurden 9 Kompetenzbereiche basierend auf praxisorientierten Psychotherapieseminaren entwickelt, von denen 2 jeweils geprüft wurden. Zur Standardisierung der Benotung wurde ein Bewertungsbogen konzipiert. Eine Mitarbeiterin erhielt ein Training als Simulationspatientin. Für die Evaluation wurde ein Fragebogen entwickelt, welcher u.a. die Umsetzbarkeit und das subjektive Erleben dieses Prüfungsformats aus der Sicht der an der Prüfung beteiligten Personen erfasst. ERGEBNISSE: 14 Prüfungskandidierende ließen sich durch 3 Prüfende prüfen. Die Gesamtdurchschnittsnote betrug 1,19 (Bereich: 1,0–2,3). Die Auswertung der Fragebögen zeigte, dass alle drei Gruppen die Prüfung als geeignet, die praktischen Fertigkeiten abzubilden, objektiv und praxisnah empfanden. Von den Prüfungskandidierenden gaben 50% an, dass die Prüfung sie gestresst habe, während die Simulationspatientin sich nie und die Prüfenden sich gar nicht (78%) oder kaum (22%) gestresst fühlten. DISKUSSION: Die Ergebnisse dieser Pilotstudie weisen auf eine gute Umsetzbarkeit der Parcoursprüfung hin, wenngleich sie auch mit Stress für die Prüfungskandidierenden verbunden war. Die Pilotstudie wird limitiert durch eine kleine und wahrscheinlich verzerrte Stichprobe (motivierte Studierende) ohne Vergleichsgruppe. Abschließend werden die Vor- und Nachteile dieses Prüfungsmodells kritisch diskutiert.


title: Weather the Cytokine Storm: A Report of Successful Management of a Colon Cancer Survivor and a Critically Ill Patient with COVID-19

text: Patients with novel corona virus infection (COVID-19) can develop acute respiratory failure secondary to acute respiratory distress syndrome. Cytokine storm is suggested as one of underlying mechanisms for the rapid clinical decline. Immunocompromised patients and cancer patients are at particular risk for poor outcomes due to COVID-19 infection. This case report describes the presentation and clinical course of a cancer survivor who became critically ill and required mechanical ventilation. The patient was treated with hydroxychloroquine, azithromycin, and ceftriaxone; however, he remained febrile, hypoxemic, continued to require full mechanical ventilator support and his chest X-ray showed increased bilateral infiltrates. The patient was treated with tocilizumab, after which he improved and was successfully extubated. This report illustrates a possible role of tocilizumab in management of cytokine storm in critically ill patients with COVID-19 infection.


Ensuring Mental Health Access for Vulnerable Populations in COVID Era


title: Key indicators for monitoring food system disruptions caused by the COVID-19 pandemic: Insights from Bangladesh towards effective response

text: In the context of developing countries, early evidence suggests that the impacts of the COVID-19 pandemic on food production systems is complex, heterogenous, and dynamic. As such, robust monitoring of the impact of the health crisis and containment measures across agricultural value chains will likely prove vitally important. With Bangladesh as a case study, we discuss the building blocks of a comprehensive monitoring system for prioritizing and designing interventions that respond to food system disruptions from COVID-19 and preemptively avoid further cascading negative effects. We also highlight the need for parallel research that identifies pathways for enhancing information flow, analysis, and action to improve the efficiency and reliability of input and output value chains. In aggregate, this preliminary work highlights the building blocks of resilient food systems to external shocks such as COVID-19 pandemic in the context of developing nations. In doing so, we call attention to the importance of ‘infection safe’ agricultural input and output distribution logistics, extended social safety nets, adequate credit facilities, and innovative labor management tools alongside, appropriate farm mechanization. In addition, digital extension services, circular nutrient flows, enhanced storage facilities, as well as innovative and robust marketing mechanisms are required. These should be considered in parallel with effective international trade management policies and institutions as crucial supportive measures.


title: The Central Role of Clinical Nutrition in COVID-19 Patients During and After Hospitalization in Intensive Care Unit

text: The COVID-19-positive patient who is subject to a hyperinflammatory condition associated with lung injury with the development of pneumonia is hospitalized in the intensive care unit. Before resolving and overcoming the “cytokine storm,” with overexpression of pro-inflammatory interleukins (IL-, Il-6), this patient will be intubated for more than 48 h and therefore needs adequate nutrition. Malnutrition can lead to sarcopenia with a decrease in lean body mass and worsening of the inflammatory state underway. In addition, severe debilitation, if not corrected with adequate nutrition, can greatly lengthen rehabilitation times with prolonged hospitalization, increased costs, and reduced turn over already in crisis due to the health emergency caused by coronavirus. The aim of this study is to focus attention on the nutritional importance that must be provided in case of COVID-19 together with pharmacological treatments to lower the number of circulating proinflammatory cytokines. Oral, enteral, and parenteral nutrition should always be carried out according to the patient’s condition and, in the case of a hyperinflammatory patient, such as the one affected by COVID-19, it has been shown that the supplementation of amino acids helps to lower the inflammatory state and promotes normal physiological recovery.


Introducing the virtual European Journal of Plastic Surgery Journal Club


title: DRDO’s Portable Low-Cost Ventilator: “DEVEN”

text: ABSTRACT: A reliable, portable and low-cost ventilator named “DEVEN” is designed and developed by scientists of Dr. APJ Abdul Kalam Missile Complex, RCI, DRDO-Hyderabad. This Ventilator is named as DEVEN—DRDO’s Economical Ventilator. DEVEN has features comparable to high-end ventilators and would serve the requirements of a large number of ventilators under the present COVID-19 pandemic situation. Also, DEVEN being a portable ventilator can be used in field application using a portable air compressor and reservoir. Hence, it can be used in an ambulance, any mobile vehicle or for application in any remote/rural area. DEVEN has a micro-controller-operated solenoid valve-based design and is developed by tweaking existing technology being used for hot gas reaction control systems (HRCS), employed in attitude control of exo-atmospheric missiles. HRCS is achieved by actuating solenoid valves through a micro-controller to control the flow of oxidizer as well as fuel. Existing controllers being used for control of electro-mechanical actuators are tweaked for control of the above-mentioned solenoid valves for inspiratory as well as expiratory lines of DEVEN. GRAPHIC ABSTRACT: [Image: see text]


title: Twitter in der Kardiologie: Praktische Anleitung für den professionellen Gebrauch

text: Social media is becoming increasingly popular in the cardiology community. Particularly Twitter is an emerging and dynamic medium to communicate, connect and educate academic and clinical cardiologists. This article aims to provide a practical guide how to professionally use this social network to keep yourself up-to-date about new techniques, the latest study results and news presented at national or international conferences.


title: Current Status of Multiple Drug Molecules, and Vaccines: An Update in SARS-CoV-2 Therapeutics

text: The coronavirus disease of 2019 (COVID-19) is a pandemic disease that has taken the lives of many around the world. It is caused by severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2). To date, the USA, Italy, Spain, France, Russia, and the UK have been hit the hardest by the virus. However, death counts are still rising. Some nations have managed to “flatten” the death rate via protective measures such physical distancing, quarantine measures, and therapeutic management. The structure of the SARS-CoV-2 virus comprises of S proteins, M proteins, E proteins, hemagglutinin esterases, nucleocapsid proteins, and a 30-kb RNA genome. Viral proteases cleave these polyproteins and RNA-dependent polymerases replicate the genome. Currently, there are no effective therapies against this new disease. Numerous investigators are developing novel protease inhibitors, some of which have made it into clinical trials. Researchers are also attempting to develop a vaccine. In this review paper, we discuss the latest therapeutic developments against COVID-19. [Figure: see text]


title: Nonpolar Europe? Examining the causes and drivers behind the decline of ordering agents in Europe

text: Is Europe headed towards nonpolarity? What would that entail for the future stability and security of the continent? Taking its cue from IR debates about the effects of polarity on international order, the article develops conceptual tools and an analytical narrative concerning Europe during the post-Cold War era. It refines the concept of a Great Power by suggesting the notion of ‘ordering agents’ and ponders whether Europe is in danger of drifting towards a period of nonpolarity with no power being able to shoulder the responsibility of ordering and providing good stewardship over Europe.


title: What does the COVID-19 pandemic teach us about global value chains? The case of medical supplies

text: The COVID-19 pandemic has caused a dramatic shortage in the medical supplies needed to treat the virus due to a massive surge in demand as the disease circled the globe during the first half of 2020. Prior to the crisis, there was an interdependence of trade and production for medical supplies, with advanced industrial countries like the United States and Germany specializing in the relatively high-tech medical devices sector, while low-cost production hubs such as China and Malaysia were leading producers of less technologically sophisticated personal protective equipment (PPE) products such as face masks, surgical gloves, and medical gowns. After the COVID-19 outbreak, global shortages of PPE products emerged as many affected countries imposed export controls and sought ways to boost domestic output. A case study of the face mask value chain in the United States shows misalignments between the priorities of U.S. federal government officials and the strategies of leading U.S. multinational producers of face masks, which resulted in exceptionally costly policy delays in terms of health outcomes. On balance, the U.S. shortage of N95 respirators during the COVID-19 pandemic is more a policy failure than a market failure. The global value chain framework highlights strategic options that could lead to more resilient supply chains and diversified sourcing patterns.


title: Cardiovascular Complications of COVID-19: Pharmacotherapy Perspective

text: Coronavirus disease of 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly the world over. The disease was declared “pandemic” by the World Health Organization. An approved therapy for patients with COVID-19 has yet to emerge; however, there are some medications used in the treatment of SARS-CoV-2 infection globally including hydroxychloroquine, remdesivir, dexamethasone, protease inhibitors, and anti-inflammatory agents. Patients with underlying cardiovascular disease are at increased risk of mortality and morbidity from COVID-19. Moreover, patients with chronic stable states and even otherwise healthy individuals might sustain acute cardiovascular problems due to COVID-19 infection. This article seeks to review the latest evidence with a view to explaining possible pharmacotherapies for the cardiovascular complications of COVID-19 including acute coronary syndrome, heart failure, myocarditis, arrhythmias, and venous thromboembolism, as well as possible interactions between these medications and those currently administered (or under evaluation) in the treatment of COVID-19.


title: Inferior ST-Elevation Myocardial Infarction Presenting When Urgent Primary Percutaneous Coronary Intervention Is Unavailable: Should We Adhere to Current Guidelines?

text: The pivotal studies that led to the recommendations for emergent reperfusion therapy for ST-elevation myocardial infarction (STEMI) were conducted for the most part over 25 years ago. At that time, contemporary standard treatments including aspirin, statin, and even anticoagulation were not commonly used. The 2013 American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines and the 2017 European Society of Cardiology guidelines give a class I recommendation (with the level of evidence A) for primary percutaneous coronary intervention (pPCI) in patients with STEMI and ischemic symptoms of less than 12 h. However, if the patient presents to a hospital without pPCI capacity, and it is anticipated that pPCI cannot be performed within 120 min of first medical contact, fibrinolytic therapy is indicated (if there are no contraindications) (class I indication, level of evidence A). Our review of the pertinent literature shows that the current recommendation for inferior STEMI is based on the level of evidence lower than A. We can consider level B even C, supporting the recommendation for fibrinolytic therapy if pPCI is not available for inferior STEMI.


title: Resilience and the world order: the EU and the RIC states

text: The aim of the article is to analyse the way the RIC (Russia, India and China) states understand resilience in the world order. In doing so, the article compares their interpretation to that developed by the European Union (EU). The first part of the article surveys the way the literature has analysed the role of resilience in the foreign policy of the EU. One of the main findings here is that the mainstream interpretation of resilience tends to be rather circular and leads to process of securitisation of the external environment. The second part of the article then presents and applies to the case of the RIC states a more nuanced framework that examines resilience along three complementary dimensions: resilience as ontology (attribute), as process and as outcome (agency and intentionality).


Disordini endocrino-metabolici da virus e COVID-19


title: SARS-CoV-2/COVID-19: a primer for cardiologists

text: In the late autumn of 2019, a new potentially lethal human coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The pandemic spread of this zoonotic virus has created a global health emergency and an unprecedented socioeconomic crisis. The severity of coronavirus disease 2019 (COVID-19), the illness caused by SARS-CoV‑2, is highly variable. Most patients (~85%) develop no or mild symptoms, while others become seriously ill, some succumbing to disease-related complications. In this review, the SARS-CoV‑2 life cycle, its transmission and the clinical and immunological features of COVID-19 are described. In addition, an overview is presented of the virological assays for detecting ongoing SARS-CoV‑2 infections and the serological tests for SARS-CoV-2-specific antibody detection. Also discussed are the different approaches to developing a COVID-19 vaccine and the perspectives of treating COVID-19 with antiviral drugs, immunomodulatory agents and anticoagulants/antithrombotics. Finally, the cardiovascular manifestations of COVID-19 are briefly touched upon. While there is still much to learn about SARS-CoV‑2, the tremendous recent advances in biomedical technology and knowledge and the huge amount of research into COVID-19 raise the hope that a remedy for this disease will soon be found. COVID-19 will nonetheless have a lasting impact on human society. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12471-020-01475-1) contains supplementary material, which is available to authorized users.


title: Asthma and Autophagy

text: Asthma is one of the most common diseases of the respiratory system, with typical pathogenesis and pathological changes. The current research shows that autophagy is mainly involved in the pathogenesis of asthma by regulating the body’s innate and adaptive immune responses. At the same time, a large number of epidemiological studies have shown that multiple autophagy genes affect the risk of asthma at the level of genetic polymorphism. This chapter will explore the relationship between autophagy and asthma.


title: Physical distancing interventions and incidence of coronavirus disease 2019: natural experiment in 149 countries

text: OBJECTIVE: To evaluate the association between physical distancing interventions and incidence of coronavirus disease 2019 (covid-19) globally. DESIGN: Natural experiment using interrupted time series analysis, with results synthesised using meta-analysis. SETTING: 149 countries or regions, with data on daily reported cases of covid-19 from the European Centre for Disease Prevention and Control and data on the physical distancing policies from the Oxford covid-19 Government Response Tracker. PARTICIPANTS: Individual countries or regions that implemented one of the five physical distancing interventions (closures of schools, workplaces, and public transport, restrictions on mass gatherings and public events, and restrictions on movement (lockdowns)) between 1 January and 30 May 2020. MAIN OUTCOME MEASURE: Incidence rate ratios (IRRs) of covid-19 before and after implementation of physical distancing interventions, estimated using data to 30 May 2020 or 30 days post-intervention, whichever occurred first. IRRs were synthesised across countries using random effects meta-analysis. RESULTS: On average, implementation of any physical distancing intervention was associated with an overall reduction in covid-19 incidence of 13% (IRR 0.87, 95% confidence interval 0.85 to 0.89; n=149 countries). Closure of public transport was not associated with any additional reduction in covid-19 incidence when the other four physical distancing interventions were in place (pooled IRR with and without public transport closure was 0.85, 0.82 to 0.88; n=72, and 0.87, 0.84 to 0.91; n=32, respectively). Data from 11 countries also suggested similar overall effectiveness (pooled IRR 0.85, 0.81 to 0.89) when school closures, workplace closures, and restrictions on mass gatherings were in place. In terms of sequence of interventions, earlier implementation of lockdown was associated with a larger reduction in covid-19 incidence (pooled IRR 0.86, 0.84 to 0.89; n=105) compared with a delayed implementation of lockdown after other physical distancing interventions were in place (pooled IRR 0.90, 0.87 to 0.94; n=41). CONCLUSIONS: Physical distancing interventions were associated with reductions in the incidence of covid-19 globally. No evidence was found of an additional effect of public transport closure when the other four physical distancing measures were in place. Earlier implementation of lockdown was associated with a larger reduction in the incidence of covid-19. These findings might support policy decisions as countries prepare to impose or lift physical distancing measures in current or future epidemic waves.


title: A visual step-by-step guide for clinicians to use video consultations in mental health services: NHS examples of real-time practice in times of normal and pandemic healthcare delivery

text: Despite the increasingly widespread use of video consultations, there are very few documented descriptions of how to set up and implement video consultations in real-time practice. This step-by-step guide will describe the set-up process based on the authors’ experience of two real-time National Health Service (NHS) examples: a single health board use (delivered in normal time), and an All-Wales National Video Consultation Service roll-out (delivered during an emergency pandemic as part of the COVID-19 response). This paper provides a simple visual step-by-step guide for using telepsychiatry via the remote use of video consultations in mental health services, and outlines the mandatory steps to achieving a safe, successful and sustainable use of video consultations in the NHS by ensuring that video consultations fit into existing and new NHS workflow systems and adhere to legal and ethical guidelines.


title: Closing Time! Examining the Impact of Gender and Executive Branch Policy Makers on the Timing of Stay-at-Home Orders

text: The 2019–20 coronavirus pandemic has significantly altered lives across the globe. In the United States, several states attempted to manage the pandemic by issuing stay-at-home orders. In this research note, I examine whether the gender of state policy makers in the executive branch might impact a state's adoption of a stay-at-home order. Using event history analysis, I find that the governor's gender has no impact on the likelihood of a state adopting a stay-at-home order. However, I find that gender plays a significant role for agency heads. Specifically, my analysis shows that states with a female-headed health agency tend to adopt stay-at-home orders earlier than states with a male administrator. These findings shed light on how female leadership in the executive branch may impact public policy regarding COVID-19.


title: International law and human security in a kaleidoscopic world

text: International law is being challenged by a multitude of new actors and networks that do not fit within the traditional Westphalian system. Similarly, security is increasingly undermined by, for example, economic, health, and environmental threats that can affect individuals’ daily lives and know no state boundaries. This is the kaleidoscopic world as outlined by Edith Brown Weiss. The concept of ‘human security’ has been advanced to inform decision-making on threats to security in the interest of individuals in a bottom-up manner. This article looks forward to methods that can counter what could be perceived as a legitimacy crisis in international law. First, some of the current challenges which international law faces are explained ranging from globalisation, the declining state-based order, and decentralised security threats. Second, the concept of human security is defined, and its contents expounded. Lastly, the thesis is advanced that a conceptual framework of human security can reorientate international law to be responsive to the kaleidoscopic world by using UN peace operations as an example of where human security could have a profound impact.


title: Persistent digital divide in health-related internet use among cancer survivors: findings from the Health Information National Trends Survey, 2003–2018

text: PURPOSE: Prior research on the use of the internet among cancer survivors indicates a digital divide. The online landscape and patterns of information consumption, however, have notably changed over the past decade necessitating an updated examination of health-related internet use (HRIU) among cancer survivors. METHODS: Using survey data from 2003, 2005, 2007, 2011, 2013, 2017, and 2018 Health Information National Trends Survey (HINTS) iterations, the objectives of this study were to report prevalence, trends, and user profiles in HRIU in terms of emailing doctors, buying medicine online, and support group participation. Descriptive analyses and weighted multivariate logistic regression analyses were performed. RESULTS: Cancer survivors who reported not using the internet were more likely to be older, belong to ethnic minorities, be less educated, and reside in rural areas as compared with those who reported using the internet. Except for participation in online support groups, all other types of HRIU increased in prevalence across the years. CONCLUSIONS: Consistent with the increased penetration of the internet and the altered online health communication landscape, we found increased prevalence of HRIU among cancer survivors. However, the digital divide persists in terms of internet access. These findings can inform initiatives to bridge the gap among survivors of varying profiles in using the internet for their health needs. IMPLICATIONS FOR CANCER SURVIVORS: There is increased reliance on online platforms to obtain and communicate health-related information. The risk with this approach is potential oversight of ensuring equity in terms of internet access and technology literacy among survivors. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s11764-020-00913-8) contains supplementary material, which is available to authorized users.


Launching Session of the Kyoto Landslide Commitment 2020


title: How the ascorbic acid and hesperidin do improve the biological activities of the cinnamon: theoretical investigation

text: DFT/B3LYP calculations have been performed on series of molecules of natural products containing cinnamon and citrus, namely, cinnamic aldehyd, ascorbic acid and hesperidin. This theoretical investigation predicts the biological activities of mixtures between cinnamon and ascorbic acid and between cinnamon and hesperidin based on already proven values for these molecules. The strength of the intermolecular interactions is evaluated in term of energy decomposition of the total interaction energy ΔE(int) between molecules, which are mainly governed by electrostatic interactions. The HOMO–LUMO gaps explain that the possible charge transfer interactions that take place within the molecules are responsible for the molecular reactivity of the studied molecules. The chemical hardness, the chemical potential and the electrophilicity indexes are good indicators for biological activities showing their improvement to that of cinnamon itself. The mixture of hesperidin and cinnamon could be an excellent blood thinner with the regard to its polarity’s enhancement.


title: Systematic and Statistical Review of Coronavirus Disease 19 Treatment Trials

text: The following systematic review and meta-analysis compile the current data regarding human controlled COVID-19 treatment trials. An electronic search of the literature compiled studies pertaining to human controlled treatment trials with COVID-19. Medications assessed included lopinavir/ritonavir, arbidol, hydroxychloroquine, tocilizumab, favipiravir, heparin, and dexamethasone. Statistical analyses were performed for common viral clearance endpoints whenever possible. Lopinavir/ritonavir showed no significant effect on viral clearance for COVID-19 cases (OR 0.95 [95% CI 0.50–1.83]). Hydroxychloroquine also showed no significant effect on COVID-19 viral clearance rates (OR 2.16 [95% CI 0.80–5.84]). Arbidol showed no 7-day (OR 1.63 [95% CI 0.76–3.50]) or 14-day viral (OR 5.37 [95% CI 0.35–83.30]) clearance difference compared to lopinavir/ritonavir. Review of literature showed no significant clinical improvement with lopinavir/ritonavir, arbidol, hydroxychloroquine, or remdesivir. Tocilizumab showed mixed results regarding survival. Favipiravir showed quicker symptom improvement compared to lopinavir/ritonavir and arbidol. Heparin and dexamethasone showed improvement with severe COVID-19 cases requiring supplemental oxygenation. Current medications do not show significant effect on COVID-19 viral clearance rates. Tocilizumab showed mixed results regarding survival. Favipiravir shows favorable results compared to other tested medications. Heparin and dexamethasone show benefit especially for severe COVID-19 cases.


COMMENT ON AN ARTICLE: “Homocysteine as a potential predictor of cardiovascular risk in patients with COVID-19“


Influenza Vaccine as Part of a Heart Disease Armamentarium in the New Cardio-Respiratory Virus Era


Prone and lateral positioning in spontaneously breathing patients with COVID-19 pneumonia undergoing non-invasive helmet CPAP treatment


Cerebral venous sinus thrombosis might be under-diagnosed in the COVID-19 era


BCG vaccination and COVID-19: much ado about nothing?


An Invited commentary on ‘’ Transforming laparoendoscopic surgical protocols during COVID-19 pandemic; big data analytics, resource allocation and operational considerations; a review article’’


Needless Waste and the Sustainability of Cataract Surgery


Modelling of Reproduction number for COVID-19 in India and high incidence states


title: Clinical and histopathological findings of cutaneous manifestations of COVID19 patients

text: COVID19 became pandemic since this is a disease with a high infection rate. The study's object is to identify clinical and histopathological findings of cutaneous manifestations of COVID19 patients. The evidence was analyzed in PubMed, CINAHL, Cochrane, Web of Science and Scopus, with the search strategy (covid 19 OR covid‐19 OR corona OR coronavirus OR sars‐cov‐2) AND (cutaneous or cutaneous manifestations OR), and 17 studies were included, involving 351 cases with COVID19 and skin manifestations. The lesions were classified mainly as maculopapular, erythematous, vesicular and urticarial. Histopathological analyzes suggest a predominance of spongiosis, perivascular infiltrate of lymphocytes and thrombogenic vasculopathy. This article is protected by copyright. All rights reserved.


Stress in the workplace for healthcare professionals


The use of simulation-CT’s as a coronavirus disease 2019 screening tool during the severe acute respiratory syndrome coronavirus 2 pandemic


Treatment discontinuation and rate of disease transmission in psoriasis patients on biologic therapy during the COVID-19 pandemic – A Canadian Multicenter Retrospective Study


Commentary: From Virtual to Reality


RECOMENDACIONES DEL GRUPO ESPAÑOL DE FOTOBIOLOGÍA DE LA AEDV EN REFERENCIA AL MANEJO DE LAS UNIDADES DE FOTOTERAPIA DURANTE LA PANDEMIA POR SARS-CoV-2


Trends in cirrhosis hospitalizations during the COVID-19 pandemic


Press review


Anxiety, Depression and Insomnia: a Cross-sectional Study of Frontline Staff Fighting Against COVID-19 in Wenzhou, China


A novel scoring system in mortality prediction of severe patients with COVID-19


The rise of no/low code software development—No experience needed?


Acute hemorrhage after intra-cerebral biopsy in COVID-19 patients: a report of 3 cases


Global CO(2) emissions level off in 2019, with a drop predicted in 2020


title: The silver lining of COVID‐19: estimation of short‐term health impacts due to lockdown in the Yangtze River Delta region, China

text: The outbreak of COVID‐19 in China has led to massive lockdowns in order to reduce the spread of the epidemic and control human‐to‐human transmission. Subsequent reductions in various anthropogenic activities have led to improved air quality during the lockdown. In this study, we apply a widely used exposure‐response function to estimate the short‐term health impacts associated with PM(2.5) changes over the Yangtze River Delta (YRD) region due to COVID‐19 lockdown. Concentrations of PM(2.5) during lockdown period reduced by 22.9% to 54.0% compared to pre‐lockdown level. Estimated PM(2.5)‐related daily premature mortality during lockdown period is 895 (95% confidential interval: 637‐1081), which is 43.3% lower than pre‐lockdown period and 46.5% lower compared with averages of 2017‐2019. According to our calculation, total number of avoided premature death associated PM(2.5) reduction during the lockdown is estimated to be 42.4 thousand over the YRD region, with Shanghai, Wenzhou, Suzhou (Jiangsu province), Nanjing, and Nantong being the top five cities with largest health benefits. Avoided premature mortality is mostly contributed by reduced death associated with stroke (16.9 thousand, accounting for 40.0%), ischemic heart disease (14.0 thousand, 33.2%) and chronic obstructive pulmonary disease (7.6 thousand, 18.0%). Our calculations do not support or advocate any idea that pandemics produce a positive note to community health. We simply present health benefits from air pollution improvement due to large emission reductions from lowered human and industrial activities. Our results show that continuous efforts to improve air quality are essential to protect public health, especially over city‐clusters with dense population.


Supportive Care For Oral Cancer Survivors In Covid‐ 19 Lock Down


The UK lockdown and the economic value of human life


Severe COVID‐19 disease in two pediatric oncology patients


The Post–COVID‐19 Environment: What Chairs Need to Know and Do


Reflexiones sobre el negacionismo en el espacio urbano latinoamericano: La observación a dos casos


title: Integrating the Bright and Dark Sides of Corporate Volunteering Climate: Is Corporate Volunteering Climate a Burden or Boost to Employees?

text: Conventional wisdom is that a corporate volunteering climate should be beneficial to employees. We challenge this perspective by integrating person–environment fit and conservation of resources theories and providing an integrative model that examines how and when corporate volunteering climate produces positive and negative consequences for employees. Using a two‐wave time‐lagged study of 283 employees in 42 companies, our multilevel model shows that positive emotions mediate the relationship between corporate volunteering climate and work engagement, and perceived role overload mediates the relationship between corporate volunteering climate and work–family conflict. Employees’ communal orientation moderates the positive relationship between corporate volunteering climate and positive emotions, whereas competitive orientation moderates the positive relationship between corporate volunteering climate and perceived role overload. Communal orientation moderates the indirect effect between corporate volunteering climate and work engagement via positive emotions, but competitive orientation moderates the indirect effect between corporate volunteering climate and work–family conflict via perceived role overload. Our study provides balanced insights to help understand the benefits and costs of corporate volunteering climate in work and non‐work domains.


Grappling with the ‘human’ problem hiding behind the technology: Telehealth during and beyond COVID‐19


title: Virus Interruptus: An Arendtian exploration of political world‐building in pandemic times

text: Building upon a series of blog posts and conversations, two feminist scholars explore how political community, trust, responsibility, and solidarity are affected by the COVID‐19 pandemic. We explore the ways in which we can engage in political world‐building during pandemic times through the work of Hannah Arendt. Following Arendt’s notion of the world as the space for human togetherness, we ask: how can we respond to COVID‐19’s interruptions to the familiarity of daily life and our relationship to public space? By extending relational accounts of public health and organizational ethics, we critique a narrow view of solidarity that focuses on individual compliance with public health directives. Instead, we argue that solidarity involves addressing structural inequities, both within public health and our wider community. Finally, we suggest possibilities for political world‐building by considering how new forms of human togetherness might emerge as we forge a collective “new normal.”


title: Deliberation, Citizen Science and Covid‐19

text: Rather than aiming to produce more ‘rational’ or more ‘other‐regarding’ citizen judgements (the outcome of which is uncertain), deliberative democratic exercises should be re‐designed to maximise democratic participation. To do this, they must involve citizens and experts, a novel arrangement that will benefit both cohorts. For the former, a more inclusive form of deliberation will offer an opportunity to contribute to political discussion and be listened to by people with political or policy‐based authority. For the latter, it will provide a venue through which expertise can be brought to bear on democratic decision making without risk of scapegoating or politicisation. More broadly, deliberation that prioritises dialogue (over, say, opinion change) affirms the principle that political decisions reflect value judgements rather than technically ‘right’ or technically ‘wrong’ answers—judgements that are legitimate if arrived at through discussion involving the people due to be affected by the resultant policy. This article sets out the advantages of this form of deliberation—which bears some similarity to certain types of citizen science—in the context of the UK government’s responses to Covid‐19; both the confused decision making evident to date, and the forthcoming re‐opening phases that will prioritise or advantage some constituencies over others.


title: Evidence‐Loving Rockstar Chief Medical Officers: Female Leadership Amidst COVID‐19 in Canada

text: This paper presents a feminist poststructuralist inquiry perspective on how news and social media discourse around the COVID‐19 pandemic is presenting a potential shift in hegemonic representations of masculine leadership. I am informed by organizational rules and sensemaking theories, and consider how Canadian and international female leaders are showing resilience, emotion, and vulnerability as they help lead their countries through these uncertain times. I reflexively ground my observations in my own sensemaking and personal experiences. Despite reservations, I am hopeful. There are indications that the “rules of the game” are starting to be challenged, and feminine frameworks that question traditional gender roles are disrupting conceptions around “business as usual.”


title: Face masks for community use: An awareness call to the differences in materials

text: See related Reply See related Reply


Nueva normalidad, vieja precariedad: la crisis pandémica en Santiago de Chile


title: Associations of Stay-at-Home Order and Face-Masking Recommendation with Trends in Daily New Cases and Deaths of Laboratory-Confirmed COVID-19 in the United States

text: BACKGROUND AND OBJECTIVES: Public health interventions have reduced coronavirus disease 2019 (COVID-19) transmission in several countries, but their impacts on COVID-19 epidemics in the USA are unclear. We examined associations of stay-at-home order (SAHO) and face-masking recommendation with COVID-19 epidemics in the USA. METHODS: In this quasi-experimental interrupted time-series study, we modeled temporal trends in daily new cases and deaths of laboratory-confirmed COVID-19 cases, and COVID-19 time-varying reproduction numbers in the USA between March 1 and April 20, 2020. In addition, we conducted simulation analyses. RESULTS: The number of residents under SAHO increased since March 19 and plateaued at 290,829,980 (88.6% of the U.S. population) on April 7. Trends in COVID-19 time-varying reproduction numbers peaked on March 23, further reduced on April 3, and fell below/around 1.0 on April 13. Early-implementation and early-lift of SAHO would reduce and increase COVID-19 epidemics, respectively. Multivariable piecewise log-linear regression revealed the states’ neighboring relationship with New York was linked to COVID-19 daily new cases and deaths. There were two turning points in daily new-case trend, being March 28 (slope-changes = −0.09) and April 3 (slope-changes = −0.09), which appeared to be associated with implementation of SAHO on March 28 (affecting 48.5% of the US population in 22 states and District of Columbia), and face-masking recommendation on April 3, respectively. There were also two turning points in daily new-death trend, being April 9 (slope-changes = −0.06) and April 19 (slope-changes = −0.90). CONCLUSIONS: We identified two turning points of COVID-19 daily new cases or deaths in the USA, which seem to be linked to implementation of SAHO and the Center for Disease Control’s face-masking recommendation.


Hindsight is 2020


Teaching and Engaging Generation Z during the Coronavirus


UGANDA: Time for a New Normal


title: Editorial Perspective: COVID‐19 pandemic‐related psychopathology in children and adolescents with mental illness

text: The coronavirus disease (COVID‐19) pandemic is likely to have negative health consequences way beyond those caused by the virus per se – including significant psychological distress. Children and adolescents who already live with a mental illness may be particularly vulnerable to the distress associated with the pandemic – due to, for example, fear of the virus as well as the significant societal changes launched to minimize spread of the virus (social distancing and quarantine). In this editorial perspective, we (a) provide data on COVID‐19 pandemic‐related psychopathology in children and adolescents from a large psychiatric treatment setting in Denmark, (b) give advice on how the likely harmful effects of the COVID‐19 pandemic on the mental health of children and adolescents may be minimized, and (c) propose six lines of research into pandemic‐related psychopathology with emphasis on children and adolescents. Finally, we underline the necessity of politicians, health authorities, and funding bodies supporting these research initiatives here and now.


title: HRS/EHRA/APHRS/LAHRS/ACC/AHA worldwide practice update for telehealth and arrhythmia monitoring during and after a pandemic

text: Coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), started in the city of Wuhan late in 2019. Within a few months, the disease spread toward all parts of the world and was declared a pandemic on March 11, 2020. The current health care dilemma worldwide is how to sustain the capacity for quality services not only for those suffering from COVID‐19 but also for non‐COVID‐19 patients, all while protecting physicians, nurses, and other allied health care workers.


A Divided City in a Time of Pandemic: Dispatches from Doha


title: Effect of low or high doses of low molecular weight heparin on thrombin generation and other hemostasis parameters in COVID‐19 critical patients

text: The clinical picture of the coronavirus 2 (SARS‐CoV‐2)/COVID‐19‐related acute respiratory syndrome is often associated with a coagulopathy. An elevated D‐dimer has been linked with an unfavorable prognosis in COVID‐19 patients.


title: In Response to "The Novel Use of Home Pulse Oximetry": An Australian offer of support.

text: We write to sincerely thank Shah et al, for sharing their article “Novel use of home pulse oximetry monitoring in COVID‐19 patients discharged from the emergency department identifies need for hospitalization”(1), and provide an international perspective from Australia. From our antipodean vantage, we have watched with concern the rapid spread of the disease through North America, and the devastating toll it has taken on colleagues, health infrastructure and the broader community.


The Need for Visible Nursing Leadership During COVID‐19


title: Psychological and Behavioural Responses to Coronavirus Disease 2019: The Role of Personality

text: This study examined the associations between personality traits and psychological and behavioural responses to the coronavirus disease 2019 (COVID‐19) pandemic. Personality was assessed in January/February 2020 when the public was not aware of the spread of coronavirus in the USA. Participants were reassessed in late March 2020 with four sets of questions about the pandemic: concerns, precautions, preparatory behaviours, and duration estimates. The sample consisted of N = 2066 participants (mean age = 51.42; range = 18–98; 48.5% women). Regression models were used to analyse the data with age, gender, education, race, and ethnicity as covariates. Consistent with the preregistered hypotheses, higher neuroticism was related to more concerns and longer duration estimates related to COVID‐19, higher extraversion was related to shorter duration estimates, and higher conscientiousness was associated with more precautions. In contrast to the preregistered hypotheses, higher neuroticism was associated with fewer precautions and unrelated to preparatory behaviours. Age moderated several trait–response associations, suggesting that some of the responses were associated more strongly in older adults, a group at risk for complications of COVID‐19. For example, older adults high in conscientiousness prepared more. The present findings provide insights into how personality predicts concerns and behaviours related to the COVID‐19 pandemic. © 2020 European Association of Personality Psychology


Covid‐19 Pandemic


title: The impact of COVID‐19 on franchising in emerging markets: An example from Brazil

text: The outbreak of COVID‐19, the disease caused by the SARS‐CoV‐2 virus, has had significant economic, political, and social consequences worldwide. The franchising sector, consisting mostly of retail and service businesses, is an example of an industry that has been deeply affected. The experiences of franchising stakeholders in Brazil highlight the strengths of the franchising model in such situations. This investigation, based on primary data from webinars with food service, education, retail, and business‐to‐business service companies in Brazil, coupled with reports from commercial and franchising entities, reveals how the COVID‐19 outbreak has affected the franchising sector. It illustrates the measures that were taken, the negotiations that take place between suppliers and landlords, the adaptation of business models, the effects on franchisor‐franchisee relationships, and the impact the pandemic has had on relationships with customers. The strategies adopted by Brazilian franchisors and franchisees suggest lessons for other franchising companies in similar situations, such as those in developing and emerging economies.


Points from the SENCo‐Forum: Special educational needs in the coronavirus lockdown


title: In Case You Haven't Heard…

text: Findings from a survey of 1,000 patients, ages 18 to 65 or older, about their virtual care experiences during the COVID‐19 pandemic published in the Patient Perspectives on Virtual Care report found that nearly three‐quarters of respondents engaged in their first virtual care visit ever during the initial surge of COVID‐19 cases in the United States. Over 75% were very or completely satisfied with their virtual care experiences. However, the results also suggest that health care organizations have an opportunity to enhance patient experience, acquisition and retention by making virtual care scheduling and follow‐up more seamless, The Associated Press reported June 24. The survey examined patients' experiences accessing virtual care, their sentiment around the visits themselves and their demand for virtual care in the future. Not only did the majority of respondents rate their experiences with virtual care positively, but 50% also indicated they would be willing to switch providers to have virtual visits on a regular basis. Kyruus, an organization that helps health systems match patients with the right providers, engaged Wakefield Research to conduct the survey between February and May of 2020.


title: Winners And Losers In Coronavirus Times: Financialisation, Financial Chains and Emerging Economic Geographies of The Covid‐19 Pandemic

text: This paper has two interrelated aims. First, it attempts to sketch a preliminary map of economic winners and losers to highlight the emerging economic geographies of the coronavirus pandemic. Second, it aims to explore the links between these emerging economic geographies and the processes of ‘financialisation’, drawing on the concept of ‘financial chains’. Regarding the first aim, the paper argues that the pandemic‐induced crisis will exacerbate social inequalities and deepen uneven development at multiple geographical scales. Regarding the second aim, the paper argues that the ‘financialisation’ perspective in general, and the concept of ‘financial chains’ in particular, provide useful insights into the crisis and its uneven effects, by shedding light on the complex web of flows of value and power relations established/emerging between the prospective winners and losers. It also highlights the prominent role of debt and debt‐based financial chains in shaping economic geographies in times of major global crisis.


Man with dyspnea


Academic Motherhood During COVID‐19: Navigating Our Dual Roles as Educators and Mothers


title: Universal public mask wear during COVID‐19 pandemic: Rationale, design and acceptability

text: See related Reply See related Reply


Get the Shovel: Mass graves and missing rites


title: Employing bioactive compounds derived from Ipomoea obscura (L.) to evaluate potential inhibitor for SARS‐CoV‐2 main protease and ACE2 protein

text: Angiotensin converting enzyme 2 (ACE2) and main protease (M(Pro)) are significant target proteins, mainly involved in the attachment of viral genome to host cells and aid in replication of severe acute respiratory syndrome‐coronaviruses or SARS‐CoV genome. In the present study, we identified 11 potent bioactive compounds from ethanolic leaf extract of Ipomoea obscura (L.) by using GC‐MS analysis. These potential bioactive compounds were considered for molecular docking studies against ACE2 and M(Pro) target proteins to determine the antiviral effects against SARS‐COV. Results exhibits that among 11 compounds from I. obscura (L.), urso‐deoxycholic acid, demeclocycline, tetracycline, chlorotetracycline, and ethyl iso‐allocholate had potential viral inhibitory activity. Hence, the present findings suggested that chemical constitution present in I. obscura (L.) will address inhibition of corona viral replication in host cells.


title: Dual‐earner Parent Couples’ Work and Care during COVID‐19

text: COVID‐19 and the associated lockdowns meant many working parents were faced with doing paid work and family care at home simultaneously. To investigate how they managed, this paper draws a subsample of parents in dual earner couples (n=1,536) from a national survey of 2,722 Australian men and women conducted during lockdown in May 2020. It asked how much time respondents spent in paid and unpaid labour, including both active and supervisory care, and about their satisfaction with work‐family balance and how their partner shared the load. Overall, paid work time was slightly lower, and unpaid work time was very much higher, during lockdown than before it. These time changes were most for mothers, but gender gaps somewhat narrowed because the relative increase in childcare was higher for fathers. More mothers than fathers were dissatisfied with their work‐family balance and partner's share before COVID‐19. For some the pandemic improved satisfaction levels, but for most they became worse. Again, some gender differences narrowed, mainly because more fathers also felt negatively during lockdown than they had before.


GAVI Alliance – Global Vaccine Summit