title: Contingency Plans in a Radiation Oncology Department Amid the 2019-nCoV Outbreak in Switzerland

text: The ongoing novel coronavirus (2019-nCoV) pandemic is expected to develop into an unprecedented stress test for health care systems worldwide. This brief report, written from a radiation oncology perspective during the developing outbreak of 2019-nCoV in Switzerland, highlights the challenges identified and measures taken in our department to mitigate risks and ensure continued operations during the outbreak.


title: Searching for Models for Psychological Science: A Possible Contribution of Simulation

text: The problem of the theoretical precariousness of psychology requires defining, at an epistemological level, its concepts and languages and the use of models for finding core concepts and building more or less 'hard' theories. After reviewing some main aims and models of psychology, and comparing them with those of other sciences, the commentary deals with the possibility of simulating life as a tool for building evolutionary psychological models. In particular, evolutionary and developmental robotics and the evo-devo models can simulate the simultaneous adaptation effects of the phylogenetic and ontogenetic development of the embodied mind in response to the characteristics of the environment. The simulation using Artificial Intelligence and robotics could contribute significantly to the definition, experimentation, and validation of the models that make up the theories of psychology in its different domains, enhancing the interdisciplinarity with other sciences that study the same objects. Further studies, both epistemological and empirical, are suggested to confirm whether this evo-devo approach can be integrated with "evolutionary psychology" and contribute to a unifying meta-theory of psychological science.


title: Peptide-like and small-molecule inhibitors against Covid-19

text: Coronavirus disease strain (SARS-CoV-2) was discovered in 2019, and it is spreading very fast around the world causing the disease Covid-19. Currently, more than 1.6 million individuals are infected, and several thousand are dead across the globe because of Covid-19. Here, we utilized the in-silico approaches to identify possible protease inhibitors against SARS-CoV-2. Potential compounds were screened from the CHEMBL database, ZINC database, FDA approved drugs and molecules under clinical trials. Our study is based on 6Y2F and 6W63 co-crystallized structures available in the protein data bank (PDB). Seven hundred compounds from ZINC/CHEMBL databases and fourteen hundred compounds from drug-bank were selected based on positive interactions with the reported binding site. All the selected compounds were subjected to standard-precision (SP) and extra-precision (XP) mode of docking. Generated docked poses were carefully visualized for known interactions within the binding site. Molecular mechanics-generalized born surface area (MM-GBSA) calculations were performed to screen the best compounds based on docking scores and binding energy values. Molecular dynamics (MD) simulations were carried out on four selected compounds from the CHEMBL database to validate the stability and interactions. MD simulations were also performed on the PDB structure 6YF2F to understand the differences between screened molecules and co-crystallized ligand. We screened 300 potential compounds from various databases, and 66 potential compounds from FDA approved drugs. Cobicistat, ritonavir, lopinavir, and darunavir are in the top screened molecules from FDA approved drugs. The screened drugs and molecules may be helpful in fighting with SARS-CoV-2 after further studies.


title: Teleurology in the Time of Covid-19 Pandemic: Here to Stay?

text: OBJECTIVE: To assess the implementation and outcomes of telemedicine in a Department of Urology in Northern Italy during the outbreak of the Covid-19 pandemic. METHODS: All the outpatient clinical activities during the 4 weeks following the national lockdown (March 9-April 3, 2020) in the Department of Urology of the Trento Province, Italy, were reviewed and categorized. Expert staff members examined the electronic records, selecting whether the clinic appointments should be canceled or confirmed (via telephone consultation or face-to-face visit). The rate, indication, and modality of visits were investigated. RESULTS: Overall, 415 of 928 (45%) scheduled patients canceled their clinic appointment themselves or were canceled by staff members without rescheduling. The remaining 523 (55%) cases were screened undergoing telephone consultation in 295 (56%) and face-to-face visit in 228 (44%). The rate of face-to-face visit decreased from 63% to 9% during week 1 and 4, respectively. Seventy-four percent of face-to-face visits regarded suspected recurrent or new onset malignancy or potentially dangerous clinical conditions (severe urinary symptoms or complicated urinary stones or infection). The median age of patients in the face-to-face and telephone groups was 59 (range 20-69) and 65 years old (range 37-88), respectively. CONCLUSION: A pandemic is a dynamic scenario, requiring reorganization and flexibility of the healthcare delivery. Forty-five percent visits were canceled without rescheduling. Although a minimum portion of face-to-face visit (<10% 1 month after the lockdown) was preserved mostly for suspected malignancy or potentially life-threatening conditions, telemedicine proved a pragmatic approach allowing efficient screening of cases and adequate protection for patients and clinicians.


Chilblains is a common cutaneous finding during the COVID-19 pandemic: A retrospective nationwide study from France


FFP2-mondmasker of chirurgisch mondkapje bij COVID-19


Current applications of artificial intelligence for COVID-19


title: Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility - King County, Washington, March 2020

text: Older adults are susceptible to severe coronavirus disease 2019 (COVID-19) outcomes as a consequence of their age and, in some cases, underlying health conditions (1). A COVID-19 outbreak in a long-term care skilled nursing facility (SNF) in King County, Washington that was first identified on February 28, 2020, highlighted the potential for rapid spread among residents of these types of facilities (2). On March 1, a health care provider at a second long-term care skilled nursing facility (facility A) in King County, Washington, had a positive test result for SARS-CoV-2, the novel coronavirus that causes COVID-19, after working while symptomatic on February 26 and 28. By March 6, seven residents of this second facility were symptomatic and had positive test results for SARS-CoV-2. On March 13, CDC performed symptom assessments and SARS-CoV-2 testing for 76 (93%) of the 82 facility A residents to evaluate the utility of symptom screening for identification of COVID-19 in SNF residents. Residents were categorized as asymptomatic or symptomatic at the time of testing, based on the absence or presence of fever, cough, shortness of breath, or other symptoms on the day of testing or during the preceding 14 days. Among 23 (30%) residents with positive test results, 10 (43%) had symptoms on the date of testing, and 13 (57%) were asymptomatic. Seven days after testing, 10 of these 13 previously asymptomatic residents had developed symptoms and were recategorized as presymptomatic at the time of testing. The reverse transcription-polymerase chain reaction (RT-PCR) testing cycle threshold (Ct) values indicated large quantities of viral RNA in asymptomatic, presymptomatic, and symptomatic residents, suggesting the potential for transmission regardless of symptoms. Symptom-based screening in SNFs could fail to identify approximately half of residents with COVID-19. Long-term care facilities should take proactive steps to prevent introduction of SARS-CoV-2 (3). Once a confirmed case is identified in an SNF, all residents should be placed on isolation precautions if possible (3), with considerations for extended use or reuse of personal protective equipment (PPE) as needed (4).


title: Serum KL-6 can distinguish between different phenotypes of severe COVID-19

text: We read the article by D'Alessandro Miriana et al. with great interest and appreciate their efforts to evaluate the role of serum Krebs von den Lungen-6 (KL-6) as a prognostic biomarker of severe coronavirus disease 2019 (COVID-19).1 This article is protected by copyright. All rights reserved.


title: Principles of Care for Patients with Liver Disease During the Coronavirus Disease 2019 (COVID-19) Pandemic: Position Statement of the Saudi Association for the Study of Liver Disease and Transplantation

text: In December 2019, a novel coronavirus was identified in patients in Wuhan, China. The virus, subsequently named severe acute respiratory syndrome coronavirus-2, spread worldwide and the disease (coronavirus disease 2019 or COVID-19) was declared a global pandemic by the World Health Organization in March 2020. Older adults and individuals with comorbidities have been reported as being more vulnerable to COVID-19. Patients with chronic liver disease (CLD) have compromised immune function due to cirrhosis and are more susceptible to infection. However, it is unclear if patients with CLD are more vulnerable to COVID-19 and its complications than other populations. The high number of severe cases of COVID-19 has placed an unusual burden on health systems, compromising their capacity to provide the regular care that patients with CLD require. Hence, it is incredibly crucial at this juncture to provide a set of interim recommendations on the management of patients with CLD during the current COVID-19 outbreak.


Dermatology staff participate in fight against Covid-19 in China


title: COVID-19: Abnormal liver function tests

text: BACKGROUND & AIMS: Recent data on the coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has begun to shine light on the impact of the disease on the liver. But no studies to date have systematically described liver test abnormalities in patients with COVID-19. We evaluated the clinical characteristics of COVID-19 in patients with abnormal liver test results. METHODS: Clinical records and laboratory results were obtained from 417 patients with laboratory-confirmed COVID-19 who were admitted to the only referral hospital in Shenzhen, China from January 11 to February 21, 2020 and followed up to March 7, 2020. Information on clinical features of patients with abnormal liver tests were collected for analysis. RESULTS: Of 417 patients with COVID-19, 318 (76.3%) had abnormal liver test results and 90 (21.5%) had liver injury during hospitalization. The presence of abnormal liver tests became more pronounced during hospitalization within 2 weeks, with 49 (23.4%), 31 (14.8%), 24 (11.5%) and 51 (24.4%) patients having alanine aminotransferase, aspartate aminotransferase, total bilirubin and gamma-glutamyl transferase levels elevated to more than 3× the upper limit of normal, respectively. Patients with abnormal liver tests of hepatocellular type or mixed type at admission had higher odds of progressing to severe disease (odds ratios [ORs] 2.73; 95% CI 1.19-6.3, and 4.44, 95% CI 1.93-10.23, respectively). The use of lopinavir/ritonavir was also found to lead to increased odds of liver injury (OR from 4.44 to 5.03, both p <0.01). CONCLUSION: Patients with abnormal liver tests were at higher risk of progressing to severe disease. The detrimental effects on liver injury mainly related to certain medications used during hospitalization, which should be monitored and evaluated frequently. LAY SUMMARY: Data on liver tests in patients with COVID-19 are scarce. We observed a high prevalence of liver test abnormalities and liver injury in 417 patients with COVID-19 admitted to our referral center, and the prevalence increased substantially during hospitalization. The presence of abnormal liver tests and liver injury were associated with the progression to severe pneumonia. The detrimental effects on liver injury were related to certain medications used during hospitalization, which warrants frequent monitoring and evaluation for these patients.


COVID-19-associated acute necrotising encephalopathy successfully treated with steroids and polyvalent immunoglobulin with unusual IgG targeting the cerebral fibre network


Guillain-Barré syndrome related to SARS-CoV-2 infection


title: Spatiotemporal Patterns of COVID-19 Impact on Human Activities and Environment in China Using Nighttime Light and Air Quality Data

text: In order to analyze the impact of COVID-19 on people's lives, activities and the natural environment, this paper investigates the spatial and temporal characteristics of Night Time Light (NTL) radiance and Air Quality Index (AQI) before and during the pandemic in mainland China. Our results show that the monthly average NTL brightness is much lower during the quarantine period than before. This study categorizes NTL into three classes: residential area, transportation and public facilities and commercial centers, with NTL radiance ranges of 5-20, 20-40 and greater than 40 nW/(cm*cm*sr), respectively. We found that the Number Of Pixels (NOP) with NTL detection increased in the residential area and decreased in the commercial centers for most of the provinces after the shutdown, while transportation and public facilities generally stayed the same. More specifically, we examined these factors in Wuhan, where the first confirmed cases were reported, and where the earliest quarantine measures were taken. Observations and analysis of pixels associated with commercial centers were observed to have lower NTL radiance values, indicating a dimming behavior, while residential area pixels recorded increased levels of brightness, after the beginning of the lockdown. The study also discovered a significant decreasing trend in the daily average AQI for the whole country, with cleaner air in most provinces during February and March, compared to January 2020. In conclusion, the outbreak and spread of COVID-19 has had a crucial impact on people's daily lives and activity ranges through the increased implementation of lockdown and quarantine policies. On the other hand, the air quality of China has improved with the reduction of non-essential industries and motor vehicle usage.


title: Urgent Guidance for Navigating and Circumventing the QTc-Prolonging and Torsadogenic Potential of Possible Pharmacotherapies for Coronavirus Disease 19 (COVID-19)

text: As the coronavirus disease 19 (COVID-19) global pandemic rages across the globe, the race to prevent and treat this deadly disease has led to the "off-label" repurposing of drugs such as hydroxychloroquine and lopinavir/ritonavir, which have the potential for unwanted QT-interval prolongation and a risk of drug-induced sudden cardiac death. With the possibility that a considerable proportion of the world's population soon could receive COVID-19 pharmacotherapies with torsadogenic potential for therapy or postexposure prophylaxis, this document serves to help health care professionals mitigate the risk of drug-induced ventricular arrhythmias while minimizing risk of COVID-19 exposure to personnel and conserving the limited supply of personal protective equipment.


Coronavirus Disease of 2019 in Patients with Well-Controlled Human Immunodeficiency Virus on Antiretroviral Therapy


title: Analysis of 8 274 cases of new coronavirus nucleic acid detection and co-infection in Wuhan/ 中华检验医学杂志

text: Objective@#To investigate the positive rate for 2019-nCoV tests and co-infections in Wuhan district.@*Methods@#A total of 8 274 cases in Wuhan were enrolled in this cross-sectional study during January 20 to February 9, 2020, and were tested for 2019-nCoV using fluorescence quantitative PCR. Both respiratory tract samples (nasopharynx, oropharynx, sputum and alveolar lavage fluid) and non-respiratory tract samples (urine, feces, anal swabs, blood and conjunctival sac swabs) were collected. If both orf1ab and N genes are positive, they are classified as nucleic acid test positive group; if both orf1ab and N genes are negative, they are classified as negative group; if single gene target is positive, they are classified as suspicious group. Individuals were divided into male group and female group according to sex. At the same time, 316 patients were tested for 13 respiratory pathogens by multiplex PCR.@*Results@#Among the 8 274 subjects, 2 745 (33.2%) were 2019-nCoV infected; 5 277 (63.8%) subjects showed negative results in the 2019-nCoV nucleic acid test; and 252 cases (3.05%) was not definitive (inconclusive result). The age of cases with COVID-19 patients and inconclusive cases was significantly higher than that of cases without 2019-nCoV infection (40 vs 56, t=27.569, P<0.001; 52 vs 56, t=6.774, P<0.001). The positive rate of 13 respiratory pathogens multiple tests was significantly lower in 104 subjects who were positive for 2019-nCoV compared with those in subjects who were negative for 2019-nCoV test (5.77% vs 18.39%, χ2=24.105, P=0.003). Four types of respiratory tract samples and five types of non-respiratory tract samples were found to be positive for 2019-nCoV nucleic acid test.@*Conclusion@#The 2019-nCoV nucleic acid positive rate in male is higher than in female. Co-infections should be pay close attention in COVID-19 patients. 2019-nCoV nucleic acid can be detected in non-respiratory tract samples.


title: Stress and cognitive functioning during a pandemic: Thoughts from stress researchers

text: In this commentary we discuss a downstream consequence of increases in stress and anxiety during the COVID-19 pandemic. Stress and anxiety can lead to mind wandering, which in turn competes for limited cognitive resources. We encourage researchers to be understanding and patient concerning the inevitable cognitive impact of the pandemic and subsequent reduced productivity levels from our students, colleagues, and ourselves. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Factors associated with post-traumatic stress disorder of nurses exposed to corona virus disease 2019 in China

text: Quantitative studies using validated questionnaires on post-traumatic stress disorder (PTSD) of Nurses exposed to corona virus disease 2019 (COVID-19) in China are rare and the baseline PTSD must first be evaluated before prevention. This study aimed to investigate the factors potentially involved in the level of PTSD of Nurses exposed to COVID-19 in China.In this cross-sectional study, male and female Nurses (nâ=â202) exposed to COVID-19 from HuBei China were included in the final sample. The PTSD Checklist-Civilian (PCL-C) questionnaire and Simplified Coping Style Questionnaire (SCSQ) were used for evaluation. Multivariate stepwise linear regression analysis and spearman correlation test were performed to assess the association between various factors associated with PTSD.The incidence of PTSD in Nurses exposed to COVID-19 was 16.83%, the PCL-C score was 27.00 (21.00-34.00), and the highest score in the three dimensions was avoidance dimension 9.50 (7.00-13.25); multivariable stepwise linear regression analysis showed that job satisfaction and gender were independently associated with lower PCL-C scores (both Pâ<â.001); PCL-C scores were correlated with positive coping (râ=â-0.151, Pâ=â.032), negative coping (râ=â0.154, Pâ=â.029).Nurses exposed to COVID-19 from HuBei China with job satisfaction, male and positive coping had low PCL-C scores which necessitate reducing the PTSD level by ways of improving job satisfaction, positive response, and strengthening the psychological counseling of female nurses in order to reduce the risk of psychological impairment.


title: Characteristics, Treatment Outcomes and Role of Hydroxychloroquine among 522 COVID-19 hospitalized patients in Jaipur City: An Epidemio-Clinical Study

text: Purpose: The present study was undertaken to investigate epidemiological distribution, clinical manifestation, co morbid status, treatment strategy and case fatality index of emerging COVID-19 infection at SMS Medical College Hospital, Jaipur, Rajasthan. It also evaluated efficacy of hydroxychloroquine (HCQ) in treatment of patients and risk of serious adverse outcomes in patients with COVID-19 in relation to their co morbid status. Materials and methods: In an attempt to provide extensive information pertaining to epidemiological and clinical characteristics of COVID-19, the present study was undertaken on 522 patients. The patients were COVID-19 confirmed positive by genomic analysis through Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) at SMS Medical College and Attached Hospitals, Jaipur. The indoor admitted patient's information inclusive of demographic profile (age, sex, nationality, residence), date of confirmation for positive COVID-19 case, travel/ exposure history, date of recovery/ death, clinical features, co morbidities and treatment plan was recorded. A serial follow-up of recovered patients to evaluate infective period of the disease was also part of the study. Results: A total of 522 patients of laboratory confirmed COVID-19 test by RT-PCR at SMS Hospitals, Jaipur were assessed. Among the confirmed cases, most of patients were young adult in the age group with mean age of 35.42 years. 22.41% patients were below 20 years of age, majority of patients (58.80%) were in the age range of 21 to 50 years and only 18.79% patient population was in the age range of above 50 years. Females (39.08%) were affected less than males (60.91%) with an average sex ratio of female: male being 0.64. Out of the total analyzed patients, only 24.32% patients were symptomatic, among them fever (55.90%), cough (52.75%), sore throat (49.60%) and shortness of breath (46.45%) were the most common presenting clinical manifestations while a few patients also had symptoms of headache (26.77%), chest pain (6.29%) and other symptoms (7.87%) like pain abdomen, fatigue, joints pain, altered sensorium etc. Most of symptomatic patients belonging to older age group. An average of 40.40% patient population of above 50 years of age, were symptomatic while none of the patients below 10 years of age were symptomatic. 13.98% patients had some or the other underlying co morbid disease. The most prevalent co morbidity was hypertension (42.46%) followed by Diabetes mellitus (39.72%), Old k-chest (20.54%), COPD/ Bronchial Asthma (16.43%), Coronary artery disease (13.69%), Chronic kidney disease (13.69%) and Valvular heart disease (6.84%) distributed in co morbid patients of COVID-19. 60.27% of patient population with underlying co morbid conditions were more prone to develop symptomatology complex as compared to that observed in patients with no co morbidity (18.42%). 116 patients had recovered with effective treatment till the date of data analysis. Time of recovery was counted from the date of positive report to 1st negative report of oropharyngeal sample by RT-PCR for COVID-19 with an average recovery time of 8.15 days. 23.27% patients recovered within 5 days, while 52.58% patients took about 6-10 days, 23.27% patients took 11-15 days and remaining 0.86% took more than 16 days to recover. In the present study 15 patients had died till analysis of data, among the deceased, 73.33% were above 50 year of age with a male preponderance (66.6%). Interestingly, all deceased (100%) had presented with clinical manifestations of COVID-19 and all had underlying multiple co morbid conditions. Majority of patients had early mortality after admission to hospital with two third death account in initial three days. Asymptomatic patients (cases) treated with HCQ recovered early (average recovery time =5.4 days) compared to asymptomatic patients who did not receive any treatment (control group) and had longer recovery time (average recovery time =7.6 days). Conclusion: The varied spectra of COVID-19 mostly affects young adult age group (third to fifth decades of life). Interestingly, early age group was also affected in significant proportion when compared with similar data from other countries. It was observed that male population seemed to be was more prone to getting infected. Majority of COVID-19 positive patients (nearly three-fourth) were asymptomatic (mostly in young age range) at the time of diagnosis, which poses a major challenge for health care workers. Fever, cough, sore throat and shortness of breath were major symptoms that could be detected in such COVID-19 patients. Symptomatic clinical manifestations were more common in old age population. Infectivity was higher in patients that had underlying co morbid disease, especially in patients with multiple co morbid conditions. Symptomatic presentation of COVID-19 was observed to be higher in patients with co morbid disease. Average recovery time from COVID-19 was 8 days with effective treatment. Mortality in COVID-19 was higher in old age population, male gender, symptomatic and co morbid patients as compared to other similarly matched group. Most of mortality was noted within first few days of admission, suggestive of early mortality due to the primary disease process. Treatment with HCQ had early recovery without effectively influencing the overall mortality.


The Wuhan SARS-CoV-2-What's next for China


Use of 4 robotic arms performing Senhance® robotic surgery may reduce the risk of coronavirus infection to medical professionals during COVID-19


Age, comorbidity, frailty status: effects on disposition and resource allocation during the COVID-19 pandemic


title: Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: a case-control study

text: BACKGROUND: The ongoing epidemics of coronavirus disease 2019 (COVID-19) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia. METHODS: We conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 pneumonia. RESULTS: During January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 pneumonia and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms (fever and cough) on admission, but most had typical chest CT images of COVID-19 pneumonia. Compared to the controls, COVID-19 pneumonia patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein (CRP), and alanine aminotransferase (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP were found in postpartum blood tests of pneumonia patients. There were three (18.8%) and three (16.7%) of the mothers with confirmed or suspected COVID-19 pneumonia had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure during hospital stay. COVID-19 infection was not found in the newborns and none developed severe neonatal complications. CONCLUSION: Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 pneumonia who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 pneumonia highlight the need of effective screening on admission.


Remote shared care delivery: a virtual response to COVID-19


Where have all the children gone? Decreases in paediatric emergency department attendances at the start of the COVID-19 pandemic of 2020


Cyclosporine therapy in cytokine storm due to coronavirus disease 2019 (COVID-19)


COVID-19 is a disease of older people


title: Digital Health Equity and COVID-19: The Innovation Curve Cannot Reinforce the Social Gradient of Health

text: Digital health innovations have been rapidly implemented and scaled to provide solutions to health delivery challenges posed by the coronavirus disease (COVID-19) pandemic. This has provided people with ongoing access to vital health services while minimizing their potential exposure to infection and allowing them to maintain social distancing. However, these solutions may have unintended consequences for health equity. Poverty, lack of access to digital health, poor engagement with digital health for some communities, and barriers to digital health literacy are some factors that can contribute to poor health outcomes. We present the Digital Health Equity Framework, which can be used to consider health equity factors. Along with person-centered care, digital health equity should be incorporated into health provider training and should be championed at the individual, institutional, and social levels. Important future directions will be to develop measurement-based approaches to digital health equity and to use these findings to further validate and refine this model.


COVID-19 in children and altered inflammatory responses


Coronavirus Disease 2019 Pandemic: Potential Collateral Damage on Patients With Operable Pancreatic Cancer


European Hernia Society (EHS) guidance for the management of adult patients with a hernia during the COVID-19 pandemic


title: Come comunicare con i familiari dei pazienti in completo isolamento durante la pandemia da SARS-CoV-2./ [How to communicate with families of patients in complete isolation during SARS-CoV-2 pandemic multidisciplinary working group "ComuniCoViD".]

text: The global emergency caused by the SARS-CoV-2 pandemic has suddenly changed how we communicate with families in all the CoViD-19 care settings, due to the obligation to maintain complete social isolation. Healthcare workers are isolated from their families, and must manage the consequences of this isolation just like the patients. They and their families perceive the personal attitudes, closeness and psychological support from the care teams. This perception of genuine participation by the healthcare workers during isolation is especially important when a patient dies, and it may influence the process of grief. This document is intended for all healthcare professionals caring for CoViD-19 patients, particularly those in more severe clinical conditions and it is aimed to help the care team to communicate with families distanced from the patient. The document consists of three parts: 1) presentation of the statements for communicating with patients family members during isolation; 2) discussion of key points as a theoretical framework for the statements; 3) instructions for telephone communication, with a checklist and a worksheet. The document was written by authors from different disciplines (doctors, nurses, psychologists, legal experts) and was then reviewed by a group of experts comprising professionals, people who have experienced ICU hospitalization, and their families. Finally, the document was approved by the National Boards of the Italian Society of Anesthesia and Intensive Care (SIAARTI), Italian Association of Critical Care Nurses (Aniarti), Italian Society of Emergency Medicine (SIMEU), and Italian Society of Palliative Care (SICP).


title: MSC Therapies for COVID-19: Importance of Patient Coagulopathy, Thromboprophylaxis, Cell Product Quality and Mode of Delivery for Treatment Safety and Efficacy

text: Numerous clinical trials of mesenchymal stromal/stem cells (MSCs) as a new treatment for coronavirus-induced disease (COVID-19) have been registered recently, most of them based on intravenous (IV) infusion. There is no approved effective therapy for COVID-19, but MSC therapies have shown first promise in the treatment of acute respiratory distress syndrome (ARDS) pneumonia, inflammation, and sepsis, which are among the leading causes of mortality in COVID-19 patients. Many of the critically ill COVID-19 patients are in a hypercoagulable procoagulant state and at high risk for disseminated intravascular coagulation, thromboembolism, and thrombotic multi-organ failure, another cause of high fatality. It is not yet clear whether IV infusion is a safe and effective route of MSC delivery in COVID-19, since MSC-based products express variable levels of highly procoagulant tissue factor (TF/CD142), compromising the cells' hemocompatibility and safety profile. Of concern, IV infusions of poorly characterized MSC products with unchecked (high) TF/CD142 expression could trigger blood clotting in COVID-19 and other vulnerable patient populations and further promote the risk for thromboembolism. In contrast, well-characterized products with robust manufacturing procedures and optimized modes of clinical delivery hold great promise for ameliorating COVID-19 by exerting their beneficial immunomodulatory effects, inducing tissue repair and organ protection. While the need for MSC therapy in COVID-19 is apparent, integrating both innate and adaptive immune compatibility testing into the current guidelines for cell, tissue, and organ transplantation is critical for safe and effective therapies. It is paramount to only use well-characterized, safe MSCs even in the most urgent and experimental treatments. We here propose three steps to mitigate the risk for these vulnerable patients: (1) updated clinical guidelines for cell and tissue transplantation, (2) updated minimal criteria for characterization of cellular therapeutics, and (3) updated cell therapy routines reflecting specific patient needs.


Trainee Led Collaboratives, Clinical Trials And New Opportunities In The Covid-19 Era


title: Efficient Suspected Infected Crowds Detection Based on Spatio-Temporal Trajectories

text: Virus transmission from person to person is an emergency event facing the global public. Early detection and isolation of potentially susceptible crowds can effectively control the epidemic of its disease. Existing metrics can not correctly address the infected rate on trajectories. To solve this problem, we propose a novel spatio-temporal infected rate (IR) measure based on human moving trajectories that can adequately describe the risk of being infected by a given query trajectory of a patient. Then, we manage source data through an efficient spatio-temporal index to make our system more scalable, and can quickly query susceptible crowds from massive trajectories. Besides, we design several pruning strategies that can effectively reduce calculations. Further, we design a spatial first time (SFT) index, which enables us to quickly query multiple trajectories without much I/O consumption and data redundancy. The performance of the solutions is demonstrated in experiments based on real and synthetic trajectory datasets that have shown the effectiveness and efficiency of our solutions.


Challenges in Neonatal COVID-19 Infection


title: Vertical transmission risk of SARS-CoV-2 infection in the third trimester: a systematic scoping review

text: Background: Studies on COVID-19 infection in pregnancy thus far have largely focused on characterizing maternal and neonatal clinical characteristics. However, another evolving focus is assessing and mitigating the risk of vertical transmission amongst COVID-19-positive mothers. The objective of this review was to summarize the current evidence on the vertical transmission potential of COVID-19 infection in the third trimester and its effects on the neonate.Methods: OVID MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trial (CENTRAL) were searched from January 2020 to May 2020, with continuous surveillance.Results: 18 studies met the inclusion criteria, consisting of 157 mothers and 160 neonates. The mean age of the pregnant patients was 30.8 years and the mean gestational period was 37 weeks and 1 d. Currently, there is currently no conclusive evidence to suggest that vertical transmission of SARS-CoV-2 occurs. Amongst 81 (69%) neonates who were tested for SARS-CoV-2, 5 (6%) had a positive result. However, amongst these 5 neonates, the earliest test was performed at 16 h after birth, and only 1 neonate was positive when they were later re-tested. However, this neonate initially tested negative at birth, suggesting that the SARS-CoV-2 infection was likely hospital-acquired rather than vertically transmitted. 13 (8%) neonates had complications or symptoms.Conclusions: The findings of this rapid descriptive review based on early clinical evidence suggest that vertical transmission of SARS-CoV-2 from mother to neonate/newborn did not occur. Future studies are needed to determine the optimal management of neonates born to COVID-19-positive mothers.


title: Scientists are racing to model the next moves of a coronavirus that's still hard to predict ;Science ;AAAS

text: Beyond China itself, Thailand is the country that most likely will have people who arrive at one of its airports with an infection by the novel coronavirus (2019-nCoV) that has sickened more than 30,000 people So says the latest update of a global risk assessment model created by a team of researchers from the Humboldt University of Berlin and the Robert Koch Institute that relies on air travel data


title: Steroid-Responsive Encephalitis in Coronavirus Disease 2019

text: Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020.


title: Public Attitudes, Behaviors, and Beliefs Related to COVID-19, Stay-at-Home Orders, Nonessential Business Closures, and Public Health Guidance - United States, New York City, and Los Angeles, May 5-12, 2020

text: SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), is thought to be transmitted mainly by person-to-person contact (1). Implementation of nationwide public health orders to limit person-to-person interaction and of guidance on personal protective practices can slow transmission (2,3). Such strategies can include stay-at-home orders, business closures, prohibitions against mass gatherings, use of cloth face coverings, and maintenance of a physical distance between persons (2,3). To assess and understand public attitudes, behaviors, and beliefs related to this guidance and COVID-19, representative panel surveys were conducted among adults aged ≥18 years in New York City (NYC) and Los Angeles, and broadly across the United States during May 5-12, 2020. Most respondents in the three cohorts supported stay-at-home orders and nonessential business closures* (United States, 79.5%; New York City, 86.7%; and Los Angeles, 81.5%), reported always or often wearing cloth face coverings in public areas (United States, 74.1%, New York City, 89.6%; and Los Angeles 89.8%), and believed that their state's restrictions were the right balance or not restrictive enough (United States, 84.3%; New York City, 89.7%; and Los Angeles, 79.7%). Periodic assessments of public attitudes, behaviors, and beliefs can guide evidence-based public health decision-making and related prevention messaging about mitigation strategies needed as the COVID-19 pandemic evolves.


Small bowel ischemia and SARS-CoV-2 infection: an underdiagnosed distinct clinical entity


Taking care of older patients with cancer in the context of COVID-19 pandemic


Covid-19 treatment update: follow the scientific evidence


title: Electrochemical detection of viruses and antibodies: A mini review

text: Near patient detection of viral infection represents a powerful approach for the control of emerging threats to global health. Moreover, the ability to identify individuals who have contracted the disease and developed antibodies that confer immunity is central to a return to normal daily activities. This review presents some of the recent advances in electrochemical sensors for the detection of viruses and their associated antibody profiles. Given the speed, portability, sensitivity and selectivity achieved using electrochemical detection, these sensor systems hold the promise of transformative change in clinical practice.


How to organize an emergency department during the COVID-19 pandemic


title: Complete dimensional collapse in the continuum limit of a delayed SEIQR network model with separable distributed infectivity

text: We take up a recently proposed compartmental SEIQR model with delays, ignore loss of immunity in the context of a fast pandemic, extend the model to a network structured on infectivity, and consider the continuum limit of the same with a simple separable interaction model for the infectivities $\beta$. Numerical simulations show that the evolving dynamics of the network is effectively captured by a single scalar function of time, regardless of the distribution of $\beta$ in the population. The continuum limit of the network model allows a simple derivation of the simpler model, which is a single scalar delay differential equation (DDE), wherein the variation in $\beta$ appears through an integral closely related to the moment generating function of $u=\sqrt{\beta}$. If the first few moments of $u$ exist, the governing DDE can be expanded in a series that shows a direct correspondence with the original compartmental DDE with a single $\beta$. Even otherwise, the new scalar DDE can be solved using either numerical integration over $u$ at each time step, or with the analytical integral if available in some useful form. Our work provides a new academic example of complete dimensional collapse, ties up an underlying continuum model for a pandemic with a simpler-seeming compartmental model, and will hopefully lead to new analysis of continuum models for epidemics.


COVID-19 in a child with severe aplastic anemia


Chilblain-like lesions during COVID-19 epidemic: a preliminary study on 63 patients


The outbreak of Novel Coronavirus disease (COVID-19) caused a worrying delay in the diagnosis of oral cancer in north-west Italy: The Turin Metropolitan Area experience


Mental health burden for Chinese middle school students affected by the COVID-19 pandemic


¿Preparados para el nuevo coronavirus?/ ¿Preparados para el nuevo coronavirus?/ Are We Ready for the New Coronavirus?


title: Estimating the reproductive number and the outbreak size of COVID-19 in Korea

text: OBJECTIVES: Since the first novel coronavirus disease 2019 (COVID-19) patient in Korea was diagnosed on January 20, 2020, 30 patients were diagnosed until February 17, 2020. However, 5,298 additional patients were confirmed until March 4, 2020. Therefore, our objective was to estimate the reproduction number (R) and evaluate the effectiveness of preventive measures. METHODS: A COVID-19 transmission model (SEIHR) was established to suit the Korean outbreak. The number of daily confirmed cases in Daegu and North Gyeongsang Province (NGP), the main area of outbreak, was used. The first patient' symptom onset date in the Daegu/NGP outbreak was assumed as January 22, 2020. The R according to the start date of the effect of preventive measures was estimated. RESULTS: The estimated R in Hubei Province, China, was 4.0281, whereas the estimated initial R in Korea was 0.555, but later in Daegu/NGP, the value was between 3.472 and 3.543. When the transmission period decreases from 4-day to 2-day, the outbreak ends early, but the peak of the epidemic increases, and the total number of patients does not change greatly. It was found that, if transmission rate decreases, the outbreak ends early, and the size of the peak and the total number of patients also decreases. CONCLUSIONS: To end the COVID-19 epidemic, efforts to reduce the spread of the virus, such as social distancing and wearing masks, are absolutely crucial with the participation of the public, along with the policy of reducing the transmission period by finding and isolating patients as quickly as possible through the efforts of the quarantine authorities.


Using Time Wisely During COVID-19


title: Application and Preliminary Outcomes of Remote Diagnosis and Treatment During the COVID-19 Outbreak: Retrospective Cohort Study

text: BACKGROUND: The coronavirus disease (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in the self-quarantine of countless people due to possible infection. This situation makes telemedicine necessary as it can overcome geographical barriers, increase the number of people served, and provide online clinical support for patients. However, the outcomes of telemedicine have not yet been evaluated. OBJECTIVE: The aim of our study is to describe the epidemiological features and clinical symptoms of patients receiving remote diagnosis and treatment at the online outpatient clinic of our hospital, as well as to analyze the outcomes and advantages of telemedicine, during the COVID-19 pandemic. METHODS: Data from patients receiving remote diagnosis and treatment via consultation services for COVID-19 concerns at the online outpatient clinic of Henan Provincial People's Hospital from January 24 to February 17, 2020, were collected. A retrospective analysis was performed on epidemiological features, clinical symptoms, and preliminary outcomes. RESULTS: Online inquiry, consultation, and suggestions were provided for patient concerns related to COVID-19. Our hospital also offered offline noncontact drug delivery services following online ordering and payment. A total of 4589 patients receiving remote diagnosis and treatment were recruited. The daily number of online outpatient visits initially increased and then decreased, reaching its peak on January 28 when the daily number of online outpatient visits totaled 612. Of 4589 patients, 1940 (42.3%) were males and 2649 (57.7%) were females (age range: 78 days to 85 years). Most patients were aged 20-39 years (n=3714, 80.9%) and came from Henan Province (n=3898, 84.9%). The number of patients from other provinces was 691 (15.1%). During the online consultations, patients discussed the following symptoms: fever (n=2383), cough (n=1740), nasal obstruction (n=794), fatigue (n=503), and diarrhea (n=276). A total of 873 orders of noncontact drug delivery following online payment was completed. The daily number of such orders gradually stabilized after the initial, steady increase. For offline drug delivery orders, the median (IQR) was 36 (58). An online satisfaction survey was filled out postconsultation by patients; of the 985 responses received, 98.1% (n=966) of respondents were satisfied with the service they received. CONCLUSIONS: Remote diagnosis and treatment offered via online outpatient consultations effectively reduced the burden on hospitals, prevented overcrowding, reduced the risk of cross-infection, and relieved patients' anxiety during the COVID-19 outbreak. This plays an essential role in pandemic management.


title: Application of remote diagnosis and treatment during the COVID-19 outbreak and their preliminary outcomesï¼retrospective cohort study

text: BACKGROUND: The novel coronavirus (severe acute respiratory syndrome coronavirus 2[SARS-CoV-2]) outbreak is now a pandemic, thousands of people now self-quarantined because of possible infection with the coronavirus, this situation makes telemedicine necessary as it can overcome geographical barriers, enlarge the size of the population served, and provide clinical support for patients online, however the outcomes of telemedicine have not yet evaluated. OBJECTIVE: To describe the epidemiological features and clinical symptoms of patients receiving remote diagnosis and treatment at the online outpatient clinic of our hospital during the coronavirus disease 2019 (COVID-19) outbreak, and to analyze the outcomes and advantages of telemedicine during the COVID-19 pandemic. METHODS: All patients receiving remote diagnosis and treatment and consultation services over COVID-19 concerns at the online outpatient clinic of Henan Provincial People's Hospital from January 24 to February 17, 2020, were collected. A retrospective analysis was performed on their epidemiological features, clinical symptoms, and preliminary outcomes. RESULTS: Online inquiry, consultation, and suggestions were provided over COVID-19 concerns for the patients. Meanwhile, the hospital offered offline non-contact drug delivery services following online ordering and payment. A total of 4,589 patients receiving remote diagnosis and treatment were recruited. The daily number of online outpatient visits first increased and then decreased, reaching the peak on January 28 when the daily number of online outpatient visits was 612. There were 1,940 males and 2,649 females (26.5%). The youngest was aged 78 days, and the eldest 85 years old. Most of the patients were aged 20 to 39 years old, and there were 3,714 patients in this age group, accounting for 80.9%. According to the statistics, most of the patients receiving online outpatient consultation over COVID-19 concerns came from Henan Province, and the number of such patients was 3,898, accounting for 84.9%. The number of patients from other provinces was 691, accounting for 15.1%. Based on the symptoms presented in the online outpatient consultation (one patient might be combined with more than one symptom), there were 2,383 patients with fever, 1,740 patients with cough, 796 patients with nasal obstruction, 503 patients with fatigue, and 276 patients with diarrhea. A total of 873 orders of non-contact drug delivery following online payment were completed. The daily number of such orders gradually stabilized after the initial steady increase. The median number of offline drug delivery orders was 36, and the interquartile range was 58. An online satisfaction survey was performed, and 985 responses were received. 966 respondents were satisfied, accounting for 98.1%. CONCLUSIONS: Remote diagnosis and treatment offered via the online outpatient consultation effectively reduce the burden on hospitals, prevent overcrowding, reduce the risk of cross-infection and relieve patients' anxiety during the COVID-19 outbreak, which play an essential role in the pandemic management.


title: Current Precautions and Future Directions in Lung Transplantation during the COVID-19 Pandemic

text: The unprecedented public health emergency caused by the acute viral respiratory coronavirus disease (COVID-19) has drastically changed current practices in solid organ transplantation, markedly so for transplantation of the lungs, the major target of the virus. Although national and state authorities do not recommend postponing transplant procedures, most specialists are reluctant to proceed due to substantial uncertainty and increased risks in the midst of the pandemic. There is an urgent need for evidence-based directions to move forward. Here, we offer our insights as specialists at a high-volume center located in a geographical area with high infection rates.


Emergency departments must not return to pre-covid days of overcrowding and lack of safety, says college


title: Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes on quality of life issues in dermatologic patients during the COVID-19 pandemic

text: The pandemic of COVID-19 is a global challenge for health care, and dermatologists are not standing apart from trying to meet this challenge. The European Academy of Dermatology and Venereology (EADV) has collected recommendations from its Task Forces (TFs) related to COVID-19. The Journal of the EADV has established a COVID-19 Special Forum giving free access to related articles. The psychosocial effects of the pandemic, an increase in contact dermatitis and several other skin diseases because of stress, disinfectants and protective equipment use, especially in healthcare workers, the temporary limited access to dermatologic care, the dilemma whether or not to pause immunosuppressive therapy, and, finally, the occurrence of skin lesions in patients infected by COVID-19 all contribute to significant quality of life (QoL) impairment. Here, we present detailed recommendations of the EADV TF on QoL and patient-oriented outcomes on how to improve QoL in dermatologic patients during the COVID-19 pandemic for several different groups of patients and for the general population.


title: Construction and immunogenic studies of a mFc fusion receptor binding domain (RBD) of spike protein as a subunit vaccine against SARS-CoV-2 infection

text: Herein, we report that a recombinant fusion protein, containing a 457 amino acid SARS-CoV-2 receptor binding domain (RBD, residues 319-541) and a mouse IgG1 Fc domain, could induce highly potent neutralizing antibodies and stimulate humoral and cellular immunity in mice. The antibodies also effectively suppressed SARS-CoV-2 RBD binding to soluble ACE2, indicating that RBD-mFc may be further developed as a safe and effective SARS-CoV-2 vaccine.


Electronic cigarette and vaping should be discouraged during the new coronavirus SARS-CoV-2 pandemic


title: Organizing a COVID-19 triage unit: a Swiss perspective

text: Background: With the rapid global spread of the acute respiratory syndrome coronavirus 2, urgent health-care measures have been implemented. We describe the organizational process in setting up a coronavirus disease 2019 triage unit in a Swiss tertiary care hospital. Methods: Our triage unit was set-up outside of the main hospital building and consists of three areas: 1. Pre-triage, 2. Triage, and 3. Triage plus. The Pre-triage check-points identify any potential COVID-19-infected patients and re-direct them to the main Triage area where trained medical staff screen which patients undergo diagnostic testing. If testing is indicated, nasopharyngeal swabs are performed. If patients require further investigations, they are referred to Triage plus. At this stage, patients are then discharged home after additional testing or admitted to the hospital for management. Observations: A total of 1265 patients were screened between 10 March 2020 and 12 April 2020 at our Triage unit. Of these, 112 (8.9%) tested positive. 73 (65%) of the positively-tested patients were female and 39 (35%) were male. The mean age for all patients was 43.8 years (SD 16.3 years). Distinguishing between genders, mean age for females was 41.1 (SD 16.5) and mean age for males was 48.6 (SD 14.9), with females being significantly younger than males (p < 0.001). Conclusion: Our triage unit was set-up as part of a large-scale restructuring process. Current challenges include low sensitivity for test results as well as limited staff and resources. We hope that our experience will help other health care institutions develop similar triage systems.


Impact of nutritional status and anemia on COVID-19: Is it a public health concern? Evidence from National Family Health Survey-4 (2015-2016), India


title: A proposal for the addressing the needs of the pediatric pulmonary work force

text: Unprecedented opportunities and daunting difficulties are anticipated in the future of pediatric pulmonary medicine. To address these issues and optimize pediatric pulmonary training, a group of faculty from various institutions met in 2019 and proposed specific, long-term solutions to the emerging problems in the field. Input on these ideas was then solicited more broadly from faculty with relevant expertise and from recent trainees. This proposal is a synthesis of these ideas. Pediatric pulmonology was among the first pediatric specialties to be grounded deliberately in science, requiring its fellows to demonstrate expertise in scientific inquiry (1). In the future, we will need more training in science, not less. Specifically, the scope of scientific inquiry will need to be broader. The proposal outlined below is designed to help optimize the practices of current providers and to prepare the next generation to be leaders in pediatric care in the future. We are optimistic that this can be accomplished. Our broad objectives are (a) to meet the pediatric subspecialty workforce demand by increasing interest and participation in pediatric pulmonary training; (b) to modernize training to ensure that future pediatric pulmonologists will be prepared clinically and scientifically for the future of the field; (c) to train pediatric pulmonologists who will add value in the future of pediatric healthcare, complemented by advanced practice providers and artificial intelligence systems that are well-informed to optimize quality healthcare delivery; and (d) to decrease the cost and improve the quality of care provided to children with respiratory diseases.


title: Hyperpyrexia in patients with COVID-19

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health emergency, in which its effective treatment and prevention remain obscured. Hyperpyrexia is an elevation of body temperature above 106.7°F (41.5°C) due to an abnormally increased hypothalamic-thermoregulatory set. The pathophysiology, impact, and outcomes of hyperpyrexia in patients with COVID-19 have not yet been studied. Herein, we present clinical features and outcomes of six patients with COVID-19 who had developed hyperpyrexia during hospitalization. All patients expired shortly after the onset of hyperpyrexia. Hyperpyrexia seems to adversely impact the outcomes and mortality in patients with COVID-19. The underlying mechanisms of developing hyperpyrexia in COVID-19 are mysterious. We propose it may be caused by SARS-CoV-2-related brain injury, exuberant immune response, and thrombus formation. More research is needed to verify our results. Understanding the association between hyperpyrexia and SARS-CoV-2 will help to elucidate the COVID-19 pathogenesis, which is mandatory for developing effective treatment strategies.


title: Prospective study of ocular and periocular diseases in animals: 188 cases/ Estudo prospectivo de doenças oculares e perioculares em animais: 188 casos

text: Histopathology of the ocular and periocular tissues submitted for diagnosis and research is still incipient in Brazil, in contrast to veterinary clinical ophthalmology. In this study, ocular and periocular tissues from domestic and wild animal species, mainly from the state of Minas Gerais, Brazil, were evaluated between February 2012 and September 2015. The samples were analyzed grossly and microscopically. Histochemistry and immunohistochemistry were performed on some of the samples. The frequency, type of ocular alteration, affected animal species, and affected ocular or periocular tissues were recorded. One hundred eighty-eight ocular and periocular tissues from domestic and, occasionally, wild animals were examined. Nine animals presented two concurrent alterations, adding up to 197 alterations. Proliferative lesions were the most frequent (92), followed by traumatic (43), inflammatory (37), degenerative (18), developmental (4) and vascular/hemorrhagic diseases (3). The globe was the most affected structure (112), followed by eyelids (52), third eyelid (17), bulbar conjunctiva (14) and retrobulbar region (2). Neoplasms arising from periocular tissues were the most frequent alteration (60), possibly related to a more active surgical service and histopathologic evaluation request. Many animals presented ocular lesions that reflected systemic diseases, which were diagnosed by necropsy and examination of other organs. Particularly in cases of neoplasia, early detection and surgical treatment can prevent systemic involvement. Ocular histopathologic evaluation can provide better characterization and prognosis of the clinical-pathological condition of the patient as well.(AU)


title: Prise en charge chirurgicale des cancers gynécologiques en période de pandémie COVID-19  Recommandations du Groupe FRANCOGYN pour le CNGOF./ [Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period - FRANCOGYN group for the CNGOF]

text: INTRODUCTION: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD: Recommendations based on the consensus conference model. RESULTS: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.


Patient-Centered, Gynecology-Specific Prioritization of Nonurgent Surgeries during the COVID-19 Pandemic: Proposal of a Novel Scoring System


The Impact of COVID-19 on Radiation Oncology Professionals and Cancer Patients: from Trauma to Psychological Growth


Modification of existing occupational therapeutic protocols in response to new normal life after COVID 19: Letter to the Editor


title: Die "historische Studie" SOLIDARITY als Antwort der Forschung auf die Sars-CoV-2 Pandemie./ [The "Historic Study" SOLIDARITY-Research's Answer to the Sars-CoV-2 Pandemic]

text: This paper is part of Forum COVID-19: Perspectives in the Humanities and Social Sciences. The novel coronavirus (Sars-CoV-2) poses a huge challenge to the world community. Knowledge about the virus and its properties is limited, but there is a great need to base political and medical decisions on scientific knowledge. This situation is leading to a dynamization of research. A prominent example of such a development is SOLIDARITY. The epistemological dimensions of this trial, which is coordinated by the WHO, and the resulting ethical implications are discussed in this article.


Medically Vulnerable Clinicians and Unnecessary Risk During the COVID-19 Pandemic


title: Analysis of clinical features and early warning signs in patients with severe COVID-19: A retrospective cohort study

text: Coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China, in December 2019. Although previous studies have described the clinical aspects of COVID-19, few studies have focused on the early detection of severe COVID-19. Therefore, this study aimed to identify the predictors of severe COVID-19 and to compare clinical features between patients with severe COVID-19 and those with less severe COVID-19. Patients admitted to designated hospital in the Henan Province of China who were either discharged or died prior to February 15, 2020 were enrolled retrospectively. Additionally, patients who underwent at least one of the following treatments were assigned to the severe group: continuous renal replacement therapy, high-flow oxygen absorption, noninvasive and invasive mechanical ventilation, or extracorporeal membrane oxygenation. The remaining patients were assigned to the non-severe group. Demographic information, initial symptoms, and first visit examination results were collected from the electronic medical records and compared between the groups. Multivariate logistic regression analysis was performed to determine the predictors of severe COVID-19. A receiver operating characteristic curve was used to identify a threshold for each predictor. Altogether,104 patients were enrolled in our study with 30 and 74 patients in the severe and non-severe groups, respectively. Multivariate logistic analysis indicated that patients aged ≥63 years (odds ratio = 41.0; 95% CI: 2.8, 592.4), with an absolute lymphocyte value of ≤1.02×109/L (odds ratio = 6.1; 95% CI = 1.5, 25.2) and a C-reactive protein level of ≥65.08mg/L (odds ratio = 8.9; 95% CI = 1.0, 74.2) were at a higher risk of severe illness. Thus, our results could be helpful in the early detection of patients at risk for severe illness, enabling the implementation of effective interventions and likely lowering the morbidity of COVID-19 patients.


title: Empfehlungen zur Durchführung einer Bronchoskopie in Zeiten der COVID-19-Pandemie./ [Recommendations for Performing Bronchoscopy in Times of the COVID-19 Pandemic]

text: COVID-19, caused by coronavirus SARS-CoV-2 is a new and ongoing infectious disease affecting healthcare systems worldwide. Healthcare worker are at high risk for COIVD-19 and many have been infected or even died in countries severely affected by COVID-19 like China or Italy. Bronchoscopy causes cough and aerosol production and has to be considered a significant risk for the staff to get infected. Particular recommendations should guide to prevent spreading COVID-19 and to protect healthcare worker when performing a bronchoscopy.


Las pandemias: el COVID-19


Considerations of Managing Lichen Planopilaris With Hydroxychloroquine During the COVID-19 Pandemic


A Unique Presentation of COVID-19 in a Patient Post Sleeve Gastrectomy


Applying Harm Reduction Principles to Address Screen Time in Young Children Amidst the COVID-19 Pandemic


Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed


title: In vitro analysis of the renin-angiotensin system and inflammatory gene transcripts in human bronchial epithelial cells after infection with severe acute respiratory syndrome coronavirus

text: INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently identified coronavirus family member that triggers a respiratory disease similar to severe acute respiratory syndrome coronavirus (SARS-CoV). SARS-CoV and SARS-CoV-2 are very similar to each other in many respects, such as structure, genetics, and pathobiology. We hypothesized that coronaviruses could affect pulmonary tissues via integration with the critical immune genes after their interaction with renin-angiotensin system (RAS) elements. The aim of the present bioinformatics study was to assess expression changes of the RAS and non-RAS genes, particularly immune response genes, in the lung epithelial cells after infection with SARS-CoV. METHODS: Linear regression, hierarchical clustering, pathway analysis, and network analysis were performed using the E-GEOD-17400 data set. RESULTS: The whole-genome expression data of the lung epithelial cells infected with SARS-CoV for 12, 24, and 48 hours were analyzed, and a total of 15 RAS family and 29 immune genes were found to be highly correlated with the exposure time to the virus in the studied groups. CONCLUSION: RAS genes are important at the initiation of the infections caused by coronavirus family members and may have a strong relationship with the exchange of immune genes in due course following the infection.


title: Inherent privacy limitations of decentralized contact tracing apps

text: Recently, there have been many efforts to use mobile apps as an aid in contact tracing to control the spread of the SARS-CoV-2 (Covid-19) pandemic. However, although many apps aim to protect individual privacy, the very nature of contact tracing must reveal some otherwise protected personal information. Digital contact tracing has endemic privacy risks that cannot be removed by technological means, and which may require legal or economic solutions. In this brief communication, we discuss a few of these inherent privacy limitations of any decentralized automatic contact tracing system.


title: SARS-CoV-2, SARS-CoV, and MERS-COV: A comparative overview

text: The recent outbreak of SARS-CoV-2 that started in Wuhan, China, has now spread to several other countries and is in its exponential phase of spread. Although less pathogenic than SARS-CoV, it has taken several lives and taken down the economies of many countries. Before this outbreak, the most recent coronavirus outbreaks were the SARS-CoV and the MERS-CoV outbreaks that happened in China and Saudi Arabia, respectively. Since the SARS-CoV-2 belongs to the same family as of SARS-CoV and MERS-CoV, they share several similarities. So, this review aims at understanding the new scenario of SARS-CoV-2 outbreak and compares the epidemiology, clinical presentations, and the genetics of these coronaviruses. Studies reveal that SARS-CoV-2 is very similar in structure and pathogenicity with SARS-CoV, but the most important structural protein, i.e., the spike protein (S), is slightly different in these viruses. The presence of a furin-like cleavage site in SARS-CoV-2 facilitates the S protein priming and might increase the efficiency of the spread of SARS-CoV-2 as compared to other beta coronaviruses. So, furin inhibitors can be targeted as potential drug therapies for SARS-CoV.


title: Luminescent silicon nanostructures and COVID-19

text: This Faraday Discussion volume is unique in the hundred plus year history of the Faraday Discussion series, being produced at a time of unprecedented circumstances worldwide and without the preceding Faraday Discussion conference having taken place.


Coronavirus 2019-nCoV: Is the genie already out of the bottle?


Potential Sensitivity of Wastewater Monitoring for SARS-CoV-2: Comparison with Norovirus Cases


title: [Epidemiological characteristics of COVID-19 in Gansu province]

text: Objective: To understand the epidemiological characteristics of COVID-19 cases in different epidemic stages in Gansu province. Methods: Epidemiological investigation was conducted to collect the information of confirmed COVID-19 cases, including demographic, epidemiological and clinical information. Results: As of 25 February 2020, a total of 91 confirmed COVID-19 cases had been reported in Gansu. The epidemic of COVID-19 in Gansu can be divided as three different stages, i.e. imported case stage, imported-case plus indigenous case stage, and indigenous case stage. A total of 63 cases were clustered cases (69.23%), 3 cases were medical staff infected with non-occupational exposure. The initial symptoms included fever (54.95%, 50/91), cough (52.75%, 48/91), or fatigue (28.57%, 26/91), the proportion of each symptom showed a decreasing trend along with the three epidemic stages, but only the differences in proportions of fever (trend χ2=2.20, P<0.05) and fatigue (trend χ2=3.18, P<0.05) among the three epidemic stages were statistically significant. The cases with critical severe symptoms accounted for 42.85% (6/14), 23.73% (14/59) and 16.67% (3/18), respectively, in three epidemic stages, showed a decreasing trend (H=6.45, P<0.05). Also, the incubation period prolonged along with the epidemic stage (F=51.65, P<0.01), but the intervals between disease onset and hospital visit (F=5.32, P<0.01), disease onset and diagnosis (F=5.25, P<0.01) became shorter along with the epidemic stage. Additionally, the basic reproduction number (R0) had decreased from 2.61 in imported case stage to 0.66 in indigenous case stage. Conclusions: The COVID-19 epidemic in Gansu was caused by the imported cases, and about 2/3 cases were clustered ones. No medical worker was observed to be infected by occupational exposure. With the progression of COVID-19 epidemic in Gansu, the change in initial symptom and incubation period suggests, the early screening cannot only depend on body temperature monitoring.


title: Cerebral Venous Thrombosis Associated with COVID-19

text: Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavir-ritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.


title: Measuring the Outreach Efforts of Public Health Authorities and the Public Response on Facebook During the COVID-19 Pandemic in Early 2020: Cross-Country Comparison

text: BACKGROUND: The coronavirus disease (COVID-19) pandemic presents one of the most challenging global crises at the dawn of a new decade. Public health authorities (PHAs) are increasingly adopting the use of social media such as Facebook to rapidly communicate and disseminate pandemic response measures to the public. Understanding of communication strategies across different PHAs and examining the public response on the social media landscapes can help improve practices for disseminating information to the public. OBJECTIVE: This study aims to examine COVID-19-related outreach efforts of PHAs in Singapore, the United States, and England, and the corresponding public response to these outreach efforts on Facebook. METHODS: Posts and comments from the Facebook pages of the Ministry of Health (MOH) in Singapore, the Centers for Disease Control and Prevention (CDC) in the United States, and Public Health England (PHE) in England were extracted from January 1, 2019, to March 18, 2020. Posts published before January 1, 2020, were categorized as pre-COVID-19, while the remaining posts were categorized as peri-COVID-19 posts. COVID-19-related posts were identified and classified into themes. Metrics used for measuring outreach and engagement were frequency, mean posts per day (PPD), mean reactions per post, mean shares per post, and mean comments per post. Responses to the COVID-19 posts were measured using frequency, mean sentiment polarity, positive to negative sentiments ratio (PNSR), and positive to negative emotions ratio (PNER). Toxicity in comments were identified and analyzed using frequency, mean likes per toxic comment, and mean replies per toxic comment. Trend analysis was performed to examine how the metrics varied with key events such as when COVID-19 was declared a pandemic. RESULTS: The MOH published more COVID-19 posts (n=271; mean PPD 5.0) compared to the CDC (n=94; mean PPD 2.2) and PHE (n=45; mean PPD 1.4). The mean number of comments per COVID-19 post was highest for the CDC (mean CPP 255.3) compared to the MOH (mean CPP 15.6) and PHE (mean CPP 12.5). Six major themes were identified, with posts about prevention and safety measures and situation updates being prevalent across the three PHAs. The themes of the MOH's posts were diverse, while the CDC and PHE posts focused on a few themes. Overall, response sentiments for the MOH posts (PNSR 0.94) were more favorable compared to response sentiments for the CDC (PNSR 0.57) and PHE (PNSR 0.55) posts. Toxic comments were rare (0.01%) across all PHAs. CONCLUSIONS: PHAs' extent of Facebook use for outreach purposes during the COVID-19 pandemic varied among the three PHAs, highlighting the strategies and approaches that other PHAs can potentially adopt. Our study showed that social media analysis was capable of providing insights about the communication strategies of PHAs during disease outbreaks.


Patient Satisfaction with Telemedicine Encounters in an Allergy/Immunology Practice During the COVID-19 Pandemic


title: Examining the Effect of COVID-19 on Foreign Exchange Rate and Stock Market -- An Applied Insight into the Variable Effects of Lockdown on Indian Economy

text: The relationship between a pandemic and the concurrent economy is quite comparable to the relation observed among health and wealth in general. Since 25th March 2020, India has been under a nation-wide lockdown. This work attempts to examine the effect of COVID-19 on the foreign exchange rates and stock market performances of India using secondary data over a span of 48 days. The study explores whether the causal relationships among the growth rate of confirmed cases (GrowthC), exchange rate (GEX) and SENSEX value (GSENSEX) are remaining the same across different pre and post-lockdown phases, attempting to capture any potential changes over time via the Vector Auto Regressive (VAR) models. A positive correlation is found between the growth rate of confirmed cases and the growth rate of exchange rate, and a negative correlation between the growth rate of confirmed cases and the growth rate of SENSEX value. A naive interpretation from this could be that with the rising growth rate of the number of confirmed cases, the economy took a toll, reflected by the Indian currency being depreciated while the stock exchange index suffered from a fall. However, on applying a VAR model, it is observed that an increase in the confirmed COVID-19 cases causes no significant change in the values of the exchange rate and SENSEX index. The result varies if the analysis is split across different time periods - before lockdown, first phase of lockdown and extension of lockdown. To compare the three periods, we had undertaken five rounds of analyses. Nuanced and sensible interpretations of the numeric results indicate significant variability across time in terms of the relation between the variables of interest. This detailed knowledge about the varying patterns of dependence could potentially help the policy makers and investors of India in order to develop their policies to cope up the situation.


title: Diabetes is a risk factor for the progression and prognosis of COVID-19

text: BACKGOUND: To figure out whether diabetes is a risk factor influencing the progression and prognosis of 2019 novel coronavirus disease (COVID-19). METHODS: A total of 174 consecutive patients confirmed with COVID-19 were studied. Demographic data, medical history, symptoms and signs, laboratory findings, chest computed tomography (CT) as well the treatment measures were collected and analysed. RESULTS: We found that COVID-19 patients without other comorbidities but with diabetes (n = 24) were at higher risk of severe pneumonia, release of tissue injury-related enzymes, excessive uncontrolled inflammation responses and hypercoagulable state associated with dysregulation of glucose metabolism. Furthermore, serum levels of inflammation-related biomarkers such as IL-6, C-reactive protein, serum ferritin and coagulation index, D-dimer, were significantly higher (P < .01) in diabetic patients compared with those without, suggesting that patients with diabetes are more susceptible to an inflammatory storm eventually leading to rapid deterioration of COVID-19. CONCLUSIONS: Our data support the notion that diabetes should be considered as a risk factor for a rapid progression and bad prognosis of COVID-19. More intensive attention should be paid to patients with diabetes, in case of rapid deterioration.


title: COVID-19 Coronavirus spike protein analysis for synthetic vaccines, a peptidomimetic antagonist, and therapeutic drugs, and analysis of a proposed achilles' heel conserved region to minimize probability of escape mutations and drug resistance

text: This paper continues a recent study of the spike protein sequence of the COVID-19 virus (SARS-CoV-2). It is also in part an introductory review to relevant computational techniques for tackling viral threats, using COVID-19 as an example. Q-UEL tools for facilitating access to knowledge and bioinformatics tools were again used for efficiency, but the focus in this paper is even more on the virus. Subsequence KRSFIEDLLFNKV of the S2' spike glycoprotein proteolytic cleavage site continues to appear important. Here it is shown to be recognizable in the common cold coronaviruses, avian coronaviruses and possibly as traces in the nidoviruses of reptiles and fish. Its function or functions thus seem important to the coronaviruses. It might represent SARS-CoV-2 Achilles' heel, less likely to acquire resistance by mutation, as has happened in some early SARS vaccine studies discussed in the previous paper. Preliminary conformational analysis of the receptor (ACE2) binding site of the spike protein is carried out suggesting that while it is somewhat conserved, it appears to be more variable than KRSFIEDLLFNKV. However compounds like emodin that inhibit SARS entry, apparently by binding ACE2, might also have functions at several different human protein binding sites. The enzyme 11ß-hydroxysteroid dehydrogenase type 1 is again argued to be a convenient model pharmacophore perhaps representing an ensemble of targets, and it is noted that it occurs both in lung and alimentary tract. Perhaps it benefits the virus to block an inflammatory response by inhibiting the dehydrogenase, but a fairly complex web involves several possible targets.


Are disease-related pulmonary perfusion abnormalities detectable in COVID-19 patients? Suspicious findings in a lung perfusion SPECT performed for ruling out classical pulmonary embolism


title: Forecast Possible Risk for COVID-19 Epidemic Dissemination Under Current Control Strategies in Japan

text: COVID-19 has globally spread to over 4 million people and the epidemic situation in Japan is very serious. The purpose of this research was to assess the risk of COVID-19 epidemic dissemination in Japan by estimating the current state of epidemic dissemination and providing some epidemic prevention and control recommendations. Firstly, the period from 6 January to 31 March 2020 was divided into four stages and the relevant parameters were estimated according to the imported cases in Japan. The basic reproduction number of the current stage is 1.954 (95% confidence interval (CI) 1.851-2.025), which means COVID-19 will spread quickly, and the self-healing rate of Japanese is about 0.495 (95% CI 0.437-0.506), with small variations in the four stages. Secondly, the results were applied to the actual reported cases from 1 to 5 April 2020, verifying the reliability of the estimated data using the accumulated reported cases located within the 95% confidence interval and the relative error of forecast data of five days being less than 2 . 5 % . Thirdly, considering the medical resources in Japan, the times the epidemic beds and ventilators become fully occupied are predicted as 5 and 15 May 2020, respectively. Keeping with the current situation, the final death toll in Japan may reach into the millions. Finally, based on experience with COVID-19 prevention and control in China, robust measures such as nationwide shutdown, store closures, citizens isolating themselves at home, and increasing PCR testing would quickly and effectively prevent COVID-19 spread.


title: High-resolution computed tomography manifestations of COVID-19 infections in patients of different ages

text: PURPOSE: We aimed to compare chest HRCT lung signs identified in scans of differently aged patients with COVID-19 infections. METHODS: Case data of patients diagnosed with COVID-19 infection in Hangzhou City, Zhejiang Province in China were collected, and chest HRCT signs of infected patients in four age groups (<18 years, 18-44 years, 45-59 years, ≥60 years) were compared. RESULTS: Small patchy, ground-glass opacity (GGO), and consolidations were the main HRCT signs in 98 patients with confirmed COVID-19 infections. Patients aged 45-59 years and aged ≥60 years had more bilateral lung, lung lobe, and lung field involvement, and greater lesion numbers than patients <18 years. GGO accompanied with the interlobular septa thickening or a crazy-paving pattern, consolidation, and air bronchogram sign were more common in patients aged 45-59 years, and ≥60 years, than in those aged <18 years, and aged 18-44 years. CONCLUSIONS: Chest HRCT manifestations in patients with COVID-19 are related to patient's age, and HRCT signs may be milder in younger patients.


Radiotherapy for COVID-19: Primum non nocere


title: COVID-19 and Health-Related Authority Allocation Puzzles

text: COVID-19-related controversies concerning the allocation of scarce resources, travel restrictions, and physical distancing norms each raise a foundational question: How should authority, and thus responsibility, over healthcare and public health law and policy be allocated? Each controversy raises principles that support claims by traditional wielders of authority in "federal" countries, like federal and state governments, and less traditional entities, like cities and sub-state nations. No existing principle divides "healthcare and public law and policy" into units that can be allocated in intuitively compelling ways. This leads to puzzles concerning (a) the principles for justifiably allocating "powers" in these domains and (b) whether and how they change during "emergencies." This work motivates the puzzles, explains why resolving them should be part of long-term responses to COVID-19, and outlines some initial COVID-19-related findings that shed light on justifiable authority allocation, emergencies, emergency powers, and the relationships between them.


title: How Is COVID-19 Affecting South Korea? What Is Our Current Strategy?

text: The outbreak of coronavirus disease 2019 (COVID-19) caused by the virus SARS-CoV-2 is expanding globally. South Korea is one of the countries most affected by COVID-19 from the very early stages of this pandemic. Explosive outbreaks occurred across South Korea in the first two months, and efforts to control this new virus have involved everyone across the country. To curb the transmission of the virus, health-care professionals, committees, and governments have combined many approaches, such as extensive COVID-19 screening, effective patient triage, the transparent provision of information, and the use of information technology. This experience could provide some valuable ideas and lessons to others who are fighting against COVID-19.


title: Assessment of Healthcare Workers' Levels of Preparedness and Awareness Regarding COVID-19 Infection in Low-Resource Settings

text: COVID-19, caused by the SARS-CoV-2 virus, is spreading rapidly worldwide, with devastating consequences for patients, healthcare workers, health systems, and economies. As it reaches low- and middle-income countries, the pandemic puts healthcare workers at high risk and challenges the abilities of healthcare systems to respond to the crisis. This study measured levels of knowledge and preparedness regarding COVID-19 among physicians and nurses. A cross-sectional survey was conducted among healthcare workers in Libya between February 26 and March 10, 2020. We obtained 1,572 valid responses of a possible 2,000 (78.6%) participants from 21 hospitals, of which 65.1% were from physicians and 34.9% from nurses. The majority of participants (70%) used social media as a source of information. A total of 47.3% of doctors and 54.7% of nurses received adequate training on how to effectively use personal protective equipment. Low confidence in managing suspected COVID-19 patients was reported by 83.8% of participants. Furthermore, 43.2% of healthcare workers were aware of proper hand hygiene techniques. Less than 7% of participants received training on how to manage COVID-19 cases, whereas 20.6% of doctors and 26.3% of nurses felt that they were personally prepared for the outbreak. Awareness and preparedness for the pandemic were low among frontline workers during the study. Therefore, an effective educational training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.


title: Social distancing alters the clinical course of COVID-19 in young adults: A comparative cohort study

text: BACKGROUND: Social distancing and stringent hygiene seem effective in reducing the number of transmitted virus particles, and therefore the infectivity, of coronavirus disease 2019 (COVID-19) and could alter the mode of transmission of the disease. However, it is not known if such practices can change the clinical course in infected individuals. METHODS: We prospectively studied an outbreak of COVID-19 in Switzerland among a population of 508 predominantly male soldiers with a median age of 21 years. We followed the number of infections in two spatially separated cohorts with almost identical baseline characteristics with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) before and after implementation of stringent social distancing. RESULTS: Of the 354 soldiers infected prior to the implementation of social distancing, 30% fell ill from COVID-19. While no soldier in a group of 154, in which infections appeared after implementation of social distancing, developed COVID-19 despite the detection of viral RNA in the nose and virus-specific antibodies within this group. CONCLUSIONS: Social distancing not only can slow the spread of SARS-CoV-2 in a cohort of young, healthy adults but can also prevent the outbreak of COVID-19 while still inducing an immune response and colonizing nasal passages. Viral inoculum during infection or mode of transmission may be key factors determining the clinical course of COVID-19.


title: Multi-Objective Neural Architecture Search Based on Diverse Structures and Adaptive Recommendation

text: The search space of neural architecture search (NAS) for convolutional neural network (CNN) is huge. To reduce searching cost, most NAS algorithms use fixed outer network level structure, and search the repeatable cell structure only. Such kind of fixed architecture performs well when enough cells and channels are used. However, when the architecture becomes more lightweight, the performance decreases significantly. To obtain better lightweight architectures, more flexible and diversified neural architectures are in demand, and more efficient methods should be designed for larger search space. Motivated by this, we propose MoARR algorithm, which utilizes the existing research results and historical information to quickly find architectures that are both lightweight and accurate. We use the discovered high-performance cells to construct network architectures. This method increases the network architecture diversity while also reduces the search space of cell structure design. In addition, we designs a novel multi-objective method to effectively analyze the historical evaluation information, so as to efficiently search for the Pareto optimal architectures with high accuracy and small parameter number. Experimental results show that our MoARR can achieve a powerful and lightweight model (with 1.9% error rate and 2.3M parameters) on CIFAR-10 in 6 GPU hours, which is better than the state-of-the-arts. The explored architecture is transferable to ImageNet and achieves 76.0% top-1 accuracy with 4.9M parameters.


title: Appropriate arrangement of cancer treatment after COVID-19 epidemic peaks in China

text: PURPOSE: COVID-19 is causing a lot of problems in health services around the world, especially in medical institutions receiving cancer patients. On March 12, China's National Health Commission announced that the peak of the COVID-19 epidemic has passed in China. Thus, a proper arrangement of medication, surgery and radiotherapy for patients with cancer is of vital importance after the epidemic peak. METHODS: A range of measures have been implemented in our center. Specific patients take priority for chemotherapy treatment. The amount of semi-elective and elective surgeries could be gradually increased beyond urgent and emergency surgery. The hypofractionated radiotherapy is recommended in the right circumstances. RESULTS: On March 13, our center announced that more than 5000 visits of chemotherapy and radiotherapy are arranged in our outpatient clinics and none of our patients and staffs have been diagnosed with COVID-19 as of March 28, 2020. CONCLUSION: The rational arrangement we make now may be helpful to the future restoration of cancer treatments in other countries.


title: Efficacy of Mass Quarantine as Leverage of Health System Governance During COVID-19 Outbreak: A Mini Policy Review

text: On January 23, 2020, the Chinese government announced the city lockdown of Wuhan. Since then, there have been controversial debates among experts about the efficacy of mass quarantine, the oldest and probably one of the most effective methods for controlling infectious disease outbreaks. The impact of health policymaking section of health system governance becomes visible to all stakeholders and the public in such emergency contexts. The success and failure of such policies should be evaluated in order to find the proper course of action for the local and international communities. In this review, we aim to investigate the efficacy of mass quarantine in China during the coronavirus disease 2019 (COVID-19) pandemic. We found good quality evidence for the effectiveness of mass quarantine during the current stage of COVID-19 pandemic, and these strategies seem to have been highly effective in controlling the spread of the disease.


title: The outlook for diagnostic purposes of the 2019-novel coronavirus disease

text: At the end of December 2019, a novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) appeared as the third unheard of outbreak of human coronavirus infection in the 21st century. First, in Wuhan, China, the novel SARS-CoV2 was named by the World Health Organization (WHO), as 2019-nCOV (COVID-19), and spread extremely all over the world. SARS-CoV2 is transmitted to individuals by human-to-human transmission leading to severe viral pneumonia and respiratory system injury. SARS-CoV2 elicits infections from the common cold to severe conditions accompanied by lung injury, acute respiratory distress syndrome, and other organ destruction. There is a possibility of virus transmission from asymptomatic cases as active carriers, in addition to symptomatic ones, which is a crucial crisis of COVID-19 that should be considered. Hence, paying more attention to the accurate and immediate diagnosis of suspected and infected cases can be a great help in preventing the rapid spread of the virus, improving the disease prognosis, and controlling the pandemic. In this review, we provide a comprehensive and up-to-date overview of the different types of Clinical and Para-clinical diagnostic methods and their practical features, which can help understand better the applications and capacities of various diagnostic approaches for COVID-19 infected cases.


Partha Kar: Covid-19-we must keep faith in our experts


Coronavirus disruptions reverberate through research


title: Exploitation of fibrin-based signaling niche for deriving progenitors from human adipose-derived mesenchymal stem cells towards potential neural engineering applications

text: Adipose-derived mesenchymal stem cells (hADMSC) retaining proliferation and multi-differentiation potential may support the central nervous system (CNS) regeneration. Multipotency of MSC may result in both desirable and undesirable cells, post-transplantation. A better strategy to attain desired cells may be in vitro commitment of hADMSCs to uni-/bi- potent neural progenitor cells (NPCs), prior to transplantation. Derivation of stable NPCs may require a suitable niche eliciting proliferation and differentiation signals. The present study designed a biomimetic niche comprising insoluble fibrin supported adhesion matrix and exogenously added growth factors (GFs) for deriving different neural cells and established the role of Notch and Wnt signals for proliferation and differentiation of hADMSCs, respectively. The stable transformation of hADMSCs into neurospheres (NS) comprising Nestin+ve NPCs was achieved consistently. Slight modifications of niche enable differentiation of NS to NPCs; NPCs to neurons; NPCs to oligodendrocyte progenitor cells (OPCs); and OPCs to oligodendrocytes (OLG). Fibrin plays a crucial role in the conversion of hADMSC to NS and NPCs to OPCs; but, not essential for OPC to OLG maturation. Co-survival and cell-cell interaction of NPC derived neurons and OPCs promoting OLG maturation is illustrated. The designed biomimetic niche shows the potential for directing autologous ADMSCs to neural cells for applications in regenerative medicine.


title: ABO Phenotype and Death in Critically Ill Patients with COVID-19

text: Blood groups are inherited traits that vary across populations, likely due to both founder effects and natural selection. A link between blood groups and susceptibility to infectious disease has been well-described, with notable examples being H. Pylori and Plasmodium falciparum infection. Blood group antigens may influence disease susceptibility by several mechanisms, including serving as receptors or decoys for infectious organisms and modifying immune response in the form of anti-ABO antibodies.


Where have the STEMIs gone during COVID-19 lockdown?


Taking the right measures to control COVID-19 in ophthalmology: the experience of a tertiary eye care referral center in Italy