title: Hematology and Oncology in Critical Illness

text: This chapter will focus on a variety of hematologic issues pertinent to the care of critically ill children. This is an area of intense research with the pathophysiology underlying these clinical conditions becoming progressively better understood. This improved understanding has resulted in new therapeutic strategies that are being assessed in multicenter clinical trials. The chapter will begin by describing the incidence and pathophysiologic significance of anemia in the pediatric intensive care unit (PICU) providing a differential diagnosis of the many conditions that may present with anemia in this setting. The chapter will next consider disseminated intravascular coagulation (DIC) focusing on the pathophysiology of a condition that has been associated with much morbidity and mortality. The underlying conditions predisposing to DIC will be detailed as well as a number of treatment options that have been implemented in clinical trials. In addition to DIC, thrombocytopenia may be caused by a number of other clinical conditions important to the pediatric critical care provider. The clinical and prognostic significance of thrombocytopenia will be addressed and a focused differential diagnosis will be provided. Thrombotic disorders are becoming increasingly recognized in children and are a particular concern for the pediatric intensivist. The epidemiology of thromboembolism in children will be reviewed focusing on the conditions most commonly associated with these thromboses. Finally, a chapter on hematologic issues in the critically ill child would not be complete without a discussion of sickle cell disease. Acute chest syndrome, one of the most frequent complications of sickle cell disease resulting in the need for intensive care services, will be discussed in detail.


title: De eerste lijn van verdediging: aangeboren immuniteit

text: Het aangeboren immuunsysteem vormt de eerste lijn van verdediging tegen pathogene indringers, waarbij de intacte huid en slijmvliezen effectieve barrières vormen. Op en in de huid en slijmvliezen bevindt zich een scala aan antimicrobiële eiwitten van de aangeboren afweer. Verschillende soorten interferonen beschermen cellen tegen virusinfectie. Het complementsysteem, wat op meerdere manieren geactiveerd kan worden, leidt tot lysis en versnelde fagocytose van micro-organismen. Fagocyten (macrofagen en granulocyten), naturalkillercellen en dendritische cellen zijn gereed om een infectie direct te bestrijden en het verworven immuunsysteem op gang te helpen. Cellen van het aangeboren immuunsysteem kunnen moleculaire patronen op micro-organismen herkennen. De twee onderdelen van het immuunsysteem, het aangeboren en verworven deel, staan niet los van elkaar. Het verworven immuunsysteem kan niet functioneren zonder de aanwezigheid van een adequaat werkend aangeboren immuunsysteem. Andersom helpt het verworven immuunsysteem bij het verwijderen en doden van micro-organismen door het aangeboren immuunsysteem.


title: Modelling of Infectious Disease with Biomathematics: Implications for Teaching and Research

text: The chapter compares a variety of models from biomathematics and bioinformatics of the spread of severe acute respiratory syndrome (SARS) that hit dozens of countries worldwide in 2003. It also investigates students’ and lecturers’ opinions regarding differences in predictions from three different models. All models were based on the real data for Hong Kong published by the World Health Organization (WHO). Although the models were based on the same data, they gave very different predictions of the spread of the disease. The models were discussed with two groups of people: undergraduate students majoring either in engineering or applied mathematics and university lecturers who teach mathematics or mathematical modelling courses. In this chapter we present, analyze, and compare responses to the same questionnaire given to the two groups.


title: Acute Pulmonary Infections

text: Acute lower respiratory infection is a common cause of morbidity in infants and children, and at times, requires intensive care and mechanical ventilation. Viral bronchiolitis and bacterial pneumonia account for the majority of lower respiratory tract infections that lead to respiratory insufficiency and pediatric intensive care admission. Twenty-seven percent of children who require mechanical ventilation for at least 24 h in pediatric intensive care units are diagnosed with bronchiolitis and 16% have the diagnosis of pneumonia. The median length of time intubated for an acute pulmonary infection leading to respiratory failure is approximately 7 days.


title: Red Blood Cell Transfusion

text: Blood is classified as a drug and transfusion is one of the most commonly performed procedures in the USA. General knowledge of blood manufacturing, shelf life and storage media, common component modifications, blood types, and product compatibility allows the clinician to better communicate their needs and to understand what options may be available when ordering blood products. All transfusions offer benefits, and the clinician must comprehend the possible adverse events, especially those related to TRALI, which continues to be the most common cause of transfusion-related death reported to FDA, with TACO as the second most-commonly reported event. Transfusing in the setting of hemorrhagic blood loss adds additional challenges regarding volume overload, coagulopathy, and optimum transfusion ratios of red cells, plasma, platelets, and cryoprecipitate. The information imparted in this chapter will help equip the clinician with the knowledge needed to make the best decisions for patients requiring blood products, especially injured patients.


title: Threats, Risks and the Derived Information Security Strategy

text: This article concentrates on the development of an information security strategy. An information security strategy needs to focus on an overall objective, usually the objectives laid out in an organization’s business strategy and its derived information technology strategy, where it takes the status quo and reflects the main objectives derived and postulates how and when to close the identified gaps. This strategy approach for improving information security is intended for an organization which supports an automotive and captive finance enterprise but is not restricted to this. The approach is aligned to the scope of ISO 270002 “Code of Practice for an Information Security Management System” [ISO05]. However, compliance is left out of the scope. The strategy concentrates on four areas considered the relevant areas for infonnation security: people, business processses. applications and infrastructure and has therefore a clear focus on processes, stability, resilience and efficiency which are the pillars of a successful enterprise.


title: Principles of Infectious Disease Epidemiology

text: In this chapter, principles and concepts of modern infectious disease epidemiology Epidemiology are presented. We delineate the role of epidemiology for public health and discuss the characteristics of infectious disease epidemiology. This chapter also includes definitions of important terms used in infectious disease epidemiology.


title: Mathematical Models in Infectious Disease Epidemiology

text: The idea that transmission and spread of infectious diseases follows laws that can be formulated in mathematical language is old. In 1766 Daniel Bernoulli published an article where he described the effects of smallpox variolation (a precursor of vaccination) on life expectancy using mathematical life table analysis (Dietz and Heesterbeek 2000). However, it was only in the twentieth century that the nonlinear dynamics of infectious disease transmission was really understood. In the beginning of that century there was much discussion about why an epidemic ended before all susceptibles were infected with hypotheses about changing virulence of the pathogen during the epidemic.


title: Epidemien und Pandemien in historischer Perspektive

text: Seuchenzüge treten definitionsgemäß in Intervallen auf. Da ihre Ätiologie und Epidemiologie im Vorfeld zunächst meist mit erheblichen Unsicherheiten behaftet sind, werden historische Denkweisen und Analogien herangezogen, um Seuchengefahren zu erkennen und Gegenmaßnahmen zu treffen. Die zugrunde liegenden Traditionen lassen sich teilweise über Jahrzehnte oder gar Jahrhunderte zurück verfolgen.


title: Negotiating Pandemic Risk: On the Scandalization and Transcultural Transformation of the Swine Flu

text: Epidemiology, it would seem, lends itself to an interdisciplinary dialogue between medicine and the humanities in particular ways. More than any other medical discipline, perhaps, epidemiology has triggered responses by cultural theorists and cultural historians, and it has done so on two levels and on account of two, mutually interrelated reasons. First, epidemiology as a discourse and medical practice has been so seductive to cultural theorists because of the metaphorical potential inherent in what Priscilla Wald has termed the “outbreak narrative”.


title: Plasma Transfusion

text: The resuscitation of the injured patient continues to be a highly debated topic. Multiple studies have been performed with the intent to determine the optimal strategy to combat, and ultimately prevent, trauma induced coagulopathy. This chapter discusses the risks and benefits of resuscitation protocols utilizing plasma. Plasma is the aqueous portion of blood that contains coagulation factors, fibrinolytic proteins, albumin, immunoglobulins, and up to 6000 other proteins. Multiple methods of collection and storage have been developed, each one affecting the plasma and its proteins differently. Once collected, plasma can be frozen for storage. If frozen within 8 h, the product is labelled as fresh frozen plasma (FFP). If frozen more than 6 h, but less than 24 h, it is labelled as plasma frozen within 24 h (FP24). When FFP and FP24 are mobilized from the blood bank, they are thawed in a water bath to create thawed plasma (TP) which can be stored in liquid form for up to 4 days prior to transfusion. Liquid plasma (LQP) is derived from whole blood and is never frozen. It can be stored for up to 30 days by some reports prior to transfusion. Each of these forms of plasma has been extensively studied for efficacy of coagulation and are all useful in the resuscitation of a traumatically injured patient. There is much more than coagulation factors in plasma that are useful to patients. Studies looking at the endotheliopathy associated with hemorrhagic shock have shown a decrease in the inflammatory response, promotion of endothelial repair, and decreased edema. Transfusion protocols utilizing plasma at the time of presentation have shown a decrease in the amount of blood products transfused, as well as an improvement in mortality. Transfusion ratios of platelets–red blood cells–plasma units in a 1:1:1 ratio have shown a significant improvement in mortality at 3 h post-admission over 1:1:2. There has not been an increase in the incidence of adverse events with the increase usage of plasma. The early administration of plasma to the massively hemorrhaging traumatically injured patient improves mortality, decreases total blood product usage, and promotes the resolution of trauma induced endotheliopathy without increasing adverse events.


title: Dual Role of Th17 Cytokines, IL-17A,F, and IL-22 in Allergic Asthma

text: The proinflammatory role of T helper (Th) 17 cells and therefore of its cytokines, IL-17 (IL-17A), IL-17F, and IL-22, in autoimmune disorders has been favored, although there is evidence that not only IL-17A but also IL-17F and IL-22 have a dual role as negative regulators. Here we review the concept of the dual function of IL-17A, IL-17F, and IL-22 in the light of recent strategies to use neutralization of these cytokines as potential alternative to neutralizing TNF and IL-1 treatments in chronic inflammatory disorders. Expectedly, in allergic lung inflammation, neutralization of IL-17A inhibited neutrophil recruitment. However, this IL-17A antibody treatment concomitantly increased eosinophil recruitment by neutralizing IL-17A’s dual role as negative regulator. IL-17A negatively regulated dendritic cell function and activation of T helper cell (Th)2 cytokine production. Furthermore, IL-17A inhibited Th2-characteristic chemokine and adhesion molecule expression. On a mechanistic level, IL-17A acted on IκB-β by preventing degradation and in turn leading to reduced NF-κB activation or IL-17A inhibited transcription factor IRF-1. Therefore, anti-IL-17A therapy, although presenting a promising lead in chronic inflammatory disorders, bears a potential risk of exacerbating allergic asthma.


title: Vom 14. bis zum 21. Jahrhundert: Epidemien, Pandemien und Bioterrorismus

text: Ausbrüche von Infektionskrankheiten wie im Jahr 2011 der Ausbruch mit EHEC oder einige Jahre zuvor SARS zeigen, wie zeitlos die Bedrohungen durch Infektionskrankheiten sind und wie rasch sie auftreten können. Viele altbekannte Probleme mit Infektionsgefahren, die man bereits vor Jahrhunderten kannte, sind selbst heutzutage noch nicht gelöst, auch wenn sich selbstverständlich die Zugänge, dank moderner Techniken und mikrobiologischer Methodik, in ungeahntem Ausmaß fortentwickelt haben. Viele Vorgehensweisen werden letztlich noch in gleicher Weise angewandt wie früher, um sich vor Infektionskrankheiten zu schützen.


title: Nachrichten

text: Nachrichten sind knapp gefasste, komprimierte Informationen – sie enthalten also nichts Überflüssiges. Nachrichten sind um Wertneutralität bemüht und deshalb besonders glaubwürdig. Sie unterscheiden sich dadurch grundsätzlich von Kommentaren und anderen meinungsbetonten journalistischen Beiträgen. Und Nachrichten sind relativ leicht verständlich. Sie sind deshalb nach strengen formalen Regeln verfasst. Das gilt nicht nur für Radio‐Nachrichten in klassischer Form, also für reine Textmeldungen, sondern auch für Meldungen mit O‐Ton, d. h. Meldungen, in die Statements und Kurzberichte eingebaut sind (mehr dazu im Beitrag »Nachrichten‐Präsentation«). Die oberste formale Regel für die Nachricht lautet: Das Wichtigste steht am Anfang. Das Wichtigste – die Kernaussage – herauszuarbeiten und so knapp und genau wie möglich in Worte zu fassen, das ist die erste und größte Aufgabe des Nachrichtenredakteurs: nicht spektakulär, aber journalistisch anspruchsvoll. Ein einfaches Beispiel aus dem Alltag einer regionalen Nachrichtenredaktion soll das klar machen. Eine Pressemeldung der Kaiserslauterer Polizei hat folgenden Wortlaut:


title: Global Challenges of Infectious Disease Epidemiology

text: As we have seen in the last chapter, infectious and parasitic diseases are major causes of morbidity and mortality worldwide, particularly in developing countries. Approximately 26% of global deaths and 26% of global burden of disease were attributed to infectious diseases in 2001 (Lopez et al.2006 see Chapter 1). One in two deaths that are mostly preventable occurs in developing countries (Kim-Farley 2004 Folch et al.2003. Looking to the remaining 21st century, we could imagine a decline in major infectious diseases like malaria and AIDS as a result of an adoption of effective prevention strategies and treatments or, like in the case of hepatitis B, as a consequence of worldwide vaccination programs in children. In addition, new vaccines, new treatment technologies, as well as an improvement in infrastructures can contribute to win the “battle against infectious diseases.”


title: Infectious Disease Control Policies and the Role of Governmental and Intergovernmental Organisations

text: Public health is generally regarded as the typical domain of national if not local governments, which takes into account local necessities arising from the epidemiologic situation, the health-care system and the government structures. Therefore in theory, public health policy is in the sovereignty of countries. However, the spread of infectious diseases has never been restricted to national borders; thus the principle of national sovereignty is largely theoretical. This is especially true in a world with unprecedented international mobility of goods and persons. Moreover, particularly public health actions in the field of infectious diseases within one country may well affect public health issues in other countries. One of the best recent examples is the Chinese management of the initial phase of the SARS epidemic, which was characterised by failing surveillance structures, insufficient control measures and restricted public information policy. Abba Ebban has described it as a paradox that in order for countries to effectively execute their public health sovereignty, they would consequently have to give up some of their sovereignty to intergovernmental organisations (Ebban 1995).


title: C7 Anti-infective activity of immunomodulators

text: Infectious diseases continue to impact human morbidity and mortality. Every individual is vulnerable to microbial infections regardless of socioeconomic status, gender, age group or ethnic background. There has been an explosion of international air travel with an estimated 2 billion passengers travelling on commercial airlines every year. The rapid expansion of globalization and mass tourism has facilitated the spread of disease-causing pathogens from one continent to another at unprecedented rates.


Medical School Approach to Manage the Current COVID-19 Crisis


Creating a “Quarantine Curriculum” to Enhance Teaching and Learning During the COVID-19 Pandemic


title: Teaching Professional Formation in Response to the COVID-19 Pandemic

text: In response to the COVID-19 pandemic, the Association of American Medical Colleges has called for a temporary suspension of clinical teaching activities for medical students. Planning for the continued involvement of learners in patient care during this pandemic should include teaching learners professional formation. The authors provide an ethical framework to guide such teaching, based on the ethical principle of beneficence and the professional virtues of courage and self-sacrifice from professional ethics in medicine. The authors show that these concepts support the conclusion that learners are ethically obligated to accept reasonable, but not unreasonable, risk. Based on this ethical framework, the authors provide an account of the process of teaching professional formation that medical educators and academic leaders should implement. Medical educators and academic leaders should embrace the opportunity that the COVID-19 pandemic presents for teaching professional formation. Learners should acquire the conceptual vocabulary of professional formation. Learners should recognize that risk of infection from patients is unavoidable. Learners should become aware of established ethical standards for professional responsibility during epidemics from the history of medicine. Learners should master understandable fear. Medical educators and academic leaders should ensure that didactic teaching of professional formation continues when it becomes justified to end learners’ participation in the processes of patient care; topics should include the professionally responsible management of scarce medical resources. The COVID-19 pandemic will not be the last major infectious disease that puts learners at risk. Professional ethics in medicine provides powerful conceptual tools that can be used as an ethical framework to guide medical educators to teach learners, who will bear leadership responsibilities in responses to future pandemics, professional formation.


Digital Clinical Placement for Medical Students in Response to COVID-19


title: Digitalization in management accounting and control: an editorial

text: Digitalization has the potential to disrupt the management accounting domain. It may not only affect the digital landscape of the organization and the associated business models, but also management accounting and control practices as well as the role of the controller. This editorial discusses these developments by introducing the concept of digitalization and describing its impact on the field of management accounting and control.


D’une crise à l’autre (rédigé le 9 mars 2020)


title: Shaping the Future of Global Health: A Review of Canadian Space Technology Applications in Healthcare

text: Technology innovation is exponential globally and the global health sector is imbibing these rapidly. In Canada, the growth in space technology innovations have been driven by the UN 2030 sustainable development goals (SDGs) and applied to public health and foreign aid priorities and policies. In this chapter, we explore the shared vision of space and global health in Canada, through an appraisal of contributions.


COVID-19 – Journal de bord – 10/03/2020 : pandémie virale : s’inquiéter, organiser, prévoir


Liebe Leserinnen und Leser, liebe Mitglieder der GOTS,


title: SPX Flow divests Power and Energy Business

text: SPX Flow Inc has completed the sale of its Power and Energy segment to funds managed by affiliates of private equity company Apollo Global Management Inc (see Pump Industry Analyst, May 2019).


Food allergy 2020: learning from the past, looking to the future


Financial Calendar


COVID-19 – Journal de bord – 15/03/2020 : premières réflexions…


Dividends


COVID-19–Journal de Bord


Masks, Gloves, Exports Licences and Composite Procedures: Implementing Regulation 2020/402 and the Limelight of Accountability


Society News


Wichtige Investitionen in die Autoindustrie


Actueel


Important Investments in the Auto Industry


Werken op een corona-afdeling


Gastrointestinale Infektiologie


Agricultural and Food Economics: the challenge of sustainability


Introducing “In Focus”, Community Resources Accelerating Science


title: Salmonella Enteritidis Effector AvrA Suppresses Autophagy by Reducing Beclin-1 Protein

text: Autophagy is a cellular process to clear pathogens. Salmonella enterica serovar Enteritidis (S.E) has emerged as one of the most important food-borne pathogens. However, major studies still focus on Salmonella enterica serovar Typhimurium. Here, we reported that AvrA, a S. Enteritidis effector, inhibited autophagy to promote bacterial survival in the host. We found that AvrA regulates the conversion of LC3 I into LC3 II and the enrichment of lysosomes. Beclin-1, a key molecular regulator of autophagy, was decreased after AvrA expressed strain colonization. In S.E-AvrA(−)-infected cells, we found the increases of protein levels of p-JNK and p-c-Jun and the transcription level of AP-1. AvrA-reduction of Beclin-1 protein expression is through the JNK pathway. The JNK inhibitor abolished the AvrA-reduced Beclin-1 protein expression. Moreover, we identified that the AvrA mutation C186A abolished its regulation of Beclin-1 expression. In addition AvrA protein was found interacted with Beclin-1. In organoids and infected mice, we explored the physiologically related effects and mechanism of AvrA in reducing Beclin-1 through the JNK pathway, thus attenuating autophagic responses. This finding not only indicates an important role of S. Enteritidis effector in reducing host protein as a strategy to suppress autophagy, but also suggests manipulating autophagy as a new strategy to treat infectious diseases.


Auspicious Symbols of Rank and Status


Outbreaks and Investigations


title: Remarks on the Classification of Viruses

text: This chapter presents remarks on viruses, phanerogram, cryptogram, and gymnogram. It discusses various characteristics of the families of viruses. Viruses are defined by the sum of the distinctive traits of the virion. These distinctive traits are as follows: (1) presence of a single nucleic acid; (2) incapacity to grow and to divide; (3) reproduction from the genetic material only; (4) absence of enzymes for energy metabolism; (5) absence of ribosomes; (6) absence of information for the production of enzymes in the energy cycle; (7) absence of information for the synthesis of the ribosomal proteins; and (8) absence of information for the synthesis of ribosomal RNA and transfer RNA. The viral infectious particle presents a great diversity in composition and structure. Order could be achieved only through a classification, which is a system of order. The goal of biological classification is to group together organisms presenting certain analogies and certain affinities and, if possible, to also bring out phylogenic relationships. The conceptions relative to the methodology of taxonomy, which is the science of classification, are diverse. A virus may have evolved from a given sector of DNA within the host cell. It could also very well have derived from the corresponding RNA messenger that contains the same information, both qualitatively and quantitatively. Therefore, theoretically, different viruses could have originated from nucleic acids of different but complementary nature. The nucleic acid of viruses is either single- or double-stranded. Viruses, as is generally accepted, derive from the nucleic acid of their host. Thus, RNA viruses could possibly have their origin in the RNA messenger.


Thorax


Infectious diseases


Snapshots of Life—Early Career Materials Scientists Managing in the Midst of a Pandemic


title: Conclusion and Afterword

text: The previous chapters contain a great deal of medical, socioeconomic, demographic, epidemiologic, racial, ethnic, educational, and cultural information pertaining particularly to the black population of the United States, but it is admittedly somewhat incomplete. There is so much more that might have been included, but space and time limitations preclude a more comprehensive coverage of everything that touches upon the healthcare scene involving black Americans. In this brief postscript, I would like to suggest to the reader to consider a few more important issues affecting black health.


title: Outstanding Black Physicians and Other Health Professionals in American History

text: An attempt to create a list of the best or most important or most accomplished people in any field will be met with questions about why certain individuals were excluded or, indeed, why some were even included. No list of this type will ever satisfy everyone. However, the thought about who the best physicians are and were is often raised, and it certainly is pertinent in a book on blacks in medicine. We sometimes refer to standout physicians in terms of their demonstrated ability to overcome adversity while accomplishing enormous gains in their careers, against all odds in many cases. Many are called visionaries. What metrics should we use? Often the term “great” is used to describe an individual physician’s attributes. However, if greatness can be defined as extraordinary competence sustained over time, many of those who had only a relatively brief opportunity to demonstrate their expertise would not make the list, although their singular accomplishment may have been groundbreaking. So perhaps a broader criterion should be used, one that does not require a long-term application of medical prowess. I would like to suggest what that overarching criterion should be: it is the unequivocal impact that an individual physician has had in saving and rescuing the lives and health of African American and other minority, vulnerable, needy, and impoverished people, and contributing in a measurable manner to their health and well-being, either by involvement as a medical practitioner, researcher, educator, or academic standout or through leadership and activism as a champion for social justice.


A Is for Amyloid


title: Long-Lasting Solutions to the Problem of Migration in Europe

text: This is the following of a previous publication on the refugee crisis in Europe and its security challenges. Here we suggest some long-lasting solutions to the problem of migration. These may be summarize in four points: dealing with the countries of origin and of transit, adequate control of borders, and positive measures to facilitate the integration of the newcomers in their countries of destination.


China’s Blacklist System under the Covid-19 Precautionary Lockdown Regime


Education in and After Covid-19: Immediate Responses and Long-Term Visions


title: Zur ätiologischen Bedeutung von Campylobacter fetus subsp. jejuni und Parvovirus für akute Enteritiden des Hundes

text: Zusammenfassung Insgesamt 179 Kot‐ und Darminhaltsproben von Hunden wurden vergleichend bakteriologisch und virologisch untersucht. Aus 108 Proben von Hunden (Einzeltiere) mit schweren Enteritiden gelang 22mal die Isolierung von C. f. subsp. jejuni und 46mal der Parvovirusnachweis. In 13 Fällen lagen beide Erreger gemeinsam vor. Bei 54 Kontrollproben gesunder Hunde konnte C. f. subsp. jejuni in 1 Fall und Parvovirus in 4 Fällen isoliert werden. 15 von 17 Hunden einer Versuchstierzucht, in der akute Gastroenteritiden aufgetreten waren, erwiesen sich ebenfalls als Träger von Campylobacter‐Keimen. Hier gelang der Parvovirusnachweis in 4 Fällen, davon 3mal gemeinsam mit C. f. subsp. jejuni. Die Ergebnisse lassen den Schluß zu, daß sowohl C. f. subsp. jejuni als auch Parvovirus eine eigenständige ätiologische Rolle bei akuten Gastroenteritiden des Hundes spielen. Der auffallend gehäufte gleichzeitige Nachweis beider Erreger bei schwer erkrankten Tieren spricht darüber hinaus für ein synergistisches Zusammenwirken. SUMMARY: Aetiological significance of Campylobacter fetus subsp. jejuni and Parvovirus for acute enteritis in dogs A total of 179 faecal and gut contents samples from dogs (individual animals) were compared by bacteriological and virological examination. From 108 samples from dogs with severe enteritis C. f. subsp. jejuni was isolated 22 times and Parvovirus 46 times. In 13 samples both agents were found. With 54 control samples from healthy dogs C. f. subsp. jejuni was isolated in one case and Parvovirus in four. 15 of 17 dogs in a breeding kennels where acute gastroenteritis had occurred were found to be carriers of Campylobacter. Here the isolation of parvovirus succeeded in 4 cases, in three of which C. f. subsp. jejuni was also isolated. The results lead to the conclusion that both C. f. subsp. jejuni and Parvovirus play an aetiological role in acute canine gastroenteritis. The frequent simultaneous isolation of both agents in severely sick animals also suggests a synergistic effect. RÉSUMÉ: A propos de la signification étiologique de Campylobacter fetus subsp. jejuni et Parvovirus dans des entérites aiguës du chien 179 échantillons de matières fécales et de contenu intestinal ont été examinés en comparaison bactériologiquement et virologiquement. Sur 108 échantillons provenant de chiens atteints d'une grave entérite, il a été possible d'isoler C. F. ssp. jejuni 22 fois et de mettre en évidence un Parvovirus 46 fois. On a rencontré les deux agents dans 13 cas. C. f. ssp. jejuni a été isolé dans 1 cas et Parvovirus dans 4 cas avec 54 échantillons de contrôle de chiens en bonne sante. 15 chiens sur 17 d'un élevage d'expérience ayant présenté une atteinte de gastroentérite aiguë se sont révélés être porteurs de Campylobacter. La mise en évidence dans ce cas de Parvovirus a été possible dans 4 cas, dont 3 avec C. f. ssp. jejuni. Les résultats permettent de conclure qu'aussi bien D. v. ssp. jejuni que Parvovirus jouent un rôle étiologique indépendant lors de gastroentérites aiguës du chien. La mise en évidence fréquente et frappante des deux germes chez des animaux gravement malades parle pour une action commune synergique. RESUMEN: Sobre la significación etiológica de Campylobacter fetus subsp. jejuni y del Parvovirus para las enteritis agudas del perro Se examinó de forma comparada bacteriológica y virológicamente un total de 179 muestras de estiércol y contenido intestinal de perros. De 108 muestras de perros (animales individuales) con enteritis graves se logró aislar 22 veces Campylobacter fetus subsp. jejuni y 46 veces la identificación del Parvovirus. En 13 casos se hallaban juntos ambos agentes etiológicos. Entre 54 muestras de control de perros sanos pudo aislarse C. f. ssp. jejuni en 1 caso y Parvovirus en 4 ocasiones. 15 de 17 perros de una explotación zootécnica experimental, en la cual habían aparecido gastroenteritis agudas, también resultaron ser portadoras de gérmenes Campylobacter. Aquí se logró identificar el Parvovirus en 4 casos, 3 de ellos junto con C. f. ssp. jejuni. Los resultados obtenidos admiten el que se saque en conclusion que tanto C. J. ssp. jejuni como Parvovirus juegan un papel etiológico independiente en las gastroenteritis agudas del perro. La puesta en evidencia simultánea, sorprendentemente tan acumulada, de ambos agentes etiológicos en los animales enfermos de gravedad aboga, además de esto, a favor de un concurso sinergístico.


title: Nachweis enteropathogener Escherichia coli‐Stämme und Rotaviren in Kotproben von Kälbern mit Diarrhoe

text: ZUSAMMENFASSUNG: Kotproben von 100 neugeborenen Kälbern mit Diarrhoen unterschiedlicher Dauer enthielten ausnahmslos E. coli‐Bakterien. Bei 40 Kotproben wurden gleichzeitig Rotaviren nachgewiesen. Die isolierten E. coli‐Stämme wurden im Darmligaturtest beim Ferkel auf Enterotoxinbildung sowie mit Hilfe der Objektträgerschnellagglutination bzw. dem Hämagglutinationstest auf O‐ und K (Fimbrien)‐Antigene untersucht. 54 E. coli‐Stämme bildeten regelmäßig Enterotoxin, von diesen 54 Stämmen wiesen 37 das K 99‐Antigen auf, 42 Stämme zeigten eine mannose‐resistente Hämagglutination von Pferdeerythrozyten. Bei den 54 Tieren, bei denen enterotoxinbildende E. coli nachweisbar waren, betrug der Anteil der Rotavirus‐positiven Proben 43% (23 Tiere). Von 63 K 99‐negativen Stämmen bildeten 17 regelmäßig und 36 unregelmäßig Enterotoxin, 5 Stämme zeigten eine mannose‐resistente Hämagglutination. Hier wiesen 25 Proben Rotaviren auf (40%). Die 0‐Gruppe 106 dominierte bei den enteropathogenen E. coli‐Stämmen. SUMMARY: Demonstration of enteropathogenic Escherichia coli‐strains and rotaviruses in faecal samples from calves with diarrhoea Faecal samples collected from 100 neonatal calves with diarrhoea of variable duration all contained E. coli bacteria. Rotaviruses were demonstrated in 40 samples at the same time. The isolated E. coli strains were tested for their ability to produce enterotoxin by using the intestinal ligature test, and for the presence of O and K (pili) antigens by employing slide agglutination and haemagglutination techniques. 54 E. coli strains regularly produced enterotoxin, 37 of these 54 strains contained K 99 antigens, 42 strains showed a mannose‐resistent haemagglutination of horse red blood cells. The number of rotavirus‐positive samples in the enterotoxin‐producing group was 23 (43%); of the 63 K 99‐negative strains, 17 produced enterotoxin regularly and 36 produced it irregularly, 5 strains showed a mannose‐resistent haemagglutination. 25 samples were positive for rotavirus (40%). 0 group 106 dominated within the enteropathogenic E. coli strains. RÉSUMÉ: Mise en évidence de souches entéropathogènes d'E. coli et de Rotavirus dans des matières fècales de veaux atteints de diarrhée Les échantillons de matières fécales de 100 veaux nouveau‐nés atteints de diarrhée de durée variable contenaient sans exception des bactéries E. coli. Des Rotavirus ont été mis en évidence simultanément dans 40 échantillons de fèces. Les souches isolées de E. coli ont été examinées du point de vue de la formation d'entérotoxine dans le test de ligature de l'intestin chez le porcelet et pour la recherche des antigènes O et K (pili) au moyen de l'agglutination rapide sur lame et du test d'hémagglutination. 54 souches d'E. coli ont régulièrement produit une entérotoxine; 37 de ces 54 souches possédaient l'antigène K 99 et 42 souches présentèrent une hémagglutination mannose‐résistante des globules rouges de cheval. Sur les 54 animaux chez lesquels un E. coli formant une toxine fut mis en évidence 43% des échantillons de matières fécales furent Rotavirus‐positifs (23 animaux). Sur les 63 souches K 99 négatives, 17 formèret régulièrement une entérotoxine et 36 irrégulièrement, 5 souches montrant une hémagglutination mannose‐résistante. 25 échantillons présentèrent dans ce cas du Rotavirus (40%). Le groupe O/106 a dominé dans les souches entéropathogènes d'E. coli. RESUMEN: Identificación de estirpes enteropatógenas de Escherichia coli y de Rotavirus en las materias fecales de terneros con diarrea Las muestras de materias fecales de 100 terneros recién nacidos con diarrea contenían sin excepción bacterias E. coli. El Rotavirus se puso en evidencia simultáneamente en 40 muestras de heces. Las cepas aisladas de E. coli se examinaron bajo el punto de vista de la formación de enterotoxina en la prueba de ligadura del intestino en el lechón y mediante la pesquisa de antígenos O y K (fimbriales) con ayuda de la aglutinación rápida sobre portaobjetos resp. la prueba de hemoaglutinación. 54 estirpes de E. coli formaban regularmente enterotoxina; 37 de estas 54 estirpes poseían el antígeno K 99 y 42 cepas presentaban una hemoaglutinación manosarresistente de los glóbulos rojos de caballo. En los 54 animales, en los que se identificó E. coli enterotoxinógena, el 43% de las muestras eran Rotavirus‐positivas (23 animales). De las 63 cepas K 99‐negativas formaban 17 regularmente y 36 irregularmente enterotoxina, 5 estirpes mostraban una hemoaglutinación manosarresistente. En este caso mostraban 25 muestras Rotavirus (40%). El grupo 0/106 dominaba en las estirpes E. coli enteropatógenas.


Editor’s Note: Empirical Software Engineering and COVID-19 research


How the COVID Pandemic May Change the World of Retailing


El error de no planificar las emergencias en salud pública


Being critical about intellectual capital accounting in 2020: An overview


MANIFESTACIONES CUTANEAS DE LA INFECCION POR COVID 19. A PROPOSITO DE UN CASO


title: Antiviral Activity of Chitosan Nanoparticles Encapsulating Curcumin Against Hepatitis C Virus Genotype 4a in Human Hepatoma Cell Lines

text: PURPOSE: Current direct-acting antiviral agents for treatment of hepatitis C virus genotype 4a (HCV-4a) have been reported to cause adverse effects, and therefore less toxic antivirals are needed. This study investigated the role of curcumin chitosan (CuCs) nanocomposite as a potential anti-HCV-4a agent in human hepatoma cells Huh7. METHODS: Docking of curcumin and CuCs nanocomposite and binding energy calculations were carried out. Chitosan nanoparticles (CsNPs) and CuCs nanocomposite were prepared with an ionic gelation method and characterized with TEM, zeta size and potential, and HPLC to calculate encapsulation efficiency. Cytotoxicity studies were performed on Huh7 cells using MTT assay and confirmed with cellular and molecular assays. Anti-HCV-4a activity was determined using real-time PCR and Western blot. RESULTS: The strength of binding interactions between protein ligand complexes gave scores with NS3 protease, NS5A polymerase, and NS5B polymerase of -124.91, -159.02, and -129.16, for curcumin respectively, and -68.51, -54.52, and -157.63 for CuCs nanocomposite, respectively. CuCs nanocomposite was prepared at sizes 29–39.5 nm and charges of 33 mV. HPLC detected 4% of curcumin encapsulated into CsNPs. IC50 was 8 µg/mL for curcumin and 25 µg/mL for the nanocomposite on Huh7 but was 25.8 µg/mL and 34 µg/mL on WISH cells. CsNPs had no cytotoxic effect on tested cell lines. Apoptotic genes’ expression revealed the caspase-dependent pathway mechanism. CsNPs and CuCs nanocomposite demonstrated 100% inhibition of viral entry and replication, which was confirmed with HCV core protein expression. CONCLUSION: CuCs nanocomposite inhibited HCV-4a entry and replication compared to curcumin alone, suggesting its potential role as an effective therapeutic agent.


title: Continuity of Constitutional Government during a Pandemic: Considering the Concept in Canada's Emergency Management Act

text: This research note examines the undefined meaning of the government's obligations to ensure “continuity of constitutional government” (CCG) as provided for in section 4(l) of the Emergency Management Act, S.C. 2007, c. 15 (Canada, 2007). Specifically, that section gives the minister of public safety and emergency preparedness the responsibility for “establishing the necessary arrangements for the continuity of constitutional government in the event of an emergency,” but the term is itself undefined. The article will canvass the origin of the term and its relationship to other so-called continuity of government (COG) concepts, along with some legal written opinion on what the term might in practice mean, should the minister ever be charged with discharging this responsibility. It will conclude with some final thoughts on the relevance of the CCG concept to the current pandemic. Given that the COVID-19 virus has infected Sophie Grégoire Trudeau, the prime minister's wife, forced a drastically reduced and possibly “virtual” federal Parliament, placed the British prime minister in intensive care and led to the self-isolation of many world leaders, the topic is relevant to Canada in 2020.


title: Context

text: This chapter gives an overview of the paradoxical dynamic that shapes the World; with on the one hand an ever-wider inequality gap; over-exploitation of natural resources and climate change; and on the other hand, a growing understanding of the possibilities and promise of the future connection, collaboration, and complementarity between people and countries—both propelled by the combination of science, wealth, and technology. This chapter points out some of the reasons for the insufficient progress made by traditional approaches to development and humanitarian aid. It offers arguments why nonprofit institutions whose justification is to help, must begin by helping their staff to help themselves. Organizations with an inspiring social mission must practice internally what they preach externally. Whether these organizations live up to the inspirational potential that goes with their mandate, is conditioned by their ability to place the aspiration for meaning at the center of their action, internally and externally.


title: Conclusion: The Next Decade and Beyond

text: Hydrocarbon wealth in the Eastern Mediterranean can become a reality or remain a dream, depending on how far regional energy cooperation can be promoted. We believe reserves discovered so far, and future ones yet to be discovered, may enrich the people of the region, if political leaders opt for rational choices and adapt to the reality of a rapidly emerging world of zero emission cars and cleaner environment while cooperating with neighbours as outlined in our Regional Energy Model.


title: Justification of the Proposed Paradigm Shift

text: This chapter goes into the benefits of the proposed perspective and approach. Arguments from various disciplines are offered to show the impact of a holistic perspective, for the individual, the community he/she lives in, and wider Society. A summary of evidence is drawn from the perspective of psychology and mental health, from biology, personal leadership and self-development, from evolutionary theories, from sociological argumentation, and from an economic viewpoint.


title: Introduction: A Roadmap

text: This chapter is the introduction which offers a roadmap to the structure and the content outline of the book. It lays out to the reader how the different chapters of the book succeed each other and build onto each other.


Gastroenteritis Viruses: Edited by D. Chadwick and J. Goode, Wiley, Chichester, United Kingdom, 2001, 323 pp., $125.00, ISBN 0-471-49663-4


IUPAC-IUBMB joint commission on biochemical nomenclature (JCBN) and nomenclature committee of IUBMB (NC-IUBMB): Newsletter 1996


What being a BDA member means for you


UK dental schools to provide alternative solution for students taking final exams


ERA-EDTA sharing Milan experience on coronavirus management in dialysis centres


IBD in the Time of COVID19


Corona: „Starke Vorliebe für die Niere“


title: AU noch bis 4. Mai am Telefon — und dann?: Praxisorganisation

text: Chaos beim Gemeinsamen Bundesausschuss (G-BA), Verunsicherung bei den Ärzten: Erst hieß es, dass ab 20. April für jede Bescheinigung der Arbeitsunfähigkeit (AU) wieder eine körperliche Untersuchung nötig sei. Nach einem Proteststurm wurde die Vorgabe binnen eines Tages wieder gekippt. Was gilt denn nun?


title: Wie das Coronavirus den Magen-Darm-Trakt angreift: Seminar / Gastromodul

text: Eine SARS-CoV-2-Infektion verursacht in bis zu 20% der Fälle nur gastroenterologische Symptome wie Diarrhö, Bauchschmerzen, Übelkeit oder Appetitlosigkeit. Auch konnte gezeigt werden, dass die Viren mit dem Stuhl ausgeschieden werden. Das Coronavirus ist zudem ein neuer Faktor in der Behandlung chronisch entzündlicher Darmerkrankungen (CED) — und bei Endoskopien.


„Anwendung von Antikörper-Schnelltests ist Körperverletzung“: SARS-CoV-2-Diagnostik -- Interviewpartner: Dr. Matthias Orth


title: Zu Joggern 10 Meter Abstand einhalten!: COVID-19 und Sport

text: Wanderer, Läufer und Radfahrer sollten deutlich mehr als zwei Meter Abstand halten und den Windschatten anderer meiden, um sich vor einer Infektion zu schützen.


Häufige Infekte: Krebsrisiko erhöht!


title: Immunity to Infection

text: This chapter describes immune responses to the six major types of pathogens: extracellular bacteria, intracellular bacteria, viruses, parasites, fungi and prions. Innate immunity mediated by neutrophils, NK cells, NKT cells, γδ T cells, complement and microbicidal molecules prevents infection or slows it until adaptive immunity can also respond to the pathogen. Extracellular entities are coated in antibody and cleared by antibody- and complement-mediated mechanisms. Parasitic worms are prevented from anchoring in the host by IgA and IgE antibodies. IgE triggers mast cell, basophil and eosinophil degranulation and the release of toxic mediators. Intracellular bacteria and parasites as well as viruses are eliminated by CTLs, NK cells, NKT cells and γδ T cells secreting cytotoxic cytokines and/or carrying out target cell cytolysis. Macrophage hyperactivation and granuloma formation may be triggered to confine persistent invaders. Th1 and Th17 responses support cell-mediated immunity against internal threats, whereas Th2 responses support humoral immunity against external threats. Each type of pathogen has evolved to evade immune responses by avoiding recognition or inactivating various leukocyte effector mechanisms.


"Rettungsschirm ist für das Gesamtsystem wichtig"


Versicherungsschutz bei Praxisschließung


Seminar- Highlights im Juni/Juli


Sommersemester 2020, Zahnmedizin im Fernstudium?


Beratungsforum "Corona-Hygiene- Pauschale" beschlossen


ZahnMEDIZIN in Zeiten von Corona


Wenn Aktien in den Keller rauschen


title: Drawing Symbolism and Leadership

text: This chapter offers a number of comic creation exercises, specifically in regard to symbolism and leadership. Students utilize the features of the comic’s medium, such as panel size and sequencing, as well as symbolism, to convey ideas related to citizenship and leadership.


title: Reading Comics for Citizenship

text: This chapter offers assignments which center on reading comics. These assignments are meant to help students read comics in light of ideas and concepts related to citizenship and the social studies.


title: Drawing Citizenship

text: This chapter offers a number of comic creation assignments. Creation is the highest level of Bloom’s revised taxonomy (Krathwohl, 2002). Students utilize the features of the comics medium, such as panel size and sequencing to name a few, to convey ideas related to citizenship in comic form.


title: Conclusion

text: This chapter tackles the questions of assessment, suitability and further reading. In this chapter, a number of criteria and rubrics are offered so teachers can assess and evaluate the activities in the previous chapters.


NVAB


Publisher Correction: Pandemic data challenges


title: Invited Review: Nutritional regulation of gut function in dairy calves: From colostrum to weaning

text: PURPOSE: Published literature regarding calf nutrition was reviewed to create an information base for the implementation of proper nutritional management to maximize health and productivity. SOURCES: The main source of data and information for this review was peer-reviewed literature. SYNTHESIS: Feeding a sufficient volume of colostrum during the first hours of life is crucial to calf health and survival; however, less is known about transition milk feeding and the potential benefits of the myriad of bioactive compounds it contains. After feeding colostrum and transition milk, calves are susceptible to diarrhea when moved onto high amounts of milk, and antibiotic use is often necessary to decrease disease. Feeding an elevated plane of milk nutrition results in increased ADG and, in some studies, increased future milk production. Thus, this nutritional strategy is recommended; however, weaning calves from high volumes of milk represents massive changes in the structure and microbiology of the gastrointestinal tract. CONCLUSIONS AND APPLICATIONS: Colostrum and transition milk contain an abundance of bioactive molecules that can positively affect gut development and microbiota. There is significant potential for the use of novel feeding strategies and microbial-based products as alternatives to antibiotics. Calves fed an elevated plane of nutrition in the first month of life have greater productivity and growth. However, weaning should take place later in life. Moreover, applying a proper step-down feeding protocol is recommended, as it allows calves to intake and digest sufficient solid feed for growth and minimize distress at weaning.


title: Epidemiology of community acquired pneumonia

text: Despite efforts in prevention worldwide including recent advances in vaccine therapy, childhood community acquired pneumonia (CAP) remains a major cause of morbidity and mortality both in the developed and the developing world. Traditionally, qualifying the aetiology of CAP proved to be fraught with challenges particularly due to low yields from blood and sputum specimens. In recent years however, new advances in techniques such as enzyme-linked immunosorbent assay and polymerase chain reaction have dramatically improved detection rates of both bacteria and viruses. In addition to qualifying the true burden of disease by known organisms such as Streptococcus pneumoniae it has led to the identification of organisms such as human bocavirus which have not previously been associated with CAP. This article aims to provide a brief update to the clinician on the current epidemiology of CAP in this post-vaccination era. It is based on a combination of recommendations from existing clinical practice guidelines, recent systematic reviews and the current literature.


title: Exacerbation of asthma and airway infection: is the virus the villain?()()

text: OBJECTIVE: To review the available literature on the association between acute viral respiratory tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses, detection methods, as well as preventive and therapeutic aspects. SOURCES: A search was conducted in PubMed, Lilacs, and SciELO databases, between the years 2002 and 2013, using the following descriptors: asthma exacerbation, virus, child, and acute respiratory infection. SUMMARY OF THE FINDINGS: A total of 42 original articles addressing the identification of respiratory viruses during episodes of asthma exacerbation were selected, mostly cross‐sectional studies. There was a wide variation in the methodology of the assessed studies, particularly in relation to the children's age and methods of collection and viral detection. The results indicate that, in up to 92.2% of exacerbations, a viral agent was potentially the main triggering factor, and human rhinovirus was the most frequently identified factor. The pattern of viral circulation may have been responsible for the seasonality of exacerbations. The association between viral infections and allergic inflammation appears to be crucial for the clinical and functional uncontrolled asthma, but few studies have evaluated other triggering factors in association with viral infection. CONCLUSIONS: Respiratory viruses are present in the majority of asthmatic children during episodes of exacerbation. The involved physiopathological mechanisms are yet to be fully established, and the synergism between allergic inflammation and viral infection appears to determine uncontrolled disease. The role of other triggering and protective agents is yet to be clearly determined.


Multiplex Molecular Testing in Clinical Microbiology and Infectious Disease


title: The prospect and development of incinerators for municipal solid waste treatment and characteristics of their pollutants in Taiwan

text: Taiwan is a small, densely populated island with unique experiences in the construction and operation of incinerators. In such a small area, Taiwan has built 22 incinerators over a short span of time, combusting large amount of municipal solid waste as much as 23,250 tons per day. This study focuses on the history of construction and development of incinerators in Taiwan as well as the characteristics of pollutants, such as heavy metals (Pb, Cd, and Hg), acid gases (NO(x), SO(x), CO, and HCl), and dioxins emitted from the incinerators. Furthermore, the study also covers the generation and composition of municipal solid waste (MSW), and the production of energy in Taiwan. According to Taiwan’s data on pollutant emissions, the emission level of pollutants is under control and meets the stringent regulations of Taiwan Environmental Protection Administration (TEPA). Researches have shown that using air pollution control devices (APCDs) in the operation of incinerators provides effective measures for air pollutant control in Taiwan. The main advantage of using incinerators is the generation of electricity (waste-to-energy) during the incineration of municipal solid waste, producing energy that can be consumed by the general public and the industry. Taiwan’s extensive experience in incinerator construction and operation may serve as an example for developing countries in devising waste treatment technology, energy recovery, and the control of contagious viral diseases.


title: GENERATION AND APPLICATION OF IMMUNOLOGICAL PROBES FOR THE STUDY OF MEMBRANE‐BOUND PROTEINS AND ENZYMES—A REVIEW

text: Immunological techniques are widely used for the detection of enzymes in food systems and for elucidating protein structure and function. The generation of anti‐bodies recognizing membrane‐bound proteins is difficult due to their hydrophobic nature, and reduced antigenicity. This review summarizes strategies for the production and purification of polyclonal antibodies recognizing membrane proteins. Applications such as enzyme immunoprecipitation, use of site‐specific anti‐peptide. antibodies for determination of the topology of membrane‐embedded proteins, immunocytochemistry, and expression vector cloning are described.


title: Equipment for Exotic Mammal and Reptile Diagnostics and Surgery

text: The practice of veterinary medicine is facilitated by appropriate equipment, and exotic pet medicine is no exception. Exotic practitioners use standard or modified veterinary and human equipment, and now even enjoy the benefit of specialized products manufactured specifically for exotic pet practice.


title: Congenital Peripheral Vestibular Syndrome in a Domestic Ferret (Mustela putorius furo)

text: A 3-month-old intact female ferret (Mustela putorius furo) was presented with a 2-month history of ataxia. On physical examination, the ferret had difficulty standing upright. During the neurologic examination, the patient had a left head tilt and positional strabismus, circled to the left, and was ataxic. Results of the complete blood count were consistent with a mild normocytic normochromic anemia. Initial treatment was supportive. Magnetic resonance imaging was performed and revealed an asymmetry of the inner ears. A brainstem auditory evoked response test was also performed. History, clinical signs, and diagnostic test results indicated that the ferret was suffering from congenital peripheral vestibular syndrome and left-sided deafness. Congenital disease should be considered in the differential diagnosis of young ferrets with peripheral vestibular syndrome. Supportive care and physiotherapy can improve balance and motor function, leading to an acceptable quality of life.


Synthèse N° 3 : Bronchites chroniques obstructives de l’enfant : un concept émergent


Infection virale sévère et surinfection bronchique chez une femme obèse


One for many


Planetary health research digest


Isolation and inclusion


Parental perinatal depression and offspring psychotic experiences


On ne meurt qu’une fois


Decarbonising economies is like denuclearising weaponry—essential for survival


A new vehicle to accelerate the UN Sustainable Development Goals


Scaling up tuberculosis preventive therapy for contacts in high transmission settings


Decolonising COVID-19


Adaptive anxiety


title: Engineering a Global Response to Infectious Diseases: This paper presents a more robust, adaptable, and scalable engineering infrastructure to improve the capability to respond to infectious diseases.Contributed Paper

text: Infectious diseases are a major cause of death and economic impact worldwide. A more robust, adaptable, and scalable infrastructure would improve the capability to respond to epidemics. Because engineers contribute to the design and implementation of infrastructure, there are opportunities for innovative solutions to infectious disease response within existing systems that have utility, and therefore resources, before a public health emergency. Examples of innovative leveraging of infrastructure, technologies to enhance existing disease management strategies, engineering approaches to accelerate the rate of discovery and application of scientific, clinical, and public health information, and ethical issues that need to be addressed for implementation are presented.


title: A Lightweight Social Computing Approach to Emergency Management Policy Selection

text: In order to select effective policies for emergency management in a timely manner, this paper proposes an agile and lightweight social computing approach to facilitating policy selection, evaluation, and adjustment relative to emergency management in both quantitative and qualitative ways. The approach consists of three components represented as PZE: 1) (P) emergency management policy selecting; 2) (Z) modeling artificial societies with the zombie-city model (a general and formal artificial society model); and 3) (E) policy evaluation. The formal specification of the zombie-city model and rigorous expressions of scenarios enable rigorous description and formal reasoning of an artificial society. A feedback loop of this approach supports the iterative adjustment of emergency management policies and the creation of more effective policies. This approach is verified by applying it to a case of an infectious disease transmission with quantitative evaluations, qualitative reasoning and analysis, and iterative adjustments. Results indicate effective emergency management policies can be established with the approach in an iterative way. In contrast with existing research, our proposed approach offers the benefits of being simple, general, rapidly adaptive to changes, and low cost.


Editorial PIAM April 2020


A Light in the Dark


title: Animal Disease Surveillance in the 21st Century: Applications and Robustness of Phylodynamic Methods in Recent U.S. Human-Like H3 Swine Influenza Outbreaks

text: Emerging and endemic animal viral diseases continue to impose substantial impacts on animal and human health. Most current and past molecular surveillance studies of animal diseases investigated spatio-temporal and evolutionary dynamics of the viruses in a disjointed analytical framework, ignoring many uncertainties and made joint conclusions from both analytical approaches. Phylodynamic methods offer a uniquely integrated platform capable of inferring complex epidemiological and evolutionary processes from the phylogeny of viruses in populations using a single Bayesian statistical framework. In this study, we reviewed and outlined basic concepts and aspects of phylodynamic methods and attempted to summarize essential components of the methodology in one analytical pipeline to facilitate the proper use of the methods by animal health researchers. Also, we challenged the robustness of the posterior evolutionary parameters, inferred by the commonly used phylodynamic models, using hemagglutinin (HA) and polymerase basic 2 (PB2) segments of the currently circulating human-like H3 swine influenza (SI) viruses isolated in the United States and multiple priors. Subsequently, we compared similarities and differences between the posterior parameters inferred from sequence data using multiple phylodynamic models. Our suggested phylodynamic approach attempts to reduce the impact of its inherent limitations to offer less biased and biologically plausible inferences about the pathogen evolutionary characteristics to properly guide intervention activities. We also pinpointed requirements and challenges for integrating phylodynamic methods in routine animal disease surveillance activities.


A planetary health perspective on COVID-19: a call for papers


Informationen der SAMM


Access Denied: Academic Life Under Lockdown


Emergency Care


Cardiovascular System and Lymphatic Vessels


Afterthoughts


The charisma machine: The life, death, and legacy of one laptop per child: Morgan G. Ames. 2019. The MIT Press, Cambridge, MA. 328 pp. Infrastructures series. ISBN 978-0-262-53744-5 (pbk)


American Association of Neuropathologists, Inc.: Abstracts of the 85(th) Annual Meeting June 11-14, 2009 San Antonio, Texas


Patient guide - COVID 19


COVID-19 and the Rationale for Pharmacotherapy: A South African Perspective


Coronavirus Disease 2019 (COVID-19) Resources


title: Potential Impact of SARS-CoV-2 Infection in HIV-positive Patients in South Africa

text: Coronaviruses are important causes of infection in both humans and animals. While in the past they were considered to be relatively harmless respiratory pathogens, outbreaks of infection with severe acute respiratory syndrome (SARS), Middle East respiratory syndrome, and currently SARS-CoV-2, have confirmed how serious these pathogens can be in respiratory tract infections. Certain conditions and underlying comorbidities are known to be risk factors for SARS-CoV-2 infection, and for associated severe disease, including older age, underlying chronic cardiovascular and respiratory conditions and diabetes mellitus. There are a number of additional conditions and comorbidities that are suspected as being important risk factors, but for which hard evidence is currently lacking. This includes underlying human immunodeficiency virus infection, which represents the major focus of this current survey of the scientific literature.


Should ACE Inhibitors and Angiotensin Receptor Blockers Be Withdrawn in the Current Setting of COVID-19 Infection?


Clinical Ethical Challenges in the Covid-19 Crisis in South Africa


Social Dimensions of COVID-19 in South Africa: A Neglected Element of the Treatment Plan


title: COVID-19 Preparedness in a Neonatal Unit at a Tertiary Hospital in Johannesburg, South Africa

text: Background: The novel coronavirus disease 2019 (COVID-19) pandemic has spread to South Africa and poses an infection risk in pregnant women and their newborns, as well as health-care workers and other patients. Objective: To discuss the implementation of international and local recommendations, and any additional actions undertaken at our Neonatal Unit in order to prepare for COVID-19. Discussion: Standard precautions in order to prepare a facility and its personnel to safely care for COVID-19 patients as outlined by the World Health Organization procedures have been implemented. Further actions undertaken in our Neonatal Unit included the creation of standard operating procedures, increased communication between neonatal and obstetric teams, limiting staff exposure, the creation of disposable resuscitation boxes to attend deliveries, reallocation of a triage area in the high care ward to an isolation area for sick newborns of suspected or confirmed maternal COVID-19 cases, staff training on personal protective equipment procedures and initiation of an online resources portal for neonatal staff. Conclusion: A rational approach to suspected cases and infection control in-line with local and international guidelines as well as ongoing education should diminish anxiety amongst health-care professionals and provide the best possible care to patients. South Africa is a low-to-middle income country, and the lack of resources available means we cannot increase our capacity, staffing numbers or available equipment. Yet, we must be as prepared, adaptable and efficient as possible to maximize the resources and equipment we have available to us.


title: Diagnosis of COVID-19: Considerations, Controversies and Challenges in South Africa

text: Coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 is a global pandemic that has resulted in over 1.5 million confirmed cases and close to 100,000 deaths. In the majority of symptomatic cases COVID-19 results in a mild disease predominantly characterised by upper respiratory tract symptoms. Reverse transcription polymerase chain reaction (RT-PCR), using a nasopharyngeal sample, is the mainstay of diagnosis, but there is an ~30% false negative rate early in the disease and in patients with mild disease. RT-PCR positivity can persist for several days after a resolution of symptoms. IgM and IgG antibody responses become positive several days after the onset of symptoms, and robust antibody responses are detectable in the second week of illness. Antibody-based immunoassays have a limited role in the diagnosis of early symptomatic disease. However, their incremental benefit over RT-PCR in the first 2 weeks of illness is currently being clarified in ongoing studies. Such assays may be useful for surveillance purposes. However, their role in potentially selecting individuals that may benefit from vaccination, or as a biomarker identifying persons that could be redeployed into essential employment roles are being investigated. Rapid antibody-based immunoassays that detect viral antigen in nasopharyngeal samples are being developed and evaluated.


COVID-19: The Concept of Herd Immunity – Is It A Strategy for South Africa?


title: Clinical Impact of Community‐Acquired Respiratory Viruses on Bronchiolitis Obliterans After Lung Transplant

text: Community‐acquired viral respiratory tract infections (RTI) in lung transplant recipients may have a high rate of progression to pneumonia and can be a trigger for immunologically mediated detrimental effects on lung function. A cohort of 100 patients was enrolled from 2001 to 2003 in which 50 patients had clinically diagnosed viral RTI and 50 were asymptomatic. All patients had nasopharyngeal and throat swabs taken for respiratory virus antigen detection, culture and RT‐PCR. All patients had pulmonary function tests at regular intervals for 12 months. Rates of rejection, decline in forced expiratory volume (L) in 1 s (FEV‐1) and bacterial and fungal superinfection were compared at the 3‐month primary endpoint. In the 50 patients with RTI, a microbial etiology was identified in 33 of 50 (66%) and included rhinovirus (9), coronavirus (8), RSV (6), influenza A (5), parainfluenza (4) and human metapneumovirus (1). During the 3‐month primary endpoint, 8 of 50 (16%) RTI patients had acute rejection versus 0 of 50 non‐RTI patients (p = 0.006). The number of patients experiencing a 20% or more decline in FEV‐1 by 3 months was 9 of 50 (18%) RTI versus 0 of 50 non‐RTI (0%) (p = 0.003). In six of these nine patients, the decline in FEV‐1 was sustained over a 1‐year period consistent with bronchiolitis obliterans syndrome (BOS). Community‐acquired respiratory viruses may be associated with the development of acute rejection and BOS.


title: Inhibitory effects of epigallocatechin gallate on the propagation of bovine coronavirus in Madin‐Darby bovine kidney cells

text: Epigallocatechin gallate (EGCg) is the main active component of tea polyphenol and shows several biological activities, such as antimicrobial, antitumor‐promoting, anti‐inflammatory and anti‐oxidative activities. In the present study, the inhibitory effect of EGCg on bovine coronavirus (BCV) propagation in Madin‐Darby bovine kidney (MDBK) cells was investigated. EGCg at concentrations of less than 10 µg/mL did not show any cytotoxicity to MDBK cells. BCV propagation was significantly inhibited by pretreatment of the virus with EGCg (0.5–10 µg/mL) before virus inoculation in dose‐dependent, incubation time‐dependent and temperature‐dependent manners. The antiviral effect of pretreating MDBK cells with EGCg on BCV propagation was much weaker than that of pretreating BCV with EGCg. The hemagglutination activity of BCV was also reduced by EGCg in a dose‐dependent manner. These results demonstrate that EGCg possesses a distinct anti‐BCV activity and strongly suggest that EGCg interferes with the adsorption of BCV to MDBK cells by the interaction of EGCg with BCV particles. EGCg may therefore be a useful candidate for controlling BCV infection more effectively.


title: Robustness of solvent/detergent treatment of plasma derivatives: a data collection from Plasma Protein Therapeutics Association member companies

text: BACKGROUND: Solvent/detergent (S/D) treatment is an established virus inactivation technology that has been applied in the manufacture of medicinal products derived from human plasma for more than 20 years. Data on the inactivation of enveloped viruses by S/D treatment collected from seven Plasma Protein Therapeutics Association member companies demonstrate the robustness, reliability, and efficacy of this virus inactivation method. STUDY DESIGN AND METHODS: The results from 308 studies reflecting production conditions as well as technical variables significantly beyond the product release specification were evaluated for virus inactivation, comprising different combinations of solvent and detergent (tri(n‐butyl) phosphate [TNBP]/Tween 80, TNBP/Triton X‐100, TNBP/Na‐cholate) and different products (Factor [F]VIII, F IX, and intravenous and intramuscular immunoglobulins). RESULTS: Neither product class, process temperature, protein concentration, nor pH value has a significant impact on virus inactivation. A variable that did appear to be critical was the concentration of solvent and detergent. CONCLUSION: The data presented here demonstrate the robustness of virus inactivation by S/D treatment for a broad spectrum of enveloped test viruses and process variables. Our data substantiate the fact that no transmission of viruses such as human immunodeficiency virus, hepatitis B virus, hepatitis C virus, or of other enveloped viruses was reported for licensed plasma derivatives since the introduction of S/D treatment.


title: Effect of Experimental Genital Mycoplasmosis on Production of Matrix Metalloproteinases in Membranes and Amniotic Fluid of Sprague–Dawley Rats

text: PROBLEM: Preterm, premature rupture of membranes (PPROM) is a dire pregnancy outcome that is frequently associated with infection by the genital mycoplasmas, Mycoplasma hominis, Ureaplasma parvum, and U. urealyticum. One potential mechanism by which these microorganisms may cause PPROM is by increasing the concentration of matrix metalloproteinases (MMPs) in the membranes and amniotic fluid. We tested this hypothesis in a well‐defined model system of genital infection with M. pulmonis, a natural reproductive pathogen of rats. METHOD OF STUDY: Timed‐pregnant, specific pathogen‐free, Sprague–Dawley rats were infected with 10(7) CFU M. pulmonis at gestation day (gd) 14. Controls received an equivalent volume (100 μL) of sterile medium. At gd 18, rats were euthanized, and membranes and amniotic fluids were harvested and stored at −70°C until analysis. Proteinase activity of amniotic fluid and membranes was resolved on discontinuous 7.5% sodium dodecyl sulfate–polyacrylamide gel electrophoresis gelatin zymography gels. Band intensity was determined using a digital gel documentation system and the manufacturer's software (Kodak). RESULTS: Gelatinolytic activity associated with a band similar in molecular weight to ProMMP‐9 (92 kDa, the inactive precursor of MMP‐9) was significantly increased in amniotic fluids and membranes harvested from M. pulmonis‐treated pups at gd 18 when compared with tissues harvested from control pups. Both ProMMP‐9 and ProMMP‐2 (72 kDa, the inactive precursor of MMP‐2) were increased in infected animals at gd 21. CONCLUSION: Our study suggests that the genital mycoplasmas can increase MMP‐9 production in vivo.


Case Study: A Patient with Asthma, Covid-19 Pneumonia and Cytokine Release Syndrome Treated with Corticosteroids and Tocilizumab


title: Strengthening the Early-Warning Function of the Surveillance System: The Macedonian Experience

text: Epidemics and pandemics can place sudden and intense demands on health systems. The world requires a global system that can identify and contain public health emergencies rapidly and reduce panic and disruption of trade, travel, and society in general. Strengthening public health preparedness requires establishing an integrated global alert and response system for epidemics and other public health emergencies along the lines of the World Health Organization’s International Health Regulations. The revised International Health Regulations provide a global framework to address these needs through a collective approach to the prevention, detection, and timely response to any public health emergency of international concern. A standardized approach for readiness and response to major epidemic-prone diseases should be developed. An early-warning and rapid-alert system is one of the possibilities to improve readiness at the local, regional, national, and international level to limit the spread of disease and to reduce health, economic, and social damage. The Republic of Macedonia, with World Health Organization support, has implemented an earlywarning system (ALERT) for priority communicable diseases to complement the routine surveillance system that reports individual confirmed cases. ALERT relies on reporting of eight syndromes by primary care facilities. Data are analyzed weekly at the regional level and transmitted to national epidemiologists. It is perceived to be a simple and flexible tool for detecting and triggering timely investigation and control of outbreaks. ALERT was identified as a useful instrument for forecasting and detecting the start of the influenza season.


title: Governance of Occupational Safety and Health and Environmental Risks

text: Occupational safety and health (OSH) activities were started in the industrialized countries already 150 years ago. Separated and specific actions were directed at accident prevention, and the diagnosis, treatment and prevention of occupational diseases. As industrialization has advanced, the complexity of safety and health problems and challenges has substantially grown, calling for more comprehensive approaches. Such development has expanded the scope, as well as blurred the borders between specific activities. In the modern world of work, occupational safety and health are part of a complex system that involves innumerable interdependencies and interactions. These are, for instance, safety, health, well-being, aspects of the occupational and general environment, corporate policies and social responsibility, community policies and services, community social environment, workers’ families, their civil life, lifestyles and social networks, cultural and religious environments, and political and media environments.


title: Infectieziekten

text: Infectieziekten zijn ziekten veroorzaakt door levende micro-organismen. Infectieziekten zijn verantwoordelijk voor meer dan een kwart van alle sterfgevallen wereldwijd. Dit aantal kan toenemen door een vergrijzende bevolking, toenemend gebruik van immunosuppressiva, antibioticaresistentie en nieuwe epidemieën zoals meest recent ebola. Resistentie tegen antimicrobiële middelen is een probleem bij middelen gebruikt in de behandeling van hiv, tuberculose en malaria, en in toenememde mate is er ook sprake van multiresistente grampositieve en gramnegatieve bacteriën die een simpele urineweginfectie of ernstige sepsis veroorzaken. In dit hoofdstuk worden de belangrijkste infectieziekten besproken aan de hand van klinische problemen: koorts, sepsis, meningitis en encefalitis, infectieuze gastro-enteritis, infectieziekten met exanthemen, infecties gepaard gaand met lymfeklierzwelling, infecties met geelzucht, opportunistische infecties, ziekenhuisinfecties, bioterrorisme, protozoaire ziekten, worminfecties en tot slot importziekten. Ook wordt een overzicht gegeven van de belangrijkste antibiotica en antivirale middelen. ELEKTRONISCH AANVULLEND MATERIAAL: De online versie van dit hoofdstuk (doi:10.1007/978-90-368-1841-4_6) bevat aanvullend materiaal, dat beschikbaar is voor geautoriseerde gebruikers.


title: Complexity Sciences

text: Complexity sciences, in plain English, are the sciences of interconnectedness. Basically, a system consists of a number of parts that are connected to each other. Systems differ depending on the nature of their connectedness. Simple systems have one-to-one relationships and their behaviour is precisely predictable. Complicated systems have one-to-many relationships with mostly predictable behaviours. This book deals with complex adaptive systems with many-to-many relationships. Their many-to-many relationships make their behaviour emergent, hence their outcomes are unpredictable. Complex adaptive systems have a special characteristic, the members of the system can learn from feedback and experiences. The relationships in complex adaptive systems change constantly allowing the system to evolve over time in light of changing demands. However, a system’s overall behaviour, despite its adaptation to changing circumstances, remains relatively stable within boundaries, but occasionally, its behaviour may change abruptly and dramatically for no apparent reason. Another important characteristic of complex adaptive systems is its nonlinear behaviour to change, i.e. the magnitude of change in one member of the system shows a disproportional change in that of others. As experience shows, small changes in the behaviour of a system member often show dramatic changes in the behaviour of the whole system, whereas a major change in the behaviour of that member typically results in little or no change. Studying complex adaptive systems aims to understand the relationships and the dynamics between the members of the systems. This understanding allows for better responses when the system as a whole is challenged by constraints and/or unfamiliar challenges. A special characteristic of social systems is their “goal-delivering” nature. In organisational terms these are codified by their purpose, goals, and values statements.


title: A Fast and Sensitive Integrated Young Interferometer Biosensor

text: We have developed an ultrasensitive biosensor based on an integrated optical Young interferometer. Key features of this sensor are that it is very compact, extremely sensitive, label free, and very fast. Therefore the Young interferometer has significant potential to be developed into a handheld, point-of-care device. In this chapter we review the progress that has been made on the development of integrated Young interferometer sensors. The sensor developed in our lab is discussed in detail. We demonstrate various applications of the current sensor. Special attention is paid to the detection of viruses. Finally a discussion on future prospects of this sensor for diagnostics is given.


title: Outbreak Investigations

text: The aim of outbreak epidemiology is to study an epidemic in order to gain control over it and to prevent further spread of the disease. Generally outbreak means a “sudden occurrence,” while in the epidemiological sense an outbreak is defined as a sudden increase in the disease frequency, related to time, place, and observed population. Thousands of outbreaks among humans and animals have been reported and investigated during the last two centuries, among them the most numerous being outbreaks of cholera, plague, malaria, smallpox, influenza, SARS, measles, salmonella, chikungunya, and various foodborne outbreaks.


title: Feasibility of Social Distancing Practices in US Schools to Reduce Influenza Transmission During a Pandemic

text: Schools are socially dense environments, and school-based outbreaks often predate and fuel community-wide transmission of seasonal and pandemic influenza. While preemptive school closures can effectively reduce influenza transmission, they are disruptive and currently recommended only for pandemics. We assessed the feasibility of implementing other social distancing practices in K-12 schools as a first step in seeking an alternative to preemptive school closures. METHODS: We conducted 36 focus groups with education and public health officials across the United States. We identified and characterized themes and compared feasibility of practices by primary versus secondary school and region of the United States. RESULTS: Participants discussed 29 school practices (25 within-school practices implemented as part of the school day and 4 reduced-schedule practices that impact school hours). Participants reported that elementary schools commonly implement several within-school practices as part of routine operations such as homeroom stay, restriction of hall movement, and staggering of recess times. Because of routine implementation and limited use of individualized schedules within elementary schools, within-school practices were generally felt to be more feasible for elementary schools than secondary schools. Of reduced-schedule practices, shortening the school week and the school day was considered the most feasible; however, reduced-schedule practices were generally perceived to be less feasible than within-school practices for all grade levels. CONCLUSIONS: Our findings suggest that schools have many options to increase social distance other than closing. Future research should evaluate which of these seemingly feasible practices are effective in reducing influenza transmission in schools and surrounding communities.


title: Neonatal nosocomial respiratory infection with coronavirus: a prospective study in a neonatal intensive care unit

text: The aim of this prospective study was to evaluate the incidence of viral respiratory infection in hospitalized premature newborn infants and to assess the role of coronaviruses. All hospitalized premature infants with a gestational age less than or equal to 32 weeks were included. Tracheal or nasopharyngal specimens were studied by immunofluorescence for coronaviruses, respiratory syncytial virus, adenoviruses, influenza and parainfluenza viruses. Forty premature infants were included; 13 samples were positive in 10 newborns (coronaviruses n = 10; influenza 1 n= 2; adenovirus n= 1). None was positive at admission. All premature infants infected with coronaviruses had symptoms of bradycardia, apnea, hypoxemia, fever or abdominal distension. Chest X‐ray revealed diffuse infiltrates in two cases. However, no significant difference was observed between infected and non‐infected premature infants for gestational age, birth weight, duration of ventilation, age at discharge, incidence of apnea or bradycardia. Nosocomial respiratory tract infection with coronaviruses appears to be frequent. The clinical consequences should be evaluated in a larger population.


title: Pandemic Influenza and Its Implications for Transplantation

text: Influenza viruses are important infections in transplant recipients. They may lead to complications including viral pneumonia, secondary bacterial infections and graft dysfunction. There has been a recent widespread outbreak of highly pathogenic H5N1 avian influenza among domestic poultry and wild birds along with a number of human cases with severe disease and high mortality. Genetic changes in the H5N1 virus may lead to efficient human‐to‐human transmission, heralding the onset of the next influenza pandemic. Discussed are the implications that such a pandemic may have on transplant patients. Logical inferences can be made from data on influenza in transplant patients and from experience with other respiratory virus outbreaks. In the event of a pandemic, it is likely that transplant patients will have more severe disease and higher mortality as compared to the general population. Vaccination and antiviral strategies may be less effective in this population. Implications for transplant programs in general are also discussed.


title: Viral Findings in Children under the Age of Two Years with Expiratory Difficulties

text: ABSTRACT. Viral findings were prospectively studied in lower respiratory tract infections in small children with and without expiratory difficulties. On first admission, a viral aetiology was found in 71 of 127 children (56%). On re‐admission, a viral etiology was found in only two of 31 cases (6%). Respiratory syncytial viruses (RSV) were responsible for 71% of the cases with viral diagnoses. A recently‐developed method for the direct detection of viral antigens in nasopharyngeal specimens by radio‐immunoassay was more sensitive than complement fixation serology, especially in patients aged less than six months. Viral diagnosis was reached using this new method alone in 43% of infections caused by RSV and in 27% of infections caused by other viruses. In children under six months, RSV were found in 89% by direct antigen detection and in 22% by serology. We suggest that direct antigen detection should be used as the primary virological method in small children with lower respiratory tract infections. The aetiological agents were the same in cases with and without expiratory difficulties, RSV being found in about 40% of children in both instances. It is concluded that host factors are critical to the development of expiratory difficulties.


title: A Test for Constant Fatality Rate of an Emerging Epidemic: With Applications to Severe Acute Respiratory Syndrome in Hong Kong and Beijing

text: summary The etiology, pathogenesis, and prognosis for a newly emerging disease are generally unknown to clinicians. Effective interventions and treatments at the earliest possible times are warranted to suppress the fatality of the disease to a minimum, and inappropriate treatments should be abolished. In this situation, the ability to extract most information out of the data available is critical so that important decisions can be made. Ineffectiveness of the treatment can be reflected by a constant fatality over time while effective treatment normally leads to a decreasing fatality rate. A statistical test for constant fatality over time is proposed in this article. The proposed statistic is shown to converge to a Brownian motion asymptotically under the null hypothesis. With the special features of the Brownian motion, we are able to analyze the first passage time distribution based on a sequential tests approach. This allows the null hypothesis of constant fatality rate to be rejected at the earliest possible time when adequate statistical evidence accumulates. Simulation studies show that the performance of the proposed test is good and it is extremely sensitive in picking up decreasing fatality rate. The proposed test is applied to the severe acute respiratory syndrome data in Hong Kong and Beijing.


title: Regulatory and microbiological safety issues surrounding cell and tissue‐engineering products

text: Cell therapies and tissue‐engineered products that contain living cells are potentially some of the most exciting of the novel therapeutic products currently under development. These products, however, present a number of important safety issues, particularly with respect to the transmission of human viruses. In addition, the short shelf life of these products precludes the normally extensive characterization performed on other biotherapeutic products. Careful examination of the risks and extensive testing of the raw materials have been used in place of product testing to ensure safety.


title: Hypocortisolism in survivors of severe acute respiratory syndrome (SARS)

text: Objective Following the severe acute respiratory syndrome (SARS) outbreak, many survivors were observed to suffer from psychosomatic symptoms reminiscent of various endocrine disorders. Hence, we sought to determine the existence of any chronic endocrine sequelae in SARS survivors. Design, patients, measurements Sixty‐one survivors of SARS prospectively recruited were analysed for hormonal derangements 3 months following recovery. Patients with pre‐existing endocrine disorders were excluded. Any endocrine abnormalities diagnosed were investigated and treated where indicated up to a year. Serial evaluation facilitated characterization of trends and prognostication of any endocrinological aberrations. Results Twenty‐four (39·3%) patients had evidence of hypocortisolism. The hypothalamic–pituitary–adrenal (HPA) axis dysfunction of the majority resolved within a year. Two (3·3%) of the hypocortisolic cohort had transient subclinical thyrotoxicosis. Four (6·7%) were biochemically hypothyroid, being comprised of three with central hypothyroidism and one with primary hypothyroidism. Two of the three with central hypothyroidism had concomitant central hypocortisolism. Eight had subnormal DHEAS levels. Conclusions These preliminary findings highlight a possible aetiologic role of SARS‐associated coronavirus in causing a reversible hypophysitis or direct hypothalamic effect, with the HPA axis affected more frequently than the HPT axis.


title: Exudative hyperresponsiveness of the airway microcirculation in seasonal allergic rhinitis

text: Background Mucosal exudation of plasma is a non‐injurious, physiological response of the airway microcirculation to different inflammatory processes. The exudative response is similar in the nose and bronchi and exudation occurs in both allergic asthma and rhinitis. The educative response is a specific end‐organ function of the mucosal microcirculation that may be altered in airway diseases. Objective This study examines the hypothesis of altered responsiveness of the superficial airway microcirculation to vascular permeability‐increasing challenges in sustained allergic inflammation. Methods Fourteen patients with birch‐pollen induced allergic rhinitis were studied for 7 weeks during a Swedish birch‐pollen season. Nasal symptoms (itching, sneezing. blockage, and discharge) were recorded and the occurrence of pollen was determined. The plasma exudation response was examined by topical histamine challenges at the end (May) and well out of (December) the season. Challenge and lavage were carried out concomitantly using a‘nasal pool’ ‐device. The unilateral nasal cavity was filled for consecutive 10 minute periods with saline and two concentrations of histamine (80μg/ mL and 400μg/mL). The lavage fluid levels of different‐sized plasma proteins (albumin‐66 000 D. fibrinogen‐340000 D, and α (2)‐macroglobulin‐725000D) were determined. Results The pollen season was mild resulting in only minor nasal symptoms. Histamine produced exudation of all plasma proteins across the microvascular epithelial barriers with particularly strong correlation between the levels of albumin and α (2)‐macroglobulin (r =0.98; P< 0.001). The exudative response to histamine was concentration‐dependent (P<0.05) and, furthermore, it was significantly greater late into the season compared with outside the pollen season (albumin: P < 0.05. tibrinogen: P<0.05. α (2)‐macroglobulin: P<0.01). Conclusion We conclude that histamine produced concentration‐dependent nasal airway exudation of bulk plasma in subjects with seasonal rhinitis and that this response is abnormally great during the pollen season. Whether angiogenesis or increased responsiveness of the mierovascular endothelium may explain this phenomenon now remains unknown. We suggest that a mierovascular exudative hyperresponsiveness may characterize allergic airway disease.


title: In Silico Prediction of SARS Protease Inhibitors by Virtual High Throughput Screening

text: A structure‐based in silico virtual drug discovery procedure was assessed with severe acute respiratory syndrome coronavirus main protease serving as a case study. First, potential compounds were extracted from protein–ligand complexes selected from Protein Data Bank database based on structural similarity to the target protein. Later, the set of compounds was ranked by docking scores using a Electronic High‐Throughput Screening flexible docking procedure to select the most promising molecules. The set of best performing compounds was then used for similarity search over the 1 million entries in the Ligand.Info Meta‐Database. Selected molecules having close structural relationship to a 2‐methyl‐2,4‐pentanediol may provide candidate lead compounds toward the development of novel allosteric severe acute respiratory syndrome protease inhibitors.


title: Important Changes in Biochemical Properties and Function of Mutated LLP12 Domain of HIV‐1 gp41

text: The human immunodeficiency virus type 1 gp41 possesses an unusually long and conserved cytoplasmic region. Mutations in the LLP12 domain in this region have been shown to significantly affect viral competence. It is likely that the impaired infectivity of this mutated virus involves certain biochemical aspects of the peptide LLP12. To test our assumptions, some important biochemical properties and functions of LLP12 domain were studied. The recombinant peptide LLP12 (LLP12 domain on gp41, including LLP1 and LLP2 domains) was prepared via bacterial expression system. Biochemical analysis directly demonstrated its multimeric potential and membrane‐binding ability. Several arginine residues in this domain were observed to be extremely highly conserved. Interestingly, the LLP12 mutants constructed by substitution of these arginine residues with alanine (separate mutations in LLP1 or LLP2 or both) showed apparent decreases in their multimeric potential and membrane‐binding ability. Comparing our results with independent data on human immunodeficiency virus from other researchers, it appears that both the multimeric state and the membrane affinity of the LLP12 domain of human immunodeficiency virus type 1 gp41 could be involved in viral competence and in the mechanism of human immunodeficiency virus type 1 Env‐mediated cell fusion.


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June 2020 People & Events


title: Evaluating Public Health Interventions: A Neglected Area in Health Technology Assessment

text: Introduction: Public health (PH) interventions are crucial for ensuring sustainable healthcare services. Nevertheless, they represent a neglected area in the field of health technology assessment (HTA) due to various methodological issues and their complex design that goes beyond clinical setting. The present study provides an environmental scan of HTA initiatives related to the assessment of PH technologies on a global level. Methods: We conducted a cross-sectional survey among 85 HTA-related European and international societies, health bodies, and networks from September 2018 to January 2019. The questionnaire contained four sections and 18 questions regarding activities related to the evaluation of PH technologies, information on existing PH technologies, and methodologies of assessment as well as barriers and facilitators to reaching a decision and implementing a PH technology. Results: Among 52 survey responses, the majority of the respondents came from European countries (35%), followed by North American (27%), and South American (19%) countries. The main type of organizations covered by our survey included HTA agencies, public administrations, and research institutes. Seventy-one % of the institutions reported engagement in any aspect of HTA in the area of PH (N = 37). Among those, 81% evaluated less than 5 PH technologies from 2013 to 2018. The most common barriers for reaching a decision on PH technologies were lack of data, conflicting stakeholder priorities, and methodological issues. A total of 76 PH interventions were reported, and most cited initiatives were related to chronic disease screening, prevention of infectious diseases, and maternal, prenatal, and neonatal screening. Conclusion: Our survey reported a rather limited involvement of HTA in the evaluation of PH technologies. In particular, an evaluation of behavioral and lifestyle interventions remains extremely rare. The implementation of collaborative HTA approaches in the setting of PH practice and policy needs to be prioritized and further strengthened. Moreover, ensuring reliable data structures and consolidation of HTA methods for the evaluation of PH technologies will be crucial for tackling the enormous burden of non-communicable diseases in societies.


title: Traditional Chinese Medicine and Gut Microbiome: Their Respective and Concert Effects on Healthcare

text: Advances in systems biology, particularly based on the omics approaches, have resulted in a paradigm shift in both traditional Chinese medicine (TCM) and the gut microbiome research. In line with this paradigm shift, the importance of TCM and gut microbiome in healthcare, as well as their interplay, has become clearer. Firstly, we briefly summarize the current status of three topics in this review: microbiome, TCM, and relationship of TCM and microbiome. Second, we focused on TCM's therapeutic effects and gut microbiome's mediation roles, including the relationships among diet, gut microbiome, and health care. Third, we have summarized some databases and tools to help understand the impact of TCM and gut microbiome on diagnosis and treatment at the molecular level. Finally, we introduce the effects of gut microbiome on TCM and host health, with two case studies, one on the metabolic effect of gut microbiome on TCM, and another on cancer treatment. In summary, we have reviewed the current status of the two components of healthcare: TCM and gut microbiome, as well as their concert effects. It is quite clear that as the holobiont, the maintenance of the health status of human would depend heavily on TCM, gut microbiome, and their combined effects.