title: Monetary incentives and peer referral in promoting digital network-based secondary distribution of HIV self-testing among men who have sex with men in China: study protocol for a three-arm randomized controlled trial

text: BACKGROUND: Human immunodeficiency virus (HIV) testing is a crucial strategy for HIV prevention. HIV testing rates remain low among men who have sex with men (MSM) in China. Digital network-based secondary distribution is considered as an effective model to enhance HIV self-testing (HIVST) among key populations. Digital platforms provide opportunities for testers to apply for HIVST kits by themselves, and secondary distribution allows them to apply for multiple kits to deliver to their sexual partners or members within their social network. We describe a three-arm randomized controlled trial to examine the effect of monetary incentives and peer referral in promoting digital network-based secondary distribution of HIVST among MSM in China. METHODS: Three hundred MSM in China will be enrolled through a digital platform for data collection. The eligibility criteria include being biological male, 18 years of age or over, ever having had sex with another man, being able to apply for kits via the online platform, and being willing to provide personal telephone number for follow-up. Eligible participants will be randomly allocated into one of the three arms: standard secondary distribution arm, secondary distribution with monetary incentives arm, and secondary distribution with monetary incentives plus peer referral arm. Participants (defined as "index") will distribute actual HIV self-test kits to members within their social network (defined as "alter") or share referral links to encourage alters to apply HIV self-test kits by themselves. All index participants will be requested to complete a baseline survey and a 3-month follow-up survey. Both indexes and alters will complete a survey upon returning the results by taking a photo of the used kits with the unique identification number. DISCUSSION: HIV testing rates remain suboptimal among MSM in China. Innovative interventions are needed to further expand the uptake of HIV testing among key populations. The findings of the trial can provide scientific evidence and experience on promoting secondary distribution of HIVST to reach key populations who have not yet been covered by existing testing services. TRIAL REGISTRATION: The study was registered in the Chinese Clinical Trial Registry (ChiCTR1900025433) on 26, August 2019, http://www.chictr.org.cn/showproj.aspx?proj=42001. Prospectively registered.


Will the Colombian intensive care units collapse due to the COVID-19 pandemic?


Cytokine storm and immunomodulatory therapy in COVID-19: Role of chloroquine and anti-IL-6 monoclonal antibodies


It's in our hands: a rapid, international initiative to translate a hand hygiene song during the COVID-19 pandemic


Remdesivir Receives Emergency Use Authorization for Severely Ill Patients with COVID-19


title: In vitro evaluation of palm fronds as feedstuff on ruminal digestibility and gas production/ Avaliação in vitro das folhas de palmeiras como alimento de digestibilidade de ruminais e produção de gás

text: This study was carried out to evaluate using palm fronds only or supplemented with fibrolytic enzymes as alternative roughage on the ruminal nutrients digestibility and gas production. Treatments were: clover hay (Trifolium alexandrinum), palm fronds only and palm fronds plus fibrolytic enzymes (enzymes were mixed with palm fronds in rate of 4 g kg-1 of dry matter (DM). The results showed a reduction (p < 0.05) in gas production, ammoniac nitrogen (NH3-N, DM and organic matter (OM) digestibility in palm fronds compared with clover hay. While supplementing palm fronds with fibrolytic enzymes improved DM and OM digestibility compared with palm fronds only without (p < 0.05) differences with clover hay. Also, supplementing palm fronds with fibrolytic enzymes reduced (p < 0.05) gas production compared with other treatments. It could be concluded that adding fibrolytic enzymes improved the utilization of palm fronds as alternative roughage without negative effect on nutrients digestibility and reduced gas production which improve the environmental aspects of feeding ruminant animals.(AU)


The Pandemic Challenge: End Separate and Unequal Healthcare


In reply: Clear plastic drapes for aerosol-generating medical procedures in COVID-19 patients: questions still remain


title: The Impact of the COVID-19 Pandemic and the Associated Belgian Governmental Measures on Cancer Screening, Surgical Pathology and Cytopathology

text: INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 caused a pandemic of coronavirus disease 2019 (COVID-19). Unprecedented public health actions were introduced, including social distancing, travel restrictions and quarantine. The Belgian government announced a national emergency plan, thereby postponing all non-urgent medical consultations and operations. This report analyses the impact of these measures on cancer screening, through assessment of the workload of a laboratory for histopathology and cytopathology. METHODS: Data on monthly numbers of histological and cytological samples, immunohistochemistry and molecular tests were extracted from the laboratory information management system. RESULTS: The global histopathological and cytological workload was substantially reduced. The impact on oncology-related surgical procedures was rather limited. The anti-COVID-19 measures significantly diminished all screening-related samples, such as colon biopsies, breast biopsies and cervical cytology, and strongly reduced the number of samples related to "functional" pathology, such as thyroidectomies and gastric biopsies. CONCLUSIONS: Since many health care interventions are reflected in the workload of a pathology laboratory, this study enabled us to identify areas for "deconfinement" health care actions. Our findings indicate that various areas in medicine were affected, but the impact seemed largest for cancer screening. Health care professionals should assure that consultations related to cancer screening are postponed instead of cancelled.


title: Andrographolide as a potential inhibitor of SARS-CoV-2 main protease: an in silico approach

text: SARS-CoV-2 virus which caused the global pandemic the Coronavirus Disease- 2019 (COVID-2019) has infected about 1,203,959 patients and brought forth death rate about 64,788 among 206 countries as mentioned by WHO in the month of April 2020. The clinical trials are underway for Remdesivir, an investigational anti-viral drug from Gilead Sciences. Antimalarial drugs such as Chloroquine and Hydroxychloroquine derivatives are being used in emergency cases; however, they are not suitable for patients with conditions like diabetes, hypertension and cardiac issues. The lack of availability of approved treatment for this disease calls forth the scientific community to find novel compounds with the ability to treat it. This paper evaluates the compound Andrographolide from Andrographis paniculata as a potential inhibitor of the main protease of SARS-COV-2 (Mpro) through in silico studies such as molecular docking, target analysis, toxicity prediction and ADME prediction. Andrographolide was docked successfully in the binding site of SARS-CoV-2 Mpro. Computational approaches also predicts this molecule to have good solubility, pharmacodynamics property and target accuracy. This molecule also obeys Lipinski's rule, which makes it a promising compound to pursue further biochemical and cell based assays to explore its potential for use against COVID-19.Communicated by Ramaswamy H. Sarma.


Diabetes mellitus: Lessons from the COVID-19 pandemic


title: Trust in Humanitarian Aid From the Earthquake in 2017 to COVID-19 in Iran: A Policy Analysis

text: The earthquake of November 2017, the great flood of April 2019, and the COVID-19 outbreak in 2020 are 3 major emergencies in Iran during the last 3 years. A common issue in all of these crises seems to be the issue of "trust." Official authorities, including the Iranian President, ministers, and the judiciary system, tried to gain people's trust by either changing policies or developing new ones. In August 2019, the new law on crisis management in Iran went into effect and the issue of public donation has been considered, too. Also, in their response to the COVID-19 outbreak, Iranian officials ordered all sectors to cooperate with the Ministry of Health and provide it with all necessary facilities. Therefore, it seems that new policies are still needed to overcome mistrust in Iran at times of emergency. Developing a policy on donation management was the first step, and there are several factors that could have contributed to the perception of the mistrust and failure in emergency missions. Mistrust can be the result of different causes, including but not limited to lack of knowledge on capabilities and efficiencies of humanitarian organizations, engagement of a wide range of organizations from different categories, extension of mistrust of an organization to other emergency organizations in the area or all of operation, lack of unity in emergency response, and poor public relations.


title: The novel coronavirus disease (COVID-19) complicated by pulmonary embolism and acute respiratory distress syndrome

text: Acute respiratory distress syndrome and coagulopathy played an important role in morbidity and mortality of severe COVID-19 patients. A higher frequency of pulmonary embolism (PE) than expected in COVID-19 patients was recently reported. The presenting symptoms for PE were untypical including dyspnea, which is one of the major symptoms in severe COVID-19, especially in those patients with acute respiratory distress syndrome (ARDS). We reported two COVID-19 cases with coexisting complications of PE and ARDS, aiming to consolidate the emerging knowledge of this global health emergency and raise the awareness that the hypoxemia or severe dyspnea in COVID-19 may be related to PE and not necessarily always due to the parenchymal disease.


title: Understanding coronavirus disease (COVID-19) risk perceptions among the public to enhance risk communication efforts: a practical approach for outbreaks, Finland, February 2020

text: Understanding risk perceptions of the public is critical for risk communication. In February 2020, the Finnish Institute for Health and Welfare started collecting weekly qualitative data on coronavirus disease (COVID-19) risk perception that informs risk communication efforts. The process is based on thematic analysis of emails and social media messages from the public and identifies factors linked to appraisal of risk magnitude, which are developed into risk communication recommendations together with health and communication experts.


title: Discovering drugs to treat coronavirus disease 2019 (COVID-19)

text: The SARS-CoV-2 virus emerged in December 2019 and then spread rapidly worldwide, particularly to China, Japan, and South Korea. Scientists are endeavoring to find antivirals specific to the virus. Several drugs such as chloroquine, arbidol, remdesivir, and favipiravir are currently undergoing clinical studies to test their efficacy and safety in the treatment of coronavirus disease 2019 (COVID-19) in China; some promising results have been achieved thus far. This article summarizes agents with potential efficacy against SARS-CoV-2.


title: Extracorporeal Membrane Oxygenation for Severe Respiratory Failure During Respiratory Epidemics and Pandemics: A Narrative Review

text: INTRODUCTION: Epidemics and pandemics from zoonotic respiratory viruses, such as the 2019 novel coronavirus, can lead to significant global intensive care burden as patients progress to acute respiratory distress syndrome (ARDS). A subset of these patients developed refractory hypoxaemia despite maximal conventional mechanical ventilation and required extracorporeal membrane oxygenation (ECMO). This review focuses on considerations for ventilatory strategies, infection control and patient selection related to ECMO for ARDS in a pandemic. We also summarise the experiences with ECMO in previous respiratory pandemics. METHODS: A review of pertinent studies was conducted via a search using MEDLINE, EMBASE and Google Scholar. References of articles were also examined to identify other relevant publications. RESULTS: Since the H1N1 Influenza pandemic in 2009, the use of ECMO for ARDS continues to grow despite limitations in evidence for survival benefit. There is emerging evidence to suggest that lung protective ventilation for ARDS can be further optimised while receiving ECMO so as to minimise ventilator-induced lung injury and subsequent contributions to multi-organ failure. Efforts to improve outcomes should also encompass appropriate infection control measures to reduce co-infections and prevent nosocomial transmission of novel respiratory viruses. Patient selection for ECMO in a pandemic can be challenging. We discuss important ethical considerations and predictive scoring systems that may assist clinical decision-making to optimise resource allocation. CONCLUSION: The role of ECMO in managing ARDS during respiratory pandemics continues to grow. This is supported by efforts to redefine optimal ventilatory strategies, reinforce infection control measures and enhance patient selection.


title: Mental Health During the Covid-19 Outbreak in China: a Meta-Analysis

text: BACKGROUND: Covid-19 has started to spread within China since the end of December 2019. Despite government's immediate actions and strict control, more and more people were infected every day. As such a contagious virus can spread easily and rapidly between people, the whole country was put into lockdown and people were forced into isolation. In order to understand the impact of Covid-19 on mental health well-being, Chinese researchers have conducted several studies. However, no consistent results were obtained. Therefore, a meta-analysis was conducted. METHODS: We searched Embase, PubMed, and Web of Science databases to find literature from December 2019 to April 2020 related to Covid-19 and mental health, among which results such as comments, letters, reviews and case reports were excluded. The incidence of anxiety and depression in the population was synthesized and discussed. RESULTS: A total of 27,475 subjects were included in 12 studies. Random effect model is used to account for the data. The results showed that the incidence of anxiety was 25% (95% CI: 0.19-0.32), and the incidence of depression was 28% (95% CI: 0.17-0.38). Significant heterogeneity was detected across studies regarding these incidence estimates. Subgroup analysis included the study population and assessment tools, and sensitivity analysis was done to explore the sources of heterogeneity. CONCLUSIONS: Owing to the significant heterogeneity detected in studies regarding this pooled prevalence of anxiety and depression, we must interpret the results with caution. As the epidemic is ongoing, it is vital to set up a comprehensive crisis prevention system, which integrating epidemiological monitoring, screening and psychological crisis prevention and interventions.


title: SARS-CoV2 RNA detection in a pancreatic pseudocyst sample

text: The involvement of gastrointestinal system in SARS-CoV2 related disease, COVID-19, is increasingly recognized. COVID-19 associated pancreatic injury has been suggested, but its correlation with pancreatic disease is still unclear. In this case report, we describe the detection of SARS-CoV2 RNA in a pancreatic pseudocyst fluid sample collected from a patient with SARS-CoV2 associated pneumonia and a pancreatic pseudocyst developed as a complication of an acute edematous pancreatitis. The detection of SARS-CoV2 within the pancreatic collection arise the question of whether this virus has a tropism for pancreatic tissue and whether it plays a role in pancreatic diseases occurrence.


Corticosteroids for critically ill COVID-19 patients with cytokine release syndrome: a limited case series


title: Correction to: Challenges and opportunities for graduate students in public health during the COVID-19 pandemic

text: This article was updated was to correct the spelling of Chenoa Cassidy-Matthews' name: it is correct as displayed here.


Photobiomodulation and Antiviral Photodynamic Therapy as a Possible Novel Approach in COVID-19 Management


title: Increased Risk of COVID-19-Related Deaths among General Practitioners in Italy

text: To date, data on COVID-19-related death cases among physicians from different medical specialties are incomplete and scattered. In Italy, available data highlight that general practitioners (GPs) are, apparently, the most heavily affected group. Indeed, they currently represent 44.1% of the total COVID-19 related death cases occurred among physicians, whereas they constitute about 15% of the total number of doctors. This high proportion is most likely the consequence of a work-related contagion happening especially during the first weeks of the epidemic, and persisting also in the following weeks, after the national lockdown. There are various reasons for these higher contagion rates: GPs perform a lot of medical examinations daily, usually in close contact with patients. Especially at the beginning of the epidemic, GPs might have had scant information on the specific safety procedures for the prevention of SARS-CoV-2 transmission (e.g., there was limited knowledge on the possibility of contagions deriving from asymptomatic patients) and, moreover, the availability of personal protective equipment was insufficient. Furthermore, the risk of infection is highly increased by the virus' characteristics, like its survival for several hours/days on different surfaces and its persistence in the air after an aerosolization process, with possibilities to be transmitted over distances longer than two meters. Following these observations, and considering the high cost in term of GPs' lives, the COVID-19 pandemic will probably revolutionize the approach to patients in general practice. Clear and effective guidelines are absolutely and urgently needed for the refinement of adequate measures to prevent SARS-CoV-2 infections among GPs.


COVID-19 pandemic: a multinational report providing professional experiences in the management of mental health of elderly


Accrual, Publication Bias, and the Coronavirus in 2020


Role of anaesthesiologists during the COVID-19 outbreak in China


title: Natural RNA dependent RNA polymerase inhibitors: Molecular docking studies of some biologically active alkaloids of Argemone mexicana

text: COVID-19 has become disastrous for world and spread all over. Researchers all around the globe are working to discover a drug to cure from COVID-19. RNA dependent RNA polymerase plays a key role in SARS-CoV-2 replication and thus it could be a potential target for SARS-CoV-2. This study revealed that Protopine, Allocryptopine and (±) 6- Acetonyldihydrochelerythrine could be potential RdRp inhibitors of SARS-CoV-2.


title: Chest CT Imaging Signature of COVID-19 Infection: In Pursuit of the Scientific Evidence

text: BACKGROUND: Chest CT may be used for the diagnosis of Coronavirus disease 2019 (COVID-19), but clear scientific evidence is lacking. Therefore, we systematically reviewed and meta-analyzed the chest CT imaging signature of COVID-19. RESEARCH QUESTION: â¢â¢â¢â¢. STUDY DESIGN AND METHODS: A systematic literature search was performed for original studies on chest CT imaging findings in patients with COVID-19. Methodologic quality of studies was evaluated. Pooled prevalence of chest CT imaging findings were calculated with the use of a random effects model in case of between-study heterogeneity (predefined as I2 ≥50); otherwise, a fixed effects model was used. RESULTS: Twenty-eight studies were included. The median number of patients with COVID-19 per study was 124 (range, 50-476), comprising a total of 3,466 patients. Median prevalence of symptomatic patients was 99% (range, >76.3%-100%). Twenty-seven of the studies (96%) had a retrospective design. Methodologic quality concerns were present with either risk of or actual referral bias (13 studies), patient spectrum bias (eight studies), disease progression bias (26 studies), observer variability bias (27 studies), and test review bias (14 studies). Pooled prevalence was 10.6% for normal chest CT imaging findings. Pooled prevalences were 90.0% for posterior predilection, 81.0% for ground-glass opacity, 75.8% for bilateral abnormalities, 73.1% for left lower lobe involvement, 72.9% for vascular thickening, and 72.2% for right lower lobe involvement. Pooled prevalences were 5.2% for pleural effusion, 5.1% for lymphadenopathy, 4.1% for airway secretions/tree-in-bud sign, 3.6% for central lesion distribution, 2.7% for pericardial effusion, and 0.7% for cavitation/cystic changes. Pooled prevalences of other CT imaging findings ranged between 10.5% and 63.2%. INTERPRETATION: Studies on chest CT imaging findings in COVID-19 suffer from methodologic quality concerns. More high-quality research is necessary to establish diagnostic CT criteria for COVID-19. Based on the available evidence that requires cautious interpretation, several chest CT imaging findings appear to be suggestive of COVID-19, but normal chest CT imaging findings do not exclude COVID-19, not even in symptomatic patients.


Initial data from the COVID-19 Global Rheumatology Alliance provider registries


title: Cerebellar Scholars' Challenging Time in COVID-19 Pandemia

text: Novel coronavirus, SARS-CoV2, has caused pandemic of highly contagious disease called coronavirus disease 2019 (COVID-19), with epicenters in China, Italy, Spain, and the USA. Primarily affecting the human respiratory system, SARS-CoV2 has some impact on the human brain, but apparently minimal on the cerebellum, at least so far. Neurological involvement in the acute phase appears to manifest with confusion, dizziness, impaired consciousness, propensity to develop acute strokes, anosmia, hypogeusia, ataxia, epilepsy, and neuralgia. Cerebellar scholars are facing a time of uncertainty. Telemedicine has suddenly emerged as an alternative to follow patients. There is an urgent need to develop novel platforms to assess and follow ataxic patients remotely, especially because cerebellar patients often require ambulatory care to maintain their autonomy.


title: COVID-19: asymptomatic carrier transmission is an underestimated problem

text: At the present time, COVID-19 is spreading rapidly [1]. The global prevention and control of COVID-19 is focused on the estimation of the relevant incubation period, basic reproduction number (R0), effective reproduction number (Rt) and death risk. Although the prevention and control of COVID-19 requires a reliable estimation of the relevant incubation period, R0, Rt and death risk. Another key epidemiological parameter-asymptomatic ratio that provides strength and range for social alienation strategies of COVID-19, which is widely defined as the proportion of asymptomatic infections among all disease infections. In fact, the ratio of asymptomatic infection is a useful indicator of the burden of disease and a better measurement of the transmissibility of the virus. So far, people have not paid enough attention to asymptomatic carriers. The asymptomatic carriers discussed in this study are recessive infections, that is, those who have never shown symptoms after onset of infection. We will discuss three aspects: detection, infectivity and proportion of healthy carriers.


title: Chest X-ray features of SARS-CoV-2 in the emergency department: a multicenter experience from northern Italian hospitals

text: OBJECTIVES: To evaluate the imaging features of routine admission chest X-ray in patients referred for novel Coronavirus 2019 infection. METHODS: All patients referred to the emergency departments, RT-PCR positive for SARS-CoV-2 infection were evaluated. Demographic and clinical data were recorded. Two radiologists (8 and 15 years of experience) reviewed all the X-ray images and evaluated the following findings: interstitial opacities, alveolar opacities (AO), AO associated with consolidation, consolidation and/or pleural effusion. We stratified patients in groups according to the time interval between symptoms onset (cut-off 5 days) and X-ray imaging and according to age (cut-off 60 years old). Computed tomography was performed in case of a discrepancy between clinical symptoms, laboratory and X-ray findings, and/or suspicion of complications. RESULTS: A total of 468 patients were tested positive for SARS-CoV-2. Lung lesions primarily manifested as interstitial opacities (71.7%) and AO opacities (60.5%), more frequently bilateral (64.5%) and with a peripheral predominance (62.5%). Patients admitted to the emergency radiology department after 5 days from symptoms onset, more frequently had interstitial and AO opacities, in comparison to those admitted within 5 days, and lung lesions were more frequently bilateral and peripheral. Older patients more frequently presented interstitial and AO opacities in comparison to younger ones. Sixty-eight patients underwent CT that principally showed the presence of ground-glass opacities and consolidations. CONCLUSIONS: The most common X-ray pattern is multifocal and peripheral, associated with interstitial and alveolar opacities. Chest X-ray, compared to CT, can be considered a reliable diagnostic tool, especially in the Emergency setting.


title: A multi-hazards earth science perspective on the COVID-19 pandemic: the potential for concurrent and cascading crises

text: Meteorological and geophysical hazards will concur and interact with coronavirus disease (COVID-19) impacts in many regions on Earth. These interactions will challenge the resilience of societies and systems. A comparison of plausible COVID-19 epidemic trajectories with multi-hazard time-series curves enables delineation of multi-hazard scenarios for selected countries (United States, China, Australia, Bangladesh) and regions (Texas). In multi-hazard crises, governments and other responding agents may be required to make complex, highly compromised, hierarchical decisions aimed to balance COVID-19 risks and protocols with disaster response and recovery operations. Contemporary socioeconomic changes (e.g. reducing risk mitigation measures, lowering restrictions on human activity to stimulate economic recovery) may alter COVID-19 epidemiological dynamics and increase future risks relating to natural hazards and COVID-19 interactions. For example, the aggregation of evacuees into communal environments and increased demand on medical, economic, and infrastructural capacity associated with natural hazard impacts may increase COVID-19 exposure risks and vulnerabilities. COVID-19 epidemiologic conditions at the time of a natural hazard event might also influence the characteristics of emergency and humanitarian responses (e.g. evacuation and sheltering procedures, resource availability, implementation modalities, and assistance types). A simple epidemic phenomenological model with a concurrent disaster event predicts a greater infection rate following events during the pre-infection rate peak period compared with post-peak events, highlighting the need for enacting COVID-19 counter measures in advance of seasonal increases in natural hazards. Inclusion of natural hazard inputs into COVID-19 epidemiological models could enhance the evidence base for informing contemporary policy across diverse multi-hazard scenarios, defining and addressing gaps in disaster preparedness strategies and resourcing, and implementing a future-planning systems approach into contemporary COVID-19 mitigation strategies. Our recommendations may assist governments and their advisors to develop risk reduction strategies for natural and cascading hazards during the COVID-19 pandemic.


title: Coronavirus disease 2019: What we know?

text: In late December 2019, a cluster of unexplained pneumonia cases has been reported in Wuhan, China. A few days later, the causative agent of this mysterious pneumonia was identified as a novel coronavirus. This causative virus has been temporarily named as severe acute respiratory syndrome coronavirus 2 and the relevant infected disease has been named as coronavirus disease 2019 (COVID-19) by the World Health Organization, respectively. The COVID-19 epidemic is spreading in China and all over the world now. The purpose of this review is primarily to review the pathogen, clinical features, diagnosis, and treatment of COVID-19, but also to comment briefly on the epidemiology and pathology based on the current evidence.


Experience of remote cardiac care during the COVID-19 pandemic: the V-LAP™ device in advanced heart failure


Experience of Remote Cardiac Care during Covid-19 Pandemic: the V-LAP™ device in advanced heart failure


Fair allocation of scarce medical resources during COVID-19 pandemic: ethical considerations


title: Glucose-6-Phosphate Dehydrogenase Deficiency: An Actionable Risk Factor for Patients with COVID-19?

text: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a common X-linked mutation that is more prevalent in African, Asian, Latin American and Mediterranean populations. Although most individuals are asymptomatic, exposure to certain food, drugs, or infections can trigger acute hemolytic anemia. Given the potential for coronavirus to trigger oxidative stress, unrecognized G6PD deficiency in the presence of the COVID-19 viral infection may cause hemolytic crisis and worse outcome in affected individuals. Further, since certain drugs that may be used to treat COVID-19 infection may cause hemolytic crisis in individuals with G6PD deficiency, it may be warranted to recommend adding G6PD deficiency to the list of screening elements in a COVID-19 workup for those patients where there is a high suspicion for this genetic mutation.


title: COVID-19 and paediatric health services: A survey of paediatric physicians in Australia and New Zealand

text: AIMS: COVID-19 is now a global pandemic. At the time of survey, fewer than 150 children in Australia and New Zealand had documented infection. The aim of this study was to assess attitudes, readiness and confidence in the early stages of the COVID-19 pandemic through an online survey of paediatric physicians and sub-specialists across Australia and New Zealand. METHODS: Multiple email list groups were used to contact paediatric physicians to undertake an online Likert scale survey between 17 and 24 March. Respondents' specialty, experience and work setting were recorded. Ordinal logistic regression was used to determine respondent factors. RESULTS: There were 542 respondents from across Australia and New Zealand: an estimated 11% of the paediatric physician workforce. A minority (36.6%) agreed that their national response had been well coordinated; the majority (92.7%) agreed that senior-level hospital administrators were taking the situation seriously. Most reported a good understanding of the natural history of COVID-19 in children, and knowledge of where to find local information. A large proportion of physicians (86.1%) were worried about becoming infected through their work; few (5.8%) reported that they would not come to work to avoid infection. Closure of school and childcares would reduce the ability to continue work at current capacity for 23.6% of respondents. CONCLUSION: Despite limited experience in pandemics, most paediatric physicians felt informed. Concern about exposure at work is common; most were willing to work regardless. The closure of schools and daycares may have an impact on staffing. Coordination and leadership will be critical.


title: Optimal group testing under real world restrictions

text: In the group testing problem one aims to infer a small set of $k$ infected individuals out of a large population of size $n$. At our disposal we have a testing scheme which allows us to test a group of individuals, such that the outcome of the test is positive, if and only if at least one infected individual is part of the test. All tests are carried out in parallel. The overall goal is to find a test design and an inference algorithm requiring as few tests as possible, such that the infected individuals can be identified with high probability. As most relevant during the outbreak of pandemic diseases (Wang et al., 2011), our analysis focusses on the so-called sublinear regime of group testing, where $k \sim n^\theta$. The optimal group testing schemes require a test-size of $\sim n/k$ and each individual has to take part in $\sim \log n$ tests (Coja-Oghlan et. al, 2019). In real world applications, like testing many individuals in a short period of time during the outbreak of epidemics, pooling in such a way is not possible due to dilution effects. Evidence of those effects is known for important applications like HIV (Wein, 1996) or COVID-19 (Seifried and Ciesek, 2020). Our main contribution is the analysis of a group testing model, where we restrict the individuals-per-test to be finite. We present an easy to implement scheme to pool individuals into tests under these natural restrictions coming with the efficient decoding algorithm DD and present simulations which suggest that the decoding procedure succeeds for moderate population sizes. Furthermore, we show that our pooling scheme requires the fewest tests as possible under all pooling schemes. Finally, we apply our methods to the finitely many tests-per-individuals setting, where we provide a full understanding of the random regular test-design in this model by building up on work of (Gandikota et al., 2016).


Blood transfusion strategies and ECMO during the COVID-19 pandemic - Authors' reply


Logistic and organizational aspects of a dedicated intensive care unit for COVID-19 patients


A student nurse in the MICU: Leveraging unexpected leadership on the frontlines of COVID-19


title: COVID-19-Associated Myocarditis in an Adolescent

text: A 17-year-old obese male was admitted to the pediatric intensive care unit after presenting with fluid-responsive septic shock following 7 days of fever, gastrointestinal symptoms and neck pain. Initial workup was positive for SARS-CoV-2 and elevated troponin I and brain natriuretic peptide. Echocardiography and cardiac magnetic resonance imaging confirmed acute myocarditis. One week after discharge, repeat echocardiogram demonstrated improved heart function with only residual myocardial dysfunction.


title: Predicting Patient-Centered Outcomes from Spine Surgery Using Risk Assessment Tools: a Systematic Review

text: PURPOSE OF REVIEW: The purpose of this systematic review is to evaluate the current literature in patients undergoing spine surgery in the cervical, thoracic, and lumbar spine to determine the available risk assessment tools to predict the patient-centered outcomes of pain, disability, physical function, quality of life, psychological disposition, and return to work after surgery. RECENT FINDINGS: Risk assessment tools can assist surgeons and other healthcare providers in identifying the benefit-risk ratio of surgical candidates. These tools gather demographic, medical history, and other pertinent patient-reported measures to calculate a probability utilizing regression or machine learning statistical foundations. Currently, much is still unknown about the use of these tools to predict quality of life, disability, and other factors following spine surgery. A systematic review was conducted using PRISMA guidelines that identified risk assessment tools that utilized patient-reported outcome measures as part of the calculation. From 8128 identified studies, 13 articles met inclusion criteria and were accepted into this review. The range of c-index values reported in the studies was between 0.63 and 0.84, indicating fair to excellent model performance. Post-surgical patient-reported outcomes were identified in the following categories (n = total number of predictive models): return to work (n = 3), pain (n = 9), physical functioning and disability (n = 5), quality of life (QOL) (n = 6), and psychosocial disposition (n = 2). Our review has synthesized the available evidence on risk assessment tools for predicting patient-centered outcomes in patients undergoing spine surgery and described their findings and clinical utility.


COVID-19 risk triage: Engaging residents in telephonic screening


title: Pregnancy, Birth and the COVID-19 Pandemic in the United States

text: How quickly and in what ways are US maternity care practices changing due to the COVID-19 pandemic? Our data indicate that partners and doulas are being excluded from birthing rooms leaving mothers unsupported, while providers face lack of protective equipment and unclear guidelines. We investigate rapidly shifting protocols for in- and out-of-hospital births and the decision making behind them. We ask, will COVID-19 cause women, families, and providers to look at birthing in a different light? And will this pandemic offer a testing ground for future policy changes to generate effective maternity care amidst pandemics and other types of disasters?


title: Child with liver transplant recovers from COVID-19 infection. A case report

text: We present the case of a 55-month-old girl who recovered from coronavirus disease 2019 (COVID-19) infection 5 months after undergoing liver transplantation; she had a co-infection with Epstein-Barr virus (EBV). To the best of our knowledge, this is the first case report of a COVID-19 infection in a pediatric patient with liver transplantation. Additionally, this is also the first report of confirmed co-infection between COVID-19 and EBV. On the basis of this case, we suggest that liver transplantation is not associated with COVID-19 symptom severity and development. Moreover, COVID-19 and EBV co-infections do not seem to aggravate the clinical outcome.


title: Post-Coronavirus Disease 2019 Health Care and University: From Efficiency to Resilience

text: After the initial emergency responses deployed to control the coronavirus disease 2019 (COVID-19) pandemic in the first half of 2020, we should now start thinking about long-term strategies and concepts for pandemic and disaster governance such as resilience. In this context, COVID-19 health care and education are especially important because they are essential public goods that determine what kind of a society we live in, during the pandemic and afterward. So for, the focus has been a tactical efficiency perspective that prioritized instrumental, logistical, or pragmatic aspects in planetary health and university education, with much less attention paid to social justice, history of inequity, and power asymmetries that affect the pandemic impacts in society. For a resilient COVID-19 response, we need to address not only medical, technical, and logistical challenges, but also the social disparities that are inherited from the prepandemic world that are negatively affecting the current pandemic outcomes.


title: Tracing Contacts to Control the COVID-19 Pandemic

text: The control of the COVID-19 pandemic requires a considerable reduction of contacts mostly achieved by imposing movement control up to the level of enforced quarantine. This has lead to a collapse of substantial parts of the economy. Carriers of the disease are infectious roughly 3 days after exposure to the virus. First symptoms occur later or not at all. As a consequence tracing the contacts of people identified as carriers is essential for controlling the pandemic. This tracing must work everywhere, in particular indoors, where people are closest to each other. Furthermore, it should respect people's privacy. The present paper presents a method to enable a thorough traceability with very little risk on privacy. In our opinion, the latter capabilities are necessary to control the pandemic during a future relaunch of our economy.


title: #Coronavirus or #Chinesevirus?!: Understanding the negative sentiment reflected in Tweets with racist hashtags across the development of COVID-19

text: Situated in the global outbreak of COVID-19, our study enriches the discussion concerning the emergent racism and xenophobia on social media. With big data extracted from Twitter, we focus on the analysis of negative sentiment reflected in tweets marked with racist hashtags, as racism and xenophobia are more likely to be delivered via the negative sentiment. Especially, we propose a stage-based approach to capture how the negative sentiment changes along with the three development stages of COVID-19, under which it transformed from a domestic epidemic into an international public health emergency and later, into the global pandemic. At each stage, sentiment analysis enables us to recognize the negative sentiment from tweets with racist hashtags, and keyword extraction allows for the discovery of themes in the expression of negative sentiment by these tweets. Under this public health crisis of human beings, this stage-based approach enables us to provide policy suggestions for the enactment of stage-specific intervention strategies to combat racism and xenophobia on social media in a more effective way.


The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus


title: Epidemic contact tracing with smartphone sensors

text: Contact tracing is widely considered as an effective procedure in the fight against epidemic diseases. However, one of the challenges for technology based contact tracing is the high number of false positives, questioning its trust-worthiness and efficiency amongst the wider population for mass adoption. To this end, this paper proposes a novel, yet practical smartphone based contact tracing approach, employing WiFi and acoustic sound for relative distance estimate, in addition to the ambient air pressure and magnetic field environment matching. We present a model combining 6 smartphone sensors, prioritising some of them when certain conditions are met. We empirically verified our approach in various realistic environments to demonstrate an achievement of up to 95% fewer false positives, and 62% more accurate than Bluetooth-only system. To the best of our knowledge, this paper was one of the first work to propose a combination of smartphone sensors for contact tracing.


COVID-19: Is it time that Social Care for the elderly was part of the National Health Service in the United Kingdom?


When nuclear medicine radiological protection meets biological COVID-19 protection


Decisiones en UCI basadas en la estrategia Living Systematic Review durante la pandemia de SARS-CoV-2. Resultados de una serie prospectiva de casos./ Decisiones en UCI basadas en la estrategia Living Systematic Review durante la pandemia de SARS-CoV-2. Resultados de una serie prospectiva de casos./ ICU decision making based on Living Systematic Review strategy during SARS-CoV-2 pandemic. Results of a prospective case serie


Cancer Surgery and COVID19


title: Using Technology to Support Expectant and Parenting Youth through Case Management: Lessons Learned in the Field

text: INTRODUCTION: The Support. Empower. Learn. Parenting Health Initiative (SELPHI) provides expectant and parenting youth ages 16-24 in Philadelphia with supports to improve educational, social, and economic outcomes to shape their health and the health of their children. Phone, text, video-based, and social media communication technology is built in to SELPHI's program design to facilitate case management and connect clients to a broad referral network. Given the novelty of using information and communication technology (ICT) in case management, the reported lessons learned seek to give providers a specific and nuanced picture of ICT in case management. METHODS: In its initial 6-month implementation period, SELPHI's five case managers, called Navigators, served 59 clients. Data from feedback surveys and case records were collected from clients and Navigators. Data included client demographic characteristics, needs assessment, and contact records to inform continuous quality improvement (CQI). RESULTS: ICT's benefits included having multiple ways to connect to difficult-to-reach clients, the ability to be more responsive to clients, and the flexibility to address scheduling and transportation barriers. ICT's challenges are related to Navigators' boundary setting, limitations on rapport building, and data security considerations. CQI data are presented to illustrate the lessons learned. Text messages were the most prevalent ICT; phone calls were most successful in engaging clients. Clients' ICT preferences differed by purpose of communication. DISCUSSION: Findings suggest that programs should understand the nuances of client contact preferences. To maximize the benefits of ICT, programs must develop or adapt protocols based on preference and purpose of communication.


title: Family cluster of three recovered cases of pneumonia due to severe acute respiratory syndrome coronavirus 2 infection

text: The coronavirus disease (COVID-19) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan, China, in late 2019 and has affected more than 1 270 000 people worldwide. The numbers of reported cases continue to rise and threaten global health. Transmissions among family members are frequently observed, although the route of transmission is partially known. Here we report three cases of SARS-CoV-2 infection within one family. Sequencing of the S gene of the viral genome showed 100% identity among samples, suggesting that the same strain caused the infection. Following treatment with oseltamivir and short-term methylprednisolone combined with symptomatic management, all three patients recovered within 3 weeks, as evidenced by the disappearance of their symptoms, clearance of pulmonary infiltrates and consecutive negative molecular diagnostic test findings. Our observations suggest the importance of preventing family transmission and the efficacy of current integrated treatment for mild/moderate pneumonia in COVID-19 cases.


A safe method to evacuate pneumoperitoneum during laparoscopic surgery in suspected COVID-19 patients


Guillain-Barré syndrome related to COVID-19 infection


title: COVID-19-associated coagulopathy: An exploration of mechanisms

text: An ongoing global pandemic of viral pneumonia (coronavirus disease [COVID-19]), due to the virus SARS-CoV-2, has infected millions of people and remains a threat to many more. Most critically ill patients have respiratory failure and there is an international effort to understand mechanisms and predictors of disease severity. Coagulopathy, characterized by elevations in D-dimer and fibrin(ogen) degradation products (FDPs), is associated with critical illness and mortality in patients with COVID-19. Furthermore, increasing reports of microvascular and macrovascular thrombi suggest that hemostatic imbalances may contribute to the pathophysiology of SARS-CoV-2 infection. We review the laboratory and clinical findings of patients with COVID-19-associated coagulopathy, and prior studies of hemostasis in other viral infections and acute respiratory distress syndrome. We hypothesize that an imbalance between coagulation and inflammation may result in a hypercoagulable state. Although thrombosis initiated by the innate immune system is hypothesized to limit SARS-CoV-2 dissemination, aberrant activation of this system can cause endothelial injury resulting in loss of thromboprotective mechanisms, excess thrombin generation, and dysregulation of fibrinolysis and thrombosis. The role various components including neutrophils, neutrophil extracellular traps, activated platelets, microparticles, clotting factors, inflammatory cytokines, and complement play in this process remains an area of active investigation and ongoing clinical trials target these different pathways in COVID-19.


COVID-19: are frontline surgical staff ready for this?


Mein Patient hat eine Warnung von seiner Corona-App  was soll ich tun? : Eindämmung der COVID-19-Pandemie


title: Democracy, Capacity, and Coercion in Pandemic Response-COVID 19 in Comparative Political Perspective

text: The COVID-19 pandemic has challenged governments around the world. It has also challenged conventional wisdom and empirical understandings in the comparative politics and policy of health. Three major questions present themselves: First, some of the countries considered to be the most prepared-having the greatest capacity for outbreak response-have failed to respond effectively to the pandemic. How should our understanding of capacity shift in light of COVID-19, and how can we incorporate political capacity into thinking about pandemic preparedness? Second, several of the mechanisms through which democracy has been shown to be beneficial for health have not traveled well to explain the performance of governments in this pandemic. Is there an authoritarian advantage in disease response? Third, after decades in which coercive public health measures have increasingly been considered counterproductive, COVID-19 has inspired widespread embrace of rigid lockdowns, isolation, and quarantine enforced by police. Will these measures prove effective in the long run and reshape public health thinking? This article explores some of these questions with emerging examples, even amid the pandemic when it is too soon to draw conclusions.


title: [Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department]

text: The rapid progression of COVID-19 is an organizational challenge for all hospitals To secure the patient overflow, the Department internal medicine of the University Hospital of Lausanne increased nurse and medical workforces as well as bed capacity by 65 %, with extraordinary help from other departments The implemented crisis management stood upon three pillars : a crisis management team, steering documents and internal communication In this new form, the Department had already taken care of 442 COVID-19 admissions by April 16, 2020 Alongside organizational challenges, clinical issues such as rapid respiratory distress, clinical suspicions with negative PCR and treatment uncertainties in the absence of sufficient evidence were overcome Despite the peak of the pandemic appearing to have passed, the next phase could be just as complicated


title: Organizational Impacts and Clinical Challenges of the COVID-19 Pandemic on a Swiss Tertiary Internal Medicine Department/ Impacts organisationnels et defis cliniques de la pandemie COVID-19 pour un service hospitalier de medecine interne universitair

text: The rapid progression of COVID-19 is an organizational challenge for all hospitals To secure the patient overflow, the Department internal medicine of the University Hospital of Lausanne increased nurse and medical workforces as well as bed capacity by 65 %, with extraordinary help from other departments The implemented crisis management stood upon three pillars : a crisis management team, steering documents and internal communication In this new form, the Department had already taken care of 442 COVID-19 admissions by April 16, 2020 Alongside organizational challenges, clinical issues such as rapid respiratory distress, clinical suspicions with negative PCR and treatment uncertainties in the absence of sufficient evidence were overcome Despite the peak of the pandemic appearing to have passed, the next phase could be just as complicated La progression rapide du COVID-19 constitue un defi organisationnel pour tous les hopitaux Pour anticiper un afflux important de patients, le service de medecine interne du CHUV a ainsi augmente ses forces de travail medico-soignantes et son nombre de lits de 65 % avec un soutien extraordinaire de toute linstitution Pour operer ces changements majeurs, lorganisation de crise mise en place sest appuyee sur trois piliers : une cellule de conduite, des documents de pilotage et une communication interne Sous cette nouvelle forme, le service a pris en charge 442 hospitalisations COVID-19 jusquau 16 avril 2020 Si les enjeux organisationnels ont ete majeurs, la gestion des situations complexes, comme les manifestations respiratoires et les multiples incertitudes cliniques diagnostiques et therapeutiques, ont ete egalement une gageure Le pic de la pandemie semble passe, mais la prochaine phase pourrait constituer un nouveau defi organisationnel


Confronting the COVID-19 surgery crisis: time for transformational change


COVID-19 Pandemic: Opportunity to Advanced Home Care for Older Adults


title: A Vision-based Social Distancing and Critical Density Detection System for COVID-19

text: Social distancing has been proven as an effective measure against the spread of the infectious COronaVIrus Disease 2019 (COVID-19). However, individuals are not used to tracking the required 6-feet (2-meters) distance between themselves and their surroundings. An active surveillance system capable of detecting distances between individuals and warning them can slow down the spread of the deadly disease. Furthermore, measuring social density in a region of interest (ROI) and modulating inflow can decrease social distancing violation occurrence chance. On the other hand, recording data and labeling individuals who do not follow the measures will breach individuals' rights in free-societies. Here we propose an Artificial Intelligence (AI) based real-time social distancing detection and warning system considering four important ethical factors: (1) the system should never record/cache data, (2) the warnings should not target the individuals, (3) no human supervisor should be in the detection/warning loop, and (4) the code should be open-source and accessible to the public. Against this backdrop, we propose using a monocular camera and deep learning-based real-time object detectors to measure social distancing. If a violation is detected, a non-intrusive audio-visual warning signal is emitted without targeting the individual who breached the social distancing measure. Also, if the social density is over a critical value, the system sends a control signal to modulate inflow into the ROI. We tested the proposed method across real-world datasets to measure its generality and performance. The proposed method is ready for deployment, and our code is open-sourced.


title: ï»¿Aus der Frühzeit der Ästhetischen Chirurgie: Eugen Holländer (18671932) und Erich Lexer (18671937) als Face-Lift-Pioniere./ [The early days of aesthetic surgery: facelift pioneers Eugen Holländer (1867-1932) and Erich Lexer (1967-1937)]

text: INTRODUCTION AND BACKGROUND: The human desire to achieve an improved/better way of looking can be traced back through all times of human history and culminated in the realm of plastic surgery in the beginning of the early 20th century. In particular a main interest was hereby the so-called facelift surgery and the first two German pioneers in this field: Eugen Holländer and Erich Lexer. AIM OF THE PAPER: The surgeons Eugen Holländer and Erich Lexer contributed to a big part to the development of facelift techniques. The paper aims to highlight in which way both surgeons conducted their research work and the topic of facelift and which findings could be drawn out of their work. METHOD: On the basis of old specialist literature and congressional quotations the curriculua vitae of Eugen Holländer and Erich Lexer are portrayed, as well as their professional career and their ground breaking work for facelift surgery and its differences amongst each other. CONCLUSION: Both Eugen Holländer and Erich Lexer performed, independently from another, the first facelifts in Germany. Hereby, their operative approach was different. In contrast to Holländer who only performed skin resections for a better tightening of the face, Lexer undermined the skin in an area of multiple centimetres.Even in their suture technique the difference was visible. Lexer for instance conducted a special suture technique by including the fascia temporalis superficialis in his sutures for achieving lasting stability and tension relief. Due to this reason Lexer can be regarded without any doubt as the initial pioneer of modern facelift surgery.


title: Open access institutional and news media tweet dataset for COVID-19 social science research

text: As COVID-19 quickly became one of the most concerned global crisis, the demand for data in academic research is also increasing. Currently, there are several open access Twitter datasets, but none of them is dedicated to the institutional and news media Twitter data collection, to fill this blank, we retrieved data from 69 institutional/news media Twitter accounts, 17 of them were related to government and international organizations, 52 of them were news media across North America, Europe and Asia. We believe our open access data can provide researchers more availability to conduct social science research.


COVID-19 and vitamin D-Is there a link and an opportunity for intervention?


title: Practical Online Assessment of Mathematical Proof

text: We discuss a practical method for assessing mathematical proof online. We examine the use of faded worked examples and reading comprehension questions to understand proof. By breaking down a given proof, we formulate a checklist that can be used to generate comprehension questions which can be assessed automatically online. We then provide some preliminary results of deploying such questions.


Centralization of the ST elevation myocardial infarction care network in the Lombardy region during the COVID-19 outbreak


100 years of influenza research seen through the lens of Covid-19


A possible benefit from therapeutic anticoagulation in COVID-19: the Dolo hospital experience in Veneto, Italy


title: Translating Diffusion, Wavelets, and Regularisation into Residual Networks

text: Convolutional neural networks (CNNs) often perform well, but their stability is poorly understood. To address this problem, we consider the simple prototypical problem of signal denoising, where classical approaches such as nonlinear diffusion, wavelet-based methods and regularisation offer provable stability guarantees. To transfer such guarantees to CNNs, we interpret numerical approximations of these classical methods as a specific residual network (ResNet) architecture. This leads to a dictionary which allows to translate diffusivities, shrinkage functions, and regularisers into activation functions, and enables a direct communication between the four research communities. On the CNN side, it does not only inspire new families of nonmonotone activation functions, but also introduces intrinsically stable architectures for an arbitrary number of layers.


Economic Impacts of the COVID-19 Crisis: An Orthopaedic Perspective


title: Caregiving in Times of Uncertainty: Helping Adult Children of Aging Parents Find Support during the COVID-19 Outbreak

text: The COVID-19 pandemic, which is especially dangerous to older people, has disrupted the lives of older people and their family caregivers. This commentary outlines the adaptive and emerging practices in formal supportive services for family caregivers, the changing types of support that family caregivers are providing to their older relatives, and the ways family caregivers are seeking informal caregiving support during the COVID-19 outbreak.


title: Hospital visiting policies in the time of coronavirus disease 2019: A nationwide website survey in Taiwan

text: BACKGROUND: Coronavirus disease 2019 (COVID-19), a novel infectious coronavirus disease, has become a worldwide pandemic. Infection control precautions for hospital visitors are needed to avoid cluster outbreaks, so this study investigated the visiting policies of all the hospitals in Taiwan in the time of COVID-19. METHODS: From March 15, 2020, to March 18, 2020, we searched the official websites of all 472 National Health Insurance-contracted hospitals to determine their visiting policies. For those hospitals that had posted new visiting policies and still allowed visits to ordinary wards, we recorded the relevant details shown on their websites, including the number of visitors allowed at one time, the number of visiting slots per day, the total visiting hours per day, and the rules provided to visitors before visiting. RESULTS: During the study period, 276 (58.5%) hospitals had posted new visiting policies on their websites, with higher proportions of academic medical centers (92.0%, 23/25) and metropolitan hospitals (91.5%, 75/82) than local community hospitals (48.8%, 178/365) doing so. Visits to ordinary wards were forbidden in 83 hospitals among those. Among the 193 hospitals that had new visiting policies and still allowed visits to ordinary wards, 73.1% (n = 141) restricted visitors to two at a time and 54.9% (n = 106) restricted visits to two visiting slots per day. Furthermore, history taking regarding travel, occupation, contacts, and cluster information was mentioned by 82.4% (n = 159) of these 193 hospitals, body temperature monitoring by 78.2% (n = 151), hand hygiene by 63.2% (n = 122), and identity checks by 51.8% (n = 100). CONCLUSION: In the time of COVID-19 covered by this study, about three-fifths of the hospitals in Taiwan had posted their visiting policies for ordinary wards on their websites. Furthermore, the thoroughness with which such visiting policies have been enforced also requires investigation.


Fire, disease and fear: Effects of the media coverage of 2019-2020 Australian bushfires and novel coronavirus 2019 on population mental health


title: It's not over until it's over: the chameleonic behavior of COVID-19 over a six-day period

text: The current global outbreak of COVID-19 represents a major challenge in terms of epidemiology, contagiousness, treatment, as well as clinical and radiological behavior of this disease. Radiological imaging plays a key role in the diagnostic process and during the monitoring of the clinical conditions especially of patients with severe symptoms. According to the preliminary data collected in our tertiary center, we have documented a peculiar behavior in patients requiring endotracheal intubation who underwent seriate chest X-rays. In fact, the radiological pattern of COVID-19 patients may worsen despite a prompt amelioration after the onset of mechanical ventilation. Thus, according to our initial evidence, we recommend to perform seriate chest X-rays in the days following the onset of mechanical ventilation even if the immediate monitoring suggests an improvement. Studies on a larger scale are necessary to fully assess the findings at chest radiographs of critical, mechanically ventilated patients and their correlation with the long-term outcome.


title: CogMol: Target-Specific and Selective Drug Design for COVID-19 Using Deep Generative Models

text: The novel nature of SARS-CoV-2 calls for the development of efficient de novo drug design approaches. In this study, we propose an end-to-end framework, named CogMol (Controlled Generation of Molecules), for designing new drug-like small molecules targeting novel viral proteins with high affinity and off-target selectivity. CogMol combines adaptive pre-training of a molecular SMILES Variational Autoencoder (VAE) and an efficient multi-attribute controlled sampling scheme that uses guidance from attribute predictors trained on latent features. To generate novel and optimal drug-like molecules for unseen viral targets, CogMol leverages a protein-molecule binding affinity predictor that is trained using SMILES VAE embeddings and protein sequence embeddings learned unsupervised from a large corpus. CogMol framework is applied to three SARS-CoV-2 target proteins: main protease, receptor-binding domain of the spike protein, and non-structural protein 9 replicase. The generated candidates are novel at both molecular and chemical scaffold levels when compared to the training data. CogMol also includes insilico screening for assessing toxicity of parent molecules and their metabolites with a multi-task toxicity classifier, synthetic feasibility with a chemical retrosynthesis predictor, and target structure binding with docking simulations. Docking reveals favorable binding of generated molecules to the target protein structure, where 87-95 % of high affinity molecules showed docking free energy<-6 kcal/mol. When compared to approved drugs, the majority of designed compounds show low parent molecule and metabolite toxicity and high synthetic feasibility. In summary, CogMol handles multi-constraint design of synthesizable, low-toxic, drug-like molecules with high target specificity and selectivity, and does not need target-dependent fine-tuning of the framework or target structure information.


title: Organ Transplantation during COVID-19 Pandemic: Making the Best Patient Care Decision

text: It is with great interest and sadness that we read the experience of Akalin et al. and Pereira et al. with unprecedented mortality (18-28%) in transplant recipients in New York City, New York. High mortality reports in transplant patients have created anxiety among some community practitioners as evidence as to why transplants should not be performed at this time, contrary to the recommendations from multiple transplant organizations.


title: Drs. Cron and Chatham reply

text: We value Dr. Caricchio's and Dr. Criner's appreciation of our commentary on the role of rheumatologists in the coronavirus disease 2019 (COVID-19) pandemic1 We applaud Temple University for collaborating in the care of hospitalized patients with COVID-19, many of whom are experiencing a cytokine storm syndrome (CSS)2.


title: Adjusted preoperative variables to predict perioperative red blood cell transfusion in coronary artery bypass grafting

text: BACKGROUND: The variables for predicting blood transfusion perioperatively are not completely clear in coronary artery bypass grafting (CABG) patients. OBJECTIVES: To construct a comprehensive model to predict perioperative RBC transfusion in patients undergoing isolated CABG using adjusted preoperative variables. METHODS: Perioperative data of 1253 patients who underwent isolated CABG by the same surgical team were collected from April 2018 to March 2019. Logistic regression analyses were used to establish equations to construct two models for predicting intraoperative and postoperative RBC transfusions, respectively. All significant variables included in the two models were combined to form a comprehensive model to predict perioperative RBC transfusion. Area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the discriminatory power of the models. RESULTS: The total RBC transfusion rate for CABG patients during hospitalization was 29.05%. The rate of intraoperative and postoperative RBC transfusions was 6.9% and 26.7%, respectively. Eight variables in a total of 30 risk factors constituted the intraoperative prediction model, 12 variables constituted the postoperative prediction model, and 13 variables for the combined model. The AUC of the three models were 0.87, 0.82, and 0.83, respectively, demonstrating moderate discriminatory power for RBC transfusion during the intraoperative, postoperative, and perioperative periods. CONCLUSION: The comprehensive model combined with all variables of predicting intraoperative and postoperative RBC transfusion is feasible for predicting perioperative RBC transfusion.


title: Managing Cancer Care during the COVID-19 Pandemic and Beyond

text: The coronavirus disease 2019 (COVID-19) pandemic is posing insurmountable challenges to healthcare systems globally. Cancer therapy is complex, and outcomes are centered on timing. Many oncology societies and health ministries have issued guidelines for cancer care to enable oncologists and patients to navigate the crisis. Lessons learned should inform care models for future pandemics.


title: Coronavirus disease 2019 (COVID-19): challenges and management of aerosol-generating procedures in dentistry

text: Data sources Experimental investigation.Study design A retrospective review to evaluate the use of a negative-pressure otolaryngology viral isolation drape (NOVID) system to reduce cross-infection through aerosol. The apparatus consists of a plastic drape suspended over the surgical field in the head and neck region with a smoke evacuator suction placed inside the chamber with an ultra-low penetrating air (ULPA) efficiency rating and a fluid suction high-efficiency particulate air (HEPA) filter compartment. Spread of patient secretions and droplet formation was evaluated using 1% fluorescein dye in 10 ml of normal saline and ultraviolet light. The dye was applied topically in the nasal cavity and nasopharynx preoperatively and intraoperatively prior to the use of instruments such as micro-debrider, electrocautery and high-speed drilling. Following completion of the surgical procedure, an ultraviolet Wood's lamp was used to evaluate the presence of droplets on the surgical drapes and surgical gowns of the operating team.Results The study sample consisted of four patients who underwent endonasal endoscopic surgical procedures; two of these patients required concurrent endoscopic sinus surgery. A micro-debrider was used in three cases; electrocautery in three cases, while a high-speed drilling was employed in two cases. Presence of fluorescein was identified around the patients' nares; on the chest wipe and instrument tray in all four patients. Dye contamination was noted on the gauze placed over the smoke evacuator (two cases of skull base surgery); no fluid droplets were identified beyond the nares or the smoke evacuator (two cases of sinus surgery). However, fluid contamination was identified underneath barrier several centimetres away from the nares (one case of trans-sphenoidal surgery). Droplets were also identified on the surgeon's gown in the abdominal region in all cases and on the arm region in one case. In one case, droplets were also identified on the abdominal region of the nurse, but this was attributed to cross contamination from surgical gauze and instruments. Conclusions This retrospective study provides preliminary data on aerosol and droplet contamination during endonasal and transoral surgery performed under a negative pressure isolation drape system. Although the authors did not screen patients for SARS-CoV-2, they propose smoke evacuator ULPA filter attachment is appropriate to capture particles down to 0.1 microns including SARS-CoV-2 which is 0.125 microns. It would be helpful to see direct evidence to support this claim in future studies. The authors have not provided details regarding set-up time and training requirements for effective application of the isolation drape apparatus or the associated costs etc. It would have also been helpful if the authors could comment on any potential difficulties in undertaking the surgical procedure with the isolation system in place. The sample size is limited to four patients and variations in the magnitude and extent of aerosol contamination needs to be investigated further before drawing any conclusions. Although unlikely, this study design did not capture the presence of aerosol/droplets in the air within the operating room which may follow removal of the isolation drape system or from exposed surgical instruments. Notwithstanding the limitations of the design, negative-pressure aspiration of air under a chamber barrier is likely to minimise the contamination from aerosol and droplet during endonasal and transoral surgery.


Balancing Choices to Recover From the COVID-19 Pandemic


title: The Fallibility of Contact-Tracing Apps

text: Since the onset of the COVID-19's global spread we have been following the debate around contact tracing apps -- the tech-enabled response to the pandemic. As corporations, academics, governments, and civil society discuss the right way to implement these apps, we noticed recurring implicit assumptions. The proposed solutions are designed for a world where Internet access and smartphone ownership are a given, people are willing and able to install these apps, and those who receive notifications about potential exposure to the virus have access to testing and can isolate safely. In this work we challenge these assumptions. We not only show that there are not enough smartphones worldwide to reach required adoption thresholds but also highlight a broad lack of internet access, which affects certain groups more: the elderly, those with lower incomes, and those with limited ability to socially distance. Unfortunately, these are also the groups that are at the highest risks from COVID-19. We also report that the contact tracing apps that are already deployed on an opt-in basis show disappointing adoption levels. We warn about the potential consequences of over-extending the existing state and corporate surveillance powers. Finally, we describe a multitude of scenarios where contact tracing apps will not help regardless of access or policy. In this work we call for a comprehensive and equitable policy response that prioritizes the needs of the most vulnerable, protects human rights, and considers long term impact instead of focusing on technology-first fixes.


Should we unstress SARS-CoV-2 infected cells?


COVID-19 pneumonia: ARDS or not?


title: [Diagnosis, treatment, control and prevention of SARS-CoV-2 and coronavirus disease 2019: back to the future]

text: The ongoing outbreak of the coronavirus disease 2019 (COVID-19) as named by the World Health Organization has millions of confirmed cases around the world and has claimed hundreds of thousands of lives. The virus was named SARS-CoV-2 in February by International Committee on Taxonomy of Viruses. COVID-19 presents as fever, dry cough, dyspnea, headache and pneumonia. In a small subset of severe cases, the disease quickly progresses to respiratory failure and even death. Since the 21st century, there have been three major outbreaks caused by human coronaviruses, including the severe acute respiratory syndrome (SARS) that broke out in 2003, the Middle East respiratory syndrome (MERS) in 2012, and the recent pandemic of COVID-19. Since 2003, significant progress has been made in the study of SARS-CoV and MERS-CoV concerning their natural origins, pathogenesis, antiviral development and vaccine design. Since SARS-CoV-2 and SARS-CoV are closely related, previous findings on SARS-CoV are highly relevant to a better understanding as well as diagnosis, treatment, prevention and control of SARS-CoV-2. In this review, we highlight recent progresses in the field; compare the biological characteristics of SARS-CoV and SARS-CoV-2; summarize the urgently-needed diagnostic, treatment, prevention and control options; and provide future perspectives for the outcome of the outbreak and research questions to be answered, including some of the difficulties in vaccine development. Hopefully, our comments and suggestions would prove useful for the control of the SARS-CoV-2 epidemic in China and the world.


The impact of COVID-19 on Brazilian mental health through vicarious traumatization


title: Infection par le SARS-CoV-2 chez les femmes enceintes : état des connaissances et proposition de prise en charge par CNGOF./ [SARS-CoV-2 infection during pregnancy. Information and proposal of management care. CNGOF]

text: A new coronavirus (SARS-CoV-2) highlighted at the end of 2019 in China is spreading across all continents. Most often at the origin of a mild infectious syndrome, associating mild symptoms (fever, cough, myalgia, headache and possible digestive disorders) to different degrees, SARS-Covid-2 can cause serious pulmonary pathologies and sometimes death. Data on the consequences during pregnancy are limited. The first Chinese data published seem to show that the symptoms in pregnant women are the same as those of the general population. There are no cases of intrauterine maternal-fetal transmission, but cases of newborns infected early suggest that there could be vertical perpartum or neonatal transmission. Induced prematurity and cases of respiratory distress in newborns of infected mothers have been described. Pregnancy is known as a period at higher risk for the consequences of respiratory infections, as for influenza, so it seems important to screen for Covid-19 in the presence of symptoms and to monitor closely pregnant women. In this context of the SARS-Covid-2 epidemic, the societies of gynecology-obstetrics, infectious diseases and neonatalogy have proposed a French protocol for the management of possible and proven cases of SARS-Covid-2 in pregnant women. These proposals may evolve on a daily basis with the advancement of the epidemic and knowledge in pregnant women. Subsequently, an in-depth analysis of cases in pregnant women will be necessary in order to improve knowledge on the subject.


title: Self-amplifying RNA SARS-CoV-2 lipid nanoparticle vaccine candidate induces high neutralizing antibody titers in mice

text: The spread of the SARS-CoV-2 into a global pandemic within a few months of onset motivates the development of a rapidly scalable vaccine. Here, we present a self-amplifying RNA encoding the SARS-CoV-2 spike protein encapsulated within a lipid nanoparticle (LNP) as a vaccine. We observe remarkably high and dose-dependent SARS-CoV-2 specific antibody titers in mouse sera, as well as robust neutralization of both a pseudo-virus and wild-type virus. Upon further characterization we find that the neutralization is proportional to the quantity of specific IgG and of higher magnitude than recovered COVID-19 patients. saRNA LNP immunizations induce a Th1-biased response in mice, and there is no antibody-dependent enhancement (ADE) observed. Finally, we observe high cellular responses, as characterized by IFN-Î³ production, upon re-stimulation with SARS-CoV-2 peptides. These data provide insight into the vaccine design and evaluation of immunogenicity to enable rapid translation to the clinic.


title: Clinical features and short-term outcomes of elderly patients with COVID-19

text: BACKGROUND: The outbreak of Coronavirus Disease 2019 (COVID-19) has become a global public health emergency. METHODS: 204 elderly patients (≥60 years old) diagnosed with COVID-19 in Renmin Hospital of Wuhan University from January 31st to February 20th, 2020 were included in this study. Clinical endpoint was in-hospital death. RESULTS: Of the 204 patients, hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease (COPD) were the most common coexisting conditions. 76 patients died in the hospital. Multivariate analysis showed that dyspnea (hazards ratio (HR) 2.2, 95% confidence interval (CI) 1.414-3.517; p < 0.001), older age (HR 1.1, 95% CI 1.070-1.123; p < 0.001), neutrophilia (HR 4.4, 95% CI 1.310-15.061; p = 0.017) and elevated ultrasensitive cardiac troponin I (HR 3.9, 95% CI 1.471-10.433; p = 0.006) were independently associated with death. CONCLUSION: Although so far the overall mortality of COVID-19 is relatively low, the mortality of elderly patients is much higher. Early diagnosis and supportive care are of great importance for the elderly patients of COVID-19.


Environmental virus surveillance in the isolation ward of COVID-19


title: Examining boundaries to understand the impact of COVID-19 on vocational behaviors

text: The COVID-19 has posed an unprecedented challenge to the global workforce. To better understand the impact of the pandemic on work and careers, I call for research taking a closer look at the boundaries in the career context. Specifically, both the micro (boundaries that demarcate role domains) and macro (national borders) boundaries should be considered. The pandemic changes the existing boundaries and challenges the "usual" practices; while it blurs the micro, cross-domain boundaries, it strengthens the macro, cross-country boundaries. I propose that the changes in the micro and macro boundaries are one of the important mechanisms in how COVID-19 affects many individuals' vocational behaviors and career outcomes. In this essay, I explain why we should pay more attention to the boundaries to learn about the impact of COVID-19 on vocational and career behaviors. I conclude with a discussion of several directions for future research.


title: A Semantically Enriched Dataset based on Biomedical NER for the COVID19 Open Research Dataset Challenge

text: Research into COVID-19 is a big challenge and highly relevant at the moment. New tools are required to assist medical experts in their research with relevant and valuable information. The COVID-19 Open Research Dataset Challenge (CORD-19) is a"call to action"for computer scientists to develop these innovative tools. Many of these applications are empowered by entity information, i. e. knowing which entities are used within a sentence. For this paper, we have developed a pipeline upon the latest Named Entity Recognition tools for Chemicals, Diseases, Genes and Species. We apply our pipeline to the COVID-19 research challenge and share the resulting entity mentions with the community.


title: Clonal haematopoiesis and COVID-19: A possible deadly liaison

text: We provide evidence for a linear correlation between the frequency of clonal haematopoiesis and COVID-19 mortality rate. We discuss the mechanistic explanations for this association mediated by a pathological inflammatory response. Our hypothesis can be tested in COVID-19-infected patients and eventually lead to new approaches to risk stratification and therapy.


title: Clinical trials of repurposed antivirals for SARS-CoV-2

text: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has prompted the repurposing of drugs on the basis of promising in vitro and therapeutic results with other human coronavirus diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). These repurposed drugs have mainly included remdesivir, favipiravir, lopinavir/ritonavir, ribavirin, interferons, and hydroxychloroquine. Unfortunately, the first open-label, randomized controlled trials are showing the poor efficacy of these repurposed drugs. These results highlight the necessity of identifying and characterizing specific and potent SARS-CoV-2 antivirals.


Physical inactivity and cardiovascular disease at the time of coronavirus disease 2019 (COVID-19)


title: The Mental Health Consequences of Coronavirus Disease 2019 Pandemic in Dentistry

text: With the spread of coronavirus disease 2019 (COVID-19), strict isolation strategies to limit virus transmission have been applied worldwide. The lockdown has affected and challenged different medical areas. Doctors, nurses, dentists, and other health care workers are concerned about contagion, not only for themselves, but also for their families and colleagues. Furthermore, the oral mucosa has been accepted as a high-risk route of transmission for COVID-19. In many countries, dentists have been forced to stop working during quarantine until further notification. Isolation and its financial impact have produced physical and psychological pressure, depression, social anxiety, and other mental health concerns. This article aims to provide a comprehensive review of the consequences of past epidemics on mental health and to assess possible aspects that might be associated with mental implications in dentists during the COVID-19 pandemic. Finally, some concrete actions to avoid subsequent potential consequences are recommended.


title: A COVID-19 pandemic guideline in evidence-based medicine

text: Data sources This review article scrutinised 16 clinical studies (clinical trials and observational studies) concerning coronavirus disease of 2019 (COVID-19). Additionally, 18 guidelines about the COVID-19 were reviewed and the key points were represented in this study.Study selection The review included human trials, in-vitro studies, review articles, and credible news reports about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 complications, treatment guidelines, management strategies, and epidemiological features. There were no exclusion criteria reported in this review and the included information was in English and Chinese languages.Data extraction and synthesis A descriptive review of the literature was conducted, taking a comprehensive approach. The paper consisted of three main parts: introduction, presentation, and management. The introduction part presented basic information about the SARS-CoV-2, its evolution and transmission, and the course of disease. The presentation section introduced the signs and symptoms, diagnosis, high risk groups, and complications of COVID-19. Eventually, some evidence was presented about the prevention, medical management, and measuring responses to the treatments in the management section.Results Based on the results of this study, non-pharmaceutical interventions, including strict social isolation and distancing measures, might reduce the spread of the SARS-CoV-2 by nearly 99.3 percent (reproduction number mitigating from 406 to 2.5 in 30 days). In the supportive management section, monitoring vital signs and neonatal feeding were stated as the most important factors to consider. For symptomatic neonates, medical management and intervention were mentioned as essential. It was claimed that for adults with mild infection, the best option would be home quarantine with further medical monitoring or hospitalisation if required. The following sequence was also suggested as early supportive therapy and monitoring: intravenous fluid administration, oxygen therapy, and application of corticosteroids. Management of critical patients with critical COVID-19 included admission to intensive care unit, use of continuous positive airway pressure and bi-level positive airway pressure in certain circumstances, endotracheal intubation, invasive mechanical ventilation, extracorporeal membrane oxygenation, and fluid resuscitation and vasopressors. Additionally, this study suggested oseltamivir, iopinavir, remdesivir, chloroquine, baricitinib, ruxolitinib, and fedratinib as possible drugs to help manage COVID-19. A soaring c-reactive protein level and decreased albumin content in the blood were reported to be associated with a deteriorating status in COVID-19 patients. To keep the number of exposures to a minimum, two separate viral clearance tests taken at least 24 hours apart, were stated as necessary laboratory results before the discharge of patients with COVID-19.Conclusions The study warns about possible exponential spread of COVID-19 and proposes to adhering to tighter restrictions of social distancing. Besides the clinical guidelines presented within the study, it also encourages further up-to-date and evidence-based management guidelines for patients with COVID-19.


Impact of the coronavirus disease 2019 pandemic on postgraduate medical education in a Singaporean academic medical institution


title: Self-supervised edge features for improved Graph Neural Network training

text: Graph Neural Networks (GNN) have been extensively used to extract meaningful representations from graph structured data and to perform predictive tasks such as node classification and link prediction. In recent years, there has been a lot of work incorporating edge features along with node features for prediction tasks. One of the main difficulties in using edge features is that they are often handcrafted, hard to get, specific to a particular domain, and may contain redundant information. In this work, we present a framework for creating new edge features, applicable to any domain, via a combination of self-supervised and unsupervised learning. In addition to this, we use Forman-Ricci curvature as an additional edge feature to encapsulate the local geometry of the graph. We then encode our edge features via a Set Transformer and combine them with node features extracted from popular GNN architectures for node classification in an end-to-end training scheme. We validate our work on three biological datasets comprising of single-cell RNA sequencing data of neurological disease, \textit{in vitro} SARS-CoV-2 infection, and human COVID-19 patients. We demonstrate that our method achieves better performance on node classification tasks over baseline Graph Attention Network (GAT) and Graph Convolutional Network (GCN) models. Furthermore, given the attention mechanism on edge and node features, we are able to interpret the cell types and genes that determine the course and severity of COVID-19, contributing to a growing list of potential disease biomarkers and therapeutic targets.


Overmedication in COVID-19 context: a report from Peru


COVID-19: A perspective of a frontline worker


From Viral City to Smart City: Learning from Pandemic Experiences


Concomitant acute aortic thrombosis and pulmonary embolism complicating COVID-19 pneumonia


title: Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020

text: Since December 2019, China has been experiencing a large outbreak of a novel coronavirus (2019-nCoV) which can cause respiratory disease and severe pneumonia. We estimated the basic reproduction number R0 of 2019-nCoV to be around 2.2 (90% high density interval: 1.4-3.8), indicating the potential for sustained human-to-human transmission. Transmission characteristics appear to be of similar magnitude to severe acute respiratory syndrome-related coronavirus (SARS-CoV) and pandemic influenza, indicating a risk of global spread.


title: Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19

text: BACKGROUND: There are many pharmacologic therapies that are being used or considered for treatment of COVID-19. There is a need for frequently updated practice guidelines on their use, based on critical evaluation of rapidly emerging literature. OBJECTIVE: Develop evidence-based rapid guidelines intended to support patients, clinicians and other health-care professionals in their decisions about treatment and management of patients with COVID-19. METHODS: IDSA formed a multidisciplinary guideline panel of infectious disease clinicians, pharmacists, and methodologists with varied areas of expertise. Process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. RESULTS: The IDSA guideline panel agreed on 7 treatment recommendations and provided narrative summaries of other treatments undergoing evaluations. CONCLUSIONS: The panel expressed the overarching goal that patients be recruited into ongoing trials, which would provide much needed evidence on the efficacy and safety of various therapies for COVID-19, given that we could not make a determination whether the benefits outweigh harms for most treatments.


title: Organización y gestión interna del servicio de farmacia./ Pharmacy Department management and organization

text: The WHO declared the SARS- CoV-2 outbreak a pandemic in March 11, 2020. Spain has been the third country with the highest number of reported cases of COVID-19. In the face of the pandemic, the authorities of the Autonomous Community of Madrid led an unprecedented transformation of hospital services by increasing the number of beds available, setting up temporary field hospitals in fairgrounds, and transforming hotels into support centers for patients with mild symptoms of COVID-19. In the light that this crisis will continue to be a real threat for the years to come, our hospital pharmacies need to be better prepared for similar outbreaks in the future. During the COVID-19 pandemic, the Department of Hospital Pharmacy of Hospital General Universitario Gregorio Marañón has faced four challenges: an exponential increase in the demand for resources, constant changes to therapeutic protocols and approaches, regulatory changes, and a dramatic impact on hospital staff (strain on human resources and psychological impact). This article is aimed at describing the main organizational changes implemented to the Department of Hospital Pharmacy of Hospital GU Gregorio Marañón and its relationship with other hospital pharmacies of the Community of Madrid. An account is provided of the strategies to be adopted for reorganizing a Department of Hospital Pharmacy and achieve a safe and effective use of medications. Strategies range from the creation of integral hospital task groups (COVID-crisis task group, protocolization task group, research task group) to the adaptation of the internal organization of the Department of Hospital Pharmacy, which encompasses aspects related to management and leadership; a communication plan (internal and external); staff management, and the reorganization and adaptation of processes. People, patients and professionals are at the core of these strategies. This paper is a reflection on key factors of "humanization in COVID times".


title: Ophthalmologische Betreuung von stationären, intensivpflichtigen SARS-CoV-2-positiven Patienten./ [Ophthalmological care of SARS-CoV-2 positive patients in intensive care units]

text: Early ophthalmological care of patients in intensive care with SARS-CoV2 (Severe-Acute-Respiratory-Syndrom-Corona-Virus-2) infections is very time-consuming; however, this approach might prevent other ophthalmological diseases, such as lagophthalmos. There is no difference in ophthalmological treatment between SARS-CoV2 positive and other intensive care patients. Due to the small number of cases in our observational study, a specific ophthalmological clinical pattern related to SARS-CoV2 infections cannot currently be identified; however, the increased occurrence of subconjunctival hemorrhage in intensive care SARS-CoV2 patients is remarkable. It remains unclear how ocular symptoms in SARS-CoV2 infections are related or how they occur in different stages of the disease. Therefore, further studies are necessary for representative statements.


title: Three kinds of treatment with Homoharringtonine, Hydroxychloroquine or shRNA and their combination against coronavirus PEDV in vitro

text: BACKGROUND: Porcine epidemic diarrhea virus (PEDV) of the family Coronaviridae has caused substantial economic losses in the swine husbandry industry. There's currently no specific drug available for treatment of coronaviruses or PEDV. METHOD: In the current study, we use coronavirus PEDV as a model to study antiviral agents. Briefly, a fusion inhibitor tHR2, recombinant lentivirus-delivered shRNAs targeted to conserved M and N sequences, homoharringtonine (HHT), and hydroxychloroquine (HCQ) were surveyed for their antiviral effects. RESULTS: Treatment with HCQ at 50 µM and HHT at 150 nM reduced virus titer in TCID50 by 30 and 3.5 fold respectively, and the combination reduced virus titer in TCID50 by 200 fold. CONCLUSION: Our report demonstrates that the combination of HHT and HCQ exhibited higher antiviral activity than either HHT or HCQ exhibited. The information may contribute to the development of antiviral strategies effective in controlling PEDV infection.


Initial effects of the COVID-19 pandemic on pediatric asthma emergency department utilization


title: Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

text: Importance: The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists-head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations: A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance: Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19.