title: [Advances in the research of mechanism and related immunotherapy on the cytokine storm induced by coronavirus disease 2019]

text: Coronavirus disease 2019 (COVID-19) has seriously affected the safety of patients and social stability. Some COVID-19 patients in the later stage of disease may develop into acute respiratory distress syndrome or even multiple organ failure. However, one of the most important mechanisms underlying the deterioration of disease is cytokine storm. At present, some therapies such as interleukin-6 antibody blocker, stem cell therapy, and transfusion of convalescent plasma have been applied to counteract the cytokine storm with some progresses being achieved. This article reviews the influences of cytokine storm syndrome on the COVID-19 and the corresponding immunotherapies to resist cytokine storm.


title: [Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies]

text: Corona Virus Disease 2019 (COVID-19) has seriously affected the treatment of patients and social stability. In the later stage of disease, some COVID-19 patients may develop into acute respiratory distress syndrome or even multiple organ failure. However, one of the most important mechanism underlying the deterioration of disease is cytokine storm. At present, some therapies such as interleukin-6 antibody blocker, stem cell therapy, and transfusion of convalescent plasma have been applied to counteract the cytokine storm and have made some progress. This article reviews the influences of cytokine storm syndrome on the COVID-19 and the corresponding immunotherapies to resist cytokine storm.


Epitopes for a 2019-nCoV vaccine


title: The genetic sequence, origin, and diagnosis of SARS-CoV-2

text: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a new infectious disease that first emerged in Hubei province, China, in December 2019, which was found to be associated with a large seafood and animal market in Wuhan. Airway epithelial cells from infected patients were used to isolate a novel coronavirus, named the SARS-CoV-2, on January 12, 2020, which is the seventh member of the coronavirus family to infect humans. Phylogenetic analysis of full-length genome sequences obtained from infected patients showed that SARS-CoV-2 is similar to severe acute respiratory syndrome coronavirus (SARS-CoV) and uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV. The possible person-to-person disease rapidly spread to many provinces in China as well as other countries. Without a therapeutic vaccine or specific antiviral drugs, early detection and isolation become essential against novel Coronavirus. In this review, we introduced current diagnostic methods and criteria for the SARS-CoV-2 in China and discuss the advantages and limitations of the current diagnostic methods, including chest imaging and laboratory detection.


Answering the initial 20 questions on COVID-19 (January-February 2020)


title: Strategy for treating vascular emergencies during the COVID-19 pandemic in China

text: Coronavirus-caused pneumonia (COVID-19) broke out in Dec 2019. The virus soon proved to be extremely contagious and caused an international pandemic. Clinicians treating COVID-19 patients face considerable danger of occupational exposure due to the highly infectious nature of the virus and precautions must be taken to prevent medical staff infections. This article lists important measures that may save the lives of patients and medical staff during the COVID-19 pandemic and help to stop the transmission of COVID-19 on hospital grounds. The suggestions include: 1. Establishing detailed Infection Control and Prevention Protocols in the operating room; 2. Expediting testing procedures and patient screening for COVID-19; 3. Utilizing case-specific treatment planning for vascular patients with COVID-19, favoring minimally invasive methods; 4. Establishing and reinforcing protective awareness within medical personnel.


title: Expression of the SARS-CoV-2 Entry Proteins, ACE2 and TMPRSS2, in Cells of the Olfactory Epithelium: Identification of Cell Types and Trends with Age

text: The COVID-19 pandemic revealed that there is a loss of smell in many patients, including in infected but otherwise asymptomatic individuals. The underlying mechanisms for the olfactory symptoms are unclear. Using a mouse model, we determined whether cells in the olfactory epithelium express the obligatory receptors for entry of the SARS-CoV-2 virus by using RNAseq, RT-PCR, in situ hybridization, Western blot, and immunocytochemistry. We show that the cell surface protein ACE2 and the protease TMPRSS2 are expressed in sustentacular cells of the olfactory epithelium but not, or much less, in most olfactory receptor neurons. These data suggest that sustentacular cells are involved in SARS-CoV-2 virus entry and impairment of the sense of smell in COVID-19 patients. We also show that expression of the entry proteins increases in animals of old age. This may explain, if true also in humans, why individuals of older age are more susceptible to the SARS-CoV-2 infection.


Some African countries begin to ease coronavirus lockdowns


title: Traditional Chinese Medicine treatment of COVID-19

text: A new kind of Pneumonia caused by new corona virus has been widespread in China since winter of 2019. No effective treatment for this disease was verified, so the morbidity and mortality rate were supposed higher than flu. The Traditional Chinese Medicine is widely used in clinical practice in China, but many other countries of the world to deal with diseases that remain clinically challenging.


Prevention of the cytokine storm in COVID-19


title: Challenges at the Time of COVID-19: Opportunities and Innovations in Antivirals from Nature

text: As viral infections are an increasing threat to human societies, the need for new therapeutic strategies is becoming even more obvious. As no vaccine is available for COVID-19, the development of directly acting antiviral agents and preventive strategies have to be considered. Nature provides a huge reservoir of anti-infectious compounds, from which we can deduce innovative ideas, therapies, and products. Anti-adhesive natural products interact with the receptor-mediated recognition and early interaction of viruses with the host cells, leading to a reduced internalisation of the virus and reduced infections (e.g., procyanidin-B-2-di-O-gallate against influenza and herpes virus). Lignans like podophyllotoxin and bicyclol show strong antiviral activities against different viruses, and essential oils can directly interact with viral membranes and reduce the host's inflammatory responses (e.g., 1,8-cineol). Echinacea extracts stimulate the immune system, and bioavailable alkamides are key players by interacting with immunomodulating cannabinoid receptors. COVID-19 and SARS-CoV-2 infections have, in part, successfully been treated in China by preparations from traditional Chinese medicine and, while it is too early to draw conclusions, some promising data are available. There is huge potential, but intensified research is needed to develop evidence-based medicines with a clearly defined chemical profile. Intensified research and development, and therefore funding, are needed for exploiting nature's reservoir against viral infections. Combined action for basic research, chemistry, pharmacognosy, virology, and clinical studies, but also supply chain, sustainable sourcing, and economic aspects have to be considered. This review calls for intensified innovative science on natural products for the patients and for a healthier world!


Surgical practice and operative surgical strategies during the COVID-19 pandemic: A commentary


title: Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study

text: BACKGROUND AND PURPOSE: COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Apart from respiratory complications, acute cerebrovascular disease (CVD) has been observed in some patients with COVID-19. Therefore, we described the clinical characteristics, laboratory features, treatment and outcomes of CVD complicating SARS-CoV-2 infection. MATERIALS AND METHODS: Demographic and clinical characteristics, laboratory findings, treatments and clinical outcomes were collected and analysed. Clinical characteristics and laboratory findings of patients with COVID-19 with or without new-onset CVD were compared. RESULTS: Of 219 patients with COVID-19, 10 (4.6%) developed acute ischaemic stroke and 1 (0.5%) had intracerebral haemorrhage. COVID-19 with new onset of CVD were significantly older (75.7±10.8 years vs 52.1±15.3 years, p<0.001), more likely to present with severe COVID-19 (81.8% vs 39.9%, p<0.01) and were more likely to have cardiovascular risk factors, including hypertension, diabetes and medical history of CVD (all p<0.05). In addition, they were more likely to have increased inflammatory response and hypercoagulable state as reflected in C reactive protein (51.1 (1.3-127.9) vs 12.1 (0.1-212.0) mg/L, p<0.05) and D-dimer (6.9 (0.3-20.0) vs 0.5 (0.1-20.0) mg/L, p<0.001). Of 10 patients with ischemic stroke; 6 received antiplatelet treatment with aspirin or clopidogrel; and 3 of them died. The other four patients received anticoagulant treatment with enoxaparin and 2 of them died. As of 24 March 2020, six patients with CVD died (54.5%). CONCLUSION: Acute CVD is not uncommon in COVID-19. Our findings suggest that older patients with risk factors are more likely to develop CVD. The development of CVD is an important negative prognostic factor which requires further study to identify optimal management strategy to combat the COVID-19 outbreak.


title: Structural features of coronavirus SARS-CoV-2 spike protein: Targets for vaccination

text: Various human pathogenic viruses employ envelope glycoproteins for host cell receptor recognition and binding, membrane fusion and viral entry. The spike (S) glycoprotein of betacoronavirus SARS-CoV-2 is a homotrimeric class I fusion protein that exists in a metastable conformation for cleavage by host cell proteases furin and TMPRSS2, thereby undergoing substantial structural rearrangement for ACE2 host cell receptor binding and subsequent viral entry by membrane fusion. The S protein is densely decorated with N-linked glycans protruding from the trimer surface that affect S protein folding, processing by host cell proteases and the elicitation of humoral immune response. Deep insight into the sophisticated structure of SARS-CoV-2 S protein may provide a blueprint for vaccination strategies, as reviewed herein.


Letter: Strategies for Prevention and Control of 2019 Novel Coronavirus Infection Among Medical Staff


title: Pandemic Programming: How COVID-19 affects software developers and how their organizations can help

text: Context. As a novel coronavirus swept the world in early 2020, thousands of software developers began working from home. Many did so on short notice, under difficult and stressful conditions. Objective. This study investigates the effects of the pandemic on developers' wellbeing and productivity. Method. A questionnaire survey was created mainly from existing, validated scales and translated into 12 languages. The data was analyzed using non-parametric inferential statistics and structural equation modeling. Results. The questionnaire received 2225 usable responses from 53 countries. Factor analysis supported the validity of the scales and the structural model achieved a good fit (CFI = 0.961, RMSEA = 0.051, SRMR = 0.067). Findings include: (1) developers' wellbeing and productivity are suffering; (2) productivity and wellbeing are closely related; (3) disaster preparedness, fear related to the pandemic and home office ergonomics all affect wellbeing or productivity; (4) women, parents and people with disabilities may be disproportionately affected. Conclusions. To improve employee productivity, software companies should focus on maximizing employee wellbeing and improving the ergonomics of employees' home offices. Women, parents and disabled persons may require extra support.


title: Seroprevalence of SARS-CoV-2 Among Frontline Healthcare Personnel During the First Month of Caring for COVID-19 Patients - Nashville, Tennessee

text: Among 249 healthcare personnel who worked in hospital units with COVID-19 patients for one month, 19 (7.6%) tested positive for SARS-CoV-2 antibodies. Only 11 (57.9%) of the 19 personnel with positive serology reported symptoms of a prior illness, suggesting asymptomatic healthcare personnel could be an important source of SARS-CoV-2 transmission.


title: Presentation of pulmonary infection on CT in COVID-19: initial experience in Brazil

text: The disease caused by the new coronavirus (SARS-CoV-2), designated COVID-19, emerged in late 2019 in China, in the city of Wuhan (Hubei province), and showed exponential growth in that country. It subsequently spread to all continents, and infection with SARS-CoV-2 is now classified as a pandemic. Given the magnitude achieved, scientific interest in COVID-19 has also grown in the international literature, including its manifestations on imaging studies, particularly on CT. To date, no case series have been published in Brazil. Therefore, our objective was to describe the CT findings in an initial series of 12 patients.


title: Work-related COVID-19 transmission in six Asian countries/areas: A follow-up study

text: OBJECTIVE: There is limited evidence of work-related transmission in the emerging coronaviral pandemic. We aimed to identify high-risk occupations for early coronavirus disease 2019 (COVID-19) local transmission. METHODS: In this observational study, we extracted confirmed COVID-19 cases from governmental investigation reports in Hong Kong, Japan, Singapore, Taiwan, Thailand, and Vietnam. We followed each country/area for 40 days after its first locally transmitted case, and excluded all imported cases. We defined a possible work-related case as a worker with evidence of close contact with another confirmed case due to work, or an unknown contact history but likely to be infected in the working environment (e.g. an airport taxi driver). We calculated the case number for each occupation, and illustrated the temporal distribution of all possible work-related cases and healthcare worker (HCW) cases. The temporal distribution was further defined as early outbreak (the earliest 10 days of the following period) and late outbreak (11th to 40th days of the following period). RESULTS: We identified 103 possible work-related cases (14.9%) among a total of 690 local transmissions. The five occupation groups with the most cases were healthcare workers (HCWs) (22%), drivers and transport workers (18%), services and sales workers (18%), cleaning and domestic workers (9%) and public safety workers (7%). Possible work-related transmission played a substantial role in early outbreak (47.7% of early cases). Occupations at risk varied from early outbreak (predominantly services and sales workers, drivers, construction laborers, and religious professionals) to late outbreak (predominantly HCWs, drivers, cleaning and domestic workers, police officers, and religious professionals). CONCLUSIONS: Work-related transmission is considerable in early COVID-19 outbreaks, and the elevated risk of infection was not limited to HCW. Implementing preventive/surveillance strategies for high-risk working populations is warranted.


title: Fecal-Oral Transmission of SARS-CoV-2 In Children: is it Time to Change Our Approach?

text: Starting from 2 pediatric cases of COVID-19, with confirmation at nasopharyngeal and rectal swabs, we considered the lesson learnt from previous Coronavirus epidemics and reviewed evidence on the current outbreak. Surveillance with rectal swabs might be extended to infants and children, for the implications for household contacts and isolation timing.


Potential of heparin and nafamostat combination therapy for COVID-19


'No one is allowed to go out': your stories from the coronavirus outbreak


COVID-19: Could India still escape?


The potential impact of vulnerability and coping capacity on the pandemic control of COVID-19


title: Aptamers, the bivalent agents as probes and therapies for coronavirus infections: A systematic review

text: The recently known coronavirus, SARS-CoV-2, has turn into the greatest global health challenge, affecting a large number of societies. The lack of specific treatment and gold-standard diagnostic system has made the situation more complicated. Efforts have led to production of several diagnostic kits that are associated with limitations such as inadequate sensitivity and accuracy. Aptamers as multipotent biological probes could be promising candidates to design sensitive and specific biosensors. Although few studies have introduced specific aptamer types of coronavirus, they may help us select the best approach to obtain specific aptamers for this virus. On the other hand, some of already-introduced aptamers have shown the inhibitory effects on coronavirus that could be applied as therapeutics. The present study has provided a systematic overview on use of aptamer-based biosensors and drugs to diagnose and treat coronavirus.


SARS-CoV-2 pulmonary infection revealed by subcutaneous emphysema and pneumomediastinum


Faecal-oral transmission of SARS-COV-2: practical implications


title: An Integrative Total Worker Health Framework for Keeping Workers Safe and Healthy During the COVID-19 Pandemic

text: OBJECTIVE: The aim was to recommend an integrated Total Worker Health (TWH) approach which embraces core human factors and ergonomic principles, supporting worker safety, health, and well-being during the COVID-19 pandemic. BACKGROUND: COVID-19 has resulted in unprecedented challenges to workplace safety and health for workers and managers in essential businesses, including healthcare workers, grocery stores, delivery services, warehouses, and distribution centers. Essential workers need protection, accurate information, and a supportive work environment with an unwavering focus on effective infection control. METHOD: The investigators reviewed emerging workplace recommendations for reducing workers' exposures to the novel coronavirus and the challenges to workers in protecting their health. Using a theoretical framework and guidelines for integrating safety and health management systems into an organization for TWH, the investigators adapted the framework's key characteristics to meet the specific worker safety and health issues for effective infection control, providing supports for increasing psychological demands while ensuring a safe work environment. RESULTS: The recommended approach includes six key characteristics: focusing on working conditions for infection control and supportive environments for increased psychological demands; utilizing participatory approaches involving workers in identifying daily challenges and unique solutions; employing comprehensive and collaborative efforts to increase system efficiencies; committing as leaders to supporting workers through action and communications; adhering to ethical and legal standards; and using data to guide actions and evaluate progress. CONCLUSION: Applying an integrative TWH approach for worker safety, health, and well-being provides a framework to help managers systematically organize and protect themselves, essential workers, and the public during the COVID-19 pandemic. APPLICATION: By using the systems approach provided by the six implementation characteristics, employers of essential workers can organize their own efforts to improve system performance and worker well-being during these unprecedented times.


Cardiovascular and immunological implications of social distancing in the context of COVID-19


Health system, public health, and economic implications of managing COVID-19 from a cardiovascular perspective


Letter to the Editor about the Article "Excess Mortality Estimation During the COVID-19 Pandemic: Preliminary Data from Portugal https://doi.org/10.20344/amp.13928"


Cardiac Surgery in the Time of Coronavirus


title: Small Solitary Ground-Glass Nodule on CT as an Initial Manifestation of Coronavirus Disease 2019 (COVID-19) Pneumonia

text: The 2019 novel coronavirus (2019-nCoV) outbreak in Wuhan, Hubei Province, China in 2019 led to large numbers of people being infected and developing atypical pneumonia (coronavirus disease 2019, COVID-19). Typical imaging manifestations of patients infected with 2019-nCoV has been reported, but we encountered an atypical radiological manifestation on baseline computed tomography (CT) images in three patients from Wuhan, China infected with the 2019-nCoV. Surprisingly, the only similar CT finding was a solitary sub-centimeter ground-glass nodule adjacent to bronchovascular bundles, which could be easily overlooked. In addition, the follow-up images in these patients showed how COVID-19 pneumonia evolved from these small nodules. The radiologic manifestation of the three cases will expand contemporary understanding of COVID-19.


COVID-19 pneumonia in patients with HIV - A Case Series


title: Maintaining Health and Well-Being by Putting Faith into Action During the COVID-19 Pandemic

text: Anxiety and fear adversely affect the physiological systems that protect individuals from infection. This article comments on the role that religious faith and practice can play in helping individuals remain free from infection by the coronavirus and in helping to moderate the effects of infection if that should occur. The author provides six recommendations to help individuals maintain spiritual, mental, and physical resilience during these anxious times of the COVID-19 pandemic.


title: Comment on "The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients"

text: We have read with great care and interest the article by Li et al The authors provide interesting elements with respect to the possible entry of severe acute respiratory syndrome coronavirus 2 at the brain area and plead for an implication of the central nervous system in respiratory problems linked to coronavirus disease. Here we provide additional elements that support those observations, notably the role of brainstem structures located in the medulla oblongata in modulating respiration. We also discussed the possible pathways the virus uses to cross the brain blood barrier and reach the brainstem.


title: Comparison of criteria of International Association of Diabetes and Pregnancy Study Groups (IADPSG) with National Institute for Health and Care Excellence (NICE) for diagnosis of gestational diabetes mellitus

text: BACKGROUND: Different screening procedures and diagnostic criteria are being followed in the same as well as in different countries with no single standard criteria established for diagnosis of GDM. So far, there are no studies in the Indian population comparing IADPSG with NICE criteria. OBJECTIVE: To compare International Association of Pregnancy and Study Groups (IADPSG) criteria with the National Institute for Health and Care Excellence (NICE) for diagnosis of gestational diabetes mellitus and its influence on maternal and perinatal outcomes. METHOD: This prospective observational study was conducted in the Department of Obstetrics and Gynaecology of a tertiary care institute in South India from March 2017 to October 2018. Six-hundred and eighty women with or without risk factors for GDM were recruited in the study and screened for GDM based on IADPSG and NICE criteria. Women with preexisting diabetes mellitus or with fasting plasma glucose ≥ 126 mg/dl were excluded. RESULTS: The overall prevalence of GDM in our study was 27.2% by either IADPSG/NICE criteria. In this study, 25.1% women and 11.6% women were diagnosed as GDM using IADPSG and NICE criteria, respectively. The level of agreement between the two diagnostic criteria was found to be poor in our study and was statistically significant (kappa = 0.429, p < 0.001). Women testing IADPSG-positive NICE-negative had a higher risk of GHTN, abortions, PROM, preterm delivery, caesarean section and congenital anomalies, meconium-stained liquor, and low Apgar scores at 1 min when compared to non GDM group. In addition, except for preterm delivery, women diagnosed as GDM by both IADPSG and NICE criteria had adverse outcomes such as preeclampsia, urinary tract infection, and polyhydramnios. Women diagnosed as GDM in IADPSG-negative NICE-positive had no significant adverse maternal or perinatal outcomes. CONCLUSIONS: IADPSG criteria appear to be more robust than NICE criteria for diagnosis of GDM. Women with substantial risk of maternal and perinatal outcomes are better identified by IADPSG criteria who would have been missed if NICE criteria was used.


Management of ovarian cancer during the COVID-19 pandemic


Hypoxia in COVID-19: Sign of Severity or Cause for Poor Outcomes


title: COVID-19 in a Patient with ß-Thalassemia Major and Severe Pulmonary Arterial Hypertension

text: We here report the successful recovery from coronavirus disease-19 (COVID-19) pneumonia in a patient with ß-thalassemia major (ß-TM) and severe pulmonary arterial hypertension (PAH), focusing on the patient's comorbidities, therapeutic course and drug interaction.


title: Quantifying the influence of inter-county mobility patterns on the COVID-19 outbreak in the United States

text: As a highly infectious respiratory disease, COVID-19 has become a pandemic that threatens global health. Without an effective treatment, non-pharmaceutical interventions, such as travel restrictions, have been widely promoted to mitigate the outbreak. Current studies analyze mobility metrics such as travel distance; however, there is a lack of research on interzonal travel flow and its impact on the pandemic. Our study specifically focuses on the inter-county mobility pattern and its influence on the COVID-19 spread in the United States. To retrieve real-world mobility patterns, we utilize an integrated set of mobile device location data including over 100 million anonymous devices. We first investigate the nationwide temporal trend and spatial distribution of inter-county mobility. Then we zoom in on the epicenter of the U.S. outbreak, New York City, and evaluate the impacts of its outflow on other counties. Finally, we develop a"log-linear double-risk"model at the county level to quantify the influence of both"external risk"imported by inter-county mobility flows and the"internal risk"defined as the vulnerability of a county in terms of population with high-risk phenotypes. Our study enhances the situation awareness of inter-county mobility in the U.S. and can help improve non-pharmaceutical interventions for COVID-19.


title: Gaining insight into SARS-CoV-2 infection and COVID-19 severity using self-supervised edge features and Graph Neural Networks

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. In this work, we present a framework for creating new edge features, via a combination of self-supervised and unsupervised learning which we then use along with node features for node classification tasks. We validate our work on two biological datasets comprising of single-cell RNA sequencing data of \textit{in vitro} SARS-CoV-2 infection and human COVID-19 patients. We demonstrate that our method achieves better performance 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.


COVID-19 Testing: The Threat of False-Negative Results


Necessitating repeated chest CT in COVID-19 pneumonia


title: COVID-19 pneumonia: infection control protocol inside computed tomography suites

text: A novel coronavirus (severe acute respiratory syndrome coronavirus 2) causes a cluster of pneumonia cases in Wuhan, China. It spread rapidly and globally. CT imaging is helpful for the evaluation of the novel coronavirus disease 2019 (COVID-19) pneumonia. Infection control inside the CT suites is also important to prevent hospital-related transmission of COVID-19. We present our experience with infection control protocol for COVID-19 inside the CT suites.


Covid-19: People in most deprived areas of England and Wales twice as likely to die


title: An Open Call for Influenza Vaccination Pending the New Wave of Covid-19

text: In their study, Yue et al. reported influenza co-infection among COVID-19 patients as 57.3%. The study included a period of January 12-February 21, 2020 in Wuhan, China. We have recently detected this rate as 0.54% in Turkey. This difference between rates of co-infection can be explained by the seasonality of the influenza virus. Our study included the period of March 10-May 10. Another study from Wuhan, including the period of 28 January-29 February 2020, reported the rate of influenza co-infection among critically ill COVID-19 patients as 49.5%. Zhu et al. reported 2.7% influenza co-infections among COVID-19 patients, in their study from January 22-February 2. Two studies from USA reported low rates of 0.08% in March 16-April 20, and 0.9% in March 3-March 25. Therefore, studies from the influenza season reported very high rates of co-infection. When the COVID-19 came to Europe and America, the influenza season was almost over and thus the co-infection rates are low. A recent research found moderate to strong correlation between higher influenza vaccine uptake in the elderly and lower COVID-19 deaths in Italy. This might be explained by the prevention of influenza co-infection. In elderly, both influenza and COVID-19 have higher rates of mortality. The impact of prevention of influenza in this fragile group is higher. Current influenza-COVID-19 co-infection reports suggest that co-infection rates are as high as 57% when influenza is circulating. Pending the new waves of COVID-19, it is reasonable to recommend influenza vaccination especially for elderly, but most probably, to general population. This article is protected by copyright. All rights reserved.


title: Strategies for radiology departments in handling the COVID-19 pandemic

text: The world is facing an unprecedented global pandemic in the form of the coronavirus disease 2019 (COVID-19) which has ravaged all aspects of life, especially health systems. Radiology services, in particular, are under threat of being overwhelmed by the sheer number of patients affected, unless drastic efforts are taken to contain and mitigate the spread of the virus. Proactive measures, therefore, must be taken to ensure the continuation of diagnostic and interventional support to clinicians, while minimizing the risk of nosocomial transmission among staff and other patients. This article aims to highlight several strategies to improve preparedness, readiness and response towards this pandemic, specific to the radiology department.


COVID-19: Face masks and human-to-human transmission


How does COVID-19 kill? Uncertainty is hampering doctors' ability to choose treatments


Critical care physicians treating COVID-19: mind the nervous system!


title: Media use and acute psychological outcomes during COVID-19 outbreak in China

text: The COVID-19 outbreak in China led to an extraordinary threat to public health and wellbeing. This study examined the psychological impact of media use among people indirectly exposed to the disease during the initial phase of the outbreak. We conducted an internet-based survey on January 28, 2020 (one week after the official declaration of person-to-person transmission of the coronavirus). Media use (media forms, content of media exposure, and media engagement) related to the outbreak and psychological outcomes (positive and negative affect, anxiety, depression, and stress) of 917 Chinese adults was assessed. A series of multivariable regressions were conducted. The results showed that use of new media, rather than traditional media, was significantly associated with more negative affect, depression, anxiety, and stress. Viewing stressful content (i.e., severity of the outbreak, reports from hospital) was associated with more negative affect and depression. Media engagement was also associated with more negative affect, anxiety, and stress. However, viewing heroic acts, speeches from experts, and knowledge of the disease and prevention were associated with more positive affect and less depression. The study suggested new media use and more media engagement was associated with negative psychological outcomes, while certain media content was associated with positive psychological impact. The present study highlights the need for timely public health communication from official sources and suggests that reduced exposure to new media may be beneficial.


COVID-19 international neurological registries


"Possible protective role of contact Lens against SARS COV 2"


title: Action at a Distance: Geriatric Research during a Pandemic

text: BACKGROUND: "Action at a distance" may be the new norm for clinical researchers in the context of the COVID-19 pandemic that may require social distancing for the next 18 months. We must minimize face-to-face contact with vulnerable populations. But we must also persist, adapt, and help our older patients and study participants during the pandemic. METHODS: Clinical researchers have an obligation to help, and we can. Recommendations for clinical researchers working with older adults during the COVID-19 pandemic are discussed. RESULTS: Implement technology now: Minimize face-to-face contact with participants by utilizing digital tools, such as shifting to electronic informed consent and digital HIPAA-compliant tools such as e-mailed surveys or telehealth assessments. Assess the psychological and social impact of COVID-19: How are participants coping? What health or social behaviors have changed? How are they keeping up with current events? What are they doing to stay connected to their families, friends, and communities? Are their healthcare needs being met? Current studies should be adapted immediately to these ends. Mobilize research platforms for patient needs: Leverage our relationships with participants and rapidly deploy novel clinical engagement techniques such as digital tools to intervene remotely and reduce the negative effects of social isolation on our participants. Equip research staff with tangible resources, and provide timely population-specific health information to support patients and healthcare providers. CONCLUSIONS: We have an opportunity to make an impact on our older adult patients now as this pandemic continues to unfold. Above all, clinical researchers need to continue working, to help as many people as possible through the crisis. J Am Geriatr Soc 68:922-925, 2020.


title: The Challenges Associated with Generating Reliable Nanogram-Per-Liter Measurements of Hexavalent Chromium in Groundwater

text: The US EPA and several states are considering regulatory limits for hexavalent chromium (Cr(VI)) below 100 ng/L, increasing the importance of obtaining accurate and reliable data. This paper presents the results of two studies investigating the effectiveness of chemical preservation on ng/L concentrations of Cr(VI) in groundwater. Chemically preserved and unpreserved aliquots of a groundwater sample were spiked with a known amount of Cr(VI), then analyzed in tandem with sets of preserved and unpreserved performance test samples over 28 days. The studies showed that while Cr(VI) appears to be relatively stable over 28 days, it may be sensitive to minor matrix changes after collection. The studies also demonstrated significant challenges to measuring Cr(VI) below 100 ng/L, as the results can be subject to positive bias or contamination that may not be readily apparent. The authors concluded that Cr(VI) measurements using a US EPA published method below 100 ng/L may be categorized as semi-quantitative at best. This article is protected by copyright. All rights reserved.


Editorial: The explosive epidemic outbreak of novel coronavirus disease 2019 (COVID-19) and the persistent threat of respiratory tract infectious diseases to global health security


title: Elderly at time of COronaVIrus disease 2019 (COVID-19): possible role of immunosenescence and malnutrition

text: The unprecedented COVID-19 pandemic is rapidly and unpredictably evolving and the majority of deaths are occurring in older people. A partial description of the magnitude of the scenario is provided by numbers and statistics, which probably underestimate the ongoing tragedy. In the present opinion paper, we have focused our attention on the evidence of the relationship among malnutrition, immunosenescence, and the higher morbidity and mortality in elderly patients. In particular, we propose the intriguing hypothesis that correction of nutritional deficits may attenuate the age-dependent alterations of the innate and adaptive immune system which participate in the increased susceptibility and worse outcome observed in the elderly COVID-19 patients.


Prolonged presence of SARS-CoV-2 viral RNA in faecal samples


title: Adolescent psychiatric disorders during the COVID-19 pandemic and lockdown

text: The aim of this paper was to review the literature on adolescent psychiatric disorders related to the COVID-19 pandemic and lockdown. Stressful life events, extended home confinement, brutal grief, intrafamilial violence, overuse of the Internet and social media are factors that could influence the mental health of adolescents during this period. The COVID-19 pandemic could result in increased psychiatric disorders such as Post-Traumatic Stress, Depressive, and Anxiety Disorders, as well as grief-related symptoms. Adolescents with psychiatric disorders are at risk of a break or change in their care and management; they may experience increased symptoms. The COVID-19 pandemic and lockdown may have a negative impact on the mental health of adolescents, although there is still no data on the long term impact of this crisis. Adolescents' individual, familial, and social vulnerability, as well as individual and familial coping abilities, are factors related to adolescent mental health in times of crisis. Adolescents are often vulnerable and require careful consideration by caregivers and healthcare system adaptations to allow for mental health support despite the lockdown. Research on adolescent psychiatric disorders in times of pandemics is necessary, as such a global situation could be prolonged or repeated.


title: The Framework for the Prediction of the Critical Turning Period for Outbreak of COVID-19 Spread in China based on the iSEIR Model

text: The goal of this study is to establish a general framework for predicting the so-called critical Turning Period in an infectious disease epidemic such as the COVID-19 outbreak in China early this year. This framework enabled a timely prediction of the turning period when applied to Wuhan COVID-19 epidemic and informed the relevant authority for taking appropriate and timely actions to control the epidemic. It is expected to provide insightful information on turning period for the world's current battle against the COVID-19 pandemic. The underlying mathematical model in our framework is the individual Susceptible-Exposed- Infective-Removed (iSEIR) model, which is a set of differential equations extending the classic SEIR model. We used the observed daily cases of COVID-19 in Wuhan from February 6 to 10, 2020 as the input to the iSEIR model and were able to generate the trajectory of COVID-19 cases dynamics for the following days at midnight of February 10 based on the updated model, from which we predicted that the turning period of CIVID-19 outbreak in Wuhan would arrive within one week after February 14. This prediction turned to be timely and accurate, providing adequate time for the government, hospitals, essential industry sectors and services to meet peak demands and to prepare aftermath planning. Our study also supports the observed effectiveness on flatting the epidemic curve by decisively imposing the Lockdown and Isolation Control Program in Wuhan since January 23, 2020. The Wuhan experience provides an exemplary lesson for the whole world to learn in combating COVID-19.


title: Az elso két sikeres, convalescens friss fagyasztott plazmával történo terápia hazai alkalmazása intenzív osztályon kezelt, kritikus állapotú, COVID19-fertozésben szenvedo betegekben: (A COVID19-pandémia orvosszakmai kérdései)/ Successful administration of convalescent plasma in critically ill COVID-19 patients in Hungary: the first two cases

text: INTRODUCTION: At present, neither specific curative treatment nor vaccines for novel coronavirus 2019 (COVID-19) are available. There is an urgent need to look for alternative strategies for COVID-19 treatment especially in the case of severe and/or critically ill patients with cytokine release syndrome (CRS). AIM: Convalescent plasma proved to increase survival rates in other severe viral infections. Therefore, convalescent plasma could be a promising treatment option for severe COVID-19 patients. METHOD: In our article, we present the first two critically ill Hungarian patients with COVID-19 infection treated with convalescent fresh frozen plasma. RESULTS: At the time of plasma therapy both patients were on mechanical ventilation and received antiviral agents and a full scale of supportive care. Each patient received 3 × 200 mL of convalescent plasma of recently recovered donors with sufficient novel anti-coronavirus IgG titers. Subsequent to convalescent plasma infusion, oxygenization improved and inflammatory markers decreased in both individuals. As compared to pretransfusion, lymphocyte counts increased and interleukin-6 level lessened. Both patients were weaned from mechanical ventilation within 2 weeks of treatment. No severe adverse effects were observed. CONCLUSIONS: Our experience indicates that convalescent plasma therapy is well tolerated and could potentially improve clinical outcomes. Optimal dose and timing as well as precise assessment of clinical benefit of convalescent plasma therapy will need further investigation in larger, well-controlled trials. This is the first report of the successful use of convalescent plasma in the treatment of critically ill patients with COVID-19 infection in Hungary. Orv Hetil. 2020; 161(27): 1111-1121.


Clinical features and outcome of HIV/SARS-CoV-2 coinfected patients in The Bronx, New York city


title: Early Outcomes of Outpatient Management of Kidney Transplant Recipients with Coronavirus Disease 2019

text: BACKGROUND AND OBJECTIVES: Outcomes of kidney transplant recipients diagnosed with coronavirus disease 2019 as outpatients have not been described. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We obtained clinical data for 41 consecutive outpatient kidney transplant recipients with known or suspected coronavirus disease 2019. Chi-squared and Wilcoxon rank sum tests were used to compare characteristics of patients who required hospitalization versus those who did not. RESULTS: Of 41 patients, 22 (54%) had confirmed coronavirus disease 2019, and 19 (46%) were suspected cases. Patients most commonly reported fever (80%), cough (56%), and dyspnea (39%). At the end of follow-up, 13 patients (32%) required hospitalization a median of 8 days (range, 1-16) after symptom onset, and 23 (56%) had outpatient symptom resolution a median of 12 days (4-23) after onset. Patients who required hospitalization were more likely to have reported dyspnea (77% versus 21%, P=0.003) and had higher baseline creatinine (median, 2.0 versus 1.3 mg/dl, P=0.02), but there were no other differences between groups. CONCLUSIONS: In an early cohort of outpatient kidney transplant recipients with known or suspected coronavirus disease 2019, many had symptomatic resolution without requiring hospitalization.


title: A plan template-based automation solution using a commercial treatment planning system

text: PURPOSE: The purpose of this study was to develop an auto-planning platform to be interfaced with a commercial treatment planning system (TPS). The main goal was to obtain robust and high-quality plans for different anatomic sites and various dosimetric requirements. METHODS: Monaco (Elekta, St. Louis, US) was the TPS in this work. All input parameters for inverse planning could be defined in a plan template inside Monaco. A software tool called Robot Framework was used to launch auto-planning trials with updated plan templates. The template modifier external to Monaco was the major component of our auto-planning platform. For current implementation, it was a rule-based system that mimics the trial-and-error process of an experienced planner. A template was automatically updated by changing the optimization constraints based on dosimetric evaluation of the plan obtained in the previous trial, along with the data of the iterative optimization extracted from Monaco. Treatment plans generated by Monaco with all plan evaluation criteria satisfied were considered acceptable, and such plans would be saved for further evaluation by clinicians. The auto-planning platform was validated for 10 prostate and 10 head-and-neck cases in comparison with clinical plans generated by experienced planners. RESULTS: The performance and robustness of our auto-planning platform was tested with clinical cases of prostate and head and neck treatment. For prostate cases, automatically generated plans had very similar plan quality with the clinical plans, and the bladder volume receiving 62.5 Gy, 50 Gy, and 40 Gy in auto-plans was reduced by 1%, 3%, and 5%, respectively. For head and neck cases, auto-plans had better conformity with reduced dose to the normal structures but slightly higher dose inhomogeneity in the target volume. Remarkably, the maximum dose in the spinal cord and brain stem was reduced by more than 3.5 Gy in auto-plans. Fluence map optimization only with less than 30 trials was adequate to generate acceptable plans, and subsequent optimization for final plans was completed by Monaco without further intervention. The plan quality was weakly dependent on the parameter selection in the initial template and the choices of the step sizes for changing the constraint values. CONCLUSION: An automated planning platform to interface with Monaco was developed, and our reported tests showed preliminary results for prostate and head and neck cases.


title: SAGES primer for taking care of yourself during and after the COVID-19 crisis

text: COVID-19 is a pandemic which has affected almost every aspect of our life since starting globally in November 2019. Given the rapidity of spread and inadequate time to prepare for record numbers of sick patients, our surgical community faces an unforeseen challenge. SAGES is committed to the protection and care of patients, their surgeons and staff, and all who are served by the medical community at large. This includes physical health, mental health, and well-being of all involved. The fear of the unknown ahead can be paralyzing. International news media have chronicled the unthinkable situations that physicians and other health care providers have been thrust into as a result of the COVID-19 pandemic. These situations include making life or death decisions for patients and their families regarding use of limited health care resources. It includes caring for patients with quickly deteriorating conditions and limited treatments available. Until recently, these situations seemed far from home, and now they are in our own hospitals. As the pandemic broadened its reach, the reality that we as surgeons may be joining the front line is real. It may be happening to you now; it may be on the horizon in the coming weeks. In this context, SAGES put together this document addressing concerns on clinician stressors in these times of uncertainty. We chose to focus on the emotional toll of the situation on the clinician, protecting vulnerable persons, reckoning with social isolation, and promoting wellness during this crisis. At the same time, the last part of this document deals with the "light at the end of the tunnel," discussing potential opportunities, lessons learned, and the positives that can come out of this crisis.


title: Potential global pandemics: the role of the WHO and other public health bodies

text: In light of the emergence of the new coronavirus in China, Emeritus Professor Alan Glasper, from the University of Southampton, discusses the response strategies adopted by international and national public health agencies.


title: Ensuring safe practice during the pandemic

text: Sam Foster, Chief Nurse, Oxford University Hospitals, considers the range of issues that needs to be considered to enable retired nurses and those redeployed from other areas to care for patients with COVID-19.


Principles of ethics and critical communication during the COVID-19 pandemic


title: Perceived versus proven SARS-CoV-2-specific immune responses in health-care professionals

text: There have been concerns about high rates of thus far undiagnosed SARS-CoV-2 infections in the health-care system. The COVID-19 Contact (CoCo) Study follows 217 frontline health-care professionals at a university hospital with weekly SARS-CoV-2-specific serology (IgA/IgG). Study participants estimated their personal likelihood of having had a SARS-CoV-2 infection with a mean of 21% [median 15%, interquartile range (IQR) 5-30%]. In contrast, anti-SARS-CoV-2 IgG prevalence was about 1-2% at baseline. Regular anti-SARS-CoV-2 IgG testing of health-care professionals may aid in directing resources for protective measures and care of COVID-19 patients in the long run.


Developing guidelines for COVID-19 management: A moving target. An invited commentary on "Evidence based management guideline for the COVID-19 pandemic - Review article"


title: The Ethics of Creating a Resource Allocation Strategy During the COVID-19 Pandemic

text: The coronavirus disease 2019 pandemic has affected nearly every aspect of medicine and raises numerous moral dilemmas for clinicians. Foremost of these quandaries is how to delineate and implement crisis standards of care and, specifically, how to consider how health care resources should be distributed in times of shortage. We review basic principles of disaster planning and resource stewardship with ethical relevance for this and future public health crises, explore the role of illness severity scoring systems and their limitations and potential contribution to health disparities, and consider the role for exceptionally resource-intensive interventions. We also review the philosophical and practical underpinnings of crisis standards of care and describe historical approaches to scarce resource allocation to offer analysis and guidance for pediatric clinicians. Particular attention is given to the impact on children of this endeavor. Although few children have required hospitalization for symptomatic infection, children nonetheless have the potential to be profoundly affected by the strain on the health care system imposed by the pandemic and should be considered prospectively in resource allocation frameworks.


Bronchoalveolar lavage findings in severe COVID-19 pneumonia


Fulminant myocarditis and COVID-19. Response


Are Genetic Vaccines the Right Weapon against COVID-19?


Correction to Lancet Infect Dis 2020; published online March 11, https://doi.org/10.1016/ S1473-3099(20)30144-4


Acute pulmonary embolism and COVID-19 pneumonia: a random association?


Caring for children with neurological disorders in China during the COVID-19 pandemic


Covid-19, TMPRSS2, and whether android regulation affects pandemic virus gender incidence and age distribution of disease


title: Isolation and characterization of Salt Overly Sensitive family genes in spinach

text: The Salt Overly Sensitive (SOS) pathway regulates intracellular sodium ion homeostasis as a salt-stress response in plants. This pathway involves three main genes designated as SOS1, SOS2, and SOS3, which are members of the Na+ /H+ exchanger (NHX), CBL-interacting protein kinase (CIPK), and Calcineurin B-like (CBL) gene families, respectively. To identify and characterize SOS genes in spinach (Spinacia oleracea), a species of the Amaranthaceae family, we conducted genome-wide identification and phylogenetic analyses of NHX, CIPK, and CBL genes from four Amaranthaceae species, Arabidopsis, and rice. Most Amaranthaceae genes exhibited orthologous relationships with Arabidopsis and/or rice, except a clade of Vac-type Amaranthaceae NHX genes. Phylogenetic analyses also revealed gene gain/loss events in Amaranthaceae species and the intron-less to intron-rich evolution of CIPK genes. A bacterial protein-rooted CIPK tree allowed naming most of the phylogenetic clades based on their evolutionary history. Single S. oleracea (So) SOS1, SOS2, and SOS3 proteins were identified. Direct protein-protein interaction was observed between SoSOS2 and SoSOS3 but not between SoSOS2 and SoSOS1 based on yeast two-hybrid assay. This may suggest distinct modes of action of spinach SOS proteins compared to Arabidopsis SOS proteins. Unlike SoSOS1 and SoSOS2, which were expressed at similar or higher levels in leaves than roots, SoSOS3 expression was significantly higher in roots than leaves, suggesting its greater importance in roots. The expression of SoSOS3 was upregulated in both roots and leaves under salinity compared to the control; however, SoSOS1 was only upregulated in roots. Thus, this study demonstrated the conservation of SOS pathway genes in spinach and also highlighted the complexity of SOS signaling in Amaranthaceae species. This article is protected by copyright. All rights reserved.


title: Prediction of COVID-19 spreading profiles in South Korea, Italy and Iran by data-driven coding

text: This work applies a data-driven coding method for prediction of the COVID-19 spreading profile in any given population that shows an initial phase of epidemic progression. Based on the historical data collected for COVID-19 spreading in 367 cities in China and the set of parameters of the augmented Susceptible-Exposed-Infected-Removed (SEIR) model obtained for each city, a set of profile codes representing a variety of transmission mechanisms and contact topologies is formed. By comparing the data of an early outbreak of a given population with the complete set of historical profiles, the best fit profiles are selected and the corresponding sets of profile codes are used for prediction of the future progression of the epidemic in that population. Application of the method to the data collected for South Korea, Italy and Iran shows that peaks of infection cases are expected to occur before mid April, the end of March and the end of May 2020, and that the percentage of population infected in each city or region will be less than 0.01%, 0.5% and 0.5%, for South Korea, Italy and Iran, respectively.


title: Rhythm blues in the time of coronavirus disease 2019 (COVID-19): how the cardiac electrophysiologist adapts to a viral pandemic in Singapore

text: Coronavirus disease 2019 (COVID-19) is a major healthcare disaster in the modern times. Healthcare services must adapt to effectively juggle between pandemic management and maintenance of business-as-usual services so that both COVID-19 and non-COVID-19 patients receive appropriate clinical care. We share our experience of significant cardiac rhythm abnormalities seen in COVID-19 patients in Singapore, how the viral pandemic has affected the cardiac electrophysiology and pacing service in a large acute care general hospital and the steps taken to alleviate the negative impact.


title: Mathematical Modeling of COVID-19 Transmission Dynamics with a Case Study of Wuhan

text: We propose a compartmental mathematical model for the spread of the COVID-19 disease with special focus on the transmissibility of super-spreaders individuals. We compute the basic reproduction number threshold, we study the local stability of the disease free equilibrium in terms of the basic reproduction number, and we investigate the sensitivity of the model with respect to the variation of each one of its parameters. Numerical simulations show the suitability of the proposed COVID-19 model for the outbreak that occurred in Wuhan, China.


Protecting our healthcare workers during the COVID-19 pandemic


Unexpected Benefits to Virtual Care During COVID-19


title: The Elabela-APJ axis: a promising therapeutic target for heart failure

text: Heart failure (HF) is a growing epidemic with high morbidity and mortality at an international scale. The apelin-APJ receptor pathway has been implicated in HF, making it a promising therapeutic target. APJ has been shown to be activated by a novel endogenous peptide ligand known as Elabela (ELA, also called Toddler or Apela), with a critical role in cardiac development and function. Activation of the ELA-APJ receptor axis exerts a wide range of physiological effects, including depressor response, positive inotropic action, diuresis, anti-inflammatory, anti-fibrotic, and anti-remodeling, leading to its cardiovascular protection. The ELA-APJ axis is essential for diverse biological processes and has been shown to regulate fluid homeostasis, myocardial contractility, vasodilation, angiogenesis, cellular differentiation, apoptosis, oxidative stress, cardiorenal fibrosis, and dysfunction. The beneficial effects of the ELA-APJ receptor system are well-established by treating hypertension, myocardial infarction, and HF. Additionally, administration of ELA protects human embryonic stem cells against apoptosis and stress-induced cell death and promotes survival and self-renewal in an APJ-independent manner (X receptor) via the phosphatidylinositol 3-kinase/Akt pathway, which may provide a new therapeutic approach for HF. Thus, targeting the ELA-APJ axis has emerged as a pre-warning biomarker and a novel therapeutic approach against progression of HF. An increased understanding of cardiovascular actions of ELA will help to develop effective interventions. This article gives an overview of the characteristics of the ELA-apelin-APJ axis and summarizes the current knowledge on its cardioprotective roles, potential mechanisms, and prospective application for acute and chronic HF.


title: Clinical characteristics and outcomes in people living with HIV hospitalized for COVID-19

text: We describe the characteristics of 31 people living with HIV (PLWH) hospitalized for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. All patients were on antiretroviral therapy and virologically suppressed at the time of admission. Clinical course and outcomes were similar to those reported in other hospitalized cohorts.


title: Pangolins Lack IFIH1/MDA5, a Cytoplasmic RNA Sensor That Initiates Innate Immune Defense Upon Coronavirus Infection

text: Zoonotic infections are an imminent threat to human health. Pangolins were recently identified as carriers and intermediate hosts of coronaviruses. Previous research has shown that infection with coronaviruses activates an innate immune response upon sensing of viral RNA by interferon-induced with helicase C domain 1 (IFIH1), also known as MDA5. Here, we performed a comparative genomics study of RNA sensor genes in three species of pangolins. DDX58/RIG-I, a sensor of cytoplasmic viral RNA and toll-like receptors (TLR) 3, 7, and 8, which bind RNA in endosomes, are conserved in pangolins. By contrast, IFIH1 a sensor of intracellular double-stranded RNA, has been inactivated by mutations in pangolins. Likewise, Z-DNA-binding protein (ZBP1), which senses both Z-DNA and Z-RNA, has been lost during the evolution of pangolins. These results suggest that the innate immune response to viruses differs significantly between pangolins and other mammals, including humans. We put forward the hypothesis that loss of IFIH1 and ZBP1 provided an evolutionary advantage by reducing inflammation-induced damage to host tissues and thereby contributed to a switch from resistance to tolerance of viral infections in pangolins.


Keeping the Wheels of the Scientific Endeavor Turning during the COVID-19 Pandemic


title: Understanding face mask use to prevent coronavirus and other illnesses: Development of a multidimensional face mask perceptions scale

text: Face masks are an avenue to curb the spread of coronavirus, but few people in Western societies wear face masks. Social scientists have rarely studied face mask wearing, leaving little guidance for methods to encourage these behaviours. In the current article, we provide an approach to address this issue by developing the 32-item and 8-dimension Face Mask Perceptions Scale (FMPS). We begin by developing an over-representative item list in a qualitative study, wherein participants' responses are used to develop items to ensure content relevance. This item list is then reduced via exploratory factor analysis in a second study, and the eight dimensions of the scale are supported. We also support the validity of the FMPS, as the scale significantly relates to both face mask wearing and health perceptions. We lastly confirm the factor structure of the FMPS in a third study via confirmatory factor analysis. From these efforts, we identify an avenue that social scientists can aid in preventing coronavirus and illness more broadly - by studying face mask perceptions and behaviours.


Prevention of skin damage caused by the protective equipment used to mitigate COVID-19


Angiotensin II infusion in COVID-19-associated vasodilatory shock: a case series


Covid-19: all non-urgent elective surgery is suspended for at least three months in England


title: In hospital verification of non CE-marked respiratory protective devices to ensure safety of healthcare staff during the COVID-19 outbreak

text: AIM: To develop a protocol to ensure the quality of respiratory protective devices for healthcare workers nursing and treating patients with possible or confirmed COVID-19 in the Catharina hospital. BACKGROUND: Due to the COVID-19 outbreak a shortage of respirators is occurring worldwide; more specifically, CE-certified FFP2 respirators. This has resulted in an increased supply to hospitals of alternative respirators of uncertain quality. Nevertheless, the quality of the respirators used by our healthcare workers must be ensured. METHOD: A protocol and criteria based on applicable standards was developed to ensure the quality of respirators. The protocol has been implemented at the Catharina hospital and includes verification of the documents accompanying the respirator, visual inspection of the respirator and a test for total inward leak of particles into respirators. FINDINGS: 67% of the respirators brands and types received in the Catharina hospital did not meet quality criteria. CONCLUSION: With a simple verification protocol the quality of the respirators can be checked and guaranteed while there is a shortage of the CE approved respirators which are normally used. With this in-hospital protocol health care workers can be equipped with safe-to-use respirators.


Resuscitating Patient Rights during the Pandemic: COVID-19 and the Risk of Resurgent Paternalism


title: Evidence Supporting a Phased Immuno-physiological Approach to COVID-19 From Prevention Through Recovery

text: This paper presents an evidence-based strategy for improving clinical outcomes in COVID-19 Recommendations are based on the phases of the disease, because optimal interventions for one phase may not be appropriate for a different phase The four phases addressed are: Prevention, Infection, Inflammation and Recovery Underlying this phased approach is recognition of emerging evidence for two different components of pathophysiology, early infection and late stage severe complications These two aspects of the disease suggest two different patterns of clinical emphasis that seem on the surface to be not entirely concordant We describe the application of therapeutic strategies and appropriate tactics that address four main stages of disease progression for COVID-19 Emerging evidence in COVID-19 suggests that the SARS-CoV-2 virus may both evade the innate immune response and kill macrophages Delayed innate immune response and a depleted population of macrophages can theoretically result in a blunted antigen presentation, delaying and diminishing activation of the adaptive immune response Thus, one clinical strategy involves supporting patient innate and adaptive immune responses early in the time course of illness, with the goal of improving the timeliness, readiness, and robustness of both the innate and adaptive immune responses At the other end of the disease pathology spectrum, risk of fatality in COVID-19 is driven by excessive and persistent upregulation of inflammatory mechanisms associated with cytokine storm Thus, the second clinical strategy is to prevent or mitigate excessive inflammatory response to prevent the cytokine storm associated with high mortality risk Clinical support for immune system pathogen clearance mechanisms involves obligate activation of immune response components that are inherently inflammatory This puts the goals of the first clinical strategy (immune activation) potentially at odds with the goals of the second strategy(mitigation of proinflammatory effects) This creates a need for discernment about the time course of the illness and with that, understanding of which components of an overall strategy to apply at each phase of the time course of the illness We review evidence from early observational studies and the existing literature on both outcomes and mechanisms of disease, to inform a phased approach to support the patient at risk for infection, with infection, with escalating inflammation during infection, and at risk of negative sequelae as they move into recovery


Commentary: Challenges to thoracic surgeons in the global coronavirus pandemic


title: Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study

text: BACKGROUND: Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. METHODS: 35â883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61â075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). FINDINGS: Seroprevalence was 5·0% (95% CI 4·7-5·4) by the point-of-care test and 4·6% (4·3-5·0) by immunoassay, with a specificity-sensitivity range of 3·7% (3·3-4·0; both tests positive) to 6·2% (5·8-6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years (<3·1% by the point-of-care test). There was substantial geographical variability, with higher prevalence around Madrid (>10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1-92·1; both tests positive) to 91·8% (86·3-95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8-16·8) to 19·3% (17·7-21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1-24·9) to 35·8% (33·1-38·5). Only 19·5% (16·3-23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. INTERPRETATION: The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. FUNDING: Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.


Back-to-work Coronavirus infection control


Latin America and Its Global Partners Toil to Procure Medical Supplies as COVID-19 Pushes the Region to Its Limit


Ground-glass opacity on chest computed tomography in a young, athletic man with coronavirus disease 2019-related pneumonia without hypoxemia


title: Targeting SARS-COV-2 non-structural protein 16: a virtual drug repurposing study

text: Non-Structural Protein 16 (nsp-16), a viral RNA methyltransferase (MTase), is one of the highly viable targets for drug discovery of coronaviruses including SARS-CoV-2. In this study, drug discovery of SARS-CoV-2 nsp-16 has been performed by a virtual drug repurposing approach. First, drug shape-based screening (among FDA approved drugs) with a known template of MTase inhibitor, sinefungin was done and best compounds with high similarity scores were selected. In addition to the selected compounds, 4 nucleoside analogs of anti-viral (Raltgravir, Maraviroc and Favipiravir) and anti-inflammatory (Prednisolone) drugs were selected for further investigations. Then, binding energies and interaction modes were found by molecular docking approaches and compouds with lower energy were selected for further investigation. After that, Molecular dynamics (MD) simulation was carried to test the potential selected compounds in a realistic environment. The results showed that Raltegravir and Maraviroc among other compounds can bind strongly to the active site of the protein compared to sinefungin, and can be potential candidates to inhibit NSP-16. Also, the MD simulation results suggested that the Maraviroc and Raltegravir are more effective drug candidates than Sinefungin for inhibiting the enzyme. It is concluded that Raltegravir and Maraviroc which may be used in the treatment of COVID-19 after Invitro and invivo studies and clinical trial for final confirmation of drug effectiveness.Communicated by Ramaswamy H. Sarma.


title: Operating room management strategy for orthopedic patients in Third Hospital of Hebei Medical University during epidemic of corona virus disease 2019/ 中华创伤杂志

text: In December 2019, the corona virus disease 2019 (COVID-19) broke out in Wuhan, Hubei Province. Although the number of newly confirmed COVID-19 cases in provinces outside of Hubei Province has declined continuously since February 4, the epidemic of COVID-19 remains serious. As companies resume work, it is still inevitable that some high-energy orthopedic trauma patients and elderly patients with low-energy fractures will need surgical treatment. The operating room, as a place for close contact between doctors, patients and nurses, increases the risk of infection and transmission. Based on the current needs of orthopedic trauma patients and the situation of the country's resistance to the epidemic of COVID-19, the authors expound the operating room management, preparation of medical materials, transfer of patients needing surgery, intraoperative protection and post-operative end disinfection in Third Hospital of Hebei Medical University so as to provide reference for prevention and control management of the operating room during the epidemic period.


P-selectin blockade in COVID-19-related ARDS


Audio Interview: Preparing for the Spread of Covid-19


title: The isolation period should be longer: Lesson from a child infected with SARS-CoV-2 in Chongqing, China

text: In December 2019, COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbroke in Wuhan, the capital city of Hubei province, China. The disease rapidly spread to other areas in China due to a huge population movement during the New Year Festival. Here, a 7-year-old child with SARS-CoV-2 infection in Chongqing, outside of Wuhan, Hubei province, was reported. This case suggested that children infected with SARS-CoV-2 are more likely to present milder manifestations than adults. The continuous positive real-time reverse transcription-polymerase chain reaction assay for SARS-CoV-2 in the child's throat swab sample indicated the isolation period for suspected child cases should be longer than 14 days.


title: Testing COVID-19 tests faces methodological challenges

text: In battling the COVID-19 pandemic, testing is essential. The detection of viral RNA allows the identification of infected persons, while the detection of antibodies may reveal a response to a previous infection. Tests for coronavirus should be rigorously evaluated in terms of their analytical and clinical performance. This poses not only logistic challenges, but also methodological ones. Some of these are generic for the diagnostic accuracy paradigm, while others are more specific for tests for viruses. Problematic for evaluations of the clinical performance of tests for viral RNA is the absence of an independent reference standard. Many studies lack rigor in terms of the recruitment of study participants. Study reports are often insufficiently informative, which makes it difficult to assess the applicability of study findings. Attempts to summarize the performance of these tests in terms of a single estimate of the clinical sensitivity fails to do justice to the identifiable sources of the large heterogeneity in mechanisms for generating false negative results.


title: Italy in a Time of Emergency and Scarce Resources: The Need for Embedding Ethical Reflection in Social and Clinical Settings

text: The COVID-19 virus is severely testing the Italian healthcare system, as the requests for intensive treatment are greater than the real capacity of the system to receive patients. Given this emergency situation, it follows that citizens are limited in their freedom of movement in order to limit infection, and that in hospitals a significant number of critical situations must be faced. This brief contribution aims to offer a reflection on the public and clinical role of the bioethicist: a figure able to promote dialogue between the world of medicine and the community, and to face ethical dilemmas even in emergent clinical settings.


Proposed Workflow for Rehabilitation in a Field Hospital Setting during the COVID-19 Pandemic


Physician Supply During the Coronavirus Disease 2019 (COVID-19) Crisis: the Role of Hazard Pay


title: How to Produce Cheap and Easy Custom-Made Sterilizable Filtering Facepiece 2/3 Masks for Healthcare Providers During Pandemic COVID-19 Emergency

text: On January 8, 2020, a novel coronavirus was officially announced as the causative pathogen of coronavirus disease (COVID-19) by the Chinese Center for Disease Control and Prevention.On February 26, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed patients and 2700 deaths.Protecting healthcare workers from infectious hazards is paramount to ensuring their safety in delivering health care.In addition, being able to protect healthcare workers, constituting the front-line response against high-threat respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2, is important for reducing secondary transmission in healthcare-associated outbreaks.Authors present a simple, reliable, and cheap protocol to produce a custom-made sterilizable filtering facepiece 2/3 masks for healthcare providers during pandemic COVID-19 emergency.


title: Digital Ischemia in COVID-19 Patients: Case Report

text: As coronavirus 2019 (COVID-19) continues to cause an immense burden on the global health care systems, it is crucial to understand the breadth of this disease process. Recent reports identified hypercoagulability in a subset of critically ill patients and extremity ischemia in an even smaller cohort. Because abnormal coagulation parameters and extremity ischemia have been shown to correlate with poor disease prognosis, understanding how to treat these patients is crucial. To better describe the identification and management of this phenomenon, we present 2 cases of critically ill patients with COVID-19 who developed fingertip ischemia while in the intensive care unit.


Smartphone based ROP (S-ROP) screening-opportunities and challenges


Emergent Strategies for the Next Phase of COVID-19


title: A single-centre experience of intravenous thrombolysis for stroke in COVID-19 patients

text: The sudden worldwide outbreak of Coronavirus Disease 2019 (COVID-19) has certainly provided new challenges in the management of acute ischaemic stroke, and the risk-benefit ratio of intravenous thrombolysis in COVID-19 positive patients is not well known. We describe four COVID-19 patients treated with intravenous thrombolysis for acute ischaemic stroke. Although rt-PA administration is the main therapeutic strategy, our patients experienced unpredictable complications and showed atypical features: the overall mortality was very high. In conclusion, in this article, we provide information about these cases and discuss the possible explanation behind this trend.


title: ‘A completely new culture of doing research.’ Coronavirus outbreak changes how scientists communicate ;Science ;AAAS

text: On 22 January, Dave O’Connor and Tom Friedrich invited several dozen colleagues around the United States to join a new workspace on the instant messaging platform Slack The scientists, both at the Wisconsin National Primate Research Center, had seen news about a new disease emerging in China and realized researchers would need a primate model if they were going to answer some important questions about its biology “We put out a call to a bunch of investigators and basically said: ‘Hey, let’s talk,’” O’Connor says The idea is to coordinate research and make sure results are comparable, Friedrich adds (They named the Slack workspace the Wu-han Clan, a play on the hip-hop group Wu-Tang Clan ) The Wu-han Clan is just one example of how the COVID-19 outbreak is transforming how scientists communicate about fast-moving health crises A torrent of data is being released daily by preprint servers that didn’t even exist a decade ago, then dissected on platforms such as Slack and Twitter, and in the media, before formal peer review begins Journal staffers are working overtime to get manuscripts reviewed, edited, and published at record speeds The venerable New England Journal of Medicine (NEJM) posted one COVID-19 paper within 48 hours of submission Viral genomes posted on a platform named GISAID, more than 200 so far, are analyzed instantaneously by a phalanx of evolutionary biologists who share their phylogenetic trees in preprints and on social media


title: Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic

text: AIMS: To investigate the work stress among Chinese nurses who are supporting Wuhan in fighting against Coronavirus Disease 2019 (COVID-19) infection and to explore the relevant influencing factors. BACKGROUND: The COVID-19 epidemic has posed a major threat to public health. Nurses have always played an important role in infection prevention, infection control, isolation, containment and public health. However, available data on the work stress among these nurses are limited. METHODS: A cross-sectional survey. An online questionnaire was completed by 180 anti-epidemic nurses from Guangxi. Data collection tools, including the Chinese version of the Stress Overload Scale (SOS) and the Self-rating Anxiety Scale (SAS), were used. Descriptive single factor correlation and multiple regression analyses were used in exploring the related influencing factors. RESULTS: The SOS (39.91 ± 12.92) and SAS (32.19 ± 7.56) scores of this nurse group were positively correlated (r = 0.676, p < .05). Multiple regression analysis showed that only children, working hours per week and anxiety were the main factors affecting nurse stress (p = .000, .048, .000, respectively). CONCLUSIONS: Nurses who fight against COVID-19 were generally under pressure. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse leaders should pay attention to the work stress and the influencing factors of the nurses who are fighting against COVID-19 infection, and offer solutions to retain mental health among these nurses.


Insights from nanomedicine into chloroquine efficacy against COVID-19


COVID-19-Where Have All the STEMIs Gone?


title: SciSight: Combining faceted navigation and research group detection for COVID-19 exploratory scientific search

text: The COVID-19 pandemic has sparked unprecedented mobilization of scientists, already generating thousands of new papers that join a litany of previous biomedical work in related areas. This deluge of information makes it hard for researchers to keep track of their own research area, let alone explore new directions. Standard search engines are designed primarily for targeted search and are not geared for discovery or making connections that are not obvious from reading individual papers. In this paper, we present our ongoing work on SciSight, a novel framework for exploratory search of COVID-19 research. Based on formative interviews with scientists and a review of existing tools, we build and integrate two key capabilities: first, exploring interactions between biomedical facets (e.g., proteins, genes, drugs, diseases, patient characteristics); and second, discovering groups of researchers and how they are connected. We extract entities using a language model pre-trained on several biomedical information extraction tasks, and enrich them with data from the Microsoft Academic Graph (MAG). To find research groups automatically, we use hierarchical clustering with overlap to allow authors, as they do, to belong to multiple groups. Finally, we introduce a novel presentation of these groups based on both topical and social affinities, allowing users to drill down from groups to papers to associations between entities, and update query suggestions on the fly with the goal of facilitating exploratory navigation. SciSight has thus far served over 10K users with over 30K page views and 13% returning users. Preliminary user interviews with biomedical researchers suggest that SciSight complements current approaches and helps find new and relevant knowledge.


Telemedicine: Has the Time Really Finally Arrived?


title: Prone Positioning for Pregnant Women With Hypoxemia Due to Coronavirus Disease 2019 (COVID-19)

text: The coronavirus disease 2019 (COVID-19) pandemic has prompted expanded use of prone positioning for refractory hypoxemia. Clinical trials have demonstrated beneficial effects of early prone positioning for acute respiratory distress syndrome (ARDS), including decreased mortality. However, pregnant women were excluded from these trials. To address the need for low-cost, low-harm interventions in the face of a widespread viral syndrome wherein hypoxemia predominates, we developed an algorithm for prone positioning of both intubated and nonintubated pregnant women. This algorithm may be appropriate for a wide spectrum of hypoxemia severity among pregnant women. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is responsible for the clinical manifestations of COVID-19. This syndrome can manifest as severe pneumonia complicated by hypoxemia and ARDS. Given the current global COVID-19 pandemic, with a large number of ARDS cases, there is renewed interest in the use of prone positioning to improve oxygenation in moderate or severe hypoxemia. Among the populations who can benefit from prone positioning are pregnant women experiencing severe respiratory distress, as long as the physiologic changes and risks of pregnancy are taken into account.


title: A new threat from an old enemy: Reemergence of coronavirus (Review)

text: The new outbreak of coronavirus from December 2019 has brought attention to an old viral enemy and has raised concerns as to the ability of current protection measures and the healthcare system to handle such a threat. It has been known since the 1960s that coronaviruses can cause respiratory infections in humans; however, their epidemic potential was understood only during the past two decades. In the present review, we address current knowledge on coronaviruses from a short history to epidemiology, pathogenesis, clinical manifestation of the disease, as well as treatment and prevention strategies. Although a great amount of research and efforts have been made worldwide to prevent further outbreaks of coronavirusassociated disease, the spread and lethality of the 2019 outbreak (COVID19) is proving to be higher than previous epidemics on account of international travel density and immune naivety of the population. Only strong, joint and coordinated efforts of worldwide healthcare systems, researchers, and pharmaceutical companies and receptive national leaders will succeed in suppressing an outbreak of this scale.


title: Epidemiologic characteristics of traumatic fractures during the outbreak of coronavirus disease 2019 (COVID-19) in China: A retrospective & comparative multi-center study

text: PURPOSE: Amid the outbreak of coronavirus disease 2019 (COVID-19), effective measures have been taken in China to suggest people wearing masks and staying at home. The majority of the people stayed at home, which had an obvious impact on the occurrence of traumatic fractures. This study aimed to describe the epidemiologic characteristics of traumatic fractures during the COVID-19, and provide reference for targeted control measures for the whole world by proposing China's experiences. METHODS: This was a retrospective & comparative multi-center study with data obtained from 11 hospitals in five provinces of China. Patients were enrolled into this study, who sustained fractures from 20 January to 19 February 2020 and the same period in 2019 (based on Chinese lunar calendar). All patients were divided into two groups: epidemic group (admitted in 2020) and control group (admitted in 2019). The data of patients' demographics (age and gender), injury related data (fracture type, fractured site, osteoporosis fracture, concurrent fractures, injury mechanism, places where fracture occurred, ISS score, Gustilo-Anderson Classification for open fracture), mortality and treatment modality were compared between the two groups. RESULTS: A total of 2,489 patients with 2,590 fractures were included. In the epidemic group, there were 865 patients, including 483 (55.8%) males and 382 (44.2%) females with an average age of 53.1 ± 23.1 years (range, 1 to 105). In the control group, there were 1,624 patients, including 876 (53.9%) males and 748 (46.1%) females with an average age of 51.2 ± 21.5 years (range, 1 to 98). Patients in the epidemic group was significantly older than those in the control group (t=-2.046, P = 0.045). For epidemic group, the mostly commonly involved age group was elderly patients, whereas it was middle-aged adults for the control group (χ2 = 14.642, P = 0.002). For epidemic group, a total of 576 (66.6%) patients had their fracture occurring at home, while in the control group there was 183 (11.3%). The proportion rates of low energy injuries (79.1%, 684/865), osteoporotic fractures (32.5%, 294/906) and closed fractures (94.5%, 817/865) in the epidemic group were significantly higher when compared to the control group, respectively (34.4%, 559/1624; 26.9%, 453/1684; 91.9%, 1,493/1692; all P<0.05). The proportion rates of Gustilo-Anderson classification (5.5%, 16/865), concurrent fractures (2.3%, 20/865), and injury severity score (15.6 ± 6.7) in epidemic group were significantly lower than those in the control group, respectively (52.8%, 199/1624; 3.9%, 63/1624; 20.1 ± 8.7; all P<0.05). No positive case with COVID-19 was diagnosed in the epidemic group. The mortality rate in the epidemic group (0.46%) was similar with that in the control group (0.43%). CONCLUSIONS: Our findings confirmed the importance of the measures to restrict people's movement and wear masks in the prevention of the spread of COVID-19. The epidemiological characteristics of traumatic fractures amid the epidemic changes dramatically, and more attempts should be focused on the prevention of low energy injuries of elderly population.


Safety considerations with chloroquine, hydroxychloroquine and azithromycin in the management of SARS-CoV-2 infection


Communicating Effectively With Hospitalized Patients and Families During the COVID-19 Pandemic


Should We Be Screening for SARS-CoV-2 in IBD Patients Before Initiation of Biologic Therapy?


UK vets coping well with global pandemic


Os direitos humanos das crianças com deficiência durante emergências de saúde: o desafio do COVID-19


title: Production of isopropyl and butyl esters by Clostridium mono-culture and co-culture

text: Production of esters from the acetone-butanol-ethanol (ABE) fermentation by Clostridium often focuses on butyl butyrate, leaving acetone as an undesired product. Addition of butyrate is also often needed because ABE fermentation does not produce enough butyrate. Here we addressed the problems using Clostridium beijerinckii BGS1 that preferred to produce isopropanol instead of acetone, and co-culturing it with Clostridium tyrobutyricum ATCC 25,755 that produced butyrate. Unlike acetone, isopropanol could be converted into ester using lipase and acids. C. tyrobutyricum ATCC 25,755 produced acids at pH 6, while C. beijerinckii BGS1 produced mainly solvents at the same pH. When the two strains were co-cultured, more butyrate was produced, leading to a higher titer of esters than the mono-culture of C. beijerinckii BGS1. As the first study reporting the production of isopropyl butyrate from the Clostridium fermentation, this study highlighted the potential use of lipase and co-culture strategy in ester production.


Practical considerations in the anaesthetic management of patients during a COVID-19 epidemic


title: TRAF4 knockdown triggers synergistic lethality with simultaneous PARP1 inhibition in endometrial cancer

text: Endometrial cancer (EC) is one of the most common cancers among females worldwide. Advanced stage patients of EC have poor prognosis. Inevitable side effects and treatment tolerance of chemotherapy for EC remain to be addressed. Our results in this study showed that EC cells with higher tumor necrosis factor receptor-associated factor 4 (TRAF4) expression have lower sensitivity to poly ADP-ribose polymerase 1 (PARP1) inhibitors. Upon TRAF4 knockdown, the colony numbers of EC cells were markedly down-regulated, and the markers of DNA double-strand breakage were significantly up-regulated after the treatment of olaparib, a PARP1 inhibitor. TRAF4 knockdown reduced the phosphorylation of protein kinase B (Akt), promoted DNA double-strand breakage, and decreased levels of DNA repair related proteins, including phosphorylated-DNA-dependent protein kinase (p-DNA-PK) and RAD51 recombinase (RAD51). In addition, TRAF4's effect on the sensitivity of EC cells to olaparib was further found to be mainly mediated by Akt phosphorylation. Moreover, in vivo results showed that TRAF4 knockdown enhanced the sensitivity of EC to PARP1 inhibitors using a mouse xenograft model. Collectively, our data suggest that combined application of TRAF4 knockdown and PARP1 inhibition can be used as a promising strategy for synthetic lethality in EC treatment.


Xenophobia due to the coronavirus outbreak - A letter to the editor in response to "the socio-economic implications of the coronavirus pandemic (COVID-19): A review"


title: Accurate closed-form solution of the SIR epidemic model

text: An accurate closed-form solution is obtained to the SIR Epidemic Model through the use of Asymptotic Approximants (Barlow et al., 2017). The solution is created by analytically continuing the divergent power series solution such that it matches the long-time asymptotic behavior of the epidemic model. The utility of the analytical form is demonstrated through its application to the COVID-19 pandemic.


title: Stop playing with data: there is no sound evidence that Bacille Calmette-Guérin may avoid SARS-CoV-2 infection (for now)

text: Since the beginning of the COVID-19 epidemic, a possible explanation for the high heterogeneity of infection/mortality rates across involved countries was hinted in the prevalence of tuberculosis vaccination with Bacille Calmette-Guérin (BCG). A systematic review was therefore performed on May 2, 2020. A total of 13 articles were ultimately retrieved, 12 of them as preprint papers. All articles were ecological studies of low quality. Most of them did not include main confounding factors (i.e. demographic of the assessed countries, share of peo- ple residing in urban settings, etc.), and simply assessed the differences among incidence/mortality of COVID-19 with vaccination rates or by having vs. having not any vaccination policy for BCG. Even though all studies shared the very same information sources (i.e. international registries for BCG vaccination rates and open source data for COVID-19 epidemics), results were conflicting, with later studies apparently denying any true correlation between COVID-19 occurrence and BCG vaccination rates and/or policies. As a consequence, there is no sound evidence to recommend BCG vaccination for the prevention of COVID-19.


title: Impact of COVID-19 on routine care for chronic diseases: A global survey of views from healthcare professionals

text: Routine care for chronic disease is an ongoing major challenge. We aimed to evaluate the global impact of COVID-19 on routine care for chronic diseases. An online survey was posted 31 March to 23 April 2020 targeted at healthcare professionals. 202 from 47 countries responded. Most reported change in routine care to virtual communication. Diabetes, chronic obstructive pulmonary disease, and hypertension were the most impacted conditions due to reduction in access to care. 80% reported the mental health of their patients worsened during COVID-19. It is important routine care continues in spite of the pandemic, to avoid a rise in non-COVID-19-related morbidity and mortality.


title: Effect of the Phytochemical Agents Against the SARS-CoV and Selected Some of them for Application to COVID-19: A Mini-Review

text: BACKGROUND: The aim of the present review is to provide basic knowledge about the treatment of Coronavirus via medicinal plants. Coronavirus (COVID-19, SARS-CoV, and MERS-CoV) as a viral pneumonia causative agent, infects thousands of people in China and worldwide. There is currently no specific medicine or vaccine available and it is considered a threat to develop effective novel drug or anti-coronavirus vaccine treatment. However, natural compounds to treat coronaviruses are the most alternative and complementary therapies due to their diverse range of biological and therapeutic properties. METHODS: We performed an open-ended, English restricted search of Scopus database, Web of Science, and Pubmed for all available literature from Jan-March, 2020, using terms related to phytochemical compounds, medicinal plants and coronavirus. RESULTS: The view on anti-coronavirus (anti-CoV) activity in the plant derived phytochemicals and medicinal plants give the strong base to develop a novel treatment of corona virus activity. Various phytochemicals and medicinal plant extracts have been revised and considered to be the potential anti-CoV agents for effective control and future drug development. We discuss some important plants (Scutellaria baicalensis, Psorothamnus arborescens, Glycyrrhiza radix, Glycyrrhiza uralensis , Lycoris radiate, Phyllanthus emblica, Camellia sinensis, Hyptis atrorubens Poit, Fraxinus sieboldiana, Erigeron breviscapus, Citri Reticulatae Pericarpium, Amaranthus tricolor, Phaseolus vulgaris, Rheum palmatum, Curcuma longa and Myrica cerifera) emerged to have broad spectrum antiviral activity. CONCLUSION: Nigella sativa has potent anti-SARS-CoV activity and it might be useful souce for developing novel antiviral therapies for coronaviruses.


Why daily death tolls have become unusually important in understanding the coronavirus pandemic


title: Correction to: Children's dental anxiety (self and proxy reported) and its association with dental behaviour in a postgraduate dental hospital

text: In the original publication of the article the third author's name "M. Kowash" was submitted as "K.


Maternal mental health in Nepal and its prioritization during COVID-19 pandemic: Missing the obvious


title: Epidemic models with varying infectivity

text: We introduce an epidemic model with varying infectivity and general exposed and infectious periods, where the infectivity of each individual is a random function of the elapsed time since infection, those function being i.i.d. for the various individuals in the population. This approach models infection-age dependent infectivity, and extends the classical SIR and SEIR models. We focus on the infectivity process (total force of infection at each time), and prove a functional law of large number (FLLN). In the deterministic limit of this LLN, the infectivity process and the susceptible process are determined by a two-dimensional deterministic integral equation. From its solutions, we then derive the exposed, infectious and recovered processes, again using integral equations. We also use these equations to derive the basic reproduction number $R_0$ during the early stage of an epidemic, in terms of the average individual infectivity function and the exponential rate of growth of the epidemic.


Characterization of acute acral skin lesions in nonhospitalized patients: A case series of 132 patients during the COVID-19 outbreak