title: Internet Use, Risk Awareness, and Demographic Characteristics Associated With Engagement in Preventive Behaviors and Testing: Cross-Sectional Survey on COVID-19 in the United States

text: BACKGROUND: During the coronavirus disease (COVID-19) pandemic, engagement in preventive behaviors and getting tested for the virus play a crucial role in protecting people from contracting the new coronavirus. OBJECTIVE: This study aims to examine how internet use, risk awareness, and demographic characteristics are associated with engagement in preventative behaviors and testing during the COVID-19 pandemic in the United States. METHODS: A cross-sectional survey was conducted on Amazon Mechanical Turk from April 10, 2020, to April 14, 2020. Participants' internet use (in terms of the extent of receiving information pertaining to COVID-19), risk awareness (whether any immediate family members, close friends or relatives, or people in local communities tested positive for COVID-19), demographics (sex, age, ethnicity, income, education level, marital status, and employment status), as well as their engagement in preventative behaviors and testing were assessed. RESULTS: Our data included 979 valid responses from the United States. Participants who received more COVID-19-related health information online reported more frequent effort to engage in all types of preventive behaviors: wearing a facemask in public (odds ratio [OR] 1.55, 95% CI 1.34-1.79, P<.001), washing hands (OR 1.58, 95% CI 1.35-1.85, P<.001), covering nose and mouth when sneezing and coughing (OR 1.78, 95% CI 1.52-2.10, P<.001), keeping social distance with others (OR 1.41, 95% CI 1.21-1.65, P<.001), staying home (OR 1.40, 95% CI 1.20-1.62, P<.001), avoiding using public transportation (OR 1.57, 95% CI 1.32-1.88, P<.001), and cleaning frequently used surfaces (OR 1.55, 95% CI 1.34-1.79, P<.001). Compared with participants who did not have positive cases in their social circles, those who had immediate family members (OR 1.48, 95% CI 8.28-26.44, P<.001) or close friends and relatives (OR 2.52, 95% CI 1.58-4.03, P<.001) who tested positive were more likely to get tested. Participants' sex, age, ethnicity, marital status, and employment status were also associated with preventive behaviors and testing. CONCLUSIONS: Our findings revealed that the extent of receiving COVID-19-related information online, risk awareness, and demographic characteristics including sex, ethnicity, age, marital status, and employment status are key factors associated with US residents' engagement in various preventive behaviors and testing for COVID-19.


title: Environmental degradation, economic growth, and energy innovation: evidence from European countries

text: This study aims to explore the relationship of environmental degradation with economic growth and energy innovation by utilizing the panel data of 33 European countries by covering the period of 1996 to 2017. We use the cross-sections independence and control the heterogeneity between cross-sections by using the second-generation econometric of panel data. The Westerlund bootstrap co-integration, CIPS unit root test, Pedroni co-integration, panel causality techniques, and FMOLS have been used to analyze the relationship. The result of the study shows that all the variables are integrated in the long run. Energy innovation has a negative and significant impact on environmental degradation. On the other hand, gross domestic product has a U-shape and significant relationship with environmental degradation by supporting Kuznets curve. Therefore, this study helps not only the policymaker and government but also the people and businessmen on how they can increase the growth of the business and economy without effecting the environment.


title: A Review of State Guidelines for Elective Orthopaedic Procedures During the COVID-19 Outbreak

text: BACKGROUND: The SARS-CoV-2 (COVID-19) pandemic has resulted in widespread cancellation of elective orthopaedic procedures. The guidance coming from multiple sources frequently has been difficult to assimilate as well as dynamic, with constantly changing standards. We seek to communicate the current guidelines published by each state, to discuss the impact of these guidelines on orthopaedic surgery, and to provide the general framework used to determine which procedures have been postponed at our institution. METHODS: An internet search was used to identify published state guidelines regarding the cancellation of elective procedures, with a publication cutoff of March 24, 2020, 5:00 P.M. Eastern Daylight Time. Data collected included the number of states providing guidance to cancel elective procedures and which states provided specific guidance in determining which procedures should continue being performed as well as to orthopaedic-specific guidance. RESULTS: Thirty states published guidance regarding the discontinuation of elective procedures, and 16 states provided a definition of "elective" procedures or specific guidance for determining which procedures should continue to be performed. Only 5 states provided guidelines specifically mentioning orthopaedic surgery; of those, 4 states explicitly allowed for trauma-related procedures and 4 states provided guidance against performing arthroplasty. Ten states provided guidelines allowing for the continuation of oncological procedures. CONCLUSIONS: Few states have published guidelines specific to orthopaedic surgery during the COVID-19 outbreak, leaving hospital systems and surgeons with the responsibility of balancing the benefits of surgery with the risks to public health.


How medical education can help in a COVID-19 crisis


Outbreak of coronavirus disease 2019


title: Disruption of Arthroplasty Practice in an Orthopedic Center in Northern Italy During the Coronavirus Disease 2019 Pandemic

text: BACKGROUND: The Coronavirus disease 2019 (COVID-19) outbreak has put strain on many healthcare systems around the world, with important consequences. The aim of this paper is to describe the impact of the COVID-19 pandemic on hip and knee arthroplasties in an Italian high-volume orthopedic center, located in the region of the country first and worst affected by the Coronavirus. METHODS: Data from an institutional database were retrospectively analyzed to obtain the number of hip and knee arthroplasties performed from February 24 to April 10 2020. The figures were compared with those of the same 7-week period of the last year (2019). RESULTS: The number of hip and knee arthroplasties showed a decrease from 706 in the same period of 2019 to 166 (76.5% less) in the current year. In 2019, a mean of 101 ± 9 hip and knee arthroplasties were performed per week compared with a mean of 24 ± 34 in 2020. Ten patients tested positive for SARS-CoV2 during their hospital stay. Two of these patients died after a regular postoperative period after developing unexpectedly COVID-19 during rehabilitation. The mortality in the 7-week period of the current year was 1.2% compared with 0% in 2019. CONCLUSION: The outbreak of COVID-19 had a considerable effect in our center on the number of hip and knee arthroplasties that rapidly decreased to 0 in parallel to the worsening of the situation in the country. Efforts will be soon requested because our practice is going to deal with the after-effects of the pandemic in the near future.


COVID-19 in a remote village in a tropical forest - a note


title: Increasing handwashing in young children: A brief review

text: Personal hygiene is critical for preventing the spread of infection. One important component of personal hygiene is handwashing. This review summarizes research on behavioral strategies to address handwashing in children, offers areas for additional research, and suggests a treatment package to teach handwashing to young children.


Predictor of poor prognosis of COVID-19 patients----liver injury


パンデミック 新型コロナウイルスが暴いた真実 (総力超大特集 武漢肺炎、日本は負けない!)


title: Correction: Identification of feature risk pathways of smoking-induced lung cancer based on SVM

text: [This corrects the article DOI: 10.1371/journal.pone.0233445.].


How swamped preprint servers are blocking bad coronavirus research


SARS-CoV-2 possible contamination of genital area: implications for sexual and vertical transmission routes


title: Finding a way in daily clinical practice during Covid-19 pandemic

text: Since some months, the Covid-19 pandemic changed our world drastically. At the start of the pandemic, in a single week, our medical communities, both in primary care , nursing homes, as in secondary and tertiary facilities have been forced to stop all regular clinical care and to shift towards hospital care that was ultimately restricted to Covid-19 related disease. The clinical presentation of Covid-19 occurred predominantly in the elderly patients (most > 65 years old) displaying a respiratory disability, and in a small proportion among them displayed a respiratory failure, in association with a broad range of pre-existing co-morbidities. Covid-19 had not been taught in university and to prepare ourselves, we aimed to retract data published from especially Chinese studies. Most literature was published without a peer-review procedure (fast track), and most intervention designs existed of small groups and a not blinded/not randomized inclusion. After an extensive week of patients' contact, we experienced various differences (compared to the prior reports) in their first presentation and in their individual course of disease.


Critical illness myopathy as a consequence of Covid-19 infection


Where is the implementation science? An opportunity to apply principles during the COVID19 pandemic


Schizophrenia and COVID-19: risks and recommendations


Medical education and COVID-19: a personal view


title: A detailed report on the measures taken in the Department of Conservative Dentistry and Periodontology in Munich at the beginning of the COVID-19 outbreak

text: OBJECTIVES: The corona disease (COVID-19) is developing into one of the greatest challenges for healthcare professionals around the world. In this article, we report the detailed actions taken in the Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany, during the early phase of the COVID-19 pandemic. MATERIAL AND METHODS: After a joint on-site inspection of the dental clinic with the Department of Clinical Microbiology and Hospital Hygiene, existing clinical and hygiene protocols were adapted for COVID-19 patients. RESULTS: A comprehensive summary of the preparation of the facilities as well as pre- treatment, treatment and posttreatment protocols are described and arising problems are being discussed. CONCLUSIONS: The importance of rigorous hygiene and treatment protocols as well as a sufficient supply of PPE for dental offices and hospitals is highlighted. The measures reported may be subject to change due to the dynamics of the pandemic. CLINICAL RELEVANCE: The modes of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (e.g., droplets, aerosols, and fomites) can pose a risk for dental healthcare professionals and patients alike. The presented measures may guide dental faculties and dental practices during the early stage of the COVID-19 crisis.


title: "Baixadeiros" horses: prevalence of anti-Trypanosoma spp. and anti-Leishmania spp. antibodies/ Cavalos "baixadeiros": prevalência de anticorpos anti-Trypanosoma spp. e anti-Leishmania spp

text: A total of 138 horse blood samples were collected from 2012 to 2013 for the subsequent separation of serum collection. For detection of anti-Leishmania spp. and anti-Trypanosoma spp. antibodies, indirect immunofluorescence reactions and immunoenzymatic assays were performed. Samples with titers ≥40 were considered positive in the indirect immunofluorescence (IFAT), and the cut off for the enzyme immunoassay (ELISA) was calculated with three standard deviations. When tested for Trypanosoma spp., 50.37% (68/135) of the samples were ELISA reagents, 18.84% (8/136) were positive for IFAT and 2.89% (4/138) for both tests. A significant statistical association was observed for the municipality (p = 0.013) and collection period (p = 0.042) in the ELISA. When tested for Leishmania spp., 25.4% (35/138) of the samples were ELISA reagents, 13.00% (18/138) were positive for the IFAT and 4.34% (6/138) were positive for two tests, there were no variables associated with seropositivity. A statistical association (p = 0.0034) was observed between the presence of anti-Trypanosoma spp. and anti-Leishmania spp. antibodies when the ELISA was used. The results suggest that this horse breed is in contact with leishmaniasis and trypanosomiasis, which demonstrates the need for a more accurate investigation into the real role of horses in these diseases to assist in disease control measures.(AU)


title: Pulmonary and cardiac pathology in African American patients with COVID-19: an autopsy series from New Orleans

text: BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly across the USA, causing extensive morbidity and mortality, particularly in the African American community. Autopsy can considerably contribute to our understanding of many disease processes and could provide crucial information to guide management of patients with coronavirus disease 2019 (COVID-19). We report on the relevant cardiopulmonary findings in, to our knowledge, the first autopsy series of ten African American decedents, with the cause of death attributed to COVID-19. METHODS: Autopsies were performed on ten African American decedents aged 44-78 years with cause of death attributed to COVID-19, reflective of the dominant demographic of deaths following COVID-19 diagnosis in New Orleans. Autopsies were done with consent of the decedents' next of kin. Pulmonary and cardiac features were examined, with relevant immunostains to characterise the inflammatory response, and RNA labelling and electron microscopy on representative sections. FINDINGS: Important findings include the presence of thrombosis and microangiopathy in the small vessels and capillaries of the lungs, with associated haemorrhage, that significantly contributed to death. Features of diffuse alveolar damage, including hyaline membranes, were present, even in patients who had not been ventilated. Cardiac findings included individual cell necrosis without lymphocytic myocarditis. There was no evidence of secondary pulmonary infection by microorganisms. INTERPRETATION: We identify key pathological states, including thrombotic and microangiopathic pathology in the lungs, that contributed to death in patients with severe COVID-19 and decompensation in this demographic. Management of these patients should include treatment to target these pathological mechanisms. FUNDING: None.


Functionally assessing coronavirus entry


title: The relationship between chronotype and intelligence: the importance of work timing

text: Sleep-wake patterns show substantial biological determination, but they are also subject to individual choice and societal pressure. Some evidence suggests that high IQ is associated with later sleep patterns. However, it is unclear whether the relationship between IQ and later sleep is due to biological or social effects, such as the timing of working hours. We investigated the association between habitual sleep timing during work days and work-free days, working time and membership in Mensa, an organization of highly intelligent individuals (IQ ≥130) using a sample of 1,172 adults split between Mensa members and age- and sex-matched volunteers from a large web-based database. We found no difference in chronotype, and the later sleep timing of Mensa members on work days was fully accounted for by later work start times. Our results indicate that later sleep timing in those with higher IQs is not due to physiological differences, but rather due to later work schedules. Later working times and the resulting lower social jetlag may be one of the reasons why higher IQ is associated with lower prospective morbidity and mortality.


title: Mobile field hospitals, an effective way of dealing with COVID-19 in China: sharing our experience

text: During the COVID-19 outbreak, China made great progress in controlling the epidemic, and the number of confirmed and suspected cases continues to decrease thanks to the various efforts employed. Mobile field hospitals have played a huge role in the centralized management of patients and they have effectively reduced transmission. This article describes some of our experiences operating mobile field hospitals in order to provide a reference and to better inform countries that are dealing with this crisis.


Addressing mental health care for the bereaved during the COVID-19 pandemic


title: One-shot screening of potential peptide ligands on HR1 domain in COVID-19 glycosylated spike (S) protein with deep siamese network

text: The novel coronavirus (2019-nCoV) has been declared to be a new international health emergence and no specific drug has been yet identified. Several methods are currently being evaluated such as protease and glycosylated spike (S) protein inhibitors, that outlines the main fusion site among coronavirus and host cells. Notwithstanding, the Heptad Repeat 1 (HR1) domain on the glycosylated spike (S) protein is the region with less mutability and then the most encouraging target for new inhibitors drugs.The novelty of the proposed approach, compared to others, lies in a precise training of a deep neural network toward the 2019-nCoV virus. Where a Siamese Neural Network (SNN) has been trained to distingue the whole 2019-nCoV protein sequence amongst two different viruses family such as HIV-1 and Ebola. In this way, the present deep learning system has precise knowledge of peptide linkage among 2019-nCoV protein structure and differently, of other works, is not trivially trained on public datasets that have not been provided any ligand-peptide information for 2019-nCoV. Suddenly, the SNN shows a sensitivity of $83\%$ of peptide affinity classification, where $3027$ peptides on SATPdb bank have been tested towards the specific region HR1 of 2019-nCoV exhibiting an affinity of $93\%$ for the peptidyl-prolyl cis-trans isomerase (PPIase) peptide. This affinity between PPIase and HR1 can open new horizons of research since several scientific papers have already shown that CsA immunosuppression drug, a main inhibitor of PPIase, suppress the reproduction of different CoV virus included SARS-CoV and MERS-CoV. Finally, to ensure the scientific reproducibility, code and data have been made public at the following link: https://github.com/bionick87/2019-nCoV


title: Structure-Dependent Antibacterial Activity of Amino Acid-Based Supramolecular Hydrogels

text: Bacterial infections are currently a major concern to human health. Amino acid-based supramolecular polymer hydrogels, which boast intrinsic antibacterial activity, are an important solution due to their good biocompatibility, cost effectiveness, and tunable structural properties. Herein, we reported three types of transparent supramolecular hydrogel with intrinsic antibacterial activity from self-assembly of commercially available Fmoc-tryptophan (Fmoc-W), Fmoc-methionine (Fmoc-M), and Fmoc-tyrosine (Fmoc-Y). The resulting hydrogels selectively inhibited the growth of Gram-positive bacteria. Moreover, the order of antibacterial activity was Fmoc-W hydrogel > Fmoc-M hydrogel > Fmoc-Y hydrogel. The critical aggregation concentration (CAC) values were found at concentrations of approximately 0.0293, 0.1172, and 0.4688 mM for Fmoc-W, Fmoc-M, and Fmoc-Y, respectively. Transmission electron microscope (TEM) images revealed rigid and aligned nanofibers for Fmoc-W hydrogel, while flexible nanofibers for Fmoc-M hydrogel and Fmoc-Y hydrogel. The results indicated that stronger aggregation capability of the gelator and the synergistic nanostructural morphology with more rigid and aligned nanofibers can lead to higher antibacterial activity of its corresponding hydrogel. In addition, the molecular arrangements of Fmoc-amino acids in the hydrogels may also contribute to their antibacterial activity. These results can guide the rational design, fabrication, and future application of other self-assembled amino acid-based hydrogels with excellent antibacterial activity.


title: Effect of temperature on the infectivity of COVID-19

text: OBJECTIVES: To evaluate the influence of temperature on the infectivity of COVID-19 in Japan. METHODS: We evaluated the relationship between the accumulated number of patients per 1,000,000 population and the average temperature in February 2020 in each prefecture by Poisson regression analysis. We introduced the monthly number of inbound visitors from China in January 2020 in each prefecture and old-age dependency ratio as additional explanatory variables in the model. RESULTS: Monthly inbound visitors from China in January 2020, old-age dependency ratio, and mean temperature in February 2020 are associated with the cumulative number of COVID-19 case on March 16, 2020. CONCLUSIONS: Our analysis showed a possible association between low temperature and increased risk of COVID-19 infection. Further evaluation would be desirable at a global level.


title: Scarce-Resource Allocation and Patient Triage During the COVID-19 Pandemic: JACC Review Topic of the Week

text: The COVID-19 pandemic and its sequelae have created scenarios of scarce medical resources, leading to the prospect that health care systems have faced or will face difficult decisions about triage, allocation, and reallocation. These decisions should be guided by ethical principles and values, should not be made before crisis standards have been declared by authorities, and, in most cases, will not be made by bedside clinicians. Do not attempt resuscitation and withholding and withdrawing decisions should be made according to standard determination of medical appropriateness and futility, but there are unique considerations during a pandemic. Transparent and clear communication is crucial, coupled with dedication to provide the best possible care to patients, including palliative care. As medical knowledge about COVID-19 grows, more will be known about prognostic factors that can guide these difficult decisions.


title: Predicting the evolution Of SARS-Covid-2 in Portugal using an adapted SIR Model previously used in South Korea for the MERS outbreak

text: The new coronavirus covid-19 has spread very quickly worldwide, leading the World Health Organization (WHO) to declare a state of pandemic. One of the questions many policy makers, and governments are asking themselves is how the spread is going to evolve in time. In this study, I applied an adapted SIR model previously used in South Korea to model the MERS outbreak, which is also caused by a coronavirus, to estimate the evolution of the curve of active cases in the case of the Portuguese situation, using Italian dara. I then construct five different scenarios for the evolution of covid-19 in Portugal. In the out of control scenario, the number of active cases could reach as much as ~40,000 people on the 5th of April (out-of-control scenario). If the self-protective and control are taken in the same level as what was considered for the South Korean model, this number could have be reduced to about 800 cases (scenario 1). Considering that this scenario is now unrealistic, three other scenarios were devised. In all these scenarios, the government measures had a 50\% effectiveness when compared to the measures in Korea. But in scenario 2 the transmission rate $\beta$ was effectively reduced to 50\%, In this scenario active cases could reach circa 7,000 people. In scenario 3, the transmission rate $\beta$ was reduced to 70\% of its initial value, in which the number of cases would reach a peak of ~11,000 people. And finally in scenario 4, $\beta$ was reduced to 80\%. In this scenario, the peak would be reached at about ~13,000 cases. This study shows the importance of control and self-protecting measure to bring down the number of affected people by following the recommendations of the WHO and health authorities. With the appropriate measures, this number can be brought down to ~7,000-13,000 people. Hopefully that will be the case not just in Portugal, but in the rest of the World.


title: Deadeye Visualization Revisited: Investigation of Preattentiveness and Applicability in Virtual Environments

text: Visualizations rely on highlighting to attract and guide our attention. To make an object of interest stand out independently from a number of distractors, the underlying visual cue, e.g., color, has to be preattentive. In our prior work, we introduced Deadeye as an instantly recognizable highlighting technique that works by rendering the target object for one eye only. In contrast to prior approaches, Deadeye excels by not modifying any visual properties of the target. However, in the case of 2D visualizations, the method requires an additional setup to allow dichoptic presentation, which is a considerable drawback. As a follow-up to requests from the community, this paper explores Deadeye as a highlighting technique for 3D visualizations, because such stereoscopic scenarios support dichoptic presentation out of the box. Deadeye suppresses binocular disparities for the target object, so we cannot assume the applicability of our technique as a given fact. With this motivation, the paper presents quantitative evaluations of Deadeye in VR, including configurations with multiple heterogeneous distractors as an important robustness challenge. After confirming the preserved preattentiveness (all average accuracies above 90 %) under such real-world conditions, we explore VR volume rendering as an example application scenario for Deadeye. We depict a possible workflow for integrating our technique, conduct an exploratory survey to demonstrate benefits and limitations, and finally provide related design implications.


title: Patient outcomes after humeral fracture surgery during the COVID-19 outbreak in Spain

text: BACKGROUND: The global spread of the 2019 novel coronavirus (COVID-19) has profoundly affected the way we conduct our healthcare practices. The goal of this paper is to report the outcomes of 11 patients who underwent humeral fracture surgery in the first few weeks of the COVID-19 outbreak in Spain. METHODS: This was a retrospective case series of 11 patients who underwent humeral fracture surgery during the first weeks of the COVID-19 outbreak in Spain, between 10 March and 25 April 2020. The clinical outcomes of these operative patients were monitored up to 12 May 2020, the final date of follow-up, a minimum of 15 days after all patients were discharged from the hospital. COVID-19 infection, mortality, demographic, clinical, and laboratory data were analyzed. RESULTS: Thirty-six humeral fractures were recorded between 10 March and 25 April 2020. During this period, humeral fracture fixation was the third most common surgery for fracture in our institution after hip fracture and ankle fracture surgery. Eleven patients underwent surgery (30.5%), of which seven were women (63.3%). The mean age was 64.8 years (SD 13.5). Nine operated cases had a proximal humerus fracture and 2 had a humeral shaft fracture. One of the 11 patients was positive for SARS-CoV-2 on the basis of quantitative reverse transcription polymerase chain reaction (RT-PCR) of throat swab samples. The overall median surgical time was 101.2 minutes (SD 28.4). The overall median hospital length stays for the patient discharged was 2.2 days (range 1-4). No COVID-19 nosocomial intrahospital infection occurred, no patient reported COVID-19 infection during the 15 days after hospital discharge. No intrahospital mortality was recorded. Furthermore, no COVID-19 infection was reported in the shoulder surgeons that performed the surgeries. CONCLUSIONS: Although humeral fractures were not the most frequent fracture during this outbreak, some required surgery. With good preoperative management that included RT-PCR for COVID-19 and chest radiographs, protective measurements for the surgical team, and rapid discharge of the patients, we were able to operate on 11 humeral fractures with no COVID-19 nosocomial intrahospital infection in the patients or in the shoulder surgeons that performed the surgeries.


COVID-19 Pandemic: The Way Forward


Virtual dermatology: a COVID-19 update


title: Hand sanitisers amid CoViD-19: A critical review of alcohol-based products on the market and formulation approaches to respond to increasing demand

text: The world is facing a medical crisis amid the CoViD-19 pandemic and the role of adequate hygiene and hand sanitisers is inevitable in controlling the spread of infection in public places and healthcare institutions. There has been a great surge in demand for hand sanitisation products leading to shortages in their supply. A consequent increase of substandard products in the market has raised safety concerns. This article, therefore, presents a critical review of hand sanitation approaches and products available on the market in light of the scientific evidence available to date. This review also provides a range of hand sanitisation product formulations, and manufacturing instructions to allow for extemporaneous preparations at the community and hospital pharmacies during this urgent crisis. In addition, this emergent situation is expected to continue, hence hand sanitisers will be in demand for an extended time, and the availability and purchase of substandard products on the market create an ongoing safety concern. Therefore, this article shall also provide various commercial organisations, interested in stepping forward the production and marketing of hand sanitisers, with a guide on the development of products of standardised ingredients and formulations.


Coronavirusâ : rester proactif


Not Dying Alone - Modern Compassionate Care in the Covid-19 Pandemic


title: Scientific and Standardization Committee Communication: Clinical Guidance on the Diagnosis, Prevention and Treatment of Venous Thromboembolism in Hospitalized Patients with COVID-19

text: The novel coronavirus disease of 2019 (COVID-19) pandemic, as declared by the World Health Organization, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Cardiovascular disease and, in particular, venous thromboembolism (VTE) has emerged as an important consideration in the management of hospitalized patients with COVID-19. The diagnosis of VTE using standardized objective testing is problematic in these patients, given the risk of infecting non-COVID-19 hospitalized patients and hospital personnel, coupled with the usual challenges of performing diagnostic testing in critically-ill patients. Early reports suggest a high incidence of VTE in hospitalized COVID-19 patients, particularly those with severe illness, that is similar to the high VTE rates observed in patients with other viral pneumonias, including severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS-CoV).


Radiotherapy imaging: An unexpected ally in fighting COVID 19 pandemic


title: Mastitis in dairy goats from the state of Minas Gerais, Brazil: profiles of farms, risk factors and characterization of bactéria/ Mastite em cabras de leite no estado de Minas Gerais: perfil de propriedades, fatores de risco e caracterização de bactérias

text: The Zona da Mata of Minas Gerais has a specialized goat milk production chain. Goat milk is superior in quality compared with milk of other domestic species, and the demand for milk and milk products for the public has increased. Data on dairy goat breeding in Minas Gerais are scarce and relatively old, and this lack of information has limited the implementation of prophylactic measures, especially for mastitis, which represents the biggest sanitary problem for dairy herds. The objective of this work was to characterize mastitis and bacteria associated with it in milking goats in the Zona da Mata of Minas Gerais. It also causes socioeconomic problems and market issues for dairy goat farming. A total of 539 lactating goats were examined and 268 individual samples (one for teat) were collected from animals positive for strip cup test and/or the California Mastitis Test (CMT). Microbiological cultures were carried out on blood agar medium and the bacteria were subjected to phenotypic, genotypic and antimicrobial susceptibility tests. The prevalence of subclinical mastitis was 28.0% and the clinical prevalence was 2.8%. Bacterial multiplication was obtained in 62% of samples. One hundred eighty seven total bacteria were identified. The most common species identified was Staphylococcus aureus (60%), followed Staphylococcus epidermidis (9.1%,), Escherichia coli (6.9%), Staphylococcus saprophyticus (5.9%) e Staphylococcus caprae (4.3%). Bacteria of the genus Staphylococcus presented a profile of resistance to antimicrobials belonging to the beta-lactam class (penicillin, ampicillin and oxacillin) in addition to tetracycline, in contrast to the other antimicrobials tested. Twelve percent of multidrug resistence (MDR) was found in five microregions. Among the bacteria with the highest prevalence of MDR, 38.5% were E. coli and 10.6% were S. aureus. The producers of the Zona da Mata of Minas Gerais are technicians who work with specialized dairy breeds and practise good management. However, some measures related to prophylaxis and control of diseases, such as vaccination, have low adherence or are not performed due to a lack of veterinary assistance. This is the first study focusing on this region, which is highly prominent in goat milk production in Brazil. It provides important information that can help in the implementation of measures for the prophylaxis and control of diseases, and for maintenance of a constant supply of products in sufficient quantities and of a quality suitable for the consumer population.(AU)


The bimodal SARS-CoV-2 outbreak in Italy as an effect of environmental and allergic causes


title: Nosocomial outbreak of COVID-19 pneumonia in Wuhan, China

text: BACKGROUND: The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), infected over 3300 healthcare workers in early 2020 in China. Little information is known about nosocomial infections of healthcare workers in the initial period. We analysed data from healthcare workers with nosocomial infections in Wuhan Union Hospital (Wuhan, China) and their family members. METHODS: We collected and analysed data on exposure history, illness timelines and epidemiological characteristics from 25 healthcare workers with laboratory-confirmed coronavirus disease 2019 (COVID-19) and two healthcare workers in whom COVID-19 was highly suspected, as well as 10 of their family members with COVID-19, between 5 January and 12 February 2020. The demographics and clinical features of the 35 laboratory-confirmed cases were investigated and viral RNA of 12 cases was sequenced and analysed. RESULTS: Nine clusters were found among the patients. All patients showed mild to moderate clinical manifestation and recovered without deterioration. The mean period of incubation was 4.5â days, the mean±sd clinical onset serial interval (COSI) was 5.2±3.2â days, and the median virus shedding time was 18.5â days. Complete genomic sequences of 12 different coronavirus strains demonstrated that the viral structure, with small irrelevant mutations, was stable in the transmission chains and showed remarkable traits of infectious traceability. CONCLUSIONS: SARS-CoV-2 can be rapidly transmitted from person to person, regardless of whether they have symptoms, in both hospital settings and social activities, based on the short period of incubation and COSI. The public health service should take practical measures to curb the spread, including isolation of cases, tracing close contacts, and containment of severe epidemic areas. Besides this, healthcare workers should be alert during the epidemic and self-quarantine if self-suspected of infection.


title: Application of CareDose 4D combined with Karl 3D technology in the low dose computed tomography for the follow-up of COVID-19

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a highly infectious disease caused by the new coronavirus. Previous studies have shown that the chest CT examination plays an important role in the diagnosis and monitoring of COVID-19. However, some patients with COVID-19 had low white blood cell counts and reduced lymphocyte ratios. Multiple CT examinations may cause radiation damages as well as increase the apoptosis of peripheral blood lymphocytes. A new low-dose CT method should be developed because the regular CT may aggravate the disease. METHOD: Sixty cases were randomly divided into the study group (n = 30) and control group (n = 30). The lung window was reconstructed by Karl 3D iterative technique in the study group. The image quality was subjectively evaluated by two senior chest group diagnostic physicians using a 5-point double-blind method. The value of CT measurement and its standard deviation (SD) was used as an objective evaluation criteria. The volume of CT dose index (CTDIvol), dose length product (DLP) and effective dose (ED) from the two groups were compared and analyzed statistically. RESULT: There was no significant difference in the occurrence rates of ground glass opacities, consolidation, crazy-paving pattern, fiber cable shadow and axial interstitial thickening between the study group and control group (p > 0.05). In addition, no significant difference was found for the subjective score of overall image quality and image noise level (SD) between the two groups (p > 0.05). However, significant differences was found in CTDIvol, DLP, and ED between the study group and the control group (p < 0.05). The effective dose of the study group was reduced by 76% compared to the control group. CONCLUSION: CareDose 4D low-dose scanning combined with Karl 3D iterative reconstruction technology can not only greatly reduce the radiation dose, but also provide images that meet the diagnostic criteria of COVID-19, which can be used as a routine method for the follow-up of COVID-19 patients.


Impact of smoking status on disease severity and mortality of hospitalized patients with COVID-19 infection: a systematic review and meta-analysis


Renin-angiotensin-aldosterone system dysregulation and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection


title: Risk Estimation of SARS-CoV-2 Transmission from Bluetooth Low Energy Measurements

text: Digital contact tracing approaches based on Bluetooth low energy (BLE) have the potential to efficiently contain and delay outbreaks of infectious diseases such as the ongoing SARS-CoV-2 pandemic. In this work we propose a novel machine learning based approach to reliably detect subjects that have spent enough time in close proximity to be at risk of being infected. Our study is an important proof of concept that will aid the battery of epidemiological policies aiming to slow down the rapid spread of COVID-19.


Uncertainties on the prognostic value of D-dimers in COVID-19 patients


title: Evolução da prevalência de infecção por COVID-19 no Rio Grande do Sul, Brasil: inquéritos sorológicos seriados./ Evolução da prevalência de infecção por COVID-19 no Rio Grande do Sul, Brasil: inquéritos sorológicos seriados./ Trends in the prevalence of COVID-19 infection in Rio Grande do Sul, Brazil: repeated serological surveys

text: COVID-19, the disease produced by the virus SARS-CoV-2, has spread quickly throughout the world, leading the World Health Organization to first classify it as an international health emergency and, subsequently, declaring it pandemic. The number of confirmed cases, as April 11, surpassed 1,700,000, but this figure does not reflect the prevalence of COVID-19 in the population as, in many countries, tests are almost exclusively performed in people with symptoms, particularly severe cases. To properly assess the magnitude of the problem and to contribute to the design of evidence-based policies for fighting COVID-19, one must accurately estimate the population prevalence of infection. Our study is aimed at estimating the prevalence of infected individuals in the state of Rio Grande do Sul, Brazil, to document how fast the infection spreads, and to estimate the proportion of infected persons who present or presented symptoms, as well as the proportion of asymptomatic infections. Four repeated serological surveys will be conducted in probability samples of nine sentinel cities every two weeks. Tests will be performed in 4,500 participants in each survey, totaling18,000 interviews. Interviews and tests will be conducted at the participants' household. A rapid test for the detection of antibodies will be used; the test was validated prior to the beginning of the fieldwork.


Caution against corticosteroid-based COVID-19 treatment


A case of erythema multiforme major in a patient with COVID 19: The role of corticosteroid treatment


title: Secondary tension pneumothorax in a COVID-19 pneumonia patient: a case report

text: PURPOSE: Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed pneumothorax in rare cases, but tension pneumothorax has only been reported once. CASE PRESENTATION: A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided tension pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the pneumothorax and the patient was discharged after 9 days of treatment. CONCLUSION: Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute tension pneumothorax. LEVEL OF EVIDENCE: V.


title: Are official confirmed cases and fatalities counts good enough to study the COVID-19 pandemic dynamics? A critical assessment through the case of Italy

text: As the COVID-19 outbreak is developing the two most frequently reported statistics seem to be the raw confirmed case and case fatalities counts. Focusing on Italy, one of the hardest hit countries, we look at how these two values could be put in perspective to reflect the dynamics of the virus spread. In particular, we find that merely considering the confirmed case counts would be very misleading. The number of daily tests grows, while the daily fraction of confirmed cases to total tests has a change point. It (depending on region) generally increases with strong fluctuations till (around, depending on region) 15th-22nd March and then decreases linearly after. Combined with the increasing trend of daily performed tests, the raw confirmed case counts are not representative of the situation and are confounded with the sampling effort. This we observe when regressing on time the logged fraction of positive tests and for comparison the logged raw confirmed count. Hence, calibrating model parameters for this virus's dynamics should not be done based only on confirmed case counts (without rescaling by the number of tests), but take also fatalities and hospitalization count under consideration as variables not prone to be distorted by testing efforts. Furthermore, reporting statistics on the national level does not say much about the dynamics of the disease, which are taking place at the regional level. These findings are based on the official data of total death counts up to 15th April 2020 released by ISTAT and up to 10th May 2020 for the number of cases. In this work we do not fit models but we rather investigate whether this task is possible at all. This work also informs about a new tool to collect and harmonize official statistics coming from different sources in the form of a package for the R statistical environment and presents the COVID-19 Data Hub.


Thrombotic complications of patients admitted to intensive care with COVID-19 at a teaching hospital in the United Kingdom


Surgical prioritization of obstetrics and gynecology procedures in the UK during the COVID-19 pandemic


title: Dermatological findings in SARS-CoV-2 positive patients: An observational study from North India

text: A novel coronavirus (severe acute respiratory syndrome corononavirus-2; SARS-CoV-2) has affected millions of people across the world. The coronavirus disease (COVID-19) resulting from SARS-CoV-2 manifests in variable clinical severity, featuring both respiratory and extra-respiratory symptoms. Dermatological manifestations of COVID-19 are sparsely reported. To study the various dermatological findings in SARS-CoV-2 positive patients in Indian population. Institutional ethical committee permission was sought and102 SARS-CoV-2 positive patients were included in the study. A thorough clinical examination was done to determine the nature and frequency of various dermatological manifestations in these patients. Out of the 102 positive cases, 95 were males. The mean age of the group was 39.30 years. Thirteen patients (12.7%) were found to have dermatological manifestations. Three (2.9%) had maculopapular rash, two (1.9%) had urticarial lesions and eight (7.8%) patients had itching without any specific cutaneous signs. Trunk was the most frequently affected area, followed by the extremities. No mucosal signs and symptoms were detected. Dermatological manifestations were seen in a small group of COVID-19 patients. The presentation may vary in different population groups and based on severity of disease.


African American children are at higher risk of COVID-19 infection


title: Endocrine surgery in the Coronavirus disease 2019 pandemic: Surgical Triage Guidelines

text: BACKGROUND: In the face of the COVID-19 pandemic, cancer care has had to adapt rapidly given the Centers for Disease Control and Prevention and the American College of Surgeons (ACS) issuing recommendations to postpone nonurgent surgeries. METHODS: An institutional multidisciplinary group of Head and Neck Surgical Oncology, Surgical Endocrinology, and Medical Endocrinology devised Surgical Triaging Guidelines for Endocrine Surgery during COVID-19, aligned with phases of care published by the ACS. RESULTS: Phases of care with examples of corresponding endocrine cases are outlined. Most cases can be safely postponed with active surveillance, including most differentiated and medullary thyroid cancers. During the most acute phase, all endocrine surgeries are deferred, except thyroid tumors requiring acute airway management. CONCLUSIONS: These guidelines provide context for endocrine surgery within the spectrum of surgical oncology, with the goal of optimal individualized multidisciplinary patient care and the expectation of significant resource diversion to care for patients with COVID-19.


Que nous apprend la pandémie de COVID-19 à nous et sur nous, les dermatologues ?/ [What can we learn from the COVID-19 pandemic in general and about ourselves as dermatologists?]


Psychological distress during COVID-19 among Malayalam-speaking Indian expats in the middle east


Reperfusion treatment for high-risk pulmonary embolism associated with COVID-19


SARS-CoV-2-Induced Kawasaki-Like Hyperinflammatory Syndrome: A Novel COVID Phenotype in Children


COVID-19 in dermatology practice: getting back on track


title: Recent progress in understanding 2019 novel coronavirus (SARS-CoV-2) associated with human respiratory disease: detection, mechanisms and treatment

text: Viral respiratory diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) always pose a severe threat to people. First identified in late December 2019, a novel coronavirus (2019-nCoV; SARS-CoV-2) has affected many provinces in China and multiple countries worldwide. The viral outbreak has aroused panic and a public-health emergency around the world, and the number of infections continues to rise. However, the causes and consequences of the pneumonia remain unknown. To effectively implement epidemic prevention, early identification and diagnosis are critical to disease control. Here we scrutinise a series of available studies by global scientists on the clinical manifestations, detection methods and treatment options for the disease caused by SARS-CoV-2, named coronavirus disease 2019 (COVID-19), and also propose potential strategies for preventing the infection.


title: 30-day mortality in patients hospitalized with COVID-19 during the first wave of the Italian epidemic: A prospective cohort study

text: Italy was the first European country hit by the COVID-19 pandemic and has the highest number of recorded COVID-19 deaths in Europe. This prospective cohort study of the correlates of the risk of death in COVID-19 patients was conducted at the Infectious Diseases and Intensive Care units of Luigi Sacco Hospital, Milan, Italy. The clinical characteristics of all the COVID-19 patients hospitalised in the early days of the epidemic (21 February -19 March 2020) were recorded upon admission, and the time-dependent probability of death was evaluated using the Kaplan-Meier method (censored as of 20 April 2020). Cox proportional hazard models were used to assess the factors independently associated with the risk of death. Forty-eight (20.6 %) of the 233 patients followed up for a median of 40 days (interquartile range 33-47) died during the follow-up. Most were males (69.1 %) and their median age was 61 years (IQR 50-72). The time-dependent probability of death was 19.7 % (95 % CI 14.6-24.9 %) 30 days after hospital admission. Age (adjusted hazard ratio [aHR] 2.08, 95 % CI 1.48-2.92 per ten years more) and obesity (aHR 3.04, 95 % CI 1.42-6.49) were independently associated with an increased risk of death, which was also associated with critical disease (aHR 8.26, 95 % CI 1.41-48.29), C-reactive protein levels (aHR 1.17, 95 % CI 1.02-1.35 per 50 mg/L more) and creatinine kinase levels above 185 U/L (aHR 2.58, 95 % CI 1.37-4.87) upon admission. Case-fatality rate of patients hospitalized with COVID-19 in the early days of the Italian epidemic was about 20 %. Our study adds evidence to the notion that older age, obesity and more advanced illness are factors associated to an increased risk of death among patients hospitalized with COVID-19.


Cancer survivorship care during COVID-19-perspectives and recommendations from the MASCC survivorship study group


title: The fiscal value of human lives lost from coronavirus disease (COVID-19) in China

text: OBJECTIVE: According to the WHO coronavirus disease (COVID-19) situation report 35, as of 24th February 2020, there was a total of 77,262 confirmed COVID-19 cases in China. That included 2595 deaths. The specific objective of this study was to estimate the fiscal value of human lives lost due to COVID-19 in China as of 24th February 2020. RESULTS: The deaths from COVID-19 had a discounted (at 3%) total fiscal value of Int$ 924,346,795 in China. Out of which, 63.2% was borne by people aged 25-49 years, 27.8% by people aged 50-64 years, and 9.0% by people aged 65 years and above. The average fiscal value per death was Int$ 356,203. Re-estimation of the economic model alternately with 5% and 10 discount rates led to a reduction in the expected total fiscal value by 21.3% and 50.4%, respectively. Furthermore, the re-estimation of the economic model using the world's highest average life expectancy of 87.1 years (which is that of Japanese females), instead of the national life expectancy of 76.4 years, increased the total fiscal value by Int$ 229,456,430 (24.8%).


title: Mouth Self-Examination for Prevention and Control of Oral Cavity Cancer Effectiveness of glucocorticoid therapy in patients with severe coronavirus disease 2019: protocol of a randomized controlled trial

text: Oral cavity cancer is one of the most common preventable cancers in the world The burden of the disease is high in South Asia Therefore, public health strategies such as creating awareness and disease screening should be advocated for its prevention and early detection Mouth self-examination serves both the purposes It is easy to perform, non-invasive, and low-cost methods It not only helps in the early detection of suspicious oral lesions but also helps people to quit their high-risk behaviors such as consumption of tobacco and alcohol BACKGROUND: At the end of 2019, a novel coronavirus outbreak causative organism has been subsequently designated the 2019 novel coronavirus (2019-nCoV) The effectiveness of adjunctive glucocorticoid therapy in the management of 2019-nCoV-infected patients with severe lower respiratory tract infections is not clear, and warrants further investigation METHODS: The present study will be conducted as an open-labeled, randomized, controlled trial We will enrol 48 subjects from Chongqing Public Health Medical Center Each eligible subject will be assigned to an intervention group (methylprednisolone via intravenous injection at a dose of 1-2 mg/kg/day for 3 days) or a control group (no glucocorticoid use) randomly, at a 1:1 ratio Subjects in both groups will be invited for 28 days of follow-up which will be scheduled at four consecutive visit points We will use the clinical improvement rate as our primary endpoint Secondary endpoints include the timing of clinical improvement after intervention, duration of mechanical ventilation, duration of hospitalization, overall incidence of adverse events, as well as rate of adverse events at each visit, and mortality at 2 and 4 weeks DISCUSSION: The present coronavirus outbreak is the third serious global coronavirus outbreak in the past two decades Oral and parenteral glucocorticoids have been used in the management of severe respiratory symptoms in coronavirus-infected patients in the past However, there remains no definitive evidence in the literature for or against the utilization of systemic glucocorticoids in seriously ill patients with coronavirus-related severe respiratory disease, or indeed in other types of severe respiratory disease In this study, we hope to discover evidence either supporting or opposing the systemic therapeutic administration of glucocorticoids in patients with severe coronavirus disease 2019 TRIAL REGISTRATION: ClinicalTrials gov, ChiCTR2000029386, http://www chictr org cn/showproj aspx?proj=48777


title: Key Vitamin D Target Genes with Functions in the Immune System

text: The biologically active form of vitamin D3, 1α,25-dihydroxyvitamin D3 (1,25(OH)2D3), modulates innate and adaptive immunity via genes regulated by the transcription factor vitamin D receptor (VDR). In order to identify the key vitamin D target genes involved in these processes, transcriptome-wide datasets were compared, which were obtained from a human monocytic cell line (THP-1) and peripheral blood mononuclear cells (PBMCs) treated in vitro by 1,25(OH)2D3, filtered using different approaches, as well as from PBMCs of individuals supplemented with a vitamin D3 bolus. The led to the genes ACVRL1, CAMP, CD14, CD93, CEBPB, FN1, MAPK13, NINJ1, LILRB4, LRRC25, SEMA6B, SRGN, THBD, THEMIS2 and TREM1. Public epigenome- and transcriptome-wide data from THP-1 cells were used to characterize these genes based on the level of their VDR-driven enhancers as well as the level of the dynamics of their mRNA production. Both types of datasets allowed the categorization of the vitamin D target genes into three groups according to their role in (i) acute response to infection, (ii) infection in general and (iii) autoimmunity. In conclusion, 15 genes were identified as major mediators of the action of vitamin D in innate and adaptive immunity and their individual functions are explained based on different gene regulatory scenarios.


title: Persistence of SARS-CoV-2 virus RNA in feces: A case series of children

text: AIMS: To determine how long SARS-CoV-2 virus RNA persists in fecal specimens in children with COVID-19. METHODS: Retrospectively, ten children with confirmed COVID-19 in the Jinan Infectious Disease Hospital Affiliated to Shandong University were enrolled between January 23, 2020 to March 9, 2020. Epidemiological, clinical, laboratory, and radiological characteristics of the children were analyzed. RT-PCR assays were performed to detect the SARS-CoV-2 virus RNA in the respiratory tract and fecal specimens in the follow-up after discharge. RESULTS: Among ten patients, five (50%) were asymptomatic and five (50%) showed mild symptoms of respiratory illness. The average age of asymptomatic children was younger than that of symptomatic children (p = 0.03). The decreases in white blood cell (WBC) (p = 0.03) and lymphocyte (p = 0.03) counts were more severe in symptomatic patients than those in asymptomatic patients. During the follow-up examination after discharge, seven out of ten patients contained SARS-CoV-2 virus RNA in their fecal specimens, despite all patients showed negative results in respiratory tract specimens. One out of those seven patients relapsed. The median time from onset to being negative results in respiratory tract and fecal specimens was 9 days and 34.43 days, respectively. CONCLUSIONS: SARS-CoV-2 virus RNA persists much longer in the gastrointestinal (GI) tract than that in respiratory tract.


The Promise and Peril of Antibody Testing for COVID-19


title: "When the going gets tough, the tough get-Creative": Israeli Jewish religious leaders find religiously innovative ways to preserve community members' sense of belonging and resilience during the COVID-19 pandemic

text: This commentary describes the religiously innovative adaptations made to customary rituals by Jewish religious leaders to address issues of belonging and resilience during the 2019 novel coronavirus (COVID-19) pandemic quarantine. These adaptations included allowing religious prayer through a "balcony" minyan, conducting an online chavruta using video conferencing, and broadcasting the Passover ceremony. The approach shown here could contribute to future evidence-based research, conducted among different faiths, about the roles of both religious leadership and information and communications technology (ICT) in preserving one's sense of belonging and resilience in times of crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: Types of Assays for SARS-CoV-2 Testing: A Review

text: Clinical laboratory testing routinely provides actionable results, which help direct patient care in the inpatient and outpatient settings. Since December 2019, a novel coronavirus (SARS-CoV-2) has been causing disease (COVID-19 [coronavirus disease 2019]) in patients, beginning in China and now extending worldwide. In this context of a novel viral pandemic, clinical laboratories have developed multiple novel assays for SARS-CoV-2 diagnosis and for managing patients afflicted with this illness. These include molecular and serologic-based tests, some with point-of-care testing capabilities. Herein, we present an overview of the types of testing available for managing patients with COVID-19, as well as for screening of potential plasma donors who have recovered from COVID-19.


SARS-CoV-2 Pathogenesis: Imbalance in the Renin-Angiotensin System Favors Lung Fibrosis


mRNA Vaccines: Possible Tools to Combat SARS-CoV-2


Lehren aus einer Kreuzfahrt mit SARS-CoV-2


The nucleic acid test of induced sputum should be used for estimation of patients cure with 2019-nCov


Response to: Optimizing Hydroxychloroquine Dosing for Patients With COVID-19: An Integrative Modeling Approach for Effective Drug Repurposing: Quantitative Clinical Pharmacology Input to SARS-CoV-2 Therapeutics Should Be Based on Robust Data


title: 2019 novel coronavirus disease (COVID-19) in Taiwan: Reports of two cases from Wuhan, China

text: We reported two cases with community-acquired pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who returned from Wuhan, China in January, 2020. The reported cases highlight non-specific clinical presentations of 2019 novel coronavirus disease (COVID-19) as well as the importance of rapid laboratory-based diagnosis.


Managing Inflammatory Bowel Disease During COVID-19: Summary of Recommendations from Gastrointestinal Societies


title: How Fear Appeal Approaches in COVID-19 Health Communication May Be Harming the Global Community

text: As health professionals develop health communication for coronavirus disease 2019 (COVID-19), we implore that these communication approaches do not include fear appeals. Fear appeals, also known as scare tactics, have been widely used to promote recommended preventive behaviors. We contend that unintended negative outcomes can result from fear appeals that intensify the already complex pandemic and efforts to contain it. We encourage public health professionals to reevaluate their desire to use fear appeals in COVID-19 health communication and recommend that evidence-based health communication be utilized to address the needs of a specific community, help people understand what they are being asked to do, explain step-by-step how to complete preventative behaviors, and consider external factors needed to support the uptake of behaviors. To aid health professionals in redirecting away from the use of fear appeals, we offer a phased approach to creating health communication messages during the COVID-19 crisis.


Comments on: All India Ophthalmic Society-Indian Journal of Ophthalmology Consensus statement on preferred practices during COVID-19 Pandemic


title: Clinical features, diagnosis and management of COVID-19 patients in the outdoor setting

text: In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, staff and patients. Patients with COVID-19 patients should be identified before they arrive in the facility and should be served expeditiously, in an environment which prevents cross-transmission of infection. Tele-consultation is assuming an important role. Changes which are taking place in response to Covid-19 pandemic will have far reaching effects on clinical services in Pakistan.


Viral screening before initiation of biologics in patients with inflammatory bowel disease during the COVID-19 outbreak


Venous thromboembolism in COVID-19 patients


title: Sindrome Takotsubo in corso di polmonite da SARS-CoV-2: una possibile complicanza cardiovascolare./ [Takotsubo syndrome during SARS-CoV-2 pneumonia: a possible cardiovascular complication]

text: Takotsubo syndrome (TTS) is one of the causes of myocardial infarction with non-obstructive coronary arteries, and is often triggered by physical events (e.g. acute respiratory failure), or emotional events (e.g. loss of a family member, cardiac stress induced by an acute illness). SARS-CoV-2 pneumonia currently represents a worldwide health problem; the correlations between cardiovascular disease, myocardial injury and SARS-CoV-2 infection are still unclear, but initial data show that myocardial damage represents a negative prognostic factor. Myocardial injury during SARS-CoV-2, as defined by a pathological rise in circulating troponin levels, is not an uncommon complication in hospitalized patients, and is significantly more frequent in intensive care unit patients and among those who died. In this setting, myocardial injury is mainly secondary to type 2 myocardial infarction (mismatch in myocardial oxygen supply and demand during respiratory failure); other causes include myocarditis, coronary thrombosis, sepsis or septic shock. At present, only few cases of TTS have been described during SARS-CoV-2. Here we report the case of a patient hospitalized for pneumonia and respiratory failure due to SARS-CoV-2 with subsequent onset of TTS triggered by both physical and emotional events.


COVID-19 pneumonia in a Turkish child presenting with abdominal complaints and reversed halo sign on thorax CT


title: The modelling of COVID19 pathways sheds light on mechanisms, opportunities and on controversial interpretations of medical treatments. v2

text: The new coronavirus (2019-nCoV or SARS-CoV2), inducing the current pandemic disease (COVID-19) and causing pneumoniae in humans, is dramatically increasing in epidemic scale since its first appearance in Wuhan, China, in December 2019. The first infection from epidemic coronaviruses in 2003 fostered the spread of an overwhelming amount of related scientific efforts. The manifold aspects that have been raised, as well as their redundancy offer precious information that has been underexploited and needs to be critically re-evaluated, appropriately used and offered to the whole community, from scientists, to medical doctors, stakeholders and common people. These efforts will favour a holistic view on the comprehension, prevention and development of strategies (pharmacological, clinical etc) as well as common intervention against the new coronavirus spreading. Here we describe a model that emerged from our analysis that was focused on the Renin Angiotensin System (RAS) and the possible routes linking it to the viral infection. because the infection is mediated by the viral receptor on human cell membranes Angiotensin Converting Enzyme (ACE2), which is a key component in RAS signalling. The model depicts the main pathways determining the disease and the molecular framework for its establishment, and can help to shed light on mechanisms involved in the infection. It promptly gives an answer to some of the controversial, and still open, issues concerning predisposing conditions and medical treatments that protect from or favour the severity of the disease (such as the use of ACE inhibitors or ARBs/sartans), or to the sex related biases in the affected population. The model highlights novel opportunities for further investigations, diagnosis and appropriate intervention to understand and fight COVID19.


Rapid random access detection of the novel SARS-coronavirus-2 (SARS-CoV-2, previously 2019-nCoV) using an open access protocol for the Panther Fusion


title: [COVID-19 associated severe psychotic relapse]

text: This is a case report of a 42-year-old patient, who was admitted to hospital with clinical pneumonia The only positive test result was for SARS-CoV-2 After a few days of treatment, the patient was discharged in stable condition for isolation at home The patient had previously had contact with the mental health services and was diagnosed with catatonic schizophrenia but had been without outpatient contact or treatment for the last four years After seven days he was admitted in a state of severe psychosis This begs the question if the psychotic relapse was triggered by a neuroinflammatory response caused by SARS-CoV-2


title: The Association Between Symptom Onset and Length of Hospital Stay in 2019 Novel Coronavirus Pneumonia Cases Without Epidemiological Trace

text: OBJECTIVE: Compared to COVID-19 cases with established epidemiological trace, little is known about the patients without one. This study reports an association between time of symptom onset (TOS) and length of hospital stay (LOS) in COVID-19 infection without epidemiological link. METHODS: Generalized linear regression models were used to examine the association between symptom onset and primary outcome LOS. A group of patients with established epidemiological link in same medical facility during that period of time were used as controls. RESULTS: A total of 38 COVID-19 patients were admitted, 26 of which were found without travel history to infected area or direct contact with a case-patient. TOS was negatively associated with LOS in patients without epidemiological trace (IRR = 0.980; 95% CI = 0.967 to 0.993; P = 0.003). CONCLUSIONS: In COVID-19 cases without typical epidemiological links, patients with later symptom onset had relatively shorter LOS.


Impact of anti-tnfα antibodies on the risk of Covid-19 and its severity in patients with inflammatory Bowel Diseases


Pemphigoid nodularis: An infrequent variant responding to rituximab


title: Overview of lethal human coronaviruses

text: Coronavirus infections of multiple origins have spread to date worldwide, causing severe respiratory diseases. Seven coronaviruses that infect humans have been identified: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, SARS-CoV, MERS-CoV, and SARS-CoV-2. Among them, SARS-CoV and MERS-CoV caused outbreaks in 2002 and 2012, respectively. SARS-CoV-2 (COVID-19) is the most recently discovered. It has created a severe worldwide outbreak beginning in late 2019, leading to date to over 4 million cases globally. Viruses are genetically simple, yet highly diverse. However, the recent outbreaks of SARS-CoV and MERS-CoV, and the ongoing outbreak of SARS-CoV-2, indicate that there remains a long way to go to identify and develop specific therapeutic treatments. Only after gaining a better understanding of their pathogenic mechanisms can we minimize viral pandemics. This paper mainly focuses on SARS-CoV, MERS-CoV, and SARS-CoV-2. Here, recent studies are summarized and reviewed, with a focus on virus-host interactions, vaccine-based and drug-targeted therapies, and the development of new approaches for clinical diagnosis and treatment.


Covid-19: Physical distancing of at least one metre is linked to large reduction in infection


title: Challenges in control of Covid-19: short doubling time and long delay to effect of interventions

text: Early assessments of the spreading rate of COVID-19 were subject to significant uncertainty, as expected with limited data and difficulties in case ascertainment, but more reliable inferences can now be made. Here, we estimate from European data that COVID-19 cases are expected to double initially every three days, until social distancing interventions slow this growth, and that the impact of such measures is typically only seen nine days - i.e. three doubling times - after their implementation. We argue that such temporal patterns are more critical than precise estimates of the basic reproduction number for initiating interventions. This observation has particular implications for the low- and middle-income countries currently in the early stages of their local epidemics.


title: Aligning difficult airway guidelines with the anesthetic COVID-19 guidelines to develop a COVID-19 difficult airway strategy: a narrative review

text: The coronavirus disease 2019 (COVID-19) pandemic is caused by a coronavirus that is transmitted primarily via aerosol, droplets or direct contact. This may place anesthetists at higher risk of infection due to their frequent involvement in aerosol-generating airway interventions. Many anesthethetic COVID-19 guidelines have emerged, whose underlying management principles include minimizing aerosol contamination and protecting healthcare workers. These guidelines originate from Australia and New Zealand, Canada, China, India, Italy, Korea, Singapore, the United States and the United Kingdom. Hospitalized COVID-19 patients may require airway interventions, and difficult tracheal intubation secondary to laryngeal edema has been reported. Pre-pandemic difficult airway guidelines include those from Canada, France, Germany, India, Japan, Scandinavia, the United States and the United Kingdom. These difficult airway guidelines require modifications in order to align with the principles of the anesthetic COVID-19 guidelines. In turn, most of the anesthetic COVID-19 guidelines do not, or only briefly, discuss an airway strategy after failed tracheal intubation. Our article identifies and compares pre-pandemic difficult airway guidelines with the recent anesthetic COVID-19 guidelines. We combine the principles from both sets of guidelines and explain the necessary modifications to the airway guidelines, to form a failed tracheal intubation airway strategy in the COVID-19 patient. Valuing, and a greater understanding of, these differences and modifications may lead to greater adherence to the new COVID-19 guidelines.


Circulating endothelial cells in COVID-19


title: A Review of Automatically Diagnosing COVID-19 based on Scanning Image

text: The pandemic of COVID-19 has caused millions of infectious. Due to the false-negative rate and the time cost of conventional RT-PCR tests, X-ray images and Computed Tomography (CT) images based diagnosing become widely adopted. Therefore, researchers of the computer vision area have developed many automatic diagnosing models to help the radiologists and pro-mote the diagnosing accuracy. In this paper, we present a review of these recently emerging automatic diagnosing models. 62 models from 14, February to 5, May, 2020 are involved. We analyzed the models from the perspective of preprocessing, feature extraction, classification, and evaluation. Then we pointed out that domain adaption in transfer learning and interpretability promotion are the possible future directions.


Update to Our Reader, Reviewer, and Author Communities-April 2020


title: Brainstem involvement and respiratory failure in COVID-19

text: Respiratory failure is the most worrisome problem of COVID-19. Patients may develop severe pneumonia requiring invasive mechanical ventilation and a significant proportion of them dies. It has been suggested that brainstem might play a role in severe respiratory failure of COVID-19 patients. We described three COVID-19 patients in ICU at Federico II Hospital in Naples that, although had recovered from pneumonia, could not be weaned from invasive mechanical ventilation. Our clinical evaluation was consistent with an involvement of the brainstem and especially of respiratory centre thus possibly explaining the weaning failure in patients that were awake and had recovered from lung involvement. Our data, though limited, indicate that brainstem involvement may play a role in respiratory failure and perhaps in the high death rate of COVID-19 patients. Moreover, the weaning failure from mechanical ventilation due to central respiratory drive depression might underlie the unusual long stay in ICU reported for COVID-19 patients.


title: An e-mental health intervention to support burdened people in times of the COVID-19 pandemic: CoPE It

text: The outbreak of the novel SARS CoV-2-virus (COVID-19) is pushing national and international healthcare systems to their limits. The aspect of mental health issues, which has been neglected (so far) in times of social isolation and governmental restrictions, now demands innovative and situation-based approaches to support psychological burdened people. The developed e-mental health intervention 'CoPE It' offers manualized, evidence-based psychotherapeutic/psychological support to overcome psychological distress in times of COVID-19. E-mental health approaches offer great possibilities to support burdened people during the SARS-CoV-2 pandemic effectively.


title: ELSA recommendations for minimally invasive surgery during a community spread pandemic: a centered approach in Asia from widespread to recovery phases

text: BACKGROUND: The COVID-19 pandemic has resulted in significant changes to surgical practice across the worlds. Some countries are seeing a tailing down of cases, while others are still having persistent and sustained community spread. These evolving disease patterns call for a customized and dynamic approach to the selection, screening, planning, and for the conduct of surgery for these patients. METHODS: The current literature and various international society guidelines were reviewed and a set of recommendations were drafted. These were circulated to the Governors of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA) for expert comments and discussion. The results of these were compiled and are presented in this paper. RESULTS: The recommendations include guidance for selection and screening of patients in times of active community spread, limited community spread, during times of sporadic cases or recovery and the transition between phases. Personal protective equipment requirements are also reviewed for each phase as minimum requirements. Capability management for the re-opening of services is also discussed. The choice between open and laparoscopic surgery is patient based, and the relative advantages of laparoscopic surgery with regard to complications, and respiratory recovery after major surgery has to be weighed against the lack of safety data for laparoscopic surgery in COVID-19 positive patients. We provide recommendations on the operating room set up and conduct of general surgery. If laparoscopic surgery is to be performed, we describe circuit modifications to assist in reducing plume generation and aerosolization. CONCLUSION: The COVID-19 pandemic requires every surgical unit to have clear guidelines to ensure both patient and staff safety. These guidelines may assist in providing guidance to units developing their own protocols. A judicious approach must be adopted as surgical units look to re-open services as the pandemic evolves.


The Immediate Impact of COVID-19 on US Dermatology Practices


Pandemic potential of 2019-nCoV


An infectious disease epidemic and resilience to suicide


title: Respiratory sampling for severe acute respiratory syndrome coronavirus 2: An Overview

text: The novel coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a pandemic in March 2020. A plethora of respiratory sampling methods for SARS-CoV-2 viral detection has been used and in the current evolving situation, there is no international consensus on the recommended method of respiratory sampling for diagnosis. Otolaryngologists deal intimately with the upper respiratory tract and a clear understanding of the respiratory sampling methods is of paramount importance. This article aims to provide an overview of the various methods and their evidence till date.


title: Immunoinflammatory response and bioactive potential of GuttaFlow bioseal and MTA Fillapex in the rat subcutaneous tissue

text: To evaluate the effect of GuttaFlow bioseal (GFB) and MTA Fillapex (MTAF) in comparison with Endofill (EF) in the subcutaneous tissue. Polyethylene tubes with GFB, MTAF, EF or empty tubes (control group; CG) were implanted into subcutaneous of rats. After 7, 15, 30 and 60 days, the capsule thickness, inflammatory reaction, interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), caspase-3, TUNEL-positive cells, von Kossa and ultrastructural features were evaluated. The data were statistically analyzed (p ≤ 0.05). At all periods, the number of IL-6- and VEGF-immunolabelled cells, and capsule thickness were lower in GFB than MTAF, which was lower than EF (p < 0.0001). At 60 days, the number of inflammatory cells was similar in GFB and MTAF (p = 0.58). Significant differences in the number of TUNEL- and caspase-3-positive cells were not observed among GFB, MTAF and CG whereas the highest values were found in EF specimens. The EF specimens exhibited several cells with condensed chromatin, typical of apoptosis. von Kossa-positive and birefringent structures were only observed in GFB and MTAF, suggesting the presence of calcite crystals. Taken together, these results show that cellular and structural damage induced by GFB and MTAF sealers were recovery over time. Moreover, these sealers express bioactive potential in subcutaneous tissue.


Using the Electronic Health Record to Conduct Adolescent Telehealth Visits in the Time of COVID-19


Hydroxychloroquine and coronavirus disease 19


Commentary: Myths and facts on vitamin D amidst the COVID-19 pandemic


title: Epidemiología de COVID-19 en México: del 27 de febrero al 30 de abril de 2020./ Epidemiología de COVID-19 en México: del 27 de febrero al 30 de abril de 2020./ Epidemiology of COVID-19 in Mexico: from the 27th of February to the 30th of April 2020

text: BACKGROUND: The first case of COVID-19 detected in Mexico was on the 27th of February 2020. On the 30th of April, 64 days after this first diagnosis, the number of patients had increased exponentially, reaching 19 224 confirmed cases and 1859 (9.67%) deaths. In response to this global outbreak, we summarize the current state of our understanding regarding COVID-19 in Mexico. METHODS: We obtained the data from the official website of the Ministry of Health in Mexico. The study period was between the 27th of February and the 30th of April 2020. The cases were confirmed using real-time reverse transcription-polymerase chain reaction, and we analysed epidemiological, demographic and clinical data. RESULTS: In Mexico, most cases of COVID-19 were located in Mexico City. The mean age of the patients was 46 years. Of the 12 656 confirmed cases, most infected individuals were between the ages of 30 and 59 years (65.85%), and there was a higher incidence rate in men (58.18%) than in women (41.82%). The patients who died had one or more comorbidities, mainly hypertension (45.53%), diabetes (39.39%) and obesity (30.4%). In the first 64 days of the epidemic, China had reported 80 304 cases with a mortality rate of 3.66%. CONCLUSIONS: Our results indicate an early transmission of COVID-19 in Mexico. The descriptive epidemiology shows similarities between the cases of COVID-19 in Mexico and those in China. In the same period of the epidemic curve, we observed a reduction in the number of confirmed cases of COVID-19 in Mexico and a higher mortality rate compared with that of China.


title: Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019

text: Health professions preventing and controlling Coronavirus Disease 2019 are prone to skin and mucous membrane injury, which may cause acute and chronic dermatitis, secondary infection and aggravation of underlying skin diseases. This is a consensus of Chinese experts on protective measures and advice on hand-cleaning- and medical-glove-related hand protection, mask- and goggles-related face protection, UV-related protection, eye protection, nasal and oral mucosa protection, outer ear, and hair protection. It is necessary to strictly follow standards of wearing protective equipment and specification of sterilizing and cleaning. Insufficient and excessive protection will have adverse effects on the skin and mucous membrane barrier. At the same time, using moisturizing products is highly recommended to achieve better protection.


title: Balancing health privacy, health information exchange, and research in the context of the COVID-19 pandemic

text: The novel coronavirus disease 2019 infection poses serious challenges to the healthcare system that are being addressed through the creation of new unique and advanced systems of care with disjointed care processes (eg, telehealth screening, drive-through specimen collection, remote testing, telehealth management). However, our current regulations on the flows of information for clinical care and research are antiquated and often conflict at the state and federal levels. We discuss proposed changes to privacy regulations such as the Health Insurance Portability and Accountability Act designed to let health information seamlessly and frictionlessly flow among the health entities that need to collaborate on treatment of patients and, also, allow it to flow to researchers trying to understand how to limit its impacts.


title: How to safely and sustainably reorganise a large general radiography service facing the COVID-19 pandemic

text: Objectives: This paper aims to share our experience in reorganising our general radiography service during the coronavirus disease (COVID-19) pandemic from the viewpoint of a large tertiary referral medical centre. Key findings: Re-organization of radiographic manpower, patient segregation, and modification of routine radiographic practices are key measures to help radiographic services deal with the COVID-19 pandemic. More specifically, emphasis on deploying more mobile radiographic units, segregating equipment, developing consistent image acquisition workflows, and strict adherence to infection control protocols are paramount to minimize the possibility of in-hospital transmission and ensure a safe environment for both patients and staff. Streamlining communication channels between leadership and ground staff allows quick dissemination of information to ultimately facilitate safe provision of services. Conclusion: COVID-19 has drastically altered the way general radiography teams provide services. The institution of several key measures will allow hospitals to safely and sustainably provide radiographic services. To date, there have been zero incidences of radiographer healthcare worker transmission within our institution during the course of work. Implication for practice: Radiographers are facing the challenge of providing high-quality services while simultaneously minimizing pathogen exposure to staff and patients. Our experience may lend support to other radiographic services respond to the COVID-19 outbreak and serve as a blueprint for future infectious disease outbreak contingency plans.


title: Studies on viral pneumonia related to novel coronavirus SARS-CoV-2, SARS-CoV, and MERS-CoV: a literature review

text: Coronaviruses are a class of RNA viruses that can cause respiratory and intestinal infections in animals and humans. SARS-CoV, MERS-CoV, and a novel coronavirus (SARS-CoV-2 [2019-nCoV]) belong to the family Coronaviridae and the genus Betacoronavirus. At present, the understanding of SARS-CoV-2 is getting deeper and deeper. In order to better prevent and treat SARS-CoV-2, this article compares the infectivity, pathogenicity, and related clinical characteristics of the three human pathogenic coronaviruses, SARS-CoV-2, SARS-CoV, and MERS-CoV to help us further understand the pathogenic characteristics of novel coronaviruses.


title: Elucidating biophysical basis of binding of inhibitors to SARS-CoV-2 main protease by using molecular dynamics simulations and free energy calculations

text: The recent outbreak of novel "coronavirus disease 2019" (COVID-19) has spread rapidly worldwide, causing a global pandemic. In the present work, we have elucidated the mechanism of binding of two inhibitors, namely α-ketoamide and Z31792168, to SARS-CoV-2 main protease (Mpro or 3CLpro) by using all-atom molecular dynamics simulations and free energy calculations. We calculated the total binding free energy (ΔGbind) of both inhibitors and further decomposed ΔGbind into various forces governing the complex formation using the Molecular Mechanics/Poisson-Boltzmann Surface Area (MM/PBSA) method. Our calculations reveal that α-ketoamide is more potent (ΔGbind= - 9.05 kcal/mol) compared to Z31792168 (ΔGbind= - 3.25 kcal/mol) against COVID-19 3CLpro. The increase in ΔGbind for α-ketoamide relative to Z31792168 arises due to an increase in the favorable electrostatic and van der Waals interactions between the inhibitor and 3CLpro. Further, we have identified important residues controlling the 3CLpro-ligand binding from per-residue based decomposition of the binding free energy. Finally, we have compared ΔGbind of these two inhibitors with the anti-HIV retroviral drugs, such as lopinavir and darunavir. It is observed that α-ketoamide is more potent compared to lopinavir and darunavir. In the case of lopinavir, a decrease in van der Waals interactions is responsible for the lower binding affinity compared to α-ketoamide. On the other hand, in the case of darunavir, a decrease in the favorable intermolecular electrostatic and van der Waals interactions contributes to lower affinity compared to α-ketoamide. Our study might help in designing rational anti-coronaviral drugs targeting the SARS-CoV-2 main protease.Communicated by Ramaswamy H. Sarma.


Potential association between COVID-19 mortality and health-care resource availability


Analyze the psychological impact of COVID-19 among the elderly population in China and make corresponding suggestions


title: BeCAPTCHA-Mouse: Synthetic Mouse Trajectories and Improved Bot Detection

text: We first study the suitability of behavioral biometrics to distinguish between computers and humans, commonly named as bot detection. We then present BeCAPTCHA-Mouse, a bot detector based on neuromotor modeling of mouse dynamics that enhances traditional CAPTCHA methods. Our proposed bot detector is trained using both human and bot data generated by two new methods developed for generating realistic synthetic mouse trajectories: i) a knowledge-based method based on heuristic functions, and ii) a data-driven method based on Generative Adversarial Networks (GANs) in which a Generator synthesizes human-like trajectories from a Gaussian noise input. Experiments are conducted on a new testbed also introduced here and available in GitHub: BeCAPTCHA-Mouse Benchmark; useful for research in bot detection and other mouse-based HCI applications. Our benchmark data consists of 10,000 mouse trajectories including real data from 58 users and bot data with various levels of realism. Our experiments show that BeCAPTCHA-Mouse is able to detect bot trajectories of high realism with 93% of accuracy in average using only one mouse trajectory. When our approach is fused with state-of-the-art mouse dynamic features, the bot detection accuracy increases relatively by more than 36%, proving that mouse-based bot detection is a fast, easy, and reliable tool to complement traditional CAPTCHA systems.


Chronic obstructive pulmonary disease is associated with severe coronavirus disease 2019 (COVID-19)


title: Evaluation of modelling study shows limits of COVID-19 importing risk simulations in sub-Saharan Africa

text: Mathematical modelling studies predicting the spread of the coronavirus disease 2019 (COVID-19) have been used worldwide, but precisions are limited. Thus, continuous evaluation of the modelling studies is crucial. We investigated situations of virus importation in sub-Saharan Africa (SSA) to assess effectiveness of a modelling study by Haider N et al. titled 'Passengers' destinations from China: low risk of novel coronavirus (2019-nCoV) transmission into Africa and South America'. We obtained epidemiological data of 2417 COVID-19 cases reported by 40 countries in SSA within 30 days of the first case confirmed in Nigeria on 27 February. Out of 442 cases which had travel history available, only one (0.2%) had a travel history to China. These findings underline the result of the model. However, the fact that there were numbers of imported cases from other regions shows the limits of the model. The limits could be attributed to the characteristics of the COVID-19 which is infectious even when the patients do not express any symptoms. Therefore, there is a profound need for all modelling researchers to take asymptomatic cases into account when they establish modelling studies.


Global Threat of SARS-CoV-2/COVID-19 and the Need for More and Better Diagnostic Tools


title: Highlights of traditional Chinese medicine frontline expert advice in the China national guideline for COVID-19

text: Introduction: The World Health Organization has declared the coronavirus disease (COVID-19) as a pandemic on 11 March 2020, after the number of confirmed cases outside China increased 13-fold. As the epicentre of the initial outbreak, China has been updating the National COVID-19 Diagnostic and Treatment Guideline with up-to-date information about the disease. To facilitate the implementation of integrative Chinese-Western Medicine in COVID-19 management, Traditional Chinese medicine (TCM) has been recommended in recent editions of the national guideline. Methods: The national guideline summarised the opinions and frontline experience of medical experts across the country to provide by far the best management for COVID-19. We extracted the case definition and clinical classifications of COVID-19 in China along with relevant TCM treatments cited in the seventh edition of the guideline, with an intend to disseminate practical information to TCM practitioners and researchers around the world. Results: We presented the most recent case definition, clinical classifications, and relevant TCM treatments of COVID-19 in accordance to recommendations of the Chinese guideline. TCM treatments are stratified into two groups based on patients' disease status. Four types of Chinese patent medicines are recommended for suspected COVID-19 cases. Several herbal formulae are recommended for confirmed COVID-19 cases according to their clinical classification and TCM pattern diagnoses. Two herbal formulae are also recommended for rehabilitation of recovering cases. Conclusion: To control the waves of COVID-19 outbreak, countries must ensure the adherence of their citizens to local public health measures. Medical professionals should diagnose and treat patients according to up-to-date guidelines. Future evaluation of the outcomes of implementing TCM recommendations will strengthen the evidence base for COVID-19 management for the sake of public health and the internationalisation of TCM.


Nimble, Together: A Training Program's Response to the COVID-19 Pandemic


Cigarette Smoking and COVID-19: A Complex Interaction


title: Clinical outcomes of 402 patients with COVID-2019 from a single center in Wuhan, China

text: The outbreak of SARS-CoV-2 has become a pandemic with significant mortality. Published studies described clinical characteristics of the disease contain small cohorts from individual centers or larger series consisting of mixed series from multiple different hospitals. We report here analyses of mortality and disease severity among 402 patients from a single hospital. The cohort includes 297 patients with confirmed and 105 with clinical diagnosis. The latter group consists of cases with inconclusive nucleic acid test but meeting the criteria for clinical diagnosis. Data are compared between sexes and among different age groups. The overall case fatality is 5.2%. However, age at 70 years or older is associated with a significantly higher mortality (17.8%) and higher rate of severe and critical illness (57.5%). Case fatality is 8% in patients 50 years of age or older, and 1.2% in those younger than 50 years. In addition, case fatality is 7.6% in male patients, as opposed to 2.9% in females, demonstrating a clear sex difference.


text: The outbreak of SARS-CoV-2 has become a pandemic with significant mortality. Published studies describing clinical characteristics of the disease contain small cohorts from individual centers or larger series consisting of mixed series from multiple different hospitals. We report here analyses of mortality and disease severity among 402 patients from a single hospital. The cohort includes 297 patients with confirmed and 105 with clinical diagnosis. The latter group consists of cases with inconclusive nucleic acid test but meeting the criteria for clinical diagnosis. Data are compared between genders and among different age groups. The overall case fatality is 5.2%. However, age at 70 years or older is associated with a significantly higher mortality (17.8%) and higher rate of severe and critical illness (57.5%). Case fatality is 8% in patients 50 years of age or older, and 1.2% in those younger than 50 years. In addition, case fatality is 7.6% in male patients, as opposed to 2.9% in females, demonstrating a clear gender difference. This article is protected by copyright. All rights reserved.


title: Moving Forward with Dysphagia Care: Implementing Strategies during the COVID-19 Pandemic and Beyond

text: Growing numbers of SARS-CoV-2 cases coupled with limited understanding of transmissibility and virulence, have challenged the current workflow and clinical care pathways for the dysphagia provider. At the same time, the need for non-COVID-19-related dysphagia care persists. Increased awareness of asymptomatic virus carriers and variable expression of the disease have also focused attention to appropriate patient care in the context of protection for the healthcare workforce. The objective of this review was to create a clinical algorithm and reference for dysphagia clinicians across clinical settings to minimize spread of COVID-19 cases while providing optimal care to patients suffering from swallowing disorders. Every practitioner and healthcare system will likely have different constraints or preferences leading to the utilization of one technique over another. Knowledge about this pandemic increases every day, but the algorithms provided here will help in considering the best options for proceeding with safe and effective dysphagia care in this new era.


title: Dental Care Provision during Coronavirus Disease 2019 (COVID-19) Pandemic: The Importance of Continuous Support for Vulnerable Patients

text: As a result of the ongoing 2019 coronavirus disease (COVID-19) pandemic, the medical and dental services across the world have to tackle unprecedented situations, providing essential care and professional support. The global health care crisis caused directly by the vast number of severe COVID-19 cases, and indirectly by reduced access to health care, as well as by limited secondary care provision, had a major impact on specialist services, and subsequently the deterioration of medical and dental conditions, particularly in vulnerable persons. In particular, at present, special care dentistry seems to play a unique role, dealing with a wide range of patients with underlying medical conditions and co-morbidities, phobic individuals, and persons with learning/physical disabilities. The effective adaptation of health services to the current new reality, based on an empathetic approach and recent guidelines, would allow us to maintain an adequate care provision, minimizing the long-term impact of the pandemic.