title: Using Wavelets and Spectral Methods to Study Patterns in Image-Classification Datasets

text: Deep learning models extract, before a final classification layer, features or patterns which are key for their unprecedented advantageous performance. However, the process of complex nonlinear feature extraction is not well understood, a major reason why interpretation, adversarial robustness, and generalization of deep neural nets are all open research problems. In this paper, we use wavelet transformation and spectral methods to analyze the contents of image classification datasets, extract specific patterns from the datasets and find the associations between patterns and classes. We show that each image can be written as the summation of a finite number of rank-1 patterns in the wavelet space, providing a low rank approximation that captures the structures and patterns essential for learning. Regarding the studies on memorization vs learning, our results clearly reveal disassociation of patterns from classes, when images are randomly labeled. Our method can be used as a pattern recognition approach to understand and interpret learnability of these datasets. It may also be used for gaining insights about the features and patterns that deep classifiers learn from the datasets.


COVID-19 Therapeutic and Prevention


Without food, there can be no exit from the pandemic


Smoking is Associated with COVID-19 Progression: A Meta-Analysis


title: Obesity is Associated with Increased Risk for Mortality Among Hospitalized Patients with COVID-19

text: OBJECTIVE: Obesity has been identified as a risk factor for severe COVID-19 caused by the SARS-CoV2 virus, however a direct association with mortality has not been reported. We sought to determine whether obesity is a risk factor for mortality among COVID-19 patients. METHODS: The study was a retrospective cohort, including patients with COVID-19 between March 1 and April 18, 2020. The primary objective was to determine if obesity is a predictor of mortality. RESULTS: A total of 238 patients were included, 218 patients (91.6%) were African American, 113 (47.5%) were male, and the mean age was 58.5 years. Of the included patients, 146 (61.3%) were obese (BMI >30kg/m2 ), with 63 (26.5%), 29 (12.2%), and 54 (22.7%) with class 1, 2, and 3 obesity, respectively. Obesity was identified as a predictor for mortality (OR 1.7(1.1-2.8),p=0.016), as was male gender (OR 5.2(1.6-16.5),p=0.01) and older age (OR 3.6(2.0-6.3),p<0.0005). Obesity (OR 1.7(1.3-2.1),p<0.0005) and older age (OR 1.3(1.0-1.6),p=0.03) were also risk factors for hypoxemia. CONCLUSIONS: Obesity was found to be a significant predictor for mortality among inpatients with COVID-19 after adjusting for age, gender, and other comorbidities. Patients with obesity were also more likely to present with hypoxemia.


title: Community Responses during Early Phase of COVID-19 Epidemic, Hong Kong

text: During the early phase of the coronavirus disease epidemic in Hong Kong, 1,715 survey respondents reported high levels of perceived risk, mild anxiety, and adoption of personal-hygiene, travel-avoidance, and social-distancing measures. Widely adopted individual precautionary measures, coupled with early government actions, might slow transmission early in the outbreak.


title: Identifying potential treatments of COVID-19 from Traditional Chinese Medicine (TCM) by using a data-driven approach

text: ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Chinese Medicine (TCM) has been widely used as an approach worldwide. Chinese Medicines (CMs) had been used to treat and prevent viral infection pneumonia diseases for thousands of years and had accumulated a large number of clinical experiences and effective prescriptions. AIM OF THE STUDY: This research aimed to systematically excavate the classical prescriptions of Chinese Medicine (CM), which have been used to prevent and treat Pestilence (Wenbing, Wenyi, Shiyi or Yibing) for long history in China, to obtain the potential prescriptions and ingredients to alternatively treat COVID-19. MATERIALS AND METHODS: We developed the screening system based on data mining, molecular docking and network pharmacology. Data mining and association network were used to mine the high-frequency herbs and formulas from ancient prescriptions. Virtual screening for the effective components of high frequency CMs and compatibility Chinese Medicine was explored by a molecular docking approach. Furthermore, network pharmacology method was used to preliminarily uncover the molecule mechanism. RESULTS: 574 prescriptions were obtained from 96,606 classical prescriptions with the key words to treat "Warm diseases (Wenbing)", "Pestilence (Wenyi or Yibing)" or "Epidemic diseases (Shiyi)". Meanwhile, 40 kinds of CMs, 36 CMs-pairs, 6 triple-CMs-groups existed with high frequency among the 574 prescriptions. Additionally, the key targets of SARS-COV-2, namely 3CL hydrolase (Mpro) and angiotensin-converting enzyme 2(ACE2), were used to dock the main ingredients from the 40 kinds by the LigandFitDock method. A total of 66 compounds components with higher frequency were docked with the COVID-19 targets, which were distributed in 26 kinds of CMs, among which Gancao (Glycyrrhizae Radix Et Rhizoma), HuangQin (Scutellariae Radix), Dahuang (Rhei Radix Et Rhizome) and Chaihu (Bupleuri Radix) contain more potential compounds. Network pharmacology results showed that Gancao (Glycyrrhizae Radix Et Rhizoma) and HuangQin (Scutellariae Radix) CMs-pairs could also interact with the targets involving in immune and inflammation diseases. CONCLUSIONS: These results we obtained probably provided potential candidate CMs formulas or active ingredients to overcome COVID-19. Prospectively, animal experiment and rigorous clinic studies are needed to confirm the potential preventive and treat effect of these CMs and compounds.


title: Molecular-based Alternatives for Colorectal Cancer Screening during the COVID-19 Pandemic

text: Due to the COVID-19 pandemic, important elective procedures, such as screening colonoscopy, have been delayed or cancelled, and there may be a very long waitlist for rescheduling once the moratorium is lifted However, DNA-based stool sample tests may be useful for colorectal cancer screening when colonoscopy is not available The aim of this review is to demonstrate the potential utility of enhanced DNA-based stool testing for colorectal cancer screening and diagnosis during crises that strain available healthcare resources, such as the current COVID-19 pandemic This review shows that DNA-based stool sample tests have the potential to enable colorectal cancer screening to prioritize patients to elective colonoscopy procedures, the continued delay of which during the COVID-19 pandemic has already placed a burden on future elective procedures


Chest tube with air leaks is a potential "super spreader" of COVID-19


The coronavirus outbreak could make it quicker and easier to trial drugs


Hepatocellular Type II Fibrinogen Inclusions in a Patient with Severe COVID-19 and Hepatitis


title: Correlation between cytokines and coagulation-related parameters in patients with coronavirus disease 2019 admitted to ICU

text: BACKGROUND: The novel SARS-CoV-2 caused a large number of infections and deaths worldwide. Thus, new ideas for an appropriated assessment of patients' condition and clinical treatment are of utmost importance. Therefore, in this study, the laboratory parameters of patients with coronavirus disease 2019 (COVID-19) were evaluated to identify the correlation between cytokine expression and other laboratory parameters. METHODS: A retrospective and single-center study was performed in Wuhan, involving 83 severe or critical COVID-19 patients admitted to the intensive care unit (ICU). Laboratory parameters in ICU patients with laboratory-confirmed infection of SARS-CoV2 were collected. The association between parameters was assessed by Spearman's rank correlation. RESULTS: Patients' median age was 66 years (IQR, 57-73), and 55 (66%) were men. Among the 83 patients, 61 (73%) had 1 or more coexisting medical condition. The median concentration of IL-2R, IL-6, IL8, IL10, and TNFα were above the normal range, without IL-1ß. A significant negative correlation between IL-6 and platelet count was discovered (r2 = -0.448, P<0.001) as well as a significant correlation between IL-6 and other platelet parameters. Finally, a correlation between multiple cytokines and coagulation indicators was found, pro-inflammatory factors were found to be more associated to coagulation parameters, with the highest correlation between IL-6 and the International normalized ratio (INR) (r2=0.444, P<0.001). CONCLUSIONS: Our results suggested that cytokines play an important role in the pathogenesis of COVID-19. In addition, IL-6 seems more relevant in the evaluation of the condition of COVID-19 patients.


A word of caution and call for cross-society collaboration to develop surgical guidance about COVID-19


Web Exclusive. Annals On Call - Clinical Reasoning and Testing for COVID-19


Time to treatment still matters in ST-elevation myocardial infarction: a call to maintain treatment effectiveness during the COVID-19 pandemic


Covid-19: Highest risk patients are asked to stay at home for 12 weeks


Nursing and the novel coronavirus: Risks and responsibilities in a global outbreak


Letter to the editor: Headline stress disorder caused by Netnews during the outbreak of COVID-19


title: Large-scale national screening for Coronavirus Disease 2019 in China

text: Faced with the new challenges in the pandemic control, imported coronavirus disease (COVID-19) infections and asymptomatic infection, Chinese authorities have implemented new intervention measures-national large-scale nucleic acid testing. This article summarizes the population who needs the nucleic acid testing, analyzes the current data of COVID-19 testing capacity, concludes the timeline of coronavirus testing and suggests what needs to be done to facilitate the government large-scale screening measures.


title: COVID-19 and the Ocular Surface: A Review of Transmission and Manifestations

text: PURPOSE: The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached pandemic proportions within an unprecedented span of time. It is controversial whether the virus can be transmitted via tears and its ocular implications have not been widely studied. In this article, the current evidence related to ocular transmission and ocular manifestations is reviewed. RESULTS: Several mechanisms for the ocular transmission of the virus are proposed with highlight on the nasolacrimal system as a conduit between the eye and the respiratory tract, and the role of the lacrimal gland in hematogenous spread. Ocular surface manifestations such as conjunctivitis are more commonly reported. CONCLUSION: The exact pathophysiology of ocular transmission of the virus remains incompletely understood, although there is preliminary evidence of SARS-CoV-2 being detected in ocular secretions. The ocular tropism of the virus and its potential to cause localized ocular disease are worth considering.


title: COVID-19 Science Policy, Experts, and Publics: Why Epistemic Democracy Matters in Ecological Crises

text: In times of planetary health crises such as the COVID-19 pandemic, a critically informed science and technology policy is crucial. In this overarching context, governments are faced with making rapid and high-stake decisions dictated by emergency that in a state of normalcy they would not, or could not pursue. Governments tend to gather, therefore, an incredible amount of unchecked power in times of fast-moving ecological crises that raises concerns about where the legitimacy of such excessive power comes from. Moreover, the elected politicians rely on the expert advice in a pandemic. This takes away democratic political authority from the sovereign people and instead places it on allegedly objective unelected experts. In contrast, experts have (1) a dubious reputation in predicting the future and (2) varying degrees of biases and self-interests, which make them susceptible, for instance, to "framing problems" in relation to the urgent public issues at stake. This article suggests new ways of thinking about COVID-19 technology policy, drawing from the field of political science and democratic theory. It examines the power-laden tensions between the political authority and the expert authority. Going forward, I highlight the brief history of epistemic democracy, taking into consideration that in advanced modern democracies, political decision making has to draw, in part, from expert knowledge, but without resulting in democratic deficits. The COVID-19 science and technology policy can usefully build on epistemic democracy while strengthening the science, society, and democracy nexus.


Predicting Severe Outcomes in COVID-19


title: The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study

text: BACKGROUND: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay. METHODS: This was an observational cohort study conducted at ten hospitals in the UK and one in Italy. All adults (≥18 years) admitted to participating hospitals with COVID-19 were included. Patients with incomplete hospital records were excluded. The study analysed routinely generated hospital data for patients with COVID-19. Frailty was assessed by specialist COVID-19 teams using the clinical frailty scale (CFS) and patients were grouped according to their score (1-2=fit; 3-4=vulnerable, but not frail; 5-6=initial signs of frailty but with some degree of independence; and 7-9=severe or very severe frailty). The primary outcome was in-hospital mortality (time from hospital admission to mortality and day-7 mortality). FINDINGS: Between Feb 27, and April 28, 2020, we enrolled 1564 patients with COVID-19. The median age was 74 years (IQR 61-83); 903 (57·7%) were men and 661 (42·3%) were women; 425 (27·2%) had died at data cutoff (April 28, 2020). 772 (49·4%) were classed as frail (CFS 5-8) and 27 (1·7%) were classed as terminally ill (CFS 9). Compared with CFS 1-2, the adjusted hazard ratios for time from hospital admission to death were 1·55 (95% CI 1·00-2·41) for CFS 3-4, 1·83 (1·15-2·91) for CFS 5-6, and 2·39 (1·50-3·81) for CFS 7-9, and adjusted odds ratios for day-7 mortality were 1·22 (95% CI 0·63-2·38) for CFS 3-4, 1·62 (0·81-3·26) for CFS 5-6, and 3·12 (1·56-6·24) for CFS 7-9. INTERPRETATION: In a large population of patients admitted to hospital with COVID-19, disease outcomes were better predicted by frailty than either age or comorbidity. Our results support the use of CFS to inform decision making about medical care in adult patients admitted to hospital with COVID-19. FUNDING: None.


title: Achados clínico-patológicos e métodos de controle da intoxicação por Pteridium (aquilinum) arachnoideum em uma propriedade do Rio Grande do Sul/ Clinical and pathological findings and control methods of the poisoning by Pteridium (aquilinum) arachnoideum in a farm of Rio Grande do Sul, Brazil

text: A infestação de pastagens por Pteridium arachnoideum é um problema que afeta a pecuária em diversas partes do mundo, ocasionando perdas produtivas e mortalidades nos rebanhos, bem como a redução das áreas de pastagens. Devido aos prejuízos na bovinocultura, foi proposto o acompanhamento de uma propriedade no Rio Grande do Sul com perdas por Pteridium arachnoideum. Realizou-se um levantamento das mortes associadas à intoxicação por samambaia na propriedade durante o período de janeiro de 2007 a janeiro de 2015. Adicionalmente, testou-se a viabilidade de ovinos como ferramenta de controle biológico de samambaia e se acompanhou as tentativas de controle da planta através do uso dos herbicidas metilsulfuron-metil e picloram, os quais eram associados ou não à roçada prévia. Das mortes por intoxicação natural acompanhadas na propriedade, observou-se 22 casos de quadro agudo de diátese hemorrágica e seis de quadro crônico de carcinomas do trato digestório superior. Em cinco bovinos jovens com diátese hemorrágica, além de hemorragias disseminadas e infartos, observou-se acentuado edema laríngeo, que cursava, clinicamente, com dispneia e estertores respiratórios característicos. Os carcinomas do trato digestório superior, apesar de menos frequentes, causaram perdas expressivas, devido à mortalidade anual de reprodutoras. Notou-se que a introdução de bovinos jovens em áreas recentemente roçadas pode resultar no consumo de grandes quantidades de samambaia e na ocorrência de surtos da enfermidade aguda. O controle das populações de samambaia pelo pastejo por ovinos não foi eficiente, devido ao baixo consumo observado com a lotação de quatro ovinos por hectare, embora mortalidade de ovinos por consumo da planta não tenha sido registrada. Após a retirada do potreiro infestado por samambaia, ao final do experimento, oito dos ovinos foram acompanhados, clinicamente, por três anos e não apresentaram nenhuma alteração. A utilização dos herbicidas resultou em uma redução da cobertura de P. arachnoideum. No entanto, essa prática necessita de estudos adicionais, já que algumas áreas não tiveram recuperação satisfatória da pastagem e o seu uso pode causar impactos ambientais e aquisição de resistência de P. arachnoideum aos herbicidas.(AU)


Observation and analysis of 26 cases of asymptomatic SARS-COV2 infection


Simultaneous onset of COVID-19 and autoimmune haemolytic anaemia


title: Quantitative clarification of key questions about COVID-19 epidemiology

text: Modeling the spread of COVID-19 is crucial for informing public health policy. All models for COVID-19 epidemiology rely on parameters describing the dynamics of the infection process. The meanings of epidemiological parameters like R_0, R_t, the"serial interval"and"generation interval"can be challenging to understand, especially as these and other parameters are conceptually overlapping and sometimes confusingly named. Moreover, the procedures used to estimate these parameters make various assumptions and use different mathematical approaches that should be understood and accounted for when relying on parameter values and reporting them to the public. Here, we offer several insights regarding the derivation of commonly-reported epidemiological parameters, and describe how mitigation measures like lockdown are expected to affect their values. We aim to present these quantitative relationships in a manner that is accessible to the widest audience possible. We hope that better communicating the intricacies of epidemiological models will improve our collective understanding of their strengths and weaknesses, and will help avoid possible pitfalls when using them.


title: Negative Transmission of SARS-CoV-2 to Hand-Expressed Colostrum from SARS-CoV-2-Positive Mothers

text: Aim: The objective of our study was to determine whether the SARS-CoV-2-positive mothers transmit the virus to their hand-expressed colostrum. Methods: This is an observational prospective study that included pregnant women who tested positive for SARS-CoV-2 by PCR test on a nasopharyngeal swab at the moment of childbirth and who wanted to breastfeed their newborns. A colostrum sample was obtained from the mothers by manual self-extraction. To collect the samples, the mothers wore surgical masks, washed their hands with an 85% alcohol-based gel, and washed their breast with gauze that was saturated with soap and water. Results: We obtained seven colostrum samples from different mothers in the first hours postdelivery. SARS-CoV-2 was not detected in any of the colostrum samples obtained in our study. Conclusion: In our study, breast milk was not a source of SARS-CoV-2 transmission. Hand expression (assuring that a mask is used and that appropriate hygienic measures are used for the hands and the breast), when direct breastfeeding is not possible, appears to be a safe way of feeding newborns of mothers with COVID-19.


Safety first - assisted human reproduction second


Consequences of the coronavirus pandemic for global health research and practice


title: Pulmonary Arterial Thrombosis in COVID-19 With Fatal Outcome: Results From a Prospective, Single-Center, Clinicopathologic Case Series

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly become pandemic, with substantial mortality. OBJECTIVE: To evaluate the pathologic changes of organ systems and the clinicopathologic basis for severe and fatal outcomes. DESIGN: Prospective autopsy study. SETTING: Single pathology department. PARTICIPANTS: 11 deceased patients with COVID-19 (10 of whom were selected at random for autopsy). MEASUREMENTS: Systematic macroscopic, histopathologic, and viral analysis (SARS-CoV-2 on real-time polymerase chain reaction assay), with correlation of pathologic and clinical features, including comorbidities, comedication, and laboratory values. RESULTS: Patients' age ranged from 66 to 91 years (mean, 80.5 years; 8 men, 3 women). Ten of the 11 patients received prophylactic anticoagulant therapy; venous thromboembolism was not clinically suspected antemortem in any of the patients. Both lungs showed various stages of diffuse alveolar damage (DAD), including edema, hyaline membranes, and proliferation of pneumocytes and fibroblasts. Thrombosis of small and mid-sized pulmonary arteries was found in various degrees in all 11 patients and was associated with infarction in 8 patients and bronchopneumonia in 6 patients. Kupffer cell proliferation was seen in all patients, and chronic hepatic congestion in 8 patients. Other changes in the liver included hepatic steatosis, portal fibrosis, lymphocytic infiltrates and ductular proliferation, lobular cholestasis, and acute liver cell necrosis, together with central vein thrombosis. Additional frequent findings included renal proximal tubular injury, focal pancreatitis, adrenocortical hyperplasia, and lymphocyte depletion of spleen and lymph nodes. Viral RNA was detectable in pharyngeal, bronchial, and colonic mucosa but not bile. LIMITATION: The sample was small. CONCLUSION: COVID-19 predominantly involves the lungs, causing DAD and leading to acute respiratory insufficiency. Death may be caused by the thrombosis observed in segmental and subsegmental pulmonary arterial vessels despite the use of prophylactic anticoagulation. Studies are needed to further understand the thrombotic complications of COVID-19, together with the roles for strict thrombosis prophylaxis, laboratory, and imaging studies and early anticoagulant therapy for suspected pulmonary arterial thrombosis or thromboembolism. PRIMARY FUNDING SOURCE: None.


title: Cadaveric Simulation of Endoscopic Endonasal Procedures: Analysis of Droplet Splatter Patterns During the COVID-19 Pandemic

text: OBJECTIVE: The primary mode of viral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is thought to occur through the spread of respiratory droplets. The objective of this study was to investigate droplet and splatter patterns resulting from common endoscopic endonasal procedures. STUDY DESIGN: Cadaver simulation series. SETTING: Dedicated surgical laboratory. SUBJECTS AND METHODS: After instilling cadaver head specimens (n = 2) with fluorescein solution, endoscopic endonasal procedures were systematically performed to evaluate the quantity, size, and distance of droplets and splatter following each experimental condition. RESULTS: There were no observable fluorescein droplets or splatter noted in the measured surgical field in any direction after nasal endoscopy, septoplasty with microdebrider-assisted turbinoplasty, cold-steel functional endoscopic sinus surgery (FESS), and all experimental conditions using an ultrasonic aspirator. Limited droplet spread was noted with microdebrider FESS (2 droplets, <1 mm in size, within 10 cm), drilling of the sphenoid rostrum with a diamond burr (8, <1 mm, 12 cm), and drilling of the frontal beak with a cutting burr (5, <1 mm, 9 cm); however, the use of concurrent suction while drilling resulted in no droplets or splatter. The control condition of external activation of the drill resulted in gross contamination (11, 2 cm, 13 cm). CONCLUSION: Our results indicate that there is very little droplet generation from routine rhinologic procedures. The droplet generation from drilling was mitigated with the use of concurrent suction. Extreme caution should be used to avoid activating powered instrumentation outside of the nasal cavity, which was found to cause droplet contamination.


title: A predictive model for Covid-19 spread applied to eight US states

text: A compartmental epidemic model is proposed to predict the Covid-19 virus spread. It considers: both detected and undetected infected populations, medical quarantine and social sequestration, release from sequestration, plus possible reinfection. The coefficients in the model are evaluated by fitting to empirical data for eight US states: Arizona, California, Florida, Illinois, Louisiana, New Jersey, New York State, and Texas. Together these states make up 43% of the US population; some of these states appear to have handled their initial outbreaks well, while others appear to be emerging hotspots. The evolution of Covid-19 is fairly similar among the states: variations in contact and recovery rates remain below 5%; however, not surprisingly, variations are larger in death rate, reinfection rate, stay-at-home effect, and release rate from sequestration. The results reveal that outbreaks may have been well underway in several states before first detected and that California might have seen more than one influx of the pandemic. Our projections based on the current situation indicate that Covid-19 will become endemic, spreading for more than two years. Should states fully relax stay-at-home orders, most states may experience a secondary peak in 2021. If lockdowns had been kept in place, the number of Covid-19 deaths so far could have been significantly lower in most states that opened up. Additionally, our model predicts that decreasing contact rate by 10%, or increasing testing by approximately 15%, or doubling lockdown compliance (from the current $\sim$ 15% to $\sim$ 30%) will eradicate infections in the state of Texas within a year. Extending our fits for all of the US states, we predict about 11 million total infections (including undetected), 8 million cumulative confirmed cases, and 630,000 cumulative deaths by November 1, 2020.


title: [Recommendations for general surgery clinical practice in novel coronavirus pneumonia situation]

text: Novel coronavirus pneumonia (NCP) is a highly infectious disease, has a long incubation period and a variety of clinical manifestations, which has a significant impact on public health and life. Afterwards, scientific and standardized work processing during the epidemic is of great significance for prevention and control. In order to implement the central government's decision-making deployment and defeat the NCP as soon as possible, we had focused on the key points in the clinical work of general surgery according to latest relevant guidelines, literature and experience in epidemic prevention. Finally, we drafted the prevention and control strategies and recommendations to make a reference for medical staff of general surgery to fight NCP.


title: Recommendations for general surgery clinical practice in novel coronavirus pneumonia situation/ 中华外科杂志


Covid-19: Surgeons embrace virtual consultations to meet patients' needs during pandemic


title: COVID-19 pandemic and cardiovascular disease: where do we stand?

text: INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease 2019 (COVID-19) which recently has been characterized as a pandemic by the World Health Organization (WHO) having killed almost 250,000 people worldwide as of May 4th 2020. Despite the fact that SARS-CoV-2 seems to predominantly affect the respiratory system leading to pneumonia and acute respiratory distress syndrome, it is now evident that it may also affect the cardiovascular system in multiple ways. EVIDENCE ACQUISITION: The current paper is a review of the most recent literature regarding SARS-CoV-2 infection and its associated main cardiovascular clinical manifestations. EVIDENCE SYNTHESIS: Cardiovascular disease represents a prevalent underlying comorbidity associated with increased mortality rates among COVID-19 affected individuals. In addition, various cardiovascular manifestations have been linked to the viral insult, including among others acute coronary syndromes, myocarditis, acute heart failure, cardiac injury, arrhythmias and acute pulmonary embolism. CONCLUSIONS: Further studies are required in order to establish the complicated association between SARS-CoV-2 infection and its effects on the cardiovascular system. Our knowledge regarding diagnostic approaches, therapeutic management and preventive measures is constantly enriched throughout an abundance of ongoing research in the respective fields.


The Clinical Microbiology Laboratory Response to COVID-19: a Micro-Comic Strip


Blood vessel injury may spur disease's fatal second phase


Therapeutic and triage strategies for 2019 novel coronavirus disease in fever clinics


Breast cancer screening of mutation carriers in the era of COVID-19 pandemic


title: Private metropolitan telepsychiatry in Australia during Covid-19: current practice and future developments

text: OBJECTIVE: This paper discusses issues arising from the rapid implementation of metropolitan telepsychiatry in private practice during the Covid-19 public health emergency. CONCLUSIONS: The relatively rapid uptake of private practice metropolitan telepsychiatry may further increase flexibility of the options for appointments through ongoing broad telepsychiatry access after the Covid-19 crisis. Telepsychiatry can be used to facilitate the temporary provision of psychiatric care, and has benefits and risks, but is not a longer-term replacement for the interpersonal richness of face-to-face consultations.


title: Review of the present features and the infection control challenges of COVID-19 pandemic in dialysis facilities

text: The COVID-19 has swept the world causing suffering, death, loss, and massive economy damage. The dialysis population is vulnerable and the dialysis facility is critical in maintaining operations and avoiding disease transmission. The present information regarding the clinical features of COVID-19 infection in the dialysis population was collected, and the useful measures of COVID-19 infection prevention and infection control in the dialysis facilities were summarized. Leadership, education, preparedness, management, and recovery phase were determined to be the critical procedures. It is hoped this updated interim review might provide information for medical professionals to take proactive action to best prepare and mitigate damage when facing the COVID-19 pandemic challenge.


title: COVID-19 transforms health care through telemedicine: evidence from the field

text: This study provides data on the feasibility and impact of video-enabled telemedicine use among patients and providers and its impact on urgent and non-urgent health care delivery from one large health system (NYU Langone Health) at the epicenter of the COVID-19 outbreak in the United States. Between March 2nd and April 14th 2020, telemedicine visits increased from 369.1 daily to 866.8 daily (135% increase) in urgent care after the system-wide expansion of virtual health visits in response to COVID-19, and from 94.7 daily to 4209.3 (4345% increase) in non-urgent care post expansion. Of all virtual visits post expansion, 56.2% and 17.6% urgent and non-urgent visits, respectively, were COVID-19-related. Telemedicine usage was highest by patients aged 20-44, particularly for urgent care. The COVID-19 pandemic has driven rapid expansion of telemedicine use for urgent care and non-urgent care visits beyond baseline periods. This reflects an important change in telemedicine that other institutions facing the COVID-19 pandemic should anticipate.


A child confirmed COVID-19 with only symptoms of conjunctivitis and eyelid dermatitis


title: Anatomical study of the female reproductive system and bacteriome of Diaphorina citri Kuwayama, (Insecta: Hemiptera, Liviidae) using micro-computed tomography

text: Huanglongbing (HLB) (citrus greening disease) is one of the most serious bacterial diseases of citrus. It is caused by (1) Candidatus Liberibacter africanus, transmitted by Trioza erytreae and (2) C.L. asiaticus and C.L. americanus, transmitted by Diaphorina citri. As part of a multidisciplinary project on D. citri (www.citrusgreening.org), we made a detailed study, using micro-computed tomography, of the female abdominal terminalia, reproductive system (ovaries, accessory glands, spermatheca, colleterial (= cement) gland, connecting ducts, and ovipositor) and bacteriome, which we present here. New terms and structures are introduced and described, particularly concerning the spermatheca, ovipositor and bacteriome. The quality of images and bacteriome reconstructions are comparable, or clearer, than those previously published using a synchrotron or fluorescence in situ hybridisation (FISH). This study: reviews knowledge of the female reproductive system and bacteriome organ in D. citri; represents the first detailed morphological study of D. citri to use micro-CT; and extensively revises existing morphological information relevant to psylloids, hemipterans and insects in general. High quality images and supplementary videos represent a significant advance in knowledge of psylloid anatomy and are useful tools for future research and as educational aids.


Telemedicine Services During COVID-19: Considerations for Medically Underserved Populations


title: Stopping the SuperSpreader Epidemic: the lessons from SARS (with, perhaps, applications to MERS)

text: I discuss the so-called SuperSpreader epidemic, for which SARS is the canonical examples (and, perhaps, MERS will be another). I use simulation by an agent-based model as well as the mathematics of multi-type branching-processes to illustrate how the SS epidemic differs from the more familiar uniform epidemic (e.g., caused by influenza). The conclusions may surprise the reader: (a) The SS epidemic must be described by at least two numbers, such as the mean reproductive number (of"secondary"cases caused by a"primary case"), R0, and the variance of same, call it V0; (b) Even if R0>1, if V0>>R0 the probability that an infection-chain caused by one primary case goes extinct without intervention may be close to one (e.g., 0.97); (c) The SS epidemic may have a long"kindling period"in which sporadic cases appear (transmitted from some unknown host) and generate a cluster of cases, but the chains peter out, perhaps generating a false sense of security that a pandemic will not occur; (d) Interventions such as isolation (or contact-tracing and secondary case isolation) may prove efficacious even without driving R0 below one; (e) The efficacy of such interventions diminishes, but slowly, with increasing V0 at fixed R0. From these considerations, I argue that the SS epidemic has dynamics sufficiently distinct from the uniform case that efficacious public-health interventions can be designed even in the absence of a vaccine or other form of treatment.


Correction to Lancet Public Health 2020; 5; e261-70


title: Epidemiologic characteristics of early cases with 2019 novel coronavirus (2019-nCoV) disease in Korea

text: In about 20 days since the diagnosis of the first case of the 2019 novel coronavirus (2019-nCoV) in Korea on January 20, 2020, 28 cases have been confirmed. Fifteen patients (53.6%) of them were male and median age of was 42 years (range, 20-73). Of the confirmed cases, 16, 9, and 3 were index (57.2%), first-generation (32.1%), and second-generation (10.7%) cases, respectively. All first-generation and second-generation patients were family members or intimate acquaintances of the index cases with close contacts. Fifteen among 16 index patients had entered Korea from January 19 to 24, 2020 while 1 patient had entered Korea on January 31, 2020. The average incubation period was 3.9 days (median, 3.0), and the reproduction number was estimated as 0.48. Three of the confirmed patients were asymptomatic when they were diagnosed. Epidemiological indicators will be revised with the availability of additional data in the future. Sharing epidemiological information among researchers worldwide is essential for efficient preparation and response in tackling this new infectious disease.


Using air purifier as a supplementary protective measure in dental clinics during the COVID-19 pandemic


Équipements de protection individuelle (EPI) pour anesthésiologistes: la nécessité de directives nationales./ Personal protective equipment (PPE) for anesthesiologists: the need for national guidelines


COVID-19 in Bangladesh: public awareness and insufficient health facilities remain key challenges


The COVID-19 Global Rheumatology Alliance: collecting data in a pandemic


COVID-19: 2020 a year in turmoil


Neutrophil-to-lymphocyte ratio and clinical outcome in COVID-19: a report from the Italian front line


Modifying Practices in GI Oncology in the Face of COVID-19: Recommendations From Expert Oncologists on Minimizing Patient Risk


Facing challenges with the novel coronavirus SARS-CoV-2 outbreak./ Facing challenges with the novel coronavirus SARS-CoV-2 outbreak


COVID-19: Do not be phobic from fever


title: Cardiac Surgery in Canada During the COVID-19 Pandemic: A Guidance Statement From the Canadian Society of Cardiac Surgeons

text: On March 11, 2020, the World Health Organization declared that COVID-19 was a pandemic.1 At that time, only 118,000 cases had been reported globally, 90% of which had occurred in 4 countries.1 Since then, the world landscape has changed dramatically. As of March 31, 2020, there are now nearly 800,000 cases, with truly global involvement.2 Countries that were previously unaffected are currently experiencing mounting rates of the novel coronavirus infection with associated increases in COVID-19-related deaths. At present, Canada has more than 8000 cases of COVID-19, with considerable variation in rates of infection among provinces and territories.3 Amid concerns over growing resource constraints, cardiac surgeons from across Canada have been forced to make drastic changes to their clinical practices. From prioritizing and delaying elective cases to altering therapeutic strategies in high-risk patients, cardiac surgeons, along with their heart teams, are having to reconsider how best to manage their patients. It is with this in mind that the Canadian Society of Cardiac Surgeons (CSCS) and its Board of Directors have come together to formulate a series of guiding statements. With strong representation from across the country and the support of the Canadian Cardiovascular Society, the authors have attempted to provide guidance to their colleagues on the subjects of leadership roles that cardiac surgeons may assume during this pandemic: patient assessment and triage, risk reduction, and real-time sharing of expertise and experiences.


title: Inequity and the disproportionate impact of COVID-19 on communities of color in the United States: The need for a trauma-informed social justice response

text: COVID-19 has had disproportionate contagion and fatality in Black, Latino, and Native American communities and among the poor in the United States. Toxic stress resulting from racial and social inequities have been magnified during the pandemic, with implications for poor physical and mental health and socioeconomic outcomes. It is imperative that our country focus and invest in addressing health inequities and work across sectors to build self-efficacy and long-term capacity within communities and systems of care serving the most disenfranchised, now and in the aftermath of the COVID-19 epidemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Mortality in Older Patients with COVID-19


title: Production networks and epidemic spreading: How to restart the UK economy?

text: We analyse the economics and epidemiology of different scenarios for a phased restart of the UK economy. Our economic model is designed to address the unique features of the COVID-19 pandemic. Social distancing measures affect both supply and demand, and input-output constraints play a key role in restricting economic output. Standard models for production functions are not adequate to model the short-term effects of lockdown. A survey of industry analysts conducted by IHS Markit allows us to evaluate which inputs for each industry are absolutely necessary for production over a two month period. Our model also includes inventory dynamics and feedback between unemployment and consumption. We demonstrate that economic outcomes are very sensitive to the choice of production function, show how supply constraints cause strong network effects, and find some counter-intuitive effects, such as that reopening only a few industries can actually lower aggregate output. Occupation-specific data and contact surveys allow us to estimate how different industries affect the transmission rate of the disease. We investigate six different re-opening scenarios, presenting our best estimates for the increase in R0 and the increase in GDP. Our results suggest that there is a reasonable compromise that yields a relatively small increase in R0 and delivers a substantial boost in economic output. This corresponds to a situation in which all non-consumer facing industries reopen, schools are open only for workers who need childcare, and everyone who can work from home continues to work from home.


title: Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy

text: OBJECTIVES: The management of healthcare workers (HCWs) exposed to confirmed cases of coronavirus disease 2019 (COVID-19) is still a matter of debate. We aimed to assess in this group the attack rate of asymptomatic carriers and the symptoms most frequently associated with infection. METHODS: Occupational and clinical characteristics of HCWs who underwent nasopharyngeal swab testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a university hospital from 24 February 2020 to 31 March 2020 were collected. For those who tested positive and for those who tested positive but who were asymptomatic, we checked the laboratory and clinical data as of 22 May to calculate the time necessary for HCWs to then test negative and to verify whether symptoms developed thereafter. Frequencies of positive tests were compared according to selected variables using multivariable logistic regression models. RESULTS: There were 139 positive tests (8.8%) among 1573 HCWs (95% confidence interval, 7.5-10.3), with a marked difference between symptomatic (122/503, 24.2%) and asymptomatic (17/1070, 1.6%) workers (p < 0.001). Physicians were the group with the highest frequency of positive tests (61/582, 10.5%), whereas clerical workers and technicians had the lowest frequency (5/137, 3.6%). The likelihood of testing positive for COVID-19 increased with the number of reported symptoms; the strongest predictors of test positivity were taste and smell alterations (odds ratio = 76.9) and fever (odds ratio = 9.12). The median time from first positive test to a negative test was 27 days (95% confidence interval, 24-30). CONCLUSIONS: HCWs can be infected with SARS-CoV-2 without displaying any symptoms. Among symptomatic HCWs, the key symptoms to guide diagnosis are taste and smell alterations and fever. A median of almost 4 weeks is necessary before nasopharyngeal swab test results are negative.


Pain: A potential new label of COVID-19


Trauma center activity and surge response during the early phase of the COVID-19 pandemic - the Philadelphia story


title: Practical aspects of targeting IL-6 in COVID-19 disease

text: Severe cases of COVID-19 are often attended by a syndrome that has been described as "cytokine storm," with some features shared with macrophage activation syndrome. A variety of experimental therapies targeting this hyperinflammatory state are now being applied in hospitals around the world. Among the most widely used treatments are monoclonal antibodies targeting interleukin-6 (IL-6) or the IL-6 receptor. Anti-IL-6 drugs are being widely used experimentally and as off-label therapy for patients with COVID-19 who are sick and deteriorating but have a reasonable chance of recovering, but they are still unproven and unapproved for this use. The pandemic has created major ethical and practical questions about patient selection and nonapproved use vs use in the context of a randomized clinical trial.


title: Putting the Air Transportation System to sleep: a passenger perspective measured by passenger-generated data

text: This paper aims at analyzing the effect on the US air transportation system of the travel restriction measures implemented during the COVID-19 pandemic from a passenger perspective. Flight centric data are not already publicly and widely available therefore the traditional metrics used to measure the state of this system are not yet available. Seven metrics based on three different passenger-generated datasets are proposed here. They aim to measure in close to real-time how the travel restriction measures impacted the relation between major stakeholders of the US air transportation system, namely passengers, airports and airlines.


Face masks for the public during covid-19: the more things change


The Use of eHealth for the Care of Patients With Diabetes in Connection to the COVID-19 Pandemic


title: Variational principles for fluid dynamics on rough paths

text: In this paper, we introduce a new framework for parametrization schemes (PS) in GFD. Using the theory of controlled rough paths, we derive a class of rough geophysical fluid dynamics (RGFD) models as critical points of rough action functionals. These RGFD models characterize Lagrangian trajectories in fluid dynamics as geometric rough paths (GRP) on the manifold of diffeomorphic maps. Three constrained variational approaches are formulated for the derivation of these models. The first is the Clebsch formulation, in which the constraints are imposed as rough advection laws. The second is the Hamilton-Pontryagin formulation, in which the constraints are imposed as right-invariant rough vector fields. The third is the Euler--Poincar\'e formulation in which the variations are constrained. These variational principles lead directly to the Lie--Poisson Hamiltonian formulation of fluid dynamics on geometric rough paths. The GRP framework preserves the geometric structure of fluid dynamics obtained by using Lie group reduction to pass from Lagrangian to Eulerian variational principles, thereby yielding a rough formulation of the Kelvin circulation theorem. The rough-path variational approach includes non-Markovian perturbations of the Lagrangian fluid trajectories. In particular, memory effects can be introduced through this formulation through a judicious choice of the rough path (e.g. a realization of a fractional Brownian motion). In the special case when the rough path is a realization of a semimartingale, we recover the SGFD models in Holm (2015). However, by eliminating the need for stochastic variational tools, we retain a pathwise interpretation of the Lagrangian trajectories. In contrast, the Lagrangian trajectories in the stochastic framework are described by stochastic integrals which do not have a pathwise interpretation. Thus, the rough path formulation restores this property.


title: Potential implications of SARS-CoV-2 epidemic in Africa: where are we going from now?

text: The SARS-CoV-2, which emerged from East Asia in December 2019, has rapidly evolved into a global pandemic infecting close to 7 million people. The current uncertainties regarding its impact on Africa calls for critical monitoring of the evolution of the pandemic and correlation of factors that influence the burden of the disease. We herein discuss possible implications of SARS-CoV-2 on the African continent.


title: Incidence and Immunologic Analysis of Coronavirus Disease (COVID-19) in Hemodialysis Patients:A Single-Center Experience

text: OBJECTIVES: COVID-19 is a great threat to the modern world and significant threat to immunocompromised patients, including patients with chronic renal failure. We evaluated COVID-19 incidence among our hemodialysis patients and investigated the most probable immune mechanisms against COVID-19. MATERIALS AND METHODS: Baskent University has 21 dialysis centers across Turkey, with 2420 patients on hemodialysis and 30 on peritoneal dialysis. Among these, we retrospectively evaluated 602 patients (257 female/345 male) with chronic renal failure receiving hemodialysis as renal replacement therapy; 7 patients (1.1%) were infected with SARS-CoV-2. We retrospectively collected patient demographic characteristics, clinical data, and immunological factors affecting the clinical course of the disease. We divided patients into groups and included 2 control groups (individuals with normal renal functions): group I included COVID-19-positive patients with normal renal function, group II included COVID-19-positive hemodialysis patients, group III included COVID-19-negative hemodialysis patients, and group IV included COVID-19-negative patients with normal renal function. Lymphocyte subsets in peripheral blood and typing of human leukocyte antigens were analyzed in all groups, with killer cell immunoglobulin like receptor genes analyzed only in COVID-19-positive patients and healthy controls. RESULTS: No deaths occurred among the 7 COVID-19-positive hemodialysis patients. Group I patients were significantly older than patients in groups II and III (P = .039, P = .030, respectively) but not significantly different from group IV (P = .060). Absolute counts of natural killer cells in healthy controls were higherthan in other groups (but not significantly). ActivatedT cells were significantly increased in both COVID-19-positive groups versus COVID-19-negative groups. Groups showed significant differences in C and DQ loci with respect to distribution of alleles in both HLA classes. CONCLUSIONS: Although immunocompromised patients are at greater risk for COVID-19, we found lower COVID-19 incidence in our hemodialysis patients, which should be further investigated in in vitro and molecular studies.


title: The EAERE Celebrates Its 30th Anniversary

text: The European Association of Environmental and Resource Economists started around 1990 and celebrates its 30th anniversary this year. The rise of environmental concerns and the wish for more cooperation between scientists within Europe, plus the drive of a few highly motivated people, led to the foundation of this academic institution. This article aims at clarifying the initial steps and the development of this highly successful association. The relationship between economics and the environment is core for the future of our world, and the EAERE was crucial in developing this field. The EAERE has been a stimulus and a home for many scientists who were interested to work in this field and who would otherwise have been quite isolated. The future of the EAERE is bright if it manages to bridge new developments in economics and in the natural sciences, and between academics and policy.


title: COVID 19, a realistic model for saturation, growth and decay of the India specific disease

text: This work presents a simple and realistic approach to handle the available data of COVID-19 patients in India and to forecast the scenario. The model proposed is based on the available facts like the onset of lockdown (as announced by the Government on 25th day, {\tau}0 and the recovery pattern dictated by a mean life recovery time of {\tau}1 ( normally said to be around 14 days). The data of infected COVID-19 patients from March 2, to April 16, 2020 has been used to fit the evolution of infected, recovery and death counts. A slow rising exponential growth, with R0 close to 1/6, is found to represent the infected counts indicating almost a linear rise. The rest of growth, saturation and decay of data is comprehensibly modelled by incorporating lockdown time controlled R0, having a normal error function like behaviour decaying to zero in some time frame of {\tau}2 . The recovery mean life time {\tau}1 dictates the peak and decay. The results predicted for coming days are interesting and optimistic. The introduced time constants based on experimental data for both the recovery rate as well as for determining the time span of activity of R0 after the lockdown are subject of debate and provide possibility to introduce trigger factors to alter these to be more suited to the model. The model can be extended to other communities with their own R0 and recovery time parameters.


Underperformance of Reverse-Transcriptase Polymerase Chain Reaction in Japan and Potential Implications From Diamond Princess Cruise Ship and Other Countries During the Ongoing COVID-19 Pandemic


title: COVID-19: Drug Targets and Potential Treatments

text: Currently, humans are immersed in a pandemic caused by the emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which threatens public health worldwide. To date, no drug or vaccine has been approved to treat the severe disease caused by this coronavirus, COVID-19. In this paper, we will focus on the main virus-based and host-based targets that can guide efforts in medicinal chemistry to discover new drugs for this devastating disease. In principle, all CoV enzymes and proteins involved in viral replication and the control of host cellular machineries are potentially druggable targets in the search for therapeutic options for SARS-CoV-2. This Perspective provides an overview of the main targets from a structural point of view, together with reported therapeutic compounds with activity against SARS-CoV-2 and/or other CoVs. Also, the role of innate immune response to coronavirus infection and the related therapeutic options will be presented.


title: Interpretation of "expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia"

text: With aim to reasonably cope with the elderly patients with hip fracture during epidemic of corona virus disease 2019 (COVID-19), Professor Su Jiacan and Academician Zhang Yingze organized the &quot;expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia&quot;that for the first time formulated the management strategies for the elderly patients with hip fracture including selection of surgical methods and protective measures for medical staff from perspective of orthopedic surgeons The authors interpret the clinical guiding value and key points of diagnosis and treatment of the consensus to help clinicians better understand the consensus and strengthen its practical application


title: Interpretation of 'expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia'

text: With aim to reasonably cope with the elderly patients with hip fracture during epidemic of corona virus disease 2019 (COVID-19), Professor Su Jiacan and Academician Zhang Yingze organized the 'expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia' that for the first time formulated the management strategies for the elderly patients with hip fracture including selection of surgical methods and protective measures for medical staff from perspective of orthopedic surgeons The authors interpret the clinical guiding value and key points of diagnosis and treatment of the consensus to help clinicians better understand the consensus and strengthen its practical application


text: With aim to reasonably cope with the elderly patients with hip fracture during epidemic of corona virus disease 2019 (COVID-19), Professor Su Jiacan and Academician Zhang Yingze organized the "expert consensus on elderly patients with hip fractures under epidemic of novel coronavirus pneumonia"that for the first time formulated the management strategies for the elderly patients with hip fracture including selection of surgical methods and protective measures for medical staff from perspective of orthopedic surgeons The authors interpret the clinical guiding value and key points of diagnosis and treatment of the consensus to help clinicians better understand the consensus and strengthen its practical application


Management strategies adopted by a paediatric palliative care network in northern Italy during the COVID-19 pandemic


title: Utility of CT scan in patients with initial negative PCR for SARS-CoV2: a report of three cases

text: PCR-based viral RNA to confirm the diagnosis of SARS-CoV-2 infection has a sensitivity of around 70%. We report three cases of patients with negative initial PCR and CT scan lesions that led us to suspect COVID-19, but which one(s) are really COVID-19?


Does SARS-CoV-2 infection cause sperm DNA fragmentation? Possible link with oxidative stress


Chloroquine-Induced First-Episode Psychosis in a Patient Self-medicated for COVID-19


Grace, Connection, and Hard Conversations: Primary Care Geriatrics in the COVID Era


title: Trends in scientific research in Online Information Review. Part 2. Mapping the scientific knowledge through bibliometric and social network analyses

text: Objective. The purpose of this work is to analyse the knowledge structure and trends in scientific research in the Online Information Reviews journal by bibliometric analysis of key words and social network analysis of co-words. Methods. Key words included in a set of 758 papers included in the Web of Science database from 2000 to 2014 were analysed. We conducted a subject analysis considering the key words assigned to papers. A social network analysis was also conducted to identify the number of co-occurrences between key words (co-words). The Pajek software was used to create and graphically visualize the networks. Results. Internet is the most frequent key word (n=219) and the most central in the network of co-words, strongly associated with Information retrieval, search engines, the World Wide Web, libraries and users Conclusions. Information science, as represented by Online Information Review in the present study, is an evolving discipline that draws on literature from a relatively wide range of subjects. Although Online Information Review appears to have well-defined and established research topics, the journal also changes rapidly to embrace new lines of research.


CORONAVIRUS 最大の脅威は中国政府の隠蔽工作 : 新型肺炎


When infection prevention enters the temple: Intergenerational social distancing and COVID-19


title: N95 Usage During the COVID-19 Pandemic

text: Personal Protective Equipment (PPE), formerly ubiquitous and disposable in the hospital and healthcare environment, has become scarce during the COVID-19 pandemic. This shortage has precipitated creative solutions to re-use and/or extend the lifetime of PPE, most notably the N95 mask. This article attempts to summarize options regarding re-use of N95 respirators and is for informational purposes only.


title: What do urologists need to know: Diagnosis, treatment, and follow-up during COVID-19 pandemic

text: Coronavirus disease 2019 (COVID-19) is an infectious disease which is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It has had unprecedented effect on healthcare systems globally with severe impact on every specialist service within the hospital including urology. While it affects the respiratory system causing symptoms ranging from fever, cough, dyspnea, diarrhea, nausea, myalgia and fatigue, it eventually causes pneumonia and respiratory distress needing oxygenation and ventilation. Laboratory diagnosis is required to confirm the diagnosis of COVID-19. Radiological changes are seen on chest XR or CT scan of patients. The surge in patients affected by the disease has led to extreme pressures on healthcare systems by the overwhelming number of critically unwell patients. This scenario has presented challenges to maintain other emergency and essential services. Reallocation of staff, wards and equipment has resulted in cancellations of many surgical procedures, requiring urologists to select only the most essential or critical procedures. The outpatient face-to-face clinics are also cancelled or changed to telephone or video consultations. In some hospitals, urologists are required to work outside of their usual scope of practice helping their respiratory and intensive care unit colleagues. The pandemic is disrupting training and education opportunities for junior medical staff. In this review we provide guidance on the diagnosis and management of COVID-19, the influence it has on urological practice and consider the long-term implications that may be of consequence for years to come.


title: Provision of dental hospital services during the COVID-19 epidemic

text: Data sources Information about health services provision of public tertiary dental hospitals in China mainland was retrieved through a web search engine. Data analysis The status of non-emergency dental services, emergency dental services and online professional consultation was recorded and analysed. If telehealth was provided, the charge,means of access, service time and service content were investigated. The geographical distribution of hospitals was recorded and classified .Results A total of 48 dental hospitals were included in the study. All 48 dental hospitals suspended general non-emergency dental treatment. They provided emergency dental services only.


Beijing proposes law to ban criticism of traditional Chinese medicine


title: Health security capacities in the context of COVID-19 outbreak: an analysis of International Health Regulations annual report data from 182 countries

text: BACKGROUND: Public health measures to prevent, detect, and respond to events are essential to control public health risks, including infectious disease outbreaks, as highlighted in the International Health Regulations (IHR). In light of the outbreak of 2019 novel coronavirus disease (COVID-19), we aimed to review existing health security capacities against public health risks and events. METHODS: We used 18 indicators from the IHR State Party Annual Reporting (SPAR) tool and associated data from national SPAR reports to develop five indices: (1) prevent, (2) detect, (3) respond, (4) enabling function, and (5) operational readiness. We used SPAR 2018 data for all of the indicators and categorised countries into five levels across the indices, in which level 1 indicated the lowest level of national capacity and level 5 the highest. We also analysed data at the regional level (using the six geographical WHO regions). FINDINGS: Of 182 countries, 52 (28%) had prevent capacities at levels 1 or 2, and 60 (33%) had response capacities at levels 1 or 2. 81 (45%) countries had prevent capacities and 78 (43%) had response capacities at levels 4 or 5, indicating that these countries were operationally ready. 138 (76%) countries scored more highly in the detect index than in the other indices. 44 (24%) countries did not have an effective enabling function for public health risks and events, including infectious disease outbreaks (7 [4%] at level 1 and 37 [20%] at level 2). 102 (56%) countries had level 4 or level 5 enabling function capacities in place. 32 (18%) countries had low readiness (2 [1%] at level 1 and 30 [17%] at level 2), and 104 (57%) countries were operationally ready to prevent, detect, and control an outbreak of a novel infectious disease (66 [36%] at level 4 and 38 [21%] at level 5). INTERPRETATION: Countries vary widely in terms of their capacity to prevent, detect, and respond to outbreaks. Half of all countries analysed have strong operational readiness capacities in place, which suggests that an effective response to potential health emergencies could be enabled, including to COVID-19. Findings from local risk assessments are needed to fully understand national readiness capacities in relation to COVID-19. Capacity building and collaboration between countries are needed to strengthen global readiness for outbreak control. FUNDING: None.


Traditional Chinese medicine is a resource for drug discovery against 2019 novel coronavirus (SARS-CoV-2)


title: Handling and Processing of Blood Specimens from Patients with COVID-19 for Safe Studies on Cell Phenotype and Cytokine Storm

text: The pandemic caused by severe acute respiratory syndrome coronavirus 2 heavily involves all those working in a laboratory. Samples from known infected patients or donors who are considered healthy can arrive, and a colleague might be asymptomatic but able to transmit the virus. Working in a clinical laboratory is posing several safety challenges. Few years ago, International Society for Advancement of Cytometry published guidelines to safely analyze and sort human samples that were revised in these days. We describe the procedures that we have been following since the first patient appeared in Italy, which have only slightly modified our standard one, being all human samples associated with risks. © 2020 International Society for Advancement of Cytometry.


Covid-19: Students on standby to help with contract tracing


title: COVID-19: gynecologic cancer surgery at a single center in Madrid

text: OBJECTIVES: While numerous medical facilities have been forced to suspend oncological surgery due to system overload, debate has emerged on using non-surgical options on cancer cases during the pandemic. The goal of our study was to analyze, in a retrospective cohort study, the results of gynecological cancer surgery and evaluate postoperative complications in a single center in one of the most affected areas in Europe. METHODS: We retrospectively analyzed the records of patients who were referred between March 2020 and May 2020 for primary surgical treatment of breast, endometrial, ovarian, cervical, or vulvar cancer. RESULTS: The study included a total of 126 patients. Median age was 60 years (range 29-89). Patients were referred with breast (76/126, 60.3%), endometrial (29/126, 23%), ovarian (14/126, 11.1%), cervical (5/126, 4%), or vulvar cancer (2/126, 1.6%). Polymerase chain reaction (PCR) test for detection of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) was only conducted in 50% of cases due to the low availability of tests during the first phase of our study, and was indicated only in suspected cases according to the healthcare authorities' protocol. Median hospital stay was 1 day (range 0-18). Excluding breast surgery, laparoscopy was the most used procedure (43/126, 34.1%). 15 patients had a postoperative complication (15/126, 11.9%); only in 2 patients (2/15 13.3%) were there reports of Clavien-Dindo grade 3 or 4 complications. 6 patients tested positive for COVID-19 following a PCR diagnostic test, and these surgeries were cancelled. CONCLUSIONS: Adequate protective measures in the setting of COVID-19 free institutions enabled the continuity of cancer surgery without significant compromise of the safety of patients or healthcare workers.


Immunopharmacological management of COVID-19: Potential therapeutic role of valproic acid


title: Prognosis analysis of patients with mental disorders with COVID-19: a single-center retrospective study

text: Our study aimed to investigate the factors affecting the prognosis of patients with mental disorders with COVID-19. All patients with mental disorders who were diagnosed with COVID-19 at the intensive care unit of Wuhan Mental Health Center during the period January 3 to March 1, 2020 were selected. The influence of the baseline characteristics, clinical symptoms, laboratory parameters and the types of mental disorders on prognosis were analyzed. According to their final prognosis, the patients were divided into the deceased group (5 patients) and the cured group (25 patients). The mortality rate of patients with dementia was significantly higher than that of patients with other mental disorders (P = 0.001). The levels of certain laboratory parameters in the serum of dementia patients were significantly increased compared with levels in nondementia patients (WBC count: 10.100±6.147 vs. 5.694±3.383, p = 0.029; neutrophil count: 8.504± 5.993 vs. 3.764 ± 2.733, P = 0.008; BUN: 8.300± 4.072 vs. 4.364 ± 1.196, P = 0.001). Our research indicated that the mortality rate of dementia patients with COVID-19 was higher than that of patients with other mental disorders. A focus on the inflammatory response of dementia patients may provide novel ideas for reducing mortality.


Spontaneous Pneumomediastinum in a Patient with Coronavirus Disease 2019 Pneumonia and the Possible Underlying Mechanism


Corrigendum to "The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China" [J. Autoimmun. 109C (2020) 102434]


The blurred line between the art and science of medicine


title: Apps Gone Rogue: Maintaining Personal Privacy in an Epidemic

text: Containment, the key strategy in quickly halting an epidemic, requires rapid identification and quarantine of the infected individuals, determination of whom they have had close contact with in the previous days and weeks, and decontamination of locations the infected individual has visited. Achieving containment demands accurate and timely collection of the infected individual's location and contact history. Traditionally, this process is labor intensive, susceptible to memory errors, and fraught with privacy concerns. With the recent almost ubiquitous availability of smart phones, many people carry a tool which can be utilized to quickly identify an infected individual's contacts during an epidemic, such as the current 2019 novel Coronavirus crisis. Unfortunately, the very same first-generation contact tracing tools have been used to expand mass surveillance, limit individual freedoms and expose the most private details about individuals. We seek to outline the different technological approaches to mobile-phone based contact-tracing to date and elaborate on the opportunities and the risks that these technologies pose to individuals and societies. We describe advanced security enhancing approaches that can mitigate these risks and describe trade-offs one must make when developing and deploying any mass contact-tracing technology. With this paper, our aim is to continue to grow the conversation regarding contact-tracing for epidemic and pandemic containment and discuss opportunities to advance this space. We invite feedback and discussion.


title: Does COVID-19 infection impact on the trend of seasonal influenza infection? 11 countries and regions, from 2014 to 2020

text: OBJECTIVES: Infection due to the 2019 novel coronavirus disease (COVID-19) is dramatically widespread around the world. The COVID-19 pandemic could increase public concern to prevent infectious disease. The present study aimed to assess the relationship between the COVID-19 epidemic and the potential decrease in seasonal influenza cases. METHODS: This study was performed to show trends in seasonal influenza cases from the 2014-2015 season to the 2019-2020 season in 11 countries and regions, and evaluate whether the trends in the 2019-2020 season were different before and after the COVID-19 pandemic compared to previous seasons using a quasi-experimental difference-in-difference design. RESULTS: In East Asia, the number of seasonal influenza cases in the 2019-20 season was lower after the COVID-19 transmission compared to previous years. However, this was not the case in American countries or in European countries. CONCLUSION: The COVID-19 epidemic might have altered health behaviors, resulting in an unexpected reduction of seasonal influenza cases.


title: Emergency preparedness after COVID-19: A review of policy statements for the U.S. water sector

text: Although COVID-19 has impacted water and wastewater utilities in new and profound ways, they must still provide their vital services despite the disruptions. The pandemic brings into focus their need for proactive emergency preparedness. In the United States, professional associations have long advocated in this area and have already developed considerable policy guidance and resources to help water and wastewater utilities prepare for and respond to emergencies. In the midst of the crisis, several U.S. policies are reviewed here. Utilities should reflect on their COVID-19 experience, learn from it, and apply their newfound perspective to strengthen future emergency preparedness.


title: Increased susceptibility of SARS-CoV2 infection on oral cancer patients; cause and effects: An hypothesis

text: In 2019, a new coronavirus (SARS CoV2) infecting humans has emerged in Wuhan, China which caused an unprecedented pandemic involving at least 185 countries infecting 2.5 million people till date. This virus is transmitted directly or indirectly through the upper aerodigestive tract. As it is evident from the recent studies that SARS-CoV-2 requires host enzyme Furin to activate receptor binding domain of its S protein and host Angiotensin Convertase Enzyme 2 (ACE2) is required as binding receptor, facilitating the entry of virus into the host cell. Evidence from literature shows that oral cancer tissues as well as paracarcinoma tissue exhibit higher expression of both Furin and ACE2, giving rise to the hypothesis that patients with oral cancer have higher chances of SARS CoV2 infection. It is also hypothesised that there will be increased severity of disease due to facilitated entry of the virus into the cells. Therefore, we suggest oral cancer patients require extra attention during COVID-19 pandemic and re-evaluation of current treatment paradigms in oral oncology is also needed.


title: Conspiracy in the Time of Corona: Automatic detection of Covid-19 Conspiracy Theories in Social Media and the News

text: Rumors and conspiracy theories thrive in environments of low confidence and low trust. Consequently, it is not surprising that ones related to the Covid-19 pandemic are proliferating given the lack of any authoritative scientific consensus on the virus, its spread and containment, or on the long term social and economic ramifications of the pandemic. Among the stories currently circulating are ones suggesting that the 5G network activates the virus, that the pandemic is a hoax perpetrated by a global cabal, that the virus is a bio-weapon released deliberately by the Chinese, or that Bill Gates is using it as cover to launch a global surveillance regime. While some may be quick to dismiss these stories as having little impact on real-world behavior, recent events including the destruction of property, racially fueled attacks against Asian Americans, and demonstrations espousing resistance to public health orders countermand such conclusions. Inspired by narrative theory, we crawl social media sites and news reports and, through the application of automated machine-learning methods, discover the underlying narrative frameworks supporting the generation of these stories. We show how the various narrative frameworks fueling rumors and conspiracy theories rely on the alignment of otherwise disparate domains of knowledge, and consider how they attach to the broader reporting on the pandemic. These alignments and attachments, which can be monitored in near real-time, may be useful for identifying areas in the news that are particularly vulnerable to reinterpretation by conspiracy theorists. Understanding the dynamics of storytelling on social media and the narrative frameworks that provide the generative basis for these stories may also be helpful for devising methods to disrupt their spread.


title: Coronavirus Act 2020: An overview by a lawyer interested in medico-legal matters

text: The Act and the regulations. How long they might last. The suspension of the renewals. Enforcement and the role of the police. Protection of whistleblowers. The trial scene. The ultimate impact.


The COVID-19 Pandemic and Mayo Clinic Proceedings


title: Type 3 hypersensitivity in COVID-19 vasculitis

text: Coronavirus Disease 2019 (COVID-19) is an ongoing public health emergency and new knowledge about its immunopathogenic mechanisms is deemed necessary in the attempt to reduce the death burden, globally. For the first time in worldwide literature, we provide scientific evidence that in COVID-19 vasculitis a life-threatening escalation from type 2 T-helper immune response (humoral immunity) to type 3 hypersensitivity (immune complex disease) takes place. The subsequent deposition of immune complexes inside the vascular walls is supposed to induce a severe inflammatory state and a cytokine release syndrome, whose interleukin-6 is the key myokine, from the smooth muscle cells of blood vessels.


title: Proyección epidemiológica de COVID-19 en Chile basado en el modelo SEIR generalizado y el concepto de recuperado./ [An epidemiological forecast of COVID-19 in Chile based on the generalized SEIR model and the concept of recovered]

text: The COVID-19 pandemic declared by the World Health Organization (WHO) has generated a wide-ranging debate regarding epidemiological forecasts and the global implications. With the data obtained from the Chilean Ministry of Health (MINSAL), a prospective study was carried out using the generalized SEIR model to estimate the course of COVID-19 in Chile. Three scenarios were estimated: Scenario 1 with official MINSAL data; scenario 2 with official MINSAL data and recovery criteria proposed by international organizations of health; and scenario 3 with official MINSAL data, recovery criteria proposed by international organizations of health, and without considering deaths in the total recovered. There are considerable differences between scenario 1 compared to 2 and 3 in the number of deaths, active patients, and duration of the disease. Scenario 3, considered the most adverse, estimates a total of 11,000 infected people, 1,151 deaths, and that the peak of the disease will occur in the first days of May. We concluded that the concept of recovered may be decisive for the epidemiological forecasts of COVID-19 in Chile.


Why more coronavirus testing won't automatically help the hardest hit


title: Validation of a commercially available SARS-CoV-2 serological immunoassay

text: OBJECTIVES: To validate the diagnostic accuracy of a Euroimmun SARS-CoV-2 IgG and IgA immunoassay for COVID-19. METHODS: In this unmatched (1:2) case-control validation study, we used sera of 181 laboratory-confirmed SARS-CoV-2 cases and 326 controls collected before SARS-CoV-2 emergence. Diagnostic accuracy of the immunoassay was assessed against a whole spike protein-based recombinant immunofluorescence assay (rIFA) by receiver operating characteristic (ROC) analyses. Discrepant cases between ELISA and rIFA were further tested by pseudo-neutralization assay. RESULTS: COVID-19 patients were more likely to be male and older than controls, and 50.3% were hospitalized. ROC curve analyses indicated that IgG and IgA had high diagnostic accuracies with AUCs of 0.990 (95% Confidence Interval [95%CI]: 0.983-0.996) and 0.978 (95%CI: 0.967-0.989), respectively. IgG assays outperformed IgA assays (p=0.01). Taking an assessed 15% inter-assay imprecision into account, an optimized IgG ratio cut-off > 2.5 displayed a 100% specificity (95%CI: 99-100) and a 100% positive predictive value (95%CI: 96-100). A 0.8 cut-off displayed a 94% sensitivity (95%CI: 88-97) and a 97% negative predictive value (95%CI: 95-99). Substituting the upper threshold for the manufacturer's, improved assay performance, leaving 8.9% of IgG ratios indeterminate between 0.8-2.5. CONCLUSIONS: The Euroimmun assay displays a nearly optimal diagnostic accuracy using IgG against SARS-CoV-2 in patient samples, with no obvious gains from IgA serology. The optimized cut-offs are fit for rule-in and rule-out purposes, allowing determination of whether individuals in our study population have been exposed to SARS-CoV-2 or not. IgG serology should however not be considered as a surrogate of protection at this stage.


Designing of improved drugs for COVID-19: Crystal structure of SARS-CoV-2 main protease Mpro


title: YouTube as a source of medical information on the novel coronavirus 2019 disease (COVID-19) pandemic

text: Media coverage on coronavirus disease 2019 (COVID-19) has been extensive, yet large gaps remain in our understanding of the role of social media platforms during worldwide health crisis. The purpose of this study was to assess the most viewed YouTube videos on COVID-19 for medical content. We coded video characteristics, source, and medical content of the 113 most-widely viewed videos about COVID-19. Seventy-nine (69.9%) videos were classified as useful, and 10 (8.8%) videos were classified as misleading. Independent users were more likely to post misleading videos than useful videos (60.0% vs 21.5%, P = 0.009). News agencies were more likely to post useful videos than misleading videos (72.2% vs 40.0%, P = 0.039). Useful videos were more likely to present any information on prevalence or incidence (79.7% vs 20.0%, P < 0.001), as well as information on outcomes or prognosis (84.8% vs 30.0%, P < 0.001) compared to misleading videos. The World Health Organization contributed one useful video (1.3%), while no videos from the Center for Disease Control were included. Although YouTube generally is a useful source of medical information on the COVID-19 pandemic, increased efforts to disseminate accurate information from reputable sources is desired to help mitigate disease spread and decrease unnecessary panic in the general population.


title: An Ensemble Approach to Predicting the Impact of Vaccination on Rotavirus Disease in Niger

text: Recently developed vaccines provide a new way of controlling rotavirus in sub-Saharan Africa. Models for the transmission dynamics of rotavirus are critical both for estimating current burden from imperfect surveillance and for assessing potential effects of vaccine intervention strategies. We examine rotavirus infection in the Maradi area in southern Niger using hospital surveillance data provided by Epicentre collected over two years. Additionally, a cluster survey of households in the region allows us to estimate the proportion of children with diarrhea who consulted at a health structure. Model fit and future projections are necessarily particular to a given model; thus, where there are competing models for the underlying epidemiology an ensemble approach can account for that uncertainty. We compare our results across several variants of Susceptible-Infectious-Recovered (SIR) compartmental models to quantify the impact of modeling assumptions on our estimates. Model-specific parameters are estimated by Bayesian inference using Markov chain Monte Carlo. We then use Bayesian model averaging to generate ensemble estimates of the current dynamics, including estimates of $R_0$, the burden of infection in the region, as well as the impact of vaccination on both the short-term dynamics and the long-term reduction of rotavirus incidence under varying levels of coverage. The ensemble of models predicts that the current burden of severe rotavirus disease is 2.9 to 4.1% of the population each year and that a 2-dose vaccine schedule achieving 70% coverage could reduce burden by 37-43%.


title: Community Transmission of SARS-CoV-2 at Two Family Gatherings - Chicago, Illinois, February-March 2020

text: SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), has spread rapidly around the world since it was first recognized in late 2019. Most early reports of person-to-person SARS-CoV-2 transmission have been among household contacts, where the secondary attack rate has been estimated to exceed 10% (1), in health care facilities (2), and in congregate settings (3). However, widespread community transmission, as is currently being observed in the United States, requires more expansive transmission events between nonhousehold contacts. In February and March 2020, the Chicago Department of Public Health (CDPH) investigated a large, multifamily cluster of COVID-19. Patients with confirmed COVID-19 and their close contacts were interviewed to better understand nonhousehold, community transmission of SARS-CoV-2. This report describes the cluster of 16 cases of confirmed or probable COVID-19, including three deaths, likely resulting from transmission of SARS-CoV-2 at two family gatherings (a funeral and a birthday party). These data support current CDC social distancing recommendations intended to reduce SARS-CoV-2 transmission. U.S residents should follow stay-at-home orders when required by state or local authorities.


title: Essential Oils as Antiviral Agents. Potential of Essential Oils to Treat SARS-CoV-2 Infection: An In-Silico Investigation

text: Essential oils have shown promise as antiviral agents against several pathogenic viruses. In this work we hypothesized that essential oil components may interact with key protein targets of the 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A molecular docking analysis was carried out using 171 essential oil components with SARS-CoV-2 main protease (SARS-CoV-2 Mpro), SARS-CoV-2 endoribonucleoase (SARS-CoV-2 Nsp15/NendoU), SARS-CoV-2 ADP-ribose-1â³-phosphatase (SARS-CoV-2 ADRP), SARS-CoV-2 RNA-dependent RNA polymerase (SARS-CoV-2 RdRp), the binding domain of the SARS-CoV-2 spike protein (SARS-CoV-2 rS), and human angiotensin-converting enzyme (hACE2). The compound with the best normalized docking score to SARS-CoV-2 Mpro was the sesquiterpene hydrocarbon (E)-ß-farnesene. The best docking ligands for SARS-CoV Nsp15/NendoU were (E,E)-α-farnesene, (E)-ß-farnesene, and (E,E)-farnesol. (E,E)-Farnesol showed the most exothermic docking to SARS-CoV-2 ADRP. Unfortunately, the docking energies of (E,E)-α-farnesene, (E)-ß-farnesene, and (E,E)-farnesol with SARS-CoV-2 targets were relatively weak compared to docking energies with other proteins and are, therefore, unlikely to interact with the virus targets. However, essential oil components may act synergistically, essential oils may potentiate other antiviral agents, or they may provide some relief of COVID-19 symptoms.


Does Ibuprofen Worsen COVID-19?


Estimating Coronavirus Disease 2019 Infection Risk in Health Care Workers


The explosion in scabies cases during COVID-19 pandemic


Searching for the bright spots in a time of crisis


[Myocardial injury in patients with COVID-19 pneumonia]


Myocardial injury in patients with COVID-19 pneumonia


Changes in the clinical practice of ophthalmology during the coronavirus disease 2019 (COVID-19) outbreak: an experience from Daegu, Korea


title: Diferencias en función de la edad y la autopercepción del envejecimiento en ansiedad, tristeza, soledad y sintomatología comórbida ansioso-depresiva durante el confinamiento por la COVID-19./ [Differences in anxiety, sadness, loneliness and comorbid anxiety and sadness as a function of age and self-perceptions of aging during the lock-out period due to COVID-19]

text: OBJECTIVES: To analyze differences by age group in anxiety, depression, loneliness and comorbid anxiety and depression in young people, middle aged adults and older adults during the lock-down period at home due to the COVID-19 pandemic, and to explore the association between negative self-perceptions of aging and psychological symptoms controlling by age group. METHOD: Participants are 1501 people (age range 18 to 88 years). Anxiety, sadness, loneliness and self-perceptions of aging were assessed. The sample was divided according to the age group and quartiles (lower, intermediate levels, and higher) of anxiety, sadness, loneliness and self-perceptions of aging. RESULTS: Older adults reported lower levels of anxiety and sadness than middle aged adults, and middle aged adults reported lower levels than younger participants. Middle aged adults reported the lowest loneliness, followed by older adults and younger participants. For each age group, those with more negative self-perceptions of aging reported higher anxiety, sadness and loneliness. More comorbid anxiety and sadness was found in younger adults and less in older adults; more depressed participants in the middle aged group, and more older adults and less younger participants were found in the group with the lowest levels of anxiety and sadness. For all the age groups, participants with high levels of comorbid anxiety and sadness are those who report the highest scores in negative self-perceptions of aging. CONCLUSIONS: Older adults reported lower psychological anxiety, sadness and loneliness than the other age groups. Having negative self-perceptions of aging damage psychological health irrespective of the chronological age.


title: Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians

text: Deaths due to COVID-19 are associated with risk factors which can lead to prolonged grief disorder, post-traumatic stress, and other poor bereavement outcomes among relatives, as well as moral injury and distress in frontline staff. Here we review relevant research evidence and provide evidence-based recommendations and resources for hospital clinicians to mitigate poor bereavement outcomes and support staff. For relatives, bereavement risk factors include dying in an intensive care unit, severe breathlessness, patient isolation or restricted access, significant patient and family emotional distress, and disruption to relatives' social support networks. Recommendations include advance care planning; proactive, sensitive, and regular communication with family members alongside accurate information provision; enabling family members to say goodbye in person where possible; supporting virtual communication; providing excellent symptom management and emotional and spiritual support; and providing and/or sign-posting to bereavement services. To mitigate effects of this emotionally challenging work on staff, we recommend an organizational and systemic approach which includes access to informal and professional support.


title: Infection control of operating room and anesthesia for cesarean section during pandemic Coronavirus disease-19 (COVID-19) outbreak in Daegu, the republic of Korea - 8 cases report

text: Background: Since the Coronavirus diseases-19 (COVID-19) was reported in Wuhan, China, Korea has also been exposed to the virus. In Korea, COVID-19 screening guidelines have been established in each hospital, trying to prevent the spread of infection. A case of successful Cesarean section from confirmed mother has been reported, but there are no guidelines for suspected mothers. Cesarean section can be operated urgently without sufficient evaluations of the infection. Case: Our hospital, located in Daegu, Korea, was designated as quarantine and delivery facility for suspected mother, and Cesarean section was done to seven suspected mothers and one confirmed mother. Conclusions: This case report suggests the guideline for infection control of surgery and anesthesia in emergent cesarean section of COVID-19 suspected mother by preparing operating room and protection strategy.


Enfermedad COVID-19: el hospital del futuro ya está aquí./ Enfermedad COVID-19: el hospital del futuro ya está aquí./ COVID-19 disease: the hospital of the future is already here


title: Mental Health Care Providers Dealing With Coronavirus Disease 2019 (COVID-19): What Is the Definition of a Case, How Is That Changing, and What Kinds of Tests Are Available?

text: The goal of this column is to inform mental health care professionals about the evolving way the diagnosis of Coronavirus Disease 2019 (COVID-19) is being made, with emphasis on tests to assist in making the diagnosis and to determine the presence of antibodies to the virus. This column also provides some general information about the disease, its relative risks, and efforts to develop effective treatments. Links to credible websites that are being continuously updated are also provided for readers who want more information and to stay current with ongoing developments.


SARS-CoV-2 downregulation of ACE2 and pleiotropic effects of ACEIs/ARBs


title: Structural basis for inhibition of the RNA-dependent RNA polymerase from SARS-CoV-2 by remdesivir

text: The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global crisis. Replication of SARS-CoV-2 requires the viral RNA-dependent RNA polymerase (RdRp) enzyme, a target of the antiviral drug remdesivir. Here we report the cryo-electron microscopy structure of the SARS-CoV-2 RdRp, both in the apo form at 2.8-angstrom resolution and in complex with a 50-base template-primer RNA and remdesivir at 2.5-angstrom resolution. The complex structure reveals that the partial double-stranded RNA template is inserted into the central channel of the RdRp, where remdesivir is covalently incorporated into the primer strand at the first replicated base pair, and terminates chain elongation. Our structures provide insights into the mechanism of viral RNA replication and a rational template for drug design to combat the viral infection.


Are Surgeons in India prepared for COVID-19?


title: SARS-CoV-2 Transmission from Presymptomatic Meeting Attendee, Germany

text: During a meeting in Munich, Germany, a presymptomatic attendee with severe acute respiratory syndrome coronavirus 2 infected at least 11 of 13 other participants. Although 5 participants had no or mild symptoms, 6 had typical coronavirus disease, without dyspnea. Our findings suggest hand shaking and face-to-face contact as possible modes of transmission.


Alarm bells ring for patient data and privacy in the covid-19 goldrush


A participação da universidade na produção de testes diagnósticos moleculares do novo coronavírus no Brasil: resposta aos desafios sanitários./ A participação da universidade na produção de testes diagnósticos moleculares do novo coronavírus no Brasil: resposta aos desafios sanitários./ University participation in the production of molecular diagnostic tests for the novel coronavirus in Brazil: the response to health challenges


title: H2S as a potential defence against COVID-19? Immunological environment shifts during pregnancy may affect the risk of developing severe complications in COVID-19 patients

text: The outbreak of COVID-19 pneumonia caused by a new coronavirus (SARS-CoV-2) is posing a global health emergency and has led to more than 380,000 deaths worldwide The cell entry of SARS-CoV-2 depends on two host proteins angiotensin-converting enzyme 2 (ACE2) and TMPRSS2 There is currently no vaccine available and also no effective drug for the treatment of COVID-19 Hydrogen sulfide (H2S) as a novel gasotransmitter has been shown to protect against lung damage via its anti-inflammation, anti-oxidative stress, anti-viral, pro-survival, and anti-aging effects In light of the research advances on H2S signalling in biology and medicine, this review proposed H2S as a potential defence against COVID-19 It is suggested that H2S may block SARS-CoV-2 entry into host cells by interfering with ACE2 and TMPRSS2, inhibit SARS-CoV-2 replication by attenuating virus assembly/release, and protect SARS-CoV-2-induced lung damage by suppressing immune response and inflammation development Preclinical studies and clinical trials with slow-releasing H2S donor(s) or the activators of endogenous H2S-generating enzymes should be considered as a preventative treatment or therapy for COVID-19


Interleukin-6 receptor blockade with subcutaneous tocilizumab in severe COVID-19 pneumonia and hyperinflammation: a case-control study


title: Implementation of a Novel Remote Physician SBRT Coverage Process during the Coronavirus Pandemic

text: Introduction: During the COVID-19 pandemic, alternative methods of care are needed to reduce the relative risk of transmission in departments. Also needed is the ability to provide vital radiation oncological care if radiation oncologists (RO) are reallocated to other departments. We implemented a novel remote RO SBRT coverage practice, requiring it to be reliable, of high audio and visual quality, timely, and the same level of specialty care as our current in-person treatment coverage practice. Methods: All observed failure modes were recorded during implementation over the first 15 sequential fractions. The time from CBCT to treatment was calculated before and after implementation to determine timeliness of remote coverage. Image quality metrics were calculated between the imaging console screen and the RO's shared screen. Comfort levels with audio/visual communication as well as overall comfort in comparison to in-person RO coverage was evaluated using Likert scale surveys after treatment. Results: Remote RO SBRT coverage was successfully implemented in 14/15 fractions with 3 observed process failures that were all corrected before treatment. Average times of pre-treatment coverage before and after implementation were 8.74 and 8.51min, respectively. The cross correlation between the imaging console screen and RO's shared screen was r=0.96 and lag was 0.05s. The average value for all survey questions was above 4.5, approaching in-person RO coverage comfort levels. Conclusions: Our novel method of remote RO SBRT coverage permits reduced personnel and patient interactions surrounding RT procedures. This may help to reduce transmission of COVID-19 in our department and provides a means for SBRT coverage if ROs are reallocated to other areas of the hospital for COVID-19 support.


title: Plausible mechanisms of Niclosamide as an antiviral agent against COVID-19

text: Corona virus disease 2019 (COVID-19) pandemic caused 18 440 deaths world wide as of 25 March 2020 and posing a serious threat to public health. There is a need, therefore, for effective therapeutic strategies to cure this disease. However, high attrition rates, substantial costs and slow pace are the major limitations of novel drug discovery. Drug repurposing, by employing 'old' drugs to treat 'new' diseases is an attractive approach in drug discovery. Niclosamide (NIC) is an approved anti-helminthic drug with diverse antiviral mechanisms. In this work we hypothesize, the potential antiviral mechanisms of NIC against COVID-19.