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159,300 | SARS-CoV-2 viral spike G614 mutation exhibits higher case fatality rate | AIM: The COVID-19 pandemic is caused by infection with the SARS-CoV-2 virus. The major mutation detected to date in the SARS-CoV-2 viral envelope spike protein, which is responsible for virus attachment to the host and is also the main target for host antibodies, is a mutation of an aspartate (D) at position 614 found frequently in Chinese strains to a glycine (G). We sought to infer health impact of this mutation. RESULT: Increased case fatality rate correlated strongly with the proportion of viruses bearing G614 on a country by country basis. The amino acid at position 614 occurs at an internal protein interface of the viral spike, and the presence of G at this position was calculated to destabilise a specific conformation of the viral spike, within which the key host receptor binding site is more accessible. CONCLUSION: These results imply that G614 is a more pathogenic strain of SARS-CoV-2, which may influence vaccine design. The prevalence of this form of the virus should also be included in epidemiologic models predicting the COVID-19 health burden and fatality over time in specific regions. Physicians should be aware of this characteristic of the virus to anticipate the clinical course of infection. |
159,301 | A Sever case of of SARS-CoV-2 infection in Gansu | An outbreak infection with the novel coronavirus (SARS-CoV-2) has developed in Wuhan since December 2019.This paper describes the first critical case in Gansu China. |
159,302 | A Case Report of Polymerase Chain Reaction-Confirmed COVID-19 in a Patient With Right Ventricular Thrombus and Bilateral Deep Vein Thrombosis | The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes the highly contagious coronavirus disease 2019 (COVID-19) has led to an unprecedented global health crisis Infected patients have been shown to trigger a heightened inflammatory response, increasing thrombotic risk We report the case of a polymerase chain reaction (PCR)confirmed COVID-19 in a Hispanic male with no past medical history who presented to the ED with upper respiratory tract symptoms including shortness of breath and cough, requiring continuous positive airway pressure (CPAP) therapy He was found to have a right ventricular thrombus (RVT) and bilateral deep vein thrombosis (DVT) on the day of admission, which were detected on transthoracic echocardiogram and duplex venous ultrasound, respectively The patient was started on therapeutic enoxaparin sodium, which led to an improvement in oxygenation, and he was eventually downgraded to the medical floors for further management |
159,303 | Managing The Impact of Covid-19 as regards the delivery of UK public services | Malin examines the impact of Covid-19 on public services in the UK which are already under pressure as a result of years of austerity 10 years of austerity has left public services in a fragile, vulnerable state, in addition to which, we are experiencing the weakest wage and productivity growth since the 19th century Starving the NHS of the resources it needed left it exposed on multiple fronts, not least from insufficient recruitment of doctors, nurses and a shortage of beds for critically ill patients The Conservative Government declared its intention to borrow for public infrastructure projects to produce faster growth, higher tax receipts and a lower deficit Infrastructure investment announced in its March 2020 budget was intended to take government spending back to the pre-austerity era, and included immediate measures for the NHS and public services |
159,304 | The impact of the novel coronavirus on trauma and orthopaedics in the UK | At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic. |
159,305 | The impact of the novel coronavirus on trauma and orthopaedics in the UK | At first glance, the novel coronavirus pandemic and orthopaedic surgery appear separate entities. Orthopaedic surgeons are not generally considered front-line staff in terms of the treatment of the disease that the novel coronavirus causes compared with anaesthetic and medical colleagues. However, the impact that the novel coronavirus is likely to have on the musculoskeletal injury burden and the morbidity associated with chronic musculoskeletal disease is significant. This article summarises the strategies currently being developed for the remodelling of orthopaedic services in the UK and the emergency British Orthopaedic Association Standards for Trauma and Orthopaedic guidelines released on 24 March 2020 in managing urgent orthopaedic patients during the novel coronavirus pandemic. |
159,306 | Identifiability of structural networks of nonlinear electronic oscillators | The interplay between structure and function is critical in the understanding of complex systems, their dynamics and their behavior. We investigated the interplay between structural and functional networks by means of the differential identifiability framework, which here quantifies the ability of identifying a particular network structure based on (1) the observation of its functional network and (2) the comparison with a prior observation under different initial conditions. We carried out an experiment consisting of the construction of [Formula: see text] different structural networks composed of [Formula: see text] nonlinear electronic circuits and studied the regions where network structures are identifiable. Specifically, we analyzed how differential identifiability is related to the coupling strength between dynamical units (modifying the level of synchronization) and what are the consequences of increasing the amount of noise existing in the functional networks. We observed that differential identifiability reaches its highest value for low to intermediate coupling strengths. Furthermore, it is possible to increase the identifiability parameter by including a principal component analysis in the comparison of functional networks, being especially beneficial for scenarios where noise reaches intermediate levels. Finally, we showed that the regime of the parameter space where differential identifiability is the highest is highly overlapped with the region where structural and functional networks correlate the most. |
159,307 | The Brighton Collaboration standardized template for collection of key information for benefit-risk assessment of viral vector vaccines | Many of the vaccines under development for COVID-19 involve the use of viral vectors. The Brighton Collaboration Benefit-Risk Assessment of Vaccines by Technology (BRAVATO, formerly the Viral Vector Vaccine Safety Working Group, V3SWG) working group has prepared a standardized template to describe the key considerations for the benefit-risk assessment of viral vector vaccines. This will facilitate key stakeholders to anticipate potential safety issues and interpret or assess safety data. This would also help improve communication and public acceptance of licensed viral vector vaccines. |
159,308 | The effects of governmental and individual predictors on COVID-19 protective behaviors in China: a path analysis model | The outbreak of the COVID-19 pandemic has plunged the world into a crisis. To contain the crisis, it is essential to build full cooperation between the government and the public. However, it is unclear which governmental and individual factors are the determinants and how they interact on protective behaviors against COVID-19. To resolve this issue, this study built a multiple mediation model and found government emergency public information as detailed pandemic information and positive risk communication had more important impacts on protective behaviors than rumor refutation and supplies. Moreover, governmental factors could indirectly affect protective behaviors through individual factors such as perceived efficacy, positive emotions, and risk perception. These findings suggest that systematic intervention programs for governmental factors need to be integrated with individual factors to finally achieve effective prevention and control of the COVID-19 pandemic among the public. This article is protected by copyright. All rights reserved. |
159,309 | Corona Games: Masks, Social Distancing and Mechanism Design | Pandemic response is a complex affair. Most governments employ a set of quasi-standard measures to fight COVID-19 including wearing masks, social distancing, virus testing and contact tracing. We argue that some non-trivial factors behind the varying effectiveness of these measures are selfish decision-making and the differing national implementations of the response mechanism. In this paper, through simple games, we show the effect of individual incentives on the decisions made with respect to wearing masks and social distancing, and how these may result in a sub-optimal outcome. We also demonstrate the responsibility of national authorities in designing these games properly regarding the chosen policies and their influence on the preferred outcome. We promote a mechanism design approach: it is in the best interest of every government to carefully balance social good and response costs when implementing their respective pandemic response mechanism. |
159,310 | Pouch volume and pouch migration after Roux-en-Y gastric bypass: a comparison of gastroscopy and 3 D-CT volumetry: is there a "migration crisis"? | BACKGROUND: Roux-en-Y gastric bypass (RYGB) is the second most frequently performed bariatric procedure worldwide. While pouch migration is a common phenomenon after sleeve gastrectomy, it has hardly been documented after RYGB so far. OBJECTIVES: The aim of this study was to correlate the diagnostic performance of gastroscopy of the gastroesophageal junction with 3-dimensional computed tomography (CT) during postoperative care of patients revised due to weight regain after RYGB, with particular attention to intrathoracic pouch migration (ITM) and pouch volume. SETTING: University Hospital Setting, Austria. METHODS: Thirty RYGB patients that were revised owing to weight regain (median age 37.5 yr) before December 2017 were included in this prospective study. CT findings were correlated with gastroscopy regarding pouch size and ITM. Pouch distention was achieved with both oral contrast and effervescent granules. All patients had CT and gastroscopy on the same day. In addition, patients were evaluated for reflux disease based on clinical history. RESULTS: ITM was found in 20 of 30 (66.7%) patients in CT, whereas gastroscopy did not correctly identify any herniation. In 16 of 28 (57.1%) patients pouch measurements at gastroscopy and CT showed a difference <40%. In 2 patients, pouch distention was not sufficient for CT volumetry. The intraclass correlation coefficient proved to be .594. Symptomatic reflux was present in 10 of 30 (33.3%) patients, 5 of whom had ITM. CONCLUSION: ITM is an underreported finding after revised RYGB and missed in gastroscopy. In terms of pouch volume, 3-dimensional-CT volumetry demonstrated only moderate agreement with gastroscopy. |
159,311 | Exponential-growth prediction bias and compliance with safety measures related to COVID-19 | OBJECTIVE: We define prediction bias as the systematic error arising from an incorrect prediction of the number of positive COVID cases x-weeks hence when presented with y-weeks of prior, actual data on the same. Our objective is to investigate the importance of an exponential-growth prediction bias (EGPB) in understanding why the COVID-19 outbreak has exploded. To that end, our goal is to document EGPB in the comprehension of disease data, study how it evolves as the epidemic progresses, and connect it with compliance of personal safety guidelines such as the use of face coverings and social distancing. We also investigate whether a behavioral nudge, cost less to implement, can significantly reduce EGPB. RATIONALE: The scientific basis for our inquiry is the received wisdom that infectious disease spread, especially in the initial stages, follows an exponential function meaning few positive cases can explode into a widespread pandemic if the disease is sufficiently transmittable. If people suffer from EGPB, they will likely make incorrect judgments about their infection risk, which in turn, may lead to reduced compliance of safety protocols. METHOD: To collect data on prediction bias, we ran an incentivized, experiment on a global, online platform with participation from people in forty-three countries, each at different stages of progression of COVID-19. We also constructed several indices of compliance by surveying participants about their frequency of hand-washing and use of sanitizers and masks; their willingness to pay for masks; their view about the social appropriateness of others' behavior; and their like/dislike of government responses. The prediction data was used to construct several measures of EGPB. Our experimental design permits us to identify the root of under-prediction as EGPB arising from the general tendency to underestimate the speed at which exponential processes unfold. RESULTS: Respondents make predictions about the path of the disease using a model that is substantially less convex than the actual data generating process. This creates significant EGPB, which, in turn, is significantly and negatively associated with non-compliance with safety measures. The bias is significantly higher for respondents from countries at a later stage relative to those at an early stage of disease progression. A simple behavioral nudge that shows prior data in terms of raw numbers, as opposed to a graph, causally reduces EGPB. CONCLUSION: Behavioral biases concerning the comprehension of disease data are quantitatively important, and act as severe impediments to effective policy action against the spread of COVID-19. Clear communication of future infection risk via raw numbers could increase the accuracy of risk perception, in turn, facilitating compliance with suggested protective behaviors. |
159,312 | αlphavbeta6 targeted molecular PET/CT imaging of lung post SARS-CoV-2 infection | The true impact and long-term damage to organs such as the lungs following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection remain to be determined Non-invasive molecularly targeted imaging may play a critical role to aid in the visualization and understanding of the systemic damage We have identified αvβ6 as molecular target;an epithelium-specific cell surface receptor that is low/undetectable in healthy adult epithelium but up-regulated in select injured tissues, including fibrotic lung Herein we report the first human positron emission tomography (PET)/computed tomography (CT) images using the integrin αvβ6 binding peptide ((18)F-αvβ6-BP) in a patient 2 months after the acute phase of infection Minimal uptake of (18)F-αvβ6-BP was noted in normal lung parenchyma, with elevated uptake in the lung corresponding to areas of opacities on CT This case suggests (18)F-αvβ6-BP PET/CT is a promising non-invasive approach to identify the presence and potentially monitor the persistence/ progression of lung damage |
159,313 | A natural food preservative peptide nisin can interact with the SARS-CoV-2 spike protein receptor human ACE2 | Nisin, a food-grade antimicrobial peptide produced by lactic acid bacteria has been examined for its probable interaction with the human ACE2 (hACE2) receptor, the site where spike protein of SARS-CoV-2 binds Among the eight nisin variants examined, nisin H, nisin Z, nisin U and nisin A showed a significant binding affinity towards hACE2, higher than that of the RBD (receptor binding domain) of the SARS-CoV-2 spike protein The molecular interaction of nisin with hACE2 was investigated by homology modeling and docking studies Further, binding efficiency of the most potent nisin H was evaluated through the interaction of hACE2:nisin H complex with RBD (receptor-binding domain) of SARS-CoV-2 and that of hACE2:RBD complex with nisin H Here, nisin H acted as a potential competitor of RBD to access the hACE2 receptor The study unravels for the first time that a globally used food preservative, nisin has the potential to bind to hACE2 |
159,314 | Identification and characterization of Jingmen tick virus in rodents from Xinjiang, China | Jingmen tick virus (JMTV) is a recently identified virus which provides an unexpected connection between segmented and unsegmented RNA viruses. Recent investigations reveal that JMTV including JMTV-like virus (Alongshan virus) could be associated with human disease, suggesting the significance of JMTV in public health. To better understand the genetic diversity and host range of JMTV, a total of 164 rodents representing 8 species were collected in Qapqal Xibe county of Xinjiang Uygur Autonomous Region, China, and were screened for JMTVs using RT- PCR. Consequently, JMTV was identified in 42 rodents including 23 Microtus arvalis voles (24.5%), 9 Apodemus uralensis mice (29.0%), 5 Mus musculus mice, 1 Rhombomys opimus gerbil, 1 Meriones tamariscinus gerbil, 1 Meriones libycus gerbil, 1 Cricetulus migratorius hamster and 1 Microtus gregalis vole. Interestingly, nearly complete genome sequences were successfully recovered from 7 JMTV positive samples. Although the newly identified rodent JMTVs were closely related to those previously identified in ticks from China, based on the phylogenetic analysis of the S1, S2 and S3 segments, the newly identified rodent viruses clustered into two genetic groups. One group comprised of viruses only found in M. arvalis, while another group included viruses from A. uralensis, C. migratorius and M. gregalis. However, all rodent viruses clustered together in the S4 tree. Considering rodents live in close proximity to humans, more efforts are needed to investigate the role of rodents in the evolution and transmission of JMTV in nature. |
159,315 | A review on novel drug targets and future directions for COVID-19 treatment | Severe acute respiratory syndrome coronavirus-2 causes coronavirus disease-19 (COVID-19) that spreads quickly in the world Considering the impact of this pandemic, researchers have been racing to understand the peculiar nature of the virus and the pathogen-esis of the disease to uncover possible drug targets, effective therapeutic agents, and vaccines Accordingly, numerous drug targets are identified by scientists Among them, structural glycoproteins, virulence factors, host-specific receptors and enzymes, non-structure proteins, the Janus kinase/signal transducers and activators of transcription (JAK/ STAT) signaling pathway, and pro-inflammatory cytokines are discussed herein This review summarizes the promising drug targets for COVID-19, and highlights antiviral strategies which depend on molecular interactions between viral small molecules and host biologic machinery for repurposing the available clinical drugs In addition, it gives a strong rational basis for the ongoing discovery of new drugs and vaccines |
159,316 | Aesthetic presence: The role of the arts in the education of creative arts therapists in the classroom and online | Literature about the integral role of the arts in learning is widely available, but much less has been written about how the arts and aesthetics support education in the creative arts therapies, particularly in the online learning environment. This article introduces the concept of aesthetic presence within the Community of Inquiry pedagogical model in line with values espoused within a Universal Design for Learning framework. The authors contextualize this concept with examples of how attention to the use of aesthetic and multimedia strategies in the classroom and in the online learning environment may foster openness and connection, encourage flexibility, humor, critical thinking, and animate and facilitate conversations about emergent and emotionally difficult themes while increasing accessibility for different kinds of learners. |
159,317 | Does Accident Insurance Cover COVID-19? | Whether an insurer is obligated to pay the insured amount should be based on that injury by accident caused by unforeseen external events other than illness If tire insurer does not want to cover the accidental injury caused by the specific events or conditions, he should limit the scope of his insurance policy Thus, the disputes can be avoided without any further explanations |
159,318 | Teaching an Instrumental Analysis Laboratory Course without Instruments During the COVID-19 Pandemic | The COVID-19 pandemic presented numerous challenges for all levels of the education system In March 2020, virtually all colleges and universities in the United States moved all instruction to an online environment as a result of the pandemic While this posed challenges for all faculty, it posed a particular challenge for those faculty members who taught laboratory courses By their nature, laboratory courses are a hands-on experience for students, and shifting them to an online format will necessarily change what students will do during their laboratory experience In this reflection, the difficulties that were encountered in switching an Instrumental Analysis lab course to an online format will be discussed The ideas deployed to address these challenges included providing current students with data collected by students in previous years and assigning them simulations to allow them to collect their own data Some of the methods employed were more successful than others, but none of them were able to completely replicate the experience they would have received by actually being in the lab and conducting the analysis themselves In the process of attempting to teach Instrumental Analysis in an online environment, it has become obvious that the time that students typically perceive as downtime where they do not see anything happening is important to their understanding of the data they collect |
159,319 | Towards Accurate Genotype–Phenotype Correlations in the CYP2D6 Gene | Establishing accurate and large-scale genotype–phenotype correlations and predictions of individual response to pharmacological treatments are two of the holy grails of Personalized Medicine These tasks are challenging and require an integrated knowledge of the complex processes that regulate gene expression and, ultimately, protein functionality in vivo, the effects of mutations/polymorphisms and the different sources of interindividual phenotypic variability A remarkable example of our advances in these challenging tasks is the highly polymorphic CYP2D6 gene, which encodes a cytochrome P450 enzyme involved in the metabolization of many of the most marketed drugs (including SARS-Cov-2 therapies such as hydroxychloroquine) Since the introduction of simple activity scores (AS) over 10 years ago, its ability to establish genotype–phenotype correlations on the drug metabolizing capacity of this enzyme in human population has provided lessons that will help to improve this type of score for this, and likely many other human genes and proteins Multidisciplinary research emerges as the best approach to incorporate additional concepts to refine and improve such functional/activity scores for the CYP2D6 gene, as well as for many other human genes associated with simple and complex genetic diseases |
159,320 | Ocorrência e caracterização de genotipos de rotavírus a partir de material fecal de leitões com diarréia, provenientes de diversas propriedades de criação de suínos, localizadas no Estado de São Paulo/ Occurrence and characterization of rotavirus genotypes from fecal material of diarrheic piglets, from many swine-producing units in São Paulo State, Brazil | Um total de 144 amostras fecais colhidas de leitões com diarréia provenientes de diversas granjas distribuídas por 10 municípios do Estado de São Paulo, Brasil, foram examinadas para a presença de rotavírus através de eletroforese em gel de poliacrilamida e ELISA, num esquema de triagem em paralelo. Destas, 24 e 39 amostras foram, respectivamente, positivas por estes testes e a caracterização dos genotipos P e G foi realizada em 43 amostras por nested RT-PCR, usando diferentes conjuntos de primers. Utilizando-se primers animais, o genotipo P[6] foi o mais freqüente, detectado em 25,58% das amostras, seguido pelo P[1] (11,62%) e P[7] (9,3%). Infecção concomitante de genotipos P[6]+P[7] (9,3%), P[1]+P[6] (4,65%), P[1]+P[6]+P[7] (2,32%) foi também observada. O genotipo G[5] foi o mais freqüente, detectado em 30,23% das amostras, seguido pelo G[10] (20,93%) e G[6] (4,65%). Infecção concomitante de genotipos G[5]+G[10] (18,6%) foi também observada. Utilizando-se primers humanos, somente o genotipo P[6] (65,11%) foi encontrado. Foram detectados os genotipos G[4] (27,9%), G[3] (13,95%) nas amostras, e as infecções concomitantes G[3]+G[4] (9,3%), G[2]+G[3]+G[4] (4,65%) e G[2]+G[3] (2,32%). A combinação mais freqüente foi G[5]P[6] e G[4]P[6], porém foram encontradas também infecções mistas, genotipos atípicos e reassortants. O seqüenciamento do gene a partir dos produtos de nested PCR dos genotipos animais P e G mostrou diversidade de nucleotídeos e aminoácidos dentro de um mesmo genotipo. As árvores filogenéticas utilizando o critério de maxima parcimônia e o algoritmo branch-and-bound, tiveram topologias nas quais as seqüências de nucleotídeos geradas neste trabalho concordam com as outras descritas anteriormente e pertencentes a um mesmo genotipo, suportadas por índices aceitáveis de "bootstrap". Os resultados deste estudo, além de contribuir para um melhor entendimento da epidemiologia dos rotavírus suínos, é relevante ao mostrar que além de haver uma diversidade de genotipos circulantes no campo, há também dentro dos mesmos genotipos, e isto deve ser considerado ao se utilizar e desenvolver métodos de diagnóstico, bem como ao se adotarem medidas preventivas específicas contra esta doença |
159,321 | Knowledge-based repositioning of the anti-HCV direct antiviral agent Sofosbuvir as SARS-CoV-2 treatment | The new human coronavirus named SARS-CoV-2 is a positive-sense RNA virus for which no specific drugs are currently available. A knowledge-based analysis strongly suggests a possible repositioning of the anti-HCV direct antiviral agent (DAA) Sofosbuvir as treatment for SARS-CoV-2. Indeed, the RNA-dependent RNA-polymerases (RdRp) of the two viruses show high sequence and structural homology, supporting the likelihood of binding the Sofosbuvir molecule with similar efficiency. Such a repositioning would allow the containment of the SARS-CoV-2 pandemic and limit the progression of disease to potentially deadly COVID19. |
159,322 | Decisions should be made case by case | [ ]expecting that there would be no let up to the curbs on daily life, the BVA issued a joint statement with the RCVS shortly before Easter in which it stated that it needed to ‘address animal health and welfare issues that may arise over this prolonged period [of lockdown], and the need to ensure the longer term viability of the veterinary sector to continue to provide care for animals’ Public health, including the safety of veterinary team members and clients, remains paramount 2 Flea and worm treatments should be dispensed in accordance with local disease risks and public health concerns, while procedures that require sedation or anaesthesia should only be carried out where there is either an immediate welfare justification or one that would emerge within the next two months ● |
159,323 | Critical reappraisal of remdesivir investigational trials in COVID-19 | During disease outbreaks, the pharmaceutical industry generally puts a lot of effort into promoting clinical trials studying their new drugs We review evidence of the ten most recent reports on remdesivir We conclude that it is far too premature to identify remdesivir as a curative or life-saving intervention during the COVID-19 pandemic |
159,324 | Outcome of COVID-19: A trend analysis | COVID-19 though originated in China traversed divergently both in magnitude and time line Outcome is an important indicator of its impact It is measured in terms of recovery and death rates out of closed cases affected by COVID virus The study attempts to analyze trends in the outcome of COVID-19 Six countries from Asia, Europe, and North America were selected for the analysis The study infers that the outcome trend out of closed cases of COVID-19 varied across countries The recovery rate is higher in Asian countries, while death rate is more in European and North American countries The panacea for overcoming COVID-19 lies in finding therapeutic solution © 2020 Medknow |
159,325 | Availability of Personal Protective Equipment in NHS Hospitals During COVID-19: A National Survey | OBJECTIVES: The continuous supply of personal protective equipment (PPE) in the National Health Service (NHS) is paramount to reduce transmission of COVID-19 to patients, public, and staff. METHODS: A 16-question survey was created to assess the availability and personal thoughts of healthcare professionals regarding PPE supply in England. The survey was distributed via social media (Facebook© and Twitter©) to UK COVID-19 healthcare professional groups, with responses collected over 3 weeks in March 2020 during the beginning of the pandemic. RESULTS: A total of 121 responses from physicians in 35 different hospitals were collected (105 inpatient wards, 16 from intensive care units). In inpatient wards, eye and face protection were unavailable to 19% (20/105). Fluid-resistant surgical masks were available to 97% (102/105) whereas filtering facepiece class 3 (FFP3) respirator for 53% (56/105) of respondents. Gloves were accessible for all respondents (100%). Body protection was available primarily as a plastic apron 84% (88/105). All of respondents working in intensive care had access to full-body PPE, except FFP3 respirators (available in 88%, 14/16). PPE is 'Always' available for 30% (36/121) of all respondents. There was a statistically significant difference between London and non-London respondents that 'Always' had PPE available (44 versus 19%, P = 0.003). CONCLUSIONS: Our survey demonstrated an overall lack of PPE volume supply in the UK hospitals during March 2020, demonstrating a lack of preparedness for a pandemic. PPE was more readily available in London which was the epicentre of the outbreak. Eye and full body protection are in most lack of supply. |
159,326 | Adaptation of a Traditional Irrigation System of Micro-Plots to Smart Agri Development: A Case Study in Murcia (Spain) | Currently, water users associations (WUAs) in semi-arid areas of southeastern Spain (Murcia region) send a multitude of data supplied by sensors in the field to the cloud The constant technological revolution offers opportunities for small farms not to be abandoned, thanks to the Internet of Things (IoT) This technology allows them to continue to manage remotely using smartphones/tablets/laptops This new system contributes to the mitigation of climate change from several aspects: reduction of water footprint and energy consumption (in the pumps that pressurize the grid, such as in the optimization of the proposed solution, by using batteries that communicate in low radiation of electric and magnetic alternating fields (LoRad), General Packet Radio Service (GPRS), or narrowband IoT (NB-IoT), or clean energy) The analysis of these data and the incorporation of new IoT technologies facilitate the maintenance of green roofs and ensure the continuity of these farms The direct benefit obtained is remarkable CO2 removal that prevents desertification by the abandonment of arable land This communication shows the implementation of a Smart Agri system in areas with micro-plots (surface less than 0 5 ha) with low-cost technology based on long-range (LoRa) systems, easily maintainable by personnel with basic knowledge of automation, which transforms into a very interesting solution for regions with development roads In addition, complex orography and difficult access are added in both physical and technological environments The main technical limitations found in such plots are poor coverage for mobile phones and unworkable and expensive implementation by wiring or WiFi/radio systems Currently, thanks to the Smart Agri system implemented in this WUA in Murcia, farmers can manage and control the irrigation systems in their plots from home Then, they cannot lose their crops and respect the isolation conditions imposed by the Spanish government as a result of the alarm caused by COVID-19 |
159,327 | Modelling spatial variations of coronavirus disease (COVID-19) in Africa | Clinical and epidemiological evidence has been advanced for human-to-human transmission of the novel coronavirus rampaging the world since late 2019. Outliers in the human-to-human transmission are yet to be explored. In this study, we examined the spatial density and leaned statistical credence to the global debate. We constructed spatial variations of clusters that examined the nexus between COVID-19 attributable deaths and confirmed cases. We rely on publicly available data on confirmed cases and death across Africa to unravel the unobserved factors, that could be responsible for the spread of COVID-19. We relied on the dynamic system generalised method of moment estimation procedure and found a ~0.045 Covid19 deaths as a result of confirmed cases in Africa. We accounted for cross-sectional dependence and found a basis for the strict orthogonal relationship. Policy measures were discussed. |
159,328 | ACE2 and SCARF expression in human dorsal root ganglion nociceptors: implications for SARS-CoV-2 virus neurological effects | SARS-CoV-2 has created a global crisis. COVID-19, the disease caused by the virus, is characterized by pneumonia, respiratory distress, and hypercoagulation and can be fatal. An early sign of infection is loss of smell, taste, and chemesthesis-loss of chemical sensation. Other neurological effects of the disease have been described, but not explained. It is now apparent that many of these neurological effects (for instance joint pain and headache) can persist for at least months after infection, suggesting a sensory neuronal involvement in persistent disease. We show that human dorsal root ganglion (DRG) neurons express the SARS-CoV-2 receptor, angiotensin-converting enzyme 2 at the RNA and protein level. We also demonstrate that SARS-CoV-2 and coronavirus-associated factors and receptors are broadly expressed in human DRG at the lumbar and thoracic level as assessed by bulk RNA sequencing. ACE2 mRNA is expressed by a subset of nociceptors that express MRGPRD mRNA, suggesting that SARS-CoV-2 may gain access to the nervous system through entry into neurons that form free nerve endings at the outermost layers of skin and luminal organs. Therefore, DRG sensory neurons are a potential target for SARS-CoV-2 invasion of the peripheral nervous system, and viral infection of human nociceptors may cause some of the persistent neurological effects seen in COVID-19. |
159,329 | Does agreement mean accuracy? Evaluating glance annotation in naturalistic driving data | Naturalistic driving studies often make use of cameras to monitor driver behavior. To analyze the resulting video images, human annotation is often adopted. These annotations then serve as the 'gold standard' to train and evaluate automated computer vision algorithms, even though it is uncertain how accurate human annotation is. In this study, we provide a first evaluation of glance direction annotation by comparing instructed, actual glance direction of truck drivers with annotated direction. Findings indicate that while for some locations high annotation accuracy is achieved, for most locations accuracy is well below 50%. Higher accuracy can be obtained by clustering these locations, but this also leads to reduced detail of the annotation, suggesting that decisions to use clustering should take into account the purpose of the annotation. The data also show that high agreement between annotators does not guarantee high accuracy. We argue that the accuracy of annotation needs to be verified experimentally more often. |
159,330 | Coronaviruses and Endocrine System: a Systematic Review on Evidences and Shadows | Coronaviruses are a big family of viruses that can infect mammalians and birds. In humans they mainly cause respiratory tract infections, with a large spectrum of severity, from mild, self-limited infections to highly lethal forms as severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and Coronavirus Disease 2019 (COVID-19). Scanty data are reported for the involvement of endocrine glands by human coronaviruses, in particular SARS-CoV-2. In this review we summarize endocrinological involvement by human coronaviruses, including data on animal coronaviruses. Avians, ferrets and bovine are affected by specific coronavirus syndromes, with variable involvement of endocrine glands. SARS-CoV and SARS-CoV-2 use angiotensin-converting enzyme 2 (ACE2) as target receptor, so ACE2 plays a central role for viral transmission and initial organ involvement. Autoptic studies on SARS patients revealed that thyroid, parathyroid, pituitary gland, endocrine pancreas and especially adrenals and testis can be impaired by different mechanisms (direct damage by SARS-CoV, inflammation, vascular derangement and autoimmune reactions) and few clinical studies have evidenced functional endocrine impairment. Only few data are available for COVID-19 and gonads and endocrine pancreas seem to be involved. International endocrinological societies have brought some recommendations for COVID-19 pandemic but further studies need to be performed, especially to detect long-term hormonal sequelae. |
159,331 | Diagnostic technologies for COVID-19: a review | Since the outbreak of COVID-19 in December 2019, the highly contagious SARS-CoV-2 virus has spread rapidly worldwide Although the governments across the world have adopted different preventative measures, the spread of the virus still cannot be effectively controlled, and the number of infections and deaths continues to grow Early diagnosis of COVID-19 is one of the key measures to control the spread of the pandemic and timely treatment of infected people This review summarizes current COVID-19 diagnostic techniques based on virology, serology, and imaging diagnostics and discusses their advantages and limitations with the aim of providing a reference for rapid and accurate diagnosis of COVID-19 © The Royal Society of Chemistry 2020 |
159,332 | COVID-19 vaccine research and development: ethical issues | The achievements of vaccine research and development bring a hope to our societies that we may cope with the COVID-19 pandemic. There are two aspects that should be maintained in balance: the immediate necessity for speed of vaccine research and the inherent need for protection of research subjects, which is the foremost concern of research ethics. This narrative review highlights ethical issues in COVID-19 vaccine research and development that every stakeholder needs to be aware of and to consider. |
159,333 | Identification of Antiviral Drug Candidates against SARS-CoV-2 from FDA-Approved Drugs | Drug repositioning is the only feasible option to immediately address the COVID-19 global challenge. We screened a panel of 48 FDA-approved drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which were preselected by an assay of SARS-CoV. We identified 24 potential antiviral drug candidates against SARS-CoV-2 infection. Some drug candidates showed very low 50% inhibitory concentrations (IC50s), and in particular, two FDA-approved drugs-niclosamide and ciclesonide-were notable in some respects. |
159,334 | Identification of Antiviral Drug Candidates against SARS-CoV-2 from FDA-Approved Drugs | Drug repositioning is the only feasible option to immediately address the COVID-19 global challenge. We screened a panel of 48 FDA-approved drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which were preselected by an assay of SARS-CoV. We identified 24 potential antiviral drug candidates against SARS-CoV-2 infection. Some drug candidates showed very low 50% inhibitory concentrations (IC50s), and in particular, two FDA-approved drugs-niclosamide and ciclesonide-were notable in some respects. |
159,335 | Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional./ Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional./ Critically ill COVID-19 patients attended by anesthesiologists in northwestern Spain: a multicenter prospective observational study | BACKGROUND AND OBJECTIVES: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak. METHODS: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. RESULTS: A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. CONCLUSIONS: A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%. |
159,336 | Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional./ Pacientes críticos COVID-19 atendidos por anestesiólogos en el Noroeste de España: estudio multicéntrico, prospectivo, observacional./ Critically ill COVID-19 patients attended by anesthesiologists in northwestern Spain: a multicenter prospective observational study | BACKGROUND AND OBJECTIVES: There are limited information on outcome, complications and treatments of critically ill COVID-19 patients requiring admission to an intensive care unit (ICU). The aim of this study is to describe the clinical ICU course, treatments used, complications and outcomes, of critically ill COVID-19 patients admitted in seven ICU in Galicia region during the 2020 March-April pandemic peak. METHODS: Between March 21 and April 19, 2020, we evaluated critically ill COVID-19 patients admitted to the ICU of Anesthesia of seven hospitals in Galicia, northwestern Spain. Outcome, complications, and treatments were monitored until May 6, 2020, the final date of follow-up. RESULTS: A total of 97 critically ill COVID-19 patients were included. During ICU stay, mechanical ventilation became necessary in 80 (82.5%) patients, and tracheostomy in 22 (22.7%) patients. Prone position was used frequently in both intubated (67.5%) and awake (27.8%) patients. Medications consisted of antivirals agents (92.7%), corticosteroids (93.8%), tocilizumab (57.7%), and intermediate or high doses of anticoagulants (83.5%). The most frequent complications were ICU-acquired infection (52.6%), thrombosis events (16.5%), and reintubation (9.3%). After a median follow-up of 42 (34-45) days, 15 patients (15.5%) deceased, 73 patients (75.2%) had been discharged from ICU, and nine patients (9.3%) were still in the ICU. CONCLUSIONS: A high proportion of our critically ill COVID-19 patients required mechanical ventilation, prone positioning, antiviral medication, corticosteroids, and anticoagulants. ICU complications were frequent, mainly infections and thrombotic events. We had a relatively low mortality of 15,5%. |
159,337 | An evaluation of additives for mitigating the risk of virus-contaminated feed using an ice-block challenge model | The role of animal feed as a vehicle for the transport and transmission of viral diseases was first identified during the porcine epidemic diarrhoea virus (PEDV) epidemic in North America. Since that time, various feed additives have been evaluated at the laboratory level to measure their effect on viral viability and infectivity in contaminated feed using bioassay piglet models. While a valid first step, the conditions of these studies were not representative of commercial swine production. Therefore, the purpose of this study was to evaluate the ability of feed additives to mitigate the risk of virus-contaminated feed using a model based on real-world conditions. This new model used an 'ice-block' challenge, containing equal concentrations of porcine reproductive and respiratory syndrome virus (PRRSV), Senecavirus A (SVA) and PEDV, larger populations of pigs, representative commercial facilities and environments, along with realistic volumes of complete feed supplemented with selected additives. Following supplementation, the ice block was manually dropped into designated feed bins and pigs consumed feed by natural feeding behaviour. After challenge, samples were collected at the pen level (feed troughs, oral fluids) and at the animal level (clinical signs, viral infection, growth rate, and mortality) across five independent experiments involving 15 additives. In 14 of the additives tested, pigs on supplemented diets had significantly greater average daily gain (ADG), significantly lower clinical signs and infection levels, and numerically lower mortality rates compared to non-supplemented controls. In conclusion, the majority of the additives evaluated mitigated the effects of PRRSV 174, PEDV and SVA in contaminated feed, resulting in improved health and performance. |
159,338 | Teledermatology in Times of COVID-19 Pandemic | Teledermatology is the need of every dermatologist in the time of COVID-19 pandemic Teledermatology will help to provide skin care to the patients in the time of pandemic and will also help to prevent the spread of COVID infection |
159,339 | Persisting alterations of iron homeostasis in COVID-19 are associated with non-resolving lung pathologies and poor patients' performance: a prospective observational cohort study | BACKGROUND: Severe coronavirus disease 2019 (COVID-19) is frequently associated with hyperinflammation and hyperferritinemia. The latter is related to increased mortality in COVID-19. Still, it is not clear if iron dysmetabolism is mechanistically linked to COVID-19 pathobiology. METHODS: We herein present data from the ongoing prospective, multicentre, observational CovILD cohort study (ClinicalTrials.gov number, NCT04416100), which systematically follows up patients after COVID-19. 109 participants were evaluated 60 days after onset of first COVID-19 symptoms including clinical examination, chest computed tomography and laboratory testing. RESULTS: We investigated subjects with mild to critical COVID-19, of which the majority received hospital treatment. 60 days after disease onset, 30% of subjects still presented with iron deficiency and 9% had anemia, mostly categorized as anemia of inflammation. Anemic patients had increased levels of inflammation markers such as interleukin-6 and C-reactive protein and survived a more severe course of COVID-19. Hyperferritinemia was still present in 38% of all individuals and was more frequent in subjects with preceding severe or critical COVID-19. Analysis of the mRNA expression of peripheral blood mononuclear cells demonstrated a correlation of increased ferritin and cytokine mRNA expression in these patients. Finally, persisting hyperferritinemia was significantly associated with severe lung pathologies in computed tomography scans and a decreased performance status as compared to patients without hyperferritinemia. DISCUSSION: Alterations of iron homeostasis can persist for at least two months after the onset of COVID-19 and are closely associated with non-resolving lung pathologies and impaired physical performance. Determination of serum iron parameters may thus be a easy to access measure to monitor the resolution of COVID-19. TRIAL REGISTRATION: ClinicalTrials.gov number: NCT04416100. |
159,340 | Technical feasibility of Magnetic Resonance Fingerprinting on a 1.5T MRI-Linac | Hybrid MRI-linac (MRL) systems enable daily multiparametric quantitative MRI to assess tumor response to radiotherapy. Magnetic Resonance Fingerprinting (MRF) may provide time efficient means of rapid multiparametric quantitative MRI. The accuracy of MRF, however, relies on adequate control over system imperfections, such as eddy currents and B1+, which are different and not as well established on MRL systems compared to diagnostic systems. In this study we investigate the technical feasibility of gradient spoiled 2D MRF on a 1.5T MRL. We show with phantom experiments that the MRL generates reliable MRF signals that are temporally stable during the day and have good agreement with spin-echo reference measurements. Subsequent in-vivo MRF scans in healthy volunteers and a patient with a colorectal liver metastasis showed good image quality, where the quantitative values of selected organs corresponded with the values reported in literature. Therefore we conclude that gradient spoiled 2D MRF is feasible on a 1.5T MRL with similar performance as on a diagnostic system. The precision and accuracy of the parametric maps are sufficient for further investigation of the clinical utility of MRF for online quantitatively MRI-guided radiotherapy. |
159,341 | Technical feasibility of magnetic resonance fingerprinting on a 1.5T MRI-linac | Hybrid MRI-linac (MRL) systems enable daily multiparametric quantitative MRI to assess tumor response to radiotherapy. Magnetic Resonance Fingerprinting (MRF) may provide time efficient means of rapid multiparametric quantitative MRI. The accuracy of MRF, however, relies on adequate control over system imperfections, such as eddy currents and $B_1^+$, which are different and not as well established on MRL systems compared to diagnostic systems. In this study we investigate the technical feasibility of gradient spoiled 2D MRF on a 1.5T MRL. We show with phantom experiments that the MRL generates reliable MRF signals that are temporally stable during the day and have good agreement with spin-echo reference measurements. Subsequent in-vivo MRF scans in healthy volunteers and a patient with a colorectal liver metastasis showed good image quality, where the quantitative values of selected organs corresponded with the values reported in literature. Therefore we conclude that gradient spoiled 2D MRF is feasible on a 1.5T MRL with similar performance as on a diagnostic system. The precision and accuracy of the parametric maps are sufficient for further investigation of the clinical utility of MRF for online quantitatively MRI-guided radiotherapy. |
159,342 | Otolaryngology Surgical Activity in Tertiary Care Center During the Covid-19 Lockdown | Corona virus disease (COVID 19) is an infectious respiratory disease caused by the novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). With many countries implementing lockdown the surgical activities in the division of otolaryngology across the world has been affected with many hospital confining themselves to only emergency or essential surgeries. The aim of this work is to report and discuss the in the surgical activity of the otolaryngology unit of the St John's National Academy of Health Sciences, Bangalore (India) during the pandemic. We performed acute and subacute emergencies which include diagnosis and treatment of malignant tumors of the head and neck, management of airway emergencies in adults and children, drainage of abscesses of the head and neck, Foreign body removal, emergency nasal debridement and surgeries for the unsafe ear. With the pandemic the surgical activities in otolaryngology changed drastically and with strict protocol and triaging put in place the risk for Health care workers was avoided and services to patients delivered. |
159,343 | Introduction to Health Law | In early February of 2020, attention was drawn to the increased number of deaths and the new cases of coronavirus infection. The epicentre of the outbreak was Wuhan in the People's Republic of China. In order to control the outbreak, Chinese leaders called on the city authorities in Wuhan to set up mass quarantine centres for infected people. The Chinese government took this step to protect the public against infectious disease. This is an example of the conflicts between public health and civil liberties/individual rights. Government authority is the pillar of the public health law. The government retains the power to achieve and maintain common good by restricting - within solid international and national limits - individual rights concerning autonomy, privacy, association, and liberty. Public health agencies have the right to collect, use, and disclose a considerable amount of personal health information and to enforce certain vaccinations, medical examinations, and treatments. In addition to the power to isolate individuals to protect the public against the spread of infectious disease, their powers can be used to control businesses and professions. There are several legal interventions to prevent injury and disease and promote the public's health. Among these tools are taxing policies, which encourage engaging in beneficial behaviour (fruit consumption) and disincentives to engage in high-risk activities (smoking). |
159,344 | Evaluation of two automated and three rapid lateral flow immunoassays for the detection of anti-SARS-CoV-2 antibodies | INTRODUCTION: Several SARS-CoV-2 immunoassays have been developed recently. The purpose of this study was to assess the performance of five immunoassays for the detection of SARS-CoV-2 antibodies. METHODS: Two quantitative automated immunoassays (Maglumi™2019-n-Cov IgG and IgM and Euroimmun Anti-SARS-CoV-2 IgG and IgA assays) and three lateral flow rapid tests were performed. This retrospective study included 200 residual sera from patients and healthy volunteers. Case serum samples (n = 128) were obtained from COVID-19 patients confirmed by RT-qPCR and CT-scan. Days since onset of symptoms was collected from their medical records. Control non-SARS-CoV-2 samples (n = 72) were obtained from anonymous stored residual serum samples. RESULTS: Maglumi™ IgG/IgM tests showed overall less sensitivity than Euroimmun IgG/IgA test (84.4 % versus 64.3 %). Both tests showed similar specificities of IgG at 99 % and 100 %, respectively. The results from the lateral flow assays were easily interpretable with unambiguous coloured reading bands. The overall sensitivity of the three tests was similar (around 70 %) without any significant differences. The sensitivity of the three lateral flow assays and also of the serological quantitative assays increased during the second week after symptom onset and all reached similar values (91 %-94 %) after 14 days. CONCLUSION: This study shows accurate and equivalent performance of the five serological antibody assays (ELISA, CLIA and three lateral flow tests) in detecting SARS-CoV-2 antibodies 14 days after the onset of COVID-19 symptoms. This is compatible with their application in specific clinical contexts and in determining epidemiological strategies for the COVID-19 pandemic. |
159,345 | [Four Case Reports of Coronavirus Disease 2019 (COVID-19) in Two Wuhan-resident Chinese and Two Cruise Ship Passengers Admitted to Our Hospital] | St Luke's International Hospital had been accepting a large number of patients with mild to severe COVID-19, before COVID-19 became a designated infectious disease on February 1, 2020 The first patient with COVID-19 admitted to our hospital was a man in his 40s from Wuhan, the second case of COVID-19 registered in Japan, and officially, the first case in a person of Chinese origin in Japan The third patient, a Canadian man in his 60s who contracted the infection in the cruise ship, Diamond Princess, had very severe disease However, his clinical symptoms improved and he was discharged from the hospital In this paper, we discuss four cases of COVID-19 |
159,346 | The role of anti-hypertensive treatment, comorbidities and early introduction of LMWH in the setting of COVID-19: A retrospective, observational study in Northern Italy | BACKGROUND: There is a great deal of debate about the role of cardiovascular comorbidities and the chronic use of antihypertensive agents (such as ACE-I and ARBs) on mortality on COVID-19 patients. Of note, ACE2 is responsible for the host cell entry of the virus. METHODS: We extracted data on 575 consecutive patients with laboratory-confirmed SARS-CoV-2 infection admitted to the Emergency Department (ED) of Humanitas Center, between February 21 and April 14, 2020. The aim of the study was to evaluate the role of chronic treatment with ACE-I or ARBs and other clinical predictors on in-hospital mortality in a cohort of COVID-19 patients. RESULTS: Multivariate analysis showed that a chronic intake of ACE-I was associated with a trend in reduction of mortality (OR: 0.53; 95% CI: 0.27-1.03; p = 0.06), differently from a chronic intake of ARB (OR: 1.1; 95% CI: 0.5-2.8; p=0.8). Increased age (ORs ranging from 3.4 to 25.2 and to 39.5 for 60-70, 70-80 and >80 years vs <60) and cardiovascular comorbidities (OR: 1.90; 95% CI: 1.1-3.3; p = 0.02) were confirmed as important risk factors for COVID-19 mortality. Timely treatment with low-molecular-weight heparin (LMWH) in ED was found to be protective (OR: 0.36; 95% CI: 0.21-0.62; p < 0.0001). CONCLUSIONS: This study can contribute to understand the reasons behind the high mortality rate of patients in Lombardy, a region which accounts for >50% of total Italian deaths. Based on our findings, we support that daily intake of antihypertensive medications in the setting of COVID-19 should not be discontinued and that a timely LMWH administration in ED has shown to decrease in-hospital mortality. |
159,347 | Health workers as hate crimes targets during coviD-19 outbreak in the Americas/ Trabajadores de la salud como objetivos de crímenes de odio durante el brote de COVID-19 en las Américas | ABSTRACT Many health workers in the Americas, especially women, have been victims of discrimination and different types of grievances during the COVID-19 pandemic. These brief reflections aim to make the problem visible, offer theoretical explanations and some recommendations. The pandemic constitutes a massive crisis that triggers fears and reassuring of diffuse anxieties, which often includes someone to blame. Healthcare workers have become circumstantial scapegoating targets. The inflicted attacks can be understood as reactive hate crimes since they are originated from an allegedly healthy person to an allegedly contaminated person. People seems to incur in a sanitary profiling process based on the health worker's uniform. However, these expressions of hatred are fueled by pre-pandemic circumstances such as the precariousness of health systems and deficient medical equipment, misogyny, or the pervasiveness of authoritarian tendencies. Understanding this situation as a human rights issue, it is suggested to consider measures in order to discourage these attacks, such as: guaranteeing the appropriate conditions of hospitals and the personal protective equipment of workers; development of recognition campaigns of the healthcare staff and the work they carry out (in particular female nurses); and implementing transitory regulations that sanction any hate crime type attack to health workers or the scientific community. Furthermore, educational advocacy efforts should reiterate basic hygiene measures for the people, but also focus on refuting false and pseudoscientific beliefs that contribute to the fear-induced construction of the health worker as a threat of contagion.(AU) |
159,348 | Health workers as hate crimes targets during coviD-19 outbreak in the Americas/ Trabajadores de la salud como objetivos de crímenes de odio durante el brote de COVID-19 en las Américas | ABSTRACT Many health workers in the Americas, especially women, have been victims of discrimination and different types of grievances during the COVID-19 pandemic. These brief reflections aim to make the problem visible, offer theoretical explanations and some recommendations. The pandemic constitutes a massive crisis that triggers fears and reassuring of diffuse anxieties, which often includes someone to blame. Healthcare workers have become circumstantial scapegoating targets. The inflicted attacks can be understood as reactive hate crimes since they are originated from an allegedly healthy person to an allegedly contaminated person. People seems to incur in a sanitary profiling process based on the health worker's uniform. However, these expressions of hatred are fueled by pre-pandemic circumstances such as the precariousness of health systems and deficient medical equipment, misogyny, or the pervasiveness of authoritarian tendencies. Understanding this situation as a human rights issue, it is suggested to consider measures in order to discourage these attacks, such as: guaranteeing the appropriate conditions of hospitals and the personal protective equipment of workers; development of recognition campaigns of the healthcare staff and the work they carry out (in particular female nurses); and implementing transitory regulations that sanction any hate crime type attack to health workers or the scientific community. Furthermore, educational advocacy efforts should reiterate basic hygiene measures for the people, but also focus on refuting false and pseudoscientific beliefs that contribute to the fear-induced construction of the health worker as a threat of contagion.(AU) |
159,349 | Optimising the assignment of swabs and reagent for PCR testing during a viral epidemic | Early large-scale swab testing is a fundamental tool for health authorities to assess the prevalence of a virus and enact appropriate mitigation measures during an epidemic. The COVID-19 pandemic has shown that the availability of chemical reagent required to carry out the tests is often a bottleneck in increasing a country's testing capacity. Further, demand is unevenly spread between more affected regions (which require more tests they can perform) and less affected ones (which have spare capacity). These issues hint at the opportunity of increasing test capacity via the optimal allocation of swabs and reagent to laboratories. We prove that this is the case, proposing an Integer Programming formulation to maximise the number of tests a country can perform and validating our approach on both real-life data from Italy and synthetic instances. Our results show that increased inter-regional collaboration and a steadier supply of reagent (i.e., coming from local production sites rather than international shipments) can dramatically increase testing capacity. Accordingly, we propose short-term and long-term recommendations for policy makers and health authorities. |
159,350 | Not-NUTs at W-NUT 2020 Task 2: A BERT-based System in Identifying Informative COVID-19 English Tweets | As of 2020 when the COVID-19 pandemic is full-blown on a global scale, people's need to have access to legitimate information regarding COVID-19 is more urgent than ever, especially via online media where the abundance of irrelevant information overshadows the more informative ones. In response to such, we proposed a model that, given an English tweet, automatically identifies whether that tweet bears informative content regarding COVID-19 or not. By ensembling different BERTweet model configurations, we have achieved competitive results that are only shy of those by top performing teams by roughly 1% in terms of F1 score on the informative class. In the post-competition period, we have also experimented with various other approaches that potentially boost generalization to a new dataset. |
159,351 | COVID-19 Emergency Sick Leave Has Helped Flatten The Curve In The United States | This paper tests whether the coronavirus disease 2019 (COVID-19) emergency sick leave provision of the bipartisan Families First Coronavirus Response Act (FFCRA) reduced the spread of the virus. Using a difference-in-differences strategy, we compare pre-post FFCRA changes in newly reported COVID-19 cases in states where workers gained the right to take paid sick leave (treatment group) to states where workers already had access to paid sick leave (control group). We adjust for differences in testing, day-of-the-week reporting, structural state differences, general virus dynamics, and policies such as stay-at-home orders (SHO). Compared to the control group and relative to the pre-FFCRA period, states that gained access to paid sick leave through FFCRA saw a statistically significant 400 fewer confirmed cases per day. This estimate translates into roughly 1 prevented COVID-19 case per day, per 1300 workers who newly gained the option to take up to two weeks of paid sick leave. [Editor's Note: This Fast Track Ahead Of Print article is the accepted version of the peer-reviewed manuscript. The final edited version will appear in an upcoming issue of Health Affairs.]. |
159,352 | Implementing malaria control in South Africa, Eswatini and southern Mozambique during the COVID-19 pandemic | The COVID-19 pandemic has strained healthcare delivery systems in a number of southern African countries Despite this, it is imperative that malaria control and elimination activities continue, especially to reduce as far as possible the number and rate of hospitalisations caused by malaria The implementation of enhanced malaria control/elimination activities in the context of COVID-19 requires measures to protect healthcare workers and the communities they serve The aim of this review is therefore to present innovative ideas for the timely implementation of malaria control without increasing the risk of COVID-19 to healthcare workers and communities Specific recommendations for parasite and vector surveillance, diagnosis, case management, mosquito vector control and community outreach and sensitisation are given |
159,353 | Colonization of the murine oropharynx by Streptococcus pyogenes is governed by the Rgg2/3 quorum sensing system | Streptococcus pyogenes is a human-restricted pathogen most often found in the human nasopharynx. Multiple bacterial factors are known to contribute to persistent colonization of this niche, and many are important in mucosal immunity and vaccine development. In this work, mice were infected intranasally with transcriptional regulator mutants of the Rgg2/3 quorum sensing (QS) system-a peptide-based signaling system conserved in sequenced isolates of S. pyogenes Deletion of the QS system's transcriptional activator (Δrgg2) dramatically diminished the percentage of colonized mice while deletion of the transcriptional repressor (Δrgg3) increased the percentage of colonized mice compared to wild type. Stimulation of the QS system using synthetic pheromones prior to inoculation did not significantly increase the percentage of animals colonized, indicating that QS-dependent colonization is responsive to the intrinsic conditions within the host upper respiratory tract. Bacterial RNA extracted directly from oropharyngeal swabs and evaluated by quantitative RT-PCR subsequently confirmed QS upregulation within one hour of inoculation. In the nasal-associated lymphoid tissue (NALT), a muted inflammatory response to the Δrgg2 bacteria suggests that their rapid elimination failed to elicit the previously characterized response to intranasal inoculation of GAS. This work identifies a new transcriptional regulatory system governing the ability of S. pyogenes to colonize the nasopharynx and provides knowledge that could help lead to decolonization therapeutics. |
159,354 | The effect of the 2019 novel coronavirus pandemic on college students in Wuhan | OBJECTIVE: This study explored a multiple mediation model in Wuhan's college students. Positive thinking and resilience were identified as mediators between 2019 novel coronavirus (2019-nCoV) victimization experiences and mental health. METHOD: The sample included 384 from 4 universities in Wuhan, China. Four structured instruments were applied to the college students, including scale of the 2019-nCoV coronavirus victimization experience, scale of the positive thinking, scale of the resilience, and scale of the mental health. The responses were scored using a 5-point Likert scale. Structural equation models were used to construct measurement and structural models. RESULTS: The findings confirmed that the 2019-nCoV victimization experience was a negative predictor of mental health; positive thinking and resilience were strong mediators between 2019-nCoV victimization experience and mental health. CONCLUSIONS: The results indicated that a complete model was significant because positive thinking compensated for resilience. Notably, these 2 strong mediators will vastly resist the negative influences of 2019-nCoV victimization experience on mental health in Wuhan's college students until the end of the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved). |
159,355 | The effect of the 2019 novel coronavirus pandemic on college students in Wuhan | OBJECTIVE: This study explored a multiple mediation model in Wuhan's college students. Positive thinking and resilience were identified as mediators between 2019 novel coronavirus (2019-nCoV) victimization experiences and mental health. METHOD: The sample included 384 from 4 universities in Wuhan, China. Four structured instruments were applied to the college students, including scale of the 2019-nCoV coronavirus victimization experience, scale of the positive thinking, scale of the resilience, and scale of the mental health. The responses were scored using a 5-point Likert scale. Structural equation models were used to construct measurement and structural models. RESULTS: The findings confirmed that the 2019-nCoV victimization experience was a negative predictor of mental health; positive thinking and resilience were strong mediators between 2019-nCoV victimization experience and mental health. CONCLUSIONS: The results indicated that a complete model was significant because positive thinking compensated for resilience. Notably, these 2 strong mediators will vastly resist the negative influences of 2019-nCoV victimization experience on mental health in Wuhan's college students until the end of the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved). |
159,356 | Consideraciones sobre el uso de antihipertensivos bloqueadores del sistema renina-angiotensina en adultos y niños ante la pandemia de COVID-19./ Considerations on the use of antihypertensive blockers of the renin-angiotensin system in adults and children in the face of the COVID-19 pandemic | As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with hypertension and other cardiovascular comorbidities develop more severe coronavirus disease (COVID)-19 and are at high risk of death, a controversy arose about the use of antihypertensives as angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs). Such drugs might increase the expression of the fundamental receptor of this new infectious agent: the angiotensin-converting enzyme 2 (ACE2). Preclinical observations indicate that the increase of ACE2 expression or the activity by ACEis and ARBs leads to a greater transformation of angiotensin (Ang)-II to Ang-(1-7), which is associated with positive effects on cardiovascular and pulmonary pathophysiology. This association has been demonstrated in observational studies in patients with cardiovascular pathology and pneumonia. It has not been possible to confirm whether users of ACEis or ARBs are more infected by the new coronavirus, due to methodological issues in studies with patients infected with SARS-CoV-2. However, the use of such antihypertensive treatments in both children and adults might reduce the virulence of infection. Therefore, changes in the antihypertensive therapy of patients at risk of contracting COVID-19 are not recommended. |
159,357 | Kawasaki disease fact check: Myths, misconceptions and mysteries | Kawasaki disease (KD) is an important cause of childhood vasculitis and a common cause of acquired heart disease in children world-wide. The emergence of Paediatric Multisystem Inflammatory Syndrome-Temporally Associated with SARS-CoV-2, a KD-like hyperinflammatory syndrome and the recent death of Dr Tomisaku Kawasaki make this a timely review. Although KD was described by Dr Kawasaki over 50 years ago, there is still no specific diagnostic test and the aetiology remains elusive. This article summarises the latest evidence, highlights important myths and misconceptions and discusses some of the mysteries that surround this disease. |
159,358 | Attaining the quadruple aim of worker well-being in the CovID-19 crisis: Competing ethical priorities | The COVID-19 pandemic presents ethical challenges to health care organizations and society as a whole regarding protection from a lethal communicable disease In traditional medical ethics, we make an appeal to the duty of the professional to serve in the face of personal peril At the same time, health care organizations are obligated to furnish protective equipment and provide a safe workplace in order to mitigate risk The ethical calculus of utility, or greatest good for the greatest number, supplies some guidance in situations of scarce resources by sustaining as large a presence of front line workers through prevention or therapeutic intervention to combat disease Determinations of utility do not absolve health care organizations of a duty to protect and avert future crises through better planning A misguided pursuit of efficiency has resulted in excessive burden of risk for health workers providing direct patient care and for workers in supporting roles There is an important duty to plan to lessen such risk in future pandemics |
159,359 | Investigating the role of environmental concern and the unified theory of acceptance and use of technology on working from home technologies adoption during COVID-19 | Working From Home (WFH) technologies has been used and discussed for a long time The many positive benefits of WFH technologies, including its potential to create a more sustainable work activity, attracted many studies to gain a better understanding of this subject This study is interested to understand the different factors, including environmental, influencing WFH technologies acceptance in this current shifting situation stimulated by the Covid-19 pandemic An extended Unified Theory of Acceptance and Use of Technology (UTAUT) model, employing Environmental Concern, was used The model was assessed by using the structural equation model The total of 172 respondents participated in this research The total of 5 hypotheses was tested The present study's model is able to predict 57 4% of WFH Technology acceptance Finally, discussion and recommendations to businesses that are currently taking WFH measures during the Covid-19 pandemic were presented |
159,360 | COVID-19 : les soignants sont-ils de véritables super-héros ? | Introduction Une grande partie des connaissances en cours concernant la COVID-19 est basée sur les données des patients hospitalisés Notre objectif est de décrire l’évolution au jour le jour de la COVID-19 dans les cas admissibles à une prise en charge ambulatoire Matériels et méthodes Cohorte prospective monocentrique de patients présentant une infection par le SARS-CoV-2 confirmée virologiquement et présentant des symptômes modérés, admissibles à une prise en charge ambulatoire, entre le 10 mars et le 2 avril 2020 Les symptômes quotidiens ont été recueillis au moyen d’un auto-questionnaire en ligne Nous avons considéré qu’un patient était guéri lorsqu’aucun des trois symptômes principaux (fièvre, dyspnée et douleur thoracique) n’était signalé après les derniers symptômes connus via l’application en ligne Résultats Un total de 186 patients ont été inclus (âge médian, 41 ans [intervalle interquartile, 19–78 ans] ;74,2 % de femmes), dont 132 (71 %) étaient des professionnels de santé Treize patients (7 %) souffraient d’hypertension artérielle (la comorbidité la plus courante) et le suivi médian après l’apparition des symptômes était de 14jours (min 4–max 24) Les professionnels de santé étaient significativement plus jeunes que les autres (âge médian de 40,3 ans contre 47,2 ans [p<0,005]), et 81,8 % étaient des femmes Quatre patients (2,2 %) ont été hospitalisés, dont un professionnel de santé Le délai médian de guérison était de 9jours après l’apparition des symptômes (IC95 % : 8–11) dans notre population globale et de 8jours (IC95 % : 8–9) et 13jours (IC95 % : 11–15) chez les professionnels de santé et les non-professionnels de santé (p<0,005), respectivement Après ajustement sur l’âge, le sexe, les comorbidités et le seuil de détection de la PCR SARS-CoV-2, le rapport de risque instantané pour l’absence de symptômes chez les professionnels de santé était de 1,76 par rapport aux non-professionnels de santé (IC95 % [1,16–2,67], p=0,037) Conclusion La grande majorité de cette cohorte de personnes atteintes d’une infection par la COVID-19 a guéri spontanément Les professionnels de santé souffrant de la COVID-19 ont eu des résultats favorables et ont eu un temps de récupération plus court que les non-professionnels de santé Des études supplémentaires sont nécessaires pour mieux comprendre ces différences |
159,361 | The Impact of the COVID-19 Pandemic on the Radiology Research Enterprise: Radiology Scientific Expert Panel | The current coronavirus disease 2019 (COVID-19) crisis continues to grow and has resulted in marked changes to clinical operations. In parallel with clinical preparedness, universities have shut down most scientific research activities. Radiology researchers are currently grappling with these challenges that will continue to affect current and future imaging research. The purpose of this article is to describe the collective experiences of a diverse international group of academic radiology research programs in managing their response to the COVID-19 pandemic. The acute response at six distinct institutions will be described first, exploring common themes, challenges, priorities, and practices. This will be followed by reflections about the future of radiology research in the wake of the COVID-19 pandemic. |
159,362 | It's F ing Chaos: COVID-19's Impact on Juvenile Delinquency and Juvenile Justice | An early examination of the impact of COVID-19 on juvenile delinquency and juvenile justice in America, this review provides initial scholarship to rapidly evolving areas of research Our appraisals of these topics are made after nearly 2 months of national COVID-19 mitigation measures, like social distancing and limited "non-essential" movement outside the home but also as states are gradually lifting stricter directives and reopening economic sectors We consider the impact of these pandemic-related changes on twenty-first century youths, their behaviors, and their separate justice system To forecast the immediate future, we draw from decades of research on juvenile delinquency and the justice system, as well as from reported patterns of reactions and responses to an unprecedented and ongoing situation As post-pandemic studies on juvenile delinquency and juvenile justice proliferate, we urge careful consideration as to how they might influence societal and the system responses to youths' delinquency Additional practical implications are discussed |
159,363 | It's F**ing Chaos: COVID-19's Impact on Juvenile Delinquency and Juvenile Justice | An early examination of the impact of COVID-19 on juvenile delinquency and juvenile justice in America, this review provides initial scholarship to rapidly evolving areas of research. Our appraisals of these topics are made after nearly 2 months of national COVID-19 mitigation measures, like social distancing and limited "non-essential" movement outside the home but also as states are gradually lifting stricter directives and reopening economic sectors. We consider the impact of these pandemic-related changes on twenty-first century youths, their behaviors, and their separate justice system. To forecast the immediate future, we draw from decades of research on juvenile delinquency and the justice system, as well as from reported patterns of reactions and responses to an unprecedented and ongoing situation. As post-pandemic studies on juvenile delinquency and juvenile justice proliferate, we urge careful consideration as to how they might influence societal and the system responses to youths' delinquency. Additional practical implications are discussed. |
159,364 | Risk factors associated with COVID-19 infection: a retrospective cohort study based on contacts tracing | This study aimed to estimate the attack rates, and identify the risk factors of COVID-19 infection. Based on a retrospective cohort study, we investigated 11,580 contacts of COVID-19 cases in Guangdong Province from 10 January to 15 March 2020. All contacts were tested by RT-PCR to detect their infection of SARS-COV-2. Attack rates by characteristics were calculated. Logistic regression was used to estimate the risk factors of infection for COVID-19. A total of 515 of 11,580 contacts were identified to be infected with SARS-COV-2. Compared to young adults aged 20-29 years, the infected risk was higher in children (RR: 2.59, 95%CI: 1.79-3.76), and old people aged 60-69 years (RR: 5.29, 95%CI: 3.76-7.46). Females also had higher infected risk (RR: 1.66, 95%CI: 1.39-2.00). People having close relationship with index cases encountered higher infected risk (RR for spouse: 20.68, 95%CI: 14.28-29.95; RR for non-spouse family members: 9.55, 95%CI: 6.73-13.55; RR for close relatives: 5.90, 95%CI: 4.06-8.59). Moreover, contacts exposed to index case in symptomatic period (RR: 2.15, 95%CI: 1.67-2.79), with critically severe symptoms (RR: 1.61, 95%CI: 1.00-2.57), with symptoms of dizzy (RR: 1.58, 95%CI: 1.08-2.30), myalgia (RR: 1.49, 95%CI: 1.15-1.94), and chill (RR: 1.42, 95%CI: 1.05-1.92) had higher infected risks. Children, old people, females, and family members are susceptible of COVID-19 infection, while index cases in the incubation period had lower contagiousness. Our findings will be helpful for developing targeted prevention and control strategies to combat the worldwide pandemic. |
159,365 | Understanding Knowledge and Behaviors Related to CoViD-19 Epidemic in Italian Undergraduate Students: The EPICO Study | Background: On February 2020, the novel coronavirus (2019-nCoV) epidemic began in Italy. In order to contain the spread of the virus, the Italian government adopted emergency measures nationwide, including closure of schools and universities, workplaces and subsequently lockdown. This survey was carried out among Italian undergraduates to explore their level of knowledge about the epidemic and the behaviors they adopted during the lockdown. Methods: An electronic questionnaire was administered to the students attending three Italian universities. Results: A good level of knowledge about the epidemic and its control was registered in the sample, mainly among students attending life sciences degree courses. The majority of the students did not modify their diet and smoking habits, while a great part of the sample reported a decrease in physical activity (PA). Conclusions: Students from life sciences courses showed a higher awareness regarding the infection and the control measures. The lockdown caused an important reduction of PA. Preventive interventions should transform the restrictive measures also as an opportunity to improve lifestyle. |
159,366 | Nursing's Response to the Executive Order to Advance American Kidney Health | The state of American kidney health is currently under the microscope. In the United States, approximately 20,000 persons advance to end-stage renal disease annually. Trends indicate accelerating increases in cost of care and a high mortality rate among patients with end-stage renal disease, with only 57% of patients surviving after 3 years. An executive order by the White House has placed the transformation of kidney care at the forefront of the country's health care agenda. The order focuses on key issues including improving outcomes, reducing treatment-related expenditures and increasing kidney donations. Mobilization of health care resources directed toward policymaking, workforce growth and development, and research will be critical to effectively achieve this executive order. Nursing's response, as the health care profession with the most members, will be crucial to achieving response implementation and success of the order. This article describes immediate and future actions including policy, leadership, clinical, educational, and research initiatives that the nursing profession should take to advance kidney health. It calls for specific actions by nursing and focuses on nursing organizations, nursing research, quality improvement initiatives, nursing innovation, advanced practice nursing, and the nephrology and transplant nursing workforce in order to improve kidney health nationally. The impact of the SARS-CoV-2 pandemic on kidney health and the implications for the profession of nursing are outlined. Although there are still many unknowns about the pandemic, nursing's voice is necessary to ensure the ongoing delivery of high-quality care. |
159,367 | COVID-19 and older people in Asia: Asian Working Group for Sarcopenia calls to actions | The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and the economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attention. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences. These considerations are particularly salient in the Asian context, with its diversity among countries in terms of sociocultural heritage, healthcare setup and availability of resources. Thus, the Asian Working Group for Sarcopenia summarized the considerations of Asian countries focusing on responses and difficulties in each country, impacts of health inequity related to the COVID-19 pandemic and proposed recommendations for older people, which are germane to the Asian context. More innovative services should be developed to address the increasing demands for new approaches to deliver healthcare in these difficult times and to establish resilient healthcare systems for older people. Geriatr Gerontol Int 2020; 9999: n/a-n/a. |
159,368 | COVID-19 and older people in Asia: Asian Working Group for Sarcopenia calls to actions | The coronavirus disease 2019 (COVID-19) pandemic has casted a huge impact on global public health and the economy. In this challenging situation, older people are vulnerable to the infection and the secondary effects of the pandemic and need special attention. To evaluate the impacts of COVID-19 on older people, it is important to balance the successful pandemic control and active management of secondary consequences. These considerations are particularly salient in the Asian context, with its diversity among countries in terms of sociocultural heritage, healthcare setup and availability of resources. Thus, the Asian Working Group for Sarcopenia summarized the considerations of Asian countries focusing on responses and difficulties in each country, impacts of health inequity related to the COVID-19 pandemic and proposed recommendations for older people, which are germane to the Asian context. More innovative services should be developed to address the increasing demands for new approaches to deliver healthcare in these difficult times and to establish resilient healthcare systems for older people. Geriatr Gerontol Int 2020; 9999: n/a-n/a. |
159,369 | Consejería: alternativa para elevar la autorresponsabilidad y autoeficacia ante la COVID-19 | WHO considers that counseling is the technique par excellence to face the problem of communicable diseases due to its great potential as a means of providing personal support and because of the possibilities it offers for behavior modification Other health problems can also benefit from the accumulated experiences in counseling This work aims at proposing a methodology for Counseling Services to people in epidemiological surveillance and patients of COVID -19 (English) [ABSTRACT FROM AUTHOR] La OMS advierte que la consejería es la técnica por excelencia para enfrentar la problemática de las enfermedades trasmisibles por su gran potencial como medio para proporcionar apoyo personal y por las posibilidades que ofrece para la modificación de comportamientos Otras problemáticas de salud pueden también beneficiarse de las experiencias acumuladas en materia de consejería Este trabajo tiene como objetivo proponer una metodología para la atención en los Servicios de Consejería a las personas en vigilancia epidemiológica y enfermas del COVID -19 (Spanish) [ABSTRACT FROM AUTHOR] Copyright of MediSur is the property of Centro Provincial de Informacion de Ciencias Medicas de Cinfuegos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts ) |
159,370 | Consejería: alternativa para elevar la autorresponsabilidad y autoeficacia ante la COVID-19/ Counseling: alternative to increase self-responsibility and self-efficacy before COVID-19 | RESUMEN La OMS advierte que la consejería es la técnica por excelencia para enfrentar la problemática de las enfermedades trasmisibles por su gran potencial como medio para proporcionar apoyo personal y por las posibilidades que ofrece para la modificación de comportamientos. Otras problemáticas de salud pueden también beneficiarse de las experiencias acumuladas en materia de consejería. Este trabajo tiene como objetivo proponer una metodología para la atención en los Servicios de Consejería a las personas en vigilancia epidemiológica y enfermas del COVID -19. |
159,371 | Migrant workers and COVID-19 | OBJECTIVES: Daily numbers of COVID-19 in Singapore from March to May 2020, the cause of a surge in cases in April and the national response were examined, and regulations on migrant worker accommodation studied. METHODS: Information was gathered from daily reports provided by the Ministry of Health, Singapore Statues online and a Ministerial statement given at a Parliament sitting on 4 May 2020. RESULTS: A marked escalation in the daily number of new COVID-19 cases was seen in early April 2020. The majority of cases occurred among an estimated 295 000 low-skilled migrant workers living in foreign worker dormitories. As of 6 May 2020, there were 17 758 confirmed COVID-19 cases among dormitory workers (88% of 20 198 nationally confirmed cases). One dormitory housing approximately 13 000 workers had 19.4% of residents infected. The national response included mobilising several government agencies and public volunteers. There was extensive testing of workers in dormitories, segregation of healthy and infected workers, and daily observation for fever and symptoms. Twenty-four dormitories were declared as 'isolation areas', with residents quarantined for 14 days. New housing, for example, vacant public housing flats, military camps, exhibition centres, floating hotels have been provided that will allow for appropriate social distancing. CONCLUSION: The COVID-19 pandemic has highlighted migrant workers as a vulnerable occupational group. Ideally, matters related to inadequate housing of vulnerable migrant workers need to be addressed before a pandemic. |
159,372 | The personality of U.S. states: Stability from 1999 to 2015 | Researchers have shown an interest in the aggregated Big Five personality of U.S. states, but typically they have relied on scores from a single sample (Rentfrow, Gosling, & Potter, 2008). We examine the replicability of U.S. state personality scores from two studies (Rentfrow et al., 2008; Rentfrow, Gosling, Jokela, & Stillwell, 2013) across a total of seven samples, two of them new. Same-trait correlations across samples are, on average, positive for all five traits, indicating score agreement. Additionally, three traits (Conscientiousness, Neuroticism, and Openness) show strongly consistent patterns of correlations with sociodemographic variables across samples. We find rank order stability in state personality scores for a 16-year period (1999-2015). |
159,373 | COVID-19 and the cancer care workforce: From doctors to ancillary staff | The COVID-19 pandemic poses daily challenges to the entire oncology workforce. Staff members must absorb multiple executive briefings, adapt to escalating scenario modelling, and seamlessly execute ever-changing operational modes in real-time. The unique threat of looming re-deployment and rationing care add to the uncertainty. We highlight the need for qualitative research to understand the psychosocial impact of these challenges. We posit that the perspective of all team members should be explored: from doctors to ancillary staff. |
159,374 | Modelling the second wave of COVID-19 infections in France and Italy via a Stochastic SEIR model | COVID-19 has forced quarantine measures in several countries across the world. These measures have proven to be effective in significantly reducing the prevalence of the virus. To date, no effective treatment or vaccine is available. In the effort of preserving both public health as well as the economical and social textures, France and Italy governments have partially released lockdown measures. Here we extrapolate the long-term behavior of the epidemics in both countries using a Susceptible-Exposed-Infected-Recovered (SEIR) model where parameters are stochastically perturbed to handle the uncertainty in the estimates of COVID-19 prevalence. Our results suggest that uncertainties in both parameters and initial conditions rapidly propagate in the model and can result in different outcomes of the epidemics leading or not to a second wave of infections. Using actual knowledge, asymptotic estimates of COVID-19 prevalence can fluctuate of order of ten millions units in both countries. |
159,375 | Effect of coronavirus disease 2019 on co 2emission in the world | In order to decrease spreading of Coronavirus disease 2019 (COVID-19) over the world, the activity of many industries has declined, several flights were cancelled and so many people staying home that made drop in fuel consumption in road transport. As industries, transport networks and businesses have closed down, it has brought a sudden drop in carbon emissions. Hence, in this paper, a simple estimation model is developed by using some excel features to assess the reduced CO 2emissions in March 2020. Then this indicator is calculated for 3 scenarios which are based on this disease situation worldwide and therefore based on different reduction percent of fossil fuels consumption in various sectors over year 2020. In scenario 1, it is assumed the number of infected people increasing but it is before peak region. In this zone, the measures to slow the rate of infection would be similar till end of year. In scenario 2, the infectious growth rate in the world reaches to peak region. Hence, the protective measures would be extended. As a result, industries activities and various kinds of transportations will be probably reduced much more in comparison with scenario 1. In scenario 3, it is assumed the growth rate begins to fall and it is after peak region. In this zone, the intervention and protective measures would be lessened toward scenario 1. So, industries activities and transportations will be likely increased in compare to other scenarios. The results show that CO 2emissions worldwide in March 2020 has been 7% lower than the monthly average of this parameter in 2019 as consequence of COVID-19. Moreover, carbon emission through 2020 has been estimated to be 34.4, 32.4 and 35.3 Gton based on scenarios 1, 2 and 3, respectively. It is worth to mention that based on these three scenarios, this indicator in 2020 will be approximately the same as 2011, 2008 and 2012. |
159,376 | Obstetric Anaemia in Africa in the Time of COVID-19: A Call to Action | Abstract As we face the COVID-19 pandemic, shortages of blood and components are a global concern Yet Africa has struggled to maintain a sustainable safe blood supply prior to the pandemic The impact of COVID-19 on an already fragile blood supply could result in devastating consequences for obstetric patients, adding to the burden of maternal mortality on the African continent Application of the principles of Patient Blood Management in the obstetric population has previously been recommended In the light of the COVD-19 pandemic, these cost effective and safe principles should be applied with urgency in Africa in an attempt to reduce maternal mortality in the wake of the pandemic |
159,377 | Maintaining Places of Social Inclusion: Ebola and the Emergency Department | We introduce the concept of places of social inclusion—institutions endowed by a society or a community with material resources, meaning, and values at geographic sites where citizens can access services for specific needs—as taken-for-granted, essential, and inherently precarious Based on our study of an emergency department that was disrupted by the threat of the Ebola virus in 2014, we develop a process model to explain how a place of social inclusion can be maintained by custodians We show how these custodians—in our fieldsite, doctors and nurses—experience and engage in institutional work to manage different levels of tension between the value of inclusion and the reality of finite resources, as well as tension between inclusion and the desire for safety We also demonstrate how the interplay of custodians’ emotions is integral to maintaining the place of social inclusion The primary contribution of our study is to shine light on places of social inclusion as important institutions in democratic society We also reveal the theoretical and practical importance of places as institutions, deepen understanding of custodians and custodianship as a form of institutional work, and offer new insight into the dynamic processes that connect emotions and institutional work © The Author(s) 2020 |
159,378 | Thoracic surgery during the coronavirus disease 2019 (COVID-19) pandemic in Madrid, Spain: single-centre report | OBJECTIVES: We reviewed the incidence of coronavirus disease 2019 cases and the postoperative outcomes of patients who had thoracic surgery during the beginning and at the highest point of transmission in our community. METHODS: We retrospectively reviewed patients who had undergone elective thoracic surgery from 12 February 2020 to 30 April 2020 and were symptomatic or tested positive for severe acute respiratory syndrome coronavirus 2 infection within 14 days after surgery, with a focus on their complications and potential deaths. RESULTS: Out of 101 surgical procedures, including 57 primary oncological resections, 6 lung transplants and 18 emergency procedures, only 5 cases of coronavirus disease 2019 were identified, 3 in the immediate postoperative period and 2 as outpatients. All 5 patients had cancer; the median age was 64 years. The main virus-related symptom was fever (80%), and the median onset of coronavirus disease 2019 was 3 days. Although 80% of the patients who had positive test results for severe acute respiratory syndrome coronavirus 2 required in-hospital care, none of them were considered severe or critical and none died. CONCLUSIONS: These results indicate that, in properly selected cases, with short preoperative in-hospital stays, strict isolation and infection control protocols, managed by a dedicated multidisciplinary team, a surgical procedure could be performed with a relatively low risk for the patient. |
159,379 | Detection of COVID-19 Using Heart Rate and Blood Pressure: Lessons Learned from Patients with ARDS | The world has been affected by COVID-19 coronavirus. At the time of this study, the number of infected people in the United States is the highest globally (7.9 million infections). Within the infected population, patients diagnosed with acute respiratory distress syndrome (ARDS) are in more life-threatening circumstances, resulting in severe respiratory system failure. Various studies have investigated the infections to COVID-19 and ARDS by monitoring laboratory metrics and symptoms. Unfortunately, these methods are merely limited to clinical settings, and symptom-based methods are shown to be ineffective. In contrast, vital signs (e.g., heart rate) have been utilized to early-detect different respiratory diseases in ubiquitous health monitoring. We posit that such biomarkers are informative in identifying ARDS patients infected with COVID-19. In this study, we investigate the behavior of COVID-19 on ARDS patients by utilizing simple vital signs. We analyze the long-term daily logs of blood pressure and heart rate associated with 70 ARDS patients admitted to five University of California academic health centers (containing 42506 samples for each vital sign) to distinguish subjects with COVID-19 positive and negative test results. In addition to the statistical analysis, we develop a deep neural network model to extract features from the longitudinal data. Using only the first eight days of the data, our deep learning model is able to achieve 78.79% accuracy to classify the vital signs of ARDS patients infected with COVID-19 versus other ARDS diagnosed patients. |
159,380 | DISPOSABLE COVID BOX – A new invention | Objective To introduce a new method to do safe bronchoscopy, a highly aerosol generating procedure through disposable COVID box in this difficult COVID time Methods We have introduced an unbelievably cheap and effective method "DISPOSABLE COVID BOX" We took an acrylic board 70 X 20 cm and attached 3 bars 32 cm long and slide it under the side of the patient A similar contraption is used on the other side Then, it is covered by a polypropylene sheet 2’ X 2’ It makes a completely disposable airtight chamber with the polypropylene sheet We make a 1 cm nick in the sheet and introduce the video-bronchoscope, which is further navigated into the patient without any discomfort either to the patient or Bronchoscopist When the procedure is finished, scope is withdrawn from the patient and the polypropylene sheet is squeezed out The polypropylene sheet is removed and disposed off with all precautions, and the acrylic boards and the bars are cleaned with 1% Sodium hypochlorite solution This way, the cost is only of polypropylene sheet which is negligible Results Videobronchoscopies in indicated patients were done using this novel disposable covid box This new invention called Disposable COVID box has been practiced for the first time, it’s an innovative technique about which we want the world to be known Conclusion To conclude, there are no aerosols released in atmosphere after the procedure, making it absolutely safe for bronchoscopist and at same time patient also remains safe We are ready again in no time with fresh polypropylene sheet to do the next bronchoscopy |
159,381 | The International Health Regulations (2005), the threat of populism and the COVID-19 pandemic | The global response to the COVID-19 pandemic has laid bare weaknesses and major challenges in the international approach to managing public health emergencies. Populist sentiment is spreading globally as democratic nations are increasing their support for or electing governments that are perceived to represent "traditional" native interests. Measures need to be taken to proactively address populist sentiment when reviewing the IHR (2005) effectiveness in the COVID-19 pandemic. We discuss how populism can impact the IHR (2005) and conversely how the IHR (2005) may be able to address populist concerns if the global community commits to helping states address public health threats that emerge within their borders. |
159,382 | 3D virtual reality simulation in radiography education: The students' experience | INTRODUCTION: Simulation forms a key element of undergraduate Radiography education as it enables students to develop their clinical skills in a safe environment. In this study, an immersive three-dimensional (3D) virtual radiography simulation tool was piloted in an undergraduate Radiography curriculum and user feedback retrieved. METHODS: The 3D virtual simulation tool by Virtual Medical Coaching Ltd was introduced to first year radiography students (n = 105). This technology guided students through a comprehensive process of learning anatomy, radiographic positioning and pathology. Students then X-rayed a virtual patient in the VR suite using HTC Vive Pro™ headsets and hand controllers. Instant feedback was provided. An online survey was later disseminated to students to gather user feedback. Thematic and descriptive statistical analyses were applied. RESULTS: A response rate of 79% (n = 83) was achieved. Most respondents (58%) reported enjoying VR simulation, whilst some felt indifferent towards it (27%). Ninety-four percent would recommend this tool to other students. The mean length of time it took for students to feel comfortable using the technology was 60 min (10-240 min). Most respondents (58%) desired more VR access. Students attributed enhanced confidence in the areas of beam collimation (75%), anatomical marker placement (63%), centring of the X-ray tube (64%) and exposure parameter selection (56%) to their VR practice. Many students (55%) advocated the use of VR in formative or low stakes assessments. Issues flagged included technical glitches, inability to palpate patient and lack of constructive feedback. CONCLUSION: Student feedback indicates that 3D virtual radiography simulation is a valuable pedagogical tool in radiography education IMPLICATIONS FOR PRACTICE: 3D immersive VR simulation is perceived by radiography students to be a valuable learning resource. VR needs to be strategically implemented into curricula to maximise its benefits. |
159,383 | Spanish registry of percutaneous VSD closure with NitOcclud Lê VSD Coil device: lessons learned after more than a hundred implants | INTRODUCTION AND OBJECTIVES: The NitOcclud Lê VSD Coil was specifically designed for transcatheter occlusion of ventricular septal defects (VSD) and became available for this purpose in August 2010. Our objective was to describe the Spanish experience of this technique and analyze its reliability and short- to mid-term efficacy. METHODS: National multicenter observational study, which retrospectively recruited all patients (of any age) with VSD (of any location or type) who underwent percutaneous NitOcclud occlusion, using an intention-to-treat analysis, until January 2019. RESULTS: A total of 117 attempts were made to implant at least 1 NitOcclud in 116 patients in 13 institutions. The median [range] age and weight was 8.6 [0.4-69] years and 27 [5.8-97] kg, respectively. In 99 patients (85%), the VSD was an isolated congenital defect. The location was perimembranous in 95 (81%), and 74 (63%) of them were aneurysmatic. The mean fluoroscopy time was 34 [11.4-124] minutes. Of the 117 attempts, 104 were successful (89%) with a follow-up of 31.4 [0.6-59] months. At the last review, final complete occlusion of the defect without residual shunt or with only a minimal shunt was achieved in 92.3% (no shunt, n=73; trivial shunt, n=23). Four patients required a second procedure for residual shunt occlusion. Two devices had to be surgically explanted due to severe hemolysis. There were no deaths or other major complications. CONCLUSIONS: The NitOcclud device can be used successfully for a wide anatomical spectrum of VSD. The main issue is residual shunt, but its incidence decreases over time. The incidence of hemolysis was very low and no permanent changes were detected in atrioventricular conduction. |
159,384 | Long-acting nanoparticulate DNase-1 for effective suppression of SARS-CoV-2-mediated neutrophil activities and cytokine storm | Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new strain of coronavirus not previously identified in humans. Globally, the number of confirmed cases and mortality rates of coronavirus disease 2019 (COVID-19) have risen dramatically. Currently, there are no FDA-approved antiviral drugs and there is an urgency to develop treatment strategies that can effectively suppress SARS-CoV-2-mediated cytokine storms, acute respiratory distress syndrome (ARDS), and sepsis. As symptoms progress in patients with SARS-CoV-2 sepsis, elevated amounts of cell-free DNA (cfDNA) are produced, which in turn induce multiple organ failure in these patients. Furthermore, plasma levels of DNase-1 are markedly reduced in SARS-CoV-2 sepsis patients. In this study, we generated recombinant DNase-1-coated polydopamine-poly(ethylene glycol) nanoparticulates (named long-acting DNase-1), and hypothesized that exogenous administration of long-acting DNase-1 may suppress SARS-CoV-2-mediated neutrophil activities and the cytokine storm. Our findings suggest that exogenously administered long-acting nanoparticulate DNase-1 can effectively reduce cfDNA levels and neutrophil activities and may be used as a potential therapeutic intervention for life-threatening SARS-CoV-2-mediated illnesses. |
159,385 | Efficacy analysis of hyperbaric oxygen therapy in the treatment of severe coronavirus disease 2019 patients | Objective To explore the potential mechanisms underlying the prominent efficiency of hyperbaric oxygen therapy (HBOT) in the treatment of severe coronavirus disease 2019 (COVID-19) patients. Methods Five COVID-19 patients, aged from 24 to 69 years old, received HBOT after routine therapies failed to stop the deterioration and progressive hypoxemia in General Hospital of the Yangtze River Shipping. The procedure of HBOT was as follows: compressed to 2.0 ATA (0.1 MPa gauge pressure, patient 1) or 1.6 ATA (0.06 MPa gauge pressure, patient 2-5) at a constant rate for 15 min, maintained for 90 min (first treatment) or 60 min (subsequent treatment), then decompressed to normal pressure for 20 min, once a day; the patients inhaled oxygen with the mask of Built-in-Breathing System continuously; and HBOT was ended when the daily mean pulse oxygen saturation (SpO2) in wards was above 95% for two days. The symptoms, respiratory rate (RR), SpO2, arterial blood gas analysis, blood routine, coagulation function, high-sensitivity C-reactive protein (hs-CRP) and chest computed tomography (CT) were collected. Paired t test was used to compare each index before and after treatment. Results After the first HBOT, the symptoms and signs of the five patients began to improve. Supine breathlessness disappeared after HBOT for four times, and digestive tract symptoms completely disappeared and only mild chest pain and breathlessness at rest and in motion remained after HBOT for five times. After finishing HBOT, the RR of the patients was significanlty lower than that before HBOT ([20.80±2.28] min-1 vs [27.20±5.40] min-1, P<0.05). After finishing HBOT, daily SpO2 in wards was increased day by day, and the daily mean SpO2 recovered to more than 95% after the first, second, third, third and sixth HBOT in the five patients, respectively. After the first HBOT decompression, SpO2 was (93.60±0.07)%, which was signficantly higher than that before HBOT ([73.20±6.42] %) (P<0.05). SpO2 values before compression of the second and third HBOT were signficantly higher than that before the first HBOT (both P<0.05). There was no significant difference in the SpO2 immediately before and after the third HBOT (P>0.05). Before HBOT, the arterial partial pressure of carbon dioxide (PaCO2) of the patients was (31.48±3.40) mmHg (1 mmHg=0.133 kPa), which was lower than the normal range (35-45 mmHg). After finishing HBOT, arterial partial pressure of oxygen ([130.20±18.58] mmHg), arterial oxygen saturation ([98.40±0.55]%), lymphocyte proportion (0.207 8±0.074 2) and lymphocyte count ([1.09±0.24]×109/L) were significantly higher than those before HBOT ([61.60±15.24] mmHg, [73.20±6.43]%, 0.094 6±0.062 1, and [0.61± 0.35]×109/L), while the levels of fibrinogen ([2.97±0.27] g/L) and hs-CRP ([7.76±6.95] mg/L) were significantly lower than those before HBOT ([4.45±0.94] g/L and [30.36±1.27] mg/L) (all P<0.05). The levels of lacttic acid and D-dimer were decreased after HBOT versus before HBOT ([1.13±0.10] mmol/L vs [2.16±1.71] mmol/L, [0.42±0.13] mg/L vs [1.84±1.29] mg/L), but the differences were not significant (both P>0.05). All the five patients had typical lung CT imaging changes of severe COVID-19 before HBOT, which were improved after HBOT. Conclusion Systemic hypoxia induced by persistent hypoxemia may be the main reason for the deterioration of severe COVID-19. The respiratory dysfunction of COVID-19 is mainly alveolar gas exchange dysfunction. HBOT may be the best way to correct the progressive hypoxemia which can not be controlled by atmospheric oxygen supply in severe COVID-19 patients. HBOT can provide enough oxygen supply for the continuous hypoxia tissues, and is beneficial to the recovery of immune function, circulatory function and stress level, so as to improve the condition of patients. |
159,386 | Kawasaki disease as the immune-mediated echo of a viral infection | Although the etiology of Kawasaki disease (KD) remains elusive, the available evidence indicates that the primum movens may be a dysregulated immune response to various microbial agents, leading to cytokine cascade and endothelial cell activation in patients with KD. Documented infections by different viruses in many individual cases have been largely reported and are discussed herein, but attempts to demonstrate their causative role in the distinctive KD scenario and KD epidemiological features have been disappointing. To date, no definite link has been irrefutably found between a single infection and KD. |
159,387 | Pharmacological therapeutics targeting RNA-dependent RNA polymerase, proteinase and spike protein: From mechanistic studies to clinical trials for COVID-19 | An outbreak of novel coronavirus-related pneumonia COVID-19, that was identified in December 2019, has expanded rapidly, with cases now confirmed in more than 211 countries or areas. This constant transmission of a novel coronavirus and its ability to spread from human to human have prompted scientists to develop new approaches for treatment of COVID-19. A recent study has shown that remdesivir and chloroquine effectively inhibit the replication and infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, 2019-nCov) in vitro. In the United States, one case of COVID-19 was successfully treated with compassionate use of remdesivir in January of 2020. In addition, a clinically proven protease inhibitor, camostat mesylate, has been demonstrated to inhibit Calu-3 infection with SARS-CoV-2 and prevent SARS-2-spike protein (S protein)-mediated entry into primary human lung cells. Here, we systemically discuss the pharmacological therapeutics targeting RNA-dependent RNA polymerase (RdRp), proteinase and S protein for treatment of SARS-CoV-2 infection. This review should shed light on the fundamental rationale behind inhibition of SARS-CoV-2 enzymes RdRp as new therapeutic approaches for management of patients with COVID-19. In addition, we will discuss the viability and challenges in targeting RdRp and proteinase, and application of natural product quinoline and its analog chloroquine for treatment of coronavirus infection. Finally, determining the structural-functional relationships of the S protein of SARS-CoV-2 will provide new insights into inhibition of interactions between S protein and angiotensin-converting enzyme 2 (ACE2) and enable us to develop novel therapeutic approaches for novel coronavirus SARS-CoV-2. |
159,388 | Exploring the effect of Covid-19 on Small and Medium Enterprises: Early Evidence from Sri Lanka | The exponential growth of the COVID-19 pandemic is of great global economic problems and has received magnificent worldwide attention The vulnerability of the pandemic with lower economic immunity is greater in developing countries The present study aims to explore the effects of the COVID-19 pandemic on SMEs in Sri Lanka Data were marshalled with the aid of qualitative interviews from conveniently chosen 14 small and medium enterprises (SMEs) The study reveals that the mitigating strategies and protocols to combat the COVID-19 have come at high economic and human costs and gravely sullied the SMEs in Sri Lanka including the shortage of materials, decline in both global and local demand for their products and services, difficulties in repaying loan and interest, cancellation of orders, dire cash deficit (inflows) and lack of savings (even problems with payroll and utility bills), limitations in recalling the employees back to work, high cost in preventing workplace COVID-19 strategies, absence of new orders, etc The COVID-19 pandemic is emotionally challenging for both employees and operators of the SMEs The government relief and the best policies and guidelines to support the SMEs are indeed crucial for riding through the crisis The present study further ensures the overarching importance of formulating after-effects COVID-19 economic revival policies Needless to say, the resilience of the SMEs is greatly dependent on the concerted efforts of the government, SMEs operators and other policymakers |
159,389 | [Clinical Course of 11 Cases of SARS-CoV-2 Infection Occurred in A Large Cruise Ship�E�Factors Associated with Severity and Prolonged Hospitalization] | The number of the patients with coronavirus disease 2019 (COVID-19) is increasing, and shortage of hospital beds for these patients is a cause for serious concern Here, we report the clinical course of 11 patients who were admitted to our hospital with COVID-19 that developed during their quarantine period in a large cruise ship, and discuss the factors associated with the disease severity and length of hospitalization The median age of the 11 patients was 62 years, and 36% were men The disease severity was mild in 7 patients, moderate in 4 patients, and severe in none of the patients The median time from symptom onset to disease remission was 13 days for patients with moderately severe disease, and 7 days for patients with mild disease The median interval from symptom onset to confirmation of the first negative result of PCR was 16 days for patients with moderately severe disease, and 14 days for patients with mild disease The median time from symptom onset to discharge was 22 5 days for patients with moderately severe disease cases, and 16 days for patients with mild disease Some patients needed prolonged hospitalization because of persistently positive results of PCR even after remission of symptoms Comparison between the patient groups with moderately severe disease and mild disease showed that the patients with moderately severe disease were older and had higher serum ferritin and serum amyloid protein (SAA) levels than the patients with mild disease Even in patients with mild to moderate COVID-19, two to three weeks were required from symptom onset to confirmation of the first negative result of PCR, and this was one of the major factors for prolonged hospitalization The serum ferritin levels and SAA levels might be predictors of the disease severity |
159,390 | How can we evaluate an interrelation of symptoms? | A pandemic of 2019 novel coronavirus (COVID-19) is an international problem and factors associated with increased risk of mortality have been reported. However, there exists limited statistical method to estimate a comprehensive risk for a case in which a patient has several characteristics and symptoms concurrently. We applied Boolean Monte Carlo method (BMCM) to the Novel Corona Virus 2019 Dataset to determine interrelation of patient's characteristics and symptoms. In the analyses, age, fever as an onset symptom, and sex were used as explanatory variables, and death as the objective variable. Among 265 patients included in the analysis, the interrelations for estimating death were determined as age "and" fever "and" sex (pâ¯<â¯0.0001 for both operators). This result indicates that satisfying the three conditions of age, fever, and sex concurrently may be associated with an increased risk of mortality. |
159,391 | Analysis of viral nucleic acid and cytokines in 12 children with 2019-nCoV infection | Objective: To analyze the viral nucleic acid and cytokines in 12 children with 2019-nCoV infection Methods: Clinical and laboratory data of the children diagnosed with 2019-nCoV infection in Guangzhou Women and Children's Medical Center from January to April 2020 were retrospectively analyzed Throat and anal swabs were collected on alternate days for the detection of 2019-nCoV nucleic acid by fluorescence quantitative PCR Flow cytometry was used to detect serum cytokines including IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-17A, IL-17F, IL-22, TNF-α and TNF-β during the early (both throat and anal swab tests were positive), the intermediate (throat swab test was negative, while anal swab test remained positive), and the convalescence (both throat and anal swab tests were negative) stages of infection Results: A total of 12 children were enrolled in this study The male-to-female ratio was 5: 1 The average age was (7 0±4 3) years There were two asymptomatic, five mild and five common cases No severe or critical cases were involved Initially, throat and anal swab nucleic acid tests were simultaneously positive in nine children newly diagnosed in our hospital and the median time of viral shedding in throat swab was longer than that in throat swab [32 (4 5, 45 0) d vs 3 (2, 9) d, Z=11 0, P=0 010] The median difference of viral shedding time between anal swab and pharyngeal swab was 25 5 (1 5, 42 8) d The overall levels of serum cytokines IL-17A, IL -4 and IL-5 in different stages of the disease (early, intermediate and convalescence stage) were statistically different (Z or F, P values were 8 33, 0 016;5 36, 0 010 and 6 56, 0 004, respectively), and a significant increase was observed in the intermediate stage of infection IL-17F, IL-2 and IL-22 were all increased during the infection, but there was no significant statistical difference among the three stages (P>0 05) Conclusions: It was noted that intestinal viral shedding needed a longer time Although the infectivity has not been determined, higher requirements have been put forward for disease prevention and control Cytokines secreted by Th2 and Th17 cells were involved in the immune response in children with non-severe 2019-nCoV infection Monitoring viral shedding and cytokine changes in pediatric patients would be conducive to disease assessment |
159,392 | Inflammation, Immunity and Immunogenetics in COVID-19: A Narrative Review | The novel Coronavirus Disease 2019 (COVID-19), that began in Wuhan Province, China was labelled as an International Public Health Emergency on January 30, 2020 and later was declared a pandemic by the World Health Organisation (WHO) on March 11, 2020. The causative agent, SARS-CoV-2 was the third coronavirus responsible for causing major disease outbreaks in human population after Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) caused by SARS-CoV and MERS-CoV respectively. The patients of COVID-19 present with a clinical feature resembling mild form of viral pneumonia which in certain cases progress to a severe form characterised by adult respiratory distress syndrome (ARDS) and/or multiorgan failure leading to death. The transition from mild to severe form of COVID-19 is affected by a lot of factors like age, co-morbidities etc. In the absence of an absolute cure, it is essential to explore the molecular pathogenesis of the disease to identify people at risk of developing severity so that alternative treatment modalities may be planned. The aim of this review is to provide an update on the general characteristics of SARS-CoV-2 and highlight the inflammatory changes and immune dysregulation that may help in identification of molecular predictors of disease severity. |
159,393 | Reference accuracy in spine surgery | OBJECTIVE: The references list is an important part of a scientific article that serves to confirm the accuracy of the authors' statements. The goal of this study was to evaluate the reference accuracy in the field of spine surgery. METHODS: Four major peer-reviewed spine surgery journals were chosen for this study based on their subspecialty clinical impact factors. Sixty articles per journal were selected from 12 issues each of The Spine Journal, Spine, and Journal of Neurosurgery: Spine, and 40 articles were selected from 8 issues of Global Spine Journal, for a total of 220 articles. All the articles were published in 2019 and were selected using computer-generated numbers. From the references list of each article, one reference was again selected by using a computer-generated number and then checked for citation or quotation errors. RESULTS: The results indicate that 84.1% of articles have a minor citation error, 4.5% of articles have a major citation error, 9.5% of articles have a minor quotation error, and 9.1% of articles have a major quotation error. Journal of Neurosurgery: Spine had the fewest citation errors compared with the other journals evaluated in this study. Using chi-square analysis, no association was determined between the occurrence of errors and potential markers of reference mistakes. Still, statistical significance was found between the occurrence of citation errors and the spine journals tested. CONCLUSIONS: In order to advance medical treatment and patient care in spine surgery, detailed documentation and attention to detail are necessary. The results from this study illustrate that improved reference accuracy is required. |
159,394 | Activity recognition in a smart home using local feature weighting and variants of nearest-neighbors classifiers | Recognition of activities, such as preparing meal or watching TV, performed by a smart home resident, can promote the independent living of elderly in a safe and comfortable environment of their own homes, for an extended period of time. Different activities performed at the same location have commonalities resulting in less inter-class variations; while the same activity performed multiple times, or by multiple residents, varies in its execution resulting in high intra-class variations. We propose a Local Feature Weighting approach (LFW) that assigns weights based on both inter-class and intra-class importance of a feature in an activity. Multiple sensors are deployed at different locations in a smart home to gather information. We exploit the obtained information, such as frequency and duration of activation of sensors, and the total sensors in an activity for feature weighting. The weights for the same features vary among activities, since a feature may have more importance for one activity but less for the other. For the classification, we exploit the two variants of K-Nearest Neighbors (KNN): Evidence Theoretic KNN (ETKNN) and Fuzzy KNN (FKNN). The evaluation of the proposed approach on three datasets, from CASAS smart home project, demonstrates its ability in the correct recognition of activities compared to the existing approaches. |
159,395 | MSstatsTMT: Statistical detection of differentially abundant proteins in experiments with isobaric labeling and multiple mixtures | Tandem mass tag (TMT) is a multiplexing technology widely-used in proteomic research. It enables relative quantification of proteins from multiple biological samples in a single mass spectrometry run with high efficiency and high throughput. However, experiments often require more biological replicates or conditions than can be accommodated by a single run, and involve multiple TMT mixtures and multiple runs. Such larger-scale experiments combine sources of biological and technical variation in patterns that are complex, unique to TMT-based workflows, and challenging for the downstream statistical analysis. These patterns cannot be adequately characterized by statistical methods designed for other technologies, such as label-free proteomics or transcriptomics. This manuscript proposes a general statistical approach for relative protein quantification in mass spectrometry-based experiments with TMT labeling. It is applicable to experiments with multiple conditions, multiple biological replicate runs and multiple technical replicate runs, and unbalanced designs. It is based on a flexible family of linear mixed-effects models that handle complex patterns of technical artifacts and missing values. The approach is implemented in MSstatsTMT, a freely available open-source R/Bioconductor package compatible with data processing tools such as Proteome Discoverer, MaxQuant, OpenMS and SpectroMine. Evaluation on a controlled mixture, simulated datasets, and three biological investigations with diverse designs demonstrated that MSstatsTMT balanced the sensitivity and the specificity of detecting differentially abundant proteins, in particular in large-scale experiments with multiple biological mixtures. |
159,396 | Effect of Combination Therapy of Hydroxychloroquine and Azithromycin on Mortality in Patients With COVID-19 | Conflicting evidence regarding the use of hydroxychloroquine (HCQ) and azithromycin for the treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection do exist. We performed a retrospective single-center cohort study including 377 consecutive patients admitted for pneumonia related to coronavirus disease 2019 (COVID-19). Of these, 297 were in combination treatment, 17 were on HCQ alone, and 63 did not receive either of these 2 drugs because of contraindications. The primary end point was in-hospital death. Mean age was 71.8 ± 13.4 years and 34.2% were women. We recorded 146 deaths: 35 in no treatment, 7 in HCQ treatment group, and 102 in HCQ + azithromycin treatment group (log rank test for Kaplan-Meier curve P < 0.001). At multivariable Cox proportional hazard regression analysis, age (hazard ratio (HR) 1.057, 95% confidence interval (CI) 1.035-1.079, P < 0.001), mechanical ventilation/continuous positive airway pressure (HR 2.726, 95% CI 1.823-4.074, P < 0.001), and C reactive protein above the median (HR 2.191, 95% CI 1.479-3.246, P < 0.001) were directly associated with death, whereas use of HCQ + azithromycin (vs. no treatment; HR 0.265, 95% CI 0.171-0.412, P < 0.001) was inversely associated. In this study, we found a reduced in-hospital mortality in patients treated with a combination of HCQ and azithromycin after adjustment for comorbidities. A large randomized trial is necessary to confirm these findings. |
159,397 | Enhanced effect of modified Zika virus E antigen on the immunogenicity of DNA vaccine | It has been reported worldwide that the Zika virus (ZIKV) could be transmitted through placentas and sexual contact. ZIKV can also cause Guillain-Barre syndrome, microcephaly and neurological abnormalities. However, there are no approved vaccines available. We constructed six DNA vaccine candidates and tested the immunogenicity. Tandem repeated envelope domain â ¢ (ED â ¢ × 3) induced highly total IgG and neutralization antibody, as well as CD8+ T cell responses. Also, stem region-removed envelope (E ΔSTEM) elicited a robust production of IFN-γ in mice. To examine in vivo protection, we used mice treated with an IFNAR1 blocking antibody before and after the challenge. Vaccination with the two candidates led to a decline in the level of viral RNAs in organs. Moreover, the sera from the vaccinated mice did not enhance the infection of Dengue virus in K562 cells. These findings suggest the potential for the development of a novel ZIKV DNA vaccine. |
159,398 | Just the Facts: Protecting frontline clinicians during the COVID-19 pandemic | There is no patient emergency more important than protecting health care workers during a pandemic. |
159,399 | Out of hospital management of LVAD patients during COVID-19 outbreak | Coronavirus disease 2019 (COVID-19) is a pandemic touching thousands of people all around the world. Patients supported with left ventricular assist devices (LVADs) are affected by long-standing cardiovascular diseases and subjected to variations of the normal cardiovascular physiology, thus requiring an even closer monitoring during the COVID-19 outbreak. Nevertheless, the COVID-19 pandemic led to a drastic reduction in routine clinical activities and a consequent risk of looser connections between LVAD patients and their referring center. Potential deleterious effects of such a situation can be a delayed recognition of LVAD-related complications, misdiagnosis of COVID-19, and impaired social and psychological well-being for patients and families. As one of the largest LVAD programs worldwide, we designed a sustainable and enforceable telemonitoring algorithm which can be easily adapted to every LVAD center so as to maintain optimal quality of care for LVAD patients during the COVID-19 pandemic. |
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