Looking beyond tracheal intubation: addition of negative airflow to a physical barrier prevents the spread of airborne particles


title: A nursing informatics response to COVID-19: perspectives from five regions of the world

text: The 21st century has seen several infectious disease outbreaks that have turned into epidemics and pandemics including Severe Acute Respiratory Syndrome (SARS) which began in Asia in 2003 (Poon, Guan, Nicholls, Yuen, & Peiris, 2004), followed by H1N1 that emerged in Mexico and the United States in 2009 (Belongia et al., 2010). Next came the lesser known Middle East Respiratory Syndrome (MERS) originating in Saudi Arabia in 2012 (Assiri et al., 2013), after which the Ebola outbreak in West Africa took place from 2014 to 2016, with a more recent occurrence in the Democratic Republic of Congo from 2018 to 2019 (Malvy, McElroy, de Clerck, Günther, & van Griensven, 2019). To date, the coronavirus (COVID-19) outbreak that started in Wuhan, in the Hubei province of China, in late December 2019 seems to be eclipsing all of these previous infectious diseases in terms of its global reach and impact (Wang, Horby, Hayden, & Gao, 2020). After being declared by the World Health Organization (WHO) as a public health emergency on 30 January 2020 (World Health Organization, 2020c), it was elevated to a pandemic status on 11 March 2020 (World Health Organization, 2020d). As of 28 April 2020, there are more than 2.9 million cases and 202,597 deaths reported worldwide (World Health Organization, 2020b).


Virtual Morning Report during COVID-19: A novel model for case-based teaching conferences


Maternal mental health in the time of the COVID-19 pandemic


title: Cardiac patient care during a pandemic: how to reorganise a heart failure unit at the time of COVID-19

text: To date, the pandemic spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has involved over 100 countries in a matter of weeks, and Italy suffers from almost 1/3 of the dead cases worldwide. In this report, we show the strategies adopted to face the emergency at Centro Cardiologico Monzino, a mono-specialist cardiology hospital sited in the region of Italy most affected by the pandemic, and specifically we describe how we have progressively modified in a few weeks the organization of our Heart Failure Unit in order to cope with the new COVID-19 outbreak. In fact, on the background of the pandemic, cardiovascular diseases still occur frequently in the general population, but we observed consistent reduction in hospital admissions for acute cardiovascular events and a dramatic increase of late presentation acute myocardial infarction. Despite a reduction of healthcare workers number, our ward has been rearranged in order to take care of both COVID-19 and cardiovascular patients. In particular according to a triple step procedure we divided admitted patients in confirmed, suspected and excluded cases (respectively allocated in "red", "pink" and "green" separated areas). Due to the absence of definite guidelines, our aim was to describe our strategy in facing the current emergency, in order to reorganize our hospital in a dynamic and proactive manner. To quote the famous Italian writer Alessandro Manzoni 'It is less bad to be agitated in doubt than to rest in error.'


In Situ Simulation Enables Operating Room Agility in the COVID-19 Pandemic


COVID-19 Psychological Impact in 3109 Healthcare workers in Spain: The PSIMCOV Group


IgG Antibody Response to SARS-CoV-2 Infection and Viral RNA Persistence in Patients on Maintenance Hemodialysis


title: Martini-Klinik experience on prostate cancer surgery during the early phase of COVID-19

text: In order to restrain an uncontrolled spread of the 2019 Coronavirus-Disease (COVID-19) and to provide sufficient intensive-care unit (ICU) capacity, medical specializations needed to develop new routines and risk-strategy protocols. Those restrictions have also impacted the urologic community. Several medical organisations developed specific information-hubs, blogs and resource centers on how to tackle the COVID-19 situation (1-3). Although the German Society of Urology ("DGU") has published a recommendation to evaluate the need for a timely therapy in prostate cancer (PCa) patients according to D'Amico risk groups on the 2nd of April 2020, up to now no compulsory directives exist regarding omitting radical prostatectomy (RP) during the COVID-19 pandemic.


title: Elderly people and responses to COVID-19 in 27 Countries

text: Amongst the most robust consensus related to the COVID-19 disease is that the elderly are by far the most vulnerable population group. Hence, public authorities target older people in order to convince them to comply with preventive measures. However, we still know little about older people's attitudes and compliance toward these measures. In this research, I aim to improve our understanding of elderly people's responses to the pandemic using data from 27 countries. Results are surprising and quite troubling. Elderly people's response is substantially similar to their fellow citizens in their 50's and 60's. This research (i) provides the first thorough description of the most vulnerable population's attitudes and compliance in a comparative perspective (ii) suggest that governments' strategies toward elderly people are far from successful and (iii) shows that methodologically, we should be more cautious in treating age as having a linear effect on COVID-19 related outcomes.


Ventilation-Perfusion Scans During the Coronavirus Disease 2019 (COVID-19) Outbreak


title: Outbreak dynamics of COVID-19 in China and the United States

text: On March 11, 2020, the World Health Organization declared the coronavirus disease 2019, COVID-19, a global pandemic. In an unprecedented collective effort, massive amounts of data are now being collected worldwide to estimate the immediate and long-term impact of this pandemic on the health system and the global economy. However, the precise timeline of the disease, its transmissibility, and the effect of mitigation strategies remain incompletely understood. Here we integrate a global network model with a local epidemic SEIR model to quantify the outbreak dynamics of COVID-19 in China and the United States. For the outbreak in China, in [Formula: see text] provinces, we found a latent period of 2.56 ± 0.72 days, a contact period of 1.47 ± 0.32 days, and an infectious period of 17.82 ± 2.95 days. We postulate that the latent and infectious periods are disease-specific, whereas the contact period is behavior-specific and can vary between different provinces, states, or countries. For the early stages of the outbreak in the United States, in [Formula: see text] states, we adopted the disease-specific values from China and found a contact period of 3.38 ± 0.69 days. Our network model predicts that-without the massive political mitigation strategies that are in place today-the United States would have faced a basic reproduction number of 5.30 ± 0.95 and a nationwide peak of the outbreak on May 10, 2020 with 3 million infections. Our results demonstrate how mathematical modeling can help estimate outbreak dynamics and provide decision guidelines for successful outbreak control. We anticipate that our model will become a valuable tool to estimate the potential of vaccination and quantify the effect of relaxing political measures including total lockdown, shelter in place, and travel restrictions for low-risk subgroups of the population or for the population as a whole.


title: COVID-19 bei hospitalisierten Kindern und Jugendlichen: Ein systematischer Review zu publizierten Fallserien (Stand 31.03.2020) und erste Daten aus Deutschland./ [COVID-19 in hospitalized children and adolescents]

text: Background: The clinical knowledge about the course, complications and treatment of COVID-19 in children and adolescents is so far limited. Aim: This systematic review summarizes the current scientific evidence regarding the clinical presentation of COVID-19 in hospitalized children based on available case series from China. In addition, first data from a nationwide pediatric hospital survey conducted by the German Society for Pediatric Infectious Diseases (DGPI) are presented. Methods: This study evaluated 12 case series from China with 6-2143 children infected with SARS-CoV2, which were identified by a literature search in PubMed up to 31 March 2020. The database of the German nationwide DGPI COVID-19 survey was accessed on 6 April 2020. Results: The median patient age in the case series was between 2 and 7 years and 18-45% were infants <1 year of age. The duration of hospital stay was 5-20 days. Most commonly reported symptoms were fever and cough; in 40-100% of cases involvement of the lower respiratory tract was reported, usually confirmed by computed tomography (CT). Severe and critical courses of disease were reported in up to 8% of the children including 2 fatalities. So far the German DGPI COVID-19 survey reported 33 hospitalized children up to 6 April 2020, mostly with upper airway infections. Of these children, 45% were infants and 32% had an underlying medical condition. So far 3 children (9%) needed admission to an intensive care unit. Conclusion: COVID-19 in hospitalized children usually presented as an uncomplicated febrile upper airway infection or mild pneumonia. Severe cases or fatalities rarely occurred in children. Information on neonates and children with underlying chronic conditions as well as on therapeutic and preventive measures are urgently needed.


title: The good, the bad and the ugly: pandemic priority decisions and triage

text: In this analysis we discuss the change in criteria for triage of patients during three different phases of a pandemic like COVID-19, seen from the critical care point of view. Availability of critical care beds has become a hot topic, and in many countries, we have seen a huge increase in the provision of temporary intensive care bed capacity. However, there is a limit where the hospitals may run out of resources to provide critical care, which is heavily dependent on trained staff, just-in-time supply chains for clinical consumables and drugs and advanced equipment. In the first (good) phase, we can still do clinical prioritisation and decision-making as usual, based on the need for intensive care and prognostication: what are the odds for a good result with regard to survival and quality of life. In the next (bad phase), the resources are mostly available, but the system is stressed by many patients arriving over a short time period and auxiliary beds in different places in the hospital being used. We may have to abandon admittance of patients with doubtful prognosis. In the last (ugly) phase, usual medical triage and priority setting may not be sufficient to decrease inflow and there may not be enough intensive care unit beds available. In this phase different criteria must be applied using a utilitarian approach for triage. We argue that this is an important transition where society, and not physicians, must provide guidance to support triage that is no longer based on medical priorities alone.


Seven days in medicine: 5-11 Feb 2020


Retraction: Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. N Engl J Med. DOI: 10.1056/NEJMoa2007621


title: Evolving Methods for Evaluating and Disseminating Computing Research

text: Social and technical trends have significantly changed methods for evaluating and disseminating computing research. Traditional venues for reviewing and publishing, such as conferences and journals, worked effectively in the past. Recently, trends have created new opportunities but also put new pressures on the process of review and dissemination. For example, many conferences have seen large increases in the number of submissions. Likewise, dissemination of research ideas has become dramatically through publication venues such as arXiv.org and social media networks. While these trends predate COVID-19, the pandemic could accelerate longer term changes. Based on interviews with leading academics in computing research, our findings include: (1) Trends impacting computing research are largely positive and have increased the participation, scope, accessibility, and speed of the research process. (2) Challenges remain in securing the integrity of the process, including addressing ways to scale the review process, avoiding attempts to misinform or confuse the dissemination of results, and ensuring fairness and broad participation in the process itself. Based on these findings, we recommend: (1) Regularly polling members of the computing research community, including program and general conference chairs, journal editors, authors, reviewers, etc., to identify specific challenges they face to better understand these issues. (2) An influential body, such as the Computing Research Association regularly issues a"State of the Computing Research Enterprise"report to update the community on trends, both positive and negative, impacting the computing research enterprise. (3) A deeper investigation, specifically to better understand the influence that social media and preprint archives have on computing research, is conducted.


Mining of epitopes on spike protein of SARS-CoV-2 from COVID-19 patients


title: Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020

text: Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak.


title: Analyzing barriers for implementation of public health and social measures to prevent the transmission of COVID-19 disease using DEMATEL method

text: BACKGROUND AND AIMS: COVID-19 is a contagious disease caused by a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Till now there are no vaccines and explicit medicines available for the treatment of COVID-19 disease, therefore the initiatives like public health and social measures are helpful in limiting the quantity of contaminations and saving lives. Keeping this in view, an attempt has been made in the present work to identify the barriers which hinder the implementation of these public health and social measures METHODS: The barriers to implement public health and social measures for preventing transmission of COVID-19 are identified using systematic literature review and these barriers are then categorized using Decision-making trial and evaluation laboratory (DEMATEL) method. RESULTS: Results reveal that among ten identified barriers, Lack of resources for implementing public health and social measures is found to be the most influential barrier to implement public health and social measures for preventing transmission of COVID-19. CONCLUSIONS: The successful implementation of public health and social measures depends on the adequate availability of resources which include medical equipment, personnel and financial dealings. The outcome of this research work will benefit and motivate the higher authorities to consider and overcome various challenges to prevent the transmission of COVID-19.


Proposed Imaging Guidelines for Pregnant Women Suspected of Having COVID-19


title: Role of Edge Device and Cloud Machine Learning in Point-of-Care Solutions Using Imaging Diagnostics for Population Screening

text: Edge devices are revolutionizing diagnostics. Edge devices can reside within or adjacent to imaging tools such as digital Xray, CT, MRI, or ultrasound equipment. These devices are either CPUs or GPUs with advanced processing deep and machine learning (artificial intelligence) algorithms that assist in classification and triage solutions to flag studies as either normal or abnormal, TB or healthy (in case of TB screening), suspected COVID-19/other pneumonia or unremarkable (in hospital or hotspot settings). These can be deployed as screening point-of-care (PoC) solutions; this is particularly true for digital and portable X-ray devices. Edge device learning can also be used for mammography and CT studies where it can identify microcalcification and stroke, respectively. These solutions can be considered the first line of pre-screening before the imaging specialist actually reviews scans and makes a final diagnosis. The key advantage of these tools is that they are instant, can be deployed remotely where experts are not available to perform pre-screening before the experts actually review, and are not limited by internet bandwidth as the nano learning data centers are placed next to the device.


title: Prenatal exposure to organic pollutants in northwestern Spain using non-invasive matrices (placenta and meconium)

text: Human exposure to environmental organic pollutants (OPs) begins in the uterine life period by trans-placental transfer. Epidemiological studies have consistently demonstrated the vulnerability of human fetuses and infants to the effects of OPs because of their rapid growth and organ development, cell differentiation, and immaturity of metabolism. The aim of the present study was to evaluate the prenatal exposure to OPs characterized by different physicochemical properties using non-invasive biological samples (meconium and placenta). A total of 88 placenta and 53 meconium samples were collected in Ourense, a city located in northwestern Spain, at the delivery and after birth from mothers and their infants from the University Hospital of Ourense, respectively. Selective pressurized liquid extraction (SPLE) methodologies were used to determine the targeted OPs in the selected biological samples. Cleanup of extracts was performed by solid-phase extraction (SPE) using EZ-POP cartridges and detection by gas chromatography (GC) coupled to tandem mass spectrometry (QqQ-MS/MS). The targeted OPs were detected with the following mean level total concentration order polycyclic aromatic hydrocarbons (PAHs)â¯>â¯organophosphorus pesticides (OPPs)â¯>â¯non-dioxin like polychlorinated biphenyls (NDLPCBs)â¯>â¯pyrethroids (PYRs)â¯>â¯polybrominated diphenyl ethers (PBDEs)â¯>â¯dioxin like polychlorinated biphenyls (DLPCBs)â¯>â¯organochlorine pesticides (OCPs) for placenta and ΣNDLPCBsâ¯>â¯ΣPAHsâ¯>â¯ΣOCPsâ¯>â¯ΣPYRsâ¯>â¯ΣOPPsâ¯>â¯ΣDLPCBsâ¯>â¯ΣPBDEs for meconium, respectively. Significant correlations (pâ¯<â¯.050) between the socio-demographic characteristics of the selected population (mother's parity, age, weight increase during pregnancy, place of living and smoking habits) and log transformed concentration of some of the targeted OPs (OCPs, PBDEs, PYRs, OPPs and PAHs) were detected. The results obtained shown the complementary information given by both biological samples selected. Nevertheless, additional research will be needed to gain an understanding of the trans-placental transfer of OPs, to choose the best biological matrix to evaluate the prenatal exposure to OPs in a correct way and to know their health implications.


Risk of COVID-19 in Patients With Cancer


Re: Silke Gillessen Sommer, Thomas Powles. Advice for Medical Oncology Care of Urological Cancer Patients During the COVID-19 Pandemic. Eur Urol 2020;78:e2-3: Is It Always Correct to Continue Androgen Receptor Signaling Inhibitors in the COVID-19 Era?


title: In silico studies on the comparative characterization of the interactions of SARS-CoV-2 spike glycoprotein with ACE-2 receptor homologs and human TLRs

text: Coronavirus disease-2019 (COVID-19) outbreak due to novel coronavirus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has come out as a major threat for mankind in recent times. It is continually taking an enormous toll on mankind by means of increasing number of deaths, associated comorbidities, and socioeconomic loss around the globe. Unavailability of chemotherapeutics/vaccine has posed tremendous challenges to scientists and doctors for developing an urgent therapeutic strategy. In this connection, the present in silico study aims to understand the sequence divergence of spike protein (the major infective protein of SARS-CoV-2), its mode of interaction with the angiotensin-converting enzyme-2 receptor (ACE2) receptor of human and related animal hosts/reservoir. Moreover, the involvement of the human Toll-like receptors (TLRs) against the spike protein has also been demonstrated. Our data indicated that the spike glycoprotein of SARS-CoV-2 is phylogenetically close to bat coronavirus and strongly binds with ACE2 receptor protein from both human and bat origin. We have also found that cell surface TLRs, especially TLR4 is most likely to be involved in recognizing molecular patterns from SARS-CoV-2 to induce inflammatory responses. The present study supported the zoonotic origin of SARS-CoV-2 from a bat and also revealed that TLR4 may have a crucial role in the virus-induced inflammatory consequences associated with COVID-19. Therefore, selective targeting of TLR4-spike protein interaction by designing competitive TLR4-antagonists could pave a new way to treat COVID-19. Finally, this study is expected to improve our understanding on the immunobiology of SARS-CoV-2 and could be useful in adopting spike protein, ACE2, or TLR-guided intervention strategy against COVID-19 shortly.


Editorial debate: Challenges we oncologists, working within a universal healthcare system, have to face in these hard times


title: Nasopharyngeal swab collection in the suspicion of Covid-19

text: RT-PCR detection of SARS-CoV-2 mRNA on nasopharyngeal swab is the standard for diagnosing active Covid-19 disease in asymptomatic subjects and in symptomatic patients without the typical radiological findings. Nasopharyngeal swabbing appears a trivial procedure, still an inappropriate nasopharyngeal sampling, performed by untrained operators, can be a relevant cause of false negative findings with a clear negative impact on the effort to control the epidemic and, when PPE is not properly used, this can expose healthcare workers and patients to risks of contagion.


title: Aldolase C is a novel molecular marker for folliculo-stellate cells in rodent pituitary

text: The anterior pituitary gland is composed of five types of hormone-producing cells and folliculo-stellate cells. Folliculo-stellate cells do not produce anterior pituitary hormones but they are thought to play important roles as stem cells, phagocytes, or supporting cells of hormone-producing cells in the anterior pituitary. S100ß protein has been used as a folliculo-stellate cell marker in some animals, including rats. However, since no reliable molecular marker for folliculo-stellate cells has been reported in mice, genetic approaches for the investigation of folliculo-stellate cells in mice are not yet available. Aldolase C/Zebrin II is a brain-type isozyme and is a fructose-1,6-bisphosphate aldolase. In the present study, we first used immunohistochemistry to verify that aldolase C was produced in the anterior pituitary of rats. Moreover, using transgenic rats expressing green fluorescent protein under the control of the S100ß gene promoter, we identified aldolase C-immunoreactive signals in folliculo-stellate cells and marginal cells located in the parenchyma of the anterior pituitary and around Rathke's cleft, respectively. We also identified aldolase C-expressing cells in the mouse pituitary using immunohistochemistry and in situ hybridization. Aldolase C was not produced in any pituitary hormone-producing cells, while aldolase C-immunopositive signal co-localized with E-cadherin- and SOX2-positive cells. Using post-embedding immunoelectron microscopy, aldolase C-immunoreactive products were observed in the cytoplasm of marginal cells and folliculo-stellate cells of the mouse pituitary. Taken together, aldolase C is a common folliculo-stellate cell marker in the anterior pituitary gland of rodents.


It's not the heat, it's the humidity: Effectiveness of a rice cooker-steamer for decontamination of cloth and surgical face masks and N95 respirators


title: Ictus isquémico e infección por SARS-CoV-2, ¿asociación casual o causal?/ Ictus isquémico e infección por SARS-CoV-2, ¿asociación casual o causal?/ Ischaemic stroke and SARS-CoV-2 infection: A causal or incidental association?

text: INTRODUCTION: Ischaemic stroke has been reported in patients with COVID-19, particularly in more severe cases. However, it is unclear to what extent this is linked to systemic inflammation and hypercoagulability secondary to the infection. METHODS: We describe the cases of 4 patients with ischaemic stroke and COVID-19 who were attended at our hospital. Patients are classified according to the likelihood of a causal relationship between the hypercoagulable state and ischaemic stroke. We also conducted a review of studies addressing the possible mechanisms involved in the aetiopathogenesis of ischaemic stroke in these patients. RESULTS: The association between COVID-19 and stroke was probably causal in 2 patients, who presented cortical infarcts and had no relevant arterial or cardioembolic disease, but did show signs of hypercoagulability and systemic inflammation in laboratory analyses. The other 2 patients were of advanced age and presented cardioembolic ischaemic stroke; the association in these patients was probably incidental. CONCLUSIONS: Systemic inflammation and the potential direct action of the virus may cause endothelial dysfunction, resulting in a hypercoagulable state that could be considered a potential cause of ischaemic stroke. However, stroke involves multiple pathophysiological mechanisms; studies with larger samples are therefore needed to confirm our hypothesis. The management protocol for patients with stroke and COVID-19 should include a complete aetiological study, with the appropriate safety precautions always being observed.


title: Exercise-induced immune system response: Anti-inflammatory status on peripheral and central organs

text: A wide array of molecular pathways has been investigated during the past decade in order to understand the mechanisms by which the practice of physical exercise promotes neuroprotection and reduces the risk of developing communicable and non-communicable chronic diseases. While a single session of physical exercise may represent a challenge for cell homeostasis, repeated physical exercise sessions will improve immunosurveillance and immunocompetence. Additionally, immune cells from the central nervous system will acquire an anti-inflammatory phenotype, protecting central functions from age-induced cognitive decline. This review highlights the exercise-induced anti-inflammatory effect on the prevention or treatment of common chronic clinical and experimental settings. It also suggests the use of pterins in biological fluids as sensitive biomarkers to follow the anti-inflammatory effect of physical exercise.


title: Covid-19 emergency in prison: Current management and forensic perspectives

text: The Covid-19 pandemic is currently a major worldwide public health problem. Contagion within prisons and in other custodial settings will need to be addressed promptly, but the management of preventive measures will be difficult due to overcrowding and inmates and officers' close physical contact. There may also be less access to care than in community settings. Accordingly, prisons are particularly vulnerable to outbreaks of infection, and in addition to the likely greater risks of contagion attention must be paid to the psychological problems that the pandemic can have on the prison population. Riots and episodes of violence have already taken place in various prisons. With the inevitable restrictions on social contact and family meetings, prisoners who already are at increased risk of mental illness and suicide are more susceptible to adverse psychological repercussions. From a forensic point of view, therefore, we stress the need for the development of a strong support network by mental health workers for the prison population.


Correction to Lancet Infect Dis 2020; published online Feb 18. https://doi.org/10.1016/S1473-3099(20)30111-0


title: In Vitro and Animal Models for SARS-CoV-2 research

text: Basic research on SARS-CoV-2 is essential to understand its detailed pathophysiology and identify best drug targets. Models that can faithfully reproduce the viral life cycle and reproduce the pathology of COVID-19 are required. Here, we briefly review the cell lines, organoids, and animal models that are currently being used in COVID-19 research.


Fonoaudiologia, amamentação e COVID-19: informações aos fonoaudiólogos./ Fonoaudiologia, amamentação e COVID-19: informações aos fonoaudiólogos./ Speech therapy, breastfeeding and COVID-19: information to speech therapist


Conceived in the covid-19 crisis: impact of maternal stress and anxiety on fetal neurobehavioral development


CORRIGENDUM to Emergency Approval of Chloroquine and Hydroxychloroquine for Treatment of COVID-19 (updated to Emergency Authorization of Chloroquine and Hydroxychloroquine for Treatment of COVID-19)


title: Social consequences of COVID-19 in a low resource setting in Sierra Leone, West Africa

text: Economical and psychological consequences of the lockdown in low-resource setting in rural Africa are unknown. We drafted a survey in order to address the social impact of COVID-19 lockdown on a rural village in Sierra Leone. The survey developed by the study group and translated in the local language, distributed to the householders of the village on April 13th and responses collected on April 14th, when Sierra Leone was on day 11 of lockdown. The questions aimed to assess in the community the following items: age group, main activities before lockdown, change in income and ability to feed the family during lockdown, anxiety during lockdown. 78 householders (100% of Bureh Town) replied. All, expect one, declared a 51-80% (19.2%) to 81-100% (79.4%) reduction of weekly income compared with the pre-lockdown period, declaring difficulties in providing food for the family members (82%), and anxiety (60%). Our analyses showed that people lost their jobs and have difficulties in providing food for their families. Highlights: Our analyses in a low resource setting in rural Africa in Sierra Leone, West Africa, showed that people lost their jobs and have difficulties in providing food for their families, as a consequence of COVID-19 lockdown.


title: Neurosurgery Residents' Perspective on COVID-19: Knowledge, Readiness, and Impact of this Pandemic

text: BACKGROUND: The novel coronavirus disease (COVID-19) is a life-threatening illness, which represents a challenge to all health care workers. Neurosurgeons worldwide are affected in different ways. OBJECTIVE: This is the first study regarding the readiness of neurosurgery residents for the COVID-19 pandemic and its impact. The aim is to identify the level of knowledge and readiness and the impact of this virus among neurosurgery residents in different programs. METHODS: A cross-sectional analysis was performed in which 52 neurosurgery residents from different centers were selected to complete a questionnaire-based survey. The questionnaire comprised 3 sections and 27 questions that ranged from knowledge to impact of the pandemic on various features. RESULTS: The median knowledge score was 4 out of 5. The proportion of participants with a satisfactory level of knowledge was 60%. There was a statistically significant difference between the knowledge score and location of the program. Around 48% of the neurosurgery residents dealt directly with patients with COVID-19. Receiving a session about personal protective equipment was reported by 57.7%. Neurosurgery training at the hospital was affected. About 90% believed that this pandemic had influenced their mental health. CONCLUSIONS: Neurosurgery residents have a relatively good knowledge about COVID-19. The location of the program was associated with knowledge level. Most participants did not receive sufficient training about personal protective equipment. Almost all responders agreed that their training at the hospital had been affected. Further studies are needed to study the impact of this pandemic on neurosurgery residents.


Cardiovascular examination should also include peripheral arterial evaluation for COVID-19 patients


title: The 2020 coronavirus lockdown and seismic monitoring of anthropic activities in Northern Italy

text: In March/April 2020 the Italian government drastically reduced vehicle traffic and interrupted all non-essential industrial activities over the entire national territory. Italy thus became the first country in the world, with the exception of Hubei, to enact lockdown measures as a consequence of the COVID-19 outbreak and the need to contain it. Italy is also a seismically active area, and as such is monitored by a dense permanent network of seismic stations. We analyse continuous seismic data from many stations in northern and central Italy, and quantify the impact of the lockdown on seismic ambient noise, as a function of time and location. We find that the lockdown reduces ambient noise significantly in the 1-10 Hz frequency range; because natural sources of seismic noise are not affected by the lockdown, the seismic signature of anthropic noise can be characterised with unprecedented clarity, by simply comparing the signal recorded before and after the lockdown. Our results correlate well with independent evaluations of the impact of the lockdown (e.g., cell phone displacements), and we submit that ambient-noise seismology is a useful tool to monitor containment measures such as the coronavirus lockdowns.


COVID-19: a case for inhibiting IL-17?


title: Sharing of Biological Samples during Public Health Emergencies: Challenges and Opportunities for National and International Action

text: Chapter 9 examines the real-time barriers to public health response that middle-income country demands caused in the context of Zika and MERS-CoV The authors identify difficulties in identifying countries that possessed relevant biological samples and data, protracted negotiations over location, collaboration, and benefit sharing of research, and the development of standard agreements afterward that aimed at reducing transaction costs for access to crucial research inputs This chapter drives home the implications of the changing system of pathogen sharing for US national security


title: [Evaluation of the emergency response strategies and measures on the epidemic of COVID-19 in Shenzhen, China]

text: Objectives: This study aimed to evaluate the effect of the strategies on COVID-19 outbreak control in Shenzhen, and to clarify the feasibility of these strategies in metropolitans that have high population density and strong mobility. Methods: The epidemic feature of COVID-19 was described by different phases and was used to observe the effectiveness of intervention. Hierarchical spot map was drawn to clarify the distribution and transmission risk of infection sources at different time points. The Susceptible-Exposed-Infectious-Asymptomatic-Recovered model was established to estimate case numbers without intervention and compare with the actual number of cases to determine the effect of intervention. The positive rate of the nucleic acid test was used to reflect the risk of human exposure. A survey on COVID-19 related knowledge, attitude and behaviors were used to estimate the abilities of personal protection and emergency response. Results: The epidemic of COVID-19 in Shenzhen experienced the rising, plateau and decline stage. The case number increased rapidly at the beginning, with short duration of peak period. Although the epidemic curve showed human-to-human transmission, the "trailing" was not obvious. From the spot map, during the intervention period, the source of infection was widely distributed. More cases and higher transmission risk were observed in areas with higher population density. After the effective intervention measures, both infection sources and the risk of transmission decreased. After compared with the estimated case numbers without intervention, actual number proved the COVID-19 control strategies were effective. The positive rate of nucleic acid test for high risk populations decreased and no new cases reported since February 16. Shenzhen citizens had high knowledge, attitude and behavior level, and high protection ability and emergency response. Conclusion: Although the response initiated by the health administration department played a key role at the early stage of the epidemic, it was not enough to contain the outbreak of COVID-19. The first-level emergency response initiated by provincial and municipal government was effective and ensured the start of work resumption after the Spring Festival. Metropolitans like Shenzhen can also achieve the goals of strategies and measures for containment and mitigation of COVID-19.


title: The urgency of utilizing COVID-19 biospecimens for research in the heart of the global pandemic

text: The outbreak of the novel coronavirus disease 2019 (COVID-19) and consequent social distancing practices have disrupted essential clinical research functions worldwide. Ironically, this coincides with an immediate need for research to comprehend the biology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the pathology of COVID-19. As the global crisis has already led to over 15,000 deaths out of 175,000 confirmed cases in New York City and Nassau County, NY alone, it is increasingly urgent to collect patient biospecimens linked to active clinical follow up. However, building a COVID-19 biorepository amidst the active pandemic is a complex and delicate task. To help facilitate rapid, robust, and regulated research on this novel virus, we report on the successful model implemented by New York University Langone Health (NYULH) within days of outbreak in the most challenging hot spot of infection globally. Using an amended institutional biobanking protocol, these efforts led to accrual of 11,120 patients presenting for SARS-CoV-2 testing, 4267 (38.4%) of whom tested positive for COVID-19. The recently reported genomic characterization of SARS-CoV-2 in the New York City Region, which is a crucial development in tracing sources of infection and asymptomatic spread of the novel virus, is the first outcome of this effort. While this growing resource actively supports studies of the New York outbreak in real time, a worldwide effort is necessary to build a collective arsenal of research tools to deal with the global crisis now, and to exploit the virus's biology for translational innovation that outlasts humanity's current dilemma.


title: Smartphone-based multiplex 30-minute nucleic acid test of live virus from nasal swab extract

text: Rapid, sensitive and specific detection and reporting of infectious pathogens is important for patient management and epidemic surveillance. We demonstrated a point-of-care system integrated with a smartphone for detecting live virus from nasal swab media, using a panel of equine respiratory infectious diseases as a model system for corresponding human diseases such as COVID-19. Specific nucleic acid sequences of five pathogens were amplified by loop-mediated isothermal amplification on a microfluidic chip and detected at the end of reactions by the smartphone. Pathogen-spiked horse nasal swab samples were correctly diagnosed using our system, with a limit of detection comparable to that of the traditional lab-based test, polymerase chain reaction, with results achieved in â¼30 minutes.


title: Distinguishing between spiritual health and religious involvement as determinants of adolescent health in Canada and the Czech Republic

text: Spiritual health is a topic of emergent interest; however, lack of a clear distinction between spiritual health and religious involvement makes it difficult to understand the potential role of spiritual health as a determinant of health. Analyses of such relationships that cross countries and cultures are rare. We therefore assessed whether differences exist between spiritual health and religious involvement and their respective associations with general indicators adolescent health. The study was based on the 2013/2014 Health Behaviour in School-aged Children study conducted in Canada (n = 10 761) and the Czech Republic (n = 4411). In both countries, we failed to identify strong or statistically significant associations between self-reported religiosity and adolescent health. In contrast, adolescents with higher spiritual health scores consistently reported enhanced levels of general health status. Study findings point to the importance of a strong sense of spiritual health as a protective determinant of adolescent health, and raise questions about religious involvement as protective to adolescent health outcomes.


Focus on "COVID Toes"


title: Rational use of face mask in a tertiary care hospital setting during COVID-19 pandemic: An observational study

text: Masks play a role in the protection of health-care workers (HCWs) from acquiring respiratory infections, including coronavirus disease 2019 (COVID-19) in health-care settings. This observational study was conducted among 382 HCWs in a tertiary care setting over a period of 1 month. Descriptive analysis was done to assess the rational and recommended use of masks/respirators during COVID-19 pandemic using a structured observation checklist as a survey tool. A total of 374 HCWs were included, 64.9% of whom were using face masks rationally as mentioned per risk area categorization with a predominance of triple-layered mask during all 4 weeks. Overall, 64.1% used masks correctly. Clear guidelines and strategies can help to increase the compliance of HCWs with rational use of face masks.


Vitamin D, Covid-19 and Children


Pandemic: Radiologists' Ethical and Professional Responsibilities


title: Estimating Risk for Death from Coronavirus Disease, China, January-February 2020

text: Since December 2019, when the first case of coronavirus disease (COVID-19) was identified in the city of Wuhan in the Hubei Province of China, the epidemic has generated tens of thousands of cases throughout China. As of February 28, 2020, the cumulative number of reported deaths in China was 2,858. We estimated the time-delay adjusted risk for death from COVID-19 in Wuhan, as well as for China excluding Wuhan, to assess the severity of the epidemic in the country. Our estimates of the risk for death in Wuhan reached values as high as 12% in the epicenter of the epidemic and ≈1% in other, more mildly affected areas. The elevated death risk estimates are probably associated with a breakdown of the healthcare system, indicating that enhanced public health interventions, including social distancing and movement restrictions, should be implemented to bring the COVID-19 epidemic under control.


title: Video Conferencing in the Intravitreal Injection Clinic in Response to the COVID-19 Pandemic

text: PURPOSE: To share a useful intervention to minimize risk of COVID-19 infection to both healthcare workers and patients in the eye clinic. METHODS: We present our experience of virtual, within-clinic remote visual acuity assessment to reduce the risk of infection with COVID-19. RESULTS: Along with standard recommendations for personal protective equipment and hand hygiene to contain viral spread and treating only urgent cases, remote within-clinic visual acuity testing and consultations can be undertaken with minimal specialist equipment and appears to provide useful information whilst being acceptable to patients. CONCLUSION: Ophthalmology practice must adapt in order to combat COVID-19. This measure can easily be incorporated into daily practice to reduce both patient footfall within the department and close contact between patient and healthcare practitioners.


The early antibody response to SARS-Cov-2 infection


title: CT imaging features of 4121 patients with COVID-19: A meta-analysis

text: OBJECTIVE: We systematically reviewed the computed tomography (CT) imaging features of coronavirus disease 2019 (COVID-19) to provide reference for clinical practice. METHODS: Our article comprehensively searched PubMed, FMRS, EMbase, CNKI, WanFang databases, and VIP databases to collect literatures about the CT imaging features of COVID-19 from 1 January to 16 March 2020. Three reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies, and then, this meta-analysis was performed by using Stata12.0 software. RESULTS: A total of 34 retrospective studies involving a total of 4121 patients with COVID-19 were included. The results of the meta-analysis showed that most patients presented bilateral lung involvement (73.8%, 95% confidence interval [CI]: 65.9%-81.1%) or multilobar involvement (67.3%, 95% CI: 54.8%-78.7%) and just little patients showed normal CT findings (8.4%). We found that the most common changes in lesion density were ground-glass opacities (68.1%, 95% CI: 56.9%-78.2%). Other changes in density included air bronchogram sign (44.7%), crazy-paving pattern (35.6%), and consolidation (32.0%). Patchy (40.3%), spider web sign (39.5%), cord-like (36.8%), and nodular (20.5%) were common lesion shapes in patients with COVID-19. Pleural thickening (27.1%) was found in some patients. Lymphadenopathy (5.4%) and pleural effusion (5.3%) were rare. CONCLUSION: The lung lesions of patients with COVID-19 were mostly bilateral lungs or multilobar involved. The most common chest CT findings were patchy and ground-glass opacities. Some patients had air bronchogram, spider web sign, and cord-like. Lymphadenopathy and pleural effusion were rare.


title: Practice and technique of using face mask amongst adults in the community: a cross-sectional descriptive study

text: BACKGROUND: The proper use of face mask comprises the correct practice and wearing technique and is important in preventing the spread of respiratory infections. Previous studies have addressed only the aspect of practice and failed to provide a detailed account of face mask usage amongst community-based populations. This study examined the practice and technique of using face mask amongst adults. METHODS: A cross-sectional descriptive design was adopted. A quota sample of 1500 adults was recruited in Hong Kong during a nonepidemic state between January and February 2017. The participants' practice of using face mask in five given situations was assessed using a questionnaire. Their technique in using face mask, including 12 steps, was assessed using an observation checklist. Statistical tests were used to compare the differences in practice and technique amongst adults of different gender and age groups. RESULTS: Findings revealed that the performance of the participants in both categories was unsatisfactory. In terms of practice, less than one-fifth of the participants reported that they always wore face mask when taking care of family members with fever (14.7%) or respiratory infections (19.5%). Male adults and those aged 55-64 reported low frequency in using face mask during required situations. In terms of technique, none of the participants performed all the required steps in using face mask correctly. More than 90% of the participants did not perform hand hygiene before putting on (91.5%), taking off (97.3%), or after disposing (91.5%) face mask. Adults aged 55 and above performed poorer than adults in the younger age groups. CONCLUSION: Compared with previous findings obtained during an epidemic, the performance of the participants during a nonepidemic state was less satisfactory. The possibility of developing fatigue after exposure to repeated epidemics was discussed. This study contributes to a comprehensive understanding of the use of face mask in a community and reveals the underperformed areas. Effort is required to enhance the proper practice of using face mask, convey the message that hand hygiene is an essential step in wearing and taking off a face mask and increase the public's general concern in the value of using face mask.


Call to action for a South American network to fight COVID-19 in pregnancy


Life Without Sports


Priorities for Cath labs in the COVID-19 tsunami


title: The effect of state-level stay-at-home orders on COVID-19 infection rates

text: State-level stay-at-home orders were monitored to determine their effect on the rate of confirmed COVID-19 diagnoses. Confirmed cases were tracked before and after state-level stay-at-home orders were put in place. Linear regression techniques were used to determine slopes for log case count data, and meta analyses were conducted to combine data across states. The results were remarkably consistent across states and support the usefulness of stay-at-home orders in reducing COVID-19 infection rates.


How to beat isolation? Academic feedback groups fit the bill, and promote growth as scholars and humans


title: Drive-through testing in COVID-19: experience from NHS Lothian

text: The growing epidemic of SARS-CoV-2 challenges healthcare resources globally and mandates innovation. We describe our novel drive-through coronavirus testing which we used for testing of possible cases in the contain phase of UK response and are now using for healthcare worker testing. We found that this system was pragmatic, cost-efficient and favourable for patients. It is easily modifiable for use in future infectious disease outbreaks.


title: Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past

text: Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus strain disease, has recently emerged in China and rapidly spread worldwide. This novel strain is highly transmittable and severe disease has been reported in up to 16% of hospitalized cases. More than 600,000 cases have been confirmed and the number of deaths is constantly increasing. COVID-19 hospitalized patients, especially those suffering from severe respiratory or systemic manifestations, fall under the spectrum of the acutely ill medical population, which is at increased venous thromboembolism risk. Thrombotic complications seem to emerge as an important issue in patients infected with COVID-19. Preliminary reports on COVID-19 patients' clinical and laboratory findings include thrombocytopenia, elevated D-dimer, prolonged prothrombin time, and disseminated intravascular coagulation. As the pandemic is spreading and the whole picture is yet unknown, we highlight the importance of coagulation disorders in COVID-19 infected patients and review relevant data of previous coronavirus epidemics caused by the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome coronavirus (MERS-CoV).


title: Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia

text: The outbreak and diffusion of the Severe Acute Respiratory Syndrome-Coronavirus-2 (Sars-CoV-2) and COronaVIrus Disease 19 (COVID-19) have caused an emergency status in the health system, including in the dentistry environment. Italy registered the third highest number of COVID-19 cases in the world and the second highest in Europe. An anonymous online survey composed of 40 questions has been sent to dentists practicing in the area of Modena and Reggio Emilia, one of the areas in Italy most affected by COVID-19. The survey was aimed at highlighting the practical and emotional consequences of COVID-19 emergence on daily clinical practice. Specifically, it assessed dentists' behavioral responses, emotions and concerns following the Sars-CoV-2 pandemic restrictive measures introduced by the Italian national administrative order of 10 March 2020 (DM-10M20), as well as the dentists' perception of infection likelihood for themselves and patients. Furthermore, the psychological impact of COVID-19 was assessed by means of the Generalized Anxiety Disorder-7 test (GAD-7), that measures the presence and severity of anxiety symptoms. Using local dental associations (ANDI-Associazione Nazionale Dentisti Italiani, CAO-Commissione Albo Odontoiatri) lists, the survey was sent by email to all dentists in the district of Modena and Reggio Emilia (874 practitioners) and was completed by 356 of them (40%). All dental practitioners closed or reduced their activity to urgent procedures, 38.2% prior to and 61.8% after the DM-10M20. All reported a routinely use of the most common protective personal equipment (PPE), but also admitted that the use of PPE had to be modified during COVID-19 pandemic. A high percentage of patients canceled their previous appointments after the DM-10M20. Almost 85% of the dentists reported being worried of contracting the infection during clinical activity. The results of the GAD-7 (General Anxiety Disorder-7) evaluation showed that 9% of respondents reported a severe anxiety. To conclude, the COVID-19 emergency is having a highly negative impact on the activity of dentists practicing in the area of Modena and Reggio Emilia. All respondents reported practice closure or strong activity reduction. The perception of this negative impact was accompanied by feelings of concern (70.2%), anxiety (46.4%) and fear (42.4%). The majority of them (89.6%) reported concerns about their professional future and the hope for economic measures to help dental practitioners.


title: Prevalence and characterization of asthma in hospitalized and non-hospitalized patients with COVID-19

text: BACKGROUND: The Centers for Disease Control and Prevention advises that patients with moderate-to-severe asthma belong to a high-risk group that is susceptible to severe COVID-19. However, the association between asthma and COVID-19 has not been well-established. OBJECTIVE: The primary objective was to determine the prevalence of asthma among COVID-19 patients in a major U.S. health system. We assessed the clinical characteristics and comorbidities in asthmatic and non-asthmatic COVID-19 patients. We also determined the risk of hospitalization associated with asthma and/or inhaled corticosteroid use. METHODS: Medical records of patients with COVID-19 were searched by a computer algorithm (March 1-April 15, 2020), and chart review was used to validate the diagnosis of asthma and medications prescribed for asthma. All patients were PCR-confirmed COVID-19. Demographics and clinical features were characterized. Regression models were used to assess the associations between asthma and corticosteroid use and the risk of COVID-19-related hospitalization. RESULTS: Of 1,526 patients identified with COVID-19, 220 (14%) were classified as having asthma. Asthma was not associated with an increased risk of hospitalization (RR of 0.96 [95%CI: 0.77-1.19]) after adjusting for age, sex, gender, and comorbidities. The ongoing use of ICS did not increase the risk of hospitalization in a similar adjusted model (RR of 1.39 [95%CI: 0.90-2.15]). CONCLUSIONS: Despite a substantial prevalence of asthma in our COVID-19 cohort, asthma was not associated with an increased risk of hospitalization. Similarly, the use of ICS with or without systemic corticosteroids was not associated with COVID-19-related hospitalization.


Our Most Powerful Weapon to Fight COVID-19: Patient Involvement


title: How does the COVID-19 pandemic affect the preoperative evaluation and anesthesia applied for urinary stones? EULIS eCORE-IAU multicenter collaborative cohort study

text: Stone disease is a unique condition that requires appropriate management in a timely manner as it can result in both emergent conditions and long term effects on kidney functions. In this study it is aimed to identify the up-to-date practice patterns related to preoperative evaluation and anesthesia for stone disease interventions during COVID-19 pandemic. The data of 473 patients from 11 centers in 5 different countries underwent interventions for urinary stones during the Covid-19 pandemic was collected and analyzed retrospectively. Information on the type of the stone related conditions, management strategies, anesthesiologic evaluation, anesthesia methods, and any alterations related to COVID-19 pandemic was collected. During the preoperative anesthesia evaluation thorax CT was performed in 268 (56.7%) and PCR from nasopharyngeal swab was performed in 31 (6.6%) patients. General anesthesia was applied in 337 (71.2%) patients and alteration in the method of anesthesia was recorded in 45 (9.5%) patients. A cut-off value of 21 days was detected for the hospitals to adapt changes related to COVID-19. Rate of preoperative testing, emergency procedures, conservative approaches and topical/regional anesthesia increased after 21 days. The preoperative evaluation for management of urinary stone disease is significantly affected by COVID-19 pandemic. There is significant alteration in anesthesia methods and interventions. The optimal methods for preoperative evaluation are still unknown and there is discordance between different centers. It takes 21 days for hospitals and surgeons to adapt and develop new strategies for preoperative evaluation and management of stones.


title: Dual Challenge of Cancer and COVID-19: Impact on Health Care and Socioeconomic Systems in Asia Pacific

text: Coronavirus or COVID-19 is caused by severe acute respiratory syndrome coronavirus 2. The COVID-19 pandemic has resulted in social and economic disruption throughout the entire world. Each country is being challenged. Although much of the world's focus has been on the rapid spread in Italy, Spain, and the United States, the potential impact on the world's poor, a majority of whom are living in Asia, could be devastating. Asia has the world's most densely populated cities, and its developing countries are facing challenges in their socioeconomic and health care systems. COVID-19 is quickly overwhelming the fragile and overstretched health systems of low- and low- to middle-income countries. With its aging population having chronic diseases and the growing burden of cancer, Asia is facing the dual challenge of controlling the spread of COVID-19 and at the same time providing and maintaining cancer care.


COVID-19, rheumatic diseases and immunosuppressive drugs: an appeal for medication adherence


Occurrence of SARS-CoV-2 during mycophenolate mofetil treatment for pemphigus


The Role of Consultation-Liaison Psychiatry in the COVID-19 Pandemic


title: Syndemic frameworks to understand the effects of COVID-19 on commercial driver stress, health, and safety

text: Introduction: U.S. commercial drivers are entrenched in a stressogenic profession, and exposures to endemic chronic stressors shape drivers' behavioral and psychosocial responses and induce profound health and safety disparities. To gain a complete understanding of how the COVID-19 pandemic will affect commercial driver stress, health, and safety over time, and to mitigate these impacts, research and prevention efforts must be grounded in theoretical perspectives that contextualize these impacts within the chronic stressors already endemic to profession, the historical and ongoing forces that have induced them, and the potentially reinforcing nature of the resulting afflictions. Methods: Extant literature reveals how an array of macro-level changes has shaped downstream trucking industry policies, resulting in stressogenic work organization and workplace characteristics. Emerging evidence suggests that the COVID-19 pandemic exacerbates existing stressors and introduces novel stressors, with potentially exacerbatory impacts on health and safety disparities. Results: As COVID-19 exerts an array of multi-level stressors on commercial drivers, syndemic frameworks can provide the appropriate theoretical lens to guide research and prevention. Syndemic frameworks can provide the grounding to allow foregoing commercial driver COVID-19 research to transcend the limitations of prevailing research frameworks by contextualizing COVID-19 stressors holistically within the complex system of endemic chronic stressors and interrelated health and safety afflictions. Syndemic-informed prevention efforts can then be implemented that simultaneously tackle multiple afflictions and the macro-level forces that result in the emergence of commercial drivers' health and safety disparities over time. Conclusions: The impacts of the COVID-19 pandemic on commercial drivers cannot be adequately understood or acted upon in isolation from the endemic chronic stressors and interrelated health and safety disparities that characterize the profession. Instead, commercial driver COVID-19 research and prevention needs syndemic frameworks to holistically understand the impacts of COVID-19 on commercial driver stress, health, and safety, and to identify high-leverage preventive actions.


title: Utility of lateral flow tests in SARS-CoV-2 infection monitorization

text: OBJECTIVE: The diagnosis of SARS-CoV-2 infection is crucial for medical and public health reasons, to allow the best treatment of cases and the best control of the pandemic. Serology testing allows for the detection of asymptomatic infections and 19-COVID cases once the virus has been cleared. We analyzed the usefulness of the SARS-CoV-2 rapid test of Autobio and tried to correlate its pattern with the severity of COVID19 infection. METHODS: We analyzed the accuracy and clinical usefulness of a point-of-care IgM and/or IgG test for SARS-CoV-2 in 35 COVID-19 patients [12 (34.3%) mild-moderate and 23 (65.7%) severe-critical] admitted to a field hospital in Madrid, as well as in 5 controls. RESULTS: The mean time from the first day of symptoms to the antibody test was 28 days (SD: 8.7), similar according to the severity of the disease. All patients with SARS-CoV-2 PCR+ showed the corresponding IgG positivity, while these results were negative in all control individuals. A total of 26 (74%) cases also presented with positive IgM, 19 (83%) were severe-critical cases and 7 (58%) were mild-moderate cases. The IgM response lasted longer in the severe critical cases (mean: 29.7 days; SD: 8.4) compared to the moderate cases (mean: 21.2 days; SD: 2.0).. CONCLUSIONS: Rapid serology tests are useful for the diagnosis of patients with COVID-19 (mainly IgG detection) and may also be correlated with the severity of the infection (based on IgM detection).


title: Tracking the reach of COVID-19 kin loss with a bereavement multiplier applied to the United States

text: The coronavirus disease 2019 (COVID-19) pandemic has led to a large increase in mortality in the United States and around the world, leaving many grieving the sudden loss of family members. We created an indicator-the COVID-19 bereavement multiplier-that estimates the average number of individuals who will experience the death of a close relative (defined as a grandparent, parent, sibling, spouse, or child) for each COVID-19 death. Using demographic microsimulation-based estimates of kinship networks in the United States, the clear age gradient in COVID-19 mortality seen across contexts, and several hypothetical infection prevalence scenarios, we estimate COVID-19 bereavement multipliers for White and Black individuals in the United States. Our analysis shows that for every COVID-19 death, approximately nine surviving Americans will lose a grandparent, parent, sibling, spouse, or child. These estimates imply, for example, that if 190,000 Americans die from COVID-19, as some models project, then â¼1.7 million will experience the death of a close relative. We demonstrate that our estimates of the bereavement multiplier are stable across epidemiological realities, including infection scenarios, total number of deaths, and the distribution of deaths, which means researchers can estimate the bereavement burden over the course of the epidemic in lockstep with rising death tolls. In addition, we provide estimates of bereavement multipliers by age group, types of kin loss, and race to illuminate prospective disparities. The bereavement multiplier is a useful indicator for tracking COVID-19's multiplicative impact as it reverberates across American families and can be tailored to other causes of death.


title: Molecular Diagnostics and In Utero Therapeutics for Orofacial Clefts

text: Orofacial clefts and their management impose a substantial burden on patients, on their families, and on the health system. Under the current standard of care, affected patients are subjected to a lifelong journey of corrective surgeries and multidisciplinary management to replace bone and soft tissues, as well as restore esthetics and physiologic functions while restoring self-esteem and psychological health. Hence, a better understanding of the dynamic interplay of molecular signaling pathways at critical phases of palate development is necessary to pioneer novel prenatal interventions. Such pathways include transforming growth factor-ß (Tgfß), sonic hedgehog (Shh), wingless-integrated site (Wnt)/ß-catenin, bone morphogenetic protein (Bmp), and fibroblast growth factor (Fgf) and its associated receptors, among others. Here, we summarize commonly used surgical methods used to correct cleft defects postnatally. We also review the advances made in prenatal diagnostics of clefts through imaging and genomics and the various in utero surgical corrections that have been attempted thus far. An overview of how key mediators of signaling that drive palatogenesis are emphasized in the context of the framework and rationale for the development and testing of therapeutics in animal model systems and in humans is provided. The pros and cons of in utero therapies that can potentially restore molecular homeostasis needed for the proper growth and fusion of palatal shelves are presented. The theme advanced throughout this review is the need to develop preclinical molecular therapies that could ultimately be translated into human trials that can correct orofacial clefts at earlier stages of development.


Opening the Workplace After COVID-19: What Lessons Can be Learned from Return-to-Work Research?


title: COVID-19 in solid organ transplantation patients: A systematic review

text: Coronavirus disease (COVID-19) rapidly progresses to severe acute respiratory syndrome. This review aimed at collating available data on COVID-19 infection in solid organ transplantation (SOT) patients. We performed a systematic review of SOT patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The MEDLINE and PubMed databases were electronically searched and updated until April 20, 2020. The MeSH terms used were "COVID-19" AND "Transplant." Thirty-nine COVID-19 cases were reported among SOT patients. The median interval for developing SARS-CoV-2 infection was 4 years since transplantation, and the fatality rate was 25.64% (10/39). Sixteen cases were described in liver transplant (LT) patients, and the median interval since transplantation was 5 years. The fatality rate among LT patients was 37.5% (6/16), with death occurring more than 3 years after LT. The youngest patient who died was 59 years old; there were no deaths among children. Twenty-three cases were described in kidney transplant (KT) patients. The median interval since transplantation was 4 years, and the fatality rate was 17.4% (4/23). The youngest patient who died was 71 years old. Among all transplant patients, COVID-19 had the highest fatality rate in patients older than 60 years : LT, 62.5% vs 12.5% (p=0.006); KT 44.44% vs 0 (p=0.039); and SOT, 52.94% vs 4.54% (p=0.001). This study presents a novel description of COVID-19 in abdominal SOT recipients. Furthermore, we alert medical professionals to the higher fatality risk in patients older than 60 years. (PROSPERO, registration number=CRD42020181299).


Neurological Dysfunction in Coronavirus Disease-19 (COVID-19)


A Case of COVID-19 Infection: Chief Symptom, Diarrhea


title: Can dapagliflozin have a protective effect against COVID-19 infection? A hypothesis

text: It has been reported that frequent occurrence of COVID-19 infection in these patients is associated with low cytosolic pH. During virus infection, serum lactate dehydrogenase (LDH) level excessively rises. LDH is a cytosolic enzyme and the serum level increases as the cell break down. When anaerobic conditions develop, lactate formation increases from pyruvate. Cell pH is regulated by very complex mechanisms. When lactate increases in the extracellular area, this symporter carries lactate and H+ ion into the cell, and the intracellular pH quickly becomes acidic. Paradoxically, Na+/H+ exchanger activation takes place. While H+ ion is thrown out of the cell, Na+ and Ca+2 enter the cell. When Na+ and Ca+2 increase in the cell, the cells swell and die. Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor. Dapagliflozin has been reported to reduce lactate levels by various mechanisms. Also, it reduces oxygen consumption in tissues and causes the use of glucose in the aerobic pathway, thereby reducing lactate production. A lactate decrease in the environment reduces the activation of lactate/H+ symporter. Thus, the H ion pumping into the cell by this symporter is reduced and the cytosolic pH is maintained. Dapagliflozin also directly inhibits NHE. Thus, Na+ and Ca+2 flow to the cell are inhibited. Dapagliflozin provides the continuation of the structure and functions of the cells. Dapagliflozin can prevent the severe course of COVID-19 infection by preventing the lowering of cytosolic pH and reducing the viral load.


title: Dual Antiplatelet Therapy Duration in Medically Managed Acute Coronary Syndrome Patients: Sub-Analysis of the OPT-CAD Study

text: INTRODUCTION: Optimal dual antiplatelet therapy (DAPT) duration for medically managed acute coronary syndrome (ACS) (MMACS) patients is still unknown. We explored the efficacy and safety of ≥ 12-month DAPT among MMACS patients. METHODS: In this sub-analysis of the optimal antiplatelet therapy for Chinese Patients with Coronary Artery Disease study (NCT01735305), clinical outcomes among MMACS patients were compared between the < 12-month and ≥ 12-month DAPT groups. The primary efficacy endpoint was a composite of cardiac death, myocardial infarction, and stroke. Safety endpoints included the Bleeding Academic Research Consortium (BARC) 2-5, BARC 3-5, and all bleeding events. Propensity score matching (PSM) was used to compare baseline characteristics between the < 12-month and ≥ 12-month DAPT groups. RESULTS: In this cohort of ACS patients (n = 10,016), MMACS patients (n = 2967) were less likely to use DAPT at 12 (31.64% vs. 67.47%, P < 0.0001) and 24 (13.82% vs. 18.71%, P < 0.0001) months and experienced more ischemic events at 12 (4.55% vs. 3.40%, P = 0.006) and 24 (6.88% vs. 5.08%, P = 0.0004) months than those treated with percutaneous coronary intervention (n = 7049). Among MMACS patients, the rate of primary efficacy endpoint occurring within the second year was significantly higher in the < 12-month DAPT group than in the ≥ 12-month group both before (2.88% vs. 1.60%, P = 0.040) and after (3.19% vs. 1.71%, P = 0.045) PSM. After PSM, no significant differences in all bleeding, BARC 2-5, and BARC 3-5 bleeding were found between the groups. CONCLUSION: MMACS patients with insufficient DAPT management experienced relatively more ischemic events. DAPT for at least 1 year may be beneficial to this special population without significantly increasing the bleeding risks. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT01735305.


Could the smoking gun in the fight against Covid-19 be the (rh) ACE2?


Unmasking of Brugada syndrome in a patient with Coronavirus disease 2019 (COVID-19)


title: CT manifestations of the coronavirus disease 2019 of imported infection versus second-generation infection in patients outside the original district (Wuhan, China) of this disease: An observational study

text: To explore the discrepancy in computed tomography (CT) manifestations of the coronavirus disease 2019 (COVID-19) in patients outside the original district (Wuhan, China) between cases with imported infection and second-generation infection, 22 patients with COVID-19 from 2 hospitals in Nanchong, China, 938 km away from the original district (Wuhan, China) of this disease were enrolled. All patients underwent initial and follow-up CT after admission during the treatment, and were divided into 2 groups. Group A and B were composed of 15 patients with a history of exposure to the original district (Wuhan, China) in short-term (i.e., imported infection), and 7 with a close contact with the patients with confirmed COVID-19 or with the healthy individuals from the original district (i.e., second-generation infection), respectively. Initial CT features including extent score and density score between groups were statistically compared. We found that all patients in group A and 3 of 7 patients in group B had abnormal CT findings while 4 of 7 patients in group B had not. Patients with abnormal CT findings were more frequent in group A than in group B (Pâ<â.05). On initial CT, pure ground glass opacity (GGO), and GGO with consolidation and/or other abnormalities were found in 20% (3/15) and 80% (12/15) patients in group A, respectively, while 1 (14.3%), 2 (28.6%), and 4 (57.1%) had pure GGOs, GGO with focal consolidation, and normal CT appearances in Group B, respectively. Patients with extent and density scores of ≥5 were more frequent in group A than in group B (all P-valuesâ<â.01). Additionally, 3 of 4 (75%) patients with normal initial CT findings had focal pure GGO lesions on follow-up. In conclusion, COVID-19 in patients with a history of exposure to the original district can be severer than with the second-generation infection on CT.


title: Management Considerations for the Surgical Treatment of Colorectal Cancer During the Global Covid-19 Pandemic

text: OBJECTIVE: The COVID-19 pandemic requires to conscientiously weigh "timely surgical intervention" for colorectal cancer against efforts to conserve hospital resources and protect patients and health care providers. SUMMARY BACKGROUND DATA: Professional societies provided ad-hoc guidance at the outset of the COVID-19 pandemic on deferral of surgical and perioperative interventions, but these lack specific parameters to determine the optimal timing of surgery. METHODS: Using the GRADE system, published evidence was analyzed to generate weighted statements for stage, site, acuity of presentation and hospital setting to specify when surgery should be pursued, the time and duration of oncologically acceptable delays, and when to utilize non-surgical modalities to bridge the waiting period. RESULTS: Colorectal cancer surgeries - prioritized as emergency, urgent with (a) imminent emergency or (b) oncologically urgent, or elective - were matched against the phases of the pandemic. Surgery in COVID-19 positive patients must be avoided. Emergent and imminent emergent cases should mostly proceed unless resources are exhausted. Standard practices allow for postponement of elective cases and deferral to nonsurgical modalities of stage II/III rectal and metastatic colorectal cancer. Oncologically urgent cases may be delayed for 6(-12) weeks without jeopardizing oncological outcomes. Outside established principles, administration of nonsurgical modalities is not justified and increases the vulnerability of patients. CONCLUSION: The COVID-19 pandemic has stressed already limited health care resources and forced rationing, triage and prioritization of care in general, specifically of surgical interventions. Established guidelines allow for modifications of optimal timing and type of surgery for colorectal cancer during an unrelated pandemic.


COVID-19 from the land "Down Under" in an upside-down world: an Australian perspective


title: Estimation of COVID-19 prevalence in Italy, Spain, and France

text: At the end of December 2019, coronavirus disease 2019 (COVID-19) appeared in Wuhan city, China. As of April 15, 2020, >1.9 million COVID-19 cases were confirmed worldwide, including >120,000 deaths. There is an urgent need to monitor and predict COVID-19 prevalence to control this spread more effectively. Time series models are significant in predicting the impact of the COVID-19 outbreak and taking the necessary measures to respond to this crisis. In this study, Auto-Regressive Integrated Moving Average (ARIMA) models were developed to predict the epidemiological trend of COVID-19 prevalence of Italy, Spain, and France, the most affected countries of Europe. The prevalence data of COVID-19 from 21 February 2020 to 15 April 2020 were collected from the World Health Organization website. Several ARIMA models were formulated with different ARIMA parameters. ARIMA (0,2,1), ARIMA (1,2,0), and ARIMA (0,2,1) models with the lowest MAPE values (4.7520, 5.8486, and 5.6335) were selected as the best models for Italy, Spain, and France, respectively. This study shows that ARIMA models are suitable for predicting the prevalence of COVID-19 in the future. The results of the analysis can shed light on understanding the trends of the outbreak and give an idea of the epidemiological stage of these regions. Besides, the prediction of COVID-19 prevalence trends of Italy, Spain, and France can help take precautions and policy formulation for this epidemic in other countries.


title: Short Report - Medical nutrition therapy for critically ill patients with COVID-19

text: No Abstract Available.


Effectively Engaging Geriatric Patients via Teledermatology


¿Podemos usar terapias respiratorias no invasivas en la pandemia COVID-19?/ ¿Podemos usar terapias respiratorias no invasivas en la pandemia COVID-19?/ Can we use noninvasive respiratory therapies in COVID-19 pandemic?


Head and neck cancer surgery in COVID-19 pandemic in Northern Italy


title: Buying time: Drug repurposing to treat the host in COVID-19H

text: In 2016 Fedson stated . "For almost two decades, leading scientists and health officials have warned that we must prepare for a potentially devastating global pandemic of an infectious disease. Initial concern was focused on H5N1 . More recently a devastating outbreak of Ebola virus..(and) several other emerging viruses are believed to seriously threaten global health and global security. To prepare, scientists have been urged to discover new vaccines and treatments for these emerging viruses. At the same time, political leaders have been urged by global health experts to invest millions in a "top down" restructuring of the global health system. This article takes a different view. It focuses on an alternative approach to the scientific discovery of treatments for individual patients, reviews the mechanisms of action and clinical experience with specific drugs that might be useful, and considers whether or not recent lessons regarding this "bottom up" approach to treatment have been learned". Now with a new virus and pandemic upon us, Fedson's 2016 comments appear chilling, are cause for reflection on what we have learnt and importantly offer focus on an immediate opportunity in the area of treating the host (Fedson DS, Ann Transl Med, 2016;4:421).


title: [Treatment strategies for colorectal cancer patients in tumor hospitals under the background of corona virus disease 2019]

text: In December 2019, a new outbreak of corona virus disease 2019 began to occur. Its pathogen is 2019-nCoV, which has the characteristics of strong infectivity and general susceptibility. The current situation of prevention and control of new coronavirus pneumonia is severe. In this context, as front-line medical workers bearing important responsibilities and pressure, while through strict management strategy, we can minimize the risk of infection exposure. By summarizing the research progress and guidelines in recent years in the fields of colorectal cancer disease screening, treatment strategies (including early colorectal cancer, locally advanced colorectal cancer, obstructive colorectal cancer, metastatic colorectal cancer and the treatment of patients after neoadjuvant therapy), the choice of medication and time limit for adjuvant therapy, the protective measures for patients undergoing emergency surgery, the re-examination of postoperative patients and the protection of medical staff, etc., authors improve treatment strategies in order to provide more choices for patients to obtain the best treatment under the severe epidemic situation of new coronavirus pneumonia. Meanwhile we hope that it can also provide more timely treatment modeling schemes for colleagues.


title: COVID-19 stressors on migrant workers in Kuwait: cumulative risk considerations

text: As a marginalised subpopulation, migrant workers often fall short from protection by public policies, they take precarious jobs with unsafe working and living conditions and they grapple with cultural and linguistic barriers. In light of the current COVID-19 pandemic, migrant workers are now exposed to additional stressors of the virus and related responses. We applied a comprehensive qualitative cumulative risk assessment framework for migrant workers living in Kuwait. This pandemic could be one of the few examples where the stressors overlap all domains of migrant workers' lives. No single intervention can solve all the problems; there must be a set of interventions to address all domains. Local authorities and employers must act quickly to stop the spread, ensure easy access to testing and treatment, provide adequate housing and clear communication, encourage wide social support, safeguard financial protection and mental well-being and continuously re-evaluate the situation as more data are collected.


Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target


title: Análise da subnotificação de COVID-19 no Brasil./ Análise da subnotificação de COVID-19 no Brasil./ Analysis of COVID-19 under-reporting in Brazil

text: OBJECTIVE: To estimate the reporting rates of coronavirus disease 2019 (COVID-19) cases for Brazil as a whole and states. METHODS: We estimated the actual number of COVID-19 cases using the reported number of deaths in Brazil and each state, and the expected case-fatality ratio from the World Health Organization. Brazil's expected case-fatality ratio was also adjusted by the population's age pyramid. Therefore, the notification rate can be defined as the number of confirmed cases (notified by the Ministry of Health) divided by the number of expected cases (estimated from the number of deaths). RESULTS: The reporting rate for COVID-19 in Brazil was estimated at 9.2% (95%CI 8.8% - 9.5%), with all the states presenting rates below 30%. São Paulo and Rio de Janeiro, the most populated states in Brazil, showed small reporting rates (8.9% and 7.2%, respectively). The highest reporting rate occurred in Roraima (31.7%) and the lowest in Paraiba (3.4%). CONCLUSION: The results indicated that the reporting of confirmed cases in Brazil is much lower as compared to other countries we analyzed. Therefore, decision-makers, including the government, fail to know the actual dimension of the pandemic, which may interfere with the determination of control measures.


Canadian Public Health Laboratory Network Statement on Point-of-Care Serology Testing in COVID-19


Pediatric inflammatory syndrome temporally related to covid-19


title: Characterization and antiinflammatory properties of fractionated pyroligneous acid from palm kernel shell

text: Pyroligneous acid (PA) obtained from slow pyrolysis of palm kernel shell (PKS) has high total phenolic contents and exhibits various biological activities including antioxidant, antibacterial and antifungal. In this study, PA obtained using slow pyrolysis method and fractionated using column chromatography was characterized (chemical and antioxidative properties) and investigated for its cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX) inhibition activities using the in vitro and in silico approaches. The F9 PA fraction exhibited highest total phenolic content of 181.75 ± 17.0 µg/mL. Fraction F21-25 showed ferric reducing antioxidant power (FRAP) (331.80 ± 4.60 mg TE/g) and IC50 of 18.56 ± 0.01 µg/mL towards COX-2 and 5.25 ± 0.03 µg/mL towards the 5-LOX enzymes, respectively. Molecular docking analysis suggested favourable binding energy for all chemical compounds present in fraction F21-25, notably 1-(2,4,6-trihydroxyphenyl)-2-pentanone, towards both COX-2 (- 6.9 kcal/mol) and 5-LOX (- 6.4 kcal/mol) enzymes. As a conclusion, PA from PKS has the potential to be used as an alternative antioxidant and antiinflammatory agents which is biodegradable and a more sustainable supply of raw materials.


title: Increasing global awareness of timely COVID-19 healthcare guidelines through FPV training tutorials: Portable public health crises teaching method

text: INTRODUCTION: The current COVID-19 pandemic has prompted a timely response from the healthcare system train a large and diverse group of healthcare workers/responders swiftly. METHODS: In order to address this need, we created a downloadable pedagogical video content through first-person point-of-view to rapidly train users on COVID-19 procedures in the Revinax® Handbook mobile App. Eight new tutorials were designed through this technology platform to assist healthcare workers/responders caring for COVID-19 patients. A survey was then sent to assess their interest. RESULTS: In one-month since the App was created, it was downloaded by 12,516 users and a feedback survey determined that the users valued the tutorials in helping them learn COVID-19 procedures efficiently in real-time. The fast-growing number of downloads and positive user feedback evidences that we created a valuable educational tool with an emergent- and growing-demand. DISCUSSION: The 71.48% App user response rate, showed largely positive feedback of the COVID-19 tutorial. The fact that these healthcare workers/responders took the time to complete the survey during a pandemic was indicative of its immediate value. Further, the App users indicated that they FPV tutorial was rather helpful in addressing their training needs regarding their roles in COVID-19 patient care during the pandemic. CONCLUSION: The tutorials were deployed to offer efficient and rapid global public health educational outreach as a tool to address COVID-19 healthcare training in a timely manner.


COVID-19 risk contagion: Organization and procedures in a South Italy geriatric oncology ward


Discussing non-beneficial treatment


title: Using Deep Learning and Explainable Artificial Intelligence in Patients' Choices of Hospital Levels

text: In countries that enabled patients to choose their own providers, a common problem is that the patients did not make rational decisions, and hence, fail to use healthcare resources efficiently. This might cause problems such as overwhelming tertiary facilities with mild condition patients, thus limiting their capacity of treating acute and critical patients. To address such maldistributed patient volume, it is essential to oversee patients choices before further evaluation of a policy or resource allocation. This study used nationwide insurance data, accumulated possible features discussed in existing literature, and used a deep neural network to predict the patients choices of hospital levels. This study also used explainable artificial intelligence methods to interpret the contribution of features for the general public and individuals. In addition, we explored the effectiveness of changing data representations. The results showed that the model was able to predict with high area under the receiver operating characteristics curve (AUC) (0.90), accuracy (0.90), sensitivity (0.94), and specificity (0.97) with highly imbalanced label. Generally, social approval of the provider by the general public (positive or negative) and the number of practicing physicians serving per ten thousand people of the located area are listed as the top effecting features. The changing data representation had a positive effect on the prediction improvement. Deep learning methods can process highly imbalanced data and achieve high accuracy. The effecting features affect the general public and individuals differently. Addressing the sparsity and discrete nature of insurance data leads to better prediction. Applications using deep learning technology are promising in health policy making. More work is required to interpret models and practice implementation.


title: Practical recommendations for the management of diabetes in patients with COVID-19

text: Diabetes is one of the most important comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2. Patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multi-organ failure. Depending on the global region, 20-50% of patients in the coronavirus disease 2019 (COVID-19) pandemic had diabetes. Given the importance of the link between COVID-19 and diabetes, we have formed an international panel of experts in the field of diabetes and endocrinology to provide some guidance and practical recommendations for the management of diabetes during the pandemic. We aim to briefly provide insight into potential mechanistic links between the novel coronavirus infection and diabetes, present practical management recommendations, and elaborate on the differential needs of several patient groups.


title: Improved polarization and energy density in boron nitride nanosheets/poly(vinylidene fluoride-chlorotrifluoroethylene) nanocomposite with trilayered architecture regulation

text: Polymer film capacitor with high energy density has attracted great attention in past decades to accomplish the requirements of miniaturization and lightweight for electronics and energy storage system. The multi-layered nanocomposite exhibits an effective route for developing polymer film with large energy capability due to the advantage of each layer. Here, two sandwich constructions of boron nitride nanosheets (BNNSs)/poly(vinylidene fluoride-chlorotrifluoroethylene) (P(VDF-CTFE)) nanocomposite film were designed to investigate the effects of architecture regulation on energy storage performance,i.e., the nanocomposite serving as inner layer with pristine films as outer layers, in which the nanocomposite film delivers a strongly polarized behavior and the pristine polymer provides a high breakdown strength. The BNNSs were liquid exfoliated from boron nitride bulk assisted with fluoro hyperbranched copolymer that was adsorbed on the surface of nanosheetsviaCH-π non-covalent interactions. The presence of fluoro segments improves the compatibility between nanosheets and P(VDF-CTFE) matrix. The maximum polarization of 7.9 µC cm-2at 300 MV m-1is achieved in the tailored sandwich film, and the discharged energy density of 9.1 J cm-3is obtained in current nanocomposite, which benefits from the barrier effect between adjacent layers induced by the redistribution of electric field and emerging charge traps at the interfaces. This sandwich BNNSs/P(VDF-CTFE) nanocomposite provides an insight prospect for structural design with respect to the advanced application of polymer film capacitor.


title: Headache Virtual Visit Toolbox: The Transition From Bedside Manners to Webside Manners

text: The COVID-19 health emergency has led many Headache providers to transition to virtual care overnight without preparation. We review our experience and discuss tips to bring humanity to the virtual visits.


title: Rapid Sentinel Surveillance for COVID-19 - Santa Clara County, California, March 2020

text: On February 27, 2020, the Santa Clara County Public Health Department (SCCPHD) identified its first case of coronavirus disease 2019 (COVID-19) associated with probable community transmission (i.e., infection among persons without a known exposure by travel or close contact with a patient with confirmed COVID-19). At the time the investigation began, testing guidance recommended focusing on persons with clinical findings of lower respiratory illness and travel to an affected area or an epidemiologic link to a laboratory-confirmed COVID-19 case, or on persons hospitalized for severe respiratory disease and no alternative diagnosis (1). To rapidly understand the extent of COVID-19 in the community, SCCPHD, the California Department of Public Health (CDPH), and CDC began sentinel surveillance in Santa Clara County. During March 5-14, 2020, four urgent care centers in Santa Clara County participated as sentinel sites. For this investigation, county residents evaluated for respiratory symptoms (e.g., fever, cough, or shortness of breath) who had no known risk for COVID-19 were identified at participating urgent care centers. A convenience sample of specimens that tested negative for influenza virus was tested for SARS-CoV-2 RNA. Among 226 patients who met the inclusion criteria, 23% had positive test results for influenza. Among patients who had negative test results for influenza, 79 specimens were tested for SARS-CoV-2, and 11% had evidence of infection. This sentinel surveillance system helped confirm community transmission of SARS-CoV-2 in Santa Clara County. As a result of these data and an increasing number of cases with no known source of transmission, the county initiated a series of community mitigation strategies. Detection of community transmission is critical for informing response activities, including testing criteria, quarantine guidance, investigation protocols, and community mitigation measures (2). Sentinel surveillance in outpatient settings and emergency departments, implemented together with hospital-based surveillance, mortality surveillance, and serologic surveys, can provide a robust approach to monitor the epidemiology of COVID-19.


Comment on "Antipsoriatic treatments during COVID-19 outbreak"


title: On the Detection of Disinformation Campaign Activity with Network Analysis

text: Online manipulation of information has become prevalent in recent years as disinformation campaigns seek to polarize political topics. While we are aware that disinformation campaigns exist, detecting their online presence is still difficult. Researchers have proposed detecting disinformation campaigns on Twitter by looking for specific coordination patterns (e.g., sharing the same hashtag in a short time frame). The problem with this approach, however, is that while the proposed coordination patterns may have been unique to the studied disinformation campaigns, the patterns have not been thoroughly validated against non-random samples or across a diverse set of campaigns. We examine the usefulness of these coordination patterns for identifying the activity of a disinformation campaign from other Twitter activity. We do this by testing the proposed coordination patterns on a large-scale dataset of ten state-attributed campaigns and various benign Twitter communities likely to coordinate and share information amongst themselves. We show that such patterns have significant limitations. First, coordination in Twitter communities is not uncommon, especially when the online world is reacting to real-world news (e.g., US impeachment trials). Second, due to the COVID-19 pandemic, we found that political bodies increased their coordinated activity. Such surge in coordination worsens the trade-off between usability and rate of detection. To identify most of the benign activity during the pandemic, the classifier misses nearly 25% of disinformation activity. Conversely, if the classifier achieves a high rate of detection for malicious coordination, it misclassifies 46% of legitimate coordinated activity. In doing this meta-analysis, we show that although coordination patterns could be useful for detecting disinformation activity, further analysis is needed to determine the community's intention.


Total pathway to method validation


Physical activity/inactivity and COVID-19


COVID-19: Navigating Uncertainties Together


A summary of the rapid services changes made in response to staff psychological needs and maintaining care to those with cancer in light of COVID-19


Answering to the Call of Critically Ill Patients: Limiting Sonographer Exposure to COVID-19 with Focused Protocols


High Levels of Ambient Ozone (O3) May Impact COVID-19 in High Altitude Mountain Environments


Covid-19, la Société française du cancer (SFC) et le BulletinduCancer./ [Covid-19, the Société française du cancer (SFC) and the BulletinduCancer]


The psychological impact of quarantine on coronavirus disease 2019 (COVID-19)


Covid-19 may be exacerbated by right-to-left interatrial shunt


title: Coronavirus Disease 2019: Coronaviruses and Blood Safety

text: With the outbreak of unknown pneumonia in Wuhan, China, in December 2019, a new coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), aroused the attention of the entire world. The current outbreak of infections with SARS-CoV-2 is termed Coronavirus Disease 2019 (COVID-19). The World Health Organization declared COVID-19 in China as a Public Health Emergency of International Concern. Two other coronavirus infections-SARS in 2002-2003 and Middle East Respiratory Syndrome (MERS) in 2012-both caused severe respiratory syndrome in humans. All 3 of these emerging infectious diseases leading to a global spread are caused by ß-coronaviruses. Although coronaviruses usually infect the upper or lower respiratory tract, viral shedding in plasma or serum is common. Therefore, there is still a theoretical risk of transmission of coronaviruses through the transfusion of labile blood products. Because more and more asymptomatic infections are being found among COVID-19 cases, considerations of blood safety and coronaviruses have arisen especially in endemic areas. In this review, we detail current evidence and understanding of the transmission of SARS-CoV, MERS-CoV, and SARS-CoV-2 through blood products as of February 10, 2020, and also discuss pathogen inactivation methods on coronaviruses.


Perioperative COVID-19 testing of orthopedic patients: Current evidence