title: SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes

text: Objectives: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. Design: An outbreak investigation. Setting: 4 nursing homes affected by COVID-19 outbreaks in central London. Participants: 394 residents and 70 staff in nursing homes. Interventions: Two point-prevalence surveys one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. Main outcome measures: All-cause mortality, and mortality attributed to COVID-19 on death certificates. Prevalence of SARS-CoV-2 infection and symptoms in residents and staff. Results: Overall, 26% (95% confidence interval 22 to 31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70 to 336). Systematic testing identified 40% (95% CI 35 to 46) of residents, of whom 43% (95% CI 34 to 52) were asymptomatic and 18% (95% CI 11 to 24) had atypical symptoms, as well as 4% (95% CI -1 to 9) of asymptomatic staff who tested positive for SARS-CoV-2. Conclusions: The SARS-CoV-2 outbreak was associated with a very high mortality rate in residents of nursing homes. Systematic testing of all residents and a representative sample of staff identified high rates of SARS-CoV-2 positivity across the four nursing homes, highlighting a potential for regular screening to prevent future outbreaks.


title: Air and surface contamination in non-health care settings among 641 environmental specimens of 39 COVID-19 cases

text: Background Little is known about the SARS-CoV-2 contamination of environmental surfaces and air in non-health care settings among COVID-19 cases. Methods and findings We explored the SARS-CoV-2 contamination of environmental surfaces and air by collecting air and swabbing environmental surfaces among 39 COVID-19 cases in Guangzhou, China. The specimens were tested by RT-PCR testing. The information collected for COVID-19 cases included basic demographic, clinical severity, onset of symptoms, radiological testing, laboratory testing and hospital admission. A total of 641 environmental surfaces and air specimens were collected among 39 COVID-19 cases before disinfection. Among them, 20 specimens (20/641, 3.1%) were tested positive from 9 COVID-19 cases (9/39, 23.1%), with 5 (5/101, 5.0%) positive specimens from 3 asymptomatic cases, 5 (5/220, 2.3%) from 3 mild cases, and 10 (10/374, 2.7%) from 3 moderate cases. All positive specimens were collected within 3 days after diagnosis, and 10 (10/42, 23.8%) were found in toilet (5 on toilet bowl, 4 on sink/faucet/shower, 1 on floor drain), 4 (4/21, 19.0%) in anteroom (2 on water dispenser/cup/bottle, 1 on chair/table, 1 on TV remote), 1 (1/8, 12.5%) in kitchen (1 on dining-table), 1 (1/18, 5.6%) in bedroom (1 on bed/sheet pillow/bedside table), 1 (1/5, 20.0%) in car (1 on steering wheel/seat/handlebar) and 3 (3/20, 21.4%) on door knobs. Air specimens in room (0/10, 0.0%) and car (0/1, 0.0%) were all negative. Conclusions SARS-CoV-2 was found on environmental surfaces especially in toilet, and could survive for several days. We provided evidence of potential for SARS-CoV-2 transmission through contamination of environmental surfaces.


Business and Society Research in Times of the Corona Crisis


title: COVID-19 higher morbidity and mortality in Chinese regions with lower air quality

text: We investigated the geographical character of the COVID-19 infection in China and correlated it with satellite- and ground-based measurements of air quality. Controlling for population size, we found more viral infections in those areas afflicted by high Carbon Monoxide, formaldehyde, PM 2.5, and Nitrogen Dioxide values. Higher mortality was also correlated with relatively poor air quality. Air pollution appears to be a risk factor for the incidence of this disease, similar to smoking. This suggests the detrimental impact of air pollution in these types of respiratory epidemics.


title: Excess mortality in England and Wales during the first wave of the COVID-19 pandemic

text: Background Deaths during the COVID-19 pandemic result directly from infection and exacerbation of other diseases and indirectly from deferment of care for other conditions, and are socially and geographically patterned. We quantified excess mortality in regions of England and Wales during the pandemic, for all causes and for non-COVID-19 associated deaths. Methods Weekly mortality data for 1 Jan 2010 to 1 May 2020 for England and Wales were obtained from the Office of National Statistics. Mean-dispersion negative binomial regressions were used to model death counts based on pre-pandemic trends and exponentiated linear predictions were subtracted from: i) all-cause deaths; and ii) all-cause deaths minus COVID-19 related deaths for the pandemic period (07-13 March to 25 April to 8 May). Findings Between 7 March and 8 May 2020, there were 47,243 (95%CI: 46,671 to 47,815) excess deaths in England and Wales, of which 9,948 (95%CI: 9,376 to 10,520) were not associated with COVID-19. Overall excess mortality rates varied from 49 per 100,000 (95%CI: 49 to 50) in the South West to 102 per 100,000 (95%CI: 102 to 103) in London. Non-COVID-19 associated excess mortality rates ranged from -1 per 100,000 (95%CI: -1 to 0) in Wales (i.e. mortality rates were no higher than expected) to 26 per 100,000 (95%CI: 25 to 26) in the West Midlands. Interpretation The COVID-19 pandemic has had markedly different impacts on the regions of England and Wales, both for deaths directly attributable to COVID-19 infection and for deaths resulting from the national public health response.


title: Coronavirus disease (COVID-19): Rheumatological Prospects/Relevance

text: In December 2019, an outbreak of a novel infection under the working name 2019-nCoV was registered in Wuhan (the Hubei Province located in China's central region), which has quickly spread throughout almost the entire world and become pandemic. The World Health Organization (WHO) proposed a new name coronavirus disease (COVID-19) for this disease, whereas the International Committee on Virus Taxonomy renamed 2019-nCov as SARS-Cov-2 (Severe Acute Respiratory Syndrome Coronavirus-2). The development of the COVID-19 pandemic is not only of great social importance, but also draws the attention of a medical community to the fundamentally new clinical and fundamental problems of the immunopathology of human diseases that are yet to be formulated. The unique experience gained in rheumatology from studies of the pathogenetic mechanisms and pharmacotherapy of immune-mediated inflammatory rheumatic diseases (IMIRDs) can be of great importance for deciphering the nature of the pathological processes that underlie the severe, potentially fatal complications of COVID-19, and may assist in improving their therapy. As for prospects in patients with IMIRDs, although the development of COVID-19 in the presence of IMIRDs has not yet fortunately been described, infection with SARS-CoV-2, like other viruses, can be assumed to cause an exacerbation of the pathological process, whereas severe immune system pathology and comorbidities can worsen the course of infection. Since, according to the current concepts, it is the «hyperimmune» response, and not just the effect only of the virus itself, that underlies lung damage and deaths from COVID-19, special attention is drawn to the effects of antirheumatic therapy that includes glucocorticoids, disease-modifying anti-rheumatic drugs (DMARDs), biological agents, and targeted DMARDs, which can have a multidirectional effect on the course of COVID-19. There are significant theoretical prerequisites for the repurposing of some drugs widely used in rheumatology for the treatment of COVID-19 and its complications. Consideration is given to the prospects of studying the immunopathology of COVID-19 and to the theoretical justifications for the use of antimalarial 4-aminoquinolines, anti-cytokine monoclonal antibodies (mAbs), and Janus kinase inhibitors for the prevention of complications and for the treatment of COVID-19.


title: Adverse articulation: Third countries in China–Australia student migration during COVID-19

text: Southeast Asian countries were articulated with the Australia–China value chain for educational services early in the COVID-19 outbreak, when travelers from China could enter Australia only via stopovers in third countries. The routes, advertised by migration brokers, allowed Australia to externalize risk of infection while profiting from international student mobility.


title: Vitamin D Insufficiency is Prevalent in Severe COVID-19

text: Background: COVID-19 is a major pandemic that has killed more than 196,000 people. The COVID-19 disease course is strikingly divergent. Approximately 80-85% of patients experience mild or no symptoms, while the remainder develop severe disease. The mechanisms underlying these divergent outcomes are unclear. Emerging health disparities data regarding African American and homeless populations suggest that vitamin D insufficiency (VDI) may be an underlying driver of COVID-19 severity. To better define the VDI-COVID-19 link, we determined the prevalence of VDI among our COVID-19 intensive care unit (ICU) patients. Methods: In an Institutional Review Board approved study performed at a single, tertiary care academic medical center, the medical records of COVID-19 patients were retrospectively reviewed. Subjects were included for whom serum 25-hydroxycholecalcifoerol (25OHD) levels were determined. COVID-19-relevant data were compiled and analyzed. We determined the frequency of VDI among COVID-19 patients to evaluate the likelihood of a VDI-COVID-19 relationship. Results: Twenty COVID-19 patients with serum 25OHD levels were identified; 65.0% required ICU admission.The VDI prevalence in ICU patients was 84.6%, vs. 57.1% in floor patients. Strikingly, 100% of ICU patients less than 75 years old had VDI. Coagulopathy was present in 62.5% of ICU COVID-19 patients, and 92.3% were lymphocytopenic. Conclusions: VDI is highly prevalent in severe COVID-19 patients. VDI and severe COVID-19 share numerous associations including hypertension, obesity, male sex, advanced age, concentration in northern climates, coagulopathy, and immune dysfunction. Thus, we suggest that prospective, randomized controlled studies of VDI in COVID-19 patients are warranted.


title: Analysis and Prediction of False Negative Results for SARS-CoV-2 Detection with Pharyngeal Swab Specimen in COVID-19 Patients: A Retrospective Study

text: Background: False negative results of SARS-CoV-2 nucleic acid detection pose threats to COVID-19 patients and medical workers alike. Objective: To develop multivariate models to determine clinical characteristics that contribute to false negative results of SARS-CoV-2 nucleic acid detection, and use them to predict false negative results as well as time windows for testing positive. Design: Retrospective Cohort Study (Ethics number of Tongji Hospital: No. IRBID: TJ-20200320) Setting: A database of outpatients in Tongji Hospital (University Hospital) from 15 January 2020 to 19 February 2020. Patients: 1,324 outpatients with COVID-19 Measurements: Clinical information on CT imaging reports, blood routine tests, and clinic symptoms were collected. A multivariate logistic regression was used to explain and predict false negative testing results of SARS-CoV-2 detection. A multivariate accelerated failure model was used to analyze and predict delayed time windows for testing positive. Results: Of the 1,324 outpatients who diagnosed of COVID-19, 633 patients tested positive in their first SARS-CoV-2 nucleic acid test (47.8%), with a mean age of 51 years (SD=14.9); the rest, which had a mean age of 47 years (SD=15.4), tested negative in the first test. Ground glass opacity in a CT imaging report was associated with a lower chance of false negatives (aOR, 0.56), and reduced the length of time window for testing positive by 26%. Consolidation was associated with a higher chance of false negatives (aOR, 1.57), and extended the length of time window for testing positive by 44%. In blood routine tests, basophils (aOR, 1.28) and eosinophils (aOR, 1.29) were associated with a higher chance of false negatives, and were found to extend the time window for testing positive by 23% and 41%, respectively. Age and gender also affected the significantly. Limitation: Data were generated in a large single-center study. Conclusion: Testing outcome and positive window of SARS-CoV-2 detection for COVID-19 patients were associated with CT imaging results, blood routine tests, and clinical symptoms. Taking into account relevant information in CT imaging reports, blood routine tests, and clinical symptoms helped reduce a false negative testing outcome. The predictive AFT model, what we believe to be one of the first statistical models for predicting time window of SARS-CoV-2 detection, could help clinicians improve the accuracy and efficiency of the diagnosis, and hence, optimizes the timing of nucleic acid detection and alleviates the shortage of nucleic acid detection kits around the world. Primary Funding Source: None.


title: Medical students perceptions and motivations in time of COVID-19 pandemic

text: Background: There has been a rapid increase in the number of cases of COVID19 in Latin America, Africa and Asia, in many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students as part of the health teams is a very important issue. It has been recommended that medical students work as volunteers, have appropriate training, do not undertake any activity beyond their level of competence, have continuous supervision and adequate personal protective equipment. However, motivation of medical students must be evaluated in order to make volunteering a more evidence-based initiative. The aim of our study was to evaluate motivation of medical students to be part of the health team to help in the COVID19 pandemic. Methods and Findings: We developed a questionnaire specifically to evaluate medical students perceptions about participating in care of patients with suspected infection due to coronavirus during the COVID19 pandemic. The questionnaire had two parts: a) individual characteristics, year and geographic location of medical school; b) twenty eight statements responded on a 5 point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings of a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyse the data. Statements with greater odds ratios for participation of medical students in COVID19 pandemic were related to sense of purpose or duty (It is the duty of the medical student to put himself at the service of the population in the pandemic), altruism (I am willing to take risks by participating in practical in the context of pandemic), perception of good performance and professional identity (I will be a better health professional for having experienced the pandemic). Males had higher odds ratios than females (1.36 [95% CI: 1.24 to 1.49] to 1.68 [95% CI: 1.47 to 1.91]). Conclusions: Medical students are motivated by sense of purpose or duty, altruism, perception of good performance and values of professionalism more than their interest in learning. These results have implications in the developing of programs of volunteering and in the design of health force policies in the present pandemic and in future health emergencies.


title: Obstetrical safety indicators for preventing hospital harms: a scoping review protocol

text: Introduction: Optimizing the safety of obstetric patient care is a primary concern for many hospitals. Identifying performance indicators that measure aspects of patient care processes related to preventable harms can present opportunities to improve health systems. In this paper, we present our protocol for a scoping review to identify performance indicators for obstetric safety. We aim to identify a comprehensive list of obstetric safety indicators which may help reduce the number of preventable patient harms, to summarize the data and to synthesize the results. Methods and analysis: We will use the methodological framework described by Arksey and O Malley and further expanded by Levac. We will search multiple electronic databases such as Medline, Embase, CINAHL and the Cochrane Library as well as websites from professional bodies and other organisations, using an iterative search strategy. We will include indicators that relate to preventable harms in the process of obstetric care. Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. For records where eligibility is not clear, the reviewers will screen the full text version. If reviewers decisions regarding eligibility differ, a third reviewer will review the full text record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardized data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators identified during our scoping review and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications of the indicators for future research, clinical practice and policy making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA ScR) Checklist. Ethics and Dissemination: The sources of information included in this scoping review will be available to the public. Therefore, ethical review for this research is not warranted. We will disseminate our research results using multiple modes of delivery such as a peer-reviewed publication, conference presentations and stakeholder communications. Keywords: Obstetrics, patient safety, performance indicators, prevention, hospital harms, scoping review, protocol.


title: The unwanted free rider: Covid-19

text: Winter holidays in the European Alps early 2020 led to unexpected challenges for the Scandinavian countries (Denmark, Norway and Sweden), since many travellers brought home a free rider virus, Covid-19. In this study a modified gravity model is used to investigate how important destination country, size and geographical distance are for the extent to which the virus was carried to Scandinavia. The number of reported Covid-19 positive cases is highest from Austria (1150 individuals), Italy (68) and Spain (90). Count data model estimations confirm that the number of Covid-19 cases in Scandinavia mainly originates from Austria and Italy, followed by Iran. The number of positive cases brought from abroad decreases significantly with the geographical distance between the home country and the destination. There is also a clear surge of infections at the beginning of the observation period (11 March to 15 March 2020), before the introduction of travel restrictions.


title: Infected Markets: Novel Coronavirus, Government Interventions, and Stock Return Volatility around the Globe

text: Abstract Do government interventions aimed at curbing the spread of COVID-19 affect stock market volatility? To answer this question, we explore the stringency of policy responses to the novel coronavirus pandemic in 67 countries around the world. We demonstrate that non-pharmaceutical interventions significantly increase equity market volatility. The effect is independent from the role of the coronavirus pandemic itself and is robust to many considerations. Furthermore, two types of actions that are usually applied chronologically particularly early—information campaigns and public event cancellations—are the major contributors to the growth of volatility.


Opportunities and threats: The necessity of research in dealing with the rapid spread of coronavirus disease 2019 (COVID-19) in Iran


Coronavirus name, animal-research data and a Solar System snowman


title: Challenges for Obstetricians and the Countermeasures of COVID-19 Epidemic

text: Since the outbreak of the novel coronavirus in Wuhan, China, as obstetricians, we also face great challenges We need to identify pregnant patients with 2019 coronavirus disease infection timely, and give them appropriate treatment in order to obtain a good maternal and infant prognosis Here, we would like to share a case and provide some suggestions on how to screen, diagnose and treat pregnant women with 2019 coronavirus disease infection during the outbreak Corresponding author: Prof Li Zou, Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China E-mail: xiehezouli@hust edu cn Received February 10, 2020 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4 0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited The work cannot be changed in any way or used commercially without permission from the journal http://creativecommons org/licenses/by-nc-nd/4 0 © 2020 by Lippincott Williams & Wilkins, Inc


title: The effect of serological screening for SARS-CoV-2 antibodies to participants' attitudes and risk behaviour: a study on a tested population sample of industry workers in Split-Dalmatia County, Croatia

text: Rapid serological tests for SARS-CoV-2 antibodies have been questioned by scientists and the public because of unexplored effects of negative test results on behaviour and attitudes, that could lower the level of adherence to protective measures. Therefore, our study aimed to investigate the changes in personal attitudes and behaviour before and after negative serological test results for SARS-CoV-2 antibodies. We conducted a survey questionnaire on 200 industry workers (69% males and 31% females) that have been previously tested negative. The survey examined participants' self-reported general attitudes towards COVID-19, sense of fear, as well as their behaviour related to protective measures before and after the testing. The participants perceived the disease as a severe health threat and acknowledged the protective measures as appropriate. They reported a high level of adherence to measures and low level of fear both before and after the testing. Although those indicators were statistically significantly reduced after the test (P < 0.004), they did not result in risk behaviour. Therefore, the serological tests are not an additional threat regarding the risk behaviour in an environment where protective measures are efficient. In contrast, they might contribute to reducing the fear in the society and working environment.


title: Secretive Jasons to offer advice on how to reopen academic labs shut by pandemic

text: A group of prominent academic scientists that has been advising the U S government on security matters since the Cold War is conducting a quick-turnaround, pro bono study of a new threat to national security—the impact of COVID-19 on academic research And this time it’s personal


title: Outcomes of Hydroxychloroquine Treatment Among Hospitalized COVID-19 Patients in the United States- Real-World Evidence From a Federated Electronic Medical Record Network

text: On March 28, 2020, in response to the rapidly accelerating COVID-19 pandemic, U.S FDA issued emergency use authorization for hydroxychloroquine (HCQ) in hospitalized COVID-19 patients based on limited in-vitro and anecdotal clinical data. Analysis of the accumulated real-world data utilizing electronic medical records (EMR) could indicate HCQ therapy benefits as we await the results of clinical trials. However, any such analysis of retrospective observational data should account for variables such as demographics and comorbidities that could affect treatment strategies or outcomes. Therefore, we report the outcomes of HCQ treatment in a propensity-matched cohort of COVID-19 hospitalized patients. Our analysis of a large retrospective cohort of hospitalized COVID-19 patients treated with HCQ did not show benefits in mortality or the need for mechanical ventilation when compared to a matched cohort of patients who did not receive HCQ.


title: COVID-19 pandemic in the African continent: forecasts of cumulative cases, new infections, and mortality

text: Background: Africa is the last major region to capitulate to the SARS-CoV-2 (COVID-19) pandemic. The first confirmed COVID-19 case in the region was reported on February 14, but what lies ahead in terms of the course and magnitude of infection remains speculative. To the best of our knowledge, no study, using a robust methodology, provides the immediate and long-term trajectory of COVID-19 for the entire region or accounts for its local context. This paper is the first systematic attempt to provide estimates on how many people would contract the virus and how many would die in the coming few months across Africa. Methods: The forecasts on caseloads and incidences are from a co-variate-based instrumental variable regression model. Fatality rates from Italy and China were further applied to generate mortality estimates after adjustments were made for differences in age-structure, health service quality, and living standards between each of the African countries and those of the reference population. We cover all countries that reported a confirmed case as of March 31, 2020. Results: By the end of June, 16,283,085 people will contract COVID-19 (95% CI 718,403 to 98, 358, 799). With a cumulative caseload of 5,413,4517 (95% CI 1,332,953 to 8,489,940) and 906,625 (95% CI 173, 821 to 4,742,917) Northern and Eastern Africa will respectively be the most and least affected sub-regions in the continent. Cumulative COVID-19 cases on June 30, 2020 are expected to reach 2,912, 864 (95% CI 465,028 to 18,286,358) in Southern Africa, 2,787, 913 (95% CI 517, 489 to 15,056,314) in Western Africa, and 1,185,742 (95% CI 229, 111 to 6,138,692) in Central Africa. New infections (incidence) for the month of April are expected to be the highest in Djibouti, 32.8 per 1000 (95% CI 6.25 to 171.77), while Morocco 1045 (95% CI 167 to 6,547) will register the highest number of deaths. Conclusion: Our study shows that countries that are least urbanized and have a low level of socio-economic development, hence least connected to the outside world, are likely to register lower and slower transmissions, at least at the early stage of the epidemic. However, the same set of enabling factors that worked for their benefit are likely to go against them in implementing interventions that have lessened the impact of the disease elsewhere.


title: A systematic examination of preprint platforms for use in the medical and biomedical sciences setting

text: Objectives The objective of this review is to identify all preprint platforms with biomedical and medical scope and to compare and contrast the key characteristics and policies of these platforms. We also aim to provide a searchable database to enable relevant stakeholders to compare between platforms. Study Design and Setting Preprint platforms that were launched up to 25th June 2019 and have a biomedical and medical scope according to MEDLINE’s journal selection criteria were identified using existing lists, web-based searches and the expertise of both academic and non-academic publication scientists. A data extraction form was developed, pilot-tested and used to collect data from each preprint platform’s webpage(s). Data collected were in relation to scope and ownership; content-specific characteristics and information relating to submission, journal transfer options, and external discoverability; screening, moderation, and permanence of content; usage metrics and metadata. Where possible, all online data were verified by the platform owner or representative by correspondence. Results A total of 44 preprint platforms were identified as having biomedical and medical scope, 17 (39%) were hosted by the Open Science Framework preprint infrastructure, six (14%) were provided by F1000 Research Ltd (the Open Research Central infrastructure) and 21 (48%) were other independent preprint platforms. Preprint platforms were either owned by non-profit academic groups, scientific societies or funding organisations (n=28; 64%), owned/partly owned by for-profit publishers or companies (n=14; 32%) or owned by individuals/small communities (n=2; 5%). Twenty-four (55%) preprint platforms accepted content from all scientific fields although some of these had restrictions relating to funding source, geographical region or an affiliated journal’s remit. Thirty-three (75%) preprint platforms provided details about article screening (basic checks) and 14 (32%) of these actively involved researchers with context expertise in the screening process. The three most common screening checks related to the scope of the article, plagiarism and legal/ethical/societal issues and compliance. Almost all preprint platforms allow submission to any peer-reviewed journal following publication, have a preservation plan for read-access, and most have a policy regarding reasons for retraction and the sustainability of the service. Forty-one (93%) platforms currently have usage metrics, with the most common metric being the number of downloads presented on the abstract page. Conclusion A large number of preprint platforms exist for use in biomedical and medical sciences, all of which offer researchers an opportunity to rapidly disseminate their research findings onto an open-access public server, subject to scope and eligibility. However, the process by which content is screened before online posting and withdrawn or removed after posting varies between platforms, which may be associated with platform operation, ownership, governance and financing. What is already known on this topic In concurrence with an increase in the number of preprint servers and platforms supporting biomedical and medical sciences research since 2013, there has been substantial growth in the number of preprints posted in this research area. The significant benefits of accelerated dissemination of research that preprints offer has attracted the support of many major funders. The raised profile of preprints has led to their wider acceptance in institutional and individual level assessment. What this study adds This is the first full examination of the characteristics and policies of 44 preprint platforms with biomedical and medical scope. We use a robust methodological approach to extract relevant information from web-based material with input from preprint platform owners. Despite concerns regarding the permanence and quality of preprints, most preprint platforms have long-term preservation strategies and many have screening checks (for example, a basic check for the relevance of content) in place. For some platforms, these checks are performed by researchers with content expertise. We provide a searchable database as a valuable resource for researchers, funders and policymakers in the biomedical and medical science field to determine which preprint platforms are relevant to their research scope and which have the functionality and policies that they value most.


title: Clinical evaluation of self-collected saliva by RT-qPCR, direct RT-qPCR, RT-LAMP, and a rapid antigen test to diagnose COVID-19

text: Background The clinical performance of six molecular diagnostic tests and a rapid antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were clinically evaluated for the diagnosis of coronavirus disease 2019 (COVID-19) in self-collected saliva. Methods Saliva samples from 103 patients with laboratory-confirmed COVID-19 (15 asymptomatic and 88 symptomatic) were collected on the day of hospital admission. SARS-CoV-2 RNA in saliva was detected using a quantitative reverse-transcription polymerase chain reaction (RT-qPCR) laboratory-developed test (LDT), a cobas SARS-CoV-2 high-throughput system, three direct RT-qPCR kits, and reverse-transcription loop mediated isothermal amplification (RT-LAMP). Viral antigen was detected by a rapid antigen immunochromatographic assay. Results Of the 103 samples, viral RNA was detected in 50.5-81.6% of the specimens by molecular diagnostic tests and an antigen was detected in 11.7% of the specimens by the rapid antigen test. Viral RNA was detected at a significantly higher percentage (65.6-93.4%) in specimens collected within 9 d of symptom onset compared to that of specimens collected after at least 10 d of symptom onset (22.2-66.7%) and that of asymptomatic patients (40.0-66.7%). Viral RNA was more frequently detected in saliva from males than females. Conclusions Self-collected saliva is an alternative specimen diagnosing COVID-19. LDT RT-qPCR, cobas SARS-CoV-2 high-throughput system, direct RT-qPCR except for one commercial kit, and RT-LAMP showed sufficient sensitivity in clinical use to be selectively used according to clinical settings and facilities. The rapid antigen test alone is not recommended for initial COVID-19 diagnosis because of its low sensitivity.


title: Laboratory Testing Methods for Novel Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2)

text: Following the first reports of coronavirus disease-19 (COVID-19) by China to the World Health Organization (WHO) on 31st December 2019, more than 4,302,774 novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) cases have been reported by authorities in 212 countries and territories by 12th May 2020. The outbreak and spread of COVID-19 worldwide, highlights the critical need for developing rapid and accurate diagnostic testing methods for emerging human coronavirus (CoV) infections. Testing is crucial to track the spread of disease during a pandemic, and to swiftly permit public health interventions including isolation, quarantine, and appropriate clinical management of afflicted individuals. The key components of viral diagnostic tests are (1) collection of the appropriate sample (blood, nasal swab, and throat swab), (2) availability of the genetic and proteomic sequences of the novel virus for analysis, and (3) rapid and accurate laboratory testing methods. The current gold standard for the molecular diagnosis of SARS-CoV-2 infection is the real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for the qualitative and quantitative detection of viral nucleic acids. Other relevant laboratory methods include enzyme-linked immunoassays (EIA) for viral antibody and antigen detection, and serum viral neutralization (SVN) assays for antibody neutralization determination. The challenges faced in developing a diagnostic test for a novel pathogen are the ability to measure low viral loads for early detection, to provide low or no cross-reactivity with other viral strains and to deliver results rapidly. Several point-of-care molecular devices are currently being integrated for fast and accurate diagnosis of SARS-CoV-2 infections. This review discusses the current laboratory methods available to test for coronaviruses by focusing on the present COVID-19 outbreak.


Diabetes und Covid-19


title: The coding capacity of SARS-CoV-2

text: SARS-CoV-2 is a coronavirus responsible for the COVID-19 pandemic. In order to understand its pathogenicity, antigenic potential and to develop diagnostic and therapeutic tools, it is essential to portray the full repertoire of its expressed proteins. The SARS-CoV-2 coding capacity map is currently based on computational predictions and relies on homology to other coronaviruses. Since coronaviruses differ in their protein array, especially in the variety of accessory proteins, it is crucial to characterize the specific collection of SARS-CoV-2 translated open reading frames (ORF)s in an unbiased and open-ended manner. Utilizing a suit of ribosome profiling techniques, we present a high-resolution map of the SARS-CoV-2 coding regions, allowing us to accurately quantify the expression of canonical viral ORFs and to identify 23 novel unannotated viral ORFs. These ORFs include several in-frame internal ORFs lying within existing ORFs, resulting in N-terminally truncated products, as well as internal out-of-frame ORFs, which generate novel polypeptides. Finally, we detected a prominent initiation at a CUG codon located in the 5’UTR. Although this codon is shared by all SARS-CoV-2 transcripts, the initiation was specific to the genomic RNA, indicating that the genomic RNA harbors unique features that may affect ribosome engagement. Overall, our work reveals the full coding capacity of SARS-CoV-2 genome, providing a rich resource, which will form the basis of future functional studies and diagnostic efforts.


title: Open source 3D printed Ventilation Device

text: COVID-19 is an acute respiratory tract infection caused by a coronavirus known as SARS-CoV-2. The common signs of infection include respiratory symptoms such as shortness of breath, breathing difficulties, dry cough, fever, and in some patients, severe acute respiratory syndrome, kidney failure, and death. 312,009 deaths from COVID-19 has been reported as of today. While respiratory symptoms are commonly caused by the infection, the use of mechanical ventilation is required for some patients. The following is intended to review the development and testing of a 3D printed and open-source mechanical ventilation device that is capable of adjusting breathing rate, volume, and pressure simultaneously and was designed according to the latest clinical observations of the current pandemic. The intuitive design of this device along with the use of primarily 3D printed or readily available components allow the rapid manufacturing and transportation of this ventilation device to the impacted regions.


title: Evolution of COVID19 new cases in 16 countries and Scenarios for Brazil using metaphorical analysis of Board, Inverted Pyramid and Papyri

text: Since the end of 2019, the world has become aware of a new virus that has emerged in China, which in February 2020 was called by the World Health Organization (WHO, 2019) as Coronavirus disease (COVID19) Due to its fast transmission, at 18:32 (GMT) on March 29, 2020, the world has officially accounted for about 710,950 new confirmed cases with 33,553 deaths and 150,734 recovered cases (Worldometers, 2020) The pandemic has become the newest challenge for several nations, especially the USA, Italy, China, Spain, Germany, Iran, for being the most affected, and since Brazil is a continental country with disabilities in its Unified Health System, it could be in the next two months among the five most affected Thus, the main objective of the research is analyze the evolution of new cases of COVID19 in 16 countries to present short-term scenarios and recommendations for Brazil to face the pandemic The research is applied, as its results and recommendations can be applied with adaptation by government authorities, business managers and citizens The research is descriptive, with a qualitative and quantitative approach, based on bibliographic and documentary research, involving the study of articles, reports, manuals and other technical documents related to the subject For the creation of scenarios, data collection focused on the number of new cases registered in 16 countries, including Brazil, as well as in the development of an approach using metaphorical analysis of the Board, the Inverted Pyramid and Papyri The main conclusion is that even though no country is prepared to face epidemics and pandemics (NTI, JHU and EIU, 2019), among the 16 countries investigated, Thailand, Finland, Australia, South Korea, Denmark and Sweden are benchmarks that Brazil could study in order not to repeat the scenarios of China, USA, Italy and Spain At the end, ten recommendations are made for future research and also to public and private managers


title: An ARIMA Model to Forecast the Spread and the Final Size of COVID-2019 Epidemic in Italy

text: Coronavirus disease (COVID-2019) is a severe ongoing novel pandemic that is spreading quickly across the world. Italy, that is widely considered one of the main epicenters of the pandemic, has registered the highest COVID-2019 death rates and death toll in the world, to the present day. In this article I estimate an autoregressive integrated moving average (ARIMA) model to forecast the epidemic trend over the period after April 4, 2020, by using the Italian epidemiological data at national and regional level. The data refer to the number of daily confirmed cases officially registered by the Italian Ministry of Health (www.salute.gov.it) for the period February 20 to April 4, 2020. The main advantage of this model is that it is easy to manage and fit. Moreover, it may give a first understanding of the basic trends, by suggesting the hypothetic epidemic's inflection point and final size.


Aerosol box for protection during airway manipulation in covid-19 patients


title: Low-Dose Whole-Lung Radiation for COVID-19 Pneumonia: Planned Day-7 Interim Analysis of a Registered Clinical Trial

text: Background: Individuals with advanced age and comorbidities face higher risk of death from COVID-19, especially once ventilator-dependent. Respiratory decline in COVID-19 is mediated by a pneumonic aberrant immune cytokine storm. Low-dose radiation was used to treat pneumonia in the pre-antibiotic era. Radiation immunomodulatory effects may improve outcomes in COVID-19. Methods: We performed a single-institution phase I/II trial evaluating the safety and efficacy of single-fraction, low-dose, whole-lung radiation for COVID-19 pneumonia. Eligible patients were hospitalized, had radiographic pneumonic infiltrates, required supplemental oxygen, and were clinically deteriorating. Results: Of nine patients screened, five were treated with whole-lung radiation from April 23-28, 2020 and followed for 7 days. Median age was 90 (range 64-94); four were nursing home residents with multiple comorbidities. Within 24 hours of radiation, three patients (60%) weaned from supplemental oxygen to ambient air, four (80%) exhibited radiographic improvement, and median Glasgow coma score improved from 10 to 14. A fourth patient (80% overall recovery) weaned from oxygen at hour 96. Mean time to clinical recovery was 35 hours. There were no acute skin, pulmonary, GI, GU toxicities. Conclusions: In a pilot trial of five oxygen-dependent patients with COVID-19 pneumonia, low-dose whole-lung radiation led to rapid improvement in clinical status, encephalopathy, and radiographic infiltrates without acute toxicity. Low-dose whole-lung radiation is safe, shows early promise of efficacy, and warrants further study in larger prospective trials. NCT04366791


title: An empirical estimate of the infection fatality rate of COVID-19 from the first Italian outbreak

text: Background: The coronavirus 2019 (COVID-19) pandemic has been spread-ing globally for months, yet the infection fatality ratio of the disease is still uncertain. This is partly because of inconsistencies in testing and death reporting standards across countries. Our purpose is to provide accurate estimates which do not rely on testing and death count data directly but only use population level statistics. Methods: We collected demographic and death records data from the Italian Institute of Statistics. We focus on the area in Italy that experienced the initial outbreak of COVID-19 and estimated a Bayesian model fitting age-stratified mortality data from 2020 and previous years. We also assessed the sensitivity of our estimates to alternative assumptions on the proportion of population infected. Findings: We estimate an overall infection fatality rate of 1.29% (95% credible interval [CrI] 0.89 - 2.01), as well as large differences by age, with a low infection fatality rate of 0.05% for under 60 year old (CrI 0-.19) and a substantially higher 4.25% (CrI 3.01-6.39) for people above 60 years of age. In our sensitivity analysis, we found that even under extreme assumptions, our method delivered useful information. For instance, even if only 10% of the population were infected, the infection fatality rate would not rise above 0.2% for people under 60. Interpretation: Our empirical estimates based on population level data show a sharp difference in fatality rates between young and old people and firmly rule out overall fatality ratios below 0.5% in populations with more than 30% over 60 years old.


title: Light propagation within N95 Filtered Face Respirators: A simulation study for UVC decontamination

text: This study presents numerical simulations of UVC light propagation through seven different filtered face respirators (FFR) to determine their suitability for UV germicidal inactivation (UVGI). UV propagation was modelled using the FullMonte program for two external light illuminations. The optical properties of the dominant three layers were determined using the inverse adding doubling method. The resulting fluence rate volume histograms and the lowest fluence rate recorded in the modelled volume, sometimes in the nW cm-2, provide feedback on a respirator's suitability for UVGI and the required exposure time for a given light source. While UVGI can present an economical approach to extend an FFR's useable lifetime, it requires careful optimization of the illumination setup and selection of appropriate respirators.


title: Comfortably Numb in the Midst of the Corona Crisis

text: The coronavirus has taken the West by surprise It has called into question basic assumptions about globalisation, how our society is organised, how safe we actually are and to what extent we control the world around us The virus arrived when we were without the proper conceptual framework to deal with a new type of virus, and we could not have imagined how much of a social challenge it would represent The novelty of the situation has made most of us feel strangely confused, numb and calm, and in many cases has left us not knowing what to do with ourselves This satirical review seeks to put some distance and detachment between us and the situation and give us an outside perspective of what the corona crisis can teach us, both at the individual and social levels Before the situation becomes the ?new normal?, we should take the time to extract some lessons from this mess


title: A Standard Virus Load Function

text: The idea is to design a simple function that can describe typical virus-load curves without solving a full virus load dynamic model. We present such a standard virus load function and validate it on data from influenza A as well as SARS-CoV-2 infection data for Macaque monkeys and humans. Further, we compare the virus load function to an established {it target model} of virus dynamics as presented by A. Smith in cite{Amber2018}. This virus-load function can be used as input to higher level models for the physiological effects of a virus infection, for models for tissue damage, and to develop treatment strategies.


title: COVID-19 Pandemic: Prevention and protection measures to be adopted at the workplace

text: SARS-CoV-2, identified in Wuhan, China, for the first time in December 2019, is a new viral strain, which has not been previously identified in humans; it can be transmitted both by air and via direct and indirect contact; however, the most frequent way it spreads is via droplets. Like the other viruses belonging to the same family of coronaviruses, it can cause from mild flu-like symptoms, such as cold, sore throat, cough and fever, to more severe ones such as pneumonia and breathing difficulties, and it can even lead to death. Since no effective specific drug therapy has been found yet, nor any vaccine capable of limiting the spread of this pathogen, it is important for ways of preventing the spread of this infection to be established. The purpose of our research was to provide a protocol to prevent the spread of SARS-CoV-2 infection in light of the limited information related to this coronavirus. In detail, we analysed and searched targeted evidence-based guidelines issued in the various countries affected by this epidemic up till now. In addition, we analyzed the recommendations for the prevention and control of other epidemics caused by other pathogens belonging to the same family of coronaviruses or others that present the same mechanisms of transmission. General organizational measures regarding the containment and management of the epidemiological emergency of COVID-19 have been imposed by the competent authorities for an adequate and proportionate management of the evolution of the epidemiological situation. The prevention and protection organizational measures therefore aim to minimize the probability of being exposed to SARS-CoV-2. For this purpose, measures must also be taken at work to avoid new infections or even the spread of the virus where it has already been present. Furthermore, environmental measures are aimed at reducing the risk of transmission of SARS-CoV-2 to individuals through contact with infected subjects, objects, equipment, or contaminated environmental surfaces. Protective devices must be used whenever there is potentially close contact with a suspect case, especially when the potentially infected person does not wear a surgical mask that could reduce the spread of viruses in the environment. By adopting this specific prevention and protection measures recommended in the workplace, it will be possible to help overcome this COVID-19 pandemic.


title: Impact of COVID-19 on psychiatric assessment in emergency and outpatient settings measured using electronic health records

text: Importance: As with other traumatic events, pandemics such as coronavirus-19 (COVID-19) may precipitate or exacerbate psychiatric symptoms such as anxiety and depression, while potentially interfering with health systems' capacity to treat such symptoms. Objective: To quantify the impact of increasing COVID-19 infection on extent of psychiatric assessment across 5 Eastern Massachusetts hospitals. Design: In silico cohort using narrative clinical notes generated between 1/2/2020 and 3/25/2020 Setting: Emergency department and outpatient settings from 2 academic medical centers and 3 community hospitals Participants: All individuals age 13 and older presenting to emergency department or outpatient clinics Main Outcome or Measure: Documentation of psychiatric symptoms reflecting depression, anxiety, psychosis, or suicide, and documentation of violence, was drawn from previously-validated term lists. Results: A total of 2,483,159 outpatient and 205,957 emergency department visit notes were analyzed. Instances of notes referencing depression or anxiety decreased 75-81% in outpatient settings with onset of coronavirus in March 2019, and by 44-45% in emergency departments. In adjusted logistic regression, presence of individual psychiatric symptoms in outpatient notes was associated with significant decreases in likelihood of coronavirus testing (for depression, OR=0.636, 95% CI 0.606-0.667). Conversely, presence of violence in an emergency department note was associated with greater likelihood of testing (OR=1.487, 95% CI 1.249-1.761). Conclusions and Relevance: Documentation of psychiatric symptoms in both outpatient and emergency department settings diminished sharply in the context of increasing coronavirus infection in Massachusetts, suggesting that efforts to provide additional resources to manage psychiatric symptoms will be needed. Funding: none.


title: A model for COVID-19 with isolation, quarantine and testing as control measures

text: In this article we propose a compartmental model for the dynamics of Coronavirus Disease 2019 (COVID-19). We take into account the presence of asymptomatic infections and the main policies that have been adopted so far to contain the epidemic: isolation (or social distancing) of a portion of the population, quarantine for confirmed cases and testing. We model isolation by separating the population in two groups: one composed by key-workers that keep working during the pandemic and have a usual contact rate, and a second group consisting of people that are enforced/recommended to stay at home. We refer to quarantine as strict isolation, and it is applied to confirmed infected cases. In the proposed model, the proportion of people in isolation, the level of contact reduction and the testing rate are control parameters that can vary in time, representing policies that evolve in different stages. We obtain an explicit expression for the basic reproduction number R0 in terms of the parameters of the disease and of the control policies. In this way we can quantify the effect that isolation and testing have in the evolution of the epidemic. We present a series of simulations to illustrate different realistic scenarios. From the expression of R0 and the simulations we conclude that isolation (social distancing) and testing among asymptomatic cases are fundamental actions to control the epidemic, and the stricter these measures are and the sooner they are implemented, the more lives can be saved. Additionally, we show that people that remain in isolation significantly reduce their probability of contagion, so risk groups should be recommended to maintain a low contact rate during the course of the epidemic.


title: Clinical and Imaging Features of COVID-19 in a Neonate

text: We report the clinical history, laboratory findings, and imaging features of coronavirus disease 2019 (COVID-19) in a neonate whose mother was also a patient. The newborn was the youngest patient with COVID-19 in the world at the time he was diagnosed. This case has brought more attention and understanding to the epidemic and mode of transmission of the disease.


title: Estimative of real number of infections by COVID-19 on Brazil and possible scenarios

text: This paper attempts to provide methods to estimate the real scenario of the novel coronavirus pandemic crisis on Brazil and the states of Distrito Federal, Sao Paulo, Pernambuco, Espirito Santo and Amazonas. By the use of a SEIRD mathematical model with age division, we predict the infection and death curve, stating the peak date for Brazil and these states. We also carry out a prediction for the ICU demand on these states for a visualization of the size of a possible collapse on the local health system. By the end, we establish some future scenarios including the stopping of social isolation and the introduction of vaccines and efficient medicine against the virus.


title: A COVID-19 outbreak in a rheumatology department upon the early days of the pandemic

text: Objectives: To describe our experience with a coronavirus disease 2019 (COVID-19) outbreak within a large rheumatology department, early in the pandemic. Methods: Symptomatic and asymptomatic healthcare workers (HCWs) had a naso-oropharyngeal swab for detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and were followed clinically. Reverse transcription polymerase-chain reaction (RT-PCR) was repeated to document cure, and serological response was assessed. Patients with risk contacts within the department in the 14 days preceding the outbreak were screened for COVID-19 symptoms. Results: 14/34 HCWs (41%; 40{+/-}14 years, 71% female) tested positive for SARS-CoV-2, and 11/34 (32%) developed symptoms but were RT-PCR-negative. Half of RT-PCR-positive HCWs did not report fever, cough, or dyspnoea before testing, which were absent in 3/14 cases (21%). Mild disease prevailed (79%), but 3 HCWs had moderate disease requiring further assessment, which excluded severe complications. Nevertheless, symptom duration (28{+/-}18 days), viral shedding (31{+/-}10 days post-symptom onset, range 15-51) and work absence (29{+/-}28 days) were prolonged. 13/14 (93%) of RT-PCR-positive and none of the RT-PCR-negative HCWs had a positive humoral response, with higher IgG-index in individuals over 50 years (14.5{+/-}7.7 vs 5.0{+/-}4.4, p=0.012). Of 617 rheumatic patients, 8 (1.3%) developed COVID-19 symptoms (1/8 hospitalisation, 8/8 complete recovery), following a consultation/procedure with an asymptomatic (7/8) or mildly-symptomatic (1/8) HCW. Conclusions: A COVID-19 outbreak can occur among HCWs and rheumatic patients, swiftly spreading over the presymptomatic stage. Mild disease without typical symptoms should be recognised, and may evolve with delayed viral shedding, prolonged recovery, and adequate immune response in most individuals.


title: Symptom clusters in Covid19: A potential clinical prediction tool from the COVID Symptom study app

text: As no one symptom can predict disease severity or the need for dedicated medical support in COVID-19, we asked if documenting symptom time series over the first few days informs outcome. Unsupervised time series clustering over symptom presentation was performed on data collected from a training dataset of completed cases enlisted early from the COVID Symptom Study Smartphone application, yielding six distinct symptom presentations. Clustering was validated on an independent replication dataset between May 1- May 28th, 2020. Using the first 5 days of symptom logging, the ROC-AUC of need for respiratory support was 78.8%, substantially outperforming personal characteristics alone (ROC-AUC 69.5%). Such an approach could be used to monitor at-risk patients and predict medical resource requirements days before they are required.


title: Remarkable variability in SARS-CoV-2 antibodies across Brazilian regions: nationwide serological household survey in 27 states

text: Population based data on COVID-19 are essential for guiding policy. We report on the first wave of seroprevalence surveys relying upon on household probabilistic samples of 133 large sentinel cities in Brazil, including 25,025 participants from all 26 states and the Federal District. Seroprevalence of antibodies to SARS-CoV-2, assessed using a lateral flow rapid test, varied markedly across the cities and regions, from below 1% in most cities in the South and Center-West regions to up to 25% in the city of Breves in the Amazon (North) region. Eleven of the 15 cities with the highest seroprevalence were located in the North, including the six cities with highest prevalence which were located along a 2,000 km stretch of the Amazon river. Overall seroprevalence for the 90 cities with sample size of 200 or greater was 1.4% (95% CI 1.3-1.6). Extrapolating this figure to the population of these cities, which represent 25% of the country population, led to an estimate of 760,000 cases, as compared to the 104,782 cases reported in official statistics. Seroprevalence did not vary significantly between infancy and age 79 years, but fell by approximately two-thirds after age 80 years. Prevalence was highest among indigenous people (3.7%) and lowest among whites (0.6%), a difference which was maintained when analyses were restricted to the North region, where most indigenous people live. Our results suggest that pandemic is highly heterogenous, with rapid escalation in the North and Northeast, and slow progression in the South and Center-West regions.


title: Evaluation of 19 antiviral drugs against SARS-CoV-2 Infection

text: The global pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) has prompted multiple clinical trials to jumpstart search for anti-SARS-CoV-2 therapies from existing drugs, including those with reported in vitro efficacies as well as those ones that are not known to inhibit SARS-CoV-2, such as ritonavir/lopinavir and favilavir. Here we report that after screening 19 antiviral drugs that are either in clinical trials or with proposed activity against SARS-CoV-2, remdesivir was the most effective. Chloroquine only effectively protected virus-induced cytopathic effect at around 30 µM with a therapeutic index of 1.5. Our findings also suggest that velpatasvir, ledipasvir, ritonavir, litonavir, lopinavir, favilavir, sofosbuvir, danoprevir, and pocapavir do not have direct antiviral effect.


title: Protected Stroke Mechanical Thrombectomy Code During the Coronavirus (COVID-19) Pandemic: Southwestern Part of Saudi Arabia Stroke Unit Local Protocol

text: Cerebrovascular diseases are a significant cause of mortality and morbidity worldwide, in particular those with large vessels occlusion (LVO). Coronavirus disease 2019 (COVID-19) has become a global crisis rapidly since its initial outbreak in Wuhan, China, in December, 2019. Stroke due to LVO needs rapid assessment and timely endovascular intervention which can be very challenging during the time of pandemic where you need to deliver proper, safe, and timely care to acute ischemic stroke (AIS) patients with LVO, yet, protecting healthcare workers and existing patients at the medical facility. In this article, we share our local experience in the stroke unit at Aseer Central Hospital which is the main hub of stroke patients in the southwestern part of Saudi Arabia and the primary regional COVID center to provide guidance to perform smooth, safe, and swift mechanical thrombectomy during the coronavirus (COVID-19) pandemic as well as possible similar future situations.


Difficult airway management in COVID times


title: Effects of a DPP-4 inhibitor and RAS blockade on clinical outcomes of patients with diabetes and COVID-19

text: Background: Dipeptidyl peptidase-4 inhibitor (DPP-4i) and renin-angiotensin system (RAS) blockade are reported to affect the clinical course of coronavirus disease 2019 (COVID-19) in patients with diabetes mellitus (DM). However, the effectiveness of these drugs in large populations is unclear. Subjects and Methods: As of May 2020, data analysis was conducted on all subjects who could confirm their history of claims related to COVID-19 in the National Health Review and Assessment Service database in Korea. Using the COVID-19 and claims data of the past 5 years, we compared the short-term prognosis of COVID-19 infection according to the use of DPP-4i and RAS blockade. Results: Totally, data of 67850 subjects were accessible. Of these, 5080 were confirmed COVID-19. Among these, 832 subjects with DM were selected for analysis in this study. Among the subjects, 263 (31.6%) and 327 (39.3%) were DPP-4i and RAS blockade users, respectively. Thirty-four subjects (4.09%) received intensive care or died. The adjusted odds ratio for severe treatment among DPP-4i users was 0.362 [95% confidence interval (CI), 0.135-0.971], and that for RAS blockade users was 0.599 (95% CI, 0.251-1.431). No synergy was observed for subjects using both drugs. Conclusion: This population-based study suggests that DPP-4i is significantly associated with a better clinical outcome of patients with COVID-19. However, the effect of RAS blockade is not significant.


title: Diaphragmatic Rupture and Gastric Perforation in a Patient with COVID-19 Pneumonia

text: We describe the case of a young female patient admitted to our emergency department during the Italian COVID-19 epidemic, for fever and dry cough associated with symptoms of gastric reflux over the previous 5 days. Lung ultrasound showed diffuse bilateral B lines with irregular pleural thickening, and consolidation with air bronchogram and slight pleural effusion in the lower left lobe. Chest HRCT and abdominal CT scanning with contrast revealed diaphragmatic rupture with gastric perforation, and atelectasis of the left pulmonary lobe with unilateral pleural effusion, diffuse ground-glass opacities and multiple small consolidations in both lobes. A nasopharyngeal swab for 2019-nCoV was positive. A diagnosis of diaphragmatic rupture and gastric perforation in COVID-19 pneumonia was made. The patient was immediately hospitalized and surgically treated. Treatment for COVID-19 and empiric antibiotic therapy were promptly started. LEARNING POINTS: Coronavirus disease (COVID-19) can cause fever, dry cough and acute respiratory failure. Cough can result in several complications, including rupture of the diaphragm and abdominal herniation. CT scanning is the gold standard technique to investigate COVID-19 pneumonia and diaphragmatic rupture.


title: Reproducing SARS-CoV-2 epidemics byregion-specific variables and modeling contacttracing App containment

text: Targeted contact-tracing through mobile phone apps has been proposed as an instrument to help contain the spread of COVID-19 and manage the lifting of nation-wide lockdowns currently in place in USA and Europe. However, there is an ongoing debate on its potential efficacy, especially in the light of region-specific demographics. We built an expanded SIR model of COVID-19 epidemics that accounts for region-specific population densities, and we used it to test the impact of a contact-tracing app in a number of scenarios. Using demographic and mobility data from Italy and Spain, we used the model to simulate scenarios that vary in baseline contact rates, population densities and fraction of app users in the population. Our results show that, in support of efficient isolation of symptomatic cases, app-mediated contact-tracing can improve containment and achieve successful epidemic mitigation even with relatively small fraction of the population using it, and, with increasing penetrance of its adoption, suppression. However, when regional differences in population density are taken into consideration, the epidemic can be significantly harder to contain in higher density areas, highlighting potential limitations of this intervention in specific contexts. This work corroborates previous results in favor of app-mediated contact-tracing as mitigation measure for COVID-19, and draw attention on the importance of region-specific demographic and mobility factors to achieve maximum efficacy in containment policies.


title: A benchmark of online COVID-19 symptom checkers

text: Background A large number of online COVID-19 symptom checkers and chatbots have been developed but anecdotal evidence suggests that their conclusions are highly variable. To our knowledge, no study has evaluated the accuracy of COVID-19 symptom checkers in a statistically rigorous manner. Methods In this paper, we evaluate 10 different COVID-19 symptom checkers screening 50 COVID-19 case reports alongside 410 non-COVID-19 control cases. Results We find that the number of correctly assessed cases varies considerably between different symptom checkers, with Symptoma (F1=0.92, MCC=0.85) showing the overall best performance followed by Infermedica (F1=0.80, MCC=0.61).


title: Interferon-Induced Transmembrane Protein 3 Blocks Fusion of Diverse Enveloped Viruses by Locally Altering Mechanical Properties of Cell Membranes

text: Interferon-induced transmembrane protein 3 (IFITM3) potently inhibits entry of diverse enveloped viruses by trapping the viral fusion at a hemifusion stage, but the underlying mechanism remains unclear. Here, we show that recombinant IFITM3 reconstituted into lipid vesicles induces negative membrane curvature and that this effect maps to its small amphipathic helix (AH). We demonstrate that AH: (i) partitions into lipid-disordered domains where IAV fusion occurs, (ii) induces negative membrane curvature, and (iii) increases lipid order and membrane stiffness. Additionally, replacing the IFITM3 AH with AH from an unrelated protein did not compromise its antiviral activity. These effects on membrane properties correlate with the fusion-inhibitory activity, as exogenous addition of AH to insulin-producing cells reduces glucose-stimulated insulin secretion. Our results thus imply that IFITM3 inhibits the transition from hemifusion to full fusion by imposing an unfavorable membrane curvature and increasing the order and stiffness of the cytoplasmic leaflet of endosomal membranes.


title: Preparedness and Mitigation by projecting the risk against COVID-19 transmission using Machine Learning Techniques

text: The outbreak of COVID-19 is first identified in China, which later spread to various parts of the globe and was pronounced pandemic by the World Health Organization (WHO). The disease of transmissible person-to-person pneumonia caused by the extreme acute respiratory coronavirus 2 syndrome (SARS-COV-2, also known as COVID-19), has sparked a global warning. Thermal screening, quarantining, and later lockdown were methods employed by various nations to contain the spread of the virus. Though exercising various possible plans to contain the spread help in mitigating the effect of COVID-19, projecting the rise and preparing to face the crisis would help in minimizing the effect. In the scenario, this study attempts to use Machine Learning tools to forecast the possible rise in number of cases by considering the data of daily new cases. To capture the uncertainty, three different techniques: (i) Decision Tree algorithm, (ii) Support Vector Machine algorithm, and (iii) Gaussian process regression are used to project the data and capture the possible deviation. Based on the projection of new cases, recovered cases, deceased cases, medical facilities, population density, number of test conducted, and facilities of services, are considered to define the criticality index (CI). CI is used to classify all the districts of country in the regions of high risk, low risk and moderate risk. An online dashpot is created which updates the data on daily bases for next four weeks. The prospective suggestions of this study would aid in planning the strategies to apply the lockdown/ any other plan for any country, which can take other parameters to define the CI.


title: Effectiveness of Ultraviolet-C Light and a High-Level Disinfection Cabinet for Decontamination of N95 Respirators

text: BACKGROUND: Shortages of personal protective equipment (PPE) including N95 respirators are an urgent concern in the setting of the global COVID-19 pandemic. Decontamination of PPE could be useful to maintain adequate supplies, but there is uncertainty regarding the efficacy of decontamination technologies. METHODS: A modification of the American Society for Testing and Materials standard quantitative carrier disk test method (ASTM E-2197-11) was used to examine the effectiveness of 3 methods, including ultraviolet-C (UV-C) light, a high-level disinfection cabinet that generates aerosolized peracetic acid and hydrogen peroxide, and dry heat at 70°C for 30 minutes. We assessed the decontamination of 3 commercial N95 respirators inoculated with methicillin-resistant Staphylococcus aureus (MRSA) and bacteriophages MS2 and Phi6; the latter is an enveloped RNA virus used as a surrogate for coronaviruses. Three and 6 log(10) reductions on respirators were considered effective for decontamination and disinfection, respectively. RESULTS: UV-C administered as a 1-minute cycle in a UV-C box or a 30-minute cycle by a room decontamination device reduced contamination but did not meet criteria for decontamination of the viruses from all sites on the N95s. The high-level disinfection cabinet was effective for decontamination of the N95s and achieved disinfection with an extended 31-minute cycle. Dry heat at 70°C for 30 minutes was not effective for decontamination of the bacteriophages. CONCLUSIONS: UV-C could be useful to reduce contamination on N95 respirators. However, the UV-C technologies studied did not meet pre-established criteria for decontamination under the test conditions used. The high-level disinfection cabinet was more effective and met criteria for disinfection with an extended cycle.


title: The heterogeneous nature of the Coronavirus receptor, angiotensin-converting enzyme 2 (ACE2) in differentiating airway epithelia

text: Coronavirus Disease 2019 (COVID-19) is transmitted through respiratory droplets containing Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) particles. Once inhaled, SARS-CoV-2 particles gain entry into respiratory ciliated cells by interacting with angiotensin converting enzyme 2 (ACE2). It is known that ACE2 functions within the renin-angiotensin system to regulate blood pressure, fluid homeostasis and inflammation. However, it is largely unknown what roles ACE2 has in ciliated cells of the airway. Therefore, understanding the function and nature of ACE2 within airway tissue has become an essential element in combatting the COVID-19 pandemic. Airway mucociliary tissue was generated in-vitro using primary human nasal epithelial cells isolated from nasal turbinates of donors and the air-liquid interface (ALI) model of differentiation. Using ALI tissue we cloned transcripts for three distinct variants of ACE2, one of which encodes the full-length ACE2 protein, the other two transcripts are truncated isoforms that had only been predicted to exist via sequence analysis software. We demonstrate that all three isoforms have the capacity to be glycosylated, a known modification of full-length ACE2. Immunofluorescence microscopy of individual ACE2 isoform transfected cells reveals distinct localization of variant 1 relative to X1 and X2. Double staining immunohistochemistry of ALI tissue using antibodies to either the N-term or C-term region of ACE2 revealed distinct and overlapping signals in the apical cytosol of ciliated cells. Most notably only the ACE2 C-term antibody displayed plasma-membrane localization in ciliated cells. We also observed a significant decrease in the total amount of ACE2 in ALI tissue derived from a 33 year-old male donor when compared to a 34 year-old female donor, thus there may be variation in the abundance of ACE2 protein in the airway among the population. Together, our data begins to highlight the dynamic status of the ACE2 protein in airway mucociliary tissue and we propose multiple ACE2 parameters that may impact an individual’s susceptibility to SARS-CoV-2. These parameters include the balance of cytosolic versus membrane bound ACE2, isoform expression levels, maintenance of post-translational modifications and the impact of genetic, environmental and lifestyle factors on these processes.


title: A path out of COVID-19 quarantine: an analysis of policy scenarios

text: In this work we present an analysis of the two major strategies currently implemented around the world in the fight against COVID-19: Social distancing & shelter-in-place measures to protect the susceptible, and testing & contact-tracing to identify, isolate and treat the infected. The majority of countries have principally relied on the former; we consider the examples of Italy, Canada and the United States. By fitting a disease transmission model to daily case report data, we infer that in each of the three countries, the current level of national shutdown is equivalent to about half the population being under quarantine. We demonstrate that in the absence of other measures, scaling back social distancing in such a way as to prevent a second wave will take prohibitively long. In contrast, South Korea, a country that has managed to control and suppress its outbreak principally through mass testing and contact tracing, and has only instated a partial shutdown. For all four countries, we estimate the level of testing which would be required to allow a complete exit from shutdown and a full lifting of social distancing measures, without a resurgence of COVID-19. We find that a "brute-force" approach of untargeted universal testing requires an average testing rate of once every 36 to 48 hours for every individual, depending on the country. If testing is combined with contact tracing, and/or if tests are able to identify latent infection, then an average rate of once every 4 to 5 days is sufficient.


title: Analytical Review of COVID-19 Outbreak in India During the Global Pandemic

text: COVID-19 is one of the very contagious diseases from the family Coronaviridae and spreading at a faster rate in the community In December 2019, the first case of COVID-19 was reported in Wuhan, China An epidemic outbreak of COVID-19 was seen in India from March 2020 Epidemiological data of COVID-19 cases of the world and India have been analyzed in our study We have utilized publicly available two databases from data repository by Johns Hopkins CSSE and covid19india org COVID-19 cases and case fatality rate (CFR) of the world have been summarized and compared with India from January 22, 2020 to April 15, 2020 Indian cases were analyzed among states of India and also compared with age and gender by performing statistical approaches such as central tendency, standard deviation and interquartile range By April 15, 2020, Indian has reported 12,322 confirmed cases, 1,498 recovered cases and 405 death cases of COVID-19 In spite of India being a diverse country with the second-highest population, the deadly side of COVID-19 was comparatively far less as compared to the other countries India has taken preemptive measures at an early stage to prevent transmission of COVID-19 outbreak and it is reviewed from our study by comparing India with other countries Our study also summarizes that age also plays a vital role in the intervention of COVID-19 cases


title: Disposable N95 Masks Pass Qualitative Fit-Test But Have Decreased Filtration Efficiency after Cobalt-60 Gamma Irradiation

text: The current COVID-19 pandemic has led to a dramatic shortage of masks and other personal protective equipment (PPE) in hospitals around the globe. One component of PPE that is in particular demand are disposable N95 face masks. To alleviate this, many methods of N95 mask sterilization have been studied and proposed with the hope of being able to safely reuse masks. Two major considerations must be made when re-sterilizing masks: (1) the sterilization method effectively kills pathogens, penetrating into the fibers of the mask, and (2) the method does not degrade the operational integrity of the N95 filters. We studied Cobalt-60 gamma irradiation as a method of effective sterilization without inducing mask degradation. Significant literature exists supporting the use of gamma radiation as a sterilization method, with viral inactivation of SARS-CoV reported at doses of at most 10 kGy, with other studies supporting 5 kGy for many types of viruses. However, concerns have been raised about the radiation damaging the fiber material within the mask, specifically by causing cross-linking of polymers, leading to cracking and degradation during fitting and/or deployment. A set of 3M 8210 and 9105 masks were irradiated using MIT's Co-60 irradiator. Three masks of each type received 0 kiloGray (kGy), 10 kGy and 50 kGy of approximately 1.3 MeV gamma radiation from the circular cobalt sources, at a dose rate of 2.2 kGy per hour. Following this sterilization procedure, the irradiated masks passed a OSHA Gerson Qualitative Fit Test QLFT 50 (saccharin apparatus) when donned correctly, performed at the Brigham and Women's Hospital, in a blinded study repeated in triplicate. However, the masks' filtration of 0.3 um particles was significantly degraded, even at 10 kGy. These results suggest against gamma, and possibly all ionizing radiation, as a method of disposable N95 sterilization. Even more importantly, they argue against using the qualitative fit test alone to assess mask integrity.


title: Covid-19 nephropathy; an emerging condition caused by novel coronavirus infection

text: Implication for health policy/practice/research/medical education: COVID-19, a pandemic caused by a novel coronavirus, has become a major public health problem worldwide. It principally affects the upper and lower respiratory tract in the majority of cases. In severe cases, it may involve multiple organs including the kidneys. Kidney involvement has been reported to be around 3-9% and the most common presentation is with acute kidney injury (AKI); however, the data is still preliminary. Data regarding COVID-19 virus affecting patients with prior kidney diseases are still rudimentary. Further research is needed to understand the full spectrum of COVID-19 infection on kidney health.


title: Predicting wildlife hosts of betacoronaviruses for SARS-CoV-2 sampling prioritization

text: Despite massive investment in research on reservoirs of emerging pathogens, it remains difficult to rapidly identify the wildlife origins of novel zoonotic viruses. Viral surveillance is costly but rarely optimized using model-guided prioritization strategies, and predictions from a single model may be highly uncertain. Here, we generate an ensemble of eight network- and trait-based statistical models that predict mammal-virus associations, and we use model predictions to develop a set of priority recommendations for sampling potential bat reservoirs and intermediate hosts for SARS-CoV-2 and related betacoronaviruses. We find over 200 bat species globally could be undetected hosts of betacoronaviruses. Although over a dozen species of Asian horseshoe bats (Rhinolophus spp.) are known to harbor SARS-like coronaviruses, we find at least two thirds of betacoronavirus reservoirs in this bat genus might still be undetected. Although identification of other probable mammal reservoirs is likely beyond existing predictive capacity, some of our findings are surprisingly plausible; for example, several civet and pangolin species were highlighted as high-priority species for viral sampling. Our results should not be over-interpreted as novel information about the plausibility or likelihood of SARS-CoV-2’s ultimate origin, but rather these predictions could help guide sampling for novel potentially zoonotic viruses; immunological research to characterize key receptors (e.g., ACE2) and identify mechanisms of viral tolerance; and experimental infections to quantify competence of suspected host species.


Local government fighting Covid-19


title: Even one metre seems generous. A reanalysis of data in: Chu et al. (2020) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19.

text: Re-examination of the large dataset collected and meta-analysed by Dr Chu and his colleagues contradicts their conclusions about the effects of separation distance on infection risk. Their conclusion was based on misunderstandings of the datasets. Each of these estimated risk relative to that incurred when touching infected individuals. Allowing for this suggests that the main advantage of social distancing, a perhaps 78% (95% CI 24, 92) reduction in risk of infection, occurs at distances below 1m. The data imply an 11% chance of further distances reducing the risk, with any effects likely to be small. However the limitations of the dataset do limit the strength of these conclusions.


The Unprecedented COVID-19 Crisis


title: Systems-level immunomonitoring from acute to recovery phase of severe COVID-19

text: The immune response to SARS-CoV2 is under intense investigation, but not fully understood att this moment. Severe disease is characterized by vigorous inflammatory responses in the lung, often with a sudden onset after 5-7 days of stable disease. Efforts to modulate this hyperinflammation and the associated acute respiratory distress syndrome, rely on the unraveling of the immune cell interactions and cytokines that drive such responses. Systems-level analyses are required to simultaneously capture all immune cell populations and the many protein mediators by which cells communicate. Since every patient analyzed will be captured at different stages of his or her infection, longitudinal monitoring of the immune response is critical. Here we report on a systems-level blood immunomonitoring study of 39 adult patients, hospitalized with severe COVID-19 and followed with up to 14 blood samples from acute to recovery phases of the disease. We describe an IFNg-Eosinophil axis activated prior to lung hyperinflammation and changes in cell-cell coregulation during different stages of the disease. We also map an immune trajectory during recovery that is shared among patients with severe COVID-19.


title: ACUTE VISION LOSS IN A PATIENT WITH COVID-19

text: To date, there have been reports of neurologic manifestations in Covid-19 patients including ischemic strokes, Guillain-Barre Syndrome and anosmia. In this case report, we report a patient who presented with dysosmia, dysgeusia along with monocular peripheral vision loss after being diagnosed with Covid-19.


title: Defining high-value information for COVID-19 decision-making

text: Initial projections from the first generation of COVID-19 models focused public attention on worst-case scenarios in the absence of decisive policy action. These underscored the imperative for strong and immediate measures to slow the spread of infection. In the coming weeks, however, as policymakers continue enlisting models to inform decisions on COVID-19, answers to the most difficult and pressing policy questions will be much more sensitive to underlying uncertainties. In this study, we demonstrate a model-based approach to assessing the potential value of reducing critical uncertainties most salient to COVID-19 decision-making and discuss priorities for acquiring new data to reduce these uncertainties. We demonstrate how information about the impact of non-pharmaceutical interventions could narrow prediction intervals around hospitalizations over the next few weeks, while information about the prevalence of undetected cases could narrow prediction intervals around the timing and height of the peak of the epidemic.


title: Another coronavirus drug target imaged

text: Researchers studying SARS-CoV-2, the novel coronavirus that causes COVID-19, have published another structure of a viral protein that could be a target for treatments, including Gilead Sciences’ remdesivir A team in China led by Zihe Rao at Tsinghua University reports the cryo-electron microscopy (cryo-EM) structure of the RNA-dependent RNA polymerase (RdRp), which is a key part of how the virus makes copies of its RNA genome (Science 2020, DOI: 10 1126/science abb7498) RdRp, along with the virus’s spike protein, which is involved in infecting human cells, and its main protease, which helps process viral protein production, is one of the main drug targets for SARS-CoV-2 Jason McLellan, the University of Texas at Austin researcher who in February published the first cryo-EM structure of the spike protein, says RdRp is the only other protein that he was interested in investigating But before he could start work on the protein, he saw that Rao’s


title: Drug repurposing screens reveal FDA approved drugs active against SARS-Cov-2

text: There are an urgent need for antivirals to treat the newly emerged SARS-CoV-2. To identify new candidates we screened a repurposing library of ~3,000 drugs. Screening in Vero cells found few antivirals, while screening in human Huh7.5 cells validated 23 diverse antiviral drugs. Extending our studies to lung epithelial cells, we found that there are major differences in drug sensitivity and entry pathways used by SARS-CoV-2 in these cells. Entry in lung epithelial Calu-3 cells is pH-independent and requires TMPRSS2, while entry in Vero and Huh7.5 cells requires low pH and triggering by acid-dependent endosomal proteases. Moreover, we found 9 drugs are antiviral in lung cells, 7 of which have been tested in humans, and 3 are FDA approved including Cyclosporine which we found is targeting Cyclophilin rather than Calcineurin for its antiviral activity. These antivirals reveal essential host targets and have the potential for rapid clinical implementation.


title: Arc Behavior in Wire Arc Additive Manufacturing Process

text: Abstract The welding arc behavior in a wire arc additive manufacturing process was studied while building a ten-layer wall over a base plate using a cold metal transfer (CMT) power source. The real-time recorded welding current, voltage, thermal cycles at the base plate, and the synchronized high-speed arc images with each deposited layer were used to understand the arc behavior. A gradual increase in the peak temperature was noticed from the first layer to the fifth layer, and the same decreased with the subsequent deposition of the layers. The intensity of the welding arc was high during the boost phase of the CMT cycle, where most of the base plate and the electrode melting happens. For a given process parameter, the welding arc intensity gradually increased from the first layer to the fifth layer while remained approximately similar from the fifth layer to the tenth layer. The effect of this arc intensity variation was reflected in the consistency of the deposited bead profile. It was observed that the bead width gradually increased from the first layer to the fourth layer and remained approximately the same from fifth to the tenth layer.


title: FORECASTING COVID-19 PANDEMIC: A DATA-DRIVEN ANALYSIS

text: In this paper, a new Susceptible-Exposed-Symptomatic Infectious-Asymptomatic Infectious-Quarantined-Hospitalized-Recovered-Dead (SEIDIUQHRD) deterministic compartmental model has been proposed and calibrated for describing the transmission dynamics of the novel coronavirus disease (COVID-19). A calibration process is executed through the solution of an inverse problem with the help of a Trust-Region-Reflective algorithm, used to determine the best parameter values that would fit the model response. The purpose of this study is to give a tentative prediction of the epidemic peak for Russia, Brazil, India and Bangladesh which could become the next COVID-19 hotspots in no time. Based on the publicly available epidemiological data from late January until 10 May, it has been estimated that the number of daily new symptomatic infectious cases for the above mentioned countries could reach the peak around the beginning of June with the peak size of {approx}15,774 symptomatic infectious cases in Russia, {approx}26,449 cases in Brazil, {approx}9,504 cases in India and {approx}2,209 cases in Bangladesh. Based on our analysis, the estimated value of the basic reproduction number (R0) as of May 11, 2020 was found to be {approx}4.234 in Russia, {approx}5.347 in Brazil, {approx}5.218 in India, {approx}4.649 in the United Kingdom and {approx}3.5 in Bangladesh. Moreover, with an aim to quantify the uncertainty of our model parameters, Latin hypercube sampling-partial rank correlation coefficient (LHS-PRCC) which is a global sensitivity analysis (GSA) method is applied which elucidates that, for Russia, the recovery rate of undetected asymptomatic carriers, the rate of getting home-quarantined or self-quarantined and the transition rate from quarantined class to susceptible class are the most influential parameters, whereas the rate of getting home-quarantined or self-quarantined and the inverse of the COVID-19 incubation period are highly sensitive parameters in Brazil, India, Bangladesh and the United Kingdom which could significantly affect the transmission dynamics of the novel coronavirus. Our analysis also suggests that relaxing social distancing restrictions too quickly could exacerbate the epidemic outbreak in the above mentioned countries.


title: ‘The economy’ as if people mattered: revisiting critiques of economic growth in a time of crisis

text: Coronavirus (COVID-19) policy shut down the world economy with a range of government actions unprecedented outside of wartime. In this paper, economic systems dominated by a capital accumulating growth imperative are shown to have had their structural weaknesses exposed, revealing numerous problems including unstable supply chains, unjust social provisioning of essentials, profiteering, precarious employment, inequities and pollution. Such phenomena must be understood in the context of long standing critiques relating to the limits of economic systems, their consumerist values and divorce from biophysical reality. Critical reflection on the Coronavirus pandemic is combined with a review of how economists have defended economic growth as sustainable, Green and inclusive regardless of systemic limits and multiple crises–climate emergency, economic crash and pandemic. Instead of rebuilding the old flawed political economy again, what the world needs now is a more robust, just, ethical and equitable social-ecological economy.


title: Screening of additives for droplet qRT-PCR thermocycling enables single influenza A virus genome quantification

text: The miniaturization of real time quantitative polymerase chain reaction (qPCR) using drop-based microfluidics, or droplet qPCR, allows for quantification of single nucleic acids. The nucleic acids are compartmentalized into aqueous microdroplets, picoliters in volume, separated by an immiscible oil, and stabilized by a surfactant. In droplet qPCR, accurate data can only be obtained if the drops remain stable to coalescence upon thermocycling and drop contents do not diffuse to neighboring drops. In this work, we present a droplet qRT-PCR assay for quantifying influenza A virus (IAV) following systematic testing of different PCR additives, resulting in the optimal combination of Tween-20 / BSA / betaine to maintain drop stability and limit dye diffusion. We use a standard qPCR machine to generate real time amplification curves of hundreds of thousands of drops and correlate this data with constructed amplification curves obtained from hundreds of drops sampled at various cycle numbers and imaged using epifluorescence microscopy. To demonstrate the utility of our method, we tested a range of in vitro transcribed M gene and IAV viral supernatant from infected cells. We directly amplified IAV genomes from infected supernatant without an RNA extraction step. Our droplet qPCR assay enables detection of IAV down to 0.274 cpd, or a single viral genome per drop, establishing the high sensitivity and precision of our method.


title: COVID-19 – legal and ethical implications for your practice

text: Most day-to-day decision making of paramedics is made in an environment where resources are not truly scarce, or not soon likely to be. Paramedics are therefore able to apply an ethical approach to their work that upholds their duty to provide patient-centred care that is in the best interests of the patient. Paramedics can and do apply a broader community-minded approach to triage at mass casualty events. However, what may be new and associated with the unprecedented public health emergency that is COVID-19 is that paramedics will now be required to make such rationing decisions across a much longer period of time for a far larger number of people. This short commentary aims to begin the discussion about the legal and ethical changes to paramedic practice that are likely to occur over the next 6 to 12 months in response to the COVID-19 crisis.


title: Impact of COVID-19 epidemic curtailment strategies in selected Indian states: an analysis by reproduction number and doubling time with incidence modelling

text: The Government of India in networks with its state government has implemented the epidemic curtailment strategies inclusive of case-isolation, quarantine and lockdown in response to ongoing novel coronavirus (COVID-19) outbreak . In this manuscript we attempt to estimate the effect of these steps across ten Indian states using crowd-sourced data. The chosen transmission parameters are -reproduction number (R0), doubling time and growth rate during the early epidemic phase (15 days into lockdown) and 30 days into lockdown (23rd April 2020) through maximum likelihood approach. The overall analysis shows the decreasing trends in reproductive numbers and growth rate (with few exceptions) and incremental doubling time. The curtailment strategies employed by the Indian government seemed to be effective in reducing the transmission parameters of the COVID-19 epidemic. The effective reproductive numbers are still higher above the threshold of 1 and the resultant absolute numbers tend to be exponentiating fundamentally. The curtailment strategy thus may take into account these findings while formulating further course of actions.


title: Essential epidemiological parameters of COVID-19 for clinical and mathematical modeling purposes: a rapid review and meta-analysis

text: We present a literature review and meta-analysis of relevant epidemiological parameters (24 for adults, 7 for children) of COVID-19. Standardization of these parameters is key to performing valid clinical and mathematical modeling, as well as forecasts, helping us to improve our understanding about the characteristics and impact of the pandemic.


title: Eulerian Modeling of Plasma-Pressure Driven Laser Impact Weld Processes

text: Abstract In this study, details of the rapidly evolving state of a laser impact welding (LIW) process are simulated by incorporating a hydrodynamic plasma pressure model into a high-fidelity thermomechanical Eulerian numerical approach. Detailed evolution of the localized velocities, shear stresses, plastic strains, and temperature state in the vicinity of the weld interface during its formation are revealed. The presented simulation technique applies a load distribution that is temporally and spatially modeled based on the plasma pressure induced during surface ablation by a nanosecond-pulsed infrared laser. Due to the Gaussian plasma-pressure loading profile, significant shear stress patterns are observed to develop in the flyer foil prior to its collision with the target foil, the character of which appears to be significant in achieving a successful impact weld. Moreover, features already known to be critical to successful impact welding of thin foils are captured by the combination of the high-fidelity Eulerian control volume and the plasma pressure model, including the requisite collision velocity and impact angle. During the impact welding, interfacial material ‘jetting’ is observed, in addition to concentrated shear stress fields along the weld front. A wavy interface arising from a regular pattern of material mixing is confirmed to occur, in addition to significant plastic strains and heat generation due to the plastic deformation, all of which indicate the formation of a collision joint due to the more realistic loading condition imposed.