title: Livestock trade networks for guiding animal health surveillance

text: BACKGROUND: Trade in live animals can contribute to the introduction of exotic diseases, the maintenance and spread endemic diseases. Annually millions of animals are moved across Europe for the purposes of breeding, fattening and slaughter. Data on the number of animals moved were obtained from the Directorate General Sanco (DG Sanco) for 2011. These were converted to livestock units to enable direct comparison across species and their movements were mapped, used to calculate the indegrees and outdegrees of 27 European countries and the density and transitivity of movements within Europe. This provided the opportunity to discuss surveillance of European livestock movement taking into account stopping points en-route. RESULTS: High density and transitivity of movement for registered equines, breeding and fattening cattle, breeding poultry and pigs for breeding, fattening and slaughter indicates that hazards have the potential to spread quickly within these populations. This is of concern to highly connected countries particularly those where imported animals constitute a large proportion of their national livestock populations, and have a high indegree. The transport of poultry (older than 72 hours) and unweaned animals would require more rest breaks than the movement of weaned animals, which may provide more opportunities for disease transmission. Transitivity is greatest for animals transported for breeding purposes with cattle, pigs and poultry having values of over 50%. CONCLUSIONS: This paper demonstrated that some species (pigs and poultry) are traded much more frequently and at a larger scale than species such as goats. Some countries are more vulnerable than others due to importing animals from many countries, having imported animals requiring rest-breaks and importing large proportions of their national herd or flock. Such knowledge about the vulnerability of different livestock systems related to trade movements can be used to inform the design of animal health surveillance systems to facilitate the trade in animals between European member states. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12917-015-0354-4) contains supplementary material, which is available to authorized users.


title: Essential Nursing Competencies Related to HIV and AIDS

text: With nearly 33 million global citizens living with HIV or AIDS, the need for a highly qualified, competent nursing workforce is critical. With the recent increase in global funding to expand access to antiretroviral therapy, there have been considerable efforts to improve the capacity of nurses to initiate and maintain antiretroviral therapy while evaluating its effectiveness, monitoring for side effects, reducing the incidence of drug–drug interactions (including drug interactions related to therapies provided by traditional healers), promoting adherence to therapies, and providing management of symptoms. Therefore, using a participatory action approach, nursing leaders from six sub-Saharan African countries collaborated to develop the essential nursing competencies related to HIV and AIDS. These competencies can help to guide preservice education related to HIV and AIDS, to strengthen in-service or capacity-building programs designed for already qualified nurses, and to guide policy and regulatory reform in the context of task-shifting, task-sharing, and scope of nursing practices. This is an online Supplement to the Journal of the Association of Nurses in AIDS Care. Visit www.nursesinaidscarejournal.org for easy navigation. A Supplement Preview was published in the January/February 2011 issue, Volume 22, Number 1. The Supplement Preview and Online Supplement are supported by grant number U92HA07230 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, funded by the President's Emergency Plan for AIDS Relief.


title: Emergency Management of the Prevention and Control of Novel Coronavirus Pneumonia in Specialized Branches of Hospital

text: In December 2019, an epidemic of novel coronavirus pneumonia (NCP) broke out in Wuhan, Hubei Province. The outbreak was severe and coincided with the Spring Festival travel season. On January 15, 2020, the West China Hospital of Sichuan University, a large hospital in China, held a seminar on prevention and control in accordance with the requirements of the National Health Commission on Prevention and Control. On January 16, the emergency plan for the prevention and treatment of NCP in West China Hospital of Sichuan University was formulated for the first time.


title: Replication and plaque formation of swine hemagglutinating encephalomyelitis virus (67N) in swine cell line, SK-K culture

text: Abstract Swine hemagglutinating encephalomyelitis virus (HEV), 67N strain, adapted to suckling mouse brain, grew readily in a porcine cell line, SK-K cell culture with cytopathic effect (CPE) consisting of syncytium formation and detachment of fused cells and round cells from glass surface. After further passages in SK-K cell monolayers with undiluted culture fluid, CPE developed earlier and became complete within 48 h postinoculation (p.i.). Viral specific antigen was detected in the cytoplasm of the infected SK-K cells by indirect immunofluorescence using rabbit antiserum against the mouse-passaged virus. The SK-K-passaged virus as well as the original mouse-passaged virus formed clear plaques on SK-K cell monolayers under simple overlay medium. The plaque assay system for HEV 67N was established by studying various factors influencing the plaque formation in the SK-K cell cultures. By this system more than 106 PFU/0.2 ml of the virus yield was detected in the fluid phase of the infected cultures at 48 h p.i. The SK-K-passaged virus caused fatal infection in 4-week-old mice by intracerebral inoculation, but was inhibited by rabbit antiserum against the mouse-passaged virus. Plaque formation and hemagglutinating activity of the virus were specifically inhibited by antisera against the mouse-passaged and SK-K-passaged 67N virus.


title: SARS-COV-2 was already spreading in France in late December 2019

text: Abstract The COVID-19 epidemic is believed to have started in late January 2020 in France. We report here a case of a patient hospitalized in December 2019 in our intensive care, of our hospital in the north of Paris, for hemoptysis with no etiological diagnosis and for which RT-PCR was performed retrospectively on the stored respiratory sample which confirmed the diagnosis of COVID-19 infection. Based on this result, it appears that the COVID-19 epidemic started much earlier.


title: Using the COVID-19 economic crisis to frame climate change as a secondary issue reduces mitigation support

text: The COVID-19 pandemic has understandably dominated public discourse, crowding out other important issues such as climate change. Currently, if climate change enters the arena of public debate, it primarily does so in direct relation to the pandemic. In two experiments, we investigated (1) whether portraying the response to the COVID-19 threat as a “trial run” for future climate action would increase climate-change concern and mitigation support, and (2) whether portraying climate change as a concern that needs to take a “back seat” while focus lies on economic recovery would decrease climate-change concern and mitigation support. We found no support for the effectiveness of a trial-run frame in either experiment. In Experiment 1, we found that a back-seat frame reduced participants’ support for mitigative action. In Experiment 2, the back-seat framing reduced both climate-change concern and mitigation support; a combined inoculation and refutation was able to offset the drop in climate concern but not the reduction in mitigation support.


title: Virus survey in populations of two subspecies of bent-winged bats (Miniopterus orianae bassanii and oceanensis) in south-eastern Australia reveals a high prevalence of diverse herpesviruses

text: While bats are often viewed as carriers of infectious disease agents, little research has been conducted on the effects these potential pathogens may have on the bat populations themselves. The southern bent-winged bat (Miniopterus orianae bassanii) is a critically endangered subspecies endemic to south-eastern Australia. Population numbers of this bat have been declining for the past 50 years, but the reasons for this are unclear. As part of a larger study to determine if disease could be a contributing factor to this decline, 351 southern bent-winged bats from four locations were captured, and oral swabs were collected and tested for the presence of potentially pathogenic viruses. Results were compared with those obtained from 116 eastern bent-winged bats (Miniopterus orianae oceanensis) from three different locations. The eastern bent-winged bat is a related but more common and widespread subspecies whose geographical range overlaps partly with southern bent-winged bats. Herpesviruses were detected in bent-winged bats from all seven locations. At least six novel herpesviruses (five betaherpesviruses and one gammaherpesvirus) were identified. The prevalence of herpesvirus infection was higher in eastern bent-winged bats (44%, 51/116), compared to southern bent-winged bats (27%, 95/351), although this varied across the locations and sampling periods. Adenoviruses and a range of different RNA viruses (lyssaviruses, filoviruses, coronaviruses and henipaviruses) were also tested for but not detected. The detected herpesviruses did not appear to be associated with obvious ill health, and may thus not be playing a role in the population decline of the southern bent-winged bat. The detection of multiple novel herpesviruses at a high prevalence of infection is consistent with our understanding of bats as hosts to a rich diversity of viruses.


title: Receptor and viral determinants of SARS-coronavirus adaptation to human ACE2

text: Human angiotensin-converting enzyme 2 (ACE2) is a functional receptor for SARS coronavirus (SARS-CoV). Here we identify the SARS-CoV spike (S)-protein-binding site on ACE2. We also compare S proteins of SARS-CoV isolated during the 2002–2003 SARS outbreak and during the much less severe 2003–2004 outbreak, and from palm civets, a possible source of SARS-CoV found in humans. All three S proteins bound to and utilized palm-civet ACE2 efficiently, but the latter two S proteins utilized human ACE2 markedly less efficiently than did the S protein obtained during the earlier human outbreak. The lower affinity of these S proteins could be complemented by altering specific residues within the S-protein-binding site of human ACE2 to those of civet ACE2, or by altering S-protein residues 479 and 487 to residues conserved during the 2002–2003 outbreak. Collectively, these data describe molecular interactions important to the adaptation of SARS-CoV to human cells, and provide insight into the severity of the 2002–2003 SARS epidemic.


Long-Term Care Facilities and the Coronavirus Epidemic: Practical Guidelines for a Population at Highest Risk


title: COVID‐19, food and nutrition insecurity and the wellbeing of children, pregnant and lactating women: A complex syndemic

text: Globally, the COVID‐19 pandemic has already led to major increases in unemployment and is expected to lead to unprecedented increases in poverty and food insecurity, as well as poor health and nutrition outcomes. Families where young children, pregnant and lactating women live need to be protected against the ongoing protracted pandemic and the aftershocks that are very likely to follow for years to come. The future wellbeing of the vast majority of the world now depends on reconfiguringthe current ineffective food, nutrition, health and social protection systems to ensure food security for all. Because food, nutrition and social protection are intimately linked with health in a multidirectional way, it is essential that that we fully address global and local food, health care, and social protection systems and the inter‐relationship among them. Implementation science research will be needed to fill in the current major gaps. Not doing so will not only put the development of individuals at further risk, but also negatively impact on the development potential of entire nations and ultimately our Planet.


Serum Amyloid A protein has been undervalued as a biomarker in cases of COVID‐19


title: Coronavirus — Aktuelle Empfehlungen für den Hausarzt: Neue DEGAM-Leitlinie

text: Innerhalb kurzer Zeit hat sich die Coronavirusinfektion COVID-19 zu einer weltweiten Pandemie entwickelt, die auch den Hausarzt vor große Herausforderungen stellt. Auf Basis der aktuellen Kenntnislage hat die Deutsche Gesellschaft für Allgemeinmedizin (DEGAM) praktische Handlungsempfehlungen entwickelt. MMW-Schriftleiter Prof. Klaus Weckbecker stellt zusammen mit Dr. Johannes Just die Leitlinie im folgenden Report vor.


title: RNA dimerization plays a role in ribosomal frameshifting of the SARS coronavirus

text: Messenger RNA encoded signals that are involved in programmed -1 ribosomal frameshifting (-1 PRF) are typically two-stemmed hairpin (H)-type pseudoknots (pks). We previously described an unusual three-stemmed pseudoknot from the severe acute respiratory syndrome (SARS) coronavirus (CoV) that stimulated -1 PRF. The conserved existence of a third stem–loop suggested an important hitherto unknown function. Here we present new information describing structure and function of the third stem of the SARS pseudoknot. We uncovered RNA dimerization through a palindromic sequence embedded in the SARS-CoV Stem 3. Further in vitro analysis revealed that SARS-CoV RNA dimers assemble through ‘kissing’ loop–loop interactions. We also show that loop–loop kissing complex formation becomes more efficient at physiological temperature and in the presence of magnesium. When the palindromic sequence was mutated, in vitro RNA dimerization was abolished, and frameshifting was reduced from 15 to 5.7%. Furthermore, the inability to dimerize caused by the silent codon change in Stem 3 of SARS-CoV changed the viral growth kinetics and affected the levels of genomic and subgenomic RNA in infected cells. These results suggest that the homodimeric RNA complex formed by the SARS pseudoknot occurs in the cellular environment and that loop–loop kissing interactions involving Stem 3 modulate -1 PRF and play a role in subgenomic and full-length RNA synthesis.


title: CD4-Independent Human Immunodeficiency Virus Infection Involves Participation of Endocytosis and Cathepsin B

text: During a comparison of the infectivity of mNDK, a CD4-independent human immunodeficiency virus type 1 (HIV-1) strain, to various cell lines, we found that HeLa cells were much less susceptible than 293T and TE671 cells. Hybridoma cells between HeLa and 293T cells were as susceptible as 293T cells, suggesting that cellular factors enhance the mNDK infection in 293T cells. By screening a cDNA expression library in HeLa cells, cystatin C was isolated as an enhancer of the mNDK infection. Because cathepsin B protease, a natural ligand of cystatin C, was upregulated in HeLa cells, we speculated that the high levels of cathepsin B activities were inhibitory to the CD4-independent infection and that cystatin C enhanced the infection by impairing the excessive cathepsin B activity. Consistent with this idea, pretreatment of HeLa cells with 125 µM of CA-074Me, a cathepsin B inhibitor, resulted in an 8-fold enhancement of the mNDK infectivity. Because cathepsin B is activated by low pH in acidic endosomes, we further examined the potential roles of endosomes in the CD4-independent infection. Suppression of endosome acidification or endocytosis by inhibitors or by an Eps15 dominant negative mutant reduced the infectivity of mNDK in which CD4-dependent infections were not significantly impaired. Taken together, these results suggest that endocytosis, endosomal acidification, and cathepsin B activity are involved in the CD4-independent entry of HIV-1.


title: Neurovirulence Properties of Recombinant Vesicular Stomatitis Virus Vectors in Non-Human Primates

text: Although vesicular stomatitis virus (VSV) neurovirulence and pathogenicity in rodents have been well studied, little is known about VSV pathogenicity in non-human primates. To address this question, we measured VSV viremia, shedding, and neurovirulence in macaques. Following intranasal inoculation, macaques shed minimal recombinant VSV (rVSV) in nasal washes for one day post-inoculation; viremia was not detected. Following intranasal inoculation of macaques, wild type (wt) VSV, rVSV, and two rVSV-HIV vectors showed no evidence of spread to CNS tissues. However, macaques inoculated intrathalamically with wt VSV developed severe neurological disease. One of four macaques receiving rVSV developed clinical and histological signs similar to the wt group, while the remaining three macaques in this group and all of the macaques in the rVSV-HIV vector groups showed no clinical signs of disease and reduced severity of histopathology compared to the wt group. The implications of these findings for rVSV vaccine development are discussed.


title: Maternal anxiety and feelings of control during labour: A study of Chinese first-time pregnant women

text: OBJECTIVE: to explore and examine the relationship between maternal anxiety levels and feelings of control during labour among Hong Kong Chinese first-time pregnant women. DESIGN: an exploratory descriptive correlation design. Data were collected on three occasions: during latent phase of labour, during active phase of labour and within 24–48 hrs after delivery. SETTING: an obstetric unit of a public teaching hospital in Hong Kong. PARTICIPANTS: a convenience sample of 90 Hong Kong Chinese first-time mothers. MEASUREMENTS AND FINDINGS: the Labour Agentry Scale (LAS) is a self-report scale designed to measure feelings of control during childbirth. A Visual Analogue Scale for anxiety (VAS-A) was used to measure women's self-reported level of anxiety during labour. Pearson Product Moment Correlation coefficient test indicated a significant negative relationship between the feelings of control and maternal anxiety during labour. No statistical relationships were detected between women's attendance at antenatal classes and feelings of control during labour. KEY CONCLUSIONS: the study showed a significant negative relationship between maternal anxiety and feelings of control during labour. IMPLICATIONS FOR PRACTICE: midwives should work with women to enhance their personal control during labour and satisfaction with their birth. The insignificant relationship between attendance at antenatal classes and feelings of control suggests the need to evaluate the content of childbirth education in order to empower women's control during labour.


title: Implications of Obesity for the Management of Severe Coronavirus Disease 2019 Pneumonia

text: To investigate patients’ characteristics, management, and outcomes in the critically ill population admitted to the ICU for severe acute respiratory syndrome coronavirus disease 2019 pneumonia causing an acute respiratory distress syndrome. DESIGN: Retrospective case-control study. SETTING: A 34-bed ICU of a tertiary hospital. PATIENTS: The first 44 coronavirus disease 2019 acute respiratory distress syndrome patients were compared with a historical control group of 39 consecutive acute respiratory distress syndrome patients admitted to the ICU just before the coronavirus disease 2019 crisis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Obesity was the most frequent comorbidity exhibited by coronavirus disease 2019 patients (n = 32, 73% vs n = 11, 28% in controls; p < 0.001). Despite the same severity of illness and level of hypoxemia at admission, coronavirus disease 2019 patients failed more high flow oxygen via nasal cannula challenges (n = 16, 100% vs n = 5, 45% in controls; p = 0.002), were more often intubated (n = 44, 100% vs n = 22, 56% in controls; p < 0.001) and paralyzed (n = 34, 77% vs n = 3, 14% in controls; p < 0.001), required higher level of positive end-expiratory pressure (15 vs 8 cm H(2)O in controls; p < 0.001), more prone positioning (n = 33, 75% vs n = 6, 27% in controls; p < 0.001), more dialysis (n = 16, 36% vs n = 3, 8% in controls; p = 0.003), more hemodynamic support by vasopressors (n = 36, 82% vs n = 22, 56% in controls; p = 0.001), and had more often a prolonged weaning from mechanical ventilation (n = 28, 64% vs n = 10, 26% in controls; p < 0.01) resulting in a more frequent resort to tracheostomy (n = 18, 40.9% vs n = 2, 9% in controls; p = 0.01). However, an intensive management requiring more staff per patient for positioning coronavirus disease 2019 subjects (6 [5–7] vs 5 [4–5] in controls; p < 0.001) yielded the same ICU survival rate in the two groups (n = 34, 77% vs n = 29, 74% in controls; p = 0.23). CONCLUSIONS: In its most severe form, coronavirus disease 2019 pneumonia striked preferentially the vulnerable obese population, evolved toward a multiple organ failure, required prolonged mechanical ventilatory support, and resulted in a high workload for the caregivers.


title: Induction of mucosal immune responses and protection against enteric viruses: rotavirus infection of gnotobiotic pigs as a model

text: Abstract Enteric viruses are a major cause of diarrhea in animals and humans. Among them, rotaviruses are one of the most important causes of diarrhea in young animals and human infants. A lack of understanding of mechanisms to induce intestinal immunity and the correlates of protective immunity in neonates has impaired development of safe and effective vaccines against enteric viruses. Studies of candidate vaccines using an adult mouse model of subclinical enteric viral infections often do not predict vaccine efficacy against disease evaluated in neonatal large animals. A series of studies have been conducted using a neonatal gnotobiotic pig model of rotavirus infection and diarrhea to identify correlates of protective immunity and to evaluate traditional and novel vaccine approaches for the induction of mucosal immune responses and protection to enteric viruses. Gnotobiotic pigs recovered from infection with virulent Wa human rotavirus (HRV) (mimic natural infection) had high numbers of intestinal IgA rotavirus-specific primary antibody-secreting cells (ASCs) and memory B-cells (to recall antigen) measured by ELISPOT assay, which correlated with complete protection against rotavirus challenge. Most short-term IgA memory B-cells were resident in the ileum, the major site of rotavirus replication. Spleen, not the bone marrow, was the major resident site for longer-term IgG memory B-cells. Candidate rotavirus vaccines evaluated in pigs for their ability to induce intestinal or systemic ASC and protection against rotavirus infection and diarrhea included attenuated live virus, inactivated virus, and baculovirus-expressed double-layered rotavirus-like particles (2/6-VLPs). In combination with those candidate vaccines, various adjuvants, delivery systems, and immunization routes were tested, including incomplete Freund’s adjuvant for i.m. immunization, and a mutant Escherichia coli heat labile enterotoxin R192G (mLT) for i.n. immunization. It was shown that orally administered replicating vaccines were most effective for priming for intestinal IgA ASC and memory B-cell responses, but i.n. administered non-replicating 2/6-VLPs plus mLT were effective as booster vaccines. We conclude that protective immunity depends on the magnitude, location, viral protein-specificity, and isotype of the antibody responses induced by vaccination. Therefore highly effective enteric viral vaccines should: (i) induce sufficient levels of intestinal IgA antibodies; (ii) include viral antigens that induce neutralizing antibodies; and (iii) require the use of effective mucosal adjuvants or antigen delivery systems for non-replicating oral or i.n. vaccines.


The Impact of the COVID-19 Pandemic on Spine Care Providers and Patients


title: Transmisión de enfermedades en los vuelos comerciales: del mito a la realidad

text: Resumen En pocas horas el transporte aéreo puede diseminar enfermedades infecto-contagiosas alrededor del mundo. Aunque se considera uno de los medios de transporte más seguros, poco se conoce sobre qué tanto lo es para la salud pública internacional, teniendo en cuenta que se está expandiendo e incrementando la cantidad de usuarios que pueden llegar a adquirir y diseminar este tipo de enfermedades. El punto crítico para evitar una pandemia es prever y estar preparados; esto se logra con el entrenamiento del personal de la salud y el de aviación. Por estas razones, este manuscrito busca mostrar el panorama general del impacto que tiene el ambiente aeronáutico sobre la transmisión de enfermedades infecciosas y las estrategias que se han ideado para lograr activar las alertas epidemiológicas tempranamente y controlar un posible brote, las cuales abarcan la educación del personal de salud, el de vuelo y el pasajero en tierra, la prevención, profilaxis e identificación temprana de la enfermedad y el manejo inmediato y retrospectivo del evento después del vuelo. Abstract Air transport could disseminate infectious diseases in a few hours around the world. Although it is considered one of the safest means of transportation, little is known about its public health safety impact, keeping in mind that it is expanding and increasing the amount of users who can acquire and spread these diseases. The critical point to avoid a pandemic outbreak is to foresee and to be prepared; this could be done with health and aviation personnel training. Thus, this paper shows a general background about the aeronautical impact on infectious diseases transmission and all strategies created to get an early activation of epidemiological alarms to control any outbreak. They include from health, flight staff and passenger education on ground to prevention, prophylaxis, early disease identification as well as both immediate and retrospective post-flight event management.


title: The impact of changes in diagnostic testing practices on estimates of COVID-19 transmission in the United States

text: Estimates of the reproductive number for novel pathogens such as SARS-CoV-2 are essential for understanding the potential trajectory of the epidemic and the level of intervention that is needed to bring the epidemic under control. However, most methods for estimating the basic reproductive number (R(0)) and time-varying effective reproductive number (R(t)) assume that the fraction of cases detected and reported is constant through time. We explore the impact of secular changes in diagnostic testing and reporting on estimates of R(0) and R(t) using simulated data. We then compare these patterns to data on reported cases of COVID-19 and testing practices from different United States (US) states. We find that changes in testing practices and delays in reporting can result in biased estimates of R(0) and R(t). Examination of changes in the daily number of tests conducted and the percent of patients testing positive may be helpful for identifying the potential direction of bias. Changes in diagnostic testing and reporting processes should be monitored and taken into consideration when interpreting estimates of the reproductive number of COVID-19.


Conseils sur les mesures barrières en ophtalmologie (SFO et du CNPO) dans cette période d’épidémie au Covid-191


title: Intersecting ethnic and native–migrant inequalities in the economic impact of the COVID-19 pandemic in the UK

text: Analyzing new nationwide data from the Understanding Society COVID-19 survey (N = 10,336), this research examines intersecting ethnic and native–migrant inequalities in the impact of COVID-19 on people’s economic well-being in the UK. The results show that compared with UK-born white British, black, Asian and minority ethnic (BAME) migrants in the UK are more likely to experience job loss during the COVID-19 lockdown, while BAME natives are less likely to enjoy employment protection such as furloughing. Although UK-born white British are more likely to reduce their work hours during the COVID-19 pandemic than BAME migrants, they are less likely to experience income loss and face increased financial hardship during the pandemic than BAME migrants. The findings show that the pandemic exacerbates entrenched socio-economic inequalities along intersecting ethnic and native–migrant lines. They urge governments and policy makers to place racial justice at the center of policy developments in response to the pandemic.


title: Developing Infectious Disease Strategies for the Developing World

text: Publisher Summary This chapter discusses various drugs for human influenza A (H5N1) and multidrug-resistant mycobacterium tuberculosis (MDR-TB). The H5N1 avian influenza does not presently meet the criteria of an antigenically shifted strain. It is presently an avian strain that has not undergone reassortment with a human strain and is not well adapted to humans. H5N1 isolates are resistant to the M2 inhibitors amantadine and rimantadine; these antivirals do not have a role for the treatment or prophylaxis against the strain. The neuraminidase inhibitors, oseltamivir and zanamivir, have in vitro activities against the human H5N1 isolates; however, recent data suggest that higher doses for longer periods may be required to be effective. Oseltamivir is an oral agent approved for prophylaxis and the treatment of influenza infections. Zanamivir is delivered topically to the respiratory tract with similar indications. The drugs discussed in the chapter for MDR-TB fall into three categories—quinolones, nitroimidazoles, and pyrroles. Drugs such as moxifloxacin are methoxyfluoroquinolones, which are already available and approved for the treatment of acute respiratory infections, such as community-acquired pneumonia, intra-abdominal infections, acute sinusitis, and skin infections. Gatifloxacin 5, is another methoxyfluoroquinolone that is in clinical development for tuberculosis treatment.


title: Identificadas las principales manifestaciones en la piel de la COVID‐19

text: La enfermedad COVID‐19 es una infección provocada por SARS‐CoV‐2. Se descubrió en diciembre de 2019, y en marzo de 2020 la Organización Mundial de la Salud anunció que ocasionaba una pandemia. La enfermedad puede afectar a varios órganos y algunas descripciones previas indicaban que puede afectar a la piel. Los investigadores, dermatólogos de toda España, revisaron 375 casos con COVID‐19 sospechado o confirmado, para desarrollar una clasificación de las lesiones que se asocian a COVID‐19 y aportar imágenes. Las lesiones de los primeros 120 casos fueron revisadas por cuatro dermatólogos, sin conocer otra información clínica, para reconocer los patrones de lesiones que se asocian con la COVID‐19. Luego aplicaron estos patrones al resto de imágenes, mientras se mejoraban. De esta forma se describieron 5 grandes tipos de lesiones. Los grupos son: lesiones que parecen sabañones, brotes de pequeñas vesículas, ronchas, erupciones elevadas rojizas y lesiones de livedo o necrosis. La livedo son manchas que se producen por una alteración de la circulación de la sangre en la piel, mientras la necrosis es la muerte prematura de tejidos. Estos signos de COVID‐19 se asocian con diferentes grados de gravedad de la enfermedad: las lesiones que parecen sabañones aparecen en las formas menos graves y la livedo o necrosis en los más graves. Los autores han señalado que algunas de las manifestaciones de la COVID‐19 en la piel pueden aparecer de forma frecuente por otras causas, especialmente las ronchas y las erupciones. Por eso es posible que no sean muy útiles para el diagnóstico.


title: Sparse evidence of MERS-CoV infection among animal workers living in Southern Saudi Arabia during 2012

text: Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging viral pathogen that primarily causes respiratory illness. We conducted a seroprevalence study of banked human serum samples collected in 2012 from Southern Saudi Arabia. Sera from 300 animal workers (17% with daily camel exposure) and 50 non-animal-exposed controls were examined for serological evidence of MERS-CoV infection by a pseudoparticle MERS-CoV spike protein neutralization assay. None of the sera reproducibly neutralized the MERS-CoV-pseudotyped lentiviral vector. These data suggest that serological evidence of zoonotic transmission of MERS-CoV was not common among animal workers in Southern Saudi Arabia during July 2012.


title: Management strategies for the burn ward during COVID-19 pandemic

text: Abstract COVID-19 pandemic is sweeping the globe. Any outpatient or new inpatient especial in burn department during the pandemic should be as a potential infectious source of COVID-19. It is very important to manage the patients and wards carefully and correctly to prevent epidemic of the virus in burn centers. This paper provides some strategies regarding management of burn ward during the epidemic of COVID-19 or other respiratory infectious diseases.


title: Eficacia y eficiencia de un programa especial para la disminución de la lista de espera de cirugía bariátrica en un hospital terciario

text: INTRODUCTION: Bariatric surgery is one of the most common surgical practices in Spain. However, this procedure currently has longest delay on surgical waiting lists (SWL). We have developed a special surgical program that aims to reduce this waiting list and to assess the economic and clinical repercussions in a high-volume bariatric surgery unit. METHODS: A three-month prospective study was carried out comparing outcomes, results and perioperative resources consumed for 45 patients who underwent bariatric surgery. The patients were divided into 2 groups: patients who underwent the standard procedure in the operating room, and patients treated in the special program. Epidemiological, healthcare and economic factors were taken into account. RESULTS: Two homogeneous groups of patients were operated on, successfully reducing the SWL. Morbidity was similar in both groups and the average cost of the surgeries performed was €5,331.40; in the standard group, the cost was €5,372.50 ± €798.10, and the cost of the special program group was €5,290.30 ± €685.10, with no significant differences. CONCLUSIONS: In hospitals with a high volume of bariatric surgery, it is feasible to incorporate special surgical programs that are able to reduce surgical waiting lists, while maintaining quality criteria and without incurring a greater expense to the healthcare system.


title: Ocular manifestation as first sign of Coronavirus Disease 2019 (COVID-19): interest of telemedicine during the pandemic context

text: Abstract We report here the case of a 27-year-old man who consulted by telemedicine during the Coronavirus Disease 2019 (COVID-19) pandemic, due to foreign body sensation and left eye redness. Examination revealed unilateral eyelid edema and moderate conjunctival hyperemia. A few hours later the patient experienced intense headache and developed fever, cough and severe dyspnea. A nasopharyngeal swab proved positive for SARS-CoV-2. This case demonstrates that conjunctivitis can be the inaugural manifestation of the COVID-19 infection. It illustrates the interest of telemedicine in ophthalmology during the COVID-19 pandemic, since moderate conjunctival hyperemia can be the first sign of a severe respiratory distress.


title: Of Viruses, Vaccines, and Variability: Qualitative Meaning Matters

text: Abstract Deaths from COVID-19 depend on millions of people understanding risk and translating this understanding into risk-reduction behaviors. Although numerical information about risk is helpful, numbers are surprisingly ambiguous, and there are predictable mismatches in risk perception between laypeople and experts. Hence, risk communication should convey the qualitative, contextualized meaning of risk.


title: Evidence for genetic variation in Natterer’s bats (Myotis nattereri) across three regions in Germany but no evidence for co-variation with their associated astroviruses

text: BACKGROUND: As bats have recently been described to harbor many different viruses, several studies have investigated the genetic co-variation between viruses and different bat species. However, little is known about the genetic co-variation of viruses and different populations of the same bat species, although such information is needed for an understanding of virus transmission dynamics within a given host species. We hypothesized that if virus transmission between host populations depends on events linked to gene flow in the bats, genetic co-variation should exist between host populations and astroviruses. RESULTS: We used 19 nuclear and one mitochondrial microsatellite loci to analyze the genetic population structure of the Natterer’s bat (Myotis nattereri) within and among populations at different geographical scales in Germany. Further, we correlated the observed bat population structure to that of partial astrovirus sequences (323–394 nt fragments of the RNA-dependent RNA polymerase gene) obtained from the same bat populations. Our analyses revealed that the studied bat colonies can be grouped into three distinct genetic clusters, corresponding to the three geographic regions sampled. Furthermore, we observed an overall isolation-by-distance pattern, while no significant pattern was observed within a geographic region. Moreover, we found no correlation between the genetic distances among the bat populations and the astrovirus sequences they harbored. Even though high genetic similarity of some of the astrovirus haplotypes found in several different regions was detected, identical astrovirus haplotypes were not shared between different sampled regions. CONCLUSIONS: The genetic population structure of the bat host suggests that mating sites where several local breeding colonies meet act as stepping-stones for gene flow. Identical astrovirus haplotypes were not shared between different sampled regions suggesting that astroviruses are mostly transmitted among host colonies at the local scale. Nevertheless, high genetic similarity of some of the astrovirus haplotypes found in several different regions implies that occasional transmission across regions with subsequent mutations of the virus haplotypes does occur. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12862-016-0856-0) contains supplementary material, which is available to authorized users.


Viral Manipulation of Host Inhibitory Receptor Signaling for Immune Evasion


title: Recent Advances Towards the Development of a Potent Antiviral Against the Hepatitis E Virus

text: Hepatitis E virus (HEV) is one of the leading causes of acute viral hepatitis. It also causes acute liver failure and acute-on-chronic liver failure in many patients, such as those suffering from other infections/liver injuries or organ transplant/chemotherapy recipients. Despite widespread sporadic and epidemic incidents, there is no specific treatment against HEV, justifying an urgent need for developing a potent antiviral against it. This review summarizes the known antiviral candidates and provides an overview of the potential targets for the development of specific antivirals against HEV.


title: Transmission dynamics of COVID-19 in Wuhan, China: effects of lockdown and medical resources

text: Due to the strong infectivity of COVID-19, it spread all over the world in about three months and thus has been studied from different aspects including its source of infection, pathological characteristics, diagnostic technology and treatment. Yet, the influences of control strategies on the transmission dynamics of COVID-19 are far from being well understood. In order to reveal the mechanisms of disease spread, we present dynamical models to show the propagation of COVID-19 in Wuhan. Based on mathematical analysis and data analysis, we systematically explore the effects of lockdown and medical resources on the COVID-19 transmission in Wuhan. It is found that the later lockdown is adopted by Wuhan, the fewer people will be infected in Wuhan, and nevertheless it will have an impact on other cities in China and even the world. Moreover, the richer the medical resources, the higher the peak of new infection, but the smaller the final scale. These findings well indicate that the control measures taken by the Chinese government are correct and timely.


title: Antiviral Drugs Specific for Coronaviruses in Preclinical Development

text: Coronaviruses are positive stranded RNA viruses that cause respiratory, enteric and central nervous system diseases in many species, including humans. Until recently, the relatively low burden of disease in humans caused by few of these viruses impeded the development of coronavirus specific therapeutics. However, the emergence of severe acute respiratory syndrome coronavirus (SARS-CoV), and more recently, Middle East respiratory syndrome coronavirus (MERS-CoV), has impelled the development of such drugs. This review focuses on some newly identified SARS-CoV inhibitors, with known mechanisms of action and their potential to inhibit the novel MERS-CoV. The clinical development of optimized versions of such compounds could be beneficial for the treatment and control of SARS-CoV, the current MERS-CoV and other future SARS-like epidemics.


title: The Multiples Fates of the Flavivirus RNA Genome During Pathogenesis

text: The Flavivirus genus comprises many viruses (including dengue, Zika, West Nile and yellow fever viruses) which constitute important public health concerns worldwide. For several of these pathogens, neither antivirals nor vaccines are currently available. In addition to this unmet medical need, flaviviruses are of particular interest since they constitute an excellent model for the study of spatiotemporal regulation of RNA metabolism. Indeed, with no DNA intermediate or nuclear step, the flaviviral life cycle entirely relies on the cytoplasmic fate of a single RNA species, namely the genomic viral RNA (vRNA) which contains all the genetic information necessary for optimal viral replication. From a single open reading frame, the vRNA encodes a polyprotein which is processed to generate the mature viral proteins. In addition to coding for the viral polyprotein, the vRNA serves as a template for RNA synthesis and is also selectively packaged into newly assembled viral particles. Notably, vRNA translation, replication and encapsidation must be tightly coordinated in time and space via a fine-tuned equilibrium as these processes cannot occur simultaneously and hence, are mutually exclusive. As such, these dynamic processes involve several vRNA secondary and tertiary structures as well as RNA modifications. Finally, the vRNA can be detected as a foreign molecule by cytosolic sensors which trigger upon activation antiviral signaling pathways and the production of antiviral factors such as interferons and interferon-stimulated genes. However, to create an environment favorable to infection, flaviviruses have evolved mechanisms to dampen these antiviral processes, notably through the production of a specific vRNA degradation product termed subgenomic flavivirus RNA (sfRNA). In this review, we discuss the current understanding of the fates of flavivirus vRNA and how this is regulated at the molecular level to achieve an optimal replication within infected cells.


title: Bovine coronavirus antigen in the host cell plasmalemma

text: Abstract Expression of bovine coronavirus (BCV) antigen in the plasmalemma of epithelioid human rectal tumor (HRT-18) and fibroblastic bovine fetal spleen (BFS) cell lines was traced by immunofluorescence and immunoelectron microscopy facilitated by colloidal gold. Cytoplasmic fluorescence was first observed at 12 hr postinfection (h.p.i) in infected HRT-18 cultures. This fluorescence coincided with the appearance of cell surface antigen reacting with colloidal gold-labeled antibodies to BCV antigens. At 24 h.p.i the amount of viral antigens at the surface of HRT-18 had increased, although cytoplasmic fluorescence remained constant. Infected BFS cells but not HRT-18 cells formed polykaryons when incubated in the presence of trypsin. One viral antigen in the plasma membrane of BFS cells was thus identified as the S glycoprotein with a fusion domain. In contrast to HRT-18 cells, the overall amount of BCV antigens at the surface of BFS cells remained constant after the onset of fusion. Analysis of the labeling characteristics established that the goldmarked-sites represented de novo expression of BCV antigen in the plasma membrane of infected cells.


Learning from COVID-19 pandemic in northen italy: Impact on mental health and clinical care


title: Obesity as a Potential Predictor of Disease Severity in Young COVID‐19 Patients: A Retrospective Study

text: OBJECTIVE: To explore the indicators for severity in young COVID‐19 patients age between 18 to 40. METHODS: This retrospective cohort study includes 65 consecutively admitted COVID‐19 patients age between 18 to 40 in Zhongnan Hospital of Wuhan University. Among them, 53 were moderate cases, 12 were severe or critical cases. Epidemiological, clinical and laboratory characteristics and treatment data were collected. A multivariate logistic regression analysis was implemented to explore risk factors. RESULTS: The severe/critical cases have obviously higher BMI (average 29.23 vs. 22.79kg/m(2)) and lower liver CT value (average 50.00 vs. 65.00mU) than moderate cases group. The severe/critical cases have higher fasting glucose, alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , and creatinine (Cr) compared with moderate cases (All P<0.01) . More severe/critical cases (58.33% vs. 1.92%) have positive urine protein. The severe/critical cases will experience a significant process of serum albumin decline. Logistic regression analysis showed that male, high body mass index (especially obesity), elevated fasting blood glucose and urinary protein positive are all risk factors for severe young COVID‐19 patients. CONCLUSION: Obesity is an important predictor of severity in young COVID‐19 patients. The main mechanism is related to the damage of liver and kidney.


title: Identification of the Active Sites in the Methyltransferases of a Transcribing dsRNA Virus

text: Many double-stranded RNA (dsRNA) viruses are capable of transcribing and capping RNA within a stable icosahedral viral capsid. The turret of turreted dsRNA viruses belonging to the family Reoviridae is formed by five copies of the turret protein, which contains domains with both 7-N-methyltransferase and 2′-O-methyltransferase activities, and serves to catalyze the methylation reactions during RNA capping. Cypovirus of the family Reoviridae provides a good model system for studying the methylation reactions in dsRNA viruses. Here, we present the structure of a transcribing cypovirus to a resolution of ~ 3.8 Å by cryo-electron microscopy. The binding sites for both S-adenosyl-l-methionine and RNA in the two methyltransferases of the turret were identified. Structural analysis of the turret in complex with RNA revealed a pathway through which the RNA molecule reaches the active sites of the two methyltransferases before it is released into the cytoplasm. The pathway shows that RNA capping reactions occur in the active sites of different turret protein monomers, suggesting that RNA capping requires concerted efforts by at least three turret protein monomers. Thus, the turret structure provides novel insights into the precise mechanisms of RNA methylation.


title: Conurbation, Urban, and Rural Living as Determinants of Allergies and Infectious Diseases: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2016-2017

text: BACKGROUND: Living in a conurbation, urban, or rural environment is an important determinant of health. For example, conurbation and rural living is associated with increased respiratory and allergic conditions, whereas a farm or rural upbringing has been shown to be a protective factor against this. OBJECTIVE: The objective of the study was to assess differences in general practice presentations of allergic and infectious disease in those exposed to conurbation or urban living compared with rural environments. METHODS: The population was a nationally representative sample of 175 English general practices covering a population of over 1.6 million patients registered with sentinel network general practices. General practice presentation rates per 100,000 population were reported for allergic rhinitis, asthma, and infectious conditions grouped into upper and lower respiratory tract infections, urinary tract infection, and acute gastroenteritis by the UK Office for National Statistics urban-rural category. We used multivariate logistic regression adjusting for age, sex, ethnicity, deprivation, comorbidities, and smoking status, reporting odds ratios (ORs) with 95% CIs. RESULTS: For allergic rhinitis, the OR was 1.13 (95% CI 1.04-1.23; P=.003) for urban and 1.29 (95% CI 1.19-1.41; P<.001) for conurbation compared with rural dwellers. Conurbation living was associated with a lower OR for both asthma (OR 0.70, 95% CI 0.67-0.73; P<.001) and lower respiratory tract infections (OR 0.94, 95% CI 0.90-0.98; P=.005). Compared with rural dwellers, the OR for upper respiratory tract infection was greater in urban (OR 1.06, 95% CI 1.03-1.08; P<.001) but no different in conurbation dwellers (OR 1.00, 95% CI 0.97-1.03; P=.93). Acute gastroenteritis followed the same pattern: the OR was 1.13 (95% CI 1.01-1.25; P=.03) for urban dwellers and 1.04 (95% CI 0.93-1.17; P=.46) for conurbation dwellers. The OR for urinary tract infection was lower for urban dwellers (OR 0.94, 95% CI 0.89-0.99; P=.02) but higher in conurbation dwellers (OR 1.06, 95% CI 1.00-1.13; P=.04). CONCLUSIONS: Those living in conurbations or urban areas were more likely to consult a general practice for allergic rhinitis and upper respiratory tract infection. Both conurbation and rural living were associated with an increased risk of urinary tract infection. Living in rural areas was associated with an increased risk of asthma and lower respiratory tract infections. The data suggest that living environment may affect rates of consultations for certain conditions. Longitudinal analyses of these data would be useful in providing insights into important determinants.


title: L’optimisme et COVID-19: une ressource pour soutenir les personnes en situation de confinement?

text: Abstract This text envisages looking at the psychological consequences of the health situation related to COVID-19 from the concept of optimism. Positive psychology has for several years been dealing with this concept, which is well known to the general public, but which has been the subject of major conceptual development in the field of science. It seems to us that the concept of optimism can be particularly useful in understanding and influencing the behaviour of our fellow citizens during the period of confinement that is currently imposed on everyone, in the same way that we must consider the consequences in the short, medium and long term, both economically and in terms of the moral and physical health of our fellow citizens, that is, after the period of confinement. Traditionally, being optimistic means being confident in the positive outcome of an event, whereas pessimism means expecting the worst. The uncertainty that this virus imposes on us and the new situations that it brings about, forces us to think the world in uncertain terms, which can be destabilizing. Understanding the contribution of the concept of optimism in the potential of the adaptive processes that each of us may or may not be able to mobilize to face and adapt to this unprecedented and unprecedented health crisis is essential. This will undoubtedly be a major challenge for the social sciences and psychology. This is why we believe that the concept of optimism can help to provide additional insights that will enable us to better grasp the rational (or non-rational) behaviours that we may face in the future, and in which we are already involved.


title: The Chinese governance system: Its strengths and weaknesses in a comparative development perspective

text: Abstract This is an overview paper focusing on the organizational aspects of the Chinese governance system and their relation to development. Compared to other developing countries like India, it has special positive features of career incentives promoting growth at the local level, the ability to take long-term decisions relatively quickly, and a unique blend of political centralization and decentralization of economic power and responsibility, that is conducive to central guidance and local business development. On the other hand, with a lack of sufficient downward (as opposed to upward) accountability and absence of institutionalized systems of scrutiny and challenge from below, mistakes or abuse of power are more difficult to check and correct quickly, political loyalty may often get a premium over performance at the upper levels, and there are insufficient checks on collusion between business and officials. The over-all organizational system is prone to over-reaction in times of crisis and thus only weakly resilient compared to systems where information flows from below are less controlled or choked.


title: Alternative infectious entry pathways for dengue virus serotypes into mammalian cells

text: The entry of two dengue virus (DENV) serotypes into Vero cells was analysed using biochemical inhibitors, dominant negative mutants of cellular proteins involved in endocytic pathways, fluorescence microscopy and infectivity determinations. By treatment with dansylcadaverine and chlorpromazine and overexpression of a dominant negative form of the Eps15 protein, a clathrin‐mediated endocytosis for productive DENV‐1 internalization into Vero cells was demonstrated whereas the infectious entry of DENV‐2 in the same cell system was independent of clathrin. Treatment with the inhibitors nystatin and methyl‐β‐cyclodextrin, as well as transfection of Vero cells with dominant negative caveolin‐1, had no effect on DENV‐2 virus infection. It was also shown, by using the K44A mutant and the inhibitor dynasore, that dynamin was required for DENV‐2 entry. Consequently, the infectious entry of DENV‐2 into Vero cells occurs by a non‐classical endocytic pathway independent of clathrin, caveolae and lipid rafts, but dependent on dynamin. By contrast, DENV‐2 entry into A549 cells was clathrin‐dependent, as previously reported in HeLa, C6/36 and BS‐C‐1 cells. Our results conclusively show, for the first time, a differential mode of infective entry for DENV‐1 and DENV‐2 into a common host cell, Vero cells, as well as alternative entry pathways for a given serotype, DENV‐2, into different types of cells.


title: Clinical Pathology in the Adult Sick Horse The Gastrointestinal System and Liver

text: The gastrointestinal tract and liver comprise key components of the equine digestive system and together have important functions in metabolism, digestion, absorption, detoxification, and synthesis. Disorders of the gastrointestinal tract and liver are common in clinical practice and can cause a variety of clinical signs. Hematologic and biochemical analysis can be helpful for identifying organ dysfunction, narrowing down the differential diagnostic list, and monitoring progress and response to treatment. This article details hematologic and biochemical tests that are important in the evaluation of intestinal and hepatic diseases and reviews bloodwork trends frequently observed in adult horses affected by enteropathy or hepatopathy.


title: Analysis of Synonymous Codon Usage Bias in Chlamydia

text: Abstract Chlamydiae are obligate intracellular bacterial pathogens that cause ocular and sexually transmitted diseases, and are associated with cardiovascular diseases. The analysis of codon usage may improve our understanding of the evolution and pathogenesis of Chlamydia and allow reengineering of target genes to improve their expression for gene therapy. Here, we analyzed the codon usage of C. muridarum, C. trachomatis (here indicating biovar trachoma and LGV), C. pneumoniae, and C. psittaci using the codon usage database and the CUSP (Create a codon usage table) program of EMBOSS (The European Molecular Biology Open Software Suite). The results show that the four genomes have similar codon usage patterns, with a strong bias towards the codons with A and T at the third codon position. Compared with Homo sapiens, the four chlamydial species show discordant seven or eight preferred codons. The ENC (effective number of codons used in a gene)‐plot reveals that the genetic heterogeneity in Chlamydia is constrained by the G+C content, while translational selection and gene length exert relatively weaker influences. Moreover, mutational pressure appears to be the major determinant of the codon usage variation among the chlamydial genes. In addition, we compared the codon preferences of C. trachomatis with those of E. coli, yeast, adenovirus and Homo sapiens. There are 23 codons showing distinct usage differences between C. trachomatis and E. coli, 24 between C. trachomatis and adenovirus, 21 between C. trachomatis and Homo sapiens, but only six codons between C. trachomatis and yeast. Therefore, the yeast system may be more suitable for the expression of chlamydial genes. Finally, we compared the codon preferences of C. trachomatis with those of six eukaryotes, eight prokaryotes and 23 viruses. There is a strong positive correlation between the differences in coding GC content and the variations in codon bias (r=0.905, P<0.001). We conclude that the variation of codon bias between C. trachomatis and other organisms is much less influenced by phylogenetic lineage and primarily determined by the extent of disparities in GC content. Edited by You‐Xin JIN


title: COVID-19 pneumonia: CT findings of 122 patients and differentiation from influenza pneumonia

text: OBJECTIVES: To investigate the clinical and chest CT characteristics of COVID-19 pneumonia and explore the radiological differences between COVID-19 and influenza. MATERIALS AND METHODS: A total of 122 patients (61 men and 61 women, 48 ± 15 years) confirmed with COVID-19 and 48 patients (23 men and 25 women, 47 ± 19 years) confirmed with influenza were enrolled in the study. Thin-section CT was performed. The clinical data and the chest CT findings were recorded. RESULTS: The most common symptoms of COVID-19 were fever (74%) and cough (63%), and 102 patients (83%) had Wuhan contact. Pneumonia in 50 patients with COVID-19 (45%) distributed in the peripheral regions of the lung, while it showed mixed distribution in 26 patients (74%) with influenza (p = 0.022). The most common CT features of the COVID-19 group were pure ground-glass opacities (GGO, 36%), GGO with consolidation (51%), rounded opacities (35%), linear opacities (64%), bronchiolar wall thickening (49%), and interlobular septal thickening (66%). Compared with the influenza group, the COVID-19 group was more likely to have rounded opacities (35% vs. 17%, p = 0.048) and interlobular septal thickening (66% vs. 43%, p = 0.014), but less likely to have nodules (28% vs. 71%, p < 0.001), tree-in-bud sign (9% vs. 40%, p < 0.001), and pleural effusion (6% vs. 31%, p < 0.001). CONCLUSIONS: There are significant differences in the CT manifestations of patients with COVID-19 and influenza. Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza. KEY POINTS: • Typical CT features of COVID-19 include pure ground-glass opacities (GGO), GGO with consolidation, rounded opacities, bronchiolar wall thickening, interlobular septal thickening, and a peripheral distribution. • Presence of rounded opacities and interlobular septal thickening, with the absence of nodules and tree-in-bud sign, and with the typical peripheral distribution, may help us differentiate COVID-19 from influenza.


title: Quorum sensing affects virulence-associated proteins F1, LcrV, KatY and pH6 etc. of Yersinia pestis as revealed by protein microarray-based antibody profiling

text: Abstract Protein microarray that consists of virulence-associated proteins of Yersinia pestis is used to compare antibody profiles elicited by the wild-type and quorum sensing (QS) mutant strain of this bacterium to define the immunogens that are impacted by QS. The results will lead the way for future functional proteomics studies. The antibody profile that was induced by the QS mutant differed from that of the parent strain. Detailed comparison of the antibody profiles, according to the proteins’ functional annotations, showed that QS affects the expression of many virulence-associated proteins of Y. pestis. The antibodies to many virulence-associated proteins were not detected or lower titers of antibodies to many proteins were detected in the sera of rabbits immunized with the QS mutant, relative to those of the wild type, which indicated that these proteins were not expressed or expressed at relatively lower levels in the QS mutant. The results demonstrated that antibody profiling by protein microarrays is a promising high-throughput method for revealing the interactions between pathogens and the host immune system.


Physician suicide and the COVID-19 pandemic


title: Immucillins ImmA and ImmH Are Effective and Non-toxic in the Treatment of Experimental Visceral Leishmaniasis

text: BACKGROUND: Immucillins ImmA (IA), ImmH (IH) and SerMe-ImmH (SMIH) are synthetic deazapurine nucleoside analogues that inhibit Leishmania (L.) infantum chagasi and Leishmania (L.) amazonensis multiplication in vitro without macrophage toxicity. Immucillins are compared to the Glucantime standard drug in the chemotherapy of Leishmania (L.) infantum chagasi infection in mice and hamsters. These agents are tested for toxicity and immune system response. METHODOLOGY/PRINCIPAL FINDINGS: BALB/c mice were infected with 10(7) amastigotes, treated with IA, IH, SMIH or Glucantime (2.5mg/kg/day) and monitored for clinical variables, parasite load, antibody levels and splenocyte IFN-γ, TNF-α, and IL-10 expression. Cytokines and CD4+, CD8+ and CD19+ lymphocyte frequencies were assessed in uninfected controls and in response to immucillins. Urea, creatinine, GOT and GPT levels were monitored in sera. Anti-Leishmania-specific IgG1 antibodies (anti-NH36) increased in untreated animals. IgG2a response, high levels of IFN-γ, TNF-α and lower levels of IL-10 were detected in mice treated with the immucillins and Glucantime. Immucillins permitted normal weight gain, prevented hepato-splenomegaly and cleared the parasite infection (85–89%) without renal and hepatic toxicity. Immucillins promoted 35% lower secretion of IFN-γ in uninfected controls than in infected mice. IA and IH increased the CD4+ T and CD19+ B cell frequencies. SMIH increased only the proportion of CD-19 B cells. IA and IH also cured infected hamsters with lower toxicity than Glucantime. CONCLUSIONS/SIGNIFICANCE: Immucillins IA, IH and SMIH were effective in treating leishmaniasis in mice. In hamsters, IA and IH were also effective. The highest therapeutic efficacy was obtained with IA, possibly due to its induction of a TH1 immune response. Low immucillin doses were required and showed no toxicity. Our results disclose the potential use of IA and IH in the therapy of visceral leishmaniasis.


title: Biologically active polymer nanosystems

text: The methods of synthesis of biologically active nanostructured systems based on functional and natural polymers are reviewed. The formation of nanosystems in the process of interaction between synthetic water-soluble polyelectrolytes and amphiphilic ionic surfactants is discussed. The influence of structure and stability of these systems on their biological activity is considered. The complexation between DNA and polycations with the formation of compacted DNA molecules, and the transport of resulting complexes into the cells are discussed. The data on nanostructuring of hemoglobin using polyfunctional crosslinkers and the data on the use of the obtained nanoparticles as oxygen-transporting blood substitutes are summarized. Using nanodisperse silver stabilized with poly(vinylpyrrolidone) as an example it was demonstrated, that transferring silver into nanodisperse state results in widening its bioactivity.


Reply to “No time like the present: time to rethink our habits in science and continuous medical education?”


title: Complete Genome Sequence of a Novel Coronavirus (SARS-CoV-2) Isolate from Bangladesh

text: The complete genome sequence of a novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) isolate obtained from a nasopharyngeal swab from a patient with COVID-19 in Bangladesh is reported.


title: Framing a Needed Discourse on Health Disparities and Social Inequities: Drawing Lessons from a Pandemic

text: COVID‐19 provides numerous opportunities for policymakers to consider matters of social equity in relation to the field of public health. Specifically, by reflecting on health disparities in relation to the disproportionate impact of COVID‐19 on minority and historically underserved populations, we can leverage a needed discourse on health outcomes for many communities. Grounded in the social determinants of health conceptual framework, this article explores the application of the disproportionate impact of COVID‐19 on vulnerable populations and communities of color for a discussion on strategies for minimizing health disparities. This article is protected by copyright. All rights reserved.


title: Clinical Outcomes and Serologic Response in Solid Organ Transplant Recipients with COVID‐19: A Case Series from the United States

text: The coronavirus disease 2019 (COVID‐19) pandemic caused by SARS coronavirus 2 (SARS‐CoV‐2) has caused significant morbidity and mortality for patients and stressed healthcare systems worldwide. The clinical features, disease course, and serologic response of COVID‐19 among immunosuppressed patients such as solid organ transplant (SOT) recipients, who are at presumed risk for more severe disease, are not well characterized. We describe our institutional experience with COVID‐19 among ten SOT patients, including the clinical presentation, treatment modalities, and outcomes of seven renal transplant recipients, one liver transplant recipient, one heart transplant recipient, and one lung transplant recipient. In addition, we report the serologic response in SOT recipients, documenting a positive IgG response in all seven hospitalized patients. We also review the existing literature on COVID‐19 in SOT recipients to consolidate the current knowledge on COVID‐19 in the SOT population for the transplant community.


title: Chest computed tomography for severe acute respiratory syndrome coronavirus 2 infection screening for COVID‐19 before emergency and elective upper endoscopy: a pilot study

text: The SARS‐CoV‐2 virus has spread worldwide and may present as an asymptomatic or subclinical infection(1). Upper gastrointestinal endoscopy is associated with a high risk of the coronavirus disease 2019 (COVID‐19) owing to aerosol generation(2). Chest computed tomography (CT) can be undertaken in general clinical facilities and is as accurate in COVID‐19 diagnosis as real‐time reverse transcription‐polymerase chain reaction (RT‐PCR)(3). In April 2020, 31 patients underwent urgent or elective esophagogastroduodenoscopy at our institution. Among those, 21 patients experienced chest CT. None had fever, respiratory symptoms, or olfactory abnormalities. Patient characteristics are shown in Table 1. CT revealed possible COVID‐19 findings in two patients (Figure 1A, 1B), and the endoscopic procedure was postponed. The first patient underwent RT‐PCR twice, and the second patient also underwent LAMP test twice, all examinations showed negative results.


title: Use of an Innovative Web-Based Laboratory Surveillance Platform to Analyze Mixed Infections Between Human Metapneumovirus (hMPV) and Other Respiratory Viruses Circulating in Alberta (AB), Canada (2009–2012)

text: We investigated the proportions of mono vs. mixed infections for human metapneumovirus (hMPV) as compared to adenovirus (ADV), four types of coronavirus (CRV), parainfluenza virus (PIV), RSV, and enterovirus/rhinovirus (ERV) in Alberta, Canada. Using the Data Integration for Alberta Laboratories (DIAL) platform, 26,226 respiratory specimens at ProvLab between 1 July 2009 and 30 June 2012 were selected and included in the study. Using the Respiratory Virus Panel these specimens tested positive for one or more respiratory virus and negative for influenza A and B. From our subset hMPV was the fourth most common virus (n=2,561) with 373 (15%) identified as mixed infection using DIAL. Mixed infection with hMPV was most commonly found in infants less than 6 months old and ERV was most commonly found in mixed infection with hMPV (230/373, 56%) across all age groups. The proportion of mixed-infection vs. mono-infection was highest for ADV (46%), followed by CRV 229E (32%), CRV HKU1 (31%), CRV NL63 (28%), CRV OC43 (23%), PIV (20%), RSV (17%), hMPV (15%) and ERV (13%). hMPV was significantly more likely to be identified in mono infection as compared with ADV, CRV, PIV, and RSV with the exception of ERV [p<0.05].


title: Saracatinib Inhibits Middle East Respiratory Syndrome-Coronavirus Replication In Vitro

text: The Middle East respiratory syndrome-coronavirus (MERS-CoV), first identified in Saudi Arabia, is an emerging zoonotic pathogen that causes severe acute respiratory illness in humans with a high fatality rate. Since its emergence, MERS-CoV continues to spread to countries outside of the Arabian Peninsula and gives rise to sporadic human infections following the entry of infected individuals to other countries, which can precipitate outbreaks similar to the one that occurred in South Korea in 2015. Current therapeutics against MERS-CoV infection have primarily been adapted from previous drugs used for the treatment of severe acute respiratory syndrome. In search of new potential drug candidates, we screened a library composed of 2334 clinically approved drugs and pharmacologically active compounds. The drug saracatinib, a potent inhibitor of Src-family of tyrosine kinases (SFK), was identified as an inhibitor of MERS-CoV replication in vitro. Our results suggest that saracatinib potently inhibits MERS-CoV at the early stages of the viral life cycle in Huh-7 cells, possibly through the suppression of SFK signaling pathways. Furthermore, saracatinib exhibited a synergistic effect with gemcitabine, an anticancer drug with antiviral activity against several RNA viruses. These data indicate that saracatinib alone or in combination with gemcitabine can provide a new therapeutic option for the treatment of MERS-CoV infection.


title: La representación de los mayores en los medios durante la pandemia COVID-19: ¿Hacia un refuerzo del edadismo?

text: Resumen Antecedentes y objetivo. La pandemia de la COVID-19 afecta de manera diferencial a distintos grupos etarios, concentrándose la mayor parte de fallecimiento entre las personas más mayores y con afecciones de salud previas. Esto ha implicado una mayor presencia de los mayores en la agenda informativa de todos los medios de comunicación. Este artículo pretende analizar esos discursos y representaciones relacionados con los mayores tal y como se presentan en los titulares de publicaciones difundidas en dos diarios de alcance nacional (ABC y El País) durante la fase más crítica de la pandemia en España. Materiales y métodos. Se analizaron 501 titulares relacionados con los mayores y la pandemia COVID-19 (380 del ABC y 121 de El País) desde la perspectiva de los Estudios Críticos del Discurso (Van Dijk, 2003) y llevándose a cabo un análisis de contenido. Resultados. El 71,4% de los titulares representaban de manera desfavorable a los mayores, presentándolos como un grupo homogéneo y asociándolos a fallecimientos, deficiencias en la atención residencial o vulnerabilidad extrema. La presencia de ciertos términos potencialmente peyorativos o impropios (ancianos, abuelos) estaba en coherencia con esa representación negativa. Conclusiones. A la luz de esos resultados, se discute en qué medida la pandemia de la COVID-19 puede reforzar una narrativa edadista de los mayores, basada en la fragilidad, el declive y la dependencia, que pueda justificar prácticas discriminatorias dirigidas a este sector de la población. Abstract Background and objective. The COVID-19 pandemic affects various age groups differently, with most deaths concentrated among the older population and those with previous health conditions. This has led to a greater presence of older people in the agenda setting of all the media. This article aims to analyse these discourses and representations related to older people as presented in the headlines of publications disseminated in two national newspapers (ABC and El País) during the most critical phase of the pandemic in Spain. Methods. An analysis was made of 501 headlines related to older people and the COVID-19 pandemic (380 from ABC, and 121 from El País) from the perspective of the Critical Discourse Studies (Van Dijk, 2003), as well as carrying out a content analysis. Results. 71.4% of the headlines represented the Older adults were represented unfavourably in 71.4% of the headlines, with them being presented as a homogeneous group and associating them with deaths, deficiencies in residential care, or extreme vulnerability. The presence of certain potentially derogatory or improper terms (elderly, grandparents) was consistent with this negative representation. Conclusion. In light of these results, it is discussed to what extent the COVID-19 pandemic may reinforce an ageist narrative of the older people, based on frailty, decline, and dependency, which may justify discriminatory practices directed at this sector of the population.


title: Clinical Characteristics of COVID‐19 in patients with pre‐existing ILD: A retrospective study in a single center in Wuhan, China

text: BACKGROUND: Since the outbreak of 2019 novel coronavirus (SARS‐CoV‐2) pneumonia, many patients with underlying disease, such as interstitial lung disease (ILD), were admitted to Tongji hospital in Wuhan, China. To date, no data have ever been reported to reflect the clinical features of Corona Virus Disease 2019 (COVID‐19) among these patients with pre‐existing ILD. METHODS: We analyzed the incidence and severity of COVID‐19 patients with ILD among 3201 COVID‐19 inpatients, and compared two independent cohorts of COVID‐19 patients with pre‐existing ILD (n=28) and non‐ILD COVID‐19 patients (n=130). RESULTS: Among those 3201 COVID‐19 inpatients, 28 of whom were COVID‐19 with ILD (0.88%). Fever was the predominant symptom both in COVID‐19 with ILD (81.54%) and non‐ILD COVID‐19 patients (72.22%). However, COVID‐19 patients with ILD were more likely to have cough, sputum, fatigue, dyspnea, and diarrhea. Very significantly higher number of neutrophils, monocytes, IL‐8, IL‐10, IL‐1β and D‐Dimer was characterized in COVID‐19 with ILD as compared to those of non‐ILD COVID‐19 patients. Furthermore, logistic regression models showed neutrophils counts, pro‐inflammatory cytokines (TNF‐α, IL6, IL1β, IL2R), and coagulation dysfunction biomarkers (D‐Dimer, PT, Fbg) were significantly associated with the poor clinical outcomes of COVID‐19. CONCLUSION: ILD patients could be less vulnerable to SARS‐CoV‐2. However, ILD patients tend to severity condition after being infected with SARS‐CoV‐2. The prognosis of COVID‐19 patients with per‐existing ILD is significantly worse than that of non‐ILD patients. And more, aggravated inflammatory responses and coagulation dysfunction appear to be the critical mechanisms in the COVID‐19 patients with ILD. This article is protected by copyright. All rights reserved.


title: Cómo adaptar una investigación cualitativa a contextos de confinamiento

text: The confinement of the population, researchers, shows the need to adapt the qualitative methodology, techniques and tools, to the current context generated by COVID-19. The Internet and the social media allow the collection of textual data, sequences, images or narratives about a limited reality for access to it in person. We enter the era of e-research, nuancing and reorienting the observation, conversation, collection and analysis of information. Currently, we are working on techniques and models of good practice in this area. This note includes data collection tools used in qualitative research in health sciences, a selection of techniques for qualitative online research is made, and 10 rules for the design of an e-research of this type are provided.


Lung ultrasound in COVID-19 pneumonia; prospects and limitations


title: Social media based surveillance systems for healthcare using machine learning: A systematic review

text: BACKGROUND: Real-time surveillance in the field of health informatics has emerged as a growing domain of interest among worldwide researchers. Evolution in this field has helped in the introduction of various initiatives related to public health informatics. Surveillance systems in the area of health informatics utilizing social media information have been developed for early prediction of disease outbreaks and to monitor diseases. In the past few years, the availability of social media data, particularly Twitter data, enabled real-time syndromic surveillance that provides immediate analysis and instant feedback to those who are charged with follow-ups and investigation of potential outbreaks. In this paper, we review the recent work, trends, and machine learning(ML) text classification approaches used by surveillance systems seeking social media data in the healthcare domain. We also highlight the limitations and challenges followed by possible future directions that can be taken further in this domain. METHODS: To study the landscape of research in health informatics performing surveillance of the various health-related data posted on social media or web-based platforms, we present a bibliometric analysis of the 1240 publications indexed in multiple scientific databases (IEEE, ACM Digital Library, ScienceDirect, PubMed) from the year 2010–2018. The papers were further reviewed based on the various machine learning algorithms used for analyzing health-related text posted on social media platforms. FINDINGS: Based on the corpus of 148 selected articles, the study finds the types of social media or web-based platforms used for surveillance in the healthcare domain, along with the health topic(s) studied by them. In the corpus of selected articles, we found 26 articles were using machine learning technique. These articles were studied to find commonly used ML techniques. The majority of studies (24%) focused on the surveillance of flu or influenza-like illness (ILI). Twitter (64%) is the most popular data source to perform surveillance research using social media text data, and Support Vector Machine (SVM) (33%) being the most used ML algorithm for text classification. CONCLUSIONS: The inclusion of online data in surveillance systems has improved the disease prediction ability over traditional syndromic surveillance systems. However, social media based surveillance systems have many limitations and challenges, including noise, demographic bias, privacy issues, etc. Our paper mentions future directions, which can be useful for researchers working in the area. Researchers can use this paper as a library for social media based surveillance systems in the healthcare domain and can expand such systems by incorporating the future works discussed in our paper.


title: Development of multisample detection system using a tag insertion primer and an electrochemical DNA chip

text: Abstract We have developed a novel multisample detection system by employing a technology combining a tag insertion primer and an electrochemical DNA chip. In the first application, Helicobacter species-infected mouse samples were detected. The primers that insert a different tag sequence in each sample were prepared, and loop-mediated isothermal amplification (LAMP) reaction was carried out. Then amplification products in which a part of the sequence was different in each sample could be obtained. The target sample in which these amplification products were mixed was injected into a cassette that included the DNA chip with immobilized probes. After the cassette was set in the DNA detection system, Genelyzer, the processes of hybridization, washing, and detection were performed by the system automatically. The positive and negative concordance rates of the existing nested polymerase chain reaction (PCR) method and this method were 100% (40/40 samples) and 97.3% (117/120 samples), respectively. This is a simple high-throughput method. Moreover, the cost per sample can be drastically lowered. Therefore, it is expected to contribute to the diagnosis of infectious agents in humans and animals.


title: Canada, Health System of

text: Abstract With a population of 35million people spread over a vast area, Canada is a highly decentralized federation. Provincial governments have most of the responsibility for the governance, organization and delivery of health services although the Government of Canada has an important role in maintaining high level standards for universal health coverage through the Canada Health Act as well as pharmaceutical regulation, health research and data collection. With 70% of total health spending financed by federal, provincial and territorial governments, most are used to provide universal access to hospital and physicians services as well as more targeted coverage for prescription drugs and long-term care. In the last decade, provincial and territorial governments have focused on reorganizing their regional delivery systems and improving the quality, timeliness and patient experience with acute, chronic care and primary care medical services. While Canada's system of universal coverage for Medicare has been effective in providing deep financial protection, the narrow scope of coverage has resulted in gaps in coverage and equitable access.


title: The Role of Defensins in HIV Pathogenesis

text: Profound loss of CD4(+) T cells, progressive impairment of the immune system, inflammation, and sustained immune activation are the characteristics of human immunodeficiency virus-1 (HIV-1) infection. Innate immune responses respond immediately from the day of HIV infection, and a thorough understanding of the interaction between several innate immune cells and HIV-1 is essential to determine to what extent those cells play a crucial role in controlling HIV-1 in vivo. Defensins, divided into the three subfamilies α-, β-, and θ-defensins based on structure and disulfide linkages, comprise a critical component of the innate immune response and exhibit anti-HIV-1 activities and immunomodulatory capabilities. In humans, only α- and β-defensins are expressed in various tissues and have broad impacts on HIV-1 transmission, replication, and disease progression. θ-defensins have been identified as functional peptides in Old World monkeys, but not in humans. Instead, θ-defensins exist only as pseudogenes in humans, chimpanzees, and gorillas. The use of the synthetic θ-defensin peptide “retrocyclin” as an antiviral therapy was shown to be promising, and further research into the development of defensin-based HIV-1 therapeutics is needed. This review focuses on the role of defensins in HIV-1 pathogenesis and highlights future research efforts that warrant investigation.


title: Methicillin-resistant Staphylococcus aureus as a cause of community-acquired pneumonia

text: New pathogens have emerged that now complicate the management of community-acquired pneumonia (CAP). Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as a potential cause of CAP, particularly complicated CAP. In this literature review, the incidence, invasiveness, and antimicrobial management of CA-MRSA is discussed. Based on existing data and the rising incidence of CA-MRSA, we recommend a change in antibiotic selection for complicated CAP.


title: Membrane Origin for Autophagy

text: Autophagy is a degradative transport route conserved among all eukaryotic organisms. During starvation, cytoplasmic components are randomly sequestered into large double‐membrane vesicles called autophagosomes and delivered into the lysosome/vacuole where they are destroyed. Cells are able to modulate autophagy in response to their needs, and under certain circumstances, cargoes, such as aberrant protein aggregates, organelles, and bacteria can be selectively and exclusively incorporated into autophagosomes. As a result, this pathway plays an active role in many physiological processes, and it is induced in numerous pathological situations because of its ability to rapidly eliminate unwanted structures. Despite the advances in understanding the functions of autophagy and the identification of several factors, named Atg proteins that mediate it, the mechanism that leads to autophagosome formation is still a mystery. A major challenge in unveiling this process arises from the fact that the origin and the transport mode of the lipids employed to compose these structures is unknown. This compendium will review and analyze the current data about the possible membrane source(s) with a particular emphasis on the yeast Saccharomyces cerevisiae, the leading model organism for the study of autophagosome biogenesis, and on mammalian cells. The information acquired investigating the pathogens that subvert autophagy in order to replicate in the host cells will also be discussed because it could provide important hints for solving this mystery.


title: Designing Defenses against Deadly Viruses

text: Viruses are curious life forms. Minimalistic and yet equipped with the evolvability to persist and proliferate, there’s clearly a lesson or two to be learned from them on survival. It is perhaps these very intrinsic qualities that have transformed some viruses into the deadliest known pathogens in the history of mankind. A viral epidemic has been the focus of many summer blockbuster movies, wherein identification, structural characterization, and the development of antibodies to “cure” the infection are all amazingly achieved within a matter of hours (and often by the one scientist-doctor-chemist-physicist-macho-hero, but more on that some other time). Such alacrity is desirable but perhaps not very realistic. What is truly exciting, however, is the level of insight that a number of recent studies have provided into how these deadly viruses hijack host defenses and how newer classes of drugs could protect if not potentially cure infection altogether.


title: Preying on Public Fears and Anxieties in a Pandemic: Businesses Selling Unproven and Unlicensed “Stem Cell Treatments” for COVID-19

text: Abstract In the midst of a global public health emergency, some businesses are taking advantage of widespread fears by marketing purported stem cell treatments for COVID-19. Such businesses target prospective clients with misleading claims, expose patients to potentially risky stem cells-based products, and undermine efforts to develop evidence-based treatments for COVID-19.


title: Boning up: amino-bisphophonates as immunostimulants and endosomal disruptors of dendritic cell in SARS-CoV-2 infection

text: Amino-bisphosphonates such as zoledronic acid (ZA) can possibly ameliorate or prevent severe COVID-19 disease by at least three distinct mechanisms: (1) as immunostimulants which could boost γδ T cell expansion, important in the acute response in the lung; (2) as DC modulators, limiting their ability to only partially activate T cells; and (3) as prenylation inhibitors of small GTPases in the endosomal pathway of the DC to prevent expulsion of lysosomes containing SARS-CoV-2 virions. Use of ZA or other amino-bisphosphonates as modulators of COVID-19 disease should be considered.


title: The association of race and COVID-19 mortality

text: BACKGROUND: COVID-19 mortality disproportionately affects the Black population in the United States (US). To explore this association a cohort study was undertaken. METHODS: We assembled a cohort of 505,992 patients receiving ambulatory care at Bronx Montefiore Health System (BMHS) between 1/1/18 and 1/1/20 to evaluate the relative risk of hospitalization and death in two time-periods, the pre-COVID time-period (1/1/20–2/15/20) and COVID time-period (3/1/20–4/15/20). COVID testing, hospitalization and mortality were determined with the Black and Hispanic patient population compared separately to the White population using logistic modeling. Evaluation of the interaction of pre-COVID and COVID time periods and race, with respect to mortality was completed. FINDINGS: A total of 9,286/505,992 (1.8%) patients were hospitalized during either or both pre-COVID or COVID periods. Compared to Whites the relative risk of hospitalization of Black patients did not increase in the COVID period (p for interaction=0.12). In the pre- COVID period, compared to Whites, the odds of death for Blacks and Hispanics adjusted for comorbidity was statistically equivalent. In the COVID period compared to Whites the adjusted odds of death for Blacks was 1.6 (95% CI 1.2–2.0, p = 0.001). There was a significant increase in Black mortality risk from pre-COVID to COVID periods (p for interaction=0.02). Adjustment for relevant clinical and social indices attenuated but did not fully explain the observed difference in Black mortality. INTERPRETATION: The BMHS COVID experience demonstrates that Blacks do have a higher mortality with COVID incompletely explained by age, multiple reported comorbidities and available metrics of sociodemographic disparity. FUNDING: N/A


title: The association between international and domestic air traffic and the coronavirus (COVID-19) outbreak

text: BACKGROUND: The World Health Organization (WHO) has declared the current outbreak of the novel coronavirus (COVID-19) a global pandemic. Many countries are facing increasing numbers of COVID-19 cases, which are, in their origin mostly attributed to regular international flight connections with China. This study aims to investigate this relation by analyzing available data on air traffic volume and the spread of COVID-19 cases. METHODS: and findings: We analyzed available data on current domestic and international passenger volume and flight routes and compared these to the distribution of domestic and international COVID-19 cases. RESULTS: Our data indicate a strong linear correlation between domestic COVID-19 cases and passenger volume for regions within China (r(2) = 0.92, p = 0.19) and a significant correlation between international COVID-19 cases and passenger volume (r(2) = 0.98, p < 0.01). CONCLUSIONS: The number of flight routes as well as total passenger volume are highly relevant risk factors for the spread of current COVID-19. Multiple regions within Asia, as well as some in North America and Europe are at serious risk of constant exposure to COVID-19 from China and other highly infected countries. Risk for COVID-19 exposure remains relatively low in South America and Africa. If adequate measures are taken, including on-site disease detection and temporary passenger quarantine, limited but not terminated air traffic can be a feasible option to prevent a long-term crisis. Reasonable risk calculations and case evaluations per passenger volume are crucial aspects which must be considered when reducing international flights.


title: A comparative analysis of carbon dioxide displacement rates for euthanasia of the ferret

text: Though carbon dioxide asphyxiation is a common method of euthanasia for laboratory animals, species-specific guidelines have not been established for this procedure in the domestic ferret (Mustela putorius furo). The authors investigated the efficacy and stress effects of carbon dioxide euthanasia in 24 ferrets that had participated in previous experimental protocols. They euthanized ferrets by placing them in cages that were either prefilled with carbon dioxide or gradually filled at a displacement rate of 10%, 20% or 50% of the cage volume per min. Blinded observers subjectively evaluated ferret distress. Prefilling the cage or filling it at a rate of 50% volume per min resulted in less time to recumbency and to last breath than did filling the cage at a slower displacement rate. Slower carbon dioxide displacement rates also caused an increase in ferret blood glucose concentrations, which may indicate distress. Overall, observers found that prefilling the euthanasia cage caused the least stress to ferrets.


Ultraviolet Light Fights New Virus


title: Effects of human visitation on calf growth and performance of calves fed different milk replacer feeding levels

text: Abstract Twenty-eight newborn Holstein heifer calves from the university herd and 8 newborn Holstein heifer calves from a commercial herd were blocked by birth and herd into 1 of 4 treatments: conventional [20% crude protein (CP), 20% fat] milk replacer (MR; treatment C) with (1) or without (0) human visitation, or a higher plane of MR nutrition (28% CP, 20% fat) regimen (treatment A) with (1) or (0) without human visitation. Calves on C MR treatments received 454g of MR from d 2 to 41. Calves on A MR received 916g of MR from d 2 to 8 and 1134g of MR from d 9 to 41. Visitation with calves occurred at 1030 and 1430h daily from d 1 to 56 and comprised verbal stimulation and stirring of starter grain. An opaque curtain divided the calf nursery, with calves in the front half assigned to visitation treatments and those in the rear half not assigned to visitation treatments. Calves were fed their MR treatment until d 43 (preweaning), after which all calves received half of their allotment of MR until d 49 (weaning). Calves were tracked for the next week until d 56 (postweaning). Starter grain and MR intakes were measured daily along with weekly body weight and skeletal measurements. One half of the calves on each treatment had blood samples taken via jugular venipuncture on d 41 (preweaning), 43, 45, 47, 49, and 51 (postweaning) to evaluate blood glucose, urea, nonesterified fatty acids, and cortisol concentrations. During the preweaning and weaning phases, calves on A0 and A1 treatments consumed more MR, less starter, and weighed more than the C0 and C1 calves. Calves on A0 and A1 had greater average daily gain (ADG), hip and withers gain, were taller at the hip, and had larger girths during the preweaning phase. Overall, body weight, withers and hip heights, and heart girths were greater in A0 andA1 calves during the weaning week. Efficiency of utilization of estimated metabolizable energy (ME) intake (ADG/ME) were similar. Glucose and nonesterified fatty acids concentrations were greater in visited calves preweaning. An interaction for glucose was observed during weaning, with A1 calves having the highest concentration and A0 calves having the lowest concentrations during weaning. Cortisol tended to be higher in visited calves during weaning. Postweaning, calves formerly fed A0 and A1 treatments had lower blood glucose and tended to have higher urea and cortisol concentrations than C0 and C1 treatments. The higher plane of nutrition fed calves tended to have higher cortisol concentrations indicating that they experienced more stress due to the removal of MR more than calves fed conventionally. Calves fed the higher plane of MR nutrition consumed more dry matter, ME, and water weighed more, had a greater ADG, and were taller than calves fed the conventional MR. These calves were more efficient (ADG/dry matter intake) when expressed on a dry matter basis, but had similar efficiency when expressed on an ME basis (ADG/ME). Visiting calves did little to reduce the stress of weaning when calves are fed the higher plane of nutrition MR feeding regimen.


Reply to Oh


title: A Systematic Review Analyzing the Prevalence and Circulation of Influenza Viruses in Swine Population Worldwide

text: The global anxiety and a significant threat to public health due to the current COVID-19 pandemic reiterate the need for active surveillance for the zoonotic virus diseases of pandemic potential. Influenza virus due to its wide host range and zoonotic potential poses such a significant threat to public health. Swine serve as a “mixing vessel” for influenza virus reassortment and evolution which as a result may facilitate the emergence of new strains or subtypes of zoonotic potential. In this context, the currently available scientific data hold a high significance to unravel influenza virus epidemiology and evolution. With this objective, the current systematic review summarizes the original research articles and case reports of all the four types of influenza viruses reported in swine populations worldwide. A total of 281 articles were found eligible through screening of PubMed and Google Scholar databases and hence were included in this systematic review. The highest number of research articles (n = 107) were reported from Asia, followed by Americas (n = 97), Europe (n = 55), Africa (n = 18), and Australia (n = 4). The H1N1, H1N2, H3N2, and A(H1N1)pdm09 viruses were the most common influenza A virus subtypes reported in swine in most countries across the globe, however, few strains of influenza B, C, and D viruses were also reported in certain countries. Multiple reports of the avian influenza virus strains documented in the last two decades in swine in China, the United States, Canada, South Korea, Nigeria, and Egypt provided the evidence of interspecies transmission of influenza viruses from birds to swine. Inter-species transmission of equine influenza virus H3N8 from horse to swine in China expanded the genetic diversity of swine influenza viruses. Additionally, numerous reports of the double and triple-reassortant strains which emerged due to reassortments among avian, human, and swine strains within swine further increased the genetic diversity of swine influenza viruses. These findings are alarming hence active surveillance should be in place to prevent future influenza pandemics.


Dermatologic surgery in the COVID‐19 era: observations and practical suggestions