title: Discovery and development of safe-in-man broad-spectrum antiviral agents

text: Viral diseases are one of the leading causes of morbidity and mortality in the world. Virus-specific vaccines and antiviral drugs are the most powerful tools to combat viral diseases. However, broad-spectrum antiviral agents (BSAAs, i.e. compounds targeting viruses belonging to two or more viral families) could provide additional protection of the general population from emerging and re-emerging viral diseases, reinforcing the arsenal of available antiviral options. Here, we review discovery and development of BSAAs and summarize the information on 120 safe-in-man agents in a freely accessible database (https://drugvirus.info/). Future and ongoing pre-clinical and clinical studies will increase the number of BSAAs, expand the spectrum of their indications, and identify drug combinations for treatment of emerging and re-emerging viral infections as well as co-infections.


title: Tele-Neuro-Ophthalmology: Vision for 20/20 and Beyond

text: BACKGROUND: Telehealth provides health care to a patient from a provider at a distant location. Prior to the COVID-19 pandemic adoption of telehealth modalities was increasing slowly but steadily. During the public health emergency rapid widespread telehealth implementation has been encouraged to promote patient and provider safety and preserve access to health care. EVIDENCE ACQUISITION: Evidence was acquired from English language Internet-searches of medical and business literature and following breaking news on the COVID-19 pandemic and responses from health care stakeholders including policy makers, payers, physicians and health care organizations, and patients. We also had extensive discussions with colleagues who are developing telehealth techniques relevant to neuro-ophthalmology. RESULTS: Regulatory, legal, reimbursement and cultural barriers impeded the widespread adoption of telehealth prior to the COVID-19 pandemic. With the increased use of telehealth in response to the public health emergency, we are rapidly accumulating experience and an evidence base identifying opportunities and challenges related to the widespread adoption of tele-neuro-ophthalmology. One of the major challenges is the current inability to adequately perform funduscopy remotely. CONCLUSIONS: Telehealth is an increasingly recognized means of healthcare delivery. Tele-neuro-ophthalmology adoption is necessary for the sake of our patients, the survival of our subspecialty, and the education of our trainees and students. Telehealth does not supplant but supplements and complements in-person neuro-ophthalmologic care. Innovations in digital optical fundus photography, mobile vision testing applications, artificial intelligence and principles of channel management will facilitate further adoption of tele-neuro-ophthalmology and bring the specialty to the leading edge of healthcare delivery.


title: Efficacy and safety of Chinese herbal medicine for Coronavirus disease 2019: A protocol for systematic review and meta-analysis

text: BACKGROUND: Coronavirus disease 2019 (COVID-19) is a global pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). There is no specific cure for this disease, and the clinical management mainly depends on supportive treatment. Traditional Chinese medicines (CHM) is widely used in treating COVID-19 in China. METHODS: A comprehensive literature search will be conducted. Two methodological trained researchers will read the title, abstract, and full texts and independently select the qualified literature according to inclusion and exclusion criteria. After assessment of the risk of bias and data extraction, we will conduct meta-analyses for outcomes related to COVID-19. The heterogeneity of data will be investigated by Cochrane χ and I tests. Then publication bias assessment will be conducted by funnel plot analysis and Egger test. RESULTS: The results of our research will be published in a peer-reviewed journal. CONCLUSION: Our study aims to systematically present the clinical evidence of CHM in the treatment of COVID-19, which will be of guiding significance for further research and clinical practice. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/H7GMU.


Prevalence of COVID-19 in Out-of-Hospital Cardiac Arrest: Implications for Bystander CPR


Estimation of Coronavirus Disease 2019 (COVID-19) Burden and Potential for International Dissemination of Infection From Iran


title: Frontline Workers in the Backrooms of COVID-19

text: OBJECTIVES: To review the response to the coronavirus disease 2019 (COVID-19) pandemic in a forensics center that integrates an academic department of pathology with multiple regional county medical examiners' offices. METHODS: Faculty and staff were asked to volunteer stories, data, and photographs describing their activities from March through May 2020. The information was assembled into a narrative summary. RESULTS: Increased deaths challenged capacity limits in a hospital morgue and a large urban medical examiner's office (MEO) successfully managed by forensic teams and monitored by an institutional command center. Autopsies of suspected and proven cases of COVID-19 were performed in both facilities. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing of decedents was performed in a MEO serving a large urban area. Scene investigators worked directly with families to meet needs unique to a pandemic. Artful photographs of decedent's hands and/or tattoos were offered to those unable to have in-person viewings. Pathologists and social workers were available to families of the deceased and created novel solutions to facilitate the grieving process. CONCLUSIONS: Forensic pathology is important to successfully navigating emerging diseases like the COVID-19 pandemic. Direct conversations with families are common in forensic pathology and serve as a model for patient- and family-centered care.


Utprøvende behandling for covid-19 bør foregå i randomiserte studier


title: Hate multiverse spreads malicious COVID-19 content online beyond individual platform control

text: We show that malicious COVID-19 content, including hate speech, disinformation, and misinformation, exploits the multiverse of online hate to spread quickly beyond the control of any individual social media platform. Machine learning topic analysis shows quantitatively how online hate communities are weaponizing COVID-19, with topics evolving rapidly and content becoming increasingly coherent. Our mathematical analysis provides a generalized form of the public health R0 predicting the tipping point for multiverse-wide viral spreading, which suggests new policy options to mitigate the global spread of malicious COVID-19 content without relying on future coordination between all online platforms.


China's experience on mental health in response to the COVID-19 pandemic


title: Analytical comparisons of SARS-COV-2 detection by qRT-PCR and ddPCR with multiple primer/probe sets

text: Different primers/probes sets have been developed all over the world for the nucleic acid detection of SARS-CoV-2 by quantitative real time polymerase chain reaction (qRT-PCR) as a standard method. In our recent study, we explored the feasibility of droplet digital PCR (ddPCR) for clinical SARS-CoV-2 nucleic acid detection compared with qRT-PCR using the same primer/probe sets issued by Chinese Center for Disease Control and Prevention (CDC) targeting viral ORF1ab or N gene, which showed that ddPCR could largely minimize the false negatives reports resulted by qRT-PCR [Suo T, Liu X, Feng J, et al. ddPCR: a more sensitive and accurate tool for SARS-CoV-2 detection in low viral load specimens. medRxiv [Internet]. 2020;2020.02.29.20029439. Available from: https://medrxiv.org/content/early/2020/03/06/2020.02.29.20029439.abstract]. Here, we further stringently compared the performance of qRT-PCR and ddPCR for 8 primer/probe sets with the same clinical samples and conditions. Results showed that none of 8 primer/probe sets used in qRT-PCR could significantly distinguish true negatives and positives with low viral load (10-4 dilution). Moreover, false positive reports of qRT-PCR with UCDC-N1, N2 and CCDC-N primers/probes sets were observed. In contrast, ddPCR showed significantly better performance in general for low viral load samples compared to qRT-PCR. Remarkably, the background readouts of ddPCR are relatively lower, which could efficiently reduce the production of false positive reports.


title: Applying principles of behaviour change to reduce SARS-CoV-2 transmission

text: Human behaviour is central to transmission of SARS-Cov-2, the virus that causes COVID-19, and changing behaviour is crucial to preventing transmission in the absence of pharmaceutical interventions. Isolation and social distancing measures, including edicts to stay at home, have been brought into place across the globe to reduce transmission of the virus, but at a huge cost to individuals and society. In addition to these measures, we urgently need effective interventions to increase adherence to behaviours that individuals in communities can enact to protect themselves and others: use of tissues to catch expelled droplets from coughs or sneezes, use of face masks as appropriate, hand-washing on all occasions when required, disinfecting objects and surfaces, physical distancing, and not touching one's eyes, nose or mouth. There is an urgent need for direct evidence to inform development of such interventions, but it is possible to make a start by applying behavioural science methods and models.


Neuro-ophthalmology in the Era of COVID-19: Future Implications of a Public Health Crisis


Management of ovarian cancer patients in affected areas during COVID-19 pandemic: Japan and Korea


Sore throat in COVID-19: Comment on "Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis"


title: Analyzing the epidemiological outbreak of COVID-19: A visual exploratory data analysis approach

text: There is an obvious concern globally regarding the fact about the emerging coronavirus 2019 novel coronavirus (2019-nCoV) as a worldwide public health threat. As the outbreak of COVID-19 causes by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) progresses within China and beyond, rapidly available epidemiological data are needed to guide strategies for situational awareness and intervention. The recent outbreak of pneumonia in Wuhan, China, caused by the SARS-CoV-2 emphasizes the importance of analyzing the epidemiological data of this novel virus and predicting their risks of infecting people all around the globe. In this study, we present an effort to compile and analyze epidemiological outbreak information on COVID-19 based on the several open datasets on 2019-nCoV provided by the Johns Hopkins University, World Health Organization, Chinese Center for Disease Control and Prevention, National Health Commission, and DXY. An exploratory data analysis with visualizations has been made to understand the number of different cases reported (confirmed, death, and recovered) in different provinces of China and outside of China. Overall, at the outset of an outbreak like this, it is highly important to readily provide information to begin the evaluation necessary to understand the risks and begin containment activities.


Darunavir does not prevent SARS-CoV-2 infection in HIV patients


title: Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid

text: Here we report a case of Covid-19-related acute necrotizing encephalopathy (ANE) where SARS-CoV-2 RNA was found in cerebrospinal fluid (CSF) 19 days after symptom onset after testing negative twice. Even though monocytes and protein levels in CSF were only marginally increased, and our patient never experienced a hyperinflammatory state, her neurological function deteriorated into coma. Magnetic resonance imaging of the brain showed pathological signal symmetrically in central thalami, subinsular regions, medial temporal lobes and brain stem. Extremely high concentrations of the neuronal injury markers neurofilament light (NfL) and tau, as well as an astrocytic activation marker, glial fibrillary acidic protein (GFAp), were measured in CSF. Neuronal rescue proteins and other pathways were elevated in the in-depth proteomics analysis. The patient received intravenous immunoglobulins (IVIG) and plasma exchange (PLEX). Her neurological status improved and she was extubated four weeks after symptom onset. This case report highlights the neurotropism of SARS-CoV-2 in selected patients and emphasizes the importance of repeated lumbar punctures and CSF analyses in patients with suspected Covid-19 and neurological symptoms.


An affordable videolaryngoscope for use during the COVID-19 pandemic


Protecting the rare during a rare pandemic


title: Evaluation of the auxiliary diagnostic value of antibody assays for the detection of novel coronavirus (SARS-CoV-2)

text: The spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has taken on pandemic proportions, affecting over 100 countries in a matter of weeks. The goal of this study was to assess the diagnostic values of different methods of detecting and estimating the SARS-CoV-2 infection, and the auxiliary diagnostic potential of antibody assays. By retrospectively analyzing the data of viral RNAs and serum immunoglobulin M-immunoglobulin G antibodies against SARS-CoV-2 from 38 cases with confirmed coronavirus disease 2019 in the Second People's Hospital of Fuyang, we found that, in the early phase of the illness, the viral RNA was most abundant in the sputum specimens, followed by that in the throat swabs, while the antibody assays identified fewer positive cases at this stage. However, the sensitivity of the antibody assays overtook that of RNA test from the eighth day of disease onset. Simultaneous use of antibody assay and reverse transcription-quantitative real-time polymerase chain reaction improved the sensitivity of the diagnoses. Moreover, we found that most of these cases with no detectable viral RNA load during the early stages were able to be seropositive after 7 days. Our findings indicate that the antibody detection could be used as an effective supplementary indicator of SARS-CoV-2 infection in suspected cases with no detectable viral RNA, and in conjunction with nucleic acid detection in confirming the infection.


COVID-19: Protecting Healthcare Workers is a priority


title: Clinically Applicable AI System for Accurate Diagnosis, Quantitative Measurements, and Prognosis of COVID-19 Pneumonia Using Computed Tomography

text: Many COVID-19 patients infected by SARS-CoV-2 virus develop pneumonia (called novel coronavirus pneumonia, NCP) and rapidly progress to respiratory failure. However, rapid diagnosis and identification of high-risk patients for early intervention are challenging. Using a large computed tomography (CT) database from 3,777 patients, we developed an AI system that can diagnose NCP and differentiate it from other common pneumonia and normal controls. The AI system can assist radiologists and physicians in performing a quick diagnosis especially when the health system is overloaded. Significantly, our AI system identified important clinical markers that correlated with the NCP lesion properties. Together with the clinical data, our AI system was able to provide accurate clinical prognosis that can aid clinicians to consider appropriate early clinical management and allocate resources appropriately. We have made this AI system available globally to assist the clinicians to combat COVID-19.


title: Design of engineered surfaces for prospective detection of Sars-CoV-2 using quartz crystal microbalance based techniques

text: INTRODUCTION: Rapid transmission of the severe acute respiratory syndrome coronavirus 2 has affected the whole world and forced it to a halt (lockdown). A fast and label free detection method for the novel coronavirus needs to be developed along with the existing enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) based methods. AREAS COVERED: In this report, biophysical aspects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike glycoprotein are outlined based on its recent reported electron microscopy structure. Protein binding sites are analyzed theoretically, which consisted of hydrophobic and positive charged amino acid residues. Different strategies to form mixed self-assembled monolayers (SAMs) of hydrophobic (CH3) and negatively charged (COOH) groups are discussed to be used for the specific and strong interactions with spike protein. Bio-interfacial interactions between the spike protein and device (sensor) surface and its implications towards designing suitable engineered surfaces are summarized. EXPERT OPINION: Implementation of the engineered surfaces in quartz crystal microbalance (QCM) based detection techniques for the diagnosis of the novel coronavirus from oral swab samples is highlighted. The proposed strategy can be explored for the label free and real time detection with sensitivity up to ng level. These engineered surfaces can be reused after desorption.


title: Biochemical characterization of a novel α-L-fucosidase from Pedobacter sp. and its application in synthesis of 3'-fucosyllactose and 2'-fucosyllactose

text: Fucosyllactoses have gained much attention owing to their multiple functions, including prebiotic, immune, gut, and cognition benefits. In this study, human milk oligosaccharide (HMO) 2'-fucosyllactose (α-L-Fuc-(1,2)-D-Galß-1,4-Glu, 2'FL) and its isomer 3'-fucosyllactose (α-L-Fuc-(1,3)-D-Galß-1,4-Glu, 3'FL) with potential prebiotic effect were synthesized efficiently by a novel recombinant α-L-fucosidase. An α-L-fucosidase gene (PbFuc) from Pedobacter sp. CAU209 was successfully cloned and expressed in Escherichia coli (E. coli). The deduced amino acid sequence shared the highest identity of 36.8% with the amino sequences of other reported α-L-fucosidases. The purified α-L-fucosidase (PbFuc) had a molecular mass of 50 kDa. The enzyme exhibited specific activity (26.3 U/mg) towards 4-nitrophenyl-α-L-fucopyranoside (pNP-FUC), 3'FL (8.9 U/mg), and 2'FL (3.4 U/mg). It showed the highest activity at pH 5.0 and 35 °C, respectively. PbFuc catalyzed the synthesis of 3'FL and 2'FL through a transglycosylation reaction using pNP-FUC as donor and lactose as acceptor, and total conversion ratio was up to 85% at the optimized reaction conditions. The synthesized mixture of 2'FL and 3'FL promoted the growth of Lactobacillus delbrueckii subsp. bulgaricus NRRL B-548, L. casei subsp. casei NRRL B-1922, L. casei subsp. casei AS 1.2435, and Bifidobacterium longum NRRL B-41409. However, the growths of E. coli ATCC 11775, S. enterica AS 1.1552, L. monocytogenes CICC 21635, and S. aureus AS 1.1861 were not stimulated by the mixture of 2'FL and 3'FL. Overall, our findings suggest that PbFuc possesses a great potential for the specific synthesis of fucosylated compounds.Key Pointsâ¢ A novel α-L-fucosidase (PbFuc) from Pedobacter sp. was cloned and expressed.â¢ PbFuc showed the highest hydrolysis activity at pH 5.0 and 35 °C, respectively.â¢ It was used for synthesis of 3'-fucosyllactose (3'FL) and 2'-fucosyllactose (2'FL).â¢ The mixture of 3'FL and 2'FL promoted the growth of some Lactobacillus sp. and Bifidobacteria sp.


title: Oropharyngeal Dysphagia and Aspiration Pneumonia Following Coronavirus Disease 2019: A Case Report

text: Cranial nerve involvement is a finding often observed in patients infected with severe acute respiratory syndrome coronavirus 2 during the pandemic outbreak of coronavirus disease 2019 (COVID-19). To our knowledge, this is the first report of oropharyngeal dysphagia associated with COVID-19. A 70-year-old male developed dysphagia and consequent aspiration pneumonia during recovery from severe COVID-19. He had altered sense of taste and absent gag reflex. Videoendoscopy, videofluorography, and high-resolution manometry revealed impaired pharyngolaryngeal sensation, silent aspiration, and mesopharyngeal contractile dysfunction. These findings suggested that glossopharyngeal and vagal neuropathy might have elicited dysphagia following COVID-19. The current case emphasizes the importance of presuming neurologic involvement and concurrent dysphagia, and that subsequent aspiration pneumonia might be overlooked in severe respiratory infection during COVID-19.


Type 1 diabetes triggered by covid-19 pandemic: A potential outbreak?


Exanthema and eosinophilia in COVID-19 patients: has viral infection a role in drug induced exanthemas?


title: Machine learning approach for prediction of hearing preservation in vestibular schwannoma surgery

text: In vestibular schwannoma patients with functional hearing status, surgical resection while preserving the hearing is feasible. Hearing levels, tumor size, and location of the tumor have been known to be candidates of predictors. We used a machine learning approach to predict hearing outcomes in vestibular schwannoma patients who underwent hearing preservation surgery: middle cranial fossa, or retrosigmoid approach. After reviewing the medical records of 52 patients with a pathologically confirmed vestibular schwannoma, we included 50 patient's records in the study. Hearing preservation was regarded as positive if the postoperative hearing was within serviceable hearing (50/50 rule). The categorical variable included the surgical approach, and the continuous variable covered audiometric and vestibular function tests, and the largest diameter of the tumor. Four different algorithms were lined up for comparison of accuracy: support vector machine(SVM), gradient boosting machine(GBM), deep neural network(DNN), and diffuse random forest(DRF). The average accuracy of predicting hearing preservation ranged from 62% (SVM) to 90% (DNN). The current study is the first to incorporate machine learning methodology into a prediction of successful hearing preservation surgery. Although a larger population may be needed for better generalization, this study could aid the surgeon's decision to perform a hearing preservation approach for vestibular schwannoma surgery.


Continuous positive airway pressure to avoid intubation in SARS-CoV-2 pneumonia: a two-period retrospective case-control study


La semFYC y la Medicina de Familia en tiempos del Coronavirus./ [semFYC and Family Medicine in the time of the Coronavirus]


title: [Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019]

text: Severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) shared similar pathogenetic, clinical and pathological features. Fever and cough were the most common symptoms of both diseases, while myalgia and diarrhea were less common in patients with COVID-19. Acute respiratory distress syndrome (ARDS) was the most severe pulmonary complication that caused high mortality rate. Histologically, diffuse alveolar damage (DAD) was the most characteristic finding in non-survivors with either SARS or COVID-19. Cases of patients died less than 10-14 days of disease duration demonstrated acute-phase DAD, while cases beyond 10-14 days of disease duration exhibited organizing-phase DAD in SARS. Meanwhile, organization and fibrosis were usually accompanied by exudation. Coronavirus was mostly detected in pneumocytes, but less in macrophages and bronchiolar epithelial cells. Hemorrhagic necrosis and lymphocyte depletion were found in lymph nodes and spleen in both SARS and COVID-19, indicating a pathological basis of lymphocytopenia. Thrombosis was commonly observed in small vessels and microvasculaturr in lungs accompanying DAD. Microthrombosis was also found in extrapulmonary organs in COVID-19, that was less reported in SARS. Damages in multiple extrapulmonary organs were observed, but coronavirus was not detected in some of those organs, indicating an alternative mechanism beyond viral infection, such as hypoxemia, ischemia and cytokine storm induced immunological injury. DAD due to viral infection and immunological injury, as well as multi-organ dysfunction and extensive microthrombus formation, brought huge challenge to the management of patients with severe SARS or COVID-19.


title: Methylprednisolone added to tocilizumab reduces mortality in SARS-CoV-2 pneumonia: An observational study

text: Although there are few randomized controlled trials (RCTs) evaluating the efficacy of drugs to treat COVID-19, different molecules have been used empirically and with great interest in those intended to control the excessive inflammatory response produced by SARS-CoV-2. By blocking the IL-6 receptor, tocilizumab has a role in controlling the inflammatory response. Clinical improvement of respiratory parameters and hospital stay have been described in small series in a series of patients without a control group [1]. There are currently numerous ongoing clinical trials aimed to clarifying the role of this molecule in COVID-19. The guidelines for the treatment of SARS-CoV-2 pneumonia from the Spanish Ministry of Health contemplate the use of tocilizumab as a therapeutic tool for those patients with severe respiratory failure or rapid respiratory deterioration with criteria for admission to the intensive care unit (ICU).


COVID-19 and Future Implications for Gastroenterology Trainees


Life in the pandemic: Social isolation and mental health


title: Non-communicable disease management in vulnerable patients during Covid-19

text: It is now well established that non-communicable diseases (NCD), like diabetes mellitus, hypertension,, respiratory and heart disease, particularly among the elderly, increase the susceptibility to COVID-19 disease. Mortality in 60%-90% of the COVID-19 cases is attributed to either one or more of these comorbidities. However, healthcare management for control of COVID-19 involves public health and policy decisions that may critically undermine the existing health needs of the most vulnerable NCD patients. Temporary closure of outpatient health facilities in some secondary and tertiary care hospitals have deprived millions of NCD patients of their regular medication and diagnostic health needs. The lack of robust primary healthcare facilities in most states, and the failure to maintain physical distancing norms due to inadequate infrastructure is also problematic. In the absence of effective public health interventions, socioeconomically vulnerable patients are likely to become non-adherent increasing manifold their risk of disease complications. In this context, the feasibility of dispensing longer than usual drug refills for chronic NCD conditions at functional government health facilities, home delivery of essential drugs, running dedicated NCD clinics at PHCs, and utilisation of telemedicine opportunities for care and support to patients warrant aggressive exploration. Keywords: Covid-19, NCDs, Medical ethics, epidemic, India.


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

text: 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: Tracheostomy in the intensive care unit: Guidelines during COVID-19 worldwide pandemic

text: PURPOSE: COVID-19 has become a pandemic with significant consequences worldwide. About 3.2% of patients with COVID-19 will require intubation and invasive ventilation. Moreover, there will be an increase in the number of critically ill patients, hospitalized and intubated due to unrelated acute pathology, who will present underlying asymptomatic or mild forms of COVID-19. Tracheostomy is one of the procedures associated with an increased production of aerosols and higher risk of transmission of the virus to the health personnel. The aim of this paper is to describe indications and recommended technique of tracheostomy in COVID-19 patients, emphasizing the safety of the patient but also the medical team involved. MATERIALS AND METHODS: A multidisciplinary group made up of surgeons with privileges to perform tracheostomies, intensive care physicians, infectious diseases specialists and intensive pulmonologists was created to update previous knowledge on performing a tracheostomy in critically ill adult patients (>18 years) amidst the SARS-CoV-2 pandemic in a high-volume referral center. Published evidence was collected using a systematic search and review of published studies. RESULTS: A guideline comprising indications, surgical technique, ventilator settings, personal protective equipment and timing of tracheostomy in COVID-19 patients was developed. CONCLUSIONS: A safe approach to performing percutaneous dilational bedside tracheostomy with bronchoscopic guidance is feasible in COVID-19 patients of appropriate security measures are taken and a strict protocol is followed. Instruction of all the health care personnel involves is key to ensure their safety and the patient's favorable recovery.


COVID-19 prevention and control strategies for psychiatric hospitals


title: Dataset of Vietnamese student's learning habits during COVID-19

text: A dataset was constructed to examine Vietnamese student's learning habits during the time schools were suspended due to the novel coronavirus - SARS-CoV-2 (COVID-19), in response to a call for interdisciplinary research on the potential effects of the coronavirus pandemic (Elsevier, 2020). The questionnaires were spread over a network of educational communities on Facebook from February 7 to February 28, 2020. Using the snowball sampling method, researchers delivered the survey to teachers and parents to provide formal consent before they forwarded it to their students and children. In order to measure the influence of students' socioeconomic status and occupational aspirations on their learning habits during school closures, the survey included three major groups of questions: (1) Individual demographics, including family socioeconomic status, school type, and occupational aspirations; (2) Student's learning habits, including hours of learning before and during the period of school suspension, with and without other people's support; and (3) Students' perceptions of their self-learning during the school closures. There was a total of 920 clicks on the survey link, but only 460 responses accompanied by consent forms were received. Non-credible answers (e.g., year of birth after 2009, more than 20 hours of learning per day) were eliminated. The final dataset included 420 valid observations.


From the editor’s desk


COVID-19 myocardial injury: We have much more to discover


Pathophysiology of the COVID-19 - entry to the CNS through the nose


title: Smart technologies for fighting pandemics: The techno- and human- driven approaches in controlling the virus transmission

text: How do governments in China and Western democracies differ in their technological response to control the transmission of the pandemic? Based on an analysis of academic papers, World Health Organization reports and newspapers, this research compares two opposing approaches, whereas the Chinese cities and government have adopted a techno-driven approach, Western governments have adopted a human-driven approach to control the transmission of Covid-19. The findings highlight that although the techno driven approach may be more productive to identify, isolate and quarantine infected individuals, it also results in the suppression and censoring the citizen views. It is further emphasized that human interaction with the technology is mediated by the political and institutional context in which the technologies are implemented. This paper contributes to literature by understanding the human-technology relationship, and offers five practical observations for controlling virus transmissions during pandemics.


title: How We Do It: Modified Residency Programming and Adoption of Remote Didactic Curriculum During the COVID-19 Pandemic

text: OBJECTIVE: To describe the modified operational plan we implemented for residents and faculty in our orthopedic surgery department to allow continuation of resident education and other core activities during the novel coronavirus (COVID-19) pandemic. DESIGN: Description of educational augmentation and programming modifications. SETTING: The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center, Baltimore, MD. PARTICIPANTS: Residents and faculty, Department of Orthopaedic Surgery. METHODS: In response to the COVID-19 pandemic, we developed and implemented a modified operational schedule and remote curriculum in the orthopedic surgery department of our health system. Our plan was guided by the following principles: protecting the workforce while providing essential clinical care; maintaining continuity of education and research; and promoting social distancing while minimizing the impact on team psychosocial well-being. RESULTS: The operational schedule and remote curriculum have been implemented successfully and allow resident education and other core departmental functions to continue as our health care system responds to the pandemic. CONCLUSIONS: We have been proactive and deliberate in implementing these operational changes, without compromise of our workforce. This experience provides residents exposure to real-life systems-based practice. We hope that our early experience will provide a framework for other surgical residency programs facing this crisis.


Drought and COVID-19 in the Eastern Mediterranean Region of the WHO


Anxiety and depression in patients with confirmed and suspected COVID-19 in Ecuador


title: NanoSPC: a scalable, portable, cloud compatible viral nanopore metagenomic data processing pipeline

text: Metagenomic sequencing combined with Oxford Nanopore Technology has the potential to become a point-of-care test for infectious disease in public health and clinical settings, providing rapid diagnosis of infection, guiding individual patient management and treatment strategies, and informing infection prevention and control practices. However, publicly available, streamlined, and reproducible pipelines for analyzing Nanopore metagenomic sequencing data are still lacking. Here we introduce NanoSPC, a scalable, portable and cloud compatible pipeline for analyzing Nanopore sequencing data. NanoSPC can identify potentially pathogenic viruses and bacteria simultaneously to provide comprehensive characterization of individual samples. The pipeline can also detect single nucleotide variants and assemble high quality complete consensus genome sequences, permitting high-resolution inference of transmission. We implement NanoSPC using Nextflow manager within Docker images to allow reproducibility and portability of the analysis. Moreover, we deploy NanoSPC to our scalable pathogen pipeline platform, enabling elastic computing for high throughput Nanopore data on HPC cluster as well as multiple cloud platforms, such as Google Cloud, Amazon Elastic Computing Cloud, Microsoft Azure and OpenStack. Users could either access our web interface (https://nanospc.mmmoxford.uk) to run cloud-based analysis, monitor process, and visualize results, as well as download Docker images and run command line to analyse data locally.


title: Psychotherapists' preferences for television and movies during the early stages of the COVID-19 pandemic

text: This study investigated psychotherapists' media use since the onset of the COVID-19 pandemic. A total of 186 psychotherapists completed a 15-item self-report survey on the movies and TV shows they had watched, and the reasons for their choices, since the outbreak of the COVID-19 pandemic. Results indicated therapists primarily watched material they described as comedic, distracting, thought-provoking, and psychologically engaging. In addition, they reported choosing media that appealed to their spouses and/or children. It is theorized that therapists' media selections are reinforcing their regulatory flexibility, allowing them to grapple with the harsh reality of the pandemic while simultaneously providing themselves emotional safety and relief in the form of distancing and distraction.


Letter: Back Pain and Accesses to Emergency Departments During COVID-19 Lockdown in Italy


This article provides a brief overview of the state of discourse, politics and provision of abortion in the Anglophone West, including developments in the wake of the COVID-19 pandemic. It then surveys three promising directions for feminist abortion scholarship. The first is work inspired by the Reproductive Justice Movement, that points to the intersectional axes of inequality that shape abortion discourse and position us in relation to reproductive choice and access issues. The second is work that examines the particularity of the constitution of the aborting body, reflecting the particularity of the pregnant body. This is a specific body, with a specific history; abortion discourse draws from and makes a significant contribution to the meaning and lived experience of this body. The third area of scholarship we highlight is that which seeks to amplify the meaning of abortion as a social good. Much abortion scholarship is attuned to a critique of negative aspects of abortion-from its representation in popular culture to restrictive law and access issues. This is critical work but/and the performative nature of abortion scholarship, like all discourse, means that it can amplify the association of negativity with abortion. The article concludes by introducing the articles contained in the special section of Women's Studies International Forum, 'Abortion at the edges: Politics, practices, performances'.


COVID-19 pandemic through the lens of a gastroenterology fellow: looking for the silver lining


How to balance acute myocardial infarction and COVID-19: the protocols from Sichuan Provincial People's Hospital


Lessons Already Learnt From the Coronavirus Disease 2019 Pandemic


Getting out of the World Health Organization might not be as easy as Trump thinks


title: Stress resilience during the coronavirus pandemic

text: The epidemic of the 2019 novel coronavirus SARS-CoV-2, causing the coronavirus disease 2019 (COVID-19) is a global public health emergency with multifaceted severe consequences for people's lives and their mental health. In this article, as members of the European College of Neuropsychopharmacology (ECNP) Resilience, we will discuss the urgent need for a focus on resilience during the current coronavirus pandemic. Resilience is pivotal to cope with stress and vital to stay in balance. We will discuss the importance of resilience at the individual and societal level, but also the implication for patients with a psychiatric condition and health care workers. We not only advocate for an increased focus on mental health during the coronavirus pandemic but also highlight the urgent need of augmenting our focus on resilience and on strategies to enhance it.


COVID-19: some unanswered questions


Symptom management and end-of-life care of residents with COVID-19 in long-term care homes


Blueprint for a pop-up SARS-CoV-2 testing lab


title: Canadian Public Health Laboratory Network Best Practices for COVID-19

text: The ability to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, is a foundational component of Canada's containment and mitigation strategies. Laboratory confirmation of COVID-19 cases allows the appropriate clinical management and public health interventions. Whether the local goal is containment or mitigation will depend on local epidemiology of the pandemic. The Respiratory Virus Infections Working Group of the Canadian Public Health Laboratory Network has developed comprehensive Best Practice Guidelines for detection of SARS-CoV-2. Best practices for specimen collection, transportation, testing and biosafety are addressed from the perspective of Canadian public health laboratories to ensure a consistent approach across the country: Population-based testing for COVID-19 should initially be carried out for surveillanceNasopharyngeal swab is the specimen of choice for routine testingNucleic acid amplification tests (such as real-time reverse transcription polymerase chain reaction) are the method of choice for routine testing of SARS-CoV-2The decentralization of nucleic acid amplification testing for COVID-19 to hospital or other high complexity medical laboratories should be promoted to increase test capacity and meet increased demandsIn the early stages of the pandemic, positive (approximately 10-20) and negative (approximately 50) tests by a provincial laboratory require confirmation at the National Microbiology LaboratoryCo-circulation of other viral agents associated with influenza-like Illnesses (e.g. influenza A and B and respiratory syncytial virus) should be monitored as capacity permits, as part of ongoing surveillanceOnce validated, serological testing may be utilized for assessing the presence/absence of immune response to the SARS-CoV-2 at either the population or individual level for select indications, but is likely to be of limited utility in diagnosis of acute COVID-19 illness These recommendations will be updated as new information becomes available.


title: Does recombinant human erythropoietin administration in critically ill COVID-19 patients have miraculous therapeutic effects?

text: An 80-year-old man with multiple comorbidities presented to the emergency department with tachypnea, tachycardia, fever, and critically low O2 saturation and definitive chest computerized tomography scan findings in favor of COVID-19 and positive PCR results in 48 hours. He received antiviral treatment plus recombinant human erythropoietin (rhEPO) due to his severe anemia. After 7 days of treatment, he was discharged with miraculous improvement in his symptoms and hemoglobin level. We concluded that rhEPO could attenuate respiratory distress syndrome and confront the severe acute respiratory syndrome coronavirus 2 virus through multiple mechanisms including cytokine modulation, antiapoptotic effects, leukocyte release from bone marrow, and iron redistribution away from the intracellular virus.


Interpreting the COVID-19 Test Results: A Guide for Physiatrists


title: A recombinant Lactobacillus plantarum strain expressing the spike protein of SARS-CoV-2

text: Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic in the past four months and causes respiratory disease in humans of almost all ages. Although several drugs have been announced to be partially effective treatments for this disease, no approved vaccine is available. Here, we described the construction of a recombinant Lactobacillus plantarum strain expressing the SARS-CoV-2 spike protein. The results showed that the spike gene with optimized codons could be efficiently expressed on the surface of recombinant L. plantarum and exhibited high antigenicity. The highest protein yield was obtained under the following conditions: cells were induced with 50 ng/mL SppIP at 37 °C for 6-10 h. The recombinant spike (S) protein was stable under normal conditions and at 50 °C, pH = 1.5, or a high salt concentration. Recombinant L. plantarum may provide a promising food-grade oral vaccine candidate against SARS-CoV-2 infection.


title: Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations

text: As coronavirus disease 2019 (COVID-19) spreads across the world, the intensive care unit (ICU) community must prepare for the challenges associated with this pandemic. Streamlining of workflows for rapid diagnosis and isolation, clinical management, and infection prevention will matter not only to patients with COVID-19, but also to health-care workers and other patients who are at risk from nosocomial transmission. Management of acute respiratory failure and haemodynamics is key. ICU practitioners, hospital administrators, governments, and policy makers must prepare for a substantial increase in critical care bed capacity, with a focus not just on infrastructure and supplies, but also on staff management. Critical care triage to allow the rationing of scarce ICU resources might be needed. Researchers must address unanswered questions, including the role of repurposed and experimental therapies. Collaboration at the local, regional, national, and international level offers the best chance of survival for the critically ill.


title: Ovarian vein thrombosis after coronavirus disease (COVID-19) infection in a pregnant woman: case report

text: Corona virus outbreak started in December 2019, and the disease has been defined by the World Health Organization as a public health emergency. Coronavirus is a source of deep venous thrombosis (DVT) due to complications such as over-coagulation, blood stasis, and endothelial damage. In this study, we report a 26-year-old pregnant woman with coronavirus who was hospitalized with a right ovarian vein thrombosis at Besat Hospital in Sanandaj. Risk classification for deep vein thrombosis (DVT) disease is of crucial importance for the forecast of coronavirus.


Crucial role of temporary airborne infection isolation rooms in an intensive care unit: containing the COVID-19 outbreak in South Korea


Elder Abuse in the COVID-19 Era


title: Data-driven Analytical Models of COVID-2019 for Epidemic Prediction, Clinical Diagnosis, Policy Effectiveness and Contact Tracing: A Survey

text: The widely spread CoronaVirus Disease (COVID)-19 is one of the worst infectious disease outbreaks in history and has become an emergency of primary international concern. As the pandemic evolves, academic communities have been actively involved in various capacities, including accurate epidemic estimation, fast clinical diagnosis, policy effectiveness evaluation and development of contract tracing technologies. There are more than 23,000 academic papers on the COVID-19 outbreak, and this number is doubling every 20 days while the pandemic is still on-going [1]. The literature, however, at its early stage, lacks a comprehensive survey from a data analytics perspective. In this paper, we review the latest models for analyzing COVID19 related data, conduct post-publication model evaluations and cross-model comparisons, and collect data sources from different projects.


title: Coronavirus (COVID-19) in Italy: knowledge, management of patients and clinical experience of Italian dentists during the spread of contagion

text: BACKGROUND: The coronavirus infection that emerged in China in the last few months of 2019 has now spread globally. Italy registered its first case in the second half of February, and in a short time period, it became the top country in Europe in terms of the number of infected people and the first in the world in terms of deaths. The medical and scientific community has been called upon to manage the emergency and to take measures. Dentists also need to take new precautions during their clinical activity to protect themselves, coworkers and patients from the risks of contagion and to avoid further spread of infection. METHODS: Following the data published in the international literature as well as the guidelines and directives constantly updated by the WHO and by the national health authorities, a questionnaire to be completed anonymously was submitted online to Italian dentists using social tools and online professional platforms. The collected data were processed statistically, providing descriptive data and analysis of correlations of the most significant parameters using the Pearson's χ2, the Likelihood-Ratio χ2, Cramér's V, Fisher's exact test, Goodman and Kruskal's Î³, and Kendall's τb (p < 0.05). RESULTS: A total of 535 dentists from Italy participated in the survey. A good level of scientific knowledge about coronavirus and the extra precautionary measures needed to limit the spread was related to the age of respondents and their sex. Coming from areas with higher concentrations of cases affected knowledge, level of attention and perception of risk related to dental activity. CONCLUSIONS: At the moment, there are no therapies or vaccines to contain the infection with the new coronavirus that is causing many infections, many of which are fatal, worldwide. Dentists are one of the categories at highest risk of encountering diseases and infections because they work in close proximity with patients, and in their procedures, there is always contact with aerosols with high bacterial and viral potential. Therefore, during this COVID-19 emergency, it is important that dentists are properly informed and take the appropriate precautionary measures.


Are certain drugs associated with enhanced mortality in COVID-19?


title: Prevention and control strategies for the diagnosis and treatment of cancer patients during the COVID-19 pandemic

text: COVID-19 has had a major impact worldwide due to its high infectiousness. Patients with cancer are more susceptible to infection and more likely to have severe events than other patients. This paper proposes management strategies for cancer patients that are beneficial for pandemic control and reduce the impact of the pandemic on cancer patients.


title: Imaging features and mechanisms of novel coronavirus pneumonia (COVID-19): Study Protocol Clinical Trial (SPIRIT Compliant)

text: INTRODUCTION: A novel coronavirus, tentatively designated as 2019 Novel Coronavirus (2019-nCoV), now called severe acute respiratory syndrome coronavirus 2, emerged in Wuhan, China, at the end of 2019 and which continues to expand. On February 11, 2020, the World Health Organization (WHO) named the disease coronavirus disease 2019 (COVID-19). On February 28, WHO increased our assessment of the risk of spread and the risk of impact of COVID-19 to very high at a global level. The COVID-19 poses significant threats to international health.Computed tomography (CT) has been an important imaging modality in assisting in the diagnosis and management of patients withCOVID-19. Some retrospective imaging studies have reported chest CT findings of COVID-19 in the past 2 months, suggesting that several CT findings may be characteristic. To our knowledge, there has been no prospective multicentre imaging study of COVID-19 to date.We proposed a hypothesis: There are some specific CT features on Chest CT of COVID-19 patients. And the mechanism of these CT features is explicable based on pathological findings. OBJECTIVE: To investigate the specific CT features of COVID-19 and the formation mechanism of these CT features. METHOD: This study is a prospective multicenter observational study. We will recruit 100 patients with COVID-19 at 55 hospitals. All patients undergo chest CT examination with the same scan protocol. The distribution and morphology of lesions on chest CT, clinical data will be recorded. A number of patients will be pathologically examined after permission is granted. The data of these three aspects will be analyzed synthetically. DISCUSSION: This study will help us to identify the chest CT features of COVID-19 and its mechanism. ETHICS AND DISSEMINATION: This retrospective study was approved by the Biomedical Research Ethics Committee of West China Hospital of Sichuan University (No. 2020-140). Written informed consent will be obtained from all study participants prior to enrollment in the study. To protect privacy of participants, all private information were kept anonymous. The results will be published in a peer-reviewed journal and will be disseminated electronically and in print regardless of results.


title: COVID-19 Outbreak in North Italy: An Overview on Dentistry. A Questionnaire Survey

text: This survey assessed the symptoms/signs, protective measures, awareness, and perception levels regarding COVID-19 among dentists in Lombardy, Italy. Moreover, an analysis of the answers gathered in areas with different prevalence of the disease was carried out. All Lombardy's dentists were sent an online ad hoc questionnaire. The questionnaire was divided into four domains: personal data, precautionary measures (before patient arrival; in the waiting room; in the operating room), awareness, and perception. Three thousand five hundred ninety-nine questionnaires were analyzed. Five hundred two (14.43%) participants had suffered one or more symptoms referable to COVID-19. Thirty-one subjects were positive to the virus SARS-CoV-2 and 16 subjects developed the disease. Only a small number of dentists (n = 72, 2.00%) were confident of avoiding infection; dentists working in low COVID-19 prevalence areas were more confident than those working in the Milan area and high prevalence area (61.24%, 61.23%, and 64.29%, p < 0.01 respectively). The level of awareness was statistically significantly higher (p < 0.01) in the Milan area (71.82%) than in the other areas. This survey demonstrated that dentists in the COVID-19 highest prevalence area, albeit reported to have more symptoms/signs than the rest of the sample, were the ones who adopted several precautionary measures less frequently and were the more confident of avoiding infection.


COVID-19 and the liver: the perils of non-peer reviewed science in times of a pandemic


title: COVID-19 - Toward a comprehensive understanding of the disease

text: The evidence on the pathophysiology of the novel coronavirus SARS-CoV-2 infection is rapidly growing. Understanding why some patients suffering from COVID-19 are getting so sick, while others are not, has become an informal imperative for researchers and clinicians around the globe. The answer to this question would allow rationalizing the fear surrounding this pandemic. Understanding of the pathophysiology of COVID-19 relies on an understanding of interplaying mechanisms, including SARS-CoV-2 virulence, human immune response, and complex inflammatory reactions with coagulation playing a major role. An interplay with bacterial co-infections, as well as the vascular system and microcirculation affected throughout the body should also be examined. More importantly, a compre-hensive understanding of pathological mechanisms of COVID-19 will increase the efficacy of therapy and decrease mortality. Herewith, presented is the current state of knowledge on COVID-19: beginning from the virus, its transmission, and mechanisms of entry into the human body, through the pathological effects on the cellular level, up to immunological reaction, systemic and organ presentation. Last but not least, currently available and possible future therapeutic and diagnostic options are briefly commented on.


title: Multicenter Evaluation of the QIAstat-Dx Respiratory Panel for Detection of Viruses and Bacteria in Nasopharyngeal Swab Specimens

text: The QIAstat-Dx Respiratory Panel (QIAstat-Dx RP) is a multiplex in vitro diagnostic test for the qualitative detection of 20 pathogens directly from nasopharyngeal swab (NPS) specimens. The assay is performed using a simple sample-to-answer platform with results available in approximately 69 min. The pathogens identified are adenovirus, coronavirus 229E, coronavirus HKU1, coronavirus NL63, coronavirus OC43, human metapneumovirus A and B, influenza A, influenza A H1, influenza A H3, influenza A H1N1/2009, influenza B, parainfluenza virus 1, parainfluenza virus 2, parainfluenza virus 3, parainfluenza virus 4, rhinovirus/enterovirus, respiratory syncytial virus A and B, Bordetella pertussis, Chlamydophila pneumoniae, and Mycoplasma pneumoniae This multicenter evaluation provides data obtained from 1,994 prospectively collected and 310 retrospectively collected (archived) NPS specimens with performance compared to that of the BioFire FilmArray Respiratory Panel, version 1.7. The overall percent agreement between QIAstat-Dx RP and the comparator testing was 99.5%. In the prospective cohort, the QIAstat-Dx RP demonstrated a positive percent agreement of 94.0% or greater for the detection of all but four analytes: coronaviruses 229E, NL63, and OC43 and rhinovirus/enterovirus. The test also demonstrated a negative percent agreement of ≥97.9% for all analytes. The QIAstat-Dx RP is a robust and accurate assay for rapid, comprehensive testing for respiratory pathogens.


The Impact of COVID-19 on Italy: A Lesson for the Future


Safe bronchodilator treatment in mechanically ventilated COVID-19 patients: A single center experience


title: Drawing on Kinship Care Support for Older People during a Pandemic (COVID-19): Practice Considerations for Social Workers in Ghana

text: Undoubtedly, the ongoing COVID-19 pandemic has brought both systemic, practice changes and limitations to social workers' commitment to the welfare of vulnerable populations such as older people. A golden preventive rule of the COVID-19 pandemic; maintaining physical and social distancing, has limited social workers' direct practice support for older people who are considered as an at-risk population. Within jurisdictions such as Ghana where kinship care practices are culturally engrained, social workers should promote kinship care support as substitute mechanisms and pathways to safeguard or meet the welfare needs of older people.


Government advice needed on TB testing during Covid-19 outbreak


title: Review of COVID-19 Antibody Therapies

text: Under the global health emergency caused by coronavirus disease 2019 (COVID-19), efficient and specific therapies are urgently needed. Compared with traditional small-molecular drugs, antibody therapies are relatively easy to develop and as specific as vaccines in targeting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and thus attract much attention in the past few months. This work reviews seven existing antibodies for SARS-CoV-2 spike (S) protein with three-dimensional (3D) structures deposited in the Protein Data Bank. Five antibody structures associated with SARS-CoV are evaluated for their potential in neutralizing SARS-CoV-2. The interactions of these antibodies with the S protein receptor-binding domain (RBD) are compared with those of angiotensin-converting enzyme 2 (ACE2) and RBD complexes. Due to the orders of magnitude in the discrepancies of experimental binding affinities, we introduce topological data analysis (TDA), a variety of network models, and deep learning to analyze the binding strength and therapeutic potential of the aforementioned fourteen antibody-antigen complexes. The current COVID-19 antibody clinical trials, which are not limited to the S protein target, are also reviewed.


title: Psychological support in times of COVID-19: the Essen community-based CoPE concept

text: The SARS CoV-2-virus (COVID-19) pandemic is pushing national and international structures to their limits. Little is known about treatment options to combat the novel virus, but the same applies to the effects of COVID-19 on people's mental health. In Germany, as in many other countries, governmental actions impact peoples' individual freedom. These highly necessary actions to slow down the spread of the virus, however, are a burden to the community. We established a structured concept to support psychological burdened people in Essen, which is located in the Ruhr area, a metropolitan region with more than 5.1 million inhabitants in the heart of the federal state North Rhine Westphalia. The psychological burden following the spread of the virus and individual restrictions should not be neglected.


Preparing for the COVID-19 Pandemic: Our Experience in New York


COVID-19: The Italian Viral "Gerocide" of the 21 st Century


title: A Survey of County Health Departments of Kansas Regarding COVID-19

text: Introduction: SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) causing COVID-19 (Coronavirus Disease 2019) initially was identified in China in December 2019 It has resulted in a pandemic with increasing spread of the virus in the U S The county health departments around U S are spearheading the response to contain the spread of this virus Methods: This project was a survey of county health departments in the state of Kansas with data collection period from April 15 to April 24, 2020 This study evaluated the staffing, resources, and funding of these health departments and how it was affecting the efforts to contain COVID-19 Descriptive statistics were used to summarize the responses Results: A total of 75% of the county health departments in Kansas responded to the survey In 89% of locations, the staffing had not increased Most health departments had an average of five people and the four largest ones had 30 to 98 staff working on COVID-19 Most locations used the Kansas Department of Health and Environment criteria for testing and used a combination of state or private laboratories The results of the tests were available three days or longer in 62% and after five days in 14% of sites All locations were active in contact tracing, but most had one to three people for this purpose and in 90% the contact tracing interview was via phone calls There was no change in funding in 21% and decreased funding in 8 5% of health departments Most locations had an average of five nasopharyngeal swabs on the day of the survey The most common needs expressed were help to increase testing capability, more public education, more personal protective equipment, increased personnel, and assistance with contract tracing Conclusion: There is an urgent need in Kansas to increase support to county health departments for testing capability, personal protective equipment, increased number of staff, increased help with contact tracing, and especially increase support for public education


Childcare for Radiology Workers During the COVID-19 Pandemic: No Small Matter


Proposed resumption of surgery algorithm after the coronavirus SARS-CoV-2 pandemic


title: A strategy for finding people infected with SARS-CoV-2: optimizing pooled testing at low prevalence

text: Suppressing SARS-CoV-2 will likely require the rapid identification and isolation of infected individuals, on an ongoing basis. RT-PCR (reverse transcription polymerase chain reaction) tests are accurate but costly, making regular testing of every individual expensive. The costs are a challenge for all countries and particularly for developing countries. Cost reductions can be achieved by combining samples and testing them in groups. We propose an algorithm for grouping subsamples, prior to testing, based on the geometry of a hypercube. At low prevalence, this testing procedure uniquely identifies infected individuals in a small number of tests. We discuss the optimal group size and explain why, given the highly infectious nature of the disease, parallel searches are preferred. We report proof of concept experiments in which a positive sample was detected even when diluted a hundred-fold with negative samples. Using these methods, the costs of mass testing could be reduced by a factor of ten to a hundred or more. If infected individuals are quickly and effectively quarantined, the prevalence will fall and so will the costs of regularly testing everyone. Such a strategy provides a possible pathway to the longterm elimination of SARS-CoV-2. Field trials of our approach are now under way in Rwanda and initial data from these are reported here.


title: Magnetic Immunoassays: A Review of Virus and Pathogen Detection Before and Amidst the Coronavirus Disease-19 (COVID-19)

text: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is a threat to the global healthcare system and economic security. As of July 2020, no specific drugs or vaccines are yet available for COVID-19, fast and accurate diagnosis for SARS-CoV-2 is essential in slowing down the spread of COVID-19 and for efficient implementation of control and containment strategies. Magnetic immunoassay is a novel and emerging topic representing the frontiers of current biosensing and magnetics areas. The past decade has seen rapid growth in applying magnetic tools for biological and biomedical applications. Recent advances in magnetic materials and nanotechnologies have transformed current diagnostic methods to nanoscale and pushed the detection limit to early stage disease diagnosis. Herein, this review covers the literatures of magnetic immunoassay platforms for virus and pathogen detections, before COVID-19. We reviewed the popular magnetic immunoassay platforms including magnetoresistance (MR) sensors, magnetic particle spectroscopy (MPS), and nuclear magnetic resonance (NMR). Magnetic Point-of-Care (POC) diagnostic kits are also reviewed aiming at developing plug-and-play diagnostics to manage the SARS-CoV-2 outbreak as well as preventing future epidemics. In addition, other platforms that use magnetic materials as auxiliary tools for enhanced pathogen and virus detections are also covered. The goal of this review is to inform the researchers of diagnostic and surveillance platforms for SARS-CoV-2 and their performances.


INTRODUCTION: Simultaneous mechanical ventilation of several patients with a single ventilator might reduce the deficit of these devices for the care of patients with acute respiratory failure due to Covid-19. OBJECTIVE: To communicate the results of a mechanical ventilation exercise with a ventilator in a lung simulator, and simultaneously in two and four. RESULTS: No statistically significant differences were observed between programmed, recorded and measured positive end-expiratory pressure, mean airway pressure and peak pressure, except when simultaneously ventilating four lung simulators. CONCLUSIONS: Simultaneous mechanical ventilation should be implemented by medical personnel with experience in the procedure, be restricted to two patients and carried out in the intensive care unit.


Estimating the Maximum Capacity of COVID-19 Cases Manageable per Day Given a Health Care System's Constrained Resources


title: Clinical and epidemiological characteristics of pediatric SARS-CoV-2 infections in China: A multicenter case series

text: BACKGROUND: As of April 18, 2020, over 2,000,000 patients had been diagnosed with coronavirus disease-2019 (COVID-19) globally, and more than 140,000 deaths had been reported. The clinical and epidemiological characteristics of adult patients have been documented recently. However, information on pediatric patients is limited. We describe the clinical and epidemiological characteristics of pediatric patients to provide valuable insight into the early diagnosis and assessment of COVID-19 in children. METHODS AND FINDINGS: This retrospective, observational study involves a case series performed at 4 hospitals in West China. Thirty-four pediatric patients with COVID-19 were included from January 27 to February 23, 2020. The final follow-up visit was completed by March 16, 2020. Clinical and epidemiological characteristics were analyzed on the basis of demographic data, medical history, laboratory tests, radiological findings, and treatment information. Data analysis was performed for 34 pediatrics patients with COVID-19 aged from 1 to 144 months (median 33.00, interquartile range 10.00-94.25), among whom 14 males (41%) were included. All the patients in the current study presented mild (18%) or moderate (82%) forms of COVID-19. A total of 48% of patients were noted to be without a history of exposure to an identified source. Mixed infections of other respiratory pathogens were reported in 16 patients (47%). Comorbidities were reported in 6 patients (18%). The most common initial symptoms were fever (76%) and cough (62%). Expectoration (21%), vomiting (12%), and diarrhea (12%) were also reported in a considerable portion of cases. A substantial increase was detected in serum amyloid A for 17 patients (among 20 patients with available data; 85%) and in high-sensitivity C-reactive protein for 17 patients (among 29 patients with available data; 59%), whereas a decrease in prealbumin was noticed in 25 patients (among 32 patients with available data; 78%). In addition, significant increases in the levels of lactate dehydrogenase and α-hydroxybutyrate dehydrogenase were detected in 28 patients (among 34 patients with available data; 82%) and 25 patients (among 34 patients with available data; 74%), respectively. Patchy lesions in lobules were detected by chest computed tomographic scans in 28 patients (82%). Ground-glass opacities, which were a typical feature in adults, were rare in pediatric patients (3%). Rapid radiologic progression and a late-onset pattern of lesions in the lobules were also noticed. Lesions in lobules still existed in 24 (among 32 patients with lesions; 75%) patients that were discharged, although the main symptoms disappeared a few days after treatment. All patients were discharged, and the median duration of hospitalization was 10.00 (8.00-14.25) days. The current study was limited by the small sample size and a lack of dynamic detection of inflammatory markers. CONCLUSIONS: Our data systemically presented the clinical and epidemiological features, as well as the outcomes, of pediatric patients with COVID-19. Stratified analysis was performed between mild and moderate cases. The findings offer new insight into early identification and intervention in pediatric patients with COVID-19.


title: Lessons Never Learned: Crisis and gender-based violence

text: The COVID-19 pandemic exposes underlying inequalities in our socio-economic and health systems, such as gender-based violence (GBV). In emergencies, particularly ones that involve quarantine, GBV often increases. Policymakers must utilize community expertise, technology and existing global guidelines to disrupt these trends in the early stages of the COVID-19 epidemic. Gender norms and roles relegating women to the realm of care work puts them on the frontlines in an epidemic, while often excluding them from developing the response. It is critical to value women's roles in society and include their voices in the decision-making process to avoid unintended consequences and ensure a comprehensive response that caters to the needs of the most vulnerable groups.


title: Meeting the Potential Emergency Global Drug Supply Challenge of Hydroxychloroquine for COVID-19

text: This paper provides an overview of the current global market and manufacturing landscape for hydroxychloroquine (HCQ). The capacity and capabilities of global producers to meet the potential demand for treating patients inflicted with COVID-19 by the novel corona virus SARS-CoV-2, should HCQ's efficacy be established by more definitive clinical trials, is also assessed. Given the large existing manufacturing base and abundance of raw materials for HCQ, the supply challenge can be met with considerable efforts and international cooperation. Preemptive and coordinated emergency efforts among global governments, regulatory agencies, chemical and pharmaceutical industries are imperative for meeting the surge in demand.


title: Acute limb ischemia in patients with COVID-19 pneumonia

text: OBJECTIVE: The aim of our study was to determine the incidence, characteristics, and clinical outcomes of patients with the novel coronavirus (COVID-19) infection who had presented with and been treated for acute limb ischemia (ALI) during the 2020 coronavirus pandemic. METHODS: We performed a single-center, observational cohort study. The data from all patients who had tested positive for COVID-19 and had presented with ALI requiring urgent operative treatment were collected in a prospectively maintained database. For the present series, successful revascularization of the treated arterial segment was defined as the absence of early (<30 days) re-occlusion or major amputation or death within 24 hours. The primary outcomes were successful revascularization, early (≤30 days) and late (≥30 days) survival, postoperative (≤30 days) complications, and limb salvage. RESULTS: We evaluated the data from 20 patients with ALI who were positive for COVID-19. For the period from January to March, the incidence rate of patients presenting with ALI in 2020 was significantly greater than that for the same months in 2019 (23 of 141 [16.3%] vs 3 of 163 [1.8%]; P < .001)]. Of the 20 included patients, 18 were men (90%) and two were women (10%). Their mean age was 75 ± 9 years (range, 62-95 years). All 20 patients already had a diagnosis of COVID-19 pneumonia. Operative treatment was performed in 17 patients (85%). Revascularization was successful in 12 of the 17 (70.6%). Although successful revascularization was not significantly associated with the postoperative use of intravenous heparin (64.7% vs 83.3%; P = .622), no patient who had received intravenous heparin required reintervention. Of the 20 patients, eight (40%) had died in the hospital. The patients who had died were significantly older (81 ± 10 years vs 71 ± 5 years; P = .008). The use of continuous postoperative systemic heparin infusion was significantly associated with survival (0% vs 57.1%; P = .042). CONCLUSIONS: In our preliminary experience, the incidence of ALI has significantly increased during the COVID-19 pandemic in the Italian Lombardy region. Successful revascularization was lower than expected, which we believed was due to a virus-related hypercoagulable state. The use of prolonged systemic heparin might improve surgical treatment efficacy, limb salvage, and overall survival.


Community Prevalence of SARS-CoV-2 Among Patients With Influenzalike Illnesses Presenting to a Los Angeles Medical Center in March 2020


title: Risk Communication During COVID-19

text: During the unprecedented times caused by the novel coronavirus disease 2019, there is rapidly evolving information and guidance. However, a focus must also be on proper and effective risk communication. This is especially the case during pandemics that have high rates of infection, significant morbidity, lack of therapeutic measures, and rapid increases in cases, all of which apply to the current coronavirus disease 2019 pandemic. A consequence of poor risk communication and heightened risk perception is hoarding behavior, which can lead to lack of medications and personal protective equipment. One potential way to ensure appropriate risk communication is using social media channels, and ensuring an ongoing consistent media presence. Another important step is to include all stakeholders including members of the allergy community in broader public health messaging. As we continue to face unprecedented times in the allergy community, an understanding and appreciation of risk communication will be essential as we communicate with, and inform, our patients, and our colleagues, moving forward.


Editorial, Authors Reply: Neurological Impact of Coronavirus Disease (COVID-19): Practical Considerations for the Neuroscience Community


title: COVID-19 and Company Knowledge Graphs: Assessing Golden Powers and Economic Impact of Selective Lockdown via AI Reasoning

text: In the COVID-19 outbreak, governments have applied progressive restrictions to production activities, permitting only those that are considered strategic or that provide essential services. This is particularly apparent in countries that have been stricken hard by the virus, with Italy being a major example. Yet we know that companies are not just isolated entities: They organize themselves into intricate shareholding structures --- forming company networks --- distributing decision power and dividends in sophisticated schemes for various purposes. One tool from the Artificial Intelligence (AI) toolbox that is particularly effective to perform reasoning tasks on domains characterized by many entities highly interconnected with one another is Knowledge Graphs (KG). In this work, we present a visionary opinion and report on ongoing work about the application of Automated Reasoning and Knowledge Graph technology to address the impact of the COVID-19 outbreak on the network of Italian companies and support the application of legal instruments for the protection of strategic companies from takeovers.


The consequences of the COVID-19 pandemic on mental health and implications for clinical practice


Differentiating COVID-19 Pneumonia from Acute Respiratory Distress Syndrome (ARDS) and High Altitude Pulmonary Edema (HAPE): Therapeutic Implications


Challenges and Lessons for Managing Glaucoma during COVID-19 Pandemic: Perspectives from Asia


title: Outcomes in Patients With Hyperglycemia Affected by COVID-19: Can We Do More on Glycemic Control?

text: OBJECTIVE: An important prognostic factor in any form of infection seems to be glucose control in patients with type 2 diabetes. There is no information about the effects of tight glycemic control on coronavirus disease 2019 (COVID-19) outcomes in patients with hyperglycemia. Therefore, we examined the effects of optimal glycemic control in patients with hyperglycemia affected by COVID-19. RESEARCH DESIGN AND METHODS: Fifty-nine patients with COVID-19 hospitalized with moderate disease were evaluated. On the basis of admission glycemia >7.77 mmol/L, patients were divided into hyperglycemic and normoglycemic groups. Interleukin 6 (IL-6) and D-dimer levels were evaluated at admission and weekly during hospitalization. The composite end point was severe disease, admission to an intensive care unit, use of mechanical ventilation, or death. RESULTS: Thirty-four (57.6%) patients were normoglycemic and 25 (42.4%) were hyperglycemic. In the hyperglycemic group, 7 (28%) and 18 (72%) patients were diagnosed with diabetes already before admission, and 10 (40%) and 15 (60%) were treated without and with insulin infusion, respectively. The mean of glycemia during hospitalization was 10.65 ± 0.84 mmol/L in the no insulin infusion group and 7.69 ± 1.85 mmol/L in the insulin infusion group. At baseline, IL-6 and D-dimer levels were significantly higher in the hyperglycemic group than in the normoglycemic group (P < 0.001). Even though all patients were on standard treatment for COVID-19 infection, IL-6 and D-dimer levels persisted higher in patients with hyperglycemia during hospitalization. In a risk-adjusted Cox regression analysis, both patients with hyperglycemia and patients with diabetes had a higher risk of severe disease than those without diabetes and with normoglycemia. Cox regression analysis evidenced that patients with hyperglycemia treated with insulin infusion had a lower risk of severe disease than patients without insulin infusion. CONCLUSIONS: Insulin infusion may be an effective method for achieving glycemic targets and improving outcomes in patients with COVID-19.


Return to play after COVID-19: a sport cardiologist's view


Barrier Shields: Not Just for Intubations in Today's COVID-19 World?


Tocilizumab for Hemophagocytic Syndrome in a Kidney Transplant Recipient With COVID-19


Use of face masks in dermatology department during the COVID-19 outbreak


title: Prevention and management of COVID-19 among patients with diabetes: an appraisal of the literature

text: The coronavirus disease 2019 (COVID-19) pandemic has emerged as one of the greatest challenges faced by humankind in the recent past. People with diabetes and related comorbidities are at increased risk of its complications and of COVID-19-related death. Older age, multi-morbidity, hyperglycaemia, cardiac injury and severe inflammatory response are predictors of poor outcome. The complex interplay between COVID-19, diabetes and the effects of related therapies is being explored. Most patients experience a mild illness with COVID-19, while people with diabetes are at increased risk of severe disease. Optimising glycaemic control and adopting measures to prevent disease spread are critical aspects. The management of mild disease is supportive, while very many immunomodulatory and antiviral therapies are being investigated for the treatment of severe disease. Several of these agents have specific considerations for use in people with diabetes. Since mass population lockdowns are considered a key step in controlling disease spread, it follows that, in addition to the direct vulnerability to severe COVID-19, people with diabetes can be affected by limited access to healthcare, insulin, other medications and blood glucose monitoring equipment. Measures to prevent disease spread at the individual and community level are the key to mitigating the rapidly escalating pandemic, while agents for chemoprophylaxis and vaccines are being explored. People with diabetes should be recognised as a vulnerable group for complicated disease and are at risk during times of disturbed social systems. Strategies are needed to safeguard the health of patients with diabetes during the pandemic. This review summarises the current knowledge and perceived challenges for prevention and management of COVID-19 in people with diabetes.


Border closure for island nations? Analysis of pandemic and bioweapon-related threats suggests some scenarios warrant drastic action


title: Eosinopenia and elevated C-reactive protein facilitate triage of COVID-19 patients in fever clinic: a retrospective case-control study

text: Background: Coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is currently a pandemic affecting over 200 countries. Many cities have established designated fever clinics to triage suspected COVID-19 patients from other patients with similar symptoms. However, given the limited availability of the nucleic acid test as well as long waiting time for both the test and radiographic examination, the quarantine or therapeutic decisions for a large number of mixed patients were often not made in time. We aimed to identify simple and quickly available laboratory biomarkers to facilitate effective triage at the fever clinics for sorting suspected COVID-19 patients from those with COVID-19-like symptoms. Methods: We collected clinical, etiological, and laboratory data of 989 patients who visited the Fever Clinic at Wuhan Union Hospital, Wuhan, China, from Jan 31 to Feb 21. Based on polymerase chain reaction (PCR) nucleic acid testing for SARS-CoV-2 infection, they were divided into two groups: SARS-CoV-2-positive patients as cases and SARS-CoV-2-negative patients as controls. We compared the clinical features and laboratory findings of the two groups, and analyzed the diagnostic performance of several laboratory parameters in predicting SARS-CoV-2 infection and made relevant comparisons to the China diagnosis guideline of having a normal or decreased number of leukocytes (≤9â¢5 109/L) or lymphopenia (<1â¢1 109/L). Findings: Normal or decreased number of leukocytes (≤9â¢5 109/L), lymphopenia (<1â¢1 109/L), eosinopenia (<0â¢02 109/L), and elevated hs-CRP (≥4 mg/L) were presented in 95â¢0%, 52â¢2%, 74â¢7% and 86â¢7% of COVID-19 patients, much higher than 87â¢2%, 28â¢8%, 31â¢3% and 45â¢2% of the controls, respectively. The eosinopenia produced a sensitivity of 74â¢7% and specificity of 68â¢7% for separating the two groups with the area under the curve (AUC) of 0â¢717. The combination of eosinopenia and elevated hs-CRP yielded a sensitivity of 67â¢9% and specificity of 78â¢2% (AUC=0â¢730). The addition of eosinopenia alone or the combination of eosinopenia and elevated hs-CRP into the guideline-recommended diagnostic parameters for COVID-19 improved the predictive capacity with higher than zero of both net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Interpretation: The combination of eosinopenia and elevated hs-CRP can effectively triage suspected COVID-19 patients from other patients attending the fever clinic with COVID-19-like initial symptoms. This finding would be particularly useful for designing triage strategies in an epidemic region having a large number of patients with COVID-19 and other respiratory diseases while limited medical resources for nucleic acid tests and radiographic examination. Funding: This work was supported by the National Natural Science Foundation of China (NSFC) and the Major Scientific and Technological Innovation Projects of Hubei Province (MSTIP).


title: Facial pressure ulcers in COVID-19 patients undergoing prone positioning: How to prevent an underestimated epidemic?

text: Prone positioning is an adjuvant therapy used to treat COVID-19 pneumonia complicated by acute respiratory distress syndrome. However, prolonged pressure on facial skin at the level of the bony structures may be responsible for facial pressure ulcers. In the context of severe COVID-19 pneumonia, we hypothesized that hypoxemia, microvascular injury and thrombosis can increase the risk of pressure ulcers. We described two cases in order to emphasize the risk of facial pressure ulcers as a result of prone positioning, so as to discuss their physiopathology and highlight the importance of appropriate preventive measures.


title: CODA-19: Reliably Annotating Research Aspects on 10,000+ CORD-19 Abstracts Using a Non-Expert Crowd

text: This paper introduces CODA-19, a human-annotated dataset that codes the Background, Purpose, Method, Finding/Contribution, and Other sections of 10,966 English abstracts in the COVID-19 Open Research Dataset. CODA-19 was created by 248 crowd workers from Amazon Mechanical Turk within 10 days, achieving a label quality comparable to that of experts. Each abstract was annotated by nine different workers, and the final labels were obtained by majority vote. The inter-annotator agreement (Cohen's kappa) between the crowd and the biomedical expert (0.741) is comparable to inter-expert agreement (0.788). CODA-19's labels have an accuracy of 82.2% when compared to the biomedical expert's labels, while the accuracy between experts was 85.0%. Reliable human annotations help scientists to understand the rapidly accelerating coronavirus literature and also serve as the battery of AI/NLP research, but obtaining expert annotations can be slow. We demonstrated that a non-expert crowd can be rapidly employed at scale to join the fight against COVID-19.


title: Collisions of three-component vector solitons in Bose-Einstein condensates

text: Ultracold gases provide an unprecedented level of control for the investigation of soliton dynamics and collisions. We present a scheme for deterministically preparing pairs of three-component solitons in a Bose-Einstein condensate. Our method is based on local spin rotations which simultaneously imprint suitable phase and density distributions. This enables us to observe striking collisional properties of the vector degree of freedom which naturally arises for the coherent nature of the emerging multi-component solitons. We find that the solitonic properties in the quasi-one-dimensional system are quantitatively described by the integrable repulsive three-component Manakov model.


title: The contribution of globular clusters to cosmic reionization

text: We study the escape fraction of ionizing photons (f_esc) in two cosmological zoom-in simulations of galaxies in the reionization era with halo mass M_halo~10^10 and 10^11 M_sun (stellar mass M*~10^7 and 10^9 M_sun) at z=5 from the Feedback in Realistic Environments project. These simulations explicitly resolve the formation of proto-globular clusters (GCs) self-consistently, where 17-39% of stars form in bound clusters during starbursts. Using post-processing Monte Carlo radiative transfer calculations of ionizing radiation, we compute f_esc from cluster stars and non-cluster stars formed during a starburst over ~100 Myr in each galaxy. We find that the averaged f_esc over the lifetime of a star particle follows a similar distribution for cluster stars and non-cluster stars. Clusters tend to have low f_esc in the first few Myrs, presumably because they form preferentially in more extreme environments with high optical depths; the f_esc increases later as feedback starts to disrupt the natal cloud. On the other hand, non-cluster stars formed between cluster complexes or in the compressed shell at the front of a superbubble can also have high f_esc. We find that cluster stars on average have comparable f_esc to non-cluster stars. This result is robust across several star formation models in our simulations. Our results suggest that the fraction of ionizing photons from proto-GCs to cosmic reionization is comparable to the cluster formation efficiency in high-redshift galaxies and hence proto-GCs likely contribute an appreciable fraction of photons but are not the dominant sources for reionization.


title: Examining COVID-19 Forecasting using Spatio-Temporal Graph Neural Networks

text: In this work, we examine a novel forecasting approach for COVID-19 case prediction that uses Graph Neural Networks and mobility data. In contrast to existing time series forecasting models, the proposed approach learns from a single large-scale spatio-temporal graph, where nodes represent the region-level human mobility, spatial edges represent the human mobility based inter-region connectivity, and temporal edges represent node features through time. We evaluate this approach on the US county level COVID-19 dataset, and demonstrate that the rich spatial and temporal information leveraged by the graph neural network allows the model to learn complex dynamics. We show a 6% reduction of RMSLE and an absolute Pearson Correlation improvement from 0.9978 to 0.998 compared to the best performing baseline models. This novel source of information combined with graph based deep learning approaches can be a powerful tool to understand the spread and evolution of COVID-19. We encourage others to further develop a novel modeling paradigm for infectious disease based on GNNs and high resolution mobility data.


title: Robustness analysis in an inter-cities mobility network: modeling municipal, state and federal initiatives as failures and attacks

text: Motivated by the challenge related to the COVID-19 epidemic and the seek for optimal containment strategies, we present a robustness analysis into an inter-cities mobility complex network. We abstract municipal initiatives as nodes' failures and the federal actions as targeted attacks. The geo(graphs) approach is applied to visualize the geographical graph and produce maps of topological indexes, such as degree and vulnerability. A Brazilian data of 2016 is considered a case study, with more than five thousand cities and twenty-seven states. Based on the Network Robustness index, we show that the most efficient attack strategy shifts from a topological degree-based, for the all cities network, to a topological vulnerability-based, for a network considering the Brazilian States as nodes. Moreover, our results reveal that individual municipalities' actions do not cause a high impact on mobility restrain since they tend to be punctual and disconnected to the country scene as a whole. Oppositely, the coordinated isolation of specific cities is key to detach entire network areas and thus prevent a spreading process to prevail.


The challenges of dental care provision in patients with learning disabilities and special requirements during COVID-19 pandemic


title: Gastrointestinal, hepatobiliary, and pancreatic manifestations of COVID-19

text: There is an increasing number of confirmed cases and deaths caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributing to the Coronavirus disease 2019 (COVID-19) pandemic. At this point, the need for further disease characterization is critical. COVID-19 is well established as a respiratory tract pathogen; however, recent studies have shown an increasing number of patients reporting gastrointestinal manifestations such as diarrhea, nausea, vomiting, and abdominal pain. The time from onset of gastrointestinal symptoms to hospital presentation is often delayed compared to that of respiratory symptoms. It has been noted that SARS-CoV-2 RNA can be detected in fecal matter for an extended period of time, even after respiratory samples have tested negative and patients are asymptomatic. In this article, SARS-CoV-2 and its disease COVID-19 will be reviewed with consideration of the latest literature about gastrointestinal symptomatology, the mechanisms by which the virus may inflict damage, and the possibility of viral replication contributing to a fecal-oral route of transmission.


title: Andrology and penile cancer. Recommendations during COVID-19 pandemia./ Andrologia y cancer de pene. Recomendaciones durante la pandemia COVID-19

text: PURPOSE: The COVID-19 pandemic which has affected Spain since the beginning of 2020 compels us to determine recomendations for the practice of Andrology in present times MATERIALS AND METHODS: A web search is carried out in English and Spanish and a joint proposal is defined by experts in Andrology from different regions of Spain RESULTS: Most diagnostic and therapeutic procedures in Andrology can be safey postponed during the COVID-19 pandemic Online consultations and outpatient surgeries must be encouraged Andrologic emergencies and penile cancer management should be considered high priority, and should be diagnosed and treated promptly even in the most severe phases of the pandemic INTRODUCCION: La pandemia COVID-19 que ha afectado a Espana desde comienzos de 2020 obliga a definir unas recomendaciones para la practica de la Andrologia en la actualidad MATERIAL Y METODOS: Se realiza una busqueda web en ingles y espanol y se define una propuesta conjunta por parte de expertos en Andrologia de distintas regiones de Espana RESULTADOS: La mayor parte de los procedimientos diagnosticos y terapeuticos en Andrologia pueden ser demorados con seguridad durante la pandemia COVID-19 Se debe fomentar la consulta telematica y lacirugia ambulatoria Las urgencias andrologicas y el manejo del cancer de pene deben considerarse una prioridad alta, diagnosticandose y tratandose con brevedadi ncluso en las fases mas severas de la pandemia


title: [Andrology and penile cancer. Recommendations during COVID-19 pandemia.]

text: PURPOSE: The COVID-19 pandemic which has affected Spain since the beginning of 2020 compels us to determine recomendations for the practice of Andrology in present times MATERIALS AND METHODS: A web search is carried out in English and Spanish and a joint proposal is defined by experts in Andrology from different regions of Spain RESULTS: Most diagnostic and therapeutic procedures in Andrology can be safey postponed during the COVID-19 pandemic Online consultations and outpatient surgeries must be encouraged Andrologic emergencies and penile cancer management should be considered high priority, and should be diagnosed and treated promptly even in the most severe phases of the pandemic


title: Pathological features of 78 metastatic or multicentric neoplasms involving the central nervous system in dogs/ Aspectos patológicos e distribuição de 78 neoplasias metastáticas ou multicêntricas envolvendo o sistema nervoso central de caninos

text: Secondary neoplasms affecting the central nervous system (CNS) may occur through blood flow or direct extension. This condition occurrence has increased both due to a longer life expectancy of dogs, as well as with the employment of chemotherapeutics, which may increase the survival period and, thus, the odds of the occurrence of metastasis. The aim of this study was to analyze the epidemiological features, such as the age, breed and sex of the animals affected, as well as the gross and microscopic findings of the metastasis from neoplasms involving the CNS of 78 dogs, and, based on the data, estimate the occurrence and frequency of the metastatic or multicentric neoplasms. Females (71.79%) were most affected than males, with an average age of 9.5-years-old and a median of 10-years-old. Most of the cases had a multifocal distribution (73.07%), and epithelial neoplasms (50%) were the most common. Telencephalon was the most affected neuroanatomical region (61.1%). Mammary neoplasms were the most frequent (47.44%), followed by hemangiosarcoma (19.23%), lymphoma (10.26%) and melanoma (6.41%). Less common neoplasms included osteosarcoma, histiocytic sarcoma and lung carcinoma (2.56%). Mammary neoplasms were mainly composed of anaplastic and micropapillary carcinomas, of which only multifocal microscopic lesions were observed.(AU)


title: Structure of understory bird communities in Atlantic Forest Remnants in Northeastern Brazil/ Estrutura das comunidades de aves de remanescentes de Mata Atlântica no nordeste do Brasil

text: The Atlantic Forest in the State of Paraíba integrates the Pernambuco Center of Endemism. The present work investigated understory bird communities of three of its remnants using ten mist nets installed at eight different points of the forest understory of each area. We captured 333 birds of 44 species and 19 families. Bird richness and abundance did not differ between the three remnants (KW = 6.08; p = 0.04 and KW = 10.54; p = 0.004). The composition was little similar among them, and each area presented high species diversity and evenness. The most captured species were Arremon taciturnus (n = 40), Chiroxiphia pareola (n = 32) and Conopophaga melanops (n = 28). C. melanops has a local threat status of vulnerable and is considered endemic. Endangered and endemic species each represented 15.91% of the captures. Both Reserva Biológica Guaribas areas had the highest number of threatened species, while Reserva Particular do Patrimônio Natural Engenho Gargaú showed the highest number of endemic and understory insectivorous species, which indicates a better quality status in comparison to the other two. These results show the importance of the remnants to bird conservation in Northeastern Brazil.(AU)


Modeling SARS-CoV-2 Positivity Using Laboratory Data: Timing Is Everything


In reply to Drs Magrini, Mazzola, Greco, Alongi, Buglione