title: Effectiveness of N95 respirators versus surgical masks against influenza: A systematic review and meta‐analysis

text: OBJECTIVE: Previous meta‐analyses concluded that there was insufficient evidence to determine the effect of N95 respirators. We aimed to assess the effectiveness of N95 respirators versus surgical masks for prevention of influenza by collecting randomized controlled trials (RCTs). METHODS: We searched PubMed, EMbase and The Cochrane Library from the inception to January 27, 2020 to identify relevant systematic reviews. The RCTs included in systematic reviews were identified. Then we searched the latest published RCTs from the above three databases and searched ClinicalTrials.gov for unpublished RCTs. Two reviewers independently extracted the data and assessed risk of bias. Meta‐analyses were conducted to calculate pooled estimates by using RevMan 5.3 software. RESULTS: A total of six RCTs involving 9 171 participants were included. There were no statistically significant differences in preventing laboratory‐confirmed influenza (RR = 1.09, 95% CI 0.92‐1.28, P > .05), laboratory‐confirmed respiratory viral infections (RR = 0.89, 95% CI 0.70‐1.11), laboratory‐confirmed respiratory infection (RR = 0.74, 95% CI 0.42‐1.29) and influenzalike illness (RR = 0.61, 95% CI 0.33‐1.14) using N95 respirators and surgical masks. Meta‐analysis indicated a protective effect of N95 respirators against laboratory‐confirmed bacterial colonization (RR = 0.58, 95% CI 0.43‐0.78). CONCLUSION: The use of N95 respirators compared with surgical masks is not associated with a lower risk of laboratory‐confirmed influenza. It suggests that N95 respirators should not be recommended for general public and nonhigh‐risk medical staff those are not in close contact with influenza patients or suspected patients.


Everything old is new again: COVID-19 and public health


title: Characterization of monoclonal and polyclonal antibodies to bovine enteric coronavirus: Establishment of an efficient ELISA for antigen detection in feces

text: Abstract Monoclonal antibodies to bovine enteric coronavirus (BEC) were produced. Additionally, polyclonal antibodies were made in rabbits and guinea pigs and extracted from the yolk of immunized hens. The antibodies were characterized by neutralization test, hemagglutination inhibition test, enzyme-linked immunosorbent assay (ELISA) and immunoblotting. Neutralizing antibody titers of polyclonal antisera ranged from 1:1280 to 1:40 000. Only one out of 908 hybridoma colonies tested secreted antibodies with neutralizing activity. By ELISA, polyclonal sera exhibited high background reactions that could be significantly reduced by treatment with kaolin in the case of rabbit sera. Attempts to establish an ELISA for BEC antigen detection based on polyclonal sera failed due to low sensitivity and specificity. Optimal results were achieved when a mixture of two monoclonal antibodies was coated onto microplates for antigen capture, while rabbit hyperimmune serum served as detecting antibodies in an indirect assay. The combination of the two monoclonal antibodies did not increase sensitivity synergistically, but in a compensatory fashion, probably because of epitope differences between BEC field strains.


title: A high-throughput approach to profile RNA structure

text: Here we introduce the Computational Recognition of Secondary Structure (CROSS) method to calculate the structural profile of an RNA sequence (single- or double-stranded state) at single-nucleotide resolution and without sequence length restrictions. We trained CROSS using data from high-throughput experiments such as Selective 2΄-Hydroxyl Acylation analyzed by Primer Extension (SHAPE; Mouse and HIV transcriptomes) and Parallel Analysis of RNA Structure (PARS; Human and Yeast transcriptomes) as well as high-quality NMR/X-ray structures (PDB database). The algorithm uses primary structure information alone to predict experimental structural profiles with >80% accuracy, showing high performances on large RNAs such as Xist (17 900 nucleotides; Area Under the ROC Curve AUC of 0.75 on dimethyl sulfate (DMS) experiments). We integrated CROSS in thermodynamics-based methods to predict secondary structure and observed an increase in their predictive power by up to 30%.


Personal Protective Equipment (PPE) and Its Use in COVID-19: Important Facts


Iranian healthcare system against COVID-19


title: Anticoagulation, Immortality, and Observations of COVID‐19

text: The current coronavirus disease 2019 (COVID‐19) pandemic has produced an understandable sense of urgency among clinicians and researchers to develop, deploy, and report novel treatment strategies. Many centers are therefore using off‐label therapies and reporting early observational results of their experiences.(1‐3) A similar situation arose during the 2014 outbreak of Ebola virus disease (EVD).


title: Inability of rat DPP4 to allow MERS-CoV infection revealed by using a VSV pseudotype bearing truncated MERS-CoV spike protein

text: Middle East respiratory syndrome (MERS) coronavirus (Co-V) contains a single spike (S) protein, which binds to a receptor molecule, dipeptidyl peptidase 4 (DPP4; also known as CD26), and serves as a neutralizing antigen. Pseudotyped viruses are useful for measuring neutralization titers against highly infectious viruses as well as for studying their mechanism of entry. In this study, we constructed a series of cytoplasmic deletion mutants of MERS-CoV S and compared the efficiency with which they formed pseudotypes with vesicular stomatitis virus. A pseudotype bearing an S protein with the C-terminal 16 amino acids deleted (MERSpv-St16) reached a maximum titer that was approximately tenfold higher than that of a pseudotype bearing a non-truncated full-length S protein. Using MERSpv-St16, we demonstrated the inability of rat DPP4 to serve as a functional receptor for MERS-CoV, suggesting that rats are not susceptible to MERS-CoV infection. This study provides novel information that enhances our understanding of the host range of MERS-CoV. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00705-015-2506-z) contains supplementary material, which is available to authorized users.


title: Reverse genetic systems: Rational design of coronavirus live attenuated vaccines with immune sequelae

text: Since the end of 2019, the global COVID-19 outbreak has once again made coronaviruses a hot topic. Vaccines are hoped to be an effective way to stop the spread of the virus. However, there are no clinically approved vaccines available for coronavirus infections. Reverse genetics technology can realize the operation of RNA virus genomes at the DNA level and provide new ideas and strategies for the development of new vaccines. In this review, we systematically describe the role of reverse genetics technology in studying the effects of coronavirus proteins on viral virulence and innate immunity, cell and tissue tropism and antiviral drug screening. An efficient reverse genetics platform is useful for obtaining the ideal attenuated strain to prepare an attenuated live vaccine.


title: Oligoadenylate synthase-like (OASL) proteins: dual functions and associations with diseases

text: The study of antiviral pathways to reveal methods for the effective response and clearance of virus is closely related to understanding interferon (IFN) signaling and its downstream target genes, IFN-stimulated genes. One of the key antiviral factors induced by IFNs, 2′-5′ oligoadenylate synthase (OAS), is a well-known molecule that regulates the early phase of viral infection by degrading viral RNA in combination with RNase L, resulting in the inhibition of viral replication. In this review, we describe OAS family proteins from a different point of view from that of previous reviews. We discuss not only RNase L-dependent (canonical) and -independent (noncanonical) pathways but also the possibility of the OAS family members as biomarkers for various diseases and clues to non-immunological functions based on recent studies. In particular, we focus on OASL, a member of the OAS family that is relatively less well understood than the other members. We will explain its anti- and pro-viral dual roles as well as the diseases related to single-nucleotide polymorphisms in the corresponding gene.


title: Respiratory Syncytial Virus Outbreak in a Long‐Term Care Facility Detected Using Reverse Transcriptase Polymerase Chain Reaction: An Argument for Real‐Time Detection Methods

text: OBJECTIVES: To report an outbreak of respiratory synctyial virus (RSV) in a long‐term care facility (LTCF) during ongoing routine respiratory illness surveillance. DESIGN: Rapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and reverse transcriptase polymerase chain reaction (RT‐PCR) testing for up to 15 viruses in symptomatic residents and chart review. SETTING: A 120‐bed LTCF. MEASUREMENTS: Comparison of rapid antigen testing, respiratory viral cultures, and DFA testing and RT‐PCR in residents with symptoms of a respiratory tract infection. RESULTS: Twenty‐two of 52 residents developed symptoms of a respiratory tract infection between January 29, 2008, and February 26, 2008. RSV was detected using RT‐PCR in seven (32%) of the 22 cases. None of the seven cases had positive RSV rapid antigen testing, and only two had positive culture or DFA results. This outbreak occurred during a time when state wide RSV rates were rapidly declining. One patient was admitted to the hospital during the infection and subsequently died. CONCLUSION: RSV may cause outbreaks in LTCFs that traditional diagnostic methods do not detect. RT‐PCR can provide a more timely and accurate diagnosis of outbreaks, which allows for early symptomatic treatment, rational use of antibiotics, and improved infection control.


title: Night Sky Brightness Monitoring Network in Wuxi, China

text: The rapid development of cities has brought tremendous pressure to astronomical observation, energy security, and the ecosystem. Automatic monitoring of night sky brightness (NSB) can help us to understand its regional differences and time variations of NSB effectively and to investigate the human and natural factors which lead to these changes. In this paper, the construction of Wuxi City night sky brightness monitoring network (WBMN) in China is presented. In addition to introducing the equipment and the installation of the network, a brief analysis of the data obtained from the stations will also be presented. The impact of human activities on the NSB is illustrated through its changes during the Spring Festival (lunar new year) and non-festival nights, and through a comparison study between NSB data taken from locations of different land usages. It is concluded that, while the reduction in human activities after non-festival midnights or the reduction in moon illumination near the new moon epoch led to darker night skies, brightening of the night skies may be attributed to firework displays during the nights of Spring Festival in 2019. On the other hand, the absence of firework during the Spring Festival in 2020 may explain the darker night skies. Finally, there is an evidence that the urban developments in Wuxi are degrading night sky quality.


Risk of COVID-19 in patients treated for cancer: an immune response-based hypothesis


title: Numerical investigation of gaseous pollutant cross-transmission for single-sided natural ventilation driven by buoyancy and wind

text: Abstract Single-sided natural ventilation was numerically investigated to determine the impact of buoyancy and wind on the cross-transmission of pollution by considering six window types commonly found in multistory buildings. The goal of this study was to predict the gaseous pollutant transmission using computational fluid dynamics based on the Reynolds-averaged Navier-Stokes equations and baseline k-ω turbulence equations. The results indicated that ventilation rates generally increased with increasing wind speeds if the effects of buoyancy and wind were not suppressed; however, the re-entry ratio representing the proportion of expelled air re-entering other floors and the corresponding risk of infection decreased. If the source of the virus was on a central floor, the risk of infection was the highest on the floors closest to the source. Different window types were also considered for determining their effectiveness in controlling cross-transmission and infection risk, depending on the source location and driving force (e.g., buoyancy and wind).


title: Emergence of COVID-19 Infection: What Is Known and What Is to Be Expected-Narrative Review Article

text: BACKGROUND: The discovery of the coronavirus disease 2019 (COVID-19) during a pneumonia outbreak in Wuhan city (China) has raised a global public health concern, as the city consists of around 11 million people and is considered a major transport and logistics hub. This deadly virus caused the world to be in high alert as the death toll and the number of confirmed cases is continuously rising since the first case was reported. The Chinese government warned that the transmission ability of the virus is increasing, and international efforts are needed to overcome this outbreak. The purpose of this review is to focus on the published articles about the new virus, which will give an insight into the current state of research and data available, as well as recommending future studies. METHODS: For this narrative review, more than 20 relevant scientific articles and reports were considered from various databases (e.g., Google Scholar, PubMed and Science Direct) using keywords such as Coronavirus Outbreak, COVID-19, Emerging Epidemics, Emerging Infections, and Novel Coronavirus. RESULTS: The results from this review show that the situation is rapidly evolving, as human-to-human transmission is occurring, and the number of new cases and mortalities is increasing by the day and on a global level. There is still ambiguity about mutation risks and how the virus spreads as the source was not yet identified. Major gaps in knowledge about the origin of the virus, epidemiology and transmission impose a great challenge, which emphasizes the need for further studies in the future.


title: Thin-section Computed Tomography Detects Long-term Pulmonary Sequelae 3 Years after Novel Influenza A Virus-associated Pneumonia

text: BACKGROUND: The aim of this research was to evaluate long-term pulmonary sequelae on paired inspiration-expiration thin-section computed tomography (CT) scans 3 years after influenza A (H1N1) virus-associated pneumonia, and to analyze the affecting factors on pulmonary fibrosis. METHODS: Twenty-four patients hospitalized with H1N1 virus-associated pneumonia at our hospital between September 2009 and January 2010 were included. The patients underwent thin-section CT 3 years after recovery. Abnormal pulmonary lesion patterns (ground-glass opacity, consolidation, parenchymal bands, air trapping, and reticulation) and evidence of fibrosis (architectural distortion, traction bronchiectasis, or honeycombing) were evaluated on follow-up thin-section CT. Patients were assigned to Group 1 (with CT evidence of fibrosis) and Group 2 (without CT evidence of fibrosis). Demographics, rate of mechanical ventilation therapy, rate of intensive care unit admission, cumulative prednisolone-equivalent dose, laboratory tests results (maximum levels of alanine aminotransferase, aspartate transaminase [AST], lactate dehydrogenase [LDH], and creatine kinase [CK]), and peak radiographic opacification of 24 patients during the course of their illness in the hospital were compared between two groups. RESULTS: Parenchymal abnormality was present in 17 of 24 (70.8%) patients and fibrosis occurred in 10 of 24 (41.7%) patients. Patients in Group 1 (10/24; 41.7%) had a higher rate of mechanical ventilation therapy (Z = −2.340, P = 0.019), higher number of doses of cumulative prednisolone-equivalent (Z = −2.579, P = 0.010), higher maximum level of laboratory tests results (AST [Z = −2.140, P = 0.032], LDH [Z = −3.227, P = 0.001], and CK [Z = −3.345, P = 0.019]), and higher peak opacification on chest radiographs (Z = −2.743, P = 0.006) than patients in group 2 (14/24; 58.3%). CONCLUSIONS: H1N1 virus-associated pneumonia frequently is followed by long-term pulmonary sequelae, including fibrotic changes, in lung parenchyma. Patients who need more steroid therapy, need more mechanical ventilation therapy, had higher laboratory tests results (maximum levels of AST, LDH, and CK), and had higher peak opacification on chest radiographs during treatment are more likely to develop lung fibrosis.


title: Investigation of the performance of TiO2 photocatalytic coatings

text: Abstract TiO2 photocatalysts were prepared and coated on surfaces. Ultrathin TiO2 coatings were obtained by wash-coating and screen-printing techniques. The latter provides films of excellent adhesion that could tolerate washing under water jet. The scratch-proof coatings were characterized, and X-ray diffraction (XRD), atomic force microscopy (AFM) and N2 physisorption indicated that the addition of polyethylene glycol (PEG) not only improved the coating properties of TiO2 but also served as poragen to produce high surface area, mesoporous TiO2. The coated TiO2 displayed better activity than the commercial P25 TiO2 for photocatalytic oxidation of ethylene, ethanol, acetaldehyde, isopropanol and acetone. The catalyst also exhibited excellent bactericidal, fungicidal and virucidal activities against a wide variety of Gram-positive and Gram-negative bacteria, fungal spores and T2 bacterial phage. A simple photoreactor with tangential air flow was designed and tested in a chamber, before incorporating in a prototype air purifier. The study showed that there is good agreement between laboratory catalyst reaction data (i.e., 110mmolh−1 for acetone) and the prototype test results (69mmolh−1).


title: Ultra-high-throughput clinical proteomics reveals classifiers of COVID-19 infection

text: Summary The COVID-19 pandemic is an unprecedented global challenge and point-of-care diagnostic classifiers are urgently required. Here, we present a platform for ultra-high throughput serum and plasma proteomics that builds on ISO13485 standardisation and high-flow liquid chromatography to facilitate implementation in clinical laboratories. Our low-cost workflow quantifies 180 proteomes per day per mass spectrometer, enables high precision quantification, and reduces batch effects for large-scale and longitudinal studies. We use our platform on samples collected from a cohort of early hospitalized cases of the SARS-CoV-2 pandemic and identify 27 potential biomarkers that are differentially expressed depending on the WHO severity grade of COVID-19. They include complement factors, the coagulation system, inflammation modulators, and pro-inflammatory upstream and downstream of interleukin 6. All protocols and software for implementing our approach are freely available. In total, our platform supports the development of routine proteomic assays to aid clinical decision making and generate hypotheses about potential COVID-19 therapeutic targets.


title: Spatiotemporal distribution of a non-haematophagous bat community and rabies virus circulation: a proposal for urban rabies surveillance in Brazil

text: In Brazil, rabies surveillance is based on monitoring domestic and wild animals, although the most prevalent lineage of the rabies virus (RABV) currently diagnosed in Brazil is associated with bats, particularly non-haematophagous bats. Disease control is based on the mass vaccination of dogs and cats. We used data collected by the passive surveillance system of the city of Campinas from 2011 to 2015, to describe the temporal and geographic distributions of the bat specimens and RABV and discuss the current rabies surveillance with the advent of the declaration of canine and feline rabies-free areas in Brazil. We described the species, locations and health statuses of the collected bat specimens. Moreover, all samples were submitted for RABV diagnosis. Then, we performed a time series decomposition for each bat family. Additionally, we determined the spatiotemporal relative risk for RABV infection using the ratio of the kernel-smoothed estimates of spatiotemporal densities of RABV-positive and RABV-negative bats. From the 2537 bat specimens, the most numerous family was Molossidae (72%), followed by Vespertilionidae (14%) and Phyllostomidae (13%). The bat families behaved differently in terms of seasonal and spatial patterns. The distribution of bats varied geographically in the urban environment, with Molossidae and Phyllostomidae being observed downtown and Vespertilionidae being observed in peripheral zones. Concurrently, a significant relative risk of RABV infection was observed downtown for Vespertilionidae and in peripheral zones for Molossidae. No RABV-positive sample clusters were observed. As a result of the official declaration of RABV-free areas in southern Brazil, mass dog and cat vaccinations are expected to halt in the near future. This stoppage would make most dog and cat populations susceptible to other RABV lineages, such as those maintained by non-haematophagous bats. In this scenario, all information available on bats and RABV distribution in urban areas is essential. Currently, few studies have been conducted. Some local health authorities, such as that in Campinas, are spontaneously basing their surveillance efforts on bat rabies, which is the alternative in reality scenario of increased susceptibility to bat-associated RABV that is developing in Brazil.


title: Granulomatous peritonitis and pleuritis in interferon‐γ gene knockout mice naturally infected with mouse hepatitis virus

text: Objective To investigate a disease outbreak in a colony of laboratory mice with targeted disruption of the gene for interferon‐γ FORMAT: A case report based on necropsy, histopathology, serology and immunohistochemistry. RESULTS: Affected mice exhibited depression and variable ascites. Necropsy revealed a granulomatous peritonitis and pleuritis with extensive adhesions although parenchymal lesions were minimal. Serum samples had high concentrations of antibody to mouse hepatitis virus and immunohistochemical examination revealed the presence of mouse hepatitis virus antigen in granuloma macrophages. Serological testing for other infectious agents and bacterial culture were negative and wild type mice kept in the same facility remained healthy. Despite the association between the disease and mouse hepatitis virus infection, the precise role played by mouse hepatitis virus was not determined. While the disease is superficially similar to feline infectious peritonitis (another coronavirus‐induced serositis), differences exist between the histopathological findings in these two conditions. CONCLUSION: This unusual disease process illustrates how new diagnostic challenges can arise in novel mouse genotypes created through molecular genetics. Furthermore, the association between the disease and mouse hepatitis virus illustrates the importance of maintaining laboratory animals under specific‐pathogen free conditions.


Bat super immunity to lethal disease could help protect people


title: The psychology behind the masks: Psychological responses to the severe acute respiratory syndrome outbreak in different regions

text: Severe acute respiratory syndrome (SARS) was first reported in China, and spread to 29 regions, affecting over 8000 people worldwide. For the general public, the psychological impact of SARS may have been greater than the physical health danger of the disease. The present paper proposes the influence of psychological factors on people's cognitive, affective, and behavioral responses during the SARS outbreak. The various papers in this special issue of the Journal reveal how people have reacted during the SARS outbreak: People's general coping styles may be related to their health behavior during the outbreak. Cultural differences were evident in the perception of SARS, and individuals’ perceptual styles may have influenced their ability to cope with the outbreak. The way in which individuals coped with SARS‐related stressful events was different from their usual practices of managing daily stress. Individual differences in the adoption of preventive measures were related to the distinct susceptibility to several social‐cognitive biases.


title: A Cross-Reactive Humanized Monoclonal Antibody Targeting Fusion Glycoprotein Function Protects Ferrets Against Lethal Nipah Virus and Hendra Virus Infection

text: BACKGROUND: Nipah virus (NiV) and Hendra virus (HeV) are zoonotic paramyxoviruses that cause severe disease in both animals and humans. There are no approved vaccines or treatments for use in humans; however, therapeutic treatment of both NiV and HeV infection in ferrets and nonhuman primates with a cross-reactive, neutralizing human monoclonal antibody (mAb), m102.4, targeting the G glycoprotein has been demonstrated. In a previous study, we isolated, characterized, and humanized a cross-reactive, neutralizing anti-F mAb (h5B3.1). The mAb h5B3.1 blocks the required F conformational change needed to facilitate membrane fusion and virus infection, and the epitope recognized by h5B3.1 has been structurally defined; however, the efficacy of h5B3.1 in vivo is unknown. METHODS: The postinfection antiviral activity of h5B3.1 was evaluated in vivo by administration in ferrets after NiV and HeV virus challenge. RESULTS: All subjects that received h5B3.1 from 1 to several days after infection with a high-dose, oral-nasal virus challenge were protected from disease, whereas all controls died. CONCLUSIONS: This is the first successful postexposure antibody therapy for NiV and HeV using a humanized cross-reactive mAb targeting the F glycoprotein, and the findings suggest that a combination therapy targeting both F and G should be evaluated as a therapy for NiV/HeV infection.


561. Recombinant Adenovirus Carrying Spike Gene Induces Effective Humoral and Cellular Immunity Against SARS-CoV in Rats


title: Identification and Characterization of a Human Coronavirus 229E Nonstructural Protein 8-Associated RNA 3′-Terminal Adenylyltransferase Activity

text: Coronavirus nonstructural protein 8 (nsp8) has been suggested to have diverse activities, including noncanonical template-dependent polymerase activities. Here, we characterized a recombinant form of the human coronavirus 229E (HCoV-229E) nsp8 and found that the protein has metal ion-dependent RNA 3′-terminal adenylyltransferase (TATase) activity, while other nucleotides were not (or very inefficiently) transferred to the 3′ ends of single-stranded and (fully) double-stranded acceptor RNAs. Using partially double-stranded RNAs, very efficient TATase activity was observed if the opposite (template) strand contained a short 5′ oligo(U) sequence, while very little (if any) activity was detected for substrates with other homopolymeric or heteropolymeric sequences in the 5′ overhang. The oligo(U)-assisted/templated TATase activity on partial-duplex RNAs was confirmed for two other coronavirus nsp8 proteins, suggesting that the activity is conserved among coronaviruses. Replacement of a conserved Lys residue with Ala abolished the in vitro RNA-binding and TATase activities of nsp8 and caused a nonviable phenotype when the corresponding mutation was introduced into the HCoV-229E genome, confirming that these activities are mediated by nsp8 and critical for viral replication. In additional experiments, we obtained evidence that nsp8 has a pronounced specificity for adenylate and is unable to incorporate guanylate into RNA products, which strongly argues against the previously proposed template-dependent RNA polymerase activity of this protein. Given the presence of an oligo(U) stretch at the 5′ end of coronavirus minus-strand RNAs, it is tempting to speculate (but remains to be confirmed) that the nsp8-mediated TATase activity is involved in the 3′ polyadenylation of viral plus-strand RNAs. IMPORTANCE Previously, coronavirus nsp8 proteins were suggested to have template-dependent RNA polymerase activities resembling those of RNA primases or even canonical RNA-dependent RNA polymerases, while more recent studies have suggested an essential cofactor function of nsp8 (plus nsp7) for nsp12-mediated RNA-dependent RNA polymerase activity. In an effort to reconcile conflicting data from earlier studies, the study revisits coronavirus nsp8-associated activities using additional controls and proteins. The data obtained for three coronavirus nsp8 proteins provide evidence that the proteins share metal ion-dependent RNA 3′ polyadenylation activities that are greatly stimulated by a short oligo(U) stretch in the template strand. In contrast, nsp8 was found to be unable to select and incorporate appropriate (matching) nucleotides to produce cRNA products from heteropolymeric and other homooligomeric templates. While confirming the critical role of nsp8 in coronavirus replication, the study amends the list of activities mediated by coronavirus nsp8 proteins in the absence of other proteins.


ABSTRACT: Since a novel coronavirus was discovered from a cluster of patients with emerging pneumonia of unknown etiology in Wuhan, China, it has spread rapidly through droplet and contact transmission. Recently, the novel coronavirus pneumonia which was named COVID-19 by the World Health Organization (WHO) has been raised as a worldwide problem. Radiological examinations were confirmed as effective methods for the screening and diagnosis of COVID-19. It is reported that some radiologists and radiological technologists were infected when giving examinations to the patients with COVID-19. In order to reduce the infection risk of medical staff in radiology department, we summarized the experience on prevention and control measures in radiology department for COVID-19, aiming to guide the prevention and practical work for radiologists and radiological technologists. KEY POINTS: • The novel coronavirus spreads rapidly through droplet and contact transmission. • Radiologists and radiological technologists were possibly infected by patients. • Prevention and control measures in radiology department for COVID-19 are important.


title: Viral Pneumonia Requiring Differentiation from Acute and Progressive Diffuse Interstitial Lung Diseases

text: OBJECTIVE: The clinical characteristics and chest imaging findings of viral pneumonia and several interstitial lung diseases (ILDs) overlap, and viral pneumonia may be underrecognized and misdiagnosed as certain ILDs. To clarify the frequency of viral pneumonia among patients with acute progressive clinical courses that required a differential diagnosis between ILDs and pneumonia, and to determine the most frequent ILDs misdiagnosed in cases of viral pneumonia. PATIENTS AND METHODS: We retrospectively analyzed patients hospitalized from 2010 to 2017 with an acute clinical course (≤30 days) who underwent bronchoalveolar lavage (BAL) for the differential diagnosis of infection and ILDs. We performed a multiplex PCR for respiratory viruses using the patients' preserved BAL fluid. The final diagnosis was made by a multidisciplinary approach and after considering the PCR results. The diagnosis at discharge was compared to the final diagnosis. RESULTS: Among the 109 patients, 53 were diagnosed with viral pneumonia. Viral pneumonia and other diseases showed some differences in symptoms and laboratory data; however, the differences were small or overlapped. Viral pneumonia was misdiagnosed on discharge as acute fibrinous organizing pneumonia, cryptogenic organizing pneumonia, or chronic eosinophilic pneumonia (AFOP/COP/CEP) (n=22), acute interstitial pneumonia (n=5), connective tissue disease-related ILDs (n=3), unclassifiable interstitial pneumonia (n=2), drug-induced ILD (n=1), and pneumonia (n=20). CONCLUSION: Approximately half of the patients who underwent BAL had viral pneumonia. The most common ILD-related misdiagnoses were AFOP/COP/CEP. Differences in symptoms and laboratory findings between viral pneumonia and other diseases were small, and viral pneumonia should be included in the differential diagnosis when physicians encounter cases in which the abovementioned ILDs are suspected.


title: Clinical features, isolation, and complete genome sequence of severe acute respiratory syndrome coronavirus 2 from the first two patients in Vietnam

text: In January 2020, we identified two SARS‐CoV‐2 infections in a familial cluster with one person coming from Wuhan, China. The complete genome sequences of two SARS‐CoV‐2 strains isolated from these patients were identical and 99.98% similar to strains isolated in Wuhan. This is genetically suggestive of human‐to‐human transmission of SARS‐CoV‐2 and indicates Wuhan as the most plausible origin of the early outbreak in Vietnam. The younger patient with a mild upper respiratory illness and a brief viral shedding, while the elderly with multi‐morbidity had pneumonia, prolonged viral shedding, and residual lung damage. Evidence of nonsynonymous substitutions in the ORF1ab region of the viral sequence warrants further studies. This article is protected by copyright. All rights reserved.


title: The Third and Fatal Shock: How Pandemic Killed the Millennial Paradigm

text: This millennium began with widespread acceptance of a governing paradigm emphasizing small government, free markets and open borders. Three crises – the 9/11 attacks, the 2008 financial crisis, and the 2020 COVID‐19 pandemic – forced American policymakers to diverge from this paradigm. At the time, these divergences were described as temporary departures from normalcy. In retrospect, it would be more accurate to regard the millennial paradigm itself as the abnormality: as a model of governance designed for rare moments of calm. In the last two decades, a different paradigm has emerged. American government has become the ultimate bearer of societal risks. Repeatedly, it has adopted extraordinary measures to protect public safety and the economy. However, the American state lacks the capacity to anticipate and manage these massive risks competently. New capabilities are required, along with a new mentality about governing. Domestic politics will complicate the task of building these capabilities. This article is protected by copyright. All rights reserved.


title: Hepatitis Relapse after Yellow Fever Infection: Is There Another Wave?

text: During the yellow fever (YF) outbreak in Brazil, many cases of fulminant hepatitis were seen, although mild to moderate hepatitis was mostly observed with complete recovery. This report presents a case of late-onset hepatitis due to YF relapse. The patient sought medical attention after jaundice recurrence 40 days after the first YF hepatitis episode. This case highlights the importance of patient follow-up after the complete resolution of YF symptoms and discharge.


The Urgency of Care during the Covid-19 Pandemic — Learning as We Go


title: Blockchain and Artificial Intelligence Technology for Novel Coronavirus Disease 2019 Self-Testing

text: The novel coronavirus disease 2019 (COVID-19) is rapidly spreading with a rising death toll and transmission rate reported in high income countries rather than in low income countries. The overburdened healthcare systems and poor disease surveillance systems in resource-limited settings may struggle to cope with this COVID-19 outbreak and this calls for a tailored strategic response for these settings. Here, we recommend a low cost blockchain and artificial intelligence-coupled self-testing and tracking systems for COVID-19 and other emerging infectious diseases. Prompt deployment and appropriate implementation of the proposed system have the potential to curb the transmissions of COVID-19 and the related mortalities, particularly in settings with poor access to laboratory infrastructure.


title: Cryptosporidium parvum and Giardia intestinalis in Calf Diarrhoea in Sweden

text: The objective of this study conducted in 75 herds was to investigate the presence and significance of Cryptosporidium parvum and Giardia intestinalis in Swedish dairy calves in comparison with rotavirus, coronavirus and Escherichia coli K99+. The farmers were asked to collect faecal samples from each heifer calf that had diarrhoea between birth and 90 days of age, and also from a healthy calf of the same age. In total, 270 samples were collected and analysed. C. parvum, either alone or together with G. intestinalis and/or rotavirus, was detected in 16 (11%) and 6 (5%) of the samples from diarrhoeic and healthy calves, respectively. Even though a higher proportion of diarrhoeic calves shed C. parvum, the difference between the groups was not statistically significant (p = 0.067), possibly due to the low number of positive samples. G. intestinalis was found in 42 (29%) of the diarrhoea samples and in 29 (23%) of the samples from healthy calves. Rotavirus and coronavirus were demonstrated in 24% and 3% of the diarrhoea samples, respectively, whereas E. coli K99+ was only found in samples from 2 healthy calves. C. parvum and G. intestinalis were found in samples from calves 7 to 84 days of age and during all seasons. The results confirm that C. parvum is present in Swedish dairy herds and might have clinical significance. G. intestinalis was the most common agent found but the importance of this parasite remains unclear. Both parasites have suggested zoonotic potential and thus warrant further attention. In addition, rotavirus is a major pathogen in neonatal enteritis in Sweden, whereas coronavirus and E. coli K99+ seem to be of less importance.


title: Gene Expression Networks in the Murine Pulmonary Myocardium Provide Insight into the Pathobiology of Atrial Fibrillation

text: The pulmonary myocardium is a muscular coat surrounding the pulmonary and caval veins. Although its definitive physiological function is unknown, it may have a pathological role as the source of ectopic beats initiating atrial fibrillation. How the pulmonary myocardium gains pacemaker function is not clearly defined, although recent evidence indicates that changed transcriptional gene expression networks are at fault. The gene expression profile of this distinct cell type in situ was examined to investigate underlying molecular events that might contribute to atrial fibrillation. Via systems genetics, a whole-lung transcriptome data set from the BXD recombinant inbred mouse resource was analyzed, uncovering a pulmonary cardiomyocyte gene network of 24 transcripts, coordinately regulated by chromosome 1 and 2 loci. Promoter enrichment analysis and interrogation of publicly available ChIP-seq data suggested that transcription of this gene network may be regulated by the concerted activity of NKX2-5, serum response factor, myocyte enhancer factor 2, and also, at a post-transcriptional level, by RNA binding protein motif 20. Gene ontology terms indicate that this gene network overlaps with molecular markers of the stressed heart. Therefore, we propose that perturbed regulation of this gene network might lead to altered calcium handling, myocyte growth, and contractile force contributing to the aberrant electrophysiological properties observed in atrial fibrillation. We reveal novel molecular interactions and pathways representing possible therapeutic targets for atrial fibrillation. In addition, we highlight the utility of recombinant inbred mouse resources in detecting and characterizing gene expression networks of relatively small populations of cells that have a pathological significance.


title: The Supramap project: linking pathogen genomes with geography to fight emergent infectious diseases

text: Novel pathogens have the potential to become critical issues of national security, public health and economic welfare. As demonstrated by the response to Severe Acute Respiratory Syndrome (SARS) and influenza, genomic sequencing has become an important method for diagnosing agents of infectious disease. Despite the value of genomic sequences in characterizing novel pathogens, raw data on their own do not provide the information needed by public health officials and researchers. One must integrate knowledge of the genomes of pathogens with host biology and geography to understand the etiology of epidemics. To these ends, we have created an application called Supramap (http://supramap.osu.edu) to put information on the spread of pathogens and key mutations across time, space and various hosts into a geographic information system (GIS). To build this application, we created a web service for integrated sequence alignment and phylogenetic analysis as well as methods to describe the tree, mutations, and host shifts in Keyhole Markup Language (KML). We apply the application to 239 sequences of the polymerase basic 2 (PB2) gene of recent isolates of avian influenza (H5N1). We map a mutation, glutamic acid to lysine at position 627 in the PB2 protein (E627K), in H5N1 influenza that allows for increased replication of the virus in mammals. We use a statistical test to support the hypothesis of a correlation of E627K mutations with avian‐mammalian host shifts but reject the hypothesis that lineages with E627K are moving westward. Data, instructions for use, and visualizations are included as supplemental materials at: http://supramap.osu.edu/sm/supramap/publications. © The Willi Hennig Society 2010.


title: Using Clinicians’ Search Query Data to Monitor Influenza Epidemics

text: Search query information from a clinician's database, UpToDate, is shown to predict influenza epidemics in the United States in a timely manner. Our results show that digital disease surveillance tools based on experts' databases may be able to provide an alternative, reliable, and stable signal for accurate predictions of influenza outbreaks.


title: A Rapid Advice Guideline for the Prevention of Novel Coronavirus Through Nutritional Intervention

text: PURPOSE OF REVIEW: An unexpected and sudden outbreak of a novel infection known as a coronavirus (COVID-19) has imposed important problems to global well-being and economy. Based upon current researches, this virus is spreading from one human to another through respiratory droplets, i.e. cough and sneeze. Till now, there has not been any specific treatment found for this virus. Hence, there is a critical need to discover alternative techniques to cope with the current scenario. RECENT FINDINGS: This review conducted an online search for prevention of coronavirus infection with the help of nutritional interventions. It has been observed that the effect of the virus is mostly on the individual with low immunity, individual affected with diseases like diabetes, and individual using any immune-suppressed drug or having past history of major surgeries or severe medical conditions. SUMMARY: Therefore, consuming foods which boost immunity helps in preventing respiratory-related disorder or suppressing diseases-related problems, which could be helpful in controlling the spread of this virus. In conclusion, it has been suggested that before the beginning of generalised treatments and interventions in each infected patient, nutritional status should be evaluated, as it can help in creating a specific nutrition intervention for the infected individual.


title: Anti-SARS drug screening by molecular docking

text: Starting from a collection of 1386 druggable compounds obtained from the 3D pharmacophore search, we performed a similarity search to narrow down the scope of docking studies. The template molecule is KZ7088 (Chou et al., 2003, Biochem Biophys Res Commun 308: 148–151). The MDL MACCS keys were used to fingerprint the molecules. The Tanimoto coefficient is taken as the metric to compare fingerprints. If the similarity threshold was 0.8, a set of 50 unique hits and 103 conformers were retrieved as a result of similarity search. The AutoDock 3.011 was used to carry out molecular docking of 50 ligands to their macromolecular protein receptors. Three compounds, i.e., C(28)H(34)O(4)N(7)Cl, C(21)H(36)O(5)N(6), and C(21)H(36)O(5)N(6), were found that may be promising candidates for further investigation. The main feature shared by these three potential inhibitors as well as the information of the involved side chains of SARS Cov Mpro may provide useful insights for the development of potent inhibitors against SARS enzyme.


title: Rapid Synthesis of Iminosugar Derivatives for Cell‐Based In Situ Screening: Discovery of “Hit” Compounds with Anticancer Activity

text: Effective and efficacious drug screening methods are imperative in the drug discovery process. A library has been constructed efficiently and followed by in situ cell‐based screening without product purification. This method led to discovery of several iminosugar derivatives with anticancer activity.[Image: see text]


title: Hot topics en infecciones respiratorias

text: Resumen Revisión crítica de los artículos sobre infecciones respiratorias publicados en el último trimestre de 2008 y el presente año. En los pacientes con bronquiectasias destacan artículos que estudian su calidad de vida, así como los que analizan la disminución del número de exacerbaciones por el efecto inmunomodulador de la utilización de macrólidos a dosis bajas en estos pacientes. En el diagnóstico de la tuberculosis, son especialmente relevantes los trabajos sobre la aplicación del interferón gamma, mientras que en el tratamiento de esta afección destacan los artículos que estudian innovaciones terapéuticas en el tratamiento de la TB-MDR y TB-XDR o -TDR. En cuanto a las publicaciones referidas a las neumonías, son llamativas las que analizan la evolución de las neumonías adquiridas en la comunidad (NAC) en pacientes afectados de enfermedad pulmonar obstructiva crónica. Asimismo, cobran especial relevancia los estudios iniciales epidemiológicos y clínicos de la pandemia por gripe A (H1N1). También son de interés la valoración de las escalas pronósticas como predictoras de soporte ventilatorio y/o del uso de aminas presoras, así como el uso de los marcadores biológicos como complemento del valor predictivo de las citadas escalas pronósticas. Siguen teniendo gran interés los estudios etiológicos y clínicos de las neumonías asociadas al sistema de salud y sus posibles diferencias respecto a las NAC. En cuanto al tratamiento de las neumonías, son interesantes los análisis de la probable capacidad moduladora de la inflamación de diversos fármacos. Abstract A critical review of articles on respiratory infections published in the last three months of 2008 to the end of 2009. There are articles on patients with bronchiectasis that study their quality of life, as well as those that analyse the decrease in the number of exacerbations due to the immunomodulatory effect of using low doses of macrolides in these patients. In the diagnosis of tuberculosis, works on the application of interferon-Á are especially relevant, whilst on the treatment of this disease, articles that study therapeutic innovations in the management of TB-MDR and TB-XDR or -TDR are also highlighted. As far as publications on pneumonia are concerned, there are those that analyse the progression of community acquired pneumonias (CAP) in patients affected with chronic obstructive pulmonary disease. Furthermore, special importance is given to the initial epidemiological and clinical studies of the influenza A (H1N1) pandemic. Also of interest is the evaluation of prognostic scales as predictors of ventilation support and/or the use of pressor amines, as well as the use of biological markers to complement the predictive value of these prognostic scales. Aetiological and clinical studies of pneumonias associated with the health system continue to be of great interest and their possible differences compared to CAPs. Also of interest in the treatment of the pneumonias, is the analysis of the potential inflammation modulatory ability of different drugs.


title: Pandemic brings accessible mental health care to rural Texas

text: The COVID‐19 pandemic has created widespread fear and economic anxiety across Texas, and mental health experts and advocates say rural areas — which already had fewer providers and higher rates of suicide and drug overdoses — could see more severe mental health impacts than the state's urban areas. They are predicting a lingering wave of trauma and depression even after the pandemic's immediate effects recede and lockdowns lift, the Fort Worth Business Press reported June 9. “There's a lot of bad things happening right now because of COVID‐19,” said Andy Keller, president and CEO of the Texas‐based Meadows Mental Health Policy Institute. “But in some ways, people in rural Texas have better access to health care than they'd ever had before. All the barriers to them accessing physicians across the state have been lifted.” In April, Gov. Greg Abbott temporarily waived restrictions on telehealth, allowing mental health care providers and local mental health authorities to broadly expand services and collect reimbursement for online appointments more easily. The state also implemented a mental health hotline in March that offers free over‐the‐phone support and provides resources and information to callers who need help.


title: Intervention Protocol of the Orthopedics and Traumatology Department of a High-Complexity University Hospital to Cope with the COVID-19 Pandemic

text: Objective To describe the protocols implemented to adapt the orthopedic team to the COVID-19 pandemic; a secondary objective is to assess the behavior of hospital and departmental variables when implementing such measures. Methods The present is a retrospective study describing three protocols: 1) reduction in the risk of infection for patients and healthcare workers; 2) adaptation of work, academic and scientific activities; and 3) adaptation of the orthopedic treatment during the pandemic. We analyzed hospital and departmental variables, including the number of patients seen in the emergency room and outpatient clinic, the number of hospitalized patients, suspected and confirmed cases in patients and orthopedic team members, changes in teaching activities from on-site attendance to videoconferencing, and number of surgeries. Period A, from March 3 to 16, was compared with period B, from March 17 to 30, 2020, which corresponded to the implementation of the protocols. Results There was a decrease in the number of outpatients and inpatients. One confirmed and two suspected cases were notified. Among the departmental members, there were 12 suspected and 6 confirmed cases. The weekly frequency of classes was maintained, while the clinical-scientific meetings decreased from ten to three. In addition, the number of surgeries was reduced. Conclusions The present study demonstrated the feasibility and efficiency of the rapid implementation of intervention protocols in the midst of the COVID-19 pandemic. The protocols focused on reducing the risk of infection for patients and healthcare professionals, adapting work, academic and scientific activities, and modifying the orthopedic treatment. With the application of the protocols, the healthcare, academic and scientific activities remained functional, prioritizing measures to confront the COVID-19 pandemic.


title: Structure of coronavirus main proteinase reveals combination of a chymotrypsin fold with an extra α-helical domain

text: The key enzyme in coronavirus polyprotein processing is the viral main proteinase, M(pro), a protein with extremely low sequence similarity to other viral and cellular proteinases. Here, the crystal structure of the 33.1 kDa transmissible gastroenteritis (corona)virus M(pro) is reported. The structure was refined to 1.96 Å resolution and revealed three dimers in the asymmetric unit. The mutual arrangement of the protomers in each of the dimers suggests that M(pro) self-processing occurs in trans. The active site, comprised of Cys144 and His41, is part of a chymotrypsin-like fold that is connected by a 16 residue loop to an extra domain featuring a novel α-helical fold. Molecular modelling and mutagenesis data implicate the loop in substrate binding and elucidate S1 and S2 subsites suitable to accommodate the side chains of the P1 glutamine and P2 leucine residues of M(pro) substrates. Interactions involving the N-terminus and the α-helical domain stabilize the loop in the orientation required for trans-cleavage activity. The study illustrates that RNA viruses have evolved unprecedented variations of the classical chymotrypsin fold.


title: Detection, sequence analysis, and antibody prevalence of porcine deltacoronavirus in Taiwan

text: Porcine deltacoronavirus (PDCoV) was initially documented in Hong Kong and later in the United States, South Korea, and Thailand. To investigate if PDCoV is also present in Taiwan, three swine coronaviruses—PDCoV, porcine epidemic diarrhea virus (PEDV), and transmissible gastroenteritis coronavirus (TGEV)—were tested using real-time reverse transcription polymerase chain reaction (rRT-PCR) in 172 rectal swab samples from piglets exhibiting diarrhea between January 2016 and May 2017 on 68 pig farms in Taiwan. The rRT-PCR results were positive for PDCoV (29/172, 16.9%), PEDV (36/172, 20.9%), TGEV (2/172, 1.2%), and coinfections (16/172, 9.3%). After cloning and sequencing, PDCoV nucleocapsid genes were analyzed. Phylogeny results indicated that the nucleotide sequences of all isolates were like those reported in other countries. To further trace PDCoV in the period of 2011 to 2015, an enzyme-linked immunosorbent assay (ELISA) was used to detect antibodies against PDCoV. The results showed that 279 of 1,039 (26.9%) sera were positive for the PDCoV nucleocapsid protein, implying that PDCoV might have existed in Taiwan before 2011.


Nitazoxanide May Modify the Course of Progressive Multifocal Leukoencephalopathy


title: Dealing with bio- and ecological complexity: Challenges and opportunities

text: Abstract The complexities of the dynamic processes and their control associated with biological and ecological systems offer many challenges for the control engineer. Over the past decades the application of dynamic modelling and control has aided understanding of their complexities. At the same time using such complex systems as test-beds for new control methods has highlighted their limitations (e.g. in relation to system identification) and has thus acted as a catalyst for methodological advance. This paper continues the theme of exploring opportunities and achievements in applying modelling and control in the bio- and ecological domains.


title: Physics in a time of COVID-19

text: As the number of COVID-19 cases continues to grow around the world, physicists — many of whom rely on international travel and collaborations — are adapting.


title: “Optimization of Surgical Resident Safety and Education During the COVID-19 Pandemic - Lessons Learned“

text: The COVID-19 pandemic has engendered rapid and significant changes in clinical patient care. Within the realm of surgical training, the resultant reduction in clinical exposure and case volume jeopardizes the quality of surgical training. Thus, our general surgery residency program proceeded to develop a tailored approach to training that mitigates impact on resident surgical education and optimizes clinical exposure without compromising safety. Residents were engaged directly in planning efforts to craft a response to the pandemic. Following the elimination of elective cases, the in-house resident complement was effectively decreased to reduce unnecessary exposure, with a back-up pool to address unanticipated absences and needs. PPE availability and supply, the greatest concern to residents, has remained adequate, while being utilized according to current guidelines. Interested residents were given the opportunity to work in designated COVID ICUs on a volunteer basis. With the decrease in operative volume and clinical duties, we shifted our educational focus to an intensive didactic schedule using a teleconferencing platform and targeting areas of weakness on prior in-service exams. We also highlighted critical COVID-19 literature in a weekly journal club to better understand this novel disease and its effect on surgical practice. The long-term impact of the COVID-19 pandemic on resident education remains to be seen. Success may be achieved with commitment to constant needs assessment in the changing landscape of healthcare with the goal of producing a skilled surgical workforce for public service.


title: Immunologic perturbations in severe COVID-19/SARS-CoV-2 infection

text: Although critical illness has been associated with SARS-CoV-2-induced hyperinflammation, the immune correlates of severe COVID-19 remain unclear. Here, we comprehensively analyzed peripheral blood immune perturbations in 42 SARS-CoV-2 infected and recovered individuals. We identified broad changes in neutrophils, NK cells, and monocytes during severe COVID-19, suggesting excessive mobilization of innate lineages. We found marked activation within T and B cells, highly oligoclonal B cell populations, profound plasmablast expansion, and SARS-CoV-2-specific antibodies in many, but not all, severe COVID-19 cases. Despite this heterogeneity, we found selective clustering of severe COVID-19 cases through unbiased analysis of the aggregated immunological phenotypes. Our findings demonstrate broad immune perturbations spanning both innate and adaptive leukocytes that distinguish dysregulated host responses in severe SARS-CoV-2 infection and warrant therapeutic investigation. One Sentence Summary Broad immune perturbations in severe COVID-19


title: Antiviral activity of a Bacillus sp. P34 peptide against pathogenic viruses of domestic animals

text: P34 is an antimicrobial peptide produced by a Bacillus sp. strain isolated from the intestinal contents of a fish in the Brazilian Amazon basin with reported antibacterial activity. The aim of this work was to evaluate the peptide P34 for its in vitro antiviral properties against canine adenovirus type 2 (CAV-2), canine coronavirus (CCoV), canine distemper virus (CDV), canine parvovirus type 2 (CPV-2), equine arteritis virus (EAV), equine influenza virus (EIV), feline calicivirus (FCV) and feline herpesvirus type 1 (FHV-1). The results showed that the peptide P34 exhibited antiviral activity against EAV and FHV-1. The peptide P34 inhibited the replication of EAV by 99.9% and FHV-1 by 94.4%. Virucidal activity was detected only against EAV. When P34 and EAV were incubated for 6 h at 37 °C the viral titer reduced from 10(4.5) TCID(50) to 10(2.75) TCID(50), showing a percent of inhibition of 98.6%. In conclusion, our results demonstrated that P34 inhibited EAV and FHV-1 replication in infected cell cultures and it showed virucidal activity against EAV. Since there is documented resistance to the current drugs used against herpesviruses and there is no treatment for equine viral arteritis, it is advisable to search for new antiviral compounds to overcome these infections.


title: Guidelines for vaccination of dogs and cats in Korea

text: This guideline contains the recommended vaccination schedules of dogs and cats from World Small Animal Veterinary Association (WSAVA) and American Animal Hospital Association (AAHA). In 2010, WSAVA published guidelines for the vaccination of dogs and cats. And, in 2011, AAHA also published guidelines for vaccination of dogs. In Korea, there is no published guideline for vaccination of dogs and cats yet. Therefore, the plane of vaccination also reports the present situation of vaccination schedule of dogs and cats in Korean animal hospitals.


title: Transmission and evolutionary dynamics of human coronavirus OC43 strains in coastal Kenya investigated by partial spike sequence analysis, 2015–16

text: Human coronavirus OC43 (HCoV-OC43) is a major contributor to seasonal outbreaks of acute respiratory illness (ARI). The origins of locally circulating HCoV-OC43 strains and characteristics of their genetic diversity are unknown for most settings despite significance to effective HCoV control strategies. Between December 2015 and June 2016, we undertook ARI surveillance in coastal Kenya in nine outpatients and one inpatient health facility (HF). Ninety-two patient samples tested HCoV-OC43 positive and forty (43.5%) were successfully sequenced in spike (S) gene region (2,864 long, ∼70%). Phylogenetic analysis confirmed co-circulation of two distinct HCoV-OC43 clades that closely clustered with genotype G (n = 34, 85%) and genotype H (n = 6, 15%) reference strains. Local viruses within the same clade displayed low genetic diversity yielding identical sequences in multiple HF. Furthermore, the newly sequenced Kenyan viruses showed close phylogenetic relationship to other contemporaneous sampled strains (2015–16) including those originating from distant places (e.g. USA and China). Using a genetic similarity threshold of 99.1 per cent at nucleotide level, the HCoV-OC43 strains sampled globally between 1967 and 2019 fell into nine sequence clusters. Notably, some of these clusters appeared to have become extinct, or occurred only sporadically in a few geographical areas while others persisted globally for multiple years. In conclusion, we found that HCoV-OC43 strains spread rapidly both locally and across the globe with limited genetic evolution in the spike gene. Full-genome sequences that are spatio-temporally representative are required to advance understanding of the transmission pathways of this important human respiratory pathogen.


title: A review of modern technologies for tackling COVID-19 pandemic

text: Abstract Objective Science and technology sector constituting of data science, machine learning and artificial intelligence are contributing towards COVID-19. The aim of the present study is to discuss the various aspects of modern technology used to fight against COVID-19 crisis at different scales, including medical image processing, disease tracking, prediction outcomes, computational biology and medicines. Methods A progressive search of the database related to modern technology towards COVID-19 is made. Further, a brief review is done on the extracted information by assessing the various aspects of modern technologies for tackling COVID-19 pandemic. Results We provide a window of thoughts on review of the technology advances used to decrease and smother the substantial impact of the outburst. Though different studies relating to modern technology towards COVID-19 have come up, yet there are still constrained applications and contributions of technology in this fight. Conclusions On-going progress in the modern technology has contributed in improving people's lives and hence there is a solid conviction that validated research plans including artificial intelligence will be of significant advantage in helping people to fight this infection.


Student placement adaptability during COVID‐19: Lessons learnt in 2020


title: Acute Liver Injury in COVID‐19: Prevalence and Association with Clinical Outcomes in a Large US Cohort

text: BACKGROUND & AIMS: Coronavirus disease 2019 (COVID‐19) has been associated with acute liver injury manifested by increased liver enzymes in reports worldwide. Prevalence of liver injury and associated clinical characteristics are not well‐defined. We aim to identify the prevalence of and risk factors for development of COVID‐19 associated acute liver injury in a large cohort in the United States. APPROACH & RESULTS: In this retrospective cohort study, all patients who underwent SARS‐CoV‐2 testing at three hospitals in the NewYork‐Presbyterian network were assessed. Of 3381 patients, 2273 tested positive and had higher initial and peak ALT than those who tested negative. Acute liver injury was categorized as mild if alanine aminotransferase (ALT) was > upper limit of normal (ULN) but < two times ULN, moderate if ALT was between two and five times ULN, and severe if ALT was > five times ULN. Among patients who tested positive, 45% had mild, 21% moderate, and 6.4% severe liver injury. In multivariable analysis, severe acute liver injury was significantly associated with elevated inflammatory markers including ferritin (OR 2.40, p<0.001) and IL‐6 (OR 1.45, p=0.009). Patients with severe liver injury had a more severe clinical course, including higher rates of ICU admission (69%), intubation (65%), renal replacement therapy (33%), and mortality (42%). In multivariable analysis, peak ALT was significantly associated with death or discharge to hospice (OR 1.14, p=0.044), controlling for age, body mass index, diabetes, hypertension, intubation, and renal replacement therapy. CONCLUSION: Acute liver injury is common in patients who test positive for SARS‐CoV‐2, but is most often mild. However, among the 6.4% of patients with severe liver injury, a severe disease course should be anticipated.


title: Ebola: A Hyperinflated Emergency

text: As with the Ebola outbreak, global under-5 mortality and morbidity should be considered a public health emergency of international concern.


title: The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Indonesia

text: In 1986, the National Nuclear Energy Agency (Batan) in Jakarta started the research and development for the setting up of a tissue bank (Batan Research Tissue Bank/BRTB) by preserving fresh amnion or fetal membranes by lyophilisation and then sterilising by gamma irradiation. During the period of 1990 and 2000, three more tissue banks were set up, i.e., Biomaterial Centre in Surabaya, Jamil Tissue Bank in Padang, and Sitanala Tissue Bank in Tangerang. In 1994, BRTB produced bone allografts. The banks established under the IAEA program concentrated its work on the production of amnion, bone and soft tissues allografts, as well as bone xenografts. These tissues (allografts and xenografts) were sterilised using gamma irradiation (about 90%) and the rest were sterilized by ETO and those products have been used in the treatment of patients at more than 50 hospitals in Indonesia. In 2004, those tissue banks produced 8,500 grafts and 5,000 of them were amnion grafts for eye treatment and wound dressing. All of those grafts were used for patients as well as for research. In 2006, the production increased to 9,000 grafts. Although the capacity of those banks can produce more grafts, we are facing problems on getting raw materials from suitable donors. To fulfill the demand of bone grafts we also produced bone xenografts. The impact of the IAEA program in tissue banking activities in Indonesia can be summarised as follows: to support the national program on importing substitutes for medical devices. The price of imported tissues are between US$ 50 and US$ 6,000 per graft. Local tissue bank can produce tissues with the same quality with the price for about 10–30% of the imported tissues.


title: Pathogenic viruses: Molecular detection and characterization

text: Abstract Pathogenic viruses are viruses that can infect and replicate within human cells and cause diseases. The continuous emergence and re-emergence of pathogenic viruses has become a major threat to public health. Whenever pathogenic viruses emerge, their rapid detection is critical to enable implementation of specific control measures and the limitation of virus spread. Further molecular characterization to better understand these viruses is required for the development of diagnostic tests and countermeasures. Advances in molecular biology techniques have revolutionized the procedures for detection and characterization of pathogenic viruses. The development of PCR-based techniques together with DNA sequencing technology, have provided highly sensitive and specific methods to determine virus circulation. Pathogenic viruses potentially having global catastrophic consequences may emerge in regions where capacity for their detection and characterization is limited. Development of a local capacity to rapidly identify new viruses is therefore critical. This article reviews the molecular biology of pathogenic viruses and the basic principles of molecular techniques commonly used for their detection and characterization. The principles of good laboratory practices for handling pathogenic viruses are also discussed. This review aims at providing researchers and laboratory personnel with an overview of the molecular biology of pathogenic viruses and the principles of molecular techniques and good laboratory practices commonly implemented for their detection and characterization.


title: Inhibitory effect of sodium houttuyfonate on synovial proliferation in vitro in cells from a patient with rheumatoid arthritis

text: The aim of the present study was to investigate the inhibitory effect of sodium houttuyfonate (SH) on synovial cell proliferation in vitro. Primary cells were obtained from the synovial tissue of a patient with rheumatoid arthritis (RA). The cells were divided into five treatment groups as follows: the control group (group 1), 25 μg/ml SH-treated group (group 2), 50 μg/ml SH-treated group (group 3), 100 μg/ml SH-treated group (group 4) and the 200 μg/ml SH-treated group (group 5). Following seven days of treatment, the proliferation rate of the synovial cells was then detected using an MTT assay. The expression level of proliferative synovial cells markedly decreased in the SH-treated groups in a dose-dependent manner compared with the control group. In conclusion, the present study demonstrated that SH was able to inhibit the proliferation of synovial cells obtained from a patient with RA. These results provide a potential theoretical basis for the development of a safe and effective treatment against RA in the future.


title: Genomic characterization and pathogenicity of a porcine hemagglutinating encephalomyelitis virus strain isolated in China

text: Porcine hemagglutinating encephalomyelitis virus (PHEV) is a member of the genus betacoronavirus within the family coronaviridae, which invades the central nervous system (CNS) via peripheral nervous system and causes encephalomyelitis or vomiting and wasting disease (VWD) in sucking piglets. Up to now, although few complete nucleotide sequences of PHEV have been reported, they are not annotated. This study aimed to illuminate genome characterization, phylogenesis and pathogenicity of the PHEV/2008 strain. The full length of the PHEV/2008 strain genome was 30,684 bp, with a G + C content of 37.27%. The genome included at a minimum of 11 predicted open reading frames (ORFs) flanked by 5′ and 3′ untranslated regions (UTR) of 211 and 289 nucleotides. The replicase polyproteins pp1a and pp1ab, which had 4382 and 7094 amino acid residues, respectively, were predicted to be cleaved into 16 subunits by two viral proteinases. Phylogenetic analysis based on the complete genome sequence revealed that PHEV/2008 strain was genetically different from other known PHEV types, which represented a novel genotype (GI-1). In addition, we found that PHEV/2008 was neurotropic and highly pathogenic to 4-week-old BALB/c mice. Taken together, this is the first detailed annotated, complete genomic sequence of a new genotype PHEV strain in China.


Differential role of N-Terminal Polyprotein Processing in Coronavirus Genome Replication and Minigenome Amplification


title: Dysfunction and toxicity of damaged proteins in the etiology of aging and age-related degenerative and malignant diseases

text: Health can be defined as a harmony, or homeostasis, of the activities of thousands of different proteins, whereas aging and diseases result from their disharmony manifested at the levels of cells and tissues. Such disharmony is caused primarily by dysfunction and toxicity of misfolded proteins damaged by oxidation. This is an overview of key data that inspired new concepts allowing interpretation and integration of the scientific literature on aging and age-related diseases. These concepts suggest strategies for prevention and attenuation of age-related degenerative and malignant diseases mimicking the life of super-centenarians.


title: Pulmonary Histoplasma Infection After Allogeneic Hematopoietic Stem Cell Transplantation: Case Report and Review of the Literature

text: Histoplasmosis causes a wide spectrum of clinical illness, including disseminated infection in the immunocompromised. We report a case of pulmonary histoplasmosis in an allogeneic stem cell transplant recipient and review the literature on this topic. Histoplasmosis in this patient population is uncommon, but it is associated with poor outcome.


title: Coronavirus Spike Protein Inhibits Host Cell Translation by Interaction with eIF3f

text: In response to viral infection, the expression of numerous host genes, including predominantly a number of proinflammatory cytokines and chemokines, is usually up-regulated at both transcriptional and translational levels. It was noted that in cells infected with coronavirus, transcription and translation of some of these genes were differentially induced. Drastic induction of their expression at the transcriptional level was observed in cells infected with coronavirus. However, induction of the same genes at the translational level was usually found to be minimal to moderate. To investigate the underlying mechanisms, yeast two-hybrid screen was carried out using SARS-CoV proteins as baits, revealing that a subunit of the eukaryotic initiation factor 3 (eIF3), eIF3f, may interact with the N-terminal region of the SARS-CoV spike (S) protein. This interaction was subsequently confirmed by co-immunoprecipitation and immunofluorescent staining. Meanwhile, parallel experiments confirmed that eIF3f could also interact with the S protein of another coronavirus, the avian coronavirus infectious bronchitis virus (IBV). These interactions led to the inhibition of translation of a reporter gene in both in vitro expression system and intact cells. Interestingly, IBV-infected cells stably expressing a Flag-tagged eIF3f showed much higher translation of IL-6 and IL-8, suggesting that the interaction between coronavirus S protein and eIF3f plays a functional role in controlling the expression of host genes, especially genes that are induced during coronavirus infection cycles. This study reveals a novel mechanism exploited by coronavirus to regulate viral pathogenesis.


COVID-19—immunity from prosecution for physicians forced to allocate scarce resources: the Italian perspective


title: Origins and pathogenesis of Middle East respiratory syndrome-associated coronavirus: recent advances

text: Middle East respiratory syndrome-associated coronavirus (MERS-CoV) has been a significant research focus since its discovery in 2012. Since 2012, 2,040 cases and 712 deaths have been recorded (as of August 11, 2017), representing a strikingly high case fatality rate of 36%. Over the last several years, MERS-CoV research has progressed in several parallel and complementary directions. This review will focus on three particular areas: the origins and evolution of MERS-CoV, the challenges and achievements in the development of MERS-CoV animal models, and our understanding of how novel proteins unique to MERS-CoV counter the host immune response. The origins of MERS-CoV, likely in African bats, are increasingly clear, although important questions remain about the establishment of dromedary camels as a reservoir seeding human outbreaks. Likewise, there have been important advances in the development of animal models, and both non-human primate and mouse models that seem to recapitulate human disease are now available. How MERS-CoV evades and inhibits the host innate immune response remains less clear. Although several studies have identified MERS-CoV proteins as innate immune antagonists, little of this work has been conducted using live virus under conditions of actual infection, but rather with ectopically expressed proteins. Accordingly, considerable space remains for major contributions to understanding unique ways in which MERS-CoV interacts with and modulates the host response. Collectively, these areas have seen significant advances over the last several years but continue to offer exciting opportunities for discovery.


title: Growth Performance and Health of Dairy Calves Bedded with Different Types of Materials

text: Abstract Granite fines, sand, rice hulls, long wheat straw, and wood shavings were compared as bedding for 60 female dairy calves. Growth, health, stress indices, and behavior of newly born calves, along with physical characteristics and bacterial counts of bedding, were evaluated for 42 d during August to October, 2002. Overall average daily gain and dry matter intake of calves did not differ due to bedding type, although during wk 2 calves housed on rice hulls had the greatest dry matter intake and those housed on wood shavings had the lowest. During wk 2, calves housed on granite fines and sand were treated more often for scours, and calves housed on long wheat straw received the fewest antibiotic treatments (week by bedding material interaction). Granite fines formed a harder surface than other bedding, and calves housed on granite fines scored the dirtiest. When bedding materials were evaluated, sand was scored to be the dirtiest, while pens bedded with rice hulls, long wheat straw, and wood shavings scored cleaner. Long wheat straw had the warmest surface temperature, and rice hulls and wood shavings were warmer than granite fines and sand. Serum cortisol, α 1-acid glycoprotein, immunoglobulin G concentrations, and the neutrophil:lymphocyte ratio were not affected by bedding type. On d 0, coliform counts were greatest in rice hulls. After use, coliform counts were greatest in long wheat straw (week by bedding material interaction). On d 42, the concentration of ammonia at 10cm above the bedding was lowest for long wheat straw. Growth performance of calves bedded for 42 d with 5 bedding types did not differ; however, the number of antibiotic treatments given for scours was greatest on granite fines and sand; coliform counts in the bedding were highest in rice hulls before use and in long wheat straw after 42 d of use.


title: A report of clinical diagnosis and treatment of nine cases of coronavirus disease 2019

text: Coronavirus disease 2019 (COVID‐19) caused by the severe acute respiratory syndrome coronavirus 2 has become an important public health issue in the world. More than 118 000 cases were confirmed around the world. The main clinical manifestations were respiratory symptoms and occasional gastrointestinal symptoms. However, there is no unified standard for the diagnosis and treatment of COVID‐19. In the retrospective analysis, we report nine cases of COVID‐19, describe the history of contact, clinical manifestations, the course of diagnosis and clinical treatment before, during and after treatment.


Letter to the Editor: A Response to the Comments of Borderas et al. (2007)


title: The Small-Compound Inhibitor K22 Displays Broad Antiviral Activity against Different Members of the Family Flaviviridae and Offers Potential as a Panviral Inhibitor

text: The virus family Flaviviridae encompasses several viruses, including (re)emerging viruses which cause widespread morbidity and mortality throughout the world. Members of this virus family are positive-strand RNA viruses and replicate their genome in close association with reorganized intracellular host cell membrane compartments. This evolutionarily conserved strategy facilitates efficient viral genome replication and contributes to evasion from host cell cytosolic defense mechanisms. We have previously described the identification of a small-compound inhibitor, K22, which exerts a potent antiviral activity against a broad range of coronaviruses by targeting membrane-bound viral RNA replication. To analyze the antiviral spectrum of this inhibitor, we assessed the inhibitory potential of K22 against several members of the Flaviviridae family, including the reemerging Zika virus (ZIKV). We show that ZIKV is strongly affected by K22. Time-of-addition experiments revealed that K22 acts during a postentry phase of the ZIKV life cycle, and combination regimens of K22 together with ribavirin (RBV) or interferon alpha (IFN-α) further increased the extent of viral inhibition. Ultrastructural electron microscopy studies revealed severe alterations of ZIKV-induced intracellular replication compartments upon infection of K22-treated cells. Importantly, the antiviral activity of K22 was demonstrated against several other members of the Flaviviridae family. It is tempting to speculate that K22 exerts its broad antiviral activity against several positive-strand RNA viruses via a similar mechanism and thereby represents an attractive candidate for development as a panviral inhibitor.


Réplica: Ivermectina en COVID-19. ¿Argumentum ad ignorantiam?


title: Diversity in the Enteric Viruses Detected in Outbreaks of Gastroenteritis from Mumbai, Western India

text: Faecal specimens collected from two outbreaks of acute gastroenteritis that occurred in southern Mumbai, India in March and October, 2006 were tested for seven different enteric viruses. Among the 218 specimens tested, 95 (43.6%) were positive, 73 (76.8%) for a single virus and 22 (23.2%) for multiple viruses. Single viral infections in both, March and October showed predominance of enterovirus (EV, 33.3% and 40%) and rotavirus A (RVA, 33.3% and 25%). The other viruses detected in these months were norovirus (NoV, 12.1% and 10%), rotavirus B (RVB, 12.1% and 10%), enteric adenovirus (AdV, 6.1% and 7.5%), Aichivirus (AiV, 3% and 7.5%) and human astrovirus (HAstV, 3% and 0%). Mixed viral infections were largely represented by two viruses (84.6% and 88.9%), a small proportion showed presence of three (7.7% and 11%) and four (7.7% and 0%) viruses in the two outbreaks. Genotyping of the viruses revealed predominance of RVA G2P[4], RVB G2 (Indian Bangladeshi lineage), NoV GII.4, AdV-40, HAstV-8 and AiV B types. VP1/2A junction region based genotyping showed presence of 11 different serotypes of EVs. Although no virus was detected in the tested water samples, examination of both water and sewage pipelines in gastroenteritis affected localities indicated leakages and possibility of contamination of drinking water with sewage water. Coexistence of multiple enteric viruses during the two outbreaks of gastroenteritis emphasizes the need to expand such investigations to other parts of India.


Effectiveness of Surgical and Cotton Masks in Blocking SARS–CoV-2: A Controlled Comparison in 4 Patients


title: Human Rhinovirus Infections in Rural Thailand: Epidemiological Evidence for Rhinovirus as Both Pathogen and Bystander

text: BACKGROUND: We describe human rhinovirus (HRV) detections in SaKaeo province, Thailand. METHODS: From September 1, 2003–August 31, 2005, we tested hospitalized patients with acute lower respiratory illness and outpatient controls without fever or respiratory symptoms for HRVs with polymerase chain reaction and molecularly-typed select HRVs. We compared HRV detection among hospitalized patients and controls and estimated enrollment adjusted incidence. RESULTS: HRVs were detected in 315 (16%) of 1919 hospitalized patients and 27 (9.6%) of 280 controls. Children had the highest frequency of HRV detections (hospitalized: <1 year: 29%, 1–4 year: 29%, ≥65 years: 9%; controls: <1 year: 24%, 1–4 year: 14%, ≥65 years: 2.8%). Enrollment adjusted hospitalized HRV detection rates were highest among persons aged <1 year (1038/100,000 persons/year), 1–4 years (457), and ≥65 years (71). All three HRV species were identified, HRV-A was the most common species in most age groups including children aged <1 year (61%) and all adult age groups. HRV-C was the most common species in the 1–4 year (51%) and 5–19 year age groups (54%). Compared to controls, hospitalized adults (≥19 years) and children were more likely to have HRV detections (odds ratio [OR]: 4.8, 95% confidence interval [CI]: 1.5, 15.8; OR: 2.0, CI: 1.2, 3.3, respectively) and hospitalized children were more likely to have HRV-A (OR 1.7, CI: 0.8, 3.5) or HVR-C (OR 2.7, CI: 1.2, 5.9) detection. CONCLUSIONS: HRV rates were high among hospitalized children and the elderly but asymptomatic children also had substantial HRV detection. HRV (all species), and HRV-A and HRV-C detections were epidemiologically-associated with hospitalized illness. Treatment or prevention modalities effective against HRV could reduce hospitalizations due to HRV in Thailand.


title: Development of a semi-structured, multifaceted, computer-aided questionnaire for outbreak investigation: e-Outbreak Platform

text: BACKGROUND: Aggressive tracing of contacts of confirmed cases is crucial to Taiwan’s successful control of the early spread of COVID-19. As the pandemic lingers, an epidemiological investigation that can be conducted efficiently in a timely manner can help decrease the burden on the health personnel and increase the usefulness of such information in decision making. AIM: To develop a new tool that can improve the current practice of epidemiological investigation by incorporating new technologies in digital platform and knowledge graphs. METHODS: To meet the various needs of the epidemiological investigation, we decided to develop an e-Outbreak Platform that provides a semi-structured, multifaceted, computer-aided questionnaire for outbreak investigation. RESULTS: There are three major parts of the platform: (1) a graphic portal that allows users to have an at-glance grasp of the functions provided by the platform and then choose the one they need; (2) disease-specific questionnaires that can accommodate different formats of the information, including text typing, button selection, and pull-down menu; and (3) functions to utilize the stored information, including report generation, statistical analyses, and knowledge graphs displaying contact tracing. When the number of outbreak investigation increases, the knowledge graphs can be extended to encompass other persons appearing in the same location at the same time, i.e., constituting a potential contact cluster. The information extracted can also be used to display the tracing on a map in animation. CONCLUSIONS: Overall, this system can provide a basis for further refinement that can be generalized to a variety of outbreak investigations.


title: Glass fragment injury to the craniocervical junction with inter-atlanto-occipital penetration to the subarachnoid space: Not-to-be-missed important aspects of craniocervical trauma even in the middle of the COVID-19 pandemic: a case report with a review of the literature

text: Abstract Background Non-missile penetrating injuries to the craniocervical junction caused by a glass fragment are rare, and a standard management strategy has not been established. Case Description A 75-year-old Japanese man was brought into our emergency department after receiving a left retroauricular stab wound by broken glass fragments. After spinal immobilization, a computed tomographic (CT) scan revealed glass fragments penetrating at the right craniocervical junction to the inter-atlanto-occipital subarachnoid space. CT angiography showed that both vertebral arteries (VAs) were not injured. Magnetic resonance imaging demonstrated that the glass fragments did not penetrate the cervical cord or medulla oblongata (MO). These glass fragments were removed via a midline incision from the external occipital protuberance to the C7 and with laminectomy without suboccipital craniectomy. Five of the glass fragments were found and removed in total. The dural defect was patched with a free fascia autograft. His postoperative course was uneventful. Postoperative CT angiography showed that both the vertebral arteries were intact as well as the complete removal of the glass fragments. Conclusions CT graphical diagnosis is useful for the management of penetrating craniocervical junction trauma, and it should be considered in the evaluation of patients who have suffered craniocervical penetrating injury even in the absence of major wounds or bleeding. Spinal immobilization of patients with craniocervical penetrating injuries is crucial to avoid not only secondary neurological damage but also secondary critical vascular damage. Incomplete or inadequate assessment of craniocervical stab wounds results in unexpected hazards that are preventable.


title: Toux chronique de l’enfant

text: Résumé Introduction La toux chronique de l’enfant bien que moins fréquente que les toux répétées liées aux infections virales reste un problème diagnostique parfois difficile à résoudre. États des connaissances La majorité des auteurs estiment que sa durée doit être supérieure à trois semaines. Peu d’études ont été consacrées au diagnostic étiologique de la toux chronique chez l’enfant mais celles-ci retrouvent les mêmes causes principales que chez l’adulte : l’asthme, les pathologies ORL (dont la sinusite), le reflux gastro-œsophagien. Chaque tranche d’âge connaît des étiologies plus spécifiques ; notamment malformatives entre 0 et 1 an, et toux psychogène chez l’adolescent. Perspectives Des techniques « nouvelles » comme l’étude de l’expectoration induite permettent d’affiner le diagnostic d’une toux chronique de l’enfant en tout cas après 7 ans. La découverte d’une bronchite à éosinophiles quelle soit associée ou pas à une hyperréactivité bronchique a des conséquences thérapeutiques indiscutables compte tenu de sa corticosensibilité. Conclusions L’exploration d’une toux chronique de l’enfant doit reposer sur un raisonnement anatomique et sur des arguments de fréquence. Le contrôle et la disparition de la toux ne seront possibles qu’avec un diagnostic précis et un traitement adapté. Summary Introduction Although less frequent than viral induced recurrent cough; chronic cough remains a sometimes difficult to resolve diagnostic tool. State of the art Most authors estimate that a cough can by considered as chronic after three weeks of duration. Few papers have been published concerning etiologic diagnosis of chronic cough in childhood but these indicate the same main causes as in adults: cough variant asthma, postnasal drip syndrome, gastro-eosophageal reflux. Nevertheless, each age bracket presents specific diagnosis : malformations between zero and one year, psychogenic cough in adolescents. Perspectives New techniques as induced sputum studies helps to reifine chronic cough diagnosis in childhood (after 7 years). Eosinophilic bronchitis, associated or not to bronchial hyperresponsiveness has important therapeutic consequences because associated with a favourable response to corticosteroids. Other techniques will be developped in the future (exhaled NO for example). Conclusions Chronic cough in childhood must be investigated from an anatomic point of view and on frequency arguments. Control and removal of the cough will only be obtained if a precise diagnosis and a suitable treatment are reached.


Emergency ophthalmic surgeries during COVID-19—a Hong Kong perspective


title: Serum Procalcitonin Measurement and Viral Testing to Guide Antibiotic Use for Respiratory Infections in Hospitalized Adults: A Randomized Controlled Trial

text: Background. Viral lower respiratory tract illness (LRTI) frequently causes adult hospitalization and is linked to antibiotic overuse. European studies suggest that the serum procalcitonin (PCT) level may be used to guide antibiotic therapy. We conducted a trial assessing the feasibility of using PCT algorithms with viral testing to guide antibiotic use in a US hospital. Methods. Three hundred patients hospitalized with nonpneumonic LRTI during October 2013–April 2014 were randomly assigned at a ratio of 1:1 to receive standard care or PCT-guided care and viral PCR testing. The primary outcome was antibiotic exposure, and safety was assessed at 1 and 3 months. Results. Among the 151 patients in the intervention group, viruses were identified in 42% (63), and 83% (126) had PCT values of <0.25 µg/mL. There were no significant differences in antibiotic use or adverse events between intervention patients and those in the nonintervention group. Subgroup analyses revealed fewer subjects with positive results of viral testing and low PCT values who were discharged receiving antibiotics (20% vs 45%; P = .002) and shorter antibiotic durations among algorithm-adherent intervention patients versus nonintervention patients (2.0 vs 4.0 days; P = .004). Compared with historical controls (from 2008–2011), antibiotic duration in nonintervention patients decreased by 2 days (6.0 vs 4.0 days; P < .001), suggesting a study effect. Conclusions. Although antibiotic use was similar in the 2 arms, subgroup analyses of intervention patients suggest that physicians responded to viral and biomarker data. These data can inform the design of future US studies. Clinical Trials Registration. NCT01907659.


title: Induction of labor and risk of third- and fourth-degree perineal tears

text: Objectives The rate of induction of labor (IOL) at term has been increasing over the years. Our objective was to evaluate the risk of third- and fourth-degree perineal tears associated with term induction of labor. This section of the Journal of Obstetrics and Gynaecology Canada contains the oral, poster, and video abstracts that were to be presented at the SOGC's 76th Annual Clinical and Scientific Conference (ACSC) to have been held from June 9 to 12, 2020, in Ottawa, Ontario, and included as part of the conference proceedings. Due to the global spread of COVID-19 and the increasing health and safety measures being put in place by all levels of government, the SOGC has cancelled the 2020 ACSC. As a result, abstract participants will instead be submitting their presentations with voice-over narration. The presentations will then be posted on the 2020 ACSC Abstract Program page of sogc.org. We invite you to visit this page in early June to participate in the 2020 Abstract Program and to learn about the exciting research being conducted and innovations emerging in the field of obstetrics and gynaecology. There will also be an opportunity to ask authors questions. I would like to thank the entire Abstract Program Committee, the reviewers, and the participants, without whom the ACSC Abstract Program would not be possible. Dr. Alain Gagnon Chair, Abstract Program Committee Methods We conducted a population-based, retrospective cohort study using the United States' Nationwide Inpatient Sample to evaluate the risk of third- and fourth-degree perineal tears in women who underwent IOL at term between 2005 and 2014. We included all term livebirths and excluded, preterm births, previous cesarean deliveries, multifetal gestations, and non-cephalic presentation. Women who underwent an IOL at term were identified using ICD-9 coding. Patient characteristics were compared between those women being induced at term with those who weren't, and logistic regression analysis were carried out to estimate the adjusted effect of IOL at term with risk of 3rd and 4th perineal tears. Results Among 5,982,945 eligible live births, 1,035,003 (17.3%) underwent an IOL at term, increasing from 15.7% to 18.5%. Women with an IOL were more likely to be older, Caucasian, and with comorbid illnesses. Compared with women who did not undergo an IOL, women in the IOL group had lower risk of cesarean deliveries, 0.89 (0.88–0.89), 2nd degree tears, 0.89 (0.89–0.90), 3rd degree tears, OR 0.81 (95% CI 0.79–0.82) and 4th degree tears, OR 0.84 (95% CI 0.82–0.87). Conclusions Induction of labor at term results in significantly lower risk of third- and fourth-degree perineal tears among all deliveries as well as among women with vaginal deliveries.


title: Marketization vs. market chase: Insights from implicit government guarantees

text: Abstract Local Government Financing Vehicles (LGFVs) and state-owned enterprises (SOEs) provide implicit guarantee during the issuing of bonds, thereby reducing their funding cost. The credit spreads are lower when issued by a LGFV with a higher administrative level. This means that implicit guarantee is also strengthened with government centralization. We also explain the anomaly of municipal corporate bonds (MCBs)’ spreads decrease after a marketization regulation of removing implicit guarantees. This paper provides strong evidence that the market will chase implicit guarantee when default wave comes even under tight government regulations.


title: Filoviruses in Bats: Current Knowledge and Future Directions

text: Filoviruses, including Ebolavirus and Marburgvirus, pose significant threats to public health and species conservation by causing hemorrhagic fever outbreaks with high mortality rates. Since the first outbreak in 1967, their origins, natural history, and ecology remained elusive until recent studies linked them through molecular, serological, and virological studies to bats. We review the ecology, epidemiology, and natural history of these systems, drawing on examples from other bat-borne zoonoses, and highlight key areas for future research. We compare and contrast results from ecological and virological studies of bats and filoviruses with those of other systems. We also highlight how advanced methods, such as more recent serological assays, can be interlinked with flexible statistical methods and experimental studies to inform the field studies necessary to understand filovirus persistence in wildlife populations and cross-species transmission leading to outbreaks. We highlight the need for a more unified, global surveillance strategy for filoviruses in wildlife, and advocate for more integrated, multi-disciplinary approaches to understand dynamics in bat populations to ultimately mitigate or prevent potentially devastating disease outbreaks.


Cardiology Practice and Training Post-COVID-19: Achieving “Normalcy” After Disruption


title: Chapter 7 Detection and Diagnosis of Viral Infections

text: Abstract Diagnostic tests are paramount in determining the etiology of viral infections. Direct diagnostic methods assay for the presence of the virus, while indirect methods test for effects of the virus. Cell culture is the process of growing cells or tissues in the laboratory. Cell lines can be infected with patient samples to allow viral replication within the cells; observable cytopathic effects can help to identify the identity of the virus. Infected cells can also be used for immunofluorescence assays, which use fluorescently labeled virus-specific antibodies to identify viruses in fixed cells or tissues. A variety of diagnostic immunoassays exist, including enzyme-linked immunosorbent assays/enzyme immunoassays, western blots, lateral flow immunoassays, and agglutination reactions. Assays that detect viral nucleic acids are based upon the principles of PCR or nucleic acid hybridization, are extremely sensitive, and are specific for a particular virus.


Ocular symptoms among non-hospitalized patients who underwent COVID-19 testing