title: Viral infections associated with haemophagocytic syndrome

text: Haemophagocytic syndrome (HPS) or haemophagocytic lymphohistiocytosis (HLH) is a rare disease caused by a dysfunction of cytotoxic T cells and NK cells. This T cell/NK cell dysregulation causes an aberrant cytokine release, resulting in proliferation/activation of histiocytes with subsequent haemophagocytosis. Histiocytic infiltration of the reticuloendothelial system results in hepatomegaly, splenomegaly, lymphadenopathy and pancytopenia ultimately leading to multiple organ dysfunctions. Common clinical features include high fevers despite broad spectrum antimicrobials, maculopapular rash, neurological symptoms, coagulopathy and abnormal liver function tests. Haemophagocytic syndrome can be either primary, i.e. due to an underlying genetic defect or secondary, associated with malignancies, autoimmune diseases (also called macrophage activation syndrome) or infections. Infectious triggers are most commonly due to viral infections mainly of the herpes group, with EBV being the most common cause. HPS can be fatal if untreated. Early recognition of the clinical presentation and laboratory abnormalities associated with HPS and prompt initiation of treatment can be life saving. HPS triggered by viral infections generally does not respond to specific antiviral therapy but may be treated with immunosuppressive/immunomodulatory agents and, in refractory cases, with bone marrow transplantation. Copyright © 2010 John Wiley & Sons, Ltd.


title: Lessons from COVID-19 to future evidence synthesis efforts: first living search strategy and out of date scientific publishing and indexing industry (submitted)

text: • The guidance on excluding non-English literature in evidence synthesis may not be suitable for topics where studies are likely to be from a non-English geography. • The routine practice of developing search strategies may not fit the rapidly changing concepts such as COVID-19 and we need living search strategies. • Out-of-date publishing and indexing policies need to be updated.


title: Detection of Bovine Torovirus in Neonatal Calf Diarrhoea in Lower Austria and Styria (Austria)

text: Faeces of 230 calves with and without diarrhoea collected during the winter period 2004/2005 in 100 Austrian farms (Styria and Lower Austria) were examined for viral, bacterial and parasitic enteropathogens. Torovirus‐specific nucleic acid confirmed by reverse transcriptase‐polymerase chain reaction was found in 12 of 230 calves (5.2%). Ten of these calves were clinically ill, several of them showing signs of dehydration and abnormal faecal consistency at the time of sampling. Computer assisted analysis of two nucleotide sequences obtained from Austrian bovine samples revealed 93% similarity to Breda strain, but only 71% or 52% similarity to Equine Berne or Porcine Markelo torovirus strains respectively. Phylogenetic analysis grouped Austrian torovirus samples into the Bovine torovirus cluster indicating the first detection of Bovine torovirus in Austria. In addition, the following agents were detected in bovine faecal samples: Bovine coronavirus, 25.7%; Escherichia coli, 17%; Cryptosporidium spp., 11.7%; Eimeria spp., 10.4%; Rotavirus, 9.1%; Clostridium perfringens, 9.1% and Giardia spp., 6.1%. Salmonella spp. was not detected.


title: Leveraging mRNAs sequences to express SARS-CoV-2 antigens in vivo

text: SARS-CoV-2 has rapidly become a pandemic worldwide; therefore, an effective vaccine is urgently needed. Recently, messenger RNAs (mRNAs) have emerged as a promising platform for vaccination. Here, we systematically investigated the untranslated regions (UTRs) of mRNAs in order to enhance protein production. Through a comprehensive analysis of endogenous gene expression and de novo design of UTRs, we identified the optimal combination of 5’ and 3’ UTR, termed as NASAR, which was five to ten-fold more efficient than the tested endogenous UTRs. More importantly, NASAR mRNAs delivered by lipid-derived nanoparticles showed dramatic expression of potential SARS-CoV-2 antigens both in vitro and in vivo. These NASAR mRNAs merit further development as alternative SARS-CoV-2 vaccines.


title: A nurse-delivered brief health education intervention to improve pneumococcal vaccination rate among older patients with chronic diseases: A cluster randomized controlled trial

text: Abstract Background The 23-valent pneumococcal polysaccharide vaccine is recommended for elders, especially those with chronic conditions. Objective The aim of this study was to determine if an additional multi-component health education intervention increases the uptake rate of the pneumococcal vaccination among older patients with chronic diseases. Methods A cluster randomized controlled trial was conducted from 3 December 2007 to 7 March 2008. The clusters were the individual weeks within five Hong Kong outpatient clinics over a 10-week period. A sample of 2517 patients aged 65 or above with chronic diseases was recruited. Intervention group received a 3-min brief telephone education intervention before and a 3-min face-to-face intervention during scheduled medical appointments at the respective clinics. All subjects received standard care including health education leaflets and/or a video show at the clinics. Pneumococcal vaccination rate and awareness of the vaccination at 3-month follow up were measured. Results The vaccination rate was higher in the intervention group compared to the control group (57% vs 48%; relative risk=1.20, 95% CI=1.06–1.37), but the two groups did not differ significantly in their awareness of the vaccination at 3-month follow up (65% vs 59%, relative risk=0.86, 95% CI=0.69–1.07). Discussion A nurse-delivered brief health education intervention was effective in increasing uptake of pneumococcal vaccination among older patients with chronic diseases.


title: Unexpected Result of Hendra Virus Outbreaks for Veterinarians, Queensland, Australia

text: A qualitative study of equine veterinarians and allied staff from Queensland, Australia, showed that veterinarians are ceasing equine practice because of fears related to Hendra virus. Their decisions were motivated by personal safety and legal liability concerns.


title: Effect of olfactory bulb ablation on spread of a neurotropic coronavirus into the mouse brain

text: Previous results suggested that, after intranasal inoculation, mouse hepatitis virus (MHV), a neurotropic coronavirus, entered the central nervous system (CNS) via the olfactory and trigeminal nerves. To prove this hypothesis, the effect of interruption of the olfactory pathway on spread of the virus was studied using in situ hybridization. Unilateral surgical ablation of this pathway prevented spread of the virus via the olfactory tract on the side of the lesion. MHV RNA could be detected, however, at distal sites on the operated side, indicating that the virus spread via well-described circuits involving the anterior commissure from the control (intact) side of the brain. Viral transport via the trigeminal nerve was not affected by removal of the olfactory bulb, showing that the surgical procedure was specific for the olfactory pathway. These results prove conclusively that MHV gains entry to the CNS via a transneuronal route, and spreads to additional sites in the brain via known neuroanatomic pathways.


title: A Case Series of MGUS and COVID‐19

text: Monoclonal Gammopathy of Undetermined Significance (MGUS) is a pre‐malignant clonal plasma cell disorder, with 25 to 30% life‐long risk of progression to multiple myeloma (MM).(1) It is usually asymptomatic, but infrequently associated with several serious conditions, such as neuropathies, glomerulonephritis, and acquired angioedema.(2) Moreover, a higher risk of infection and deep venous thrombosis has been reported in patients with MGUS.(3,4)


title: Health Care Workers and Patients as Trojan Horses: a COVID19 ward outbreak

text: Summary Background Transmission in healthcare settings can result in significant infections in healthcare workers and patients. Understanding infection dynamics has important implications for methods employed in hospitals to prevent nosocomial-transmission events. Methods In this case series report we describe a cluster of COVID-19 (Coronavirus disease 2019) in a tertiary care university hospital, in the early phases of the epidemic, after hospital visiting had been stopped and when the UK lockdown was in place. Findings A 48 year old patient developed COVID-19 31 days post-admission and four days after admission to a medical ward from ITU. Infection was likely acquired from an asymptomatic or minimally symptomatic healthcare worker (HCW). Subsequent investigation over a 14 day period revealed symptoms in 23 staff members and five linked cases in patients on the same ward. Nine of the 23 affected staff members provided care for and had direct exposure with the index case. Four staff reported caring for the index case without use of personal protective equipment. One was coughed on directly by the patient 24 hours prior to the onset of symptoms. Conclusion SARS CoV2 infection can be introduced to a ward area by asymptomatic and minimally symptomatic healthcare workers. Staff members and patients can act as Trojan horses carrying infection into and around the hospital, setting up unexpected transmission events. Transmission of infection from pre-symptomatic, asymptomatic and minimally symptomatic individuals means that universal use of measures to prevent transmission is required for successful reduction of transmission events in the hospital setting.


title: ISDE guidance statement: management of upper gastrointestinal endoscopy and surgery in COVID-19 outbreak

text: This is an official guidance statement of The International Society of the Diseases of the Esophagus (ISDE) to address all the operators involved in management of patients affected by upper gastrointestinal diseases during COVID-19 pandemic. This guidance is based on the best available evidence to date and will be updated as new evidence becomes available.


Tromboembolismo Pulmonar Y Acro-Isquemia En Un Paciente Con Cáncer De Pulmón Y Covid-19


Active smoking and severity of coronavirus disease 2019 (COVID-19): Differences in measurement of variables could cause errors in the results.


title: Protective role of follicular CXCR5+CD8+ T cells against dengue virus 2 infection

text: Abstract Follicular CXCR5+CD8+ T cells have antiviral effects in chronic virus infection, but the roles of these cells during dengue virus 2 (DENV2) infection remain poorly understood. Objective This study was conducted to analyzed in detail the dynamic changes and functional properties of circulating follicular CXCR5+CD8+ T cells to explore their effects on DENV2 infection. Methods Circulating follicular CXCR5+CD8+ T cells and cytokines were analyzed by flow cytometry in DENV2 patients at difference days after DENV2 infection. CD8+ T cells were isolated and purified from DENV2 patients, then were stimulated with NS1 peptides and TCR stimulant. After cultivation, multiple parameters were tested. Results (1) CXCR5+CD8+ T cells emerged after DENV2 infection, with high PD-1 expression, and were correlated with the reduction in DENV2 RNA viral loads. (2) PD-1+CXCR5+CD8+ T cells were negatively associated with disease progression. (3) Serum IFN-γ, IL-6 and IL-10 levels were increased late in the course of DENV2 infection. (4) CXCR5+CD8+ T cells from DENV2 patients exhibited increased cytotoxicity and IFN-γ and IL-10 secretion. Conclusion CXCR5+CD8+ T cells could play a protective role in dengue pathogenesis and may be a novel strategy for controlling DENV2 infection and vaccine development.


title: COVID‐19 as an accelerator for digitalization at a German university: Establishing hybrid campuses in times of crisis

text: As a result of the COVID‐19 outbreak, teaching in universities needed to be quickly transitioned from regular on‐campus classes into technology‐enhanced teaching formats. In this paper, we present the case study of Chemnitz University of Technology (Germany), where digital classes were introduced in a matter of weeks. By analyzing syllabus data, we found that the use of video and video conferencing is an important current development. Related to these findings, we present evidence from instructional psychology and social media research that can help in the design of teaching during this crisis. We highlight the need for multimodal learning, i.e., learning settings that use multiple sensory modalities. Importantly, we present a strategy of hybrid campuses for this and potential future emergencies. This approach describes how the social distancing measures currently in effect can be used to re‐think higher education based on a reasonable use of technology. Taken together, the COVID‐19 crisis can be a time of major reform in higher education that will accelerate the process of digitalization in an unprecedented way. This article is protected by copyright. All rights reserved.


title: The incidence and aetiology of hospitalised community-acquired pneumonia among Vietnamese adults: a prospective surveillance in Central Vietnam

text: BACKGROUND: Lower respiratory tract infection (LRTI) including Community-acquired pneumonia (CAP) is a common infectious disease that is associated with significant morbidity and mortality. The patterns of aetiological pathogens differ by region and country. Special attention must be paid to CAP in Southeast Asia (SEA), a region facing rapid demographic transition. Estimates burden and aetiological patterns of CAP are essential for the clinical and public health management. The purposes of the study are to determine the incidence, aetiological pathogens, clinical pictures and risk factors of community-acquired pneumonia (CAP) in the Vietnamese adult population. METHODS: A prospective surveillance for hospitalised adult CAP was conducted in Khanh Hoa Province, Central Vietnam. All adults aged ≥15 years with lower respiratory tract infections (LRTI) admitted to a provincial hospital from September 2009 to August 2010 were enrolled in the study. Patients were classified into CAP and non-pneumonic LRTI (NPLRTI) according to the radiological findings. Bacterial pathogens were identified from sputum samples by the conventional culture and polymerase chain reaction (PCR) for Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis; 13 respiratory viruses were identified from nasopharyngeal specimens by PCR. RESULTS: Of all 367 LRTI episodes examined, 174 (47%) were CAP. Older age, the presence of underlying respiratory conditions, and higher index score of smoking were associated with CAP. The one-year estimated incidence of hospitalised adult CAP in our study population was 0.81 per 1,000 person years. The incidence increased considerably with age and was highest among the elderly. The case fatality proportion of hospitalised CAP patients was 9.8%. Among 286 sputum samples tested for bacterial PCR, 79 (28%) were positive for H. influenzae, and 65 (23%) were positive for S. pneumoniae. Among 357 samples tested for viral PCR, 73 (21%) were positive for respiratory viruses; influenza A (n = 32, 9%) was the most common. CONCLUSIONS: The current adult CAP incidence in Vietnam was relatively low; this result was mainly attributed to the young age of our study population.


title: Unexpected times

text: The world has changed this year under the shadow of the COVID-19 pandemic. Lockdowns around the world have reduced energy demand, resulting in emissions declines, but what could the post-COVID-19 world look like — a return to normal, or will this start a transition?


title: The exploration of artificial incubation of Cherax quadricarinatus eggs

text: The redclaw crayfish, Cherax quadricarinatus, is an economically valuable freshwater crayfish. However, some production obstacles, such as a low egg hatching rate and asynchronous hatching, are hindering its development in the aquaculture industry. Artificial incubation of eggs may solve these problems. This study explored the technology of artificial incubation of redclaw crayfish eggs. The following results were obtained: 1) 75% alcohol as a disinfectant for 60 s had a preferable antibacterial effect and promoted the hatching rate; 2) densities of 300 and 600 eggs/incubator resulted in significantly higher hatching and survival rates than a density of 900 eggs/incubator; 3) at a density of 600 eggs/incubator, the optimum number of net pieces for attachment of freshly hatched juveniles was 20 per incubator; 4) with a density of 600 eggs/incubator and 20 net pieces/incubator, the hatching rate was 82.05% ± 4.09%, the survival rate was 55.12% ± 7.51%, and a total of 129,200 SPF (specific pathogen-free) seedlings were cultivated. This artificial incubation system was maintained at close to an aseptic state, with an absence of white spot virus, iridovirus, Vibrio and ciliates; this was true for all water sources used and for incubation of both eggs and juvenile crayfish. In conclusion, if we implement reasonable methods of disinfection, SPF detection and pathogen isolation and utilize optimal egg densities and incubation systems, large-scale production of SPF seedlings of Cherax quadricarinatus is possible.


title: Pathogens, prejudice, and politics: the role of the global health community in the European refugee crisis

text: Summary Involuntary migration is a crucially important global challenge from an economic, social, and public health perspective. The number of displaced people reached an unprecedented level in 2015, at a total of 60 million worldwide, with more than 1 million crossing into Europe in the past year alone. Migrants and refugees are often perceived to carry a higher load of infectious diseases, despite no systematic association. We propose three important contributions that the global health community can make to help address infectious disease risks and global health inequalities worldwide, with a particular focus on the refugee crisis in Europe. First, policy decisions should be based on a sound evidence base regarding health risks and burdens to health systems, rather than prejudice or unfounded fears. Second, for incoming refugees, we must focus on building inclusive, cost-effective health services to promote collective health security. Finally, alongside protracted conflicts, widening of health and socioeconomic inequalities between high-income and lower-income countries should be acknowledged as major drivers for the global refugee crisis, and fully considered in planning long-term solutions.


title: COVID-19 and the nicotinic cholinergic system

text: We have read with great interest the paper by Leung et al. published in European Respiratory Journal [1], the correspondence by Russo et al. [2] and also the subsequent comment by the first group [3]. Both research teams are reporting increased ACE-2 expression in airways of current smokers and those with COPD with important implications for COVID-19 patients. Since ACE-2 has been shown to be the main receptor utilised by SARS-CoV-2 to enter the host cells [2], the authors conclude that nicotine is a risk factor for COVID-19 pandemic. Russo et al. [2] have shown that nicotine up-regulates ACE-2 through alpha7 nAChRs which are present in neuronal and non-neuronal cells. Leung et al. [3] provided further evidence in support of this hypothesis and propose the repurposing of alpha7-nAChR antagonists for the pandemic (e.g. methyllycaconitine, alpa-conotoxin), expecting that such treatment will alter ACE-2 expression and prevent SARS-CoV-2 entry.


title: Transmission of COVID-19 virus by droplets and aerosols: A critical review on the unresolved dichotomy

text: The practice of social distancing and wearing masks has been popular worldwide in combating the contraction of COVID-19. Undeniably, although such practices help control the COVID-19 pandemic to a greater extent, the complete control of viral-laden droplet and aerosol transmission by such practices is poorly understood. This review paper intends to outline the literature concerning the transmission of viral-laden droplets and aerosols in different environmental settings and demonstrates the behavior of droplets and aerosols resulted from a cough-jet of an infected person in various confined spaces. The case studies that have come out in different countries have, with prima facie evidence, manifested that the airborne transmission plays a profound role in contracting susceptible hosts. Interestingly, the nosocomial transmission by airborne SARS-CoV-2 viral-laden aerosols in healthcare facilities may be plausible. Hence, clearly defined, science-based administrative, clinical, and physical measures are of paramount importance to eradicate the COVID-19 pandemic from the world.


title: Identifying potential treatments of COVID-19 from Traditional Chinese Medicine (TCM) by using a data-driven approach

text: Abstract Ethnopharmacological relevance : Traditional Chinese Medicine (TCM) has been widely used as an approach worldwide. Chinese Medicines (CMs) had been used to treat and prevent viral infection pneumonia diseases for thousands of years and had accumulated a large number of clinical experiences and effective prescriptions. Aim of the study : This research aimed to systematically excavate the classical prescriptions of Chinese Medicine (CM), which have been used to prevent and treat Pestilence (Wenbing, Wenyi, Shiyi or Yibing) for long history in China, to obtain the potential prescriptions and ingredients to alternatively treat COVID-19. Materials and methods We developed the screening system based on data mining, molecular docking and network pharmacology. Data mining and association network were used to mine the high-frequency herbs and formulas from ancient prescriptions. Virtual screening for the effective components of high frequency CMs and compatibility Chinese Medicine was explored by a molecular docking approach. Furthermore, network pharmacology method was used to preliminarily uncover the molecule mechanism. Results 574 prescriptions were obtained from 96,606 classical prescriptions with the key words to treat “Warm diseases (Wenbing)”, “Pestilence (Wenyi or Yibing)” or “Epidemic diseases (Shiyi)”. Meanwhile, 40 kinds of CMs, 36 CMs-pairs, 6 triple-CMs-groups existed with high frequency among the 574 prescriptions. Additionally, the key targets of SARS-COV-2, namely 3CL hydrolase (Mpro) and angiotensin-converting enzyme 2(ACE2), were used to dock the main ingredients from the 40 kinds by the LigandFitDock method. A total of 66 compounds components with higher frequency were docked with the COVID-19 targets, which were distributed in 26 kinds of CMs, among which Gancao (Glycyrrhizae Radix Et Rhizoma), HuangQin (Scutellariae Radix), Dahuang (Rhei Radix Et Rhizome) and Chaihu (Bupleuri Radix) contain more potential compounds. Network pharmacology results showed that Gancao (Glycyrrhizae Radix Et Rhizoma) and HuangQin (Scutellariae Radix) CMs-pairs could also interact with the targets involving in immune and inflammation diseases. Conclusions These results we obtained probably provided potential candidate CMs formulas or active ingredients to overcome COVID-19. Prospectively, animal experiment and rigorous clinic studies are needed to confirm the potential preventive and treat effect of these CMs and compounds.


title: Evidenced-based best practice advice for patients treated with systemic immunosuppressants in relation to COVID-19()()()

text: The emergence of the COVID-19 pandemic led to significant uncertainty among physicians and patients about the safety of immunosuppressive medications used for the management of dermatologic conditions. We review available data on commonly used immunosuppressants and their effect on viral infections beyond COVID-19. Notably, the effect of some immunosuppressants on viruses related to SARS-CoV2, including SARS and MERS, has been previously investigated. In the absence of data on the effect of immunosuppressants on COVID-19, these data could be used to make clinical decisions on initiation and continuation of immunosuppressive medications during this pandemic. In summary, we recommend considering the discontinuation of oral JAK inhibitors and prednisone, considering the delay of rituximab infusion, and the careful continuation of cyclosporine, mycophenolate, azathioprine, methotrexate, and biologics in patients currently benefitting from such treatments.


title: Pre‐symptomatic transmission of novel coronavirus in community settings

text: We used contact tracing to document how COVID‐19 was transmitted across 5 generations involving 10 cases, starting with an individual who became ill on January 27. We calculated the incubation period of the cases as the interval between infection and development of symptoms. The median incubation period was 6.0 days (interquartile range, 3.5‐9.5 days). The last two generations were infected in public places, 3 and 4 days prior to the onset of illness in their infectors. Both had certain underlying conditions and comorbidity. Further identification of how individuals transmit prior to being symptomatic will have important consequences.


title: Porcine deltacoronavirus (PDCoV) infection antagonizes interferon-λ1 production

text: Porcine deltacoronavirus (PDCoV) is a novel swine enteropathogenic coronavirus that causes watery diarrhea, vomiting and mortality in nursing piglets. Type III interferons (IFN-λs) are the major antiviral cytokines in intestinal epithelial cells, the target cells in vivo for PDCoV. In this study, we found that PDCoV infection remarkably inhibited Sendai virus-induced IFN-λ1 production by suppressing transcription factors IRF and NF-κB in IPI-2I cells, a line of porcine intestinal mucosal epithelial cells. We also confirmed that PDCoV infection impeded the activation of IFN-λ1 promoter stimulated by RIG-I, MDA5 and MAVS, but not by TBK1 and IRF1. Although the expression levels of IRF1 and MAVS were not changed, PDCoV infection resulted in reduction of the number of peroxisomes, the platform for MAVS to activate IRF1, and subsequent type III IFN production. Taken together, our study demonstrates that PDCoV suppresses type III IFN responses to circumvent the host’s antiviral immunity.


title: Epstein-Barr Virus Stimulates Torque Teno Virus Replication: A Possible Relationship to Multiple Sclerosis

text: Viral infections have been implicated in the pathogenesis of multiple sclerosis. Epstein-Barr virus (EBV) has frequently been investigated as a possible candidate and torque teno virus (TTV) has also been discussed in this context. Nevertheless, mechanistic aspects remain unresolved. We report viral replication, as measured by genome amplification, as well as quantitative PCR of two TTV-HD14 isolates isolated from multiple sclerosis brain in a series of EBV-positive and -negative lymphoblastoid and Burkitt's lymphoma cell lines. Our results demonstrate the replication of both transfected TTV genomes up to day 21 post transfection in all the evaluated cell lines. Quantitative amplification indicates statistically significant enhanced TTV replication in the EBV-positive cell lines, including the EBV-converted BJAB line, in comparison to the EBV-negative Burkitt's lymphoma cell line BJAB. This suggests a helper effect of EBV infections in the replication of TTV. The present study provides information on a possible interaction of EBV and TTV in the etiology and progression of multiple sclerosis.


title: H7N9: a low pathogenic avian influenza A virus infecting humans

text: Human infections by the newly reassorted avian influenza A (H7N9) virus were reported for the first time in early 2013, and the virus was confirmed to be a low pathogenic avian influenza virus in poultry. Because continuously reported cases have been increasing since the summer of 2013, this novel virus poses a potential threat to public health in China and is attracting broad attention worldwide. In this review, we summarize and discuss the characteristics of the H7N9 virus revealed by the recent timely studies from the perspectives of epidemiology, host preference, clinical manifestations, immunopathogenesis, drug resistance, vaccine development, and burden of disease. This knowledge about the novel avian-origin H7N9 virus will provide a useful reference for clinical interventions of human infections and help to rapidly pave the way to develop an efficient and safe vaccine.


title: Environmental Maintenance with Effective and Useful Zoning for Severe COVID‐19 due to Protect to and from Patients and Medical Staffs

text: AIM: In the present, the coronavirus disease 2019 (COVID‐19) pandemic accelerates all over the world, global health care systems have become overwhelmed with potentially infectious patients seeking testing and care. So, we must set up effective and useful zoning for unfamiliar COVID‐19 because it is the most important to prevent spread of infection to and from medical staffs or other patients and patients relies on effective use of standard precaution with personal protective equipment (PPE). METHOD: We set up a special ward changed a general ward we always used as an acute care unit for severe COVID‐19 patients with taking into consideration airflow, the direction of movement of medical staffs, and prevention of infection spread to medical staffs and other patients. And, we checked daily condition and body temperature of all medical staffs for 60 days. RESULT: There were no evidence of COVID‐19 infection in all medical staffs and patients during the period thanks to effective and useful zoning with PPE. CONCLUSION: We should set up the special wards and rooms with some devices for the time to come due to protect medical staffs and other patients, and prevent from the explosion of COVID‐19 anywhere with effective and useful zoning with PPE.


title: E-Cigarette, or Vaping, Product Use Associated Lung Injury (EVALI) with Acute Respiratory Failure in Three Adolescent Patients: a Clinical Timeline, Treatment, and Product Analysis

text: INTRODUCTION: E-cigarette, or vaping, product use associated lung injury (EVALI) has become a recent concern among public health officials. Factors that contribute to the concern include an increasing number of cases over time, the severity of the illness, and an unknown understanding of the pathophysiology and etiology of the illness. CASE SERIES: We cared for three adolescent patients with acute respiratory failure secondary to EVALI. All three patients were treated with high-dose steroids in addition to antimicrobials, which resulted in clinical improvement and resolution of their respiratory failure. Pulmonary function testing was performed on these previously healthy patients both acutely and subacutely. Additionally, we report the results from the laboratory analysis of one vaping device fluid which revealed previously unpublished components within these products. DISCUSSION: EVALI is a recent public health concern without a known etiology which can cause life-threatening lung injury in patients without prior lung pathology. We hope these cases will highlight the importance of return precautions in adolescents with vague respiratory symptoms and provide a cautionary tale to providers while they counsel patients regarding the use of these products.


title: Parainfluenza Virus Type 3 Pneumonia in Bone Marrow Transplant Recipients: Multiple Small Nodules in High-Resolution Lung Computed Tomography Scans Provide a Radiological Clue to Diagnosis

text: We report the findings of high-resolution chest computed tomography of 6 hematopoietic stem cell transplant recipients with parainfluenza virus type 3 pneumonia who were not infected with any other pathogens. All patients had multiple small nodules (diameter, <5 mm) without cavitation in a peribronchial distribution. Changes preceded microbiological diagnosis in 4 of 6 cases.


COVID‐19 in a patient with severe asthma treated with Omalizumab


title: Evolution of Chinese airport network

text: Abstract With the rapid development of the economy and the accelerated globalization process, the aviation industry plays a more and more critical role in today’s world, in both developed and developing countries. As the infrastructure of aviation industry, the airport network is one of the most important indicators of economic growth. In this paper, we investigate the evolution of the Chinese airport network (CAN) via complex network theory. It is found that although the topology of CAN has remained steady during the past few years, there are many dynamic switchings inside the network, which have changed the relative importance of airports and airlines. Moreover, we investigate the evolution of traffic flow (passengers and cargoes) on CAN. It is found that the traffic continues to grow in an exponential form and has evident seasonal fluctuations. We also found that cargo traffic and passenger traffic are positively related but the correlations are quite different for different kinds of cities.


Detection and Characterization of a Novel Norovirus in Bats, China


title: The 1-Year Impact of Severe Acute Respiratory Syndrome on Pulmonary Function, Exercise Capacity, and Quality of Life in a Cohort of Survivors

text: Objective To examine pulmonary function, exercise capacity, and health-related quality of life (HRQoL) among severe acute respiratory syndrome (SARS) survivors. Methods We evaluated survivors with confirmed SARS at the Prince of Wales Hospital, Hong Kong, at 3, 6, and 12 months after symptom onset. Our assessment included: lung volume (total lung capacity [TLC], vital capacity, residual volume, functional residual capacity), spirometry (FVC, FEV1), diffusing capacity of the lung for carbon monoxide (Dlco), inspiratory and expiratory respiratory muscle strength, 6-min walk distance (6MWD), chest radiographs (CXRs), and HRQoL by Medical Outcomes Study 36-Item Short-Form General Health Survey questionnaire. Results Ninety-seven patients completed the serial assessments. There were 39 male and 58 female patients, and 63 patients (70%) were health-care workers (mean age, 36.9 years [SD, 9.5 years]; body mass index, 23.7 kg/m2 [SD, 4.0 kg/m2]). At 1 year, 27 patients (27.8%) had abnormal CXR findings. Four patients (4.1%), 5 patients (5.2%), and 23 patients (23.7%) had FVC, TLC, and Dlco values < 80% of predicted values, respectively. The 6MWD at 12 months was 511.0 m (SD, 89.8 m), which was higher than at 3 months (mean difference, 47.0 m; 95% confidence interval [CI], 31.8 to 62.1 m; p < 0.01) but not different from 6 months (mean difference, 9.7 m; 95% CI, − 4.4 to 23.8 m; p = 0.18). The 6MWD was lower than that for normal control subjects of the same age groups, and there was impairment of HRQoL at 12 months. Patients who required ICU admission (n = 31) showed higher CXR scores (1.6 [SD, 3.1]; vs 0.4 [SD, 1.1]; p = 0.04) and lower percentage of predicted FVC, TLC, and Dlco than those who did not, but there were no differences in 6MWD and health status. Conclusion Significant impairment in Dlco was noted in 23.7% of survivors 1 year after illness onset. Exercise capacity and health status of SARS survivors were remarkably lower than those of a normal population.


title: Unusual Microbleeds in Brain MRI of Covid‐19 Patients

text: BACKGROUND AND PURPOSE: Covid‐19, initially described as a respiratory system's infection, is currently more and more recognized as a multiorganic disease, including neurological manifestations. There is growing evidence about a potential neuroinvasive role of SARS‐CoV‐2. The purpose of this study is to describe new findings, in the form of cerebral microbleeds affecting different brain structures, observed in MRIs of critically ill patients. METHODS: For this purpose, the MR images of 9 patients with a common pattern of abnormal findings (2 women/7 men; 55‐79 years of age; mean age: 67.7 years) were depicted. All patients were tested positive for SARS‐CoV‐2 and presented with delayed recovery of consciousness or important agitation, requiring brain MRI. RESULTS: All patients had suffered from severe (5/9) or moderate (4/9) acute respiratory distress syndrome, requiring prolonged stay in the intensive care unit. Their common MRI finding was the presence of microbleeds in unusual distribution with a specific predilection for the corpus callosum. Other uncommon locations of microbleeds were the internal capsule (5/9), as well as middle cerebellar peduncles (5/9). Subcortical regions were also affected in the majority of patients. CONCLUSIONS: Brain MRI raised evidence that Covid‐19 or its related treatment may involve the brain with an unusual pattern of microbleeds, predominantly affecting the corpus callosum. The mechanism of this finding is still unclear but the differential diagnosis should include thrombotic microangiopathy related to direct or indirect—through the cytokine cascade—damage by the SARS‐CoV‐2 on the endothelium of brain's vessels, as well as mechanisms similar to the hypoxemia brain‐blood‐barrier injury.


title: Generation and characterization of human monoclonal neutralizing antibodies with distinct binding and sequence features against SARS coronavirus using XenoMouse®

text: Abstract Passive therapy with neutralizing human monoclonal antibodies (mAbs) could be an effective therapy against severe acute respiratory syndrome coronavirus (SARS-CoV). Utilizing the human immunoglobulin transgenic mouse, XenoMouse®, we produced fully human SARS-CoV spike (S) protein specific antibodies. Antibodies were examined for reactivity against a recombinant S1 protein, to which 200 antibodies reacted. Twenty-seven antibodies neutralized 200TCID50 SARS-CoV (Urbani). Additionally, 57 neutralizing antibodies were found that are likely specific to S2. Mapping of the binding region was achieved with several S1 recombinant proteins. Most S1 reactive neutralizing mAbs bound to the RBD, aa 318–510. However, two S1 specific mAbs reacted with a domain upstream of the RBD between aa 12 and 261. Immunoglobulin gene sequence analyses suggested at least 8 different binding specificities. Unique human mAbs could be used as a cocktail that would simultaneously target several neutralizing epitopes and prevent emergence of escape mutants.


title: Hyphema: Considerations in the Small Animal Patient

text: Classification, diagnosis, and treatment of hemorrhage into the anterior chamber of the eye, or hyphema, can be a challenging and frustrating process for many practitioners, especially in emergency situations. This review outlines an inclusive list of causes, diagnostics, and treatments for traumatic and nontraumatic hyphema in both canine and feline patients. The review is tailored to small animal practitioners, especially in emergency practice, and is designed to provide concise but thorough descriptions on investigating underlying causes of hyphema and treating accordingly.


title: The Flow Physics of COVID-19

text: Flow physics plays a key role in nearly every facet of the COVID-19 pandemic. This includes the generation and aerosolization of virus-laden respiratory droplets from a host, its airborne dispersion and deposition on surfaces, as well as the subsequent inhalation of these bioaerosols by unsuspecting recipients. Fluid dynamics is also key to preventative measures such as the use of face masks, hand-washing, ventilation of indoor environments, and even social distancing. This article summarizes what we know, and more importantly, what we need to learn about the science underlying these issues so that we are better prepared to tackle the next outbreak of COVID-19 or a similar disease.


title: Coupling dynamics of epidemic spreading and information diffusion on complex networks

text: Abstract The interaction between disease and disease information on complex networks has facilitated an interdisciplinary research area. When a disease begins to spread in the population, the corresponding information would also be transmitted among individuals, which in turn influence the spreading pattern of the disease. In this paper, firstly, we analyze the propagation of two representative diseases (H7N9 and Dengue fever) in the real-world population and their corresponding information on Internet, suggesting the high correlation of the two-type dynamical processes. Secondly, inspired by empirical analyses, we propose a nonlinear model to further interpret the coupling effect based on the SIS (Susceptible-Infected-Susceptible) model. Both simulation results and theoretical analysis show that a high prevalence of epidemic will lead to a slow information decay, consequently resulting in a high infected level, which shall in turn prevent the epidemic spreading. Finally, further theoretical analysis demonstrates that a multi-outbreak phenomenon emerges via the effect of coupling dynamics, which finds good agreement with empirical results. This work may shed light on the in-depth understanding of the interplay between the dynamics of epidemic spreading and information diffusion.


title: Molecular monitoring of causative viruses in child acute respiratory infection in endemo-epidemic situations in Shanghai

text: Abstract Background Numerous viruses are responsible for respiratory infections; however, both their distribution and genetic diversity, in a limited area and a population subgroup, have been studied only rarely during a sustained period of time. Methods A 2-year surveillance program of children presenting with acute respiratory infections (ARIs) was carried out to characterize the viral etiology and to assess whether using gene amplification and sequencing could be a reliable approach to monitor virus introduction and spread in a population subgroup. Results Using multiplex RT-PCR, 15 different respiratory viruses were detected within the 486 nasopharyngeal positive samples collected among 817 children aged <9-year old who presented with ARI during October 2006 to September 2008. A single virus was detected in 373 patients (45.7%), and two to four viruses in 113 patients (13.8%). The most frequent causative viruses were respiratory syncytial virus (RSV) (24.7%), human bocavirus (24.5%), and human rhinovirus (HRV) (15%). RSV was more prevalent in winter and among young infants. Cases of seasonal influenza A and B viruses were reported mainly in January and August. An increase in adenovirus infection was observed during the spring of the second year of the study. Sequence analyses showed multiple introductions of different virus subtypes and identified a high prevalence of the newly defined HRV-C species. A higher viral incidence was observed during the winter of 2008, which was unusually cold. Conclusions This study supports the usefulness of multiplex RT-PCR for virus detection and co-infection, and for implementation of a molecular monitoring system for endemic and epidemic viral respiratory infections.


title: Immature and Mature Human Astrovirus: Structure, Conformational Changes, and Similarities to Hepatitis E Virus

text: Abstract Human astroviruses (HAstVs) are a major cause of gastroenteritis. HAstV assembles from the structural protein VP90 and undergoes a cascade of proteolytic cleavages. Cleavage to VP70 is required for release of immature particles from cells, and subsequent cleavage by trypsin confers infectivity. We used electron cryomicroscopy and icosahedral image analysis to determine the first experimentally derived, three-dimensional structures of an immature VP70 virion and a fully proteolyzed, infectious virion. Both particles display T =3 icosahedral symmetry and nearly identical solid capsid shells with diameters of ~350Å. Globular spikes emanate from the capsid surface, yielding an overall diameter of ~440Å. While the immature particles display 90 dimeric spikes, the mature capsid only displays 30 spikes, located on the icosahedral 2-fold axes. Loss of the 60 peripentonal spikes likely plays an important role in viral infectivity. In addition, immature HAstV bears a striking resemblance to the structure of hepatitis E virus (HEV)-like particles, as previously predicted from structural similarity of the crystal structure of the astrovirus spike domain with the HEV P-domain [Dong, J., Dong, L., Méndez, E. & Tao, Y. (2011). Crystal structure of the human astrovirus capsid spike. Proc. Natl. Acad. Sci. USA 108, 12681–12686]. Similarities between their capsid shells and dimeric spikes and between the sequences of their capsid proteins suggest that these viral families are phylogenetically related and may share common assembly and activation mechanisms.


title: The Occupational and Psychosocial Impact of SARS on Academic Physicians in Three Affected Hospitals

text: A cross-sectional anonymous survey was administered to all directory-listed physicians within a network of three large teaching hospitals that provided care to SARS patients in Toronto. One hundred ninety-three physicians participated, 23% of whom provided direct care to SARS patients. A significantly higher rate of psychological distress was seen among physicians providing direct care to SARS patients (45.7%) than among those not providing direct care (17.7%), and physicians providing direct care reported feeling more stigmatized. Several physicians (10.9%) reported entering the hospital despite experiencing identified SARS symptoms. The most frequent SARS concerns were about the care of non-SARS patients following suspension of nonessential services and loss of physician income.


title: Guidance for the care of neuromuscular patients during the COVID-19 pandemic outbreak from the French Rare Health Care for Neuromuscular Diseases Network

text: Abstract In France, the epidemic phase of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in February 2020 and resulted in the implementation of emergency measures and a degradation in the organization of neuromuscular reference centers. In this special context, the French Rare Health Care for Neuromuscular Diseases Network (FILNEMUS) has established guidance in an attempt to homogenize the management of neuromuscular (NM) patients within the French territory. Hospitalization should be reserved for emergencies, the conduct of treatments that cannot be postponed, check-ups for which the diagnostic delay may result in a loss of survival chance, and cardiorespiratory assessments for which the delay could be detrimental to the patient. A national strategy was adopted during a period of 1 to 2 months concerning treatments usually administered in hospitalization. NM patients treated with steroid/ immunosuppressants for a dysimmune pathology should continue all of their treatments in the absence of any manifestations suggestive of COVID-19. A frequently asked questions (FAQ) sheet has been compiled and updated on the FILNEMUS website. Various support systems for self-rehabilitation and guided exercises have been also provided on the website. In the context of NM diseases, particular attention must be paid to two experimental COVID-19 treatments, hydroxycholoroquine and azithromycin: risk of exacerbation of myasthenia gravis and QT prolongation in patients with pre-existing cardiac involvement. The unfavorable emergency context related to COVID-19 may specially affect the potential for intensive care admission (ICU) for people with NMD. In order to preserve the fairest medical decision, a multidisciplinary working group has listed the neuromuscular diseases with a good prognosis, usually eligible for resuscitation admission in ICU and, for other NM conditions, the positive criteria suggesting a good prognosis. Adaptation of the use of noninvasive ventilation (NIV) make it possible to limit nebulization and continue using NIV in ventilator-dependent patients.


title: Mental health status of people isolated due to Middle East Respiratory Syndrome

text: OBJECTIVES: Isolation due to the management of infectious diseases is thought to affect mental health, but the effects are still unknown. We examined the prevalence of anxiety symptoms and anger in persons isolated during the Middle East Respiratory Syndrome (MERS) epidemic both at isolation period and at four to six months after release from isolation. We also determined risk factors associated with these symptoms at four to six months. METHODS: Of 14,992 individuals isolated for 2-week due to having contact with MERS patients in 2015, when MERS was introduced to Korea, 1,692 individuals were included in this study. Anxiety symptoms were evaluated with the Generalized Anxiety Disorder 7-item scale and anger was assessed with the State-Trait Anger Expression Inventory at four to six months after release from isolation for MERS. RESULTS: Of 1,692 who came in contact with MERS patients, 1,656 were not diagnosed with MERS. Among 1,656, anxiety symptoms showed 7.6% (95% confidence interval [CI], 6.3 to 8.9%) and feelings of anger were present in 16.6% (95% CI, 14.8 to 18.4%) during the isolation period. At four to six months after release from isolation, anxiety symptoms were observed in 3.0% (95%CI, 2.2 to 3.9%). Feelings of anger were present in 6.4% (95% CI, 5.2 to 7.6%). Risk factors for experiencing anxiety symptoms and anger at four to six months after release included symptoms related to MERS during isolation, inadequate supplies (food, clothes, accommodation), social networking activities (email, text, Internet), history of psychiatric illnesses, and financial loss. CONCLUSIONS: Mental health problems at four to six month after release from isolation might be prevented by providing mental health support to individuals with vulnerable mental health, and providing accurate information as well as appropriate supplies, including food, clothes, and accommodation.


Epidémie au nouveau coronavirus (SARS-CoV-2) et prescription de la clozapine: quelles mesures? Pourquoi?


title: Update on Human Rhinovirus and Coronavirus Infections

text: Human rhinovirus (HRV) and coronavirus (HCoV) infections are associated with both upper respiratory tract illness (“the common cold”) and lower respiratory tract illness (pneumonia). New species of HRVs and HCoVs have been diagnosed in the past decade. More sensitive diagnostic tests such as reverse transcription-polymerase chain reaction have expanded our understanding of the role these viruses play in both immunocompetent and immunosuppressed hosts. Recent identification of severe acute respiratory syndrome and Middle East respiratory syndrome viruses causing serious respiratory illnesses has led to renewed efforts for vaccine development. The role these viruses play in patients with chronic lung disease such as asthma makes the search for antiviral agents of increased importance.


title: Ebola crisis response in the USA: Communication management and SOPs

text: Abstract This research focuses on the 2014 Ebola crisis response by emergency managers in the Dallas-Fort Worth (DFW) Metropolitan region in the State of Texas, U.S.A. It examines the patterns of crisis communication and the use of Standard Operating Procedures (SOPs) during the first month of the crisis. Primary data collected from 24 face-to-face interviews and 12 online surveys are analyzed. The research identifies elements contributing to organizational failures, which by their very nature gain public and media attention, and also explicates the less mentioned successful decisions made by response agencies in the DFW region. It is important to investigate both failures and successes to help inform organizational learning for better preparedness to future health crises. Findings suggest that, although there was a breakdown in communication between small city governments/ municipalities and higher levels of government at the State and Federal levels, prior training and collaborative relationships helped in improvised decision-making. Takeaways for practitioners include reiterating the importance of establishing SOPs, merits of flexibility, and improvisational decisions for shared learning.


title: Fuzzy logic approach for infectious disease diagnosis: A methodical evaluation, literature and classification

text: This paper presents a systematic review of the literature and the classification of fuzzy logic application in an infectious disease. Although the emergence of infectious diseases and their subsequent spread have a significant impact on global health and economics, a comprehensive literature evaluation of this topic has yet to be carried out. Thus, the current study encompasses the first systematic, identifiable and comprehensive academic literature evaluation and classification of the fuzzy logic methods in infectious diseases. 40 papers on this topic, which have been published from 2005 to 2019 and related to the human infectious diseases were evaluated and analyzed. The findings of this evaluation clearly show that the fuzzy logic methods are vastly used for diagnosis of diseases such as dengue fever, hepatitis and tuberculosis. The key fuzzy logic methods used for the infectious disease are the fuzzy inference system; the rule-based fuzzy logic, Adaptive Neuro-Fuzzy Inference System (ANFIS) and fuzzy cognitive map. Furthermore, the accuracy, sensitivity, specificity and the Receiver Operating Characteristic (ROC) curve were universally applied for a performance evaluation of the fuzzy logic techniques. This thesis will also address the various needs between the different industries, practitioners and researchers to encourage more research regarding the more overlooked areas, and it will conclude with several suggestions for the future infectious disease researches.


title: Effectiveness of contact precautions against multidrug-resistant organism transmission in acute care: a systematic review of the literature

text: Contact precautions are widely recommended to prevent multidrug-resistant organism (MDRO) transmission. However, conflicting data exist regarding their effectiveness. Prior systematic reviews examined contact precautions as part of a larger bundled approach, limiting ability to understand their effectiveness. The aim of this review was to characterize the effectiveness of contact precautions alone against transmission of any MDRO among adult acute care patients. Directed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, comprehensive searches of four electronic scientific literature databases were conducted for studies published in English from January 2004 to June 2014. Studies were included if interventional, original research, evaluating contact isolation precautions against MDRO transmission among inpatients. Searches returned 284 studies, six of which were included in the review. These studies measured four different MDROs with one study showing a reduction in transmission. Whereas studies were of high quality regarding outcome operationalization and statistical analyses, overall quality was moderate to low due to poor intervention description, population characterization and potential biases. Where compliance was measured (N = 4), it presented a threat to validity because it included select parts of the intervention, ranged from 21% to 87%, and was significantly different across study phases (N = 2). The poor quality of evidence on this topic continues to limit interpretation of these data. Hence, this conflicting body of literature does not constitute evidence for or against contact precautions. We recommend that researchers consider power calculation, compliance monitoring, non-equivalent concurrent controls when designing future studies on this topic.


title: Sublingual Immunization of Trivalent Human Papillomavirus DNA Vaccine in Baculovirus Nanovector for Protection against Vaginal Challenge

text: Here, we report the immunogenicity of a sublingually delivered, trivalent human papillomavirus (HPV) DNA vaccine encapsidated in a human endogenous retrovirus (HERV) envelope-coated, nonreplicable, baculovirus nanovector. The HERV envelope-coated, nonreplicable, baculovirus-based DNA vaccine, encoding HPV16L1, -18L1 and -58L1 (AcHERV-triHPV), was constructed and sublingually administered to mice without adjuvant. Following sublingual (SL) administration, AcHERV-triHPV was absorbed and distributed throughout the body. At 15 minutes and 1 day post-dose, the distribution of AcHERV-triHPV to the lung was higher than that to other tissues. At 30 days post-dose, the levels of AcHERV-triHPV had diminished throughout the body. Six weeks after the first of three doses, 1×10(8) copies of SL AcHERV-triHPV induced HPV type-specific serum IgG and neutralizing antibodies to a degree comparable to that of IM immunization with 1×10(9) copies. AcHERV-triHPV induced HPV type-specific vaginal IgA titers in a dose-dependent manner. SL immunization with 1×10(10) copies of AcHERV-triHPV induced Th1 and Th2 cellular responses comparable to IM immunization with 1×10(9) copies. Molecular imaging revealed that SL AcHERV-triHPV in mice provided complete protection against vaginal challenge with HPV16, HPV18, and HPV58 pseudoviruses. These results support the potential of SL immunization using multivalent DNA vaccine in baculovirus nanovector for induction of mucosal, systemic, and cellular immune responses.


Zoonotic tuberculosis in Africa: challenges and ways forward


title: Feather Pecking and Cannibalism in Non-Beak-Trimmed Laying Hen Flocks—Farmers’ Perspectives

text: SIMPLE SUMMARY: Pecking-related problems are common in intensive egg production, diminishing hen welfare and production performance, and negatively affecting sustainability. Beak trimming is a common practice to control these problems, but in Finland beak trimming is prohibited. Finnish egg producers have decades-long experience of egg production with intact-beaked hens. This experience, and their management of pecking-related problems, could benefit producers in other countries. The online questionnaire aimed to gather information about Finnish farmers’ attitudes towards beak trimming, their estimation of the seriousness of pecking problems in their laying hen flocks, common risk factors and the best practices to prevent attendant problems. The questionnaire received 35 responses. Finnish egg producers appeared strongly to support a policy of not trimming beaks. Motivation against beak trimming was explained by considering it to be unnecessary and unethical. Most respondents did not regard pecking-related problems as being very severe in their flocks. Lighting, feeding and flock management problems represented the most important risk factors regarding pecking problems. Generally, the same topics were highlighted as being the most important intervention measures for managing an on-going pecking problem. The study indicates that it is possible to incorporate a non-beak-trimming policy as a component of sustainable egg production. ABSTRACT: Pecking-related problems are common in intensive egg production, compromising hen welfare, causing farmers economic losses and negatively affecting sustainability. These problems are often controlled by beak trimming, which in Finland is prohibited. An online questionnaire aimed to collect information from farmers about pecking-related problems in Finnish laying hen flocks, important risk factors and the best experiences to prevent the problems. Additionally, the farmers’ attitudes towards beak trimming were examined. We received 35 responses, which represents about 13% of all Finnish laying hen farms with ≥300 laying hens. The majority of respondents stated that a maximum of 5–7% incidence of feather pecking or 1–2% incidence of cannibalism would be tolerable. The majority of respondents (74%) expressed that they would definitely not use beak-trimmed hens. Only two respondents indicated that they would probably use beak-trimmed hens were the practice permitted. Among risk factors, light intensity earned the highest mean (6.3), on a scale from 1 (not important) to 7 (extremely important). Other important problems included those that occurred during rearing, feeding, flock management and problems with drinking water equipment (mean 5.9, each). The most important intervention measures included optimal lighting and feeding, flock management, and removing the pecker and victim. Concluding, Finnish farmers had strong negative attitudes towards beak trimming. The study underlines the importance of flock management, especially lighting and feeding, in preventing pecking problems and indicates that it is possible to incorporate a non-beak-trimming policy into sustainable egg production.


title: Nanoparticle-based vaccine development and evaluation against viral infections in pigs

text: Virus infections possess persistent health challenges in swine industry leading to severe economic losses worldwide. The economic burden caused by virus infections such as Porcine Reproductive and Respiratory Syndrome Virus, Swine influenza virus, Porcine Epidemic Diarrhea Virus, Porcine Circovirus 2, Foot and Mouth Disease Virus and many others are associated with severe morbidity, mortality, loss of production, trade restrictions and investments in control and prevention practices. Pigs can also have a role in zoonotic transmission of some viral infections to humans. Inactivated and modified-live virus vaccines are available against porcine viral infections with variable efficacy under field conditions. Thus, improvements over existing vaccines are necessary to: (1) Increase the breadth of protection against evolving viral strains and subtypes; (2) Control of emerging and re-emerging viruses; (3) Eradicate viruses localized in different geographic areas; and (4) Differentiate infected from vaccinated animals to improve disease control programs. Nanoparticles (NPs) generated from virus-like particles, biodegradable and biocompatible polymers and liposomes offer many advantages as vaccine delivery platform due to their unique physicochemical properties. NPs help in efficient antigen internalization and processing by antigen presenting cells and activate them to elicit innate and adaptive immunity. Some of the NPs-based vaccines could be delivered through both parenteral and mucosal routes to trigger efficient mucosal and systemic immune responses and could be used to target specific immune cells such as mucosal microfold (M) cells and dendritic cells (DCs). In conclusion, NPs-based vaccines can serve as novel candidate vaccines against several porcine viral infections with the potential to enhance the broader protective efficacy under field conditions. This review highlights the recent developments in NPs-based vaccines against porcine viral pathogens and how the NPs-based vaccine delivery system induces innate and adaptive immune responses resulting in varied level of protective efficacy.


title: Effects of nursing organizational culture and job stress on Korean infection control nurses’ turnover intention

text: This study's aim was to discern the nursing organizational culture and job stress, induced by infection control nurses (ICNs)’ working together, affects ICNs’ turnover intentions. Job stress was the most significant factor affecting ICNs’ turnover intention. To reduce ICNs’ turnover intention, their task stress needs to be lowered and managed. In particular, efforts should be made to establish a relation-oriented organizational culture that values positive relationships while enhancing their community spirit at the organization level.


Re: Chilblain‐like lesions on feet and hands during the COVID‐19 pandemic


title: Uptake and effectiveness of facemask against respiratory infections at mass gatherings: a systematic review

text: Abstract Objectives The risk of acquisition and transmission of respiratory infections is high among attendees of mass gatherings (MGs). Currently used interventions have limitations yet the role of facemask in preventing those infections at MG has not been systematically reviewed. We have conducted a systematic review to synthesise evidence about the uptake and effectiveness of facemask against respiratory infections in MGs. Methods A comprehensive literature search was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines using major electronic databases such as, Medline, EMBASE, SCOPUS and CINAHL. Results Of 25 studies included, the pooled sample size was 12710 participants from 55 countries aged 11 to 89 years, 37% were female. The overall uptake of facemask ranged from 0.02% to 92.8% with an average of about 50%. Only 13 studies examined the effectiveness of facemask, and their pooled estimate revealed significant protectiveness against respiratory infections (relative risk [RR]=0.89, 95% CI: 0.84-0.94, p <0.01), but the study end points varied widely. Conclusion A modest proportion of attendees of MGs use facemask, the practice is more widespread among health care workers. Facemask use seems to be beneficial against certain respiratory infections at MGs but its effectiveness against specific infection remains unproven.


title: The SARS-CoV-2 conserved macrodomain is a highly efficient ADP-ribosylhydrolase

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and other SARS-like-CoVs encode 3 tandem macrodomains within non-structural protein 3 (nsp3). The first macrodomain, Mac1, is conserved throughout CoVs, binds to and hydrolyzes mono-ADP-ribose (MAR) from target proteins. Mac1 likely counters host-mediated anti-viral ADP-ribosylation, a posttranslational modification that is part of the host response to viral infections. Mac1 is essential for pathogenesis in multiple animal models of CoV infection, implicating it as a virulence factor and potential therapeutic target. Here we report the crystal structure of SARS-CoV-2 Mac1 in complex with ADP-ribose. SARS-CoV-2, SARS-CoV and MERS-CoV Mac1 exhibit similar structural folds and all 3 proteins bound to ADP-ribose with low μM affinities. In contrast, we found that only the MERS-CoV Mac1 protein bound to poly-ADP-ribose (PAR), and none of these enzymes could hydrolyze PAR. Importantly, using ADP-ribose detecting antibodies and both gel-based assay and novel ELISA assays, we demonstrated highly efficient de-MARylating activity for all 3 CoV Mac1 proteins. We conclude that the SARS-CoV-2 and other CoV Mac1 proteins are highly efficient MAR-hydrolases with strikingly similar activity, indicating that compounds targeting CoV Mac1 proteins may have broad anti-CoV activity. IMPORTANCE SARS-CoV-2 has recently emerged into the human population and has led to a worldwide pandemic of COVID-19 that has caused nearly 350 thousand deaths worldwide. With, no currently approved treatments, novel therapeutic strategies are desperately needed. All coronaviruses encode for a highly conserved macrodomain (Mac1) that binds to and removes ADP-ribose adducts from proteins in a dynamic post-translational process increasingly recognized as an important factor that regulates viral infection. The macrodomain is essential for CoV pathogenesis and may be a novel therapeutic target. Thus, understanding its biochemistry and enzyme activity are critical first steps for these efforts. Here we report the crystal structure of SARS-CoV-2 Mac1 in complex with ADP-ribose, and describe its ADP-ribose binding and hydrolysis activities in direct comparison to SARS-CoV and MERS-CoV Mac1 proteins. These results are an important first step for the design and testing of potential therapies targeting this unique protein domain.


title: Redox process is crucial for inhibitory properties of aurintricarboxylic acid against activity of YopH: virulence factor of Yersinia pestis

text: YopH is a bacterial protein tyrosine phosphatase, which is essential for the viability and pathogenic virulence of the plague-causing Yersinia sp. bacteria. Inactivation of YopH activity would lead to the loss of bacterial pathogenicity. We have studied the inhibitory properties of aurintricarboxylic acid (ATA) against YopH phosphatase and found that at nanomolar concentrations ATA reversibly decreases the activity of YopH. Computational docking studies indicated that in all binding poses ATA binds in the YopH active site. Molecular dynamics simulations showed that in the predicted binding pose, ATA binds to the essential Cys403 and Arg409 residues in the active site and has a stronger binding affinity than the natural substrate (pTyr). The cyclic voltammetry experiments suggest that ATA reacts remarkably strongly with molecular oxygen. Additionally, the electrochemical reduction of ATA in the presence of a negative potential from −2.0 to 2.5 V generates a current signal, which is observed for hydrogen peroxide. Here we showed that ATA indicates a unique mechanism of YopH inactivation due to a redox process. We proposed that the potent inhibitory properties of ATA are a result of its strong binding in the YopH active site and in situ generation of hydrogen peroxide near catalytic cysteine residue.


title: Evolutionary Responses to a Constructed Niche: Ancient Mesoamericans as a Model of Gene-Culture Coevolution

text: Culture and genetics rely on two distinct but not isolated transmission systems. Cultural processes may change the human selective environment and thereby affect which individuals survive and reproduce. Here, we evaluated whether the modes of subsistence in Native American populations and the frequencies of the ABCA1*Arg230Cys polymorphism were correlated. Further, we examined whether the evolutionary consequences of the agriculturally constructed niche in Mesoamerica could be considered as a gene-culture coevolution model. For this purpose, we genotyped 229 individuals affiliated with 19 Native American populations and added data for 41 other Native American groups (n = 1905) to the analysis. In combination with the SNP cluster of a neutral region, this dataset was then used to unravel the scenario involved in 230Cys evolutionary history. The estimated age of 230Cys is compatible with its origin occurring in the American continent. The correlation of its frequencies with the archeological data on Zea pollen in Mesoamerica/Central America, the neutral coalescent simulations, and the F(ST)-based natural selection analysis suggest that maize domestication was the driving force in the increase in the frequencies of 230Cys in this region. These results may represent the first example of a gene-culture coevolution involving an autochthonous American allele.


title: Shared Decision Making in Cardiac Transplantation during the COVID19 Pandemic: Patient Refusal of Transplantation

text: Abstract SDM with advanced heart failure patients is critical in making decisions regarding therapies such as LVAD and cardiac transplantation. We describe a case wherein the risks of COVID19 infection affected the decision of a patient around proceeding with cardiac transplantation.


title: The SARS-CoV S glycoprotein

text: The severe acute respiratory syndrome-coronavirus (SARS-CoV) spike (S) glycoprotein alone can mediate the membrane fusion required for virus entry and cell fusion. It is also a major immunogen and a target for entry inhibitors. Recent rapid advances in our knowledge of the structure and function of this protein have lead to the development of a number of candidate vaccine immunogens and SARS-CoV entry inhibitors.


title: Psychological distress among health professional students during the COVID-19 outbreak

text: BACKGROUND: Due to the drastic surge of COVID-19 patients, many countries are considering or already graduating health professional students early to aid professional resources. We aimed to assess outbreak-related psychological distress and symptoms of acute stress reaction (ASR) in health professional students and to characterize individuals with potential need for interventions. METHODS: We conducted a prospective cohort study of 1442 health professional students at Sichuan University, China. At baseline (October 2019), participants were assessed for childhood adversity, stressful life events, internet addiction, and family functioning. Using multivariable logistic regression, we examined associations of the above exposures with subsequent psychological distress and ASR in response to the outbreak. RESULTS: Three hundred and eighty-four (26.63%) participants demonstrated clinically significant psychological distress, while 160 (11.10%) met the criterion for a probable ASR. Individuals who scored high on both childhood adversity and stressful life event experiences during the past year were at increased risks of both distress (ORs 2.00–2.66) and probable ASR (ORs 2.23–3.10), respectively. Moreover, internet addiction was associated with elevated risks of distress (OR 2.05, 95% CI 1.60–2.64) and probable ASR (OR 2.15, 95% CI 1.50–3.10). By contrast, good family functioning was associated with decreased risks of distress (OR 0.43, 95% CI 0.33–0.55) and probable ASR (OR 0.48, 95% CI 0.33–0.69). All associations were independent of baseline psychological distress. CONCLUSIONS: Our findings suggest that COVID-19 related psychological distress and high symptoms burden of ASR are common among health professional students. Extended family and professional support should be considered for vulnerable individuals during these unprecedented times.


MERS-CoV: a global challenge


title: Liver Disease in the Adolescent

text: This article discusses common liver diseases in the adolescent. Briefly reviewed is the evaluation of the adolescent with new-onset liver enzyme elevation. Then the article discusses common liver diseases, such as nonalcoholic fatty liver disease, hepatitis, metabolic disease, biliary atresia, cystic fibrosis, and inherited disorders of cholestasis. Finally, a management approach to the adolescent with liver disease is outlined, noting the challenges that must be addressed to effectively care for not only liver disease in the adolescent but also the patient as a whole.


title: Ocular disease in rats: a review

text: The rat Rattus norvegicus is widely used in experimental work, both providing a rodent model for human ocular disease and as a species for toxicologic screening. In addition, the rat is more and more widely kept as a pet, being both friendly and intelligent. Diagnosis and treatment of ocular disease is important for the welfare of individual animals and whole colonies, but also to ensure that spontaneous disease is not compromising experimental work. Here, ophthalmic conditions are reviewed in order to provide a survey of ocular disease in the rat both for veterinary ophthalmologists and for laboratory animal veterinarians and research workers.


title: Sources of viral respiratory infections in Canadian acute care hospital healthcare personnel

text: Summary Background Viral respiratory illnesses are common causes of outbreaks and can be fatal to some patients. Aim To investigate the association between laboratory-confirmed viral respiratory infections and potential sources of exposure during the previous 7 days. Methods In this nested case–control analysis, healthcare personnel from nine Canadian hospitals who developed acute respiratory illnesses during the winters of 2010/11–2013/14 submitted swabs that were tested for viral pathogens. Associated illness diaries and the weekly diaries of non-ill participants provided information on contact with people displaying symptoms of acute respiratory illness in the previous week. Conditional logistic regression assessed the association between cases, who were matched by study week and site with controls with no respiratory symptoms. Findings There were 814 laboratory-confirmed viral respiratory illnesses. The adjusted odds ratio (aOR) of a viral illness was higher for healthcare personnel reporting exposures to ill household members [7.0, 95% confidence interval (CI) 5.4–9.1], co-workers (3.4, 95% CI 2.4–4.7) or other social contacts (5.1, 95% CI 3.6–7.1). Exposures to patients with respiratory illness were not associated with infection (aOR 0.9, 95% CI 0.7–1.2); however, healthcare personnel with direct patient contact did have higher odds (aOR 1.3, 95% CI 1.1–1.6). The aORs for exposure and for direct patient contact were similar for illnesses caused by influenza. Conclusion Community and co-worker contacts are important sources of viral respiratory illness in healthcare personnel, while exposure to patients with recognized respiratory infections is not associated. The comparatively low risk associated with direct patient contact may reflect transmission related to asymptomatic patients or unrecognized infections.


title: Identification of new reference genes for the normalisation of canine osteoarthritic joint tissue transcripts from microarray data

text: BACKGROUND: Real-time reverse transcriptase quantitative polymerase chain reaction (real-time RT-qPCR) is the most accurate measure of gene expression in biological systems. The comparison of different samples requires the transformation of data through a process called normalisation. Reference or housekeeping genes are candidate genes which are selected on the basis of constitutive expression across samples, and allow the quantification of changes in gene expression. At present, no reference gene has been identified for any organism which is universally optimal for use across different tissue types or disease situations. We used microarray data to identify new reference genes generated from total RNA isolated from normal and osteoarthritic canine articular tissues (bone, ligament, cartilage, synovium and fat). RT-qPCR assays were designed and applied to each different articular tissue. Reference gene expression stability and ranking was compared using three different mathematical algorithms. RESULTS: Twelve new potential reference genes were identified from microarray data. One gene (mitochondrial ribosomal protein S7 [MRPS7]) was stably expressed in all five of the articular tissues evaluated. One gene HIRA interacting protein 5 isoform 2 [HIRP5]) was stably expressed in four of the tissues evaluated. A commonly used reference gene glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was not stably expressed in any of the tissues evaluated. Most consistent agreement between rank ordering of reference genes was observed between Bestkeeper© and geNorm, although each method tended to agree on the identity of the most stably expressed genes and the least stably expressed genes for each tissue. New reference genes identified using microarray data normalised in a conventional manner were more stable than those identified by microarray data normalised by using a real-time RT-qPCR methodology. CONCLUSION: Microarray data normalised by a conventional manner can be filtered using a simple stepwise procedure to identify new reference genes, some of which will demonstrate good measures of stability. Mitochondrial ribosomal protein S7 is a new reference gene worthy of investigation in other canine tissues and diseases. Different methods of reference gene stability assessment will generally agree on the most and least stably expressed genes, when co-regulation is not present.


title: An emergent clade of SARS-CoV-2 linked to returned travellers from Iran

text: The SARS-CoV-2 epidemic has rapidly spread outside China with major outbreaks occurring in Italy, South Korea, and Iran. Phylogenetic analyses of whole-genome sequencing data identified a distinct SARS-CoV-2 clade linked to travellers returning from Iran to Australia and New Zealand. This study highlights potential viral diversity driving the epidemic in Iran, and underscores the power of rapid genome sequencing and public data sharing to improve the detection and management of emerging infectious diseases.


title: Damage/Danger Associated Molecular Patterns (DAMPs) Modulate Chlamydia pecorum and C. trachomatis Serovar E Inclusion Development In Vitro

text: Persistence, more recently termed the chlamydial stress response, is a viable but non-infectious state constituting a divergence from the characteristic chlamydial biphasic developmental cycle. Damage/danger associated molecular patterns (DAMPs) are normal intracellular components or metabolites that, when released from cells, signal cellular damage/lysis. Purine metabolite DAMPs, including extracellular ATP and adenosine, inhibit chlamydial development in a species-specific manner. Viral co-infection has been shown to reversibly abrogate Chlamydia inclusion development, suggesting persistence/chlamydial stress. Because viral infection can cause host cell DAMP release, we hypothesized DAMPs may influence chlamydial development. Therefore, we examined the effect of extracellular ATP, adenosine, and cyclic AMP exposure, at 0 and 14 hours post infection, on C. pecorum and C. trachomatis serovar E development. In the absence of de novo host protein synthesis, exposure to DAMPs immediately post or at 14 hours post infection reduced inclusion size; however, the effect was less robust upon 14 hours post infection exposure. Additionally, upon exposure to DAMPs immediately post infection, bacteria per inclusion and subsequent infectivity were reduced in both Chlamydia species. These effects were reversible, and C. pecorum exhibited more pronounced recovery from DAMP exposure. Aberrant bodies, typical in virus-induced chlamydial persistence, were absent upon DAMP exposure. In the presence of de novo host protein synthesis, exposure to DAMPs immediately post infection reduced inclusion size, but only variably modulated chlamydial infectivity. Because chlamydial infection and other infections may increase local DAMP concentrations, DAMPs may influence Chlamydia infection in vivo, particularly in the context of poly-microbial infections.


title: Cross-Reactive Human IgM-Derived Monoclonal Antibodies that Bind to HIV-1 Envelope Glycoproteins

text: Elicitation of antibodies with potent and broad neutralizing activity against HIV by immunization remains a challenge. Several monoclonal antibodies (mAbs) isolated from humans with HIV-1 infection exhibit such activity but vaccine immunogens based on structures containing their epitopes have not been successful for their elicitation. All known broadly neutralizing mAbs (bnmAbs) are immunoglobulin (Ig) Gs (IgGs) and highly somatically hypermutated which could impede their elicitation. Ig Ms (IgMs) are on average significantly less divergent from germline antibodies and are relevant for the development of vaccine immunogens but are underexplored compared to IgGs. Here we describe the identification and characterization of several human IgM-derived mAbs against HIV-1 which were selected from a large phage-displayed naive human antibody library constructed from blood, lymph nodes and spleens of 59 healthy donors. These antibodies bound with high affinity to recombinant envelope glycoproteins (gp140s, Envs) of HIV-1 isolates from different clades. They enhanced or did not neutralize infection by some of the HIV-1 primary isolates using CCR5 as a coreceptor but neutralized all CXCR4 isolates tested although weakly. One of these antibodies with relatively low degree of somatic hypermutation was more extensively characterized. It bound to a highly conserved region partially overlapping with the coreceptor binding site and close to but not overlapping with the CD4 binding site. These results suggest the existence of conserved structures that could direct the immune response to non-neutralizing or even enhancing antibodies which may represent a strategy used by the virus to escape neutralizing immune responses. Further studies will show whether such a strategy plays a role in HIV infection of humans, how important that role could be, and what the mechanisms of infection enhancement are. The newly identified mAbs could be used as reagents to further characterize conserved non-neutralizing, weakly neutralizing or enhancing epitopes and modify or remove them from candidate vaccine immunogens.


title: Preparedness is Essential for Western Pacific Islands During the COVID-19 Pandemic

text: OBJECTIVES: To clarify the pandemic status in Western Pacific countries or territories. METHODS: The WHO’s daily situation reports of COVID-19 were reviewed from January 20, 2020, to March 24, 2020. Changes in the infections, deaths, and the case fatality rate (CFR) in Western Pacific countries or territories were counted. RESULTS: As of March 24, a total of 17 countries or territories had reported the presence of COVID-19 in the Western Pacific Region, 96,580 people have been infected and a total of 3502 deaths. Fifty-three percent (9/17) of these countries or territories had their first case within 2 wk since the WHO’s first report, most are China’s neighbors with a large and dense population. No other country or territory in this region reported a new infection from January 30 to February 28. However, 8 (47.0%) countries or territories have reported the first cases in 3 wk since February 28, almost all are islands. Many countries maintained a small number of infections for a long time after the first report, but a rapid increase occurred later. Deaths occurred in 8 countries with a total CFR of 3.63%, and the CFR varies widely, from 0.39% (Singapore) to 7.14% (Philippines). CONCLUSIONS: The regional spread of COVID-19 urgently requires an aggressive preparedness for the Western Pacific Islands.


title: Is the role of rhinoviruses as causative agents of pediatric community-acquired pneumonia over-estimated?

text: The role that rhinoviruses, enteroviruses, parainfluenza viruses, coronaviruses and human bocavirus play in pediatric pneumonia is insufficiently studied. We used polymerase chain reaction (PCR) to study 9 virus groups, including 16 different viruses or viral strains, in 56 ambulatory children with radiologically confirmed community-acquired pneumonia (CAP). The same tests were carried out on 474 apparently healthy control children of the same age and sex. The mean age of children with CAP was 6.5 years (SD 4.2). Respiratory syncytial virus (RSV) was found in 19.6 % of 56 cases and in 2.1 % of 474 controls. Adenoviruses were present in 12.5 % of cases (0.2 % controls) and metapneumovirus and influenza A virus each in 10.7 % of cases (0.2 % controls). Interestingly, rhinoviruses were less common in cases (10.7 %) than in controls (22.4 %): odds ratio 0.36 (95%CI) 0.15–0.87) in conditional logistic regression including 56 cases and 280 controls matched for age, sex and sampling month. The prevalence of parainfluenza viruses, enteroviruses, coronaviruses and human bocavirus were similar in both groups. Conclusion: We conclude that the role of rhinoviruses as an etiology of pediatric CAP has been over-estimated, mainly due to the non-controlled designs of previous studies.


title: Inhibition of SARS-coronavirus infection in vitro by S-nitroso-N-acetylpenicillamine, a nitric oxide donor compound

text: Abstract Introduction: The recent outbreak of severe acute respiratory syndrome (SARS) warrants the search for effective antiviral agents to treat the disease. This study describes the assessment of the antiviral potential of nitric oxide (NO) against SARS coronavirus (SARS-CoV) strain Frankfurt-1 replicating in African Green Monkey (Vero E6) cells. Results: Two organic NO donor compounds, S-nitroso-N-acetylpenicillamine (SNAP) and sodium nitroprusside (SNP), were tested in a broad range of concentrations. The non-nitrosylated form of SNAP, N-acetylpenicillamine (NAP), was included as a control compound in the assay. Antiviral activity was estimated by the inhibition of the SARS-CoV cytopathic effect in Vero E6 cells, determined by a tetrazolium-based colorimetric method. Cytotoxicity of the compounds was tested in parallel. Conclusion: The survival rate of SARS-CoV infected cells was greatly increased by the treatment with SNAP, and the concentration of this compound needed to inhibit the viral cytopathic effect to 50% was 222μM, with a selectivity index of 3. No anti-SARS-CoV effect could be detected for SNP and NAP.


title: Structure-based immunogen design—leading the way to the new age of precision vaccines

text: Vaccines have been one of the most successful interventions in global health. However, traditional vaccine development has proven insufficient to deal with pathogens that elude the immune system through highly variable and non-functional epitopes. Emerging B cell technologies have yielded potent monoclonal antibodies targeting conserved epitopes, and their structural characterization has provided templates for rational immunogen design. Here, we review immunogen design strategies that leverage structural information to steer bulk immune responses towards the induction of precise antibody specificities targeting key antigenic sites. Immunogens designed to elicit well-defined antibody responses will become the basis of what we dubbed precision vaccines. Such immunogens have been used to tackle long-standing vaccine problems and have demonstrated their potential to seed the next-generation of vaccines.


title: Amiodarone-related pneumonitis and peripheral neuropathy in an elderly patient

text: Amiodarone, which has been used since 1967 as an antiarrhythmic drug, gives rise to a variety of cardiac and extracardiac adverse side-effects. Among these, pulmonary toxicity is considered the most frequent and serious extracardiac side-effect, since it may occur in various atypical forms and often limits the drug’s clinical use. We encountered a 67-year-old white male patient with suspected amiodarone pneumonitis characterized by multiple lung nodules associated with pleural and pericardial effusion and peripheral neuropathy. Because differential diagnosis with pulmonary infectious diseases may be extremely difficult, the attending physician should therefore bear in mind the possibility of amiodarone pneumonitis whenever the drug is given.


title: Actualités en pathologie comparée : sur quelques maladies animales menaçantes pour l’homme

text: SUMMARY The last major human epidemics of infectious diseases have arisen from animals. Some of them are especially threatening. The authors call attention to the danger of spread of avian influenza, either directly or indirectly through genetic rearrangements. They underline the role of animals in the epidemiology of SARS, West Nile virus, hepatitis E, NIPA and Hendra virus, ehrlichiosis and Lyme disease. The authors recommend health surveillance not only in humans but also in animals ; the teaching of zoonoses, and research on animal diseases transmissible to humans.


title: Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study

text: BACKGROUND: Chronic obstructive pulmonary disease (COPD), lung cancer, and tuberculosis are three leading causes of death in China, where prevalences of smoking and solid-fuel use are also high. We aimed to predict the effects of risk-factor trends on COPD, lung cancer, and tuberculosis. METHODS: We used representative data sources to estimate past trends in smoking and household solid-fuel use and to construct a range of future scenarios. We obtained the aetiological effects of risk factors on diseases from meta-analyses of epidemiological studies and from large studies in China. We modelled future COPD and lung cancer mortality and tuberculosis incidence, taking into account the accumulation of hazardous effects of risk factors on COPD and lung cancer over time, and dependency of the risk of tuberculosis infection on the prevalence of disease. We quantified the sensitivity of our results to methods and data choices. FINDINGS: If smoking and solid-fuel use remain at current levels between 2003 and 2033, 65 million deaths from COPD and 18 million deaths from lung cancer are predicted in China; 82% of COPD deaths and 75% of lung cancer deaths will be attributable to the combined effects of smoking and solid-fuel use. Complete gradual cessation of smoking and solid-fuel use by 2033 could avoid 26 million deaths from COPD and 6·3 million deaths from lung cancer; interventions of intermediate magnitude would reduce deaths by 6−31% (COPD) and 8−26% (lung cancer). Complete cessation of smoking and solid-fuel use by 2033 would reduce the projected annual tuberculosis incidence in 2033 by 14−52% if 80% DOTS coverage is sustained, 27−62% if 50% coverage is sustained, or 33−71% if 20% coverage is sustained. INTERPRETATION: Reducing smoking and solid-fuel use can substantially lower predictions of COPD and lung cancer burden and would contribute to effective tuberculosis control in China. FUNDING: International Union Against Tuberculosis and Lung Disease.


title: A role for arrays in clinical virology: fact or fiction?

text: Abstract Microarrays of DNA probes have at least three roles in clinical virology. These are: firstly, in diagnosis, to recognise the causative agent of an illness; secondly, for molecular typing for (i) patient management, (ii) epidemiological reasons (e.g. investigating routes of transmission), (iii) purposes related to vaccine use; and thirdly, in research, to investigate the interactions between the virus and the host cell. Microarrays intended for syndromic diagnostic purposes require genome specific probes to capture the unknown target viral sequences and thereby reveal the presence of that virus in a test sample. Microarrays intended for typing and patient management, e.g. monitoring antiviral drug resistant mutations require a set of probes representing the important sequence variants of one or more viral genes. Microarrays intended for research into virus–host interactions require probes representative of each individual gene or mRNA of either the virus or the host genome. Diagnostic microarrays are dependent for their utility and versatility on generic, multiplex or random polymerase chain reactions that will amplify any of several (unknown) viral target sequences from a patient sample. In this review, the existing and potential applications of microarrays in virology, and the problems that need to be overcome for future success, are discussed.


title: Eggshell color in brown-egg laying hens — a review

text: ABSTRACT The major pigment in eggshells of brown-egg laying hens is protoporphyrin IX, but traces of biliverdin and its zinc chelates are also present. The pigment appears to be synthesized in the shell gland. The protoporphyrin IX synthetic pathway is well defined, but precisely where and how it is synthesized in the shell gland of the brown-egg laying hen is still ambiguous. The pigment is deposited onto all shell layers including the shell membranes, but most of it is concentrated in the outermost layer of the calcareous shell and in the cuticle. Recently, the genes that are involved in pigment synthesis have been identified, but the genetic control of synthesis and deposition of brown pigment in the commercial laying hen is not fully understood. The brown coloration of the shell is an important shell quality parameter and has a positive influence on consumer preference. The extent of pigment deposition is influenced by the housing system, hen age, hen strain, diet, stressors, and certain diseases such as infectious bronchitis. In this article, the physiological and biochemical characteristics of the brown pigment in commercial brown-egg layers are reviewed in relation to its various functions in the poultry industry.


title: Clostridium perfringens type E enteritis in calves: two cases and a brief review of the literature

text: Abstract Toxigenic types of Clostridium perfringens are important causes of enteric disease in domestic animals, although type E is putatively rare, appearing as an uncommon cause of enterotoxemia of lambs, calves, and rabbits. We report here two geographically distinct cases of type E enterotoxemia in calves, and diagnostic findings which suggest that type E may play a significant role in enteritis of neonatal calves. The cases had many similarities, including a history of diarrhea and sudden death, abomasitis, and hemorrhagic enteritis. In both cases, anaerobic cultures of abomasum yielded heavy growth of C. perfringens genotype E. Four percent of > 1000 strains of C. perfringens from cases of enteritis in domestic animals were type E, and all (n=45) were from neonatal calves with hemorrhagic enteritis. Furthermore, type E isolates represented nearly 50% of all isolates submitted from similar clinical cases in calves. Commercial toxoids available in North America have no label claims for efficacy against type E infections. Consideration should be given to type E-associated enteritis when planning for the health care of calves.


title: S1 gene-based phylogeny of infectious bronchitis virus: An attempt to harmonize virus classification

text: Abstract Infectious bronchitis virus (IBV) is the causative agent of a highly contagious disease that results in severe economic losses to the global poultry industry. The virus exists in a wide variety of genetically distinct viral types, and both phylogenetic analysis and measures of pairwise similarity among nucleotide or amino acid sequences have been used to classify IBV strains. However, there is currently no consensus on the method by which IBV sequences should be compared, and heterogeneous genetic group designations that are inconsistent with phylogenetic history have been adopted, leading to the confusing coexistence of multiple genotyping schemes. Herein, we propose a simple and repeatable phylogeny-based classification system combined with an unambiguous and rationale lineage nomenclature for the assignment of IBV strains. By using complete nucleotide sequences of the S1 gene we determined the phylogenetic structure of IBV, which in turn allowed us to define 6 genotypes that together comprise 32 distinct viral lineages and a number of inter-lineage recombinants. Because of extensive rate variation among IBVs, we suggest that the inference of phylogenetic relationships alone represents a more appropriate criterion for sequence classification than pairwise sequence comparisons. The adoption of an internationally accepted viral nomenclature is crucial for future studies of IBV epidemiology and evolution, and the classification scheme presented here can be updated and revised novel S1 sequences should become available.