title: The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China

text: Abstract The 2019-nCoV is officially called SARS-CoV-2 and the disease is named COVID-19. This viral epidemic in China has led to the deaths of over 1800 people, mostly elderly or those with an underlying chronic disease or immunosuppressed state. This is the third serious Coronavirus outbreak in less than 20 years, following SARS in 2002–2003 and MERS in 2012. While human strains of Coronavirus are associated with about 15% of cases of the common cold, the SARS-CoV-2 may present with varying degrees of severity, from flu-like symptoms to death. It is currently believed that this deadly Coronavirus strain originated from wild animals at the Huanan market in Wuhan, a city in Hubei province. Bats, snakes and pangolins have been cited as potential carriers based on the sequence homology of CoV isolated from these animals and the viral nucleic acids of the virus isolated from SARS-CoV-2 infected patients. Extreme quarantine measures, including sealing off large cities, closing borders and confining people to their homes, were instituted in January 2020 to prevent spread of the virus, but by that time much of the damage had been done, as human-human transmission became evident. While these quarantine measures are necessary and have prevented a historical disaster along the lines of the Spanish flu, earlier recognition and earlier implementation of quarantine measures may have been even more effective. Lessons learned from SARS resulted in faster determination of the nucleic acid sequence and a more robust quarantine strategy. However, it is clear that finding an effective antiviral and developing a vaccine are still significant challenges. The costs of the epidemic are not limited to medical aspects, as the virus has led to significant sociological, psychological and economic effects globally. Unfortunately, emergence of SARS-CoV-2 has led to numerous reports of Asians being subjected to racist behavior and hate crimes across the world.


title: Distinct Roles for Sialoside and Protein Receptors in Coronavirus Infection

text: Coronaviruses (CoVs) are common human and animal pathogens that can transmit zoonotically and cause severe respiratory disease syndromes. CoV infection requires spike proteins, which bind viruses to host cell receptors and catalyze virus-cell membrane fusion. Several CoV strains have spike proteins with two receptor-binding domains, an S1A that engages host sialic acids and an S1B that recognizes host transmembrane proteins. As this bivalent binding may enable broad zoonotic CoV infection, we aimed to identify roles for each receptor in distinct infection stages. Focusing on two betacoronaviruses, murine JHM-CoV and human Middle East respiratory syndrome coronavirus (MERS-CoV), we found that virus particle binding to cells was mediated by sialic acids; however, the transmembrane protein receptors were required for a subsequent virus infection. These results favored a two-step process in which viruses first adhere to sialic acids and then require subsequent engagement with protein receptors during infectious cell entry. However, sialic acids sufficiently facilitated the later stages of virus spread through cell-cell membrane fusion, without requiring protein receptors. This virus spread in the absence of the prototype protein receptors was increased by adaptive S1A mutations. Overall, these findings reveal roles for sialic acids in virus-cell binding, viral spike protein-directed cell-cell fusion, and resultant spread of CoV infections.


title: SARS-CoV-2 PCR and antibody testing for an entire rural community: methods and feasibility of high-throughput testing procedures

text: High-volume, community-wide ascertainment of SARS-CoV-2 prevalence by PCR and antibody testing was successfully performed using a community-led, drive-through model with strong operational support, well-trained testing units, and an effective technical platform.


title: Intervention time series analysis of crime rates: The case of sentence reform in Virginia

text: Abstract We review the basic concepts of intervention analysis in the context of structural time series models and we apply this methodology to investigate the possible reduction in monthly crime rates reported from January 1984 up to and including December 2010 after Virginia abolished parole and reformed sentencing in January 1995. We find that the change in legislation has significantly reduced the burglary rates and to a lesser extent the murder rates in Virginia. The robustness of our results is investigated with an automatic detection of breaks procedure as well as with analyses of quarterly rather than monthly data.


title: Best practice recommendations for point-of-care lung ultrasound in patients with suspected COVID-19

text: Abstract Background Lung point-of-care ultrasound (POCUS) is a critical tool for evaluating patients with dyspnea in the emergency department (ED), including patients with suspected COVID-19. However, given the threat of nosocomial disease spread, the use of ultrasound is no longer risk-free. Objective of the Review: Here, we review the lung POCUS findings in patients with COVID-19. In doing so we present a scanning protocol for lung POCUS in COVID-19 which maximizes clinical utility and provider safety. Discussion In COVID-19 lung, POCUS findings are predominatly located in the posterior and lateral lung zones bilaterally. A 6-zone scanning protocol which prioritizes obtaining images in these locations optimizes provider positioning, and minimizes time spent scanning which can reduce risk to health care workers performing POCUS. Conclusions Lung POCUS can offer valuable clinical data when evaluating patients with COVID-19. Scanning protocols such as that presented here which target clinical utility and decreased nosocomial disease spread must be prioritized.


title: TRIM25 in the Regulation of the Antiviral Innate Immunity

text: TRIM25 is an E3 ubiquitin ligase enzyme that is involved in various cellular processes, including regulation of the innate immune response against viruses. TRIM25-mediated ubiquitination of the cytosolic pattern recognition receptor RIG-I is an essential step for initiation of the intracellular antiviral response and has been thoroughly documented. In recent years, however, additional roles of TRIM25 in early innate immunity are emerging, including negative regulation of RIG-I, activation of the melanoma differentiation-associated protein 5–mitochondrial antiviral signaling protein–TRAF6 antiviral axis and modulation of p53 levels and activity. In addition, the ability of TRIM25 to bind RNA may uncover new mechanisms by which this molecule regulates intracellular signaling and/or RNA virus replication.


title: The tissue distribution of spontaneous cell-mediated cytotoxicity effector lymphocytes in swine

text: Abstract Peripheral blood lymphocytes, intraepithelial lymphocytes from the small intestine and lymphocytes from the thymus, spleen, mesenteric lymph nodes and Peyer's patches from 5 young adult pigs were used as effector cells in a spontaneous cell-mediated cytotoxicity chromium release assay against PK-15 cells persistently infected with transmissible gastroenteritis virus as targets. Both peripheral blood and intraepithelial lymphocytes caused marked specific chromium release, while the lymphocytes from the remaining tissues were inactive in spontaneous cell-mediated cytotoxicity.


title: South-Africa: challenges and successes of the Covid-19 lockdown

text: Abstract At the beginning of March 2020, South-Africa (59 million inhabitants) was hit by the pandemic of Covid-19 and soon became the most affected country in Africa by the SARS-CoV-2 virus. From one single case on March 5th, the number of cases increased rapidly, forcing the South-African Government to swiftly react and place the country under strict lockdown for six weeks. The strategy of the South-African Government borne fruits with a contained spread of the virus. If the number of positive cases at the end of the lockdown reached 5647, the number of fatal casualties was limited to 103 deaths. The lockdown was overall well respected, even if serious problems of food supply soon occurred in informal settlements leading to riots and confrontation with security forces. Indeed, populations were obedient, but not being able to practice sport or outdoors activities appeared heavy. The constant fear of the poorest not to have enough money to pay rent and buy food (even if the Government organised food parcels’ distributions), and to find less and less work was echoed by the fear of losing jobs among those more privileged. Despite the risk of an economic crisis, the South-African Government has continued on the reasonable path of containing the pandemic with ending the lockdown at a slow pace, in five phases.


Bone Marrow Cytologic and Histologic Biopsies: Indications, Technique, and Evaluation


title: Two cases of COVID‐19 with positive salivary and negative pharyngeal or respiratory swabs at hospital discharge: A rising concern

text: We report two cases of COVID‐19 showing negative respiratory swabs but positive salivary samples at the same time. These findings rise the concern about how to manage these patients before hospital discharging, thus avoiding contagion among their family members or a second coronavirus wave once the lockdown is over.


title: Clinical Features and Outcomes of Severe Acute Respiratory Syndrome and Predictive Factors for Acute Respiratory Distress Syndrome

text: Background Severe acute respiratory syndrome (SARS) is an emerging infectious disease, and indeed, the SARS epidemic in Taiwan from March to July 2003 had a great impact. This study depicts the clinical characteristics and short-term outcomes of patients with SARS treated at Taipei Veterans General Hospital; potential predictive factors for acute respiratory distress syndrome (ARDS) are also analyzed. Methods This study retrospectively analyzed data for 67 SARS patients, who were grouped according to whether or not ARDS developed during the clinical course of SARS. Results There were 32 males (mean age, 50.3 years; range, 20–75 years) and 35 females (mean age, 51.1 years; range, 23–86 years). Twenty-five patients (37.3%) were health care workers. At admission, 50 patients (74.6%) had abnormal chest radiographs, and all patients developed pulmonary infiltrates during the following week. During hospitalization, lymphopenia was found in 57 patients (85.1%); and elevated levels of lactate dehydrogenase (LDH; n = 55; 83.3%), C-reactive protein (n = 55; 83.3%), aminotransferases (n = 44; 65.7%), and creatine kinase (n = 14; 20.9%) were also noted. ARDS developed in 33 patients (49.3%), who were generally older than the patients in whom ARDS did not develop, male, non-health care workers, and who generally had dyspnea at the time of diagnosis, and a history of diabetes mellitus, hypertension or cerebrovascular accident. Patients with, versus those without, ARDS also tended to present with more severe lymphopenia and leukocytosis, and with higher levels of LDH and aspartate aminotransferase. The overall mortality rate was 31.3% (21/67), whereas the rate for patients who developed ARDS was 63.6% (21/33). Multivariate analyses showed that age greater than 65 years (odds ratio, OR, 10.6; 95% confidence interval, CI, 2.1–54.1), pre-existing diabetes mellitus (OR, 13.7; 95% CI, 1.3–146.9), and elevated levels of LDH (OR, 8.4; 95% CI, 1.9–36.9) at admission, were independent predictors of ARDS. Conclusion The clinical manifestations of SARS showed high variability, and were related to the underlying health status of individual patients. Importantly, the development of ARDS was associated with significant mortality, despite aggressive therapy.


title: Kitchen Spectroscopy: Shining a (UV) Light on Everyday Objects

text: Fluorescent objects often lead to a sense of joy and intrigue. While the current COVID-19 pandemic limits the synthesis of “glowy things” like quantum dots, many household objects fluoresce, providing an opportunity to brighten your day while learning fundamental chemistry.


title: The Epidemiological and Clinical Characteristics of 81 Children with COVID-19 in a Pandemic Hospital in Turkey: an Observational Cohort Study

text: BACKGROUND: Coronavirus disease-2019 (COVID-19) pandemic has affected millions of people throughout the world since December 2019. However, there is a limited amount of data about pediatric patients infected with the disease agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). METHODS: The epidemiological, laboratory, radiological, and treatment features of the pediatric patients who were positive for SARS-CoV-2 based on the reverse-transcription polymerase chain reaction (RT-PCR) test, were investigated retrospectively. RESULTS: The median age of 81 children included in the study was 9.50 years (0–17.75 years). The most frequent symptoms at the time of admission were fever (58%), cough (52%), and fatigue or myalgia (19%). The abnormal laboratory findings in these cases were decreased lymphocytes (2.5%, n = 2), leucopenia (5%, n = 4), and increased lactate dehydrogenase (17.2%, n = 14), C-reactive protein (16%, n = 13), procalcitonin (3.7%, n = 3), and D-dimer (12.3%, n = 10). Three (4%) patients had consolidation in chest computed tomography, and three (4%) had ground-glass opacities. None of the patients needed intensive care except for the newborns. The median time to turn SARS-CoV-2 negative in the RT-PCR test was 5 (3–10) days. The median length of hospital stay was 5 (4–10) days. The time to turn SARS-CoV-2 negative in the RT-PCR test and the length of hospital stay were significantly longer for those aged five years or younger than others (P = 0.037, P = 0.01). CONCLUSION: Compared to adults, COVID-19 is milder and more distinctive in children. As a result, more conservative approaches might be preferred in children for the diagnostic, clinical, and even therapeutic applications.


title: Angiotensin-converting enzyme 2 (ACE2) mediates influenza H7N9 virus-induced acute lung injury

text: Since March 2013, the emergence of an avian-origin influenza A (H7N9) virus has raised concern in China. Although most infections resulted in respiratory illness, some severe cases resulted in acute respiratory distress syndrome (ARDS), which is a severe form of acute lung injury (ALI) that further contributes to morbidity. To date, no effective drugs that improve the clinical outcome of influenza A (H7N9) virus-infected patients have been identified. Angiotensin-converting enzyme (ACE) and ACE2 are involved in several pathologies such as cardiovascular functions, renal disease, and acute lung injury. In the current study, we report that ACE2 could mediate the severe acute lung injury induced by influenza A (H7N9) virus infection in an experimental mouse model. Moreover, ACE2 deficiency worsened the disease pathogenesis markedly, mainly by targeting the angiotensin II type 1 receptor (AT1). The current findings demonstrate that ACE2 plays a critical role in influenza A (H7N9) virus-induced acute lung injury, and suggest that might be a useful potential therapeutic target for future influenza A (H7N9) outbreaks.


title: Human iPSC-derived alveolar and airway epithelial cells can be cultured at air-liquid interface and express SARS-CoV-2 host factors

text: Development of an anti-SARS-CoV-2 therapeutic is hindered by the lack of physiologically relevant model systems that can recapitulate host-viral interactions in human cell types, specifically the epithelium of the lung. Here, we compare induced pluripotent stem cell (iPSC)-derived alveolar and airway epithelial cells to primary lung epithelial cell controls, focusing on expression levels of genes relevant for COVID-19 disease modeling. iPSC-derived alveolar epithelial type II-like cells (iAT2s) and iPSC-derived airway epithelial lineages express key transcripts associated with lung identity in the majority of cells produced in culture. They express ACE2 and TMPRSS2, transcripts encoding essential host factors required for SARS-CoV-2 infection, in a minor subset of each cell sub-lineage, similar to frequencies observed in primary cells. In order to prepare human culture systems that are amenable to modeling viral infection of both the proximal and distal lung epithelium, we adapt iPSC-derived alveolar and airway epithelial cells to two-dimensional air-liquid interface cultures. These engineered human lung cell systems represent sharable, physiologically relevant platforms for SARS-CoV-2 infection modeling and may therefore expedite the development of an effective pharmacologic intervention for COVID-19.


title: A single amino acid substitution (R441A) in the receptor-binding domain of SARS coronavirus spike protein disrupts the antigenic structure and binding activity

text: Abstract The spike (S) protein of severe acute respiratory syndrome coronavirus (SARS-CoV) has two major functions: interacting with the receptor to mediate virus entry and inducing protective immunity. Coincidently, the receptor-binding domain (RBD, residues 318–510) of SAR-CoV S protein is a major antigenic site to induce neutralizing antibodies. Here, we used RBD-Fc, a fusion protein containing the RBD and human IgG1 Fc, as a model in the studies and found that a single amino acid substitution in the RBD (R441A) could abolish the immunogenicity of RBD to induce neutralizing antibodies in immunized mice and rabbits. With a panel of anti-RBD mAbs as probes, we observed that R441A substitution was able to disrupt the majority of neutralizing epitopes in the RBD, suggesting that this residue is critical for the antigenic structure responsible for inducing protective immune responses. We also demonstrated that the RBD-Fc bearing R441A mutation could not bind to soluble and cell-associated angiotensin-converting enzyme 2 (ACE2), the functional receptor for SARS-CoV and failed to block S protein-mediated pseudovirus entry, indicating that this point mutation also disrupted the receptor-binding motif (RBM) in the RBD. Taken together, these data provide direct evidence to show that a single amino acid residue at key position in the RBD can determine the major function of SARS-CoV S protein and imply for designing SARS vaccines and therapeutics.


title: Good urodynamic practice adaptations during the COVID‐19 pandemic

text: Urodynamics testing forms the cornerstone of investigations when it comes to lower urinary tract dysfunction. It has to be done to the highest standards by following the International Continence Society Good Urodynamics Practice protocols. However, with the COVID‐19 pandemic, certain adaptations to the urodynamics procedure need to be considered especially when it comes to quality control. This article aims to define these adaptations to help urodynamicists in their daily practice.


title: A Prospective Study of Respiratory Viral Infection in Pregnant Women With and Without Asthma

text: BACKGROUND: Respiratory viral infections are common in pregnancy, but their health impact, especially in asthma, is unknown. The objective of this study was to assess the frequency, severity, and consequences of respiratory viral infection during pregnancy in women with and without asthma. METHODS: In this prospective cohort study, common cold symptoms were assessed during pregnancy in 168 women with asthma and 117 women without asthma using the common cold questionnaire and by self-report. Nasal and throat swabs were collected for suspected infections and tested by polymerase chain reaction for respiratory viruses. Pregnancy and asthma outcomes were recorded. RESULTS: Pregnant women with asthma had more prospective self-reported and questionnaire-detected common colds than pregnant women without asthma (incidence rate ratio, 1.77; 95% CI, 1.30-2.42; P < .0001). Retrospectively reported common colds in early pregnancy and post partum were increased in women with asthma compared with women without asthma. The severity of cold symptoms was also increased in women with asthma (total cold score median, 8; interquartile range [5, 10] in women with asthma vs 6 [5, 8] in control subjects; P = .031). Among women with asthma, having a laboratory-confirmed viral infection was associated with poorer maternal health, with 60% of infections associated with uncontrolled asthma and a higher likelihood of preeclampsia. CONCLUSIONS: Pregnant women with asthma have more common colds during pregnancy than pregnant women without asthma. Colds during pregnancy were associated with adverse maternal and pregnancy outcomes. Prevention of viral infection in pregnancy may improve the health of mothers with asthma.


title: Sunscope: A Video-guided Intubation System Through a Detachable Imaging Probe

text: We have designed a novel apparatus, the Sunscope, which integrates a semiconductor image sensor into a compact video-guided intubation system. This device consists of three separate modules: viewer, console and visual tube. The 4-inch LCD viewer panel displays the real-time video image with optimal view angle. The console is designed with respect to ergonomics allowing comfortable manipulation and internally accommodating the power supply, image processing components and connector platform for both viewer and probe. The distal end of the detachable probe is packaged with a high resolution lens, CMOS sensor, and four LEDs. The proximal end is a 6-pin connector which can be readily removed and attached on demand. The probe is detachable and disposable with length and diameter adaptable to the size of the endotracheal tube. In our preliminary test, the video-guided apparatus helped inexperienced performers to identify the vocal cords correctly and improve the success rate of intubation on the simulation model. With further improvements on the miniature design, all captured images could be transmitted to remote devices through standard wireless transmission and could thus be stored in a specific database station. The wireless technique enables image sharing on multiple devices while a powerful database can provide valuable resources for training, data mining and serial case studies. We demonstrate that the CMOS image sensor combined with advanced reduced instruction set computer machine can serve as a visual aid for tracheal intubation. The disposable station will become a revolutionary technology both in clinical practice and medical education.


Rapid Ramp-up of Powered Air-Purifying Respirator (PAPR) Training for Infection Prevention and Control during the COVID-19 Pandemic


title: Indicators of Critical Illness and Predictors of Mortality in COVID-19 Patients

text: COVID-19 is an emerging disease all over the world and spreading at an unpredicted rate, resulting in significant influences on global economies and public health. Clinical, laboratory, and imaging characteristics have been partially described in some observational studies. Not enough systematic reviews on predictors of critical illness and mortality in COVID 19 have been published to date. In this review, we had illustrated the prognostic predictors of COVID-19 by gathering published information on the risk factors related to the outcomes of SARS-CoV-2 infections.


title: Etiology, Seasonality, and Clinical Features of Viral Respiratory Tract Infections in Children Hospitalized With Acute Bronchiolitis: A Single-Center Study

text: The purpose of this study was to evaluate the viral frequency, seasonality, and clinical and demographic features of patients hospitalized with acute bronchiolitis. A cross-sectional, descriptive study was performed in 316 infants younger than 2 years of age who were hospitalized for acute viral bronchiolitis. Respiratory tract infection agents were investigated with polymerase chain reaction (PCR). A total of 316 infants were included in this study. Of the 316 infants, at least one respiratory tract pathogen was detected in 75% (237/316). Respiratory syncytial virus (RSV) was the most common virus identified in 127 infants (40.1%) followed by rhinovirus (n = 78, 24.6%). In this study, where viral agents were determined via PCR in patients who were followed-up due to the diagnosis of acute bronchiolitis, RSV was detected as the most common agent, as in other studies. In almost half of the RSV-positive patients, RSV was accompanied by a second or third agent.


title: Urology in the Era of COVID-19: Mass Casualty Triage

text: INTRODUCTION: The COVID-19 pandemic represents an uncertain challenge that could generate large numbers of patients in a short period of time. METHODS: How best to manage this situation is evolving. There will not be an ideal solution so we must all work together to solve the challenge. RESULTS: Applying principles of mass casualty medicine in triaging urology patients in need of elective and emergent surgeries is of paramount importance. CONCLUSIONS: Accordingly, there is a crucial need to find a guide to pragmatic management of urological patients during this pandemic.


Is COVID-19 affecting the incidence of hip fractures?


title: Coronavirus‐days ın dermatology

text: Severe acute respiratory syndrome‐corona virus‐2, which causes coronavirus disease 2019 (COVID‐19), is highly contagious and a particularly popular problem in all around the World and also in all departments of every hospital. In order to protect the well‐being of health care providers while providing a sufficient workforce to respond to the COVID‐19 are vital for pandemic planning. In this article, we will discuss this problem from a dermatological aspect.


title: Bat Migration

text: This article summarizes current knowledge about the migratory behavior of temperate and tropical bats. A close association between migration and hibernation exists in temperate, but not in tropical, bats. Compared with birds, bats are relatively short-distance migrators, with maximum migration distances being <2000km; intercontinental migration is likely to be uncommon in bats. Migratory bats have lower levels of population subdivision and larger genetically effective population sizes than nonmigratory bats. A variety of methods, including banding, genetic analyses, stable isotope analyses, and tracking with radio or satellite transmitters, are currently being used to study bat migration. The conservation of migratory bats poses special challenges that require national and international efforts. Migratory bats sometimes harbor pathogens that can be transmitted to humans. Overall, the beneficial aspects of migratory bats, including control of insect populations and dispersal of pollen and seeds over broad areas, far outweigh their negative aspects.


title: Some actions for behavior analyst licensing bodies to consider in response to the COVID‐19 pandemic

text: The COVID‐19 global pandemic has had a significant impact on the practice of applied behavior analysis (ABA). Practitioners and caregivers have had to adapt quickly as physical distancing, stay‐at‐home orders, and shelter‐in‐place directives have become commonplace. As the field copes with the changes produced by the COVID‐19 outbreak, many behavior analytic practitioners are seeking guidance from regulatory bodies to ensure they are practicing legally and ethically. This article outlines some actions that the regulatory bodies that manage state behavior analyst licensure programs may consider to assist ABA practitioners and consumers during this unprecedented time. Additionally, suggestions are offered as to how state licensing bodies might prepare to support the practice of licensees during future events that present challenges similar to the current pandemic.


title: Comparison of Neurotization Versus Nerve Repair in an Animal Model of Chronically Denervated Muscle

text: Purpose Reinnervation of chronically denervated muscle is clinically unpredictable and poorly understood. Current operative strategies include either direct nerve repair, nerve grafting, nerve transfer, or neurotization. The goal of this study is to compare muscle recovery using microneural repair versus neurotization in a rat model of chronic denervation. Methods Fifty-eight Sprague-Dawley rats had surgical denervation of the tibialis anterior muscle by transecting the common peroneal nerve. After 0, 8, 12, or 22 weeks of denervation, animals were assigned to either a direct repair or a neurotization cohort. An additional 7 animals were used for a sham cohort, and 7 of the 58 were used as controls. After a 12-week recovery period, animals had contractile strength and EMG testing of the tibialis anterior muscle. Peak force and characteristics were compared to the unoperated, contralateral limb. Tibialis anterior muscles were then harvested for mass and histologic evaluation. Results Sixty-two animals completed testing. Denervated controls demonstrated a significant decrease in muscle mass, contractile strength, and peak motor nerve conduction amplitude compared to sham animals. In all groups, chronicity of denervation adversely affected functional recovery. On average, repair animals performed better than neurotization animals with respect to muscle mass, contractile strength, and peak motor amplitude. Differences in contractile force, however, were significant only at the 0 week denervation group (94% ± 30 vs 50% ± 20, repair vs neurotization). Neurotized muscles processed for histologic analysis demonstrated acetylcholinesterase activity at the nerve-muscle interface, confirming the formation of motor end plates de novo. Conclusions We demonstrated that neurotization is capable of reinnervating de novo end plates in chronically denervated muscle. Our data do not support the hypothesis that direct muscle neurotization is superior to nerve repair for functional restoration of chronically denervated muscle. However, as the duration of denervation increases, the difference between outcomes of the neurotization and repair group narrows, suggesting that neurotization may offer a viable surgical alternative in the setting of prolonged denervation.


title: Successful use of methylprednisolone for treating severe COVID-19

text: Timely and appropriate application of methylprednisolone in severe and critical COVID-19 patients could effectively avoid invasive mechanical ventilation and reduce the mortality.


title: Nano zinc oxide–sodium alginate antibacterial cellulose fibres

text: Abstract In the present study, antibacterial cellulose fibres were successfully fabricated by a simple and cost-effective procedure by utilizing nano zinc oxide. The possible nano zinc oxide was successfully synthesized by precipitation technique and then impregnated effectively over cellulose fibres through sodium alginate matrix. XRD analysis revealed the ‘rod-like’ shape alignment of zinc oxide with an interplanar d-spacing of 0.246nm corresponding to the (101) planes of the hexagonal wurtzite structure. TEM analysis confirmed the nano dimension of the synthesized zinc oxide nanoparticles. The presence of nano zinc oxide over cellulose fibres was evident from the SEM–EDS experiments. FTIR and TGA studies exhibited their effective bonding interaction. The tensile stress–strain curves data indicated the feasibility of the fabricated fibres for longer duration utility without any significant damage or breakage. The antibacterial studies against Escherichia coli revealed the excellent bacterial devastation property. Further, it was observed that when all the parameters remained constant, the variation of sodium alginate concentration showed impact in devastating the E. coli. In overall, the fabricated nano zinc oxide–sodium alginate cellulose fibres can be effectively utilized as antibacterial fibres for biomedical applications.


title: Arthroscopy and COVID-19: Impact of the Pandemic on Our Surgical Practices

text: Abstract The aim of this article is to study systematically current evidence on status of arthroscopic surgeries during the COVID-19 pandemic. We aim to study (1) changes in global arthroscopic practices, (2) recommendations on reducing risk to patients and health care workers (HCW), (3) changes in follow-up protocols of these patients. Systematic search was carried out by two different reviewers using three different online databases for all studies published in the English language before April 2020. The total number of abstracts screened initially was 314. After screening of these abstracts, a total of 13 studies were included for the systematic review. Numbers of orthopaedic injuries have seen a sharp fall during this time. Most elective surgical facilities were also closed at this time. Most studies have recommended telemedicine as an essential medium of providing continued care to patients during COVID-19. Studies have recommended that a conservative approach should be preferred for most patients with ligament injuries, and alternative procedures that have less requirement for an operating room should be explored. Common recommendation in all studies is that procedures of more elective nature should be postponed to a safer time frame when the transmission of COVID-19 virus in the population has declined. When surgeries are resumed, there is a need for triage of arthroscopy procedures from more important or urgent to less important ones. Elective surgical procedures should preferably be started with patients with no co-morbidities and lesser risk of peri-operative complications. All patients undergoing surgery and health care personnels should have some screening for disease. Attempts should be made to have shortest hospital stay. Choice of anaesthetic procedure should emphasize on minimal aerosolization of the virus. Regional anaesthesia is the preferred choice as far as possible. Most guidelines have recommended that patient follow up should be made telephonically or on video-conferencing.


title: Optimisation of reverse transcriptase loop-mediated isothermal amplification assay for rapid detection of Macrobrachium rosenbergii noda virus and extra small virus in Macrobrachium rosenbergii

text: Abstract The standardisation and optimisation of a one step single tube reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) procedure is described for rapid diagnosis of white tail disease, a viral disease caused by Macrobrachium rosenbergii noda virus (MrNV) and extra small virus (XSV), in giant fresh water prawn, M. rosenbergii. Time, temperature and quantity of each reagent were optimised for the detection of the two viruses. This method was more sensitive than the conventional reverse transcriptase polymerase chain reaction (RT-PCR) for detecting the two viruses. The RT-LAMP reaction is highly suited for disease diagnosis in developing countries. Amplification of DNA can be detected without the use of agarose gel electrophoresis, by the production of a whitish precipitate of magnesium pyrophosphate as a by-product. The cost of RT-LAMP for one reaction is nearly 4 times less than that of RT-PCR.


title: Assessing factors critical to smart technology applications to mobile health care − the fgm-fahp approach

text: Abstract Smart technologies present numerous opportunities for enhancing mobile health care. However, some concerns regarding the viability of smart technology applications must be addressed. This study investigated these concerns by reviewing the current practices of smart technology applications to mobile health care. As a result, five factors critical to the applicability of a smart technology to mobile health care are identified, and the fuzzy geometric mean-fuzzy analytic hierarchy process (FGM-FAHP) approach is proposed to assess the relative importance levels of the identified factors. The experimental results showed that the three most critical factors identified include: (a) the relaxation of the related medical laws; (b) unobtrusiveness; and (c) the precise need and situation of a user. Accordingly, approximately 44%, 26%, and 15% of the budget should be allocated to the realization of the three critical factors, respectively. In addition, the challenges involved and opportunities for enhancing the effectiveness of existing applications are discussed.


title: Discovery of 2-aryl and 2-pyridinylbenzothiazoles endowed with antimicrobial and aryl hydrocarbon receptor agonistic activities

text: Benzothiazole is a privileged scaffold in medicinal chemistry present in diverse bioactive compounds with multiple pharmacological applications such as analgesic, anticonvulsant, antidiabetic, anti-inflammatory, anticancer and radioactive amyloidal imagining agents. We reported in this work the study of sixteen functionalized 2-aryl and 2-pyridinylbenzothiazoles as antimicrobial agents and as aryl hydrocarbon receptor (AhR) modulators. The antimicrobial activity against Gram-positive (S. aureus and M. luteus) and Gram-negative (P. aeruginosa, S. enterica and E. coli) pathogens yielded MIC ranging from 3.13 to 50 μg/mL and against the yeast C. albicans, the benzothiazoles displayed MIC from 12.5 to 100 μg/mL. All compounds showed promising antibiofilm activity against S. aureus and P. aeruginosa. The arylbenzothiazole 12 displayed the greatest biofilm eradication in S. aureus (74%) subsequently verified by fluorescence microscopy. The ability of benzothiazoles to modulate AhR expression was evaluated in a cell-based reporter gene assay. Six benzothiazoles (7, 8-10, 12, 13) induced a significant AhR-mediated transcription and interestingly compound 12 was also the strongest AhR-agonist identified. Structure-activity relationships are suggested herein for the AhR-agonism and antibiofilm activities. Furthermore, in silico predictions revealed a good ADMET profile and druglikeness for the arylbenzothiazole 12 as well as binding similarities to AhR compared with the endogenous agonist FICZ.


title: Novel Porcine Epidemic Diarrhea Virus (PEDV) Variants with Large Deletions in the Spike (S) Gene Coexist with PEDV Strains Possessing an Intact S Gene in Domestic Pigs in Japan: A New Disease Situation

text: Since late 2013, after an absence of seven years, outbreaks of porcine epidemic diarrhea virus (PEDV) infection have reemerged and swept rapidly across Japan, resulting in significant economic losses. In this study, we report the emergence, mixed infection, and genetic characterization of 15 novel field PEDV variants with large genomic deletions. The sizes of deletion varied between 582 nt (194 aa) and 648 nt (216 aa) at positions 28–714 (10–238) on the S gene (protein). Among 17 PEDV samples isolated from individual pigs, all of them contained at least two distinct genotypes with large genomic deletions, and 94.1% of them were found to consist of strains with an intact S gene. These variants were found in eight primary and nine recurrent outbreaks, and they might be associated with persistent PEDV infection in the farms. Full-length S and ORF3 genes of eight variants derived from 2 samples were characterized. This is the first report of mixed infections caused by various genotypes of PEDV and would be important for the studies of viral isolation, pathogenesis, and molecular epidemiology of the disease.


title: A SimpleProbe(®) real‐time PCR assay for differentiating the canine parvovirus type 2 genotype

text: BACKGROUND: Canine parvovirus type 2 (CPV‐2) causes an important canine viral disease worldwide. CPV‐2 belongs to the Protoparvovirus genus in the family Parvoviridae. An amino acid change at position 426 of the VP2 protein differentiate types of CPV‐2, designated as CPV‐2a (Asn), CPV‐2b (Asp), and CPV‐2c (Glu). In this study, we compared CPV‐2 genotyping results obtained by SimpleProbe(®) real‐time PCR and DNA sequencing analysis to identify the accuracy and sensitivity of these methods. METHODS: One hundred rectal swabs were collected from CPV‐2 naturally infected dogs from 2015 to 2017 at the Animal Disease Diagnostic Center, National Pingtung University of Science and Technology. CPV‐2 genotyping was performed by SimpleProbe(®) real‐time PCR and DNA sequencing to compare results. RESULTS: CPV‐2a (n = 23), 2b (n = 6) and 2c (n = 71) genotyping results obtained by both techniques were identical with specificity of 100% for SimpleProbe(®) assay. In the SimpleProbe(®) assay, amplifying the DNAs prepared from the clinical specimens showed three distinct melting curve peaks. CPV‐2b had the highest melting peak of 57.8°C (CI 95%: 57.7‐58.5°C) followed by CPV‐2c with a slightly lower melting peak of 52.3°C (CI 95%: 52.2‐53.2°C) and CPV‐2a with the lowest peak of 50.2°C (CI 95%: 50.1‐50.5°C). CONCLUSION: This study developed a novel method for genotyping CPV‐2 strains using the SimpleProbe(®) real‐time PCR assay. This assay is a reliable and sensitive tool for differentiating between the CPV‐2a, 2b and 2c and this technique can be used for molecular CPV‐2 epidemiology studies.


title: Touristification. Empty concept or element of analysis in tourism geography?

text: Since the end of the last century, geographers have been using the concept of touristification understood as a complex process in which various stakeholders interfere, transforming a territory through tourist activity. However, over recent years, this word has become popular in other areas with a distinct connotation, understanding touristification as a negative idea of tourism, like the massification of a destination or as a synonymous for gentrification or tourism-phobia. This situation discourages the use of the term and causes the necessity to question the usefulness of the concept, considered as too ambiguous or even empty. We argue for a correct use of the term touristification, focused on the territorial phenomenon and process it is meant to describe in a geographical approach without ideological preconceived notion, to construct knowledge from a territorial understanding of tourism in an ever-globalized world.


title: Peritoneal Perfusion With Oxygenated Perfluorocarbon Augments Systemic Oxygenation

text: Background Despite maximal ventilatory support, many patients die from hypoxia in the setting of potentially reversible pulmonary failure. There remains a pressing need for additional pulmonary supportive care measures, especially techniques that do not require systemic anticoagulation. The objective of our experiments was to determine whether systemic oxygenation could be increased in a large animal, with induced hypoxia, by perfusing the abdominal cavity with oxygenated perfluorocarbons. Methods Fifteen pigs with a mean (± SD) weight of 45 ± 5 kg were intubated and rendered hypoxic by ventilating them with a blend of nitrogen and oxygen to achieve subatmospheric concentrations of inspired oxygen ranging from 18 to 10%, resulting in baseline mean Pao2 range of 65.9 ± 9.7 to 26.6 ± 2.8 mm Hg, respectively. Peritoneal perfusion was performed in eight animals with oxygenated perfluorocarbon and in seven control animals with oxygenated saline solution. Results The average increase in Pao2 with oxygenated perfluorocarbon perfusion, compared to oxygenated saline solution perfusion, ranged from 8.1 to 18.2 mm Hg. A common treatment effect was estimated across all fraction of inspired oxygen (Fio2) values, representing the average mean difference in oxygen uptake between oxygenated perfluorocarbon and saline solution, irrespective of the level of Fio2. This average was 12.8 mm Hg (95% confidence interval, 7.4 to 18.2; p < 0.001). The most clinically relevant results occurred at an Fio2 of 14%, resulting in a baseline mean Pao2 of 39.4 ± 5.0 mm Hg with oxygenated saline solution perfusion, and a mean Pao2 of 55.3 ± 7.6 mm Hg with oxygenated perfluorocarbon perfusion. This corresponded to an increase in arterial oxygen saturation from 73 to 89%. Conclusion These results of our principle experiments demonstrate that the peritoneal cavity can be used for gas exchange and, in our model, yielded clinically relevant increases in systemic arterial oxygen levels. This technique may have the potential for the supportive care of patients dying from hypoxia in the setting of reversible lung injury.


title: Vasculitis induced by immunization with Bacillus Calmette-Guérin followed by atypical mycobacterium antigen: a new mouse model for Kawasaki disease

text: Kawasaki disease causes systemic vasculitis. The development of skin lesions at the vaccination site with Bacillus Calmette-Guérin (BCG) is an important diagnostic symptom. We hypothesized that infection with ubiquitous microorganisms immunogenically related to BCG might induce an immunopathologic reaction leading to the development of Kawasaki disease. Mice were first inoculated with BCG, and then secondarily inoculated 4 weeks later with crude extract from Mycobacterium intracellulare (cMI), an abundant atypical mycobacterium. Animals inoculated with BCG followed by cMI developed coronary arteritis with infiltration of inflammatory cells, whereas control animals inoculated with only cMI or BCG did not, suggesting that the immune response to the mycobacteria induced autoimmunity to the vascular wall. Intravenous injection with antibodies to peroxiredoxin II, a modulator of vascular remodeling and a suggested target for autoimmune vasculitis, also resulted in coronary arteritis, but only after prior inoculation with BCG. Tumor necrosis factor-α, MCP1 and interferon-γ production were significantly higher in the animals inoculated with BCG than in the control groups (P<0.05). BCG immunization was required for the development of coronary arteritis, suggesting that these cytokines might play important roles. The results indicate that BCG induces primary autoimmunity and stimulates cytokine induction, and that atypical mycobacterial infection boosts the autoimmunity resulting in coronary arteritis.


title: Defending against the Novel Coronavirus (COVID-19) Outbreak: How Can the Internet of Things (IoT) help to save the World?

text: • IoT within infectious disease epidemiology is an emerging field of research, however the ubiquitous availability of smart technologies, as well as increased risks of infectious disease spread through the globalization and interconnectedness of the world necessitates its use for predicting, preventing and controlling emerging infectious diseases; • Considering the present situation in China, IoT based smart disease surveillance systems have the potential to be a major breakthrough in efforts to control the current pandemic. With much of the infrastructure itself in place already (i.e. smartphones, wearable technologies, internet access) the role this technology can have in limiting the spread of the pandemic involves only the collection and analysis of data already gathered. • More research must be carried out for the development of automated and effective alert systems to provide early and timely detection of outbreaks of such diseases in order to reduce morbidity mortality and prevent global spread.


title: ABO Phenotype and Death in Critically Ill Patients with COVID‐19

text: Blood groups are inherited traits that vary across populations, likely due to both founder effects and natural selection. A link between blood groups and susceptibility to infectious disease has been well‐described, with notable examples being H. Pylori and Plasmodium falciparum infection. Blood group antigens may influence disease susceptibility by several mechanisms, including serving as receptors or decoys for infectious organisms and modifying immune response in the form of anti‐ABO antibodies.


title: Bat Origins of MERS-CoV Supported by Bat Coronavirus HKU4 Usage of Human Receptor CD26

text: The recently reported Middle East respiratory syndrome coronavirus (MERS-CoV) is phylogenetically closely related to the bat coronaviruses (BatCoVs) HKU4 and HKU5. However, the evolutionary pathway of MERS-CoV is still unclear. A receptor binding domain (RBD) in the MERS-CoV envelope-embedded spike protein specifically engages human CD26 (hCD26) to initiate viral entry. The high sequence identity in the viral spike protein prompted us to investigate if HKU4 and HKU5 can recognize hCD26 for cell entry. We found that HKU4-RBD, but not HKU5-RBD, binds to hCD26, and pseudotyped viruses embedding HKU4 spike can infect cells via hCD26 recognition. The structure of the HKU4-RBD/hCD26 complex revealed a hCD26-binding mode similar overall to that observed for MERS-RBD. HKU4-RBD, however, is less adapted to hCD26 than MERS-RBD, explaining its lower affinity for receptor binding. Our findings support a bat origin for MERS-CoV and indicate the need for surveillance of HKU4-related viruses in bats.


title: New pharmacological strategies to fight enveloped viruses

text: Enveloped viruses pose an important health threat because most of the persistent and many emerging viruses are enveloped. In particular, newly emerging viruses create a need to develop broad-spectrum antivirals, which usually are obtained by targeting host cell factors. Persistent viruses have developed efficient strategies to escape host immune control, and treatment options are limited. Targeting host cell factors essential for virus persistence, or immune-based therapies provide alternative approaches. In this review, we therefore focus on recent developments to generate antivirals targeting host cell factors or immune-based therapeutic approaches to fight infections with enveloped viruses.


title: A high-throughput strategy for COVID-19 testing based on next-generation sequencing

text: COVID-19 testing as sufficient as needed is essential for healthcare workers, patients, and authorities to make informed decisions to confront and eventually defeat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, diagnosis of COVID-19 relies on quantitative reverse-transcription PCR, which is low-throughput, laborious, and often false-negative, making it overwhelmingly challenging to meet testing needs even in industrialized countries. Here we propose a new strategy, which employs a modified loop-mediated isothermal amplification (LAMP) assay, a simple procedure requiring no sophisticated instruments, to index and amplify viral genes from individual specimens, of which the products are readily available for construction of multiplexed libraries for next-generation sequencing. Our strategy would allow precise diagnosis of thousands of specimens in 1-2 days with significantly lower operating expenses. Furthermore, this strategy will make it possible for patients to collect, process, and mail their own samples to facilities for a quick, reliable diagnosis at a population scale.


title: Isolation of Viruses from 94 Flocks of Fowls with Respiratory Disease

text: Summary Virological studies were made on 94 flocks of fowls suffering from respiratory disease. Infectious bronchitis virus was detected in 50 flocks by egg inoculation and using tissue culture techniques adenovirus was detected in 41, reovirus in 3 and mycoplasmas in 4 flocks. In addition small 20 nm. particles associated with adenoviruses were seen on 6 occasions and it is believed that they may be adeno-associated parvoviruses. Direct examination of allantoic fluid or tissue cultures using the electron microscope was found to be a quick and efficient method of virus and mycoplasma identification. In addition it demonstrated strains of infectious bronchitis virus which failed to cause dwarfing and allowed the detection of parvoviruses.


title: Absence of nosocomial transmission of coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in the pre-pandemic phase in Hong Kong

text: BACKGROUND: To describe the infection control strategy to achieve zero nosocomial transmission of symptomatic coronavirus disease (COVID-19) due to SARS-CoV-2 during the pre-pandemic phase (the first 72 days after announcement of pneumonia cases in Wuhan) in Hong Kong. METHODS: Administrative support with the aim of zero nosocomial transmission by reducing elective clinical services, decanting wards, mobilizing isolation facilities, providing adequate personal protective equipment, coordinating laboratory network for rapid molecular diagnosis under 4-tier active surveillance for hospitalized- and out-patients, and organizing staff forum and training was implemented under the framework of preparedness plan in Hospital Authority. The trend of SARS-CoV-2 in the first 72 days was compared with that of SARS-CoV 2003. RESULTS: Up to day 72 of the epidemic, 130 (0.40%) of 32,443 patients being screened confirmed to have SARS-CoV-2 by RT-PCR. Compared with SARS outbreak in 2003, the SARS-CoV-2 case load constituted 8.9% (130 SARS-CoV-2/1458 SARS-CoV) of SARS-CoV infected cases at day 72 of the outbreak. The incidences of nosocomial acquisition of SARS-CoV per-1,000-SARS-patient-day and per-100-SARS-patient-admission were 7.9 and 16.9 respectively, which were significantly higher than the corresponding incidences of SARS-CoV-2 (zero infection, p<0.001). CONCLUSION: Administrative support to infection control could minimize the risk of nosocomial transmission of SARS-CoV-2.


title: Identification of respiratory viruses with a novel point-of-care multianalyte antigen detection test in children with acute respiratory tract infection

text: Abstract Background Rapid etiological diagnosis of a respiratory virus infection may have impact on antiviral and antibiotic therapy, patient cohorting, and prediction of the clinical course. Most point-of-care tests for detection of respiratory viruses have limitations in diagnostic performance and clinical usability. A novel, multianalyte point-of-care antigen detection test system (mariPOC®; ArcDia International Oy Ltd., Turku, Finland) detects eight respiratory viruses (influenza A and B viruses, respiratory syncytial virus (RSV), adenovirus, human metapneumovirus, and parainfluenza type 1, 2, and 3 viruses) from a single nasopharyngeal swab specimen by a fully automated, random-access immunoassay method. Objectives To evaluate mariPOC® point-of-care test system in comparison with reverse transcription polymerase chain reaction (RT-PCR) in a pediatric emergency department setting. Study design Prospectively collected samples from 158 children (mean age, 1.8 years) with respiratory symptoms and/or fever were analyzed both by mariPOC® and by multiplex RT-PCR. Results The sensitivities and specificities (95% confidence intervals) of the mariPOC® test were for influenza A (n =7), 71% (38–100) and 100%; influenza B (n =22), 86% (72–100) and 98% (95–100); RSV (n =35), 89% (78–99) and 100%; adenovirus (n =12), 25% (1–50) and 97% (95–99); and for human metapneumovirus (n =8), 50% (15–85) and 100%, respectively. Parainfluenzaviruses were detected only in five patients. Conclusions This novel point-of-care test system is a rapid, practical, and specific method for simultaneous detection of eight respiratory viruses. Compared with RT-PCR, its sensitivity is moderately high for detection of RSV and influenza viruses, and low for adenovirus.


title: Pandemic Influenza Vaccines: What did We Learn from the 2009 Pandemic and are We Better Prepared Now?

text: In 2009, a novel A(H1N1) influenza virus emerged with rapid human-to-human spread and caused the first pandemic of the 21st century. Although this pandemic was considered mild compared to the previous pandemics of the 20(th) century, there was still extensive disease and death. This virus replaced the previous A(H1N1) and continues to circulate today as a seasonal virus. It is well established that vaccines are the most effective method to alleviate the mortality and morbidity associated with influenza virus infections, but the 2009 A(H1N1) influenza pandemic, like all significant infectious disease outbreaks, presented its own unique set of problems with vaccine supply and demand. This manuscript describes the issues that confronted governments, international agencies and industries in developing a well-matched vaccine in 2009, and identifies the key improvements and remaining challenges facing the world as the next influenza pandemic inevitably approaches.


Research in dermatology in the COVID‐19 era


title: Detection of Novel SARS-like and Other Coronaviruses in Bats from Kenya

text: Diverse coronaviruses have been identified in bats from several continents but not from Africa. We identified group 1 and 2 coronaviruses in bats in Kenya, including SARS-related coronaviruses. The sequence diversity suggests that bats are well-established reservoirs for and likely sources of coronaviruses for many species, including humans.


title: Dengue Virus

text: Dengue is the most prevalent arthropod-borne virus affecting humans today. The virus group consists of 4 serotypes that manifest with similar symptoms. Dengue causes a spectrum of disease, ranging from a mild febrile illness to a life-threatening dengue hemorrhagic fever. Breeding sites for the mosquitoes that transmit dengue virus have proliferated, partly because of population growth and uncontrolled urbanization in tropical and subtropical countries. Successful vector control programs have also been eliminated, often because of lack of governmental funding. Dengue viruses have evolved rapidly as they have spread worldwide, and genotypes associated with increased virulence have spread across Asia and the Americas. This article describes the virology, epidemiology, clinical manifestations and outcomes, and treatments/vaccines associated with dengue infection.


title: Clinical characteristics of the lower respiratory tract infection caused by a single infection or coinfection of the human parainfluenza virus in children

text: BACKGROUND: Human parainfluenza virus (HPIV), usually combined with other pathogens, causes lower respiratory tract infection (LRTI) in children. However, clinical characteristics of HPIV coinfection with other pathogens were unclear. This study aimed to investigate the viral and atypical bacterial etiology of LRTI in children and compare the clinical characteristics of HPIV single infection with those of coinfection. METHODS: This study included 1335 patients, aged between 1 to 71 months, diagnosed with LRTI in Yuying Children's Hospital, Zhejiang, China, from December 2013 to June 2015. Nasopharyngeal secretions were collected, and respiratory pathogens were detected using Multiplex polymerase chain reaction. The clinical data of patients were collected and analyzed. RESULTS: At least 1 pathogen was detected in 1181/1335 (88.5%) patients. The pathogens identified most frequently were respiratory syncytial virus, human rhinovirus, HPIV, adenovirus, and human metapneumovirus. The coinfection rate was 24.8%. HPIV coinfection with other viruses was more associated with running nose, shortness of breath, and oxygen support compared with HPIV single infection. Moreover, HPIV coinfection with atypical bacteria was more related to running nose, moist rales, and longer hospital duration compared with HPIV single infection, and also to longer hospital duration compared with coinfection with other viruses. CONCLUSIONS: This study demonstrated that viral infections were highly associated with LRTI and the rate of coinfection was high. HPIV single infection was milder than coinfection with other viruses. Moreover, HPIV coinfection with atypical bacteria was more serious than HPIV single infection and coinfection with other viruses.


Environmentally Sustainable Management of Used Personal Protective Equipment


title: A Bibliometric Analysis of PubMed Literature on Middle East Respiratory Syndrome

text: Middle East Respiratory Syndrome (MERS), a pandemic threat to human beings, has aroused huge concern worldwide, but no bibliometric studies have been conducted on MERS research. The aim of this study was to map research productivity on the disease based on the articles indexed in PubMed. The articles related to MERS dated from 2012 to 2015 were retrieved from PubMed. The articles were classified into three categories according to their focus. Publication outputs were assessed and frequently used terms were mapped using the VOS viewer software. A total of 443 articles were included for analysis. They were published in 162 journals, with Journal of Virology being the most productive (44 articles; 9.9%) and by six types of organizations, with universities being the most productive (276 articles; 62.4%).The largest proportion of the articles focused on basic medical sciences and clinical studies (47.2%) and those on prevention and control ranked third (26.2%), with those on other focuses coming in between (26.6%). The articles on prevention and control had the highest mean rank for impact factor (IF) (226.34), followed by those on basic medical sciences and clinical studies (180.23) and those on other focuses (168.03). The mean rank differences were statistically significant (p = 0.000). Besides, “conronavirus”, “case”, “transmission” and “detection” were found to be the most frequently used terms. The findings of this first bibliometric study on MERS suggest that the prevention and control of the disease has become a big concern and related research should be strengthened.


title: Inflammation, Immunity and Immunogenetics in COVID-19: A Narrative Review

text: The novel Coronavirus Disease 2019 (COVID-19), that began in Wuhan Province, China was labelled as an International Public Health Emergency on January 30, 2020 and later was declared a pandemic by the World Health Organisation (WHO) on March 11, 2020. The causative agent, SARS-CoV-2 was the third coronavirus responsible for causing major disease outbreaks in human population after Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) caused by SARS-CoV and MERS-CoV respectively. The patients of COVID-19 present with a clinical feature resembling mild form of viral pneumonia which in certain cases progress to a severe form characterised by adult respiratory distress syndrome (ARDS) and/or multiorgan failure leading to death. The transition from mild to severe form of COVID-19 is affected by a lot of factors like age, co-morbidities etc. In the absence of an absolute cure, it is essential to explore the molecular pathogenesis of the disease to identify people at risk of developing severity so that alternative treatment modalities may be planned. The aim of this review is to provide an update on the general characteristics of SARS-CoV-2 and highlight the inflammatory changes and immune dysregulation that may help in identification of molecular predictors of disease severity.


title: Moving from Empirical to Rational Vaccine Design in the ‘Omics’ Era

text: An ideal vaccine provides long lasting protection against a pathogen by eliciting a well-rounded immune response which engages both innate and adaptive immunity. However, we have a limited understanding of how components of innate immunity, antibody and cell-mediated adaptive immunity interact and function together at a systems level. With advances in high-throughput ‘Omics’ methodologies it has become possible to capture global changes in the host, at a cellular and molecular level, that are induced by vaccination and infection. Analysis of these datasets has shown the promise of discovering mechanisms behind vaccine mediated protection, immunological memory, adverse effects as well as development of more efficient antigens and adjuvants. In this review, we will discuss how systems vaccinology takes advantage of new technology platforms and big data analysis, to enable the rational development of better vaccines.


“If the virus doesn’t kill me…”: socioeconomic impacts of COVID-19 on rural working people in the Global South


title: Viruses and disease: emerging concepts for prevention, diagnosis and treatment

text: Viruses cause a wide range of human diseases, ranging from acute self‐resolving conditions to acute fatal diseases. Effects that arise long after the primary infection can also increase the propensity for chronic conditions or lead to the development of cancer. Recent advances in the fields of virology and pathology have been fundamental in improving our understanding of viral pathogenesis, in providing improved vaccination strategies and in developing newer, more effective treatments for patients worldwide. The reviews assembled here focus on the interface between virology and pathology and encompass aspects of both the clinical pathology of viral disease and the underlying disease mechanisms. Articles on emerging diseases caused by Ebola virus, Marburg virus, coronaviruses such as SARS and MERS, Nipah virus and noroviruses are followed by reviews of enteroviruses, HIV infection, measles, mumps, human respiratory syncytial virus (RSV), influenza, cytomegalovirus (CMV) and varicella zoster virus (VZV). The issue concludes with a series of articles reviewing the relationship between viruses and cancer, including the role played by Epstein–Barr virus (EBV) in the pathogenesis of lymphoma and carcinoma; how human papillomaviruses (HPVs) are involved in the development of skin cancer; the involvement of hepatitis B virus infection in hepatocellular carcinoma; and the mechanisms by which Kaposi's sarcoma‐associated herpesvirus (KSHV) leads to Kaposi's sarcoma. We hope that this collection of articles will be of interest to a wide range of scientists and clinicians at a time when there is a renaissance in the appreciation of the power of pathology as virologists dissect the processes of disease. Copyright © 2014 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.


title: The resumption of sports competitions after COVID-19 lockdown: The case of the Spanish football league

text: In this work, we present a stochastic discrete-time SEIR Susceptible-Exposed-Infectious-Recoveredmodel adapted to describe the propagation of COVID-19 during a football tournament. Specifically, we are concerned about the re-start of the Spanish national football league, La Liga, which is currently –May 2020– stopped with 11 fixtures remaining. Our model includes two additional states of an individual, confined and quarantined, which are reached when an individual presents COVID-19 symptoms or has undergone a virus test with a positive result. The model also accounts for the interaction dynamics of players, considering three different sources of infection: the player social circle, the contact with his/her team colleagues during training sessions, and the interaction with rivals during a match. Our results highlight the influence of the days between matches, the frequency of virus tests and their sensitivity on the number of players infected at the end of the season. Following our findings, we finally propose a variety of strategies to minimize the probability that COVID-19 propagates in case the season of La Liga was re-started after the current lockdown.


title: COVID-19 admissions calculators: General population and paediatric cohort

text: Abstract The world is in the grip of pandemic COVID-19 (SARS-CoV-2). Children appear to be only mildly affected but for those countries that are still preparing for their first wave of infections, it is salutary to have some estimates with which to plan for eventual contingencies. These assessments would include acute hospital admission requirements, intensive care admissions and deaths per given population. It is also useful to have an estimate of how many paediatric admissions to expect per given population. However it is only very recently that paediatric epidemiological data has become available. This paper will create an interactive spreadsheet model to estimate population and paediatric admissions for a given population, with the author's country, Malta, as a worked example for both.


title: Complete genome sequence and analysis of a new lethal arterivirus, Trionyx sinensis hemorrhagic syndrome virus (TSHSV), amplified from an infected Chinese softshell turtle

text: Trionyx sinensis hemorrhagic syndrome virus (TSHSV) is a newly discovered lethal arterivirus that causes serious disease in Trionyx sinensis in China. In this study, the complete genome sequence of TSHSV was determined by RACE cloning, and the functions of the predicted proteins were predicted. The complete genome of TSHSV was found to be 17,875 bp in length, and a 3’-end poly(A) tail was detected. Eight TSHSV hypothetical proteins (TSHSV-HPs) were predicted by gene model identification. TSHSV-HP2, 3 and 4 were associated with replicase activity, since papain-like protease (PLPs), serine-type endopeptidase, P-loop-containing nucleoside triphosphate hydrolase, and EndoU-like endoribonuclease motifs were detected. Phylogenetic analysis showed that TSHSV clusters with an arterivirus from a Chinese broad-headed pond turtle.


Brain antibodies in MS-patients — an activity parameter for immunosuppressive therapy?


title: The cholesterol transport inhibitor U18666A inhibits type I feline coronavirus infection

text: Abstract Feline infectious peritonitis (FIP) is a feline coronavirus (FCoV)-induced fatal disease in wild and domestic cats. FCoV exists in two serotypes. Type I FCoV is the dominant serotype worldwide. Therefore, it is necessary to develop antiviral drugs against type I FCoV infection. We previously reported that type I FCoV is closely associated with cholesterol throughout the viral life cycle. In this study, we investigated whether U18666A, the cholesterol synthesis and transport inhibitor, shows antiviral effects against type I FCoV. U18666A induced cholesterol accumulation in cells and inhibited type I FCoV replication. Surprisingly, the antiviral activity of U18666A was suppressed by the histone deacetylase inhibitor (HDACi), Vorinostat. HDACi has been reported to revert U18666A-induced dysfunction of Niemann-Pick C1 (NPC1). In conclusion, these findings demonstrate that NPC1 plays an important role in type I FCoV infection. U18666A or other cholesterol transport inhibitor may be considered as the antiviral drug for the treatment of cats with FIP.


title: Durable Survival Outcomes in Primary and Secondary Central Nervous System Lymphoma After High-dose Chemotherapy and Autologous Stem Cell Transplantation Using a Thiotepa, Busulfan, and Cyclophosphamide Conditioning Regimen

text: Abstract Background High-dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) has been investigated in patients with primary central nervous system lymphoma (PCNSL) and non-Hodgkin lymphoma (NHL) with CNS involvement and has shown promising results. Patients and Methods A retrospective analysis was performed of 48 consecutive patients who had undergone HDC/ASCT with TBC (thiotepa, busulfan, cyclophosphamide) conditioning for PCNSL (27 patients), secondary CNS lymphoma (SCNSL) (8 patients), or relapsed disease with CNS involvement (13 patients) from July 2006 to December 2017. Of the 27 patients with PCNSL, 21 had undergone ASCT at first complete remission (CR1). Results The 2-year progression-free survival (PFS) rate was 80.5% (95% confidence interval [CI], 69.9-92.9) and the 2-year overall survival (OS) rate was 80.1% (95% CI, 69.2%-92.7%) among all patients. The 2-year PFS and OS rate for patients with PCNSL in CR1 was 95.2% (95% CI, 86.6%-100%) and 95.2% (95% CI, 86.6%-100%), respectively. On univariate analysis of the patients with PCNSL, ASCT in CR1 was the only variable statistically significant for outcome (P = .007 for PFS; P = .008 for OS). Among patients with SCNSL or CNS relapse, the 2-year PFS and OS rate were comparable at 75.9% (95% CI, 59.5%-96.8%) and 75.3% (95% CI, 58.6%-98.6%), respectively. The most common side effects were febrile neutropenia (89.6%; of which 66.7% had an infectious etiology identified), nausea/vomiting (85.4%), diarrhea (93.8%), mucositis (89.6%), and electrolyte abnormalities (89.6%). Four patients (8.3%) died of treatment-related overwhelming infection; of these patients, 3 had SCNSL. Conclusion HDC and ASCT using TBC conditioning for both PCNSL and secondary CNS NHL appears to have encouraging long-term efficacy with manageable side effects.


title: Knowledge, Attitude and Practice Towards COVID-19 Among Chronic Disease Patients at Addis Zemen Hospital, Northwest Ethiopia

text: PURPOSE: The recent outbreak of coronavirus disease 2019 (COVID-19) is the worst global crisis after the Second World War. Since no successful treatment and vaccine have been reported, efforts to enhance the knowledge, attitudes, and practice of the public, especially the high-risk groups, are critical to manage COVID-19 pandemic. Thus, this study aimed to assess knowledge, attitude, and practice towards COVID-19 among patients with chronic disease. PATIENTS AND METHODS: A cross-sectional study was conducted among 404 chronic disease patients from March 02 to April 10, 2020, at Addis Zemen Hospital, Northwest Ethiopia. Both bivariable and multivariable logistic regression analyses with a 95% confidence interval were fitted to identify factors associated with poor knowledge and practice towards COVID-19. The adjusted odds ratio (AOR) was used to determine the magnitude of the association between the outcome and independent variables. P-value <0.05 was considered statistically significant. RESULTS: The mean age of the participants was 56.5±13.5. The prevalence of poor knowledge and poor practice was 33.9% and 47.3%, respectively. Forty-one percent of the participants perceived that avoiding of attending a crowded population is very difficult. Age (AOR=1.05, (95% CI (1.01–1.08)), educational status of “can’t read and write” (AOR=7.1, 95% CI (1.58–31.93)), rural residence (AOR=19.0, 95% CI (6.87–52.66)) and monthly income (AOR=0.8, 95% CI (0.79–0.89)) were significantly associated with poor knowledge. Being unmarried (AOR=3.9, 95% CI (1.47–10.58)), cannot read and write (AOR=2.7, 95% CI (1.03–7.29)), can read and write (AOR=3.5, 95% CI (1.48–8.38)), rural residence (AOR=2.7, 95% CI (1.09–6.70)), income of <7252 Ethiopian birr (AOR=2.3, 95% CI (1.20–4.15)) and poor knowledge (AOR=8.6, 95% CI (3.81–19.45)) were significantly associated with poor practice. CONCLUSION: The prevalence of poor knowledge and poor practice was high. Leaflets prepared in local languages should be administered and health professionals should provide detailed information about COVID-19 to their patients.


title: Study in performance analysis of China Urban Emergency Response System based on Petri net

text: Abstract Urban Emergency Response System (UERS) is a modernization symbol of a city. With acceleration of urbanization process and constant expansion of city size in China, China cities must respond to various emergencies timely and effectively to satisfy urban residents’ needs for public security. In recent years, many China cities made trials and efforts in setting up and improving the UERS. At the same time, the China government began to build Emergency Response Systems (ERS) in some cities to deal with various possible emergencies. In this paper, using Petri net (PN), we study the performance of China typical UERS and establish its PN model for performance analysis. Based on the Markov chain (MC) of the model, the performance of China typical UERS is analyzed. Results from our simulation are in conformity with practical operation of China current UERS.


title: SARS-CoV-2/COVID-19: Systematischer Review zu Anforderungen an die persönliche Schutzausrüstung bei primärem Patientenkontakt und Strukturierung des Operationsbereiches

text: BACKGROUND: The SARS-CoV-2/COVID-19 pandemic necessitates a rapid reorganization of the hospital procedures. The establishment of centers dedicated to COVID-19 treatment and care also necessitates preparation of the surgical departments for the forthcoming emergency interventions for infected patients and patients with an unclear infection status. This article summarizes the evidence on standards for personal protective equipment for personnel in the central emergency admission department and in the operations area as well as restructuring measures for the procedures in the operations area in a COVID-plus area. METHOD: A systematic literature search was carried out. RESULTS: The grey area of unknown infected and potential transmitters of SARS-CoV-2/COVID-19 is high. Patients with an unclear infection status or who are highly suspected of having an infection should be classified as infectious until the contrary can be proven. The protection of personnel in healthcare professions against infections is of particular importance. The supply of adequate personal protective equipment in a risk-stratified form can substantially influence the success of combating the pandemic. Most operations must be assessed as aerosol-forming procedures and necessitate the maximum protection of personnel working directly on the patient. Particular attention should be paid to obligatory hygiene regulatory measures for protection against contamination during the reorganization in the operations area and on the transport routes between the wards. CONCLUSION: The correct personal protective equipment considering the occupational safety helps to sustainably protect personnel from infections. Reorganizational measures in the operating room are urgently indicated for potential aerosol-forming procedures in infected patients or patients with an unclear infection status. The current dynamic situation necessitates a high level of flexibility as well as reassessment and adaptation of the measures at short intervals.


title: Risk Overgeneralization in Times of a Contagious Disease Threat

text: People’s assessment of risks is swayed by their current feelings. COVID-19 invokes powerful feelings because it is (i) a salient, enormous threat, (ii) unfamiliar, and (iii) intertwined with xenophobia. These three factors are known to exert predictable influence on people’s risk overgeneralization, policy preference, and sociopolitical attitudes. We provide a succinct, illustrative review of empirical work on these dynamics in times of a disease outbreak (e.g., the 2009 H1N1 swine flu, the 2014 Ebola). Theoretical and applied implications for the present COVID-19 pandemic include the value of salience in motivating public opinion change, the importance of reducing unfamiliarity for curbing risk-averse tendencies, and the need for policies that guard against xenophobia-driven racism in collaborative efforts.


Early Lessons on the Importance of Lung Imaging in Novel Coronavirus Disease (COVID-19).


title: Potential Maternal and Infant Outcomes from Coronavirus 2019-nCoV (SARS-CoV-2) Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections

text: In early December 2019 a cluster of cases of pneumonia of unknown cause was identified in Wuhan, a city of 11 million persons in the People’s Republic of China. Further investigation revealed these cases to result from infection with a newly identified coronavirus, initially termed 2019-nCoV and subsequently SARS-CoV-2. The infection moved rapidly through China, spread to Thailand and Japan, extended into adjacent countries through infected persons travelling by air, eventually reaching multiple countries and continents. Similar to such other coronaviruses as those causing the Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS), the new coronavirus was reported to spread via natural aerosols from human-to-human. In the early stages of this epidemic the case fatality rate is estimated to be approximately 2%, with the majority of deaths occurring in special populations. Unfortunately, there is limited experience with coronavirus infections during pregnancy, and it now appears certain that pregnant women have become infected during the present 2019-nCoV epidemic. In order to assess the potential of the Wuhan 2019-nCoV to cause maternal, fetal and neonatal morbidity and other poor obstetrical outcomes, this communication reviews the published data addressing the epidemiological and clinical effects of SARS, MERS, and other coronavirus infections on pregnant women and their infants. Recommendations are also made for the consideration of pregnant women in the design, clinical trials, and implementation of future 2019-nCoV vaccines.


Consider Adjunctive Ketamine in Mechanically Ventilated COVID-19 Patients


title: Tests in short supply? Try group testing

text: Christopher R. Bilder, Peter C. Iwen, Baha Abdalhamid, Joshua M. Tebbs and Christopher S. McMahan explain how, by pooling specimens, testing capacity for SARS‐CoV‐2 can be increased


title: Effects of Fruit and Vegetable Consumption on Risk of Asthma, Wheezing and Immune Responses: A Systematic Review and Meta-Analysis

text: Evidence suggests that reduced intake of fruit and vegetables may play a critical role in the development of asthma and allergies. The present review aimed to summarize the evidence for the association between fruit and vegetable intake, risk of asthma/wheeze and immune responses. Databases including PubMed, Cochrane, CINAHL and EMBASE were searched up to June 2016. Studies that investigated the effects of fruit and vegetable intake on risk of asthma/wheeze and immune responses were considered eligible (n = 58). Studies used cross-sectional (n = 30), cohort (n = 13), case-control (n = 8) and experimental (n = 7) designs. Most of the studies (n = 30) reported beneficial associations of fruit and vegetable consumption with risk of asthma and/or respiratory function, while eight studies found no significant relationship. Some studies (n = 20) reported mixed results, as they found a negative association between fruit only or vegetable only, and asthma. In addition, the meta-analyses in both adults and children showed inverse associations between fruit intake and risk of prevalent wheeze and asthma severity (p < 0.05). Likewise, vegetable intake was negatively associated with risk of prevalent asthma (p < 0.05). Seven studies examined immune responses in relation to fruit and vegetable intake in asthma, with n = 6 showing a protective effect against either systemic or airway inflammation. Fruit and vegetable consumption appears to be protective against asthma.


title: Sculpting the proteome with small molecules

text: The ubiquitin-proteasome system (UPS) pervades the biology of eukaryotes. Because it depends on the activity of hundreds of different enzymes and protein-protein interactions, the UPS provides many opportunities for selective modulation of the pathway with small molecules. Here we discuss the principles that underlie the development of effective inhibitors or activators of the pathway. We emphasize insights from structural analysis and describe strategies for evaluating the selectivity of compounds.


title: Estimated effectiveness of traveller screening to prevent international spread of 2019 novel coronavirus (2019-nCoV)

text: Traveller screening is being used to limit further global spread of 2019 novel coronavirus (nCoV) following its recent emergence. Here, we project the impact of different travel screening programs given remaining uncertainty around the values of key nCoV life history and epidemiological parameters. Even under best-case assumptions, we estimate that screening will miss more than half of infected travellers. Breaking down the factors leading to screening successes and failures, we find that most cases missed by screening are fundamentally undetectable, because they have not yet developed symptoms and are unaware they were exposed. These findings emphasize the need for measures to track travellers who become ill after being missed by a travel screening program. We make our model available for interactive use so stakeholders can explore scenarios of interest using the most up-to-date information. We hope these findings contribute to evidence-based policy to combat the spread of nCoV, and to prospective planning to mitigate future emerging pathogens.


Les urgences neuro-ophtalmologiques pendant l’infection COVID-191,2


COVID-19 Reveals Why We Need Physician Advocates Now


title: The Impact of Triathlon Training and Racing on Athletes’ General Health

text: Although the sport of triathlon provides an opportunity to research the effect of multi-disciplinary exercise on health across the lifespan, much remains to be done. The literature has failed to consistently or adequately report subject age group, sex, ability level, and/or event-distance specialization. The demands of training and racing are relatively unquantified. Multiple definitions and reporting methods for injury and illness have been implemented. In general, risk factors for maladaptation have not been well-described. The data thus far collected indicate that the sport of triathlon is relatively safe for the well-prepared, well-supplied athlete. Most injuries ‘causing cessation or reduction of training or seeking of medical aid’ are not serious. However, as the extent to which they recur may be high and is undocumented, injury outcome is unclear. The sudden death rate for competition is 1.5 (0.9–2.5) [mostly swim-related] occurrences for every 100,000 participations. The sudden death rate is unknown for training, although stroke risk may be increased, in the long-term, in genetically susceptible athletes. During heavy training and up to 5 days post-competition, host protection against pathogens may also be compromised. The incidence of illness seems low, but its outcome is unclear. More prospective investigation of the immunological, oxidative stress-related and cardiovascular effects of triathlon training and competition is warranted. Training diaries may prove to be a promising method of monitoring negative adaptation and its potential risk factors. More longitudinal, medical-tent-based studies of the aetiology and treatment demands of race-related injury and illness are needed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s40279-014-0244-0) contains supplementary material, which is available to authorized users.


Propofol and sedation in patients with coronavirus disease


title: Coronavirus Non-Structural Protein 1 Is a Major Pathogenicity Factor: Implications for the Rational Design of Coronavirus Vaccines

text: Attenuated viral vaccines can be generated by targeting essential pathogenicity factors. We report here the rational design of an attenuated recombinant coronavirus vaccine based on a deletion in the coding sequence of the non-structural protein 1 (nsp1). In cell culture, nsp1 of mouse hepatitis virus (MHV), like its SARS-coronavirus homolog, strongly reduced cellular gene expression. The effect of nsp1 on MHV replication in vitro and in vivo was analyzed using a recombinant MHV encoding a deletion in the nsp1-coding sequence. The recombinant MHV nsp1 mutant grew normally in tissue culture, but was severely attenuated in vivo. Replication and spread of the nsp1 mutant virus was restored almost to wild-type levels in type I interferon (IFN) receptor-deficient mice, indicating that nsp1 interferes efficiently with the type I IFN system. Importantly, replication of nsp1 mutant virus in professional antigen-presenting cells such as conventional dendritic cells and macrophages, and induction of type I IFN in plasmacytoid dendritic cells, was not impaired. Furthermore, even low doses of nsp1 mutant MHV elicited potent cytotoxic T cell responses and protected mice against homologous and heterologous virus challenge. Taken together, the presented attenuation strategy provides a paradigm for the development of highly efficient coronavirus vaccines.


title: Emerging patterns of hypercoagulability associated with critical COVID-19: A review

text: Abstract While the COVID-19 pandemic sweeps the world, much evidence is being gathered regarding its novel pathological mechanisms. It is the authors’ clinical experience that patients in the intensive care unit suffering from COVID-19 are extremely pro-coagulable, with venous and arterial thromboembolism frequently observed, and losses of vascular access lines and filtration circuits to thrombosis now commonplace. Here, we explore the evidence for hypercoagulability in this group, presenting evidence of both a localised pulmonary hypercoagulability, and a systemic hypercoagulability resulting in thrombosis distant to the pulmonary vasculature. Furthermore, we discuss the possible risk factors exacerbated by, or selected for in COVID-19. We review the available evidence for use of plasma D-dimer as a prognostic marker, exploring the possibility that it acts as a marker of a COVID-19-associated hypercoagulability. We review the evidence for a pro-coagulant subtype of disseminated intravascular coagulation, discussing its clinical significance. Finally, we discuss the current evidence surrounding treatment of COVID-19 hypercoagulability, including prophylactic and treatment-dose heparin, thrombolytic agents, antiplatelet agents, and direct thrombin inhibitors, among others. We suggest areas in which further investigation is urgently needed to reduce the startling incidence of thrombosis in this group, a complication no doubt contributing to morbidity and mortality.


Super-spreading events and contribution to transmission of MERS, SARS, and COVID-19


Gastroenterology services in the time of COVID-19 pandemic


title: Future Veterinary Diagnostics

text: Abstract The development of rapid, accurate, and sensitive diagnostic methods for detecting pathogens is the basis for treating, controlling, and eradicating infectious diseases of veterinary importance. Scientific and technological advancements have revolutionized the field of veterinary diagnostics. Genome sequencing has allowed efficient, sensitive, and specific diagnostic assays to be developed based on the detection of nucleic acids. The integration of advances in biochemistry, proteomics, engineering, and medicine offers enormous potential for the rapid and accurate diagnosis of viral, microbial, genetic, and metabolic disease. In the future, polymerase chain reaction assays, microarray testing, genomic analysis, and metabolic profiling will be accomplished in a rapid, portable, sensitive, and cost-efficient manner.


title: Rethinking “Elective” Procedures for Women's Reproduction during Covid‐19

text: Common hospital and surgical center responses to the Covid‐19 pandemic included curtailing “elective” procedures, which are typically determined based on implications for physical health and survival. However, in the focus solely on physical health and survival, procedures whose main benefits advance components of well‐being beyond health, including self‐determination, personal security, economic stability, equal respect, and creation of meaningful social relationships, have been disproportionately deprioritized. We describe how female reproduction‐related procedures, including abortion, surgical sterilization, reversible contraception devices and in vitro fertilization, have been broadly categorized as “elective,” a designation that fails to capture the value of these procedures or their impact on women's overall well‐being. We argue that corresponding restrictions and delays of these procedures are problematically reflective of underlying structural views that marginalize women's rights and interests and therefore threaten to propagate gender injustice during the pandemic and beyond. Finally, we propose a framework for triaging reproduction‐related procedures during Covid‐19 that is more individualized, accounts for their significance for comprehensive well‐being, and can be used to inform resumption of operations as well as subsequent restriction phases.


title: More on ‘Association between ABO blood groups and risk of SARS‐CoV‐2 pneumonia’

text: We read with interest the recent report from Li and colleagues describing an association between ABO blood groups and risk of SARS-CoV-2 pneumonia [1]. In an initial study of 265 patients with COVID, the authors observed that blood group O individuals were significantly under-represented amongst patients who required hospitalization for severe COVID-19 infection (p < 0.01). Conversely, blood group A was significantly more common in patients with severe COVID-19 compared to the local population (p=0.017). Subsequently, in a larger validation cohort that included 2153 patients with COVID-19, this ABO effect was reproduced with blood group O again being associated with a significant protective effect (p < 0.001). In keeping with these data, another independent study (n=2173) also reported that blood group O was associated with reduced susceptibility to severe COVID-19.


title: Non-canonical translation in RNA viruses

text: Viral protein synthesis is completely dependent upon the translational machinery of the host cell. However, many RNA virus transcripts have marked structural differences from cellular mRNAs that preclude canonical translation initiation, such as the absence of a 5′ cap structure or the presence of highly structured 5′UTRs containing replication and/or packaging signals. Furthermore, whilst the great majority of cellular mRNAs are apparently monocistronic, RNA viruses must often express multiple proteins from their mRNAs. In addition, RNA viruses have very compact genomes and are under intense selective pressure to optimize usage of the available sequence space. Together, these features have driven the evolution of a plethora of non-canonical translational mechanisms in RNA viruses that help them to meet these challenges. Here, we review the mechanisms utilized by RNA viruses of eukaryotes, focusing on internal ribosome entry, leaky scanning, non-AUG initiation, ribosome shunting, reinitiation, ribosomal frameshifting and stop-codon readthrough. The review will highlight recently discovered examples of unusual translational strategies, besides revisiting some classical cases.


title: Geospatial distribution of viromes in tropical freshwater ecosystems

text: Abstract This study seeks to understand the general distribution of virome abundance and diversity in tropical freshwater ecosystems in Singapore and the geospatial distribution of the virome under different landuse patterns. Correlations between diversity, environmental parameters and land use patterns were analyzed and significant correlations were highlighted. Overall, the majority (65.5%) of the annotated virome belonged to bacteriophages. The percentage of Caudovirales was higher in reservoirs whereas the percentages of Dicistroviridae, Microviridae and Circoviridae were higher in tributaries. Reservoirs showed a higher Shannon-index virome diversity compared to upstream tributaries. Land use (urbanized, agriculture and parkland areas) influenced the characteristics of the virome distribution pattern. Dicistroviridae and Microviridae were enriched in urbanized tributaries while Mimiviridae, Phycodnaviridae, Siphoviridae and Podoviridae were enriched in parkland reservoirs. Several sequences closely related to the emerging zoonotic virus, cyclovirus, and the human-related virus (human picobirnavirus), were also detected. In addition, the relative abundance of PMMoV (pepper mild mottle virus) sequences was significantly correlated with RT-qPCR measurements (0.588 < r < 0.879, p < 0.05). This study shows that spatial factors (e.g., reservoirs/tributaries, land use) are the main drivers of the viral community structure in tropical freshwater ecosystems.


title: Costly Lessons From the 2015 Middle East Respiratory Syndrome Coronavirus Outbreak in Korea

text: Since the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea (hereafter Korea) began on May 11, 2015, a total of 186 persons have been infected by the MERS coronavirus, 38 of whom have died. With this number, Korea becomes second only to the Kingdom of Saudi Arabia in the ranking of cumulative MERS cases. In this paper Korea’s unique experience of an outbreak of MERS will be summarized and discussed briefly.


title: Respiratory syncytial virus, human metapneumovirus, and influenza virus infection in Bangkok, 2016-2017

text: Children and adults residing in densely populated urban centers around the world are at risk of seasonal influenza-like illness caused by respiratory viruses such as influenza virus, human metapneumovirus (hMPV), and respiratory syncytial virus (RSV). In a large metropolitan of Thailand’s capital city Bangkok, most respiratory infections are rarely confirmed by molecular diagnostics. We therefore examined the frequency of RSV, hMPV, and influenza virus in 8,842 patients who presented influenza-like illness and sought medical care at a large hospital in Bangkok between 2016 and 2017. Using a multiplex real-time reverse-transcription polymerase chain reaction (RT-PCR), 30.5% (2,699/8,842) of nasopharyngeal (NP) swab samples tested positive for one or more of these viruses. Influenza virus comprised 17.3% (1,528/8,842), of which the majority were influenza A/H3N2. Such infection was most prevalent among adults and the elderly. RSV was identified in 11.4% (1,011/8,842) and were mostly ON1 and BA9 genotypes. Of the hMPV-positive samples (3.6%, 318/8,842), genotypes A2, B1, and B2 were detected. A small number of individuals experienced co-infections (1.8%, 155/8,842), most commonly between RSV and influenza A/H3N2. RSV and hMPV co-infections were also found, but mainly in young children. Viral respiratory tract infection peaked locally in the rainy season (June to September). These findings support the utility of rapid nucleic acid testing of RSV, hMPV, and influenza virus in patients with ILI.


title: Erythromycin Estolate Inhibits Zika Virus Infection by Blocking Viral Entry as a Viral Inactivator

text: Recently, Zika virus (ZIKV) has attracted much attention in consideration of its association with severe neurological complications including fetal microcephaly. However, there are currently no prophylactic vaccines or therapeutic drugs approved for clinical treatments of ZIKV infection. To determine the potential anti-ZIKV inhibitors, we screened a library of clinical drugs with good safety profiles. Erythromycin estolate (Ery-Est), one of the macrolide antibiotics, was found to effectively inhibit ZIKV infection in different cell types and significantly protect A129 mice from ZIKV-associated neurological signs and mortality. Through further investigation, Ery-Est was verified to inhibit ZIKV entry by disrupting the integrity of the viral membrane which resulted in the loss of ZIKV infectivity. Furthermore, Ery-Est also showed inhibitory activity against dengue virus (DENV) and yellow fever virus (YFV). Thus, Ery-Est may be a promising drug for patients with ZIKV infection, particularly pregnant women.


title: Clinical Approach to Abortion, Stillbirth, and Neonatal Death in Dogs and Cats

text: This article reviews post-mortem examination, sample collection, and diagnostic procedures used to determine the cause of abortion, stillbirth, and neonatal death in dogs and cats.