title: The Relationships between Respiratory Virus Infection and Aminotransferase in Children

text: PURPOSE: We sought to examine the relationship between the clinical manifestations of nonspecific reactive hepatitis and respiratory virus infection in pediatric patients. METHODS: Patients admitted to the pediatric unit of Konyang University Hospital for lower respiratory tract disease between January 1, 2014 and December 31, 2014 and who underwent reverse transcriptase polymerase chain reaction tests were examined. The patients were divided into those with increased levels of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) and those with normal ALT or AST levels. Further, patients with increased ALT and AST levels were individually compared with patients in the normal group, and the blood test results were compared according to the type of respiratory virus. RESULTS: Patients with increased ALT or AST levels had one more day of hospital stay, on average, compared with patients in the normal group (5.3±3.1 days vs. 4.4±3.0 days, p=0.019). Patients in the increased ALT level group were younger and had a longer mean hospital stay, compared with patients in the normal group (p=0.022 and 0.003, respectively). The incidences of increased ALT or AST were the highest in adenovirus infections (6/24, 25.0%), followed by enterovirus (2/11, 18.2%) and respiratory syncytial virus A (21/131, 16.0%) infections. CONCLUSION: Nonspecific reactive hepatitis is more common among patients with adenovirus, enterovirus and respiratory syncytial virus infection, as well as among those infected at a younger age. Compared with AST levels, ALT levels are better indicators of the severity of nonspecific reactive hepatitis.


title: Rotavirus A in wild and domestic animals from areas with environmental degradation in the Brazilian Amazon

text: Acute gastroenteritis is one of the main causes of mortality in humans and young animals. Domestic and mainly wild animals such as bats, small rodents and birds are highly diversified animals in relation to their habitats and ecological niches and are widely distributed geographically in environments of forest fragmentation in some areas of the Amazon, being considered important sources for viruses that affect humans and other animals. Due to the anthropical activities, these animals changed their natural habitat and adapted to urbanized environments, thus representing risks to human and animal health. Although the knowledge of the global diversity of enteric viruses is scarce, there are reports demonstrating the detection of rotavirus in domestic animals and animals of productive systems, such as bovines and pigs. The present study investigated the prevalence of Rotavirus A in 648 fecal samples of different animal species from the northeastern mesoregion of the state of Pará, Brazil, which is characterized as an urbanized area with forest fragments. The fecal specimens were collected from October 2014 to April 2016 and subjected to a Qualitative Real-Time Polymerase Chain Reaction (RT-qPCR), using the NSP3 gene as a target. It was observed that 27.5% (178/648) of the samples presented positive results for RVA, with 178 samples distributed in birds (23.6%), canines (21.35%), chiropterans (17.98%), bovines (14.6%), horses (8.43%), small rodents (6.74%), pigs (3.93%) and felines (3.37%), demonstrating the circulation of RVA in domestic animals and suggesting that such proximity could cause transmissions between different species and the occurrence of rearrangements in the genome of RVA as already described in the literature, associated to the traces of environmental degradation in the studied areas.


title: New onset anosmia and ageusia in adult patients diagnosed with SARS-CoV-2

text: OBJECTIVE: We investigated the prevalence of anosmia and ageusia in adult patients with a laboratory confirmed diagnosis of severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2). METHODS: A retrospective observational analysis of patients with SARS-CoV-2 admitted to hospital or managed in the community and their household contacts across a London population during March 1 - April 1, 2020. Symptomatology and duration were extracted from routinely collected clinical data and follow-up telephone consultations. Descriptive statistics were used. RESULTS: Of 386 patients, 141 (92 community patients, 49 discharged inpatients) were included for analysis. 77/141 (55%) reported anosmia and ageusia; nine reported only ageusia and three only anosmia. The median onset of anosmia in relation to onset of SARS-CoV-2 symptoms (as defined by the Public Health England case definition) was 4 days (Interquartile range 5). Median duration of anosmia was 8 days (IQR 16). Median duration of SARS-CoV-2 symptoms in community patients was 10 days (IQR 8) versus 18 days (IQR 13.5) in admitted patients. As of April 1, 45 patients had ongoing SARS-CoV-2 symptoms and/or anosmia. 107/141 (76%) patients had household contacts. Of 185 non-tested household contacts, 79 (43%) had SARS-CoV-2 symptoms with 46/79 (58%) reporting anosmia. Six household contacts had anosmia only. CONCLUSIONS: Over half of positive patients reported anosmia and ageusia suggesting these should be added to the case definition and guide self-isolation protocols. This adaptation may be integral to case finding in the absence of population-level testing. Until we have successful population-level vaccination coverage, these steps remain critical in the current and future waves of this pandemic.


Response to ‘Vitamin D concentrations and COVID-19 infection in UK Biobank’


title: Invertebrate RNA virus diversity from a taxonomic point of view

text: Abstract Invertebrates are hosts to diverse RNA viruses that have all possible types of encapsidated genomes (positive, negative and ambisense single stranded RNA genomes, or a double stranded RNA genome). These viruses also differ markedly in virion morphology and genome structure. Invertebrate RNA viruses are present in three out of four currently recognized orders of RNA viruses: Mononegavirales, Nidovirales, and Picornavirales, and 10 out of 37 RNA virus families that have yet to be assigned to an order. This mini-review describes general properties of the taxonomic groups, which include invertebrate RNA viruses on the basis of their current classification by the International Committee on Taxonomy of Viruses (ICTV).


title: U.S. Medical Examiner/Coroner capability to handle highly infectious decedents

text: In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs′ capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.


title: Expression and purification of SARS coronavirus membrane protein

text: To construct a recombinant plasmid Pet23a-M, the gene encoding severe acute respiratory syndrome (SARS) coronavirus membrane protein was amplified by RT-PCR and cloned into the expression plasmid Pet23a. Results of restriction endonuclease analysis, PCR detection and DNA sequencing analysis revealed that the cloned DNA sequence was the same as that reported. The recombinants were transformed intoEscherichia coli (E. Coli) BL21 (DE3) and induced by Isopropyl-β-D-thiogalactopyranoside (IPTG). The expression of 27 kD (1 kD=0.992 1 ku) protein was detected by SDS-PAGE and pured by metal chelated chromatography. Results of Western-blot showed that this expressed protein could react with antibodies in sera of SARS patients during convalescence. This provided the basis for the further study on SARS virus vaccine and diagnostic agents.


title: Brexit and health security: why we need to protect our global networks

text: As the United Kingdom (UK) negotiates its separation from the European Union (EU), it is important to remember the public health mechanisms that are directly facilitated via our relationship with the EU. One such mechanism is the UK’s role within the European Centre for Disease Prevention and Control (ECDC). Global health protection is an area that is currently experiencing an unprecedented wave of innovation, both technologically and ideologically, and we must therefore ensure that our future relationship with ECDC is one that facilitates full involvement with the global health security systems of the future.


title: Global threat of COVID 19 and evacuation of the citizens of different countries

text: Beginning from China on December 2019, COVID-19 epidemic has spreaded all over the world in a short period of time and has been a pandemic. In challenge with this pandemic quarantine technique has been used widely after tens of years. In the course of the pandemic, many countries evacuated their citizens from affected regions and combined the evacuation with quarantine process. Some examples of these countries who evacuated their citizens are Germany, Italy, Spain, and USA. In further times, during the course of pandemic, according to spread, other countries evacuated their citizens from these countries too. Despite being the origin of the pandemic, in later times Wuhan was also a place where people were evacuated to. Evacuation and quarantine have caused social and psychological impacts on people and some of them took place in mainstream media. In this review article, evacuation and quarantine processes as well as the society’s reactions to these, have been compiled.


title: Neurosurgical management of brain and spine tumors in the COVID-19 era: an institutional experience from the epicenter of the pandemic

text: The challenges of neurosurgical patient management and surgical decision-making during the 2019–2020 COVID-19 worldwide pandemic are immense and never-before-seen in our generation of neurosurgeons. In this case-based formatted report, we present the Mount Sinai Hospital (New York, NY) Department of Neurosurgery institutional experience in the epicenter of the pandemic and the guiding principles for our current management of intracranial, skull base, and spine tumors. The detailed explanations of our surgical reasoning for each tumor case is tailored to assist neurosurgeons across the United States as they face these complex operative decisions put forth by the realities of the pandemic.


title: Epidemic and genetic characterization of porcine epidemic diarrhea virus strains circulating in the regions around Hunan, China, during 2017-2018

text: Outbreaks of porcine epidemic diarrhea (PED) caused by porcine epidemic diarrhea virus (PEDV) infection have caused high mortality of piglets and significant economic losses to the Chinese swine industry. In the current study, 184 specimens from pigs with or without signs of diarrhea were collected from 39 farms across eight provinces, mainly around Hunan, People's Republic of China, in 2017 to 2018 in order to obtain epidemiological information on PEDV infections in these regions. The results indicated an average PEDV-positive rate of 38.04% (70/184) and more-pronounced disease severity in diarrheic pigs (48.76%; 59/121) than in non-diarrheic pigs (17.46%; 11/63). Phylogenetic and sequence analysis demonstrated that 14 representative PEDV strains from 14 swine farms belonged to the G2 group (G2-a and G2-b subgroups) and displayed a high degree of genetic variation. In particular, two out of the 14 PEDV strains were found to have unique indels in the S1 gene. The strain HN-SY-2017-Oct had a 9-nucleotide (T(1152)GAAGCCAAT(1160)T) insertion, and the strain ZJ-2018-May had a 3-nucleotide (AAA) deletion at position 1126 in the S1 gene. A three-dimensional structural prediction revealed that these unique insertions might lengthen the loop on the surface or increase the likelihood of the surface protein being phosphorylated at (388)Y, thereby affecting the virulence or pathogenicity of PEDV. Collectively, the data show that PED remains a severe threat to the pig industry and that variant PEDV stains are circulating in China. The updated PEDV epidemiological data will facilitate the design of PEDV vaccines and the application of effective measures for PED prevention.


title: Clinical evaluation of AusDiagnostics SARS-CoV-2 multiplex tandem PCR assay

text: BACKGROUND: In the context of the pandemic, the rapid emergency use authorisation of diagnostic assays for SARS-CoV-2 has meant there are few peer-reviewed published studies of clinical performance of commercial assays. AIMS: To evaluate the clinical performance of AusDiagnostics respiratory multiplex tandem PCR assay including SARS-CoV-2. METHODS: We reviewed the results following implementation of AusDiagnostics respiratory multiplex tandem PCR assay including SARS-CoV-2, and compared with an in-house RT-PCR assay at our State Reference Laboratory. RESULTS: Initial validation using AusDiagnostics coronavirus multiplex tandem PCR assay including SARS-CoV-2 demonstrated good concordance with the State Reference Laboratory. After implementing the AusDiagnostics respiratory multiplex tandem PCR assay including SARS-CoV-2, we tested 7,839 samples. 127 samples in which SARS-CoV-2 was detected using the AusDiagnostics assay were referred for testing at the State Reference Laboratory, with concordant results in 118/127 (92.9%) of samples. After resolution of discrepancies, 125/127 (98.4%) of AusDiagnostics results were determined to be true positive results. Out of 7,839 samples tested for SARS-CoV-2 during this period, only 2 tests (0.02%) were indeterminate results. CONCLUSION: The AusDiagnostics respiratory MT-PCR assay is a reliable assay for detection of SARS-CoV-2.


title: An Overview of Practical Applications of Protein Disorder Prediction and Drive for Faster, More Accurate Predictions

text: Protein disordered regions are segments of a protein chain that do not adopt a stable structure. Thus far, a variety of protein disorder prediction methods have been developed and have been widely used, not only in traditional bioinformatics domains, including protein structure prediction, protein structure determination and function annotation, but also in many other biomedical fields. The relationship between intrinsically-disordered proteins and some human diseases has played a significant role in disorder prediction in disease identification and epidemiological investigations. Disordered proteins can also serve as potential targets for drug discovery with an emphasis on the disordered-to-ordered transition in the disordered binding regions, and this has led to substantial research in drug discovery or design based on protein disordered region prediction. Furthermore, protein disorder prediction has also been applied to healthcare by predicting the disease risk of mutations in patients and studying the mechanistic basis of diseases. As the applications of disorder prediction increase, so too does the need to make quick and accurate predictions. To fill this need, we also present a new approach to predict protein residue disorder using wide sequence windows that is applicable on the genomic scale.


title: Genomic and Proteomic Analysis of Schizaphis graminum Reveals Cyclophilin Proteins Are Involved in the Transmission of Cereal Yellow Dwarf Virus

text: Yellow dwarf viruses cause the most economically important virus diseases of cereal crops worldwide and are transmitted by aphid vectors. The identification of aphid genes and proteins mediating virus transmission is critical to develop agriculturally sustainable virus management practices and to understand viral strategies for circulative movement in all insect vectors. Two cyclophilin B proteins, S28 and S29, were identified previously in populations of Schizaphisgraminum that differed in their ability to transmit the RPV strain of Cereal yellow dwarf virus (CYDV-RPV). The presence of S29 was correlated with F2 genotypes that were efficient virus transmitters. The present study revealed the two proteins were isoforms, and a single amino acid change distinguished S28 and S29. The distribution of the two alleles was determined in 12 F2 genotypes segregating for CYDV-RPV transmission capacity and in 11 genetically independent, field-collected S . graminum biotypes. Transmission efficiency for CYDV-RPV was determined in all genotypes and biotypes. The S29 isoform was present in all genotypes or biotypes that efficiently transmit CYDV-RPV and more specifically in genotypes that efficiently transport virus across the hindgut. We confirmed a direct interaction between CYDV-RPV and both S28 and S29 using purified virus and bacterially expressed, his-tagged S28 and S29 proteins. Importantly, S29 failed to interact with a closely related virus that is transported across the aphid midgut. We tested for in vivo interactions using an aphid-virus co-immunoprecipitation strategy coupled with a bottom-up LC-MS/MS analysis using a Q Exactive mass spectrometer. This analysis enabled us to identify a third cyclophilin protein, cyclophilin A, interacting directly or in complex with purified CYDV-RPV. Taken together, these data provide evidence that both cyclophilin A and B interact with CYDV-RPV, and these interactions may be important but not sufficient to mediate virus transport from the hindgut lumen into the hemocoel.


title: Preventing airborne infection

text: Good ventilation is essential in indoor spaces including planes


Assessing the severity of COVID-19.


title: Epidemiology of infections following haploidentical peripheral blood hematopoietic cell transplantation

text: BACKGROUND: The use of T‐cell replete haploidentical hematopoietic cell transplant (haplo‐HCT) has increased substantially since the introduction of post‐transplant cyclophosphamide (PTCy) regimens. Limited data exist concerning infectious complications of haplo‐HCT utilizing mobilized peripheral blood (PB) hematopoietic cells. METHODS: This retrospective cohort study included all adult patients at our institution undergoing PB haplo‐HCT with PTCy between June 2009 and June 2015. Infections were microbiologically confirmed. Invasive fungal infections (IFI) classified as “proven” or “probable” by standard definitions were included. RESULTS: In total, 104 patients were identified. Median follow‐up was 218 days (range: 6–1576). A total of 322 episodes of infection were recorded. Eighty‐nine percent of patients experienced at least one infection. Median time to first infection was 22 days. Patients experiencing at least one bacterial, viral, and IFI were 62%, 72%, and 6%, respectively. The majority (69%) of bacterial infections were caused by enteric organisms. Seven cases of Staphylococcus aureus infection were recorded, with one bacteremia case. Cytomegalovirus (CMV) viremia occurred in 54/71 (76%) at‐risk patients at a median time of 24 days. Sixteen (15%) patients developed CMV disease. Nineteen percent (20/104) of patients developed BK polyomavirus‐associated cystitis. Six (6%) patients experienced a total of seven IFI. Infection was the primary cause of death for 12% (6/51) of patients and was a secondary cause for 41%. CONCLUSION: In PB haplo‐HCT patients, a high incidence of CMV viremia and disease was observed. Infections with enteric bacteria were common. Fungal and staphylococcal infections were uncommon. Further studies are needed to compare infectious complications in haplo‐HCT with other transplant modalities.


title: Role of sialic acids in rotavirus infection

text: Rotaviruses are the leading cause of childhood diarrhea. The entry of rotaviruses into the host cell is a complex process that includes several interactions of the outer layer proteins of the virus with different cell surface molecules. The fact that neuraminidase treatment of the cells, or preincubation of the virus with sialic acid-containing compounds decrease the infectivity of some rotavirus strains, suggested that these viruses interact with sialic acid on the cell surface. The infectivity of some other rotavirus strains is not affected by neuraminidase treatment of the cells, and therefore they are considered neuraminidase-resistant. However, the current evidence suggests that even these neuraminidase-resistant strains might interact with sialic acids located in context different from that of the sialic acids used by the neuraminidase-sensitive strains. This review summarizes our current knowledge of the rotavirus-sialic acid interaction, its structural basis, the specificity with which distinct rotavirus isolates interact with sialic acid-containing compounds, and also the potential use of these compounds as therapeutic agents.


title: Bactrian camels shed large quantities of Middle East respiratory syndrome coronavirus (MERS-CoV) after experimental infection

text: In 2012, Middle East respiratory syndrome coronavirus (MERS-CoV) emerged. To date, more than 2300 cases have been reported, with an approximate case fatality rate of 35%. Epidemiological investigations identified dromedary camels as the source of MERS-CoV zoonotic transmission and evidence of MERS-CoV circulation has been observed throughout the original range of distribution. Other new-world camelids, alpacas and llamas, are also susceptible to MERS-CoV infection. Currently, it is unknown whether Bactrian camels are susceptible to infection. The distribution of Bactrian camels overlaps partly with that of the dromedary camel in west and central Asia. The receptor for MERS-CoV, DPP4, of the Bactrian camel was 98.3% identical to the dromedary camel DPP4, and 100% identical for the 14 residues which interact with the MERS-CoV spike receptor. Upon intranasal inoculation with 107 plaque-forming units of MERS-CoV, animals developed a transient, primarily upper respiratory tract infection. Clinical signs of the MERS-CoV infection were benign, but shedding of large quantities of MERS-CoV from the URT was observed. These data are similar to infections reported with dromedary camel infections and indicate that Bactrians are susceptible to MERS-CoV and given their overlapping range are at risk of introduction and establishment of MERS-CoV within the Bactrian camel populations.


Resolution of Acute Disseminated Encephalomyelitis Following Termination of Pregnancy


title: Venezuelan Equine Encephalitis Virus Induces Apoptosis through the Unfolded Protein Response Activation of EGR1

text: Venezuelan equine encephalitis virus (VEEV) is a previously weaponized arthropod-borne virus responsible for causing acute and fatal encephalitis in animal and human hosts. The increased circulation and spread in the Americas of VEEV and other encephalitic arboviruses, such as eastern equine encephalitis virus and West Nile virus, underscore the need for research aimed at characterizing the pathogenesis of viral encephalomyelitis for the development of novel medical countermeasures. The host-pathogen dynamics of VEEV Trinidad donkey-infected human astrocytoma U87MG cells were determined by carrying out RNA sequencing (RNA-Seq) of poly(A) and mRNAs. To identify the critical alterations that take place in the host transcriptome following VEEV infection, samples were collected at 4, 8, and 16 h postinfection and RNA-Seq data were acquired using an Ion Torrent PGM platform. Differential expression of interferon response, stress response factors, and components of the unfolded protein response (UPR) was observed. The protein kinase RNA-like endoplasmic reticulum kinase (PERK) arm of the UPR was activated, as the expression of both activating transcription factor 4 (ATF4) and CHOP (DDIT3), critical regulators of the pathway, was altered after infection. Expression of the transcription factor early growth response 1 (EGR1) was induced in a PERK-dependent manner. EGR1(−/−) mouse embryonic fibroblasts (MEFs) demonstrated lower susceptibility to VEEV-induced cell death than isogenic wild-type MEFs, indicating that EGR1 modulates proapoptotic pathways following VEEV infection. The influence of EGR1 is of great importance, as neuronal damage can lead to long-term sequelae in individuals who have survived VEEV infection. IMPORTANCE Alphaviruses represent a group of clinically relevant viruses transmitted by mosquitoes to humans. In severe cases, viral spread targets neuronal tissue, resulting in significant and life-threatening inflammation dependent on a combination of virus-host interactions. Currently there are no therapeutics for infections cause by encephalitic alphaviruses due to an incomplete understanding of their molecular pathogenesis. Venezuelan equine encephalitis virus (VEEV) is an alphavirus that is prevalent in the Americas and that is capable of infecting horses and humans. Here we utilized next-generation RNA sequencing to identify differential alterations in VEEV-infected astrocytes. Our results indicated that the abundance of transcripts associated with the interferon and the unfolded protein response pathways was altered following infection and demonstrated that early growth response 1 (EGR1) contributed to VEEV-induced cell death.


title: Nutritional management of the foal with diarrhoea

text: Diarrhoea is a common problem in the neonatal and suckling foal. In certain circumstances supplemental nutrition is necessary depending on the age of foal, severity of diarrhoea and presence of other systemic manifestations. Nutritional supplementation can be provided either enterally or parenterally. Enteral nutrition is superior to parenteral nutrition because it is the most natural and physiologically sound means to provide nutritional support. Parenteral nutrition may be warranted if the foal is unable to receive or tolerate enteral nutrition. Dextrose alone or with amino acids and lipids can provide appropriate nutrition when enteral feeding is not tolerated. As soon as the foal stabilises enteral feeding can be reintroduced.


title: Human seroprevalence indicating hantavirus infections in tropical rainforests of Côte d’Ivoire and Democratic Republic of Congo

text: Hantaviruses are members of the Bunyaviridae family carried by small mammals and causing human hemorrhagic fevers worldwide. In Western Africa, where a variety of hemorrhagic fever viruses occurs, indigenous hantaviruses have been molecularly found in animal reservoirs such as rodents, shrews, and bats since 2006. To investigate the human contact to hantaviruses carried by these hosts and to assess the public health relevance of hantaviruses for humans living in the tropical rainforest regions of Western and Central Africa, we performed a cross-sectional seroprevalence study in the region of Taï National Park in Côte d’Ivoire and the Bandundu region near the Salonga National Park in the Democratic Republic (DR) of Congo. Serum samples were initially screened with enzyme-linked immunosorbent assays using nucleoproteins of several hantaviruses as diagnostic antigens. Positive results were confirmed by Western blotting and immunofluorescence testing. Seroprevalence rates of 3.9% (27/687) and 2.4% (7/295), respectively, were found in the investigated regions in Côte d’Ivoire and the DR Congo. In Côte d’Ivoire, this value was significantly higher than the seroprevalence rates previously reported from the neighboring country Guinea as well as from South Africa. Our study indicates an exposure of humans to hantaviruses in West and Central African tropical rainforest areas. In order to pinpoint the possible existence and frequency of clinical disease caused by hantaviruses in this region of the world, systematic investigations of patients with fever and renal or respiratory symptoms are required.


title: Oral vitamin A supplementation of porcine epidemic diarrhea virus infected gilts enhances IgA and lactogenic immune protection of nursing piglets

text: Vitamin A (VA) has pleiotropic effects on the immune system and is critical for mucosal immune function and intestinal lymphocyte trafficking. We hypothesized that oral VA supplementation of porcine epidemic diarrhea virus (PEDV)-infected pregnant gilts would enhance the gut-mammary gland-secretory IgA axis to boost lactogenic immunity and passive protection of nursing piglets against PEDV challenge. Gilts received daily oral retinyl acetate (30 000 IU) starting at gestation day 76 throughout lactation. At 3–4 weeks pre-partum, VA-supplemented (PEDV + VA) and non-supplemented (PEDV) gilts were PEDV or mock inoculated (mock + VA and mock, respectively). PEDV + VA gilts had decreased mean PEDV RNA shedding titers and diarrhea scores. To determine if lactogenic immunity correlated with protection, all piglets were PEDV-challenged at 3–5 days post-partum. The survival rate of PEDV + VA litters was 74.2% compared with 55.9% in PEDV litters. Mock and mock + VA litter survival rates were 5.7% and 8.3%, respectively. PEDV + VA gilts had increased PEDV IgA antibody secreting cells and PEDV IgA antibodies in serum pre-partum and IgA(+)β7(+) (gut homing) cells in milk post piglet challenge compared with PEDV gilts. Our findings suggest that oral VA supplementation may act as an adjuvant during pregnancy, enhancing maternal IgA and lactogenic immune protection in nursing piglets.


title: The practical need to challenge the status quo: New directions in bioethics

text: Abstract Those of us working in bioethics field take it for granted that the rest of the world reads our work and uses it as part of their scholarship and reasoning processes. Having widespread national and international influence is true for some of the biggest name bioethicists, but interactions at new international conferences or browsing through publications often brings revealing – and potentially humbling – news about how little effect our research tends to have on what is going on elsewhere. We are unrecognized outside of our small, tightly bound professional groups, and our ideas fail to be incorporated freely throughout outsiders’ scholarly work. Putting our professional hurt feelings aside, we should have far greater concerns of possibly unneeded effort and hampered progress in the field based on unintentional ignorance of how other geographic regions are doing their bioethics. It makes no practical sense for efforts to be duplicated, especially if someone else has done it better, or at least, earlier. More wasteful is exploring already well-examined ground, and then previously found not worth any further resources. At the very least, needless research is a lost opportunity to make bioethics better.


title: Serologic Follow-up of Middle East Respiratory Syndrome Coronavirus Cases and Contacts—Abu Dhabi, United Arab Emirates

text: BACKGROUND: Although there is evidence of person-to-person transmission of Middle East respiratory syndrome coronavirus (MERS-CoV) in household and healthcare settings, more data are needed to describe and better understand the risk factors and transmission routes in both settings, as well as the extent to which disease severity affects transmission. METHODS: A seroepidemiological investigation was conducted among MERS-CoV case patients (cases) and their household contacts to investigate transmission risk in Abu Dhabi, United Arab Emirates. Cases diagnosed between 1 January 2013 and 9 May 2014 and their household contacts were approached for enrollment. Demographic, clinical, and exposure history data were collected. Sera were screened by MERS-CoV nucleocapsid protein enzyme-linked immunosorbent assay and indirect immunofluorescence, with results confirmed by microneutralization assay. RESULTS: Thirty-one of 34 (91%) case patients were asymptomatic or mildly symptomatic and did not require oxygen during hospitalization. MERS-CoV antibodies were detected in 13 of 24 (54%) case patients with available sera, including 1 severely symptomatic, 9 mildly symptomatic, and 3 asymptomatic case patients. No serologic evidence of MERS-CoV transmission was found among 105 household contacts with available sera. CONCLUSIONS: Transmission of MERS-CoV was not documented in this investigation of mostly asymptomatic and mildly symptomatic cases and their household contacts. These results have implications for clinical management of cases and formulation of isolation policies to reduce the risk of transmission.


title: Organisation de la ventilation artificielle dans les unités de réanimation en France

text: Résumé Objectifs Dans le domaine de la ventilation en réanimation, préciser le matériel, la formation des équipes, la maintenance et les référentiels disponibles. Type d’étude Enquête déclarative. Méthodes Entre septembre et décembre 2010, ont été recueillis : répartition et type des ventilateurs (ventilateurs lourds, de dépannage, ventilation non invasive (VNI) et de transport), formation des médecins et des soignants, maintenance, présence de référentiels. Les résultats sont présentés en médiane/extrêmes ou proportions. Résultats Les 62 unités analysées étaient équipées de 15 ventilateurs (médiane, extrêmes 1−50), de plusieurs marques 47 (76 %) fois. Des ventilateurs étaient spécifiquement disponibles pour la VNI 22 fois (35 %), le dépannage 49 (79 %) fois, et le transport dans 100 % des unités. Les soignants étaient formés par les médecins dans 54 unités (87 %) ou par un industriel dans 29 unités (47 %). Les médecins étaient formés par les médecins séniors dans 55 unités (89 %) ou par un industriel dans 21 unités (34 %). Les formations étaient ponctuelles dans 24 (39 %) unités ou semestrielles 16 (26 %) fois. L’entretien était effectué par le personnel de réanimation dans 39 (63 %) unités, par du personnel dédié (17 [27 %] cas), du personnel biomédical (14 [23 %] cas). Un référentiel pour l’entretien existait dans 48 (77 %) unités, le réglage du ventilateur 22 (35 %) fois et en cas de panne 20 (32 %) fois. Conclusion Cette première enquête montre une grande hétérogénéité des pratiques et de distribution du matériel. La formation et la connaissance des équipements sont des cibles pour l’amélioration de la sécurité. Abstract Objectives To clarify the procedures related to mechanical ventilation in the intensive care unit setting: allocation of ventilators, team education, maintenance and reference documents. Study design Declarative survey. Methods Between September and December 2010, we assessed the assignment and types of ventilators (ICU ventilators, temporary repair ventilators, non-invasive ventilators [NIV], and transportation ventilators), medical and nurse education, maintenance of the ventilators, presence of reference documents. Results are expressed in median/range and proportions. Results Among the 62 participating ICUs, a median of 15 ventilators/ICU (range 1−50) was reported with more than one trademark in 47 (76%) units. Specific ventilators were used for NIV in 22 (35%) units, temporary repair in 49 (79%) and transportation in all the units. Nurse education courses were given by ICU physicians in 54 (87%) units or by a company in 29 (47%) units. Medical education courses were made by ICU senior physicians in 55 (89%) units or by a company in 21 (34%) units. These courses were organized occasionally in 24 (39%) ICU and bi-annually in 16 (26%) units. Maintenance procedures were made by the ICU staff in 39 (63%) units, dedicated staff (17 [27%]) or bioengineering technicians (14 [23%] ICU). Reference documents were written for maintenance procedures in 48 (77%) units, ventilator setup in 22 (35%) units and ventilator dysfunction in 20 (32%) ICU. Conclusions This first survey shows disparate distribution of ventilators and practices among French ICU. Education and understanding of the proper use of ventilators are key issues for security improvement.


title: Videogames and guns in adolescents: T ests of a bipartite theory

text: Abstract The possible role of video gaming in imprinting aggressive and specifically gun-related behaviors has been elusive, and findings regarding these associations have been inconsistent. I address this gap by proposing and testing a bipartite theory that can explain inconsistent results regarding the previously assumed linear association between videogames and gun-related behaviors. The theory suggests that this association follows a U-shape. It posits that at low levels of video gaming time, video gaming displaces gun-related behaviors and shelters adolescents by keeping them occupied and by reducing opportunities and motivation to acquire guns. However, at some level of gaming time (because most popular games adolescents play include violent aspects), the assumed imprinting of aggressive behaviors overpowers the positive displacement force, and this can trivialize and naturalize gun-carrying behaviors, and ultimately increase motivation to obtain and carry guns. I tested this theory with two national samples of American adolescents (n1 = 24,779 and n2 = 26,543, out of which 403 and 378, respectively, reported bringing a gun to school in the last month). Multiple analyses supported the proposed U-shaped association. These findings show that the moral panic over video games is largely unsubstantiated, especially among light to moderate gamers.


title: Sepsis biomarkers: an omics perspective

text: Sepsis is a common cause of death in hospitalized patients worldwide. The early detection of sepsis remains a great challenge for clinicians, and delayed diagnosis frequently undermines treatment efforts, thereby contributing to high mortality. Omics technologies allow high-throughput screening of sepsis biomarkers. This review describes currently available and novel sepsis biomarkers in the context of genomics, transcriptomics, proteomics, and metabolomics. The combination of these technologies can help refine the diagnosis of sepsis. This review paper serves as a reference for future studies that employ an integrated, multi-omics approach to disease identification.


title: Market report: Air Filters

text: Abstract Sales of air filters will rise at a rate of 8% per year over the next four years to US$6.2 billion in 2007, according to the continuously updated on-line report Air Filtration and Purification World Market, published by the McIlvaine Company. This is a short news story only. Visit www.filtsep.com for the latest filtration industry news


title: Emerging infectious diseases and biological invasions: a call for a One Health collaboration in science and management

text: The study and management of emerging infectious diseases (EIDs) and of biological invasions both address the ecology of human-associated biological phenomena in a rapidly changing world. However, the two fields work mostly in parallel rather than in concert. This review explores how the general phenomenon of an organism rapidly increasing in range or abundance is caused, highlights the similarities and differences between research on EIDs and invasions, and discusses shared management insights and approaches. EIDs can arise by: (i) crossing geographical barriers due to human-mediated dispersal, (ii) crossing compatibility barriers due to evolution, and (iii) lifting of environmental barriers due to environmental change. All these processes can be implicated in biological invasions, but only the first defines them. Research on EIDs is embedded within the One Health concept—the notion that human, animal and ecosystem health are interrelated and that holistic approaches encompassing all three components are needed to respond to threats to human well-being. We argue that for sustainable development, biological invasions should be explicitly considered within One Health. Management goals for the fields are the same, and direct collaborations between invasion scientists, disease ecologists and epidemiologists on modelling, risk assessment, monitoring and management would be mutually beneficial.


title: Single Particle Tracking Assay to Study Coronavirus Membrane Fusion

text: Single particle tracking (SPT) of individual virion fusion with host cell membranes using total internal reflection microscopy (TIRFM) is a powerful technique for quantitatively characterizing virus–host interactions. One significant limitation of this assay to its wider use across many types of enveloped viruses, such as coronavirus, has been incorporating non-lipid receptors (proteins) into the supported lipid bilayers (SLBs) used to monitor membrane fusion. Here, we describe a method for incorporating a proteinaceous viral receptor, feline aminopeptidase N (fAPN), into SLBs using cell blebbing of mammalian cells expressing fAPN in the plasma membrane. This receptor binds feline coronavirus (FECV 1683). We describe how to carry out single particle tracking of FECV fusion in this SLB platform to obtain fusion kinetics.


title: Endothelial cell dysfunction: a major player in SARS-CoV-2 infection (COVID-19)?

text: Coronavirus disease 2019 (COVID-19) represents a public health crisis of pandemic proportions. Caused by SARS-CoV-2, which stands for severe acute respiratory syndrome (SARS) coronavirus 2, the symptoms most commonly reported include cough, fever, and shortness of breath, but also extra-pulmonary symptoms, such as neurological and gastroenterological manifestations.


Targeting the interleukin‐17 pathway to prevent acute respiratory distress syndrome associated with SARS‐CoV‐2 infection


title: Free market versus state or something else?: civic sector and competition law’s roles during the COVID-19 pandemic in Japan

text: COVID-19 is a highly transmittable disease. Until a vaccine is found, social distancing is the only way to prevent the virus from killing millions. Lockdown may also be necessary. Such measures inevitably cause an economic recession, so supplementing individuals’ incomes prove vital. Without income support, employees must go to work and risk contracting and spreading the virus. Instituting protective measures is the role of the government; however, a dysfunctional government causes citizens to seek alternative solutions from either the civic sector or charitable organizations.


title: Evolutionary relationship analysis of Middle East respiratory syndrome coronavirus 4a and 4b protein coding sequences

text: The 4a and 4b proteins of the Middle East respiratory syndrome coronavirus (MERS-CoV) have been described for their antagonism on host innate immunity. However, unlike clustering patterns of the complete gene sequences of human and camel MERS-CoVs, the 4a and 4b protein coding regions did not constitute species-specific phylogenetic groups. Moreover, given the estimated evolutionary rates of the complete, 4a, and 4b gene sequences, the 4a and 4b proteins might be less affected by species-specific innate immune pressures. These results suggest that the 4a and 4b proteins of MERS-CoV may function against host innate immunity in a manner independent of host species and/or evolutionary clustering patterns.


title: First Isolation and Rapid Identification of Newcastle Disease Virus from Aborted Fetus of Dromedary Camel Using Next-Generation Sequencing

text: Newcastle disease virus (NDV) causes morbidities and mortalities in wild and domestic birds globally. For humans, exposure to infected birds can cause conjunctivitis and influenza-like symptoms. NDV infections in mammals are rarely reported. In this study, using next-generation sequencing, an NDV was identified and isolated from Vero cells inoculated with the nasal swab of an aborted dromedary fetus in Dubai, during the time when an NDV outbreak occurred in a pigeon farm located in close proximity to the dairy camel farm where the mother of the aborted dromedary fetus resided, and there were a lot of pigeons in the camel farm. Genome analysis revealed that the structurally and functionally important features of other NDVs were also present in this dromedary NDV genome. Phylogenetic analysis based on the nucleotide sequences of fusion protein (F), hemagglutinin-neuraminidase protein (HN) and complete polyprotein showed that the virus belonged to sub-genotype VIg of class II NDV and is most closely related to pigeon NDVs in Egypt in the same year. The present study is the first that demonstrated isolation of NDV in dromedaries. Further study is warranted to investigate the relationship between NDV infection and abortion.


title: Impact of Preexisting Adenovirus Vector Immunity on Immunogenicity and Protection Conferred with an Adenovirus-Based H5N1 Influenza Vaccine

text: The prevalence of preexisting immunity to adenoviruses in the majority of the human population might adversely impact the development of adaptive immune responses against adenovirus vector-based vaccines. To address this issue, we primed BALB/c mice either intranasally (i.n.) or intramuscularly (i.m.) with varying doses of wild type (WT) human adenovirus subtype 5 (HAd5). Following the development of immunity against HAd5, we immunized animals via the i.n. or i.m. route of inoculation with a HAd vector (HAd-HA-NP) expressing the hemagglutinin (HA) and nucleoprotein (NP) of A/Vietnam/1203/04 (H5N1) influenza virus. The immunogenicity and protection results suggest that low levels of vector immunity (<520 virus-neutralization titer) induced by priming mice with up to 10(7) plaque forming units (p.f.u.) of HAd-WT did not adversely impact the protective efficacy of the vaccine. Furthermore, high levels of vector immunity (approximately 1500 virus-neutralization titer) induced by priming mice with 10(8) p.f.u. of HAd-WT were overcome by either increasing the vaccine dose or using alternate routes of vaccination. A further increase in the priming dose to 10(9) p.f.u. allowed only partial protection. These results suggest possible strategies to overcome the variable levels of human immunity against adenoviruses, leading to better utilization of HAd vector-based vaccines.


title: Mechanistic Study of the Reaction of Thiol‐Containing Enzymes with α,β‐Unsaturated Carbonyl Substrates by Computation and Chemoassays

text: We investigated the reactions between substituted α,β‐unsaturated carbonyl compounds (Michael systems) and thiols by computations as well as chemoassays. The results give insight into variations in the underlying mechanisms as a function of the substitution pattern. This is of interest for the mechanisms of inhibition of the SARS coronavirus main protease (SARS‐CoV M(pro)) by etacrynic acid derivatives as well as for the excess toxicity of substituted α,β‐unsaturated carbonyl compounds. This study compares possible reaction courses including 1,4‐addition followed by a ketonization step, and underscores the importance of a base‐catalyzed step for the reactivity of thiol groups in enzymes. Phenyl and methyl substituents at the Michael system decrease the reactivity of the electrophilic compound, but chlorophenyl substituents partly recover the reactivity. Computations also indicate that electron‐pushing substituents lead to a change in the reaction mechanism. The conformation of the Michael system is also found to significantly influence reactivity: the s‐cis conformation leads to higher reactivity than the s‐trans conformation. The computed data explain the trends in measured inhibition potencies of substituted α,β‐unsaturated carbonyl compounds and of reaction rates in chemical assays. They also indicate that the reversibility of inhibition does not stand in contrast to the formation of a new covalent bond between inhibitor and protease.


title: #pandemicpedagogy: using twitter for knowledge exchange

text: The COVID‐19 crisis has resulted in homeworking becoming the norm internationally. As a result, international, national and institutional medical education conferences, workshops and seminars have been cancelled or postponed indefinitely. Consequently, the opportunity for knowledge exchange and networking has been reduced. Hull York Medical School runs a medical education research unit with associated masters and PhD programmes that rely on conferences as opportunities for postgraduate students to learn from others in the field, showcase their research and innovative pedagogy, as well as network for future employment.


title: Complete Genome Sequences of Four Bovine Coronavirus Isolates from Pennsylvania

text: We report four full-genome sequences of bovine coronavirus (BCoV) isolates from dairy calves in Pennsylvania obtained in 2016 and 2017. BCoV is a pathogen of great importance to cattle health, and this is the first report of full-genome sequences of BCoV from PA cattle.


title: Analysis of the parameters of respiration patterns extracted from thermal image sequences

text: Abstract Remote estimation of vital signs is an important and active area of research. The goal of this work was to analyze the feasibility of estimating respiration parameters from video sequences of faces recorded using a mobile thermal camera. Different estimators were analyzed and experimentally verified. It was demonstrated that the respiration rate, periodicity of respiration, and presence and length of apnea periods could be reliably estimated from signals recorded using a portable thermal camera. The size of the camera and efficiency of the methods allow the implementation of this method in smart glasses.


Axalta to Apply Antimicrobial Technology in Chicago Hospital for COVID-19 Patients


title: Are you prepared? Defining occupational health resource needs to prevent infectious disease transmission in the health care sector

text: Abstract This article discusses the extent of resource allocation to Occupational Health (OH) to prevent infectious disease exposure and transmission in British Columbia (B.C.). It also characterizes the delineation of roles and responsibilities within OH services in B.C. health care settings and highlights areas where improvements to current OH programs could be made to prevent and control occupational infections. Given the breadth of OH responsibilities, resource allocation in many health care institutions for these services is inadequate and roles and responsibilities may not be clearly delineated.


title: Body surface infrared thermometry in patients with central venous cateter-related infections

text: OBJECTIVE: To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections. METHODS: Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject. RESULTS: A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus -0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus -0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus -0.22 - -0.10ºC; p<0.01). CONCLUSION: Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.


title: DEA, SAMHSA relax OTP/OBOT regulations due to COVID‐19

text: Opioid treatment programs (OTPs) that dispense methadone got a fast and clear reprieve from federal authorities last week in the face of COVID‐19. The Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) issued policies that give OTPs flexibility in take‐homes, limiting the frequency of face‐to‐face contact and opportunities for transmission of COVID‐19. There is also greater flexibility for office‐based opioid treatment (OBOT) with buprenorphine.


Can we perform like SUPER-CRIPPLES during these crazy times of coronavirus pandemic?


title: Respiratory Viruses in Adults With Community-Acquired Pneumonia

text: Background Use of nucleic acid amplification techniques has increased the identification of respiratory viruses (RVs) in adult patients with community-acquired pneumonia (CAP). The objectives of the present study were to identify RV in patients with CAP using three different sampling methods and to compare CAP virus proportions and types with two comparison groups. Methods The study population included 183 adult patients with CAP, 450 control subjects, and 201 patients with nonpneumonic lower respiratory tract infection (NPLRTI). Each participant was sampled by oropharyngeal swab, nasopharyngeal swab, and nasopharyngeal washing, and the samples were tested for detection of 12 RVs by multiplex TaqMan Hydrolysis probe-based real-time polymerase chain reaction (Integrated DNA Technology; Coralville, IA). Results At least one RV was identified in 58 patients with CAP (31.7%) compared with 32 (7.1%) in control subjects and 104 (51.7%) in patients with NPLRTI (P < .01 and P < .01, respectively). Coronaviruses were identified in 24 (13.1%) patients with CAP, compared with 17 (3.8%) in control subjects, and 21 (10.4%) patients with NPLRTI. Respiratory syncytial virus was identified in 13 (7.1%), four (0.9%), and seven (3.5%); rhinovirus in nine (4.9%), nine (2.0%), and 15 (7.5%); and influenza virus in eight (4.4%), two (0.4%), and 63 (31.3%) patients with CAP, control subjects, and patients with NPLRTI, respectively. Conclusions The proportion of RV involvement in CAP is higher than previously reported. The proportion of RV identified in healthy subjects is significantly lower than in CAP, but it is not zero and should be weighed when interpreting corresponding proportions among patients.


What to expect from COVID-19 serology in a period of deconfinement?


title: Antibacterial activity of Artemisia asiatica essential oil against some common respiratory infection causing bacterial strains and its mechanism of action in Haemophilus influenzae

text: Abstract The main objective of the current study was to investigate the chemical composition of the essential oil of Artemisia asiatica together with investigating the antibacterial effects it exerts on several common respiratory infection causing bacteria including Haemophilus influenzae. Its mechanism of action was studied using various state-of-the-art assays like scanning electron microscopy, DNA, RNA and protein leakage assays, growth curve assays etc. The essential oil was extracted from the leaves of A. asiatica by supercritical CO2 fluid extraction technology. Chemical composition of essential oils was analyzed by gas chromatography-mass-spectrometry (GC-MS). The antibacterial activity was evaluated against 6 bacteria by the paper disc diffusion method. The minimum inhibitory concentration (MIC) and minimum bactericide concentration (MBC) values of the essential oil were estimated by agar dilution method. The antibacterial mechanism was evaluated by growth curve, the integrity of cell membrane and scanning electronmicroscope (SEM). Gas chromatographic analysis of the A. asiatica essential oil led to the identification of 16 chemical constituents accounting for 97.2% of the total oil composition. The major components were found to be Piperitone, (z)-davanone, p-cymene and 1, 8-cineole. The essential oil showed maximum growth inhibition against Haemophilus influenzae with a zone of inhibition of 24.5 mm and MIC/MBC values of 1.9/4.5 mg/mL respectively. Bacteria treated with the essential oil led to a rapid decrease in the number of viable cells. On adding the essential oil of A. asiatica to the bacterial culture, the constituents of the bacterial cell got released into the medium and this cell constituent release increased with increasing doses of the essential oil. SEM showed that the bacterial cells treated with the essential oil showed damaged cell wall, deformed cell morphology and shrunken cells.


A New Decade of Veterinary Research: Societal Relevance, Global Collaboration, and Translational Medicine


title: Structure-based virtual screening and molecular dynamics simulation of SARS-CoV-2 Guanine-N7 methyltransferase (nsp14) for identifying antiviral inhibitors against COVID-19

text: The recent pandemic caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) calls the whole world into a medical emergency. For tackling Coronavirus Disease 2019 (COVID-19), researchers from around the world are swiftly working on designing and identifying inhibitors against all possible viral key protein targets. One of the attractive drug targets is guanine-N7 methyltransferase which plays the main role in capping the 5′-ends of viral genomic RNA and sub genomic RNAs, to escape the host’s innate immunity. We performed homology modeling and molecular dynamic (MD) simulation, in order to understand the molecular architecture of Guanosine-P3-Adenosine-5’,5’-Triphosphate (G3A) binding with C-terminal N7-MTase domain of nsp14 from SARS-CoV-2. The residue Asn388 is highly conserved in present both in N7-MTase from SARS-CoV and SARS-CoV-2 and displays a unique function in G3A binding. For an in-depth understanding of these substrate specificities, we tried to screen and identify inhibitors from the Traditional Chinese Medicine (TCM) database. The combination of several computational approaches, including screening, MM/GBSA, MD simulations, and PCA calculations, provides the screened compounds that readily interact with the G3A binding site of homology modeled N7-MTase domain. Compounds from this screening will have strong potency towards inhibiting the substrate-binding and efficiently hinder the viral 5’-end RNA capping mechanism. We strongly believe the final compounds can become COVID-19 therapeutics, with huge international support. Communicated by Ramaswamy H. Sarma.


title: Toward a conceptualization of supplier-switching processes in business relationships

text: Abstract This paper employs a practice perspective to study and conceptualize supplier-switching processes in business relationships. It is based on case study research of a company in the international marine industry, which intended to switch one of its key suppliers for a new one as a result of cost-cutting strategies and dissatisfaction with the old supplier. The case study describes the process, which ended with the old supplier being only partially switched. The findings show how (partial) switching from one supplier to another happened via three key sub-processes and associated practices, which the involved actors in the case drew upon in the switching process: (1) initiation – a process enabled by legitimizing and search practices; (2) substitution – a process enabled by transfer, translation, and transformation practices; and (3a) stabilization – a process enabled by institutionalizing practices; and (3b) restoration – a process whereby the old supplier is retained as a result of new conditions, this retention being enabled by certain repair practices. By identifying the processes and practices that enable switching to happen, the findings offer an initial conceptualization of supplier-switching processes, which comprises an important and heretofore underexplored aspect of supplier switching. The research highlights the importance of recognizing how relationships embedded in interorganizational routines are produced and reproduced in the switching process through the actions and interactions of the actors involved.


Unusually High Rates of Acute Rejection During the COVID-19 Pandemic: Cause for Concern?


title: Prospective Trial of Sacroiliac Joint Fusion Using 3D-Printed Triangular Titanium Implants

text: BACKGROUND: Prior trials provide strong evidence supporting minimally invasive sacroiliac joint (SIJ) fusion using triangular titanium implants (TTI) for chronic SIJ dysfunction. OBJECTIVE: To assess the safety and effectiveness of SIJF using a 3D-printed TTI. METHODS: Fifty-one subjects with carefully diagnosed SIJ dysfunction underwent SIJF with 3D TTI. Subjects completed pain, disability and quality of life questionnaires at baseline and 3, 6 and 12 months postoperatively. Functional tests were performed in the clinic at each visit. Pelvic CT scans were independently evaluated for radiolucency, bridging bone and other endpoints. RESULTS: Ninety percent had 12-month follow-up. Dysfunction due to pain (Oswestry Disability Index [ODI]) decreased from 52.8 at baseline to 27.9 at 12 months (p<.0001 for change, p=.004 for non-inferiority primary hypothesis). SIJ pain scores improved from 78 preoperatively to 21 at 12-month follow-up (P<.0001). Ninety-six percent experienced an improvement of 20 points or more in VAS SIJ pain by month 12. The percentage of subjects reporting minimal difficulty performing physical activities typically impaired by back/SIJ pain improved significantly for all activities. The proportion of subjects taking opioids for SIJ pain decreased from 57% to 22%. Three physical function tests improved markedly from baseline to 1 year. Positive radiographic findings were observed, including a 70% and 77% rate of bone bridging observed at 6 and 12 months, respectively. There was no evidence of device breakage, migration or subsidence. CONCLUSION: In this prospective multicenter trial, SIJF with 3D-printed TTI markedly improved pain, disability and quality of life. Results are consistent with 3 prior prospective multicenter trials of a milled implant but suggest accelerated bony fusion with the newer implant. Physical function improved, and high rates of opioid cessation were observed. LEVEL OF EVIDENCE: Level II.


title: Safety management of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019

text: Abstract This article introduces safety management strategies of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019 in a tertiary designated hospital. The key points includes establishing a special sampling room, strict sterilization of the entire environment, training of professional nurses, enhancement of personal protection, standardization of methods and processes for swab collection, and a timely and safety sample submission. More than 11,000 nasopharyngeal specimens were collected by eight nurses, with an average of 1375 specimen swab collections each nurse, and no one was infected.


title: Laparoscopic Pneumoperitoneum Escape and Contamination during Surgery using the Airseal Insufflation System: Video Vignette

text: Unanticipated behaviours of the Airseal Insufflation and Access System (Conmed, NY, USA), in the public domain since 2017, have been recently restated by the manufacturer in light of the COVID19 pandemic and widespread concerns regarding aerosolization hazards during surgery. The associated video illustrates this device’s tendency for intra‐abdominal gas effluvium to be continually blown into the operating room during use as well as the phenomenon of air entrainment (i.e. the tendency for room air to be sucked into the abdomen) during high pressure intraoperative suctioning. We used a combination of assessment technologies in a high‐fidelity simulation model (fresh porcine cadaver) as well as during clinical surgery to examine gas flow through the Airseal 12mm valve‐less trocar with the Airseal IFS carbon dioxide (CO(2)) insufflator in Airseal mode.


Foreword: Neonatal Intensive Care Unit Preparedness for the Novel Coronavirus Disease-2019 Pandemic: A New York City Hospital Perspective


Using Probiotics to Flatten the Curve of Coronavirus Disease COVID-2019 Pandemic


title: Reality check for stem cell cures

text: Summary Four decades after the first preparation of embryonic stem cells, early hopes for regenerative medicine have failed to convert to real world applications. While rogue clinics try to cash in on unproven treatments, the real cures are still in medical trials and new avenues like the use of animals as intermediate hosts are still being explored. Michael Gross reports.


title: Public Response to Community Mitigation Measures for Pandemic Influenza

text: We report the results of a national survey conducted to help public health officials understand the public’s response to community mitigation interventions for a severe outbreak of pandemic influenza. Survey results suggest that if community mitigation measures are instituted, most respondents would comply with recommendations but would be challenged to do so if their income or job were severely compromised. The results also indicate that community mitigation measures could cause problems for persons with lower incomes and for racial and ethnic minorities. Twenty-four percent of respondents said that they would not have anyone available to take care of them if they became sick with pandemic influenza. Given these results, planning and public engagement will be needed to encourage the public to be prepared.


title: Synthesis and Biological Evaluation of Novel (thio)semicarbazone-Based Benzimidazoles as Antiviral Agents against Human Respiratory Viruses

text: Respiratory RNA viruses are responsible for recurrent acute respiratory illnesses that still represent a major medical need. Previously we developed a large variety of benzimidazole derivatives able to inhibit these viruses. Herein, two series of (thio)semicarbazone- and hydrazone-based benzimidazoles have been explored, by derivatizing 5-acetyl benzimidazoles previously reported by us, thereby evaluating the influence of the modification on the antiviral activity. Compounds 6, 8, 16 and 17, bearing the 5-(thio)semicarbazone and 5-hydrazone functionalities in combination with the 2-benzyl ring on the benzimidazole core structure, acted as dual inhibitors of influenza A virus and human coronavirus. For respiratory syncytial virus (RSV), activity is limited to the 5-thiosemicarbazone (25) and 5-hydrazone (22) compounds carrying the 2-[(benzotriazol-1/2-yl)methyl]benzimidazole scaffold. These molecules proved to be the most effective antiviral agents, able to reach the potency profile of the licensed drug ribavirin. The molecular docking analysis explained the SAR of these compounds around their binding mode to the target RSV F protein, revealing the key contacts for further assessment. The herein-investigated benzimidazole-based derivatives may represent valuable hit compounds, deserving subsequent structural improvements towards more efficient antiviral agents for the treatment of pathologies caused by these human respiratory viruses.


title: Lung epithelium as a sentinel and effector system in pneumonia – molecular mechanisms of pathogen recognition and signal transduction

text: Pneumonia, a common disease caused by a great diversity of infectious agents is responsible for enormous morbidity and mortality worldwide. The bronchial and lung epithelium comprises a large surface between host and environment and is attacked as a primary target during lung infection. Besides acting as a mechanical barrier, recent evidence suggests that the lung epithelium functions as an important sentinel system against pathogens. Equipped with transmembranous and cytosolic pathogen-sensing pattern recognition receptors the epithelium detects invading pathogens. A complex signalling results in epithelial cell activation, which essentially participates in initiation and orchestration of the subsequent innate and adaptive immune response. In this review we summarize recent progress in research focussing on molecular mechanisms of pathogen detection, host cell signal transduction, and subsequent activation of lung epithelial cells by pathogens and their virulence factors and point to open questions. The analysis of lung epithelial function in the host response in pneumonia may pave the way to the development of innovative highly needed therapeutics in pneumonia in addition to antibiotics.


title: Tetraspanin Assemblies in Virus Infection

text: Tetraspanins (Tspans) are a family of four-span transmembrane proteins, known as plasma membrane “master organizers.” They form Tspan-enriched microdomains (TEMs or TERMs) through lateral association with one another and other membrane proteins. If multiple microdomains associate with each other, larger platforms can form. For infection, viruses interact with multiple cell surface components, including receptors, activating proteases, and signaling molecules. It appears that Tspans, such as CD151, CD82, CD81, CD63, CD9, Tspan9, and Tspan7, coordinate these associations by concentrating the interacting partners into Tspan platforms. In addition to mediating viral attachment and entry, these platforms may also be involved in intracellular trafficking of internalized viruses and assist in defining virus assembly and exit sites. In conclusion, Tspans play a role in viral infection at different stages of the virus replication cycle. The present review highlights recently published data on this topic, with a focus on events at the plasma membrane. In light of these findings, we propose a model for how Tspan interactions may organize cofactors for viral infection into distinct molecular platforms.


title: Antibodies anti-Shiga toxin 2 B subunit from chicken egg yolk: Isolation, purification and neutralization efficacy

text: Abstract Shiga toxins (Stx1 and Stx2) are the main virulence factors of enterohemorrhagic Escherichia coli (EHEC), a foodborne pathogen associated with diarrhea, hemorrhagic colitis and hemolytic uremic syndrome. The aim of this study was to evaluate the antibodies against Stx2 obtained from egg yolks of laying hens immunized with a recombinant Stx2B subunit. A high specific response in serum was observed 25 days after the first immunization and IgY antibodies were extracted from day 47th and purified from egg yolk. A concentration of 0.84 mg of total IgY/ml of egg yolk was obtained, of which 8% were antigen specific. The ability of anti-Stx2B IgY to recognize Stx2B and Stx2 either in solid-phase or in solution were evaluated and compared with anti-Stx2B rabbit antibodies by Western blotting and ELISA. The protective efficacy of IgY against Stx2 was determined by in vitro and in vivo experiments. The results show that IgY was able to recognize Stx2B and Stx2 in denatured conditions, attached to a solid-phase and free in solution. The anti-Stx2B IgY could effectively block the biological activity of Stx2 on Vero cells and protect mice from Stx2 challenge. The data suggest that immunization of hens with Stx2B could be a strategy to obtain at low cost a relatively high concentration of anti-Stx2 egg yolk IgY, able to neutralize Stx2 lethal activity. IgY technology could be an useful tool for research, diagnosis and therapy of EHEC infection.


title: Feline coronavirus-associated myocarditis in a domestic longhair cat

text: CASE SUMMARY: A 9-month-old entire male domestic longhair indoor cat presented with a 3-week history of fluctuating fever, weight loss and small intestine diarrhoea, which was unresponsive to antibiotics and supportive treatment. Abdominal ultrasound revealed severe jejunal and ileocolic junction intestinal wall thickening with loss of layering. An enterectomy was performed and histopathology revealed severe pyogranulomatous enteritis with vasculitits, compatible with the diagnosis of feline infectious peritonitis (FIP). Four days after surgery, the cat re-presented with anorexia and acute onset of expiratory dyspnoea. Echocardiography showed left ventricular hypertrophy and bilateral atrial enlargement. Congestive heart failure caused by hypertrophic cardiomyopathy was suspected and treatment with furosemide was started, which led to amelioration of the clinical signs. The following day, four-limb ataxia, hypermetria and bilateral uveitis were evident. Given the persistent anorexia and worsening of the clinical signs, the cat was humanely euthanized and a post-mortem examination was performed. Necropsy revealed multifocal pyogranulomatous lesions involving multiple organs (adrenal glands, kidneys, lungs, brain, myocardium, lymph nodes, liver), compatible with the diagnosis of FIP. Immunohistochemistry performed on the myocardium revealed feline coronavirus-positive macrophages associated with pyogranulomatous lesions, justifying a diagnosis of feline coronavirus-associated myocarditis. RELEVANCE AND NOVEL INFORMATION: To the authors’ knowledge, the case described here represents the first published report of feline coronavirus-associated myocarditis. This should be considered as a possible differential diagnosis in cats presenting with cardiac-related signs and other clinical signs compatible with FIP.


title: Characteristics and Outcomes of COVID-19 Patients in New York City's Public Hospital System

text: Background New York City (NYC) has borne the greatest burden of COVID-19 in the United States, but information about characteristics and outcomes of racially/ethnically diverse individuals tested and hospitalized for COVID-19 remains limited. In this case series, we describe characteristics and outcomes of patients tested for and hospitalized with COVID-19 in New York City's public hospital system. Methods We reviewed the electronic health records of all patients who received a SARS-CoV-2 test between March 5 and April 9, 2020, with follow up through April 16, 2020. The primary outcomes were a positive test, hospitalization, and death. Demographics and comorbidities were also assessed. Results 22254 patients were tested for SARS-CoV-2. 13442 (61%) were positive; among those, the median age was 52.7 years (interquartile range [IQR] 39.5-64.5), 7481 (56%) were male, 3518 (26%) were Black, and 4593 (34%) were Hispanic. Nearly half (4669, 46%) had at least one chronic disease (27% diabetes, 30% hypertension, and 21% cardiovascular disease). Of those testing positive, 6248 (46%) were hospitalized. The median age was 61.6 years (IQR 49.7-72.9); 3851 (62%) were male, 1950 (31%) were Black, and 2102 (34%) were Hispanic. More than half (3269, 53%) had at least one chronic disease (33% diabetes, 37% hypertension, 24% cardiovascular disease, 11% chronic kidney disease). 1724 (28%) hospitalized patients died. The median age was 71.0 years (IQR 60.0, 80.9); 1087 (63%) were male, 506 (29%) were Black, and 528 (31%) were Hispanic. Chronic diseases were common (35% diabetes, 37% hypertension, 28% cardiovascular disease, 15% chronic kidney disease). Male sex, older age, diabetes, cardiac history, and chronic kidney disease were significantly associated with testing positive, hospitalization, and death. Racial/ethnic disparities were observed across all outcomes. Conclusions and Relevance This is the largest and most racially/ethnically diverse case series of patients tested and hospitalized for COVID-19 in the United States to date. Our findings highlight disparities in outcomes that can inform prevention and testing recommendations.


Moderate to severe hidradenitis suppurativa under systemic therapy during the COVID‐19 outbreak


title: Death by food

text: Although death from food is not an uncommon finding in forensic facilities worldwide, the range of underlying lethal mechanisms and associated conditions that should be sought at the time of autopsy is quite disparate. Deaths may occur from i) infectious agents including bacteria, viruses, protozoa, cestodes, nematodes and prions; ii) natural toxins including amanita toxins, tetrodotoxin, ciguatera and scombroid; iii) anaphylaxis; iv) poisoning; v) mechanical issues around airway and gut obstruction and/or perforation; and vi) miscellaneous causes. Food-related deaths are important in terms of global mortality, and thus autopsies need to be comprehensive with full ancillary testing. Medicolegal matters may involve issues concerning likely exposure to infectious agents, possible foods ingested, the declared content and possible components of food, the significance of toxicological analyses, and aspects of duty of care in cases of café coronary syndrome and gastroenteritis while in care.


title: Chapter 5 Viral Contamination of Food

text: Abstract A review of the relevant foodborne viruses is presented. Published data from scientific journals as well as the data presented in official reports and published on the Internet were used for this review. In the review, information is given for the main foodborne viruses, implicated virus species, and food matrices involved, some history data are given, as well as modes of transmission, and sources of the virus presence in food. Results of surveys on the presence of viruses in different kind of foods commodities (fresh produces and shellfish) and in some cases connections to caused outbreaks are presented. Also, possible zoonotic infection and implicated viruses that could be transmitted through food are given. Human Norovirus followed by hepatitis A virus are the most common foodborne viruses, which are transmitted by food consumed raw, such as shellfish, fresh vegetables, and berry fruit. In developed countries, hepatitis E virus is increasingly being recognized as an emerging viral foodborne pathogen that includes zoonotic transmission via pork products. The existing knowledge gaps and the major future expectations in the detection and surveillance of foodborne viruses are mentioned.


title: The effects of a prebiotic supplement (Prebio Support) on fecal and salivary IgA in neonatal dairy calves

text: Abstract The newborn calf's gastrointestinal tract is sterile at birth, but by 3days of age coliforms, Lactobacilli, and Bifidobacteria are the predominant flora in the feces. During the preweaning period, calves are susceptible to diarrhea that can lead to high levels of morbidity and mortality. Diarrhea has been related with a decrease of beneficial microbiota and an increase of coliform counts in feces. Prebiotic supplements are believed to decrease diarrhea and positively affect some parameters of the immune system. In calves, these supplements have shown some promising effects on intestinal microbial populations but there is limited information about effects on immunity. The main objectives of this study were to evaluate effects of a prebiotic supplement containing fermentation products of lactic acid bacteria on the mucosal immune system by measuring fecal and salivary IgA and to evaluate calf health and growth performance. In this trial 40 Holstein calves were randomly assigned to receive milk replacer with a prebiotic supplement (20g/day Prebio Support™; Meiji Feed Co., Ltd. Tokyo, Japan) or the same milk replacer with no prebiotic (control). Fecal and salivary IgA, calf health, plasma IgG, and lymphocyte counts were not affected by treatment. Lactobacilli count in feces was higher (P =0.05) and Bifidobacteria tended to be higher (P =0.07) in calves fed prebiotic. Prebiotic supplement increased beneficial bacteria in calves, but did not decrease overall incidence of diarrhea in this trial. Calves in this study were all affected by cryptosporidiosis and some were treated with antibiotics, so it is possible that this limited some of the effects of the prebiotic product. Fecal IgA seemed to be a good measure of mucosal immunity, and more studies are needed to develop methods to measure this type of immunity in calves.


title: 2019 novel coronavirus disease (COVID-19) in hemodialysis patients: a report of two cases

text: Abstract Objective To analyze the diagnosis and treatment of patients with chronic renal failure complicated with novel coronavirus pneumonia, and to evaluate the effect of blood purification technology on the treatment and prognosis of such patients Methods Two COVID-19 cases undergoing hemodialysis with chronic renal failure were retrospectively analysed in our hospital. Results Two COVID-19 patients were admitted to hospital due to cough, with or without fever. Laboratory tests showed decreased lymphocyte count, elevated PCT, IL-10, IL-6, TNF-α, IL-2R, high-sensitivity cardiac troponin I, NT-proBNP, creatinine, and urea nitrogen. Chest CT scan showed multiple blurred plaques and patchy shadows in both patients. Two patients received continuous venovenous hemodiafiltration (CVVHDF) every other day for 4-6 hours everytime, in addition to the standard treatment. After CVVHDF, not only cytokines were reduced, but also liver function and cardiac function significantly improved. Both patients did not develop severe pneumonia. They were discharged on March 1, 2020 when meeting the discharge criteria. Conclusion Two COVID-19 patients on maintenance hemodialysis discharged after a month of hospitalization. The removal of cytokines through blood purification technology may be beneficial for the recovery of COVID-19 patients.


title: Recommendations for the organization of electrophysiology and cardiac pacing services during the COVID-19 pandemic: Latin American Heart Rhythm Society (LAHRS) in collaboration with: Colombian College Of Electrophysiology, Argentinian Society of Cardiac Electrophysiology (SADEC), Brazilian Society Of Cardiac Arrhythmias (SOBRAC), Mexican Society Of Cardiac Electrophysiology (SOMEEC)

text: COVID-19 is a rapidly evolving public health emergency that has largely impacted the provision of healthcare services around the world. The challenge for electrophysiology teams is double; on one side preventing disease spread by limiting all nonessential face-to-face interactions, but at the same time ensuring continued care for patients who need it. These guidelines contain recommendations regarding triaging in order to define what procedures, device checks and clinic visits can be postponed during the pandemic. We also discuss best practices to protect patients and healthcare workers and provide guidance for the management of COVID-19 patients with arrhythmic conditions.


Advances in antiviral nucleoside analogues and their prodrugs


title: Short-term outcome of critically ill patients with severe acute respiratory syndrome

text: OBJECTIVE: To document the outcome and determine prognostic factors for patients with severe acute respiratory syndrome who require admission to an intensive care unit. DESIGN: Observational cohort study involving retrospective analysis of demographic, clinical, laboratory and radiological data. SETTING: Adult intensive care unit in a tertiary referral university hospital involved in a major outbreak of severe acute respiratory syndrome (SARS). PATIENTS: The first 54 patients admitted with SARS to an intensive care unit (ICU). All were treated with corticosteroids, ribavirin, broad spectrum antimicrobials and supportive therapy. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: All patients were admitted for respiratory failure. The median APACHE II score was 11 (interquartile range 8–13). At 28 days 34 patients (63%; 95% CI 49.6–74.6) were alive and not mechanically ventilated. Six patients were alive but ventilated (11.3%; 95% confidence interval 5.3–22.6) and 14 had died (25.9%; CI 16.1–38.9). Seven of 27 ventilated patients developed evidence of barotrauma (25.9%; 95% CI 13.2–44.7). Median maximal multiple-organ dysfunction score was 5 (interquartile range 3.3–9). Median maximal respiratory dysfunction score was 3 (interquartile range 3–4). Increased age, severity of illness, lymphocyte count, decreased steroid dose, positive fluid balance, chronic disease or immunosuppression and nosocomial sepsis were associated with poor outcome on univariate analysis. Poor outcome was defined as death or need for mechanical ventilation at 28 days after ICU admission. CONCLUSIONS: Mortality amongst critically ill patients with SARS is high. It causes predominantly severe respiratory failure, with little other organ failure, and a high incidence of barotrauma amongst those requiring mechanical ventilation. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is available in the online version of this article at http://dx.doi.org/10.1007/10.1007/00134-003-2143-y


title: COVID‐19 rise in Younger adults with Obesity: Visceral Adiposity can predict the Risk

text: A concerning rise in coronavirus disease 2019 (COVID‐19) cases has been recently reported, particularly in the USA. The causes of this increase are likely multifactorial and the object of an ongoing health and socio‐economic debate. However, preliminary data indicate that the new COVID‐19 cases are increasing among younger and obese adults. Considering this recent spike, the timing of the paper by Deng et al is of particular importance (1). Deng et al not only confirmed that obesity is a major and independent risk factor for COVID‐19 complications in young adults (2), they pointed out ectopic and visceral fat depots as new markers of that risk. The authors found that computed tomography (CT) imaging of fatty liver and epicardial adipose tissue (EAT) were significantly higher in severely and critically ill COVID‐19 patients under 40 years old as compared to those with milder disease.


title: Mechanisms of rhinovirus-induced asthma

text: Abstract Several epidemiological studies using sensitive detection methodologies have confirmed that the majority of acute asthma exacerbations follow upper respiratory tract infections – common colds. Most of these colds are due to human rhinoviruses (RVs). RVs are able to reach and replicate in epithelial cells of the lower airways and can activate these cells to produce pro-inflammatory mediators. Under some circumstances, RVs can also become cytotoxic to the epithelium. Atopic asthmatic individuals produce less interferon-γ and more interleukin-10 than normal subjects in response to RV infection. Symptom severity as well as viral shedding after experimental RV infection, is inversely correlated with ‘atopic’ status, expressed as the interferon-γ to interleukin-5 ratio. Expression of co-stimulatory molecules on immune cells is also affected in atopic asthmatics, suggesting an aberrant immune response to RV that may lead to suboptimal viral clearance and viral persistence. Some of the above effects can be reversed in vitro by corticosteroids, second-generation antihistamines or anti-oxidants; however, the optimal strategy for treating acute asthma exacerbations requires further research at both mechanistic and clinical levels.


title: Emerging Infectious Diseases in Free-Ranging Wildlife–Australian Zoo Based Wildlife Hospitals Contribute to National Surveillance

text: Emerging infectious diseases are increasingly originating from wildlife. Many of these diseases have significant impacts on human health, domestic animal health, and biodiversity. Surveillance is the key to early detection of emerging diseases. A zoo based wildlife disease surveillance program developed in Australia incorporates disease information from free-ranging wildlife into the existing national wildlife health information system. This program uses a collaborative approach and provides a strong model for a disease surveillance program for free-ranging wildlife that enhances the national capacity for early detection of emerging diseases.


title: Tracing environmental markers of autoimmunity: introducing the infectome

text: We recently introduced the concept of the infectome as a means of studying all infectious factors which contribute to the development of autoimmune disease. It forms the infectious part of the exposome, which collates all environmental factors contributing to the development of disease and studies the sum total of burden which leads to the loss of adaptive mechanisms in the body. These studies complement genome-wide association studies, which establish the genetic predisposition to disease. The infectome is a component which spans the whole life and may begin at the earliest stages right up to the time when the first symptoms manifest, and may thus contribute to the understanding of the pathogenesis of autoimmunity at the prodromal/asymptomatic stages. We provide practical examples and research tools as to how we can investigate disease-specific infectomes, using laboratory approaches employed from projects studying the “immunome” and “microbiome”. It is envisioned that an understanding of the infectome and the environmental factors that affect it will allow for earlier patient-specific intervention by clinicians, through the possible treatment of infectious agents as well as other compounding factors, and hence slowing or preventing disease development.


Please cite this paper as: bin‐Reza et al. (2012) The use of masks and respirators to prevent transmission of influenza: a systematic review of the scientific evidence. Influenza and Other Respiratory Viruses 6(4), 257–267. There are limited data on the use of masks and respirators to reduce transmission of influenza. A systematic review was undertaken to help inform pandemic influenza guidance in the United Kingdom. The initial review was performed in November 2009 and updated in June 2010 and January 2011. Inclusion criteria included randomised controlled trials and quasi‐experimental and observational studies of humans published in English with an outcome of laboratory‐confirmed or clinically‐diagnosed influenza and other viral respiratory infections. There were 17 eligible studies. Six of eight randomised controlled trials found no significant differences between control and intervention groups (masks with or without hand hygiene; N95/P2 respirators). One household trial found that mask wearing coupled with hand sanitiser use reduced secondary transmission of upper respiratory infection/influenza‐like illness/laboratory‐confirmed influenza compared with education; hand sanitiser alone resulted in no reduction. One hospital‐based trial found a lower rate of clinical respiratory illness associated with non‐fit‐tested N95 respirator use compared with medical masks. Eight of nine retrospective observational studies found that mask and/or respirator use was independently associated with a reduced risk of severe acute respiratory syndrome (SARS). Findings, however, may not be applicable to influenza and many studies were suboptimal. None of the studies established a conclusive relationship between mask/respirator use and protection against influenza infection. Some evidence suggests that mask use is best undertaken as part of a package of personal protection especially hand hygiene. The effectiveness of masks and respirators is likely linked to early, consistent and correct usage.


title: DIC in COVID‐19: Implications for Prognosis and Treatment?

text: The ongoing COVID‐19 pandemic is an exceptional challenge for the health systems throughout the world. So far, no causative therapy nor protective vaccines are available. In several countries, the capacities for intensive care and for support in case of acute respiratory distress syndrome (ARDS) are overstretched, and the mortality is considerable. In this situation, useful prognostic parameters and targeted supportive treatment are urgently needed.


title: Chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19): A single-center case study in Ningbo, China

text: OBJECTIVE: The purpose of this study was to investigate the chest CT imaging features and clinical outcome of coronavirus disease 2019 (COVID-19) in Ningbo, China. METHODS: In this retrospective study, twenty-eight confirmed and seven highly suspected cases of COVID-19 were enrolled in Ningbo first hospital from January 26, 2020 to March 5, 2020. Cases were confirmed by real-time polymerase chain reaction (RT-PCR). The initial and follow-up chest CT imaging features, epidemiological history, and outcome were analyzed. RESULTS: The average age of the patients was 57.3 ± 15.3 years (range: 27–96 years), including 25 females and 10 males. On CT images, 89.3% (25/28) confirmed and 100% (7/7) suspected patients had ground-glass opacities (GGOs), and GGOs with mixed consolidations were observed in 35.7% (10/28) confirmed and 42.9% (3/7) suspected cases, most of these lesions were distributed under the peripheral of both lungs. 17 confirmed and 4 suspected cases had a history of participating in Ningbo Tian-tong Temple rituals and all had GGOs in their lungs during the initial CT scan. As of March 25, 2020, the lung lesions of our cases were significantly resolved and all patients have been discharged from the hospital. CONCLUSION: The most common chest CT features are multiple bilateral and peripheral GGOs with mixed consolidations or not in the lungs of patients with COVID-19. Chest CT plays an important role in the diagnosis and monitoring treatment response of this disease. There was no reported death in our cases.


title: Carbohydrate arrays as tools for the glycomics revolution

text: Abstract Determining the roles of carbohydrates in cell biology is hindered by the tremendous efforts that must be taken either to synthesize carbohydrates chemically or to isolate them from natural sources. Several platforms have been developed to study glycobiology. These platforms include the covalent and non-covalent immobilization of carbohydrates on microtiter plates, nitrocellulose membranes, coated slides, glass slides, gold surfaces and microspheres. Each platform has both positive and negative attributes for studying carbohydrate biology, such as flexibility and the amount of material required for study. Here we discuss these techniques with the goal of developing a ‘gold standard’ in the field of glycomics.


title: World Health Organization Methodology to Prioritize Emerging Infectious Diseases in Need of Research and Development

text: The World Health Organization R&D Blueprint aims to accelerate the availability of medical technologies during epidemics by focusing on a list of prioritized emerging diseases for which medical countermeasures are insufficient or nonexistent. The prioritization process has 3 components: a Delphi process to narrow down a list of potential priority diseases, a multicriteria decision analysis to rank the short list of diseases, and a final Delphi round to arrive at a final list of 10 diseases. A group of international experts applied this process in January 2017, resulting in a list of 10 priority diseases. The robustness of the list was tested by performing a sensitivity analysis. The new process corrected major shortcomings in the pre–R&D Blueprint approach to disease prioritization and increased confidence in the results.


title: Mannan oligosaccharide increases serum concentrations of antibodies and inflammatory mediators in weanling pigs experimentally infected with porcine reproductive and respiratory syndrome virus(,)(2)

text: Mannan-containing products are capable of modulating immune responses in animals. However, different products may have diverse immunomodulation. The experiment was conducted to examine effects of mannan oligosaccharide (Actigen; ACT) on growth performance and serum concentrations of antibodies and inflammatory mediators in weanling pigs (Sus scrofa) experimentally infected with porcine reproductive and respiratory syndrome virus (PRRSV). A total of 32 PRRSV-negative pigs (3 wk old) were randomly assigned from within blocks to 1 of 4 treatments in a 2 by 2 factorial arrangement [2 types of diet: control (0%) and ACT addition (0.04%); and with and without PRRSV] in a randomized complete block design. Pigs were blocked by initial BW within sex. Ancestry was equalized across treatments. Pigs (8/treatment) were kept individually in each pen. After 2 wk of an 8-wk period of feeding the treatments, pigs received an intranasal inoculation of PRRSV or sham medium at 5 wk of age. Infection by PRRSV decreased ADG, ADFI, and G:F throughout the experiment (P < 0.01). Actigen did not affect ADG (P = 0.450), but decreased (P = 0.047) ADFI from 28 to 42 days postinoculation (DPI). During that time, ACT improved G:F in infected pigs but not in sham controls (interaction, P = 0.009). Dietary ACT did not affect viremia in infected pigs (P > 0.05), but increased PRRSV-specific antibody titer at 35 DPI (P = 0.042). Infection with PRRSV induced the febrile responses of pigs from 3 to 10 DPI (P < 0.001) with return to normal at 14 DPI. During the experimental period, the rectal temperature of pigs was found slightly elevated by ACT (P = 0.045). Infected pigs had greater serum concentrations of IL-1β, tumor necrosis factor (TNF)-α, IL-12, interferon (IFN)-γ, IL-10, and haptoglobin (Hp) than sham controls (P < 0.001). These results indicate that PRRSV stimulated secretion of cytokines involved in innate, T-helper 1, and T-regulatory immune responses. Actigen tended to decrease the serum TNF-α concentration regardless of PRRSV (P = 0.058). The ACT × PRRSV interaction was significant for IL-1β (P = 0.016), IL-12 (P = 0.026), and Hp (P = 0.047), suggesting that infected pigs fed ACT had greater serum concentrations of these mediators than those fed the control. The increases in IL-1β and IL-12 may favorably promote innate and T-cell immune functions in infected pigs fed ACT. Feeding ACT may be useful as ACT is related to increased PRRSV antibody titers and G:F in infected pigs at certain times during infection.