title: Learning for Video Compression with Recurrent Auto-Encoder and Recurrent Probability Model

text: The past few years have witnessed increasing interests in applying deep learning to video compression. However, the existing approaches compress a video frame with only a few number of reference frames, which limits their ability to fully exploit the temporal correlation among video frames. To overcome this shortcoming, this paper proposes a Recurrent Learned Video Compression (RLVC) approach with the Recurrent Auto-Encoder (RAE) and Recurrent Probability Model (RPM). Specifically, the RAE employs recurrent cells in both the encoder and decoder. As such, the temporal information in a large range of frames can be used for generating latent representations and reconstructing compressed outputs. Furthermore, the proposed RPM network recurrently estimates the Probability Mass Function (PMF) of the latent representation, conditioned on the distribution of previous latent representations. Due to the correlation among consecutive frames, the conditional cross entropy can be lower than the independent cross entropy, thus reducing the bit-rate. The experiments show that our approach achieves the state-of-the-art learned video compression performance in terms of both PSNR and MS-SSIM. Moreover, our approach outperforms the default Low-Delay P (LDP) setting of x265 on PSNR, and also has better performance on MS-SSIM than the SSIM-tuned x265 and the slowest setting of x265.


title: Exploring the Impact of COVID-19 on Progress Towards Achieving Global Surgery Goals

text: INTRODUCTION: In the 5 months since it began, the COVID-19 pandemic has placed extraordinary demands on health systems around the world including surgery. Competing health objectives and resource redeployment threaten to retard the scale-up of surgical services in low- and middle-income countries where access to safe, affordable and timely care is low. The key aspiration of the Lancet Commission on global surgery was promotion of resilience in surgical systems. The current pandemic provides an opportunity to stress-test those systems and identify fault-lines that may not be easily apparent outside of times of crisis. METHODS: We endeavoured to explore vulnerable points in surgical systems learning from the experience of past outbreaks, using examples from the current pandemic, and make recommendations for future health emergencies. The 6-component framework for surgical systems planning was used to categorise the effects of COVID-19 on surgical systems, with a particular focus on low- and middle-income countries. Key vulnerabilities were identified and recommendations were made for the current pandemic and for the future. RESULTS: Multiple stress points were identified throughout all of the 6 components of surgical systems. The impact is expected to be highest in the workforce, service delivery and infrastructure domains. Innovative new technologies should be employed to allow consistent, high-quality surgical care to continue even in times of crisis. CONCLUSIONS: If robust progress towards global surgery goals for 2030 is to continue, the stress points identified should be reinforced. An ongoing process of reappraisal and fortification will keep surgical systems in low- and middle-income countries responsive to "old threats and new challenges". Multiple opportunities exist to help realise the dream of surgical systems resilient to external shocks.


title: Management of Acute Severe Ulcerative Colitis in a Pregnant Woman With COVID-19 Infection: A Case Report and Review of the Literature

text: First detected in Wuhan, China, the novel 2019 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped RNA beta-coronavirus responsible for an unprecedented, worldwide pandemic caused by COVID-19. Optimal management of immunosuppression in inflammatory bowel disease (IBD) patients with COVID-19 infection currently is based on expert opinion, given the novelty of the infection and the corresponding lack of high-level evidence in patients with immune-mediated conditions. There are limited data regarding IBD patients with COVID-19 and no data regarding early pregnancy in the era of COVID-19. This article describes a patient with acute severe ulcerative colitis (UC) during her first trimester of pregnancy who also has COVID-19. The case presentation is followed by a review of the literature to date on COVID-19 in regard to inflammatory bowel disease and pregnancy, respectively.


title: Air care: an 'aerography' of breath, buildings and bugs in the cystic fibrosis clinic

text: With significant relevance to the Covid-19 pandemic, this paper contributes to emerging 'aerographic' research on the socio-materialities of air and breath, based on an in-depth empirical study of three hospital-based lung infection clinics treating people with cystic fibrosis. We begin by outlining the changing place of atmosphere in hospital design from the pre-antibiotic period and into the present. We then turn to the first of three aerographic themes where air becomes a matter of grasping and visualising otherwise invisible airborne infections. This includes imagining patients located within bodily spheres or 'cloud bodies', conceptually anchored in Irigaray's thoughts on the 'forgetting of the air' and Sloterdijk's immunitary 'spherology' of the body. Our second theme explores the material politics of air, air conditioning, window design and the way competing 'air regimes' come into conflict with each other at the interface of buildings, bodies and the biotic. Our final theme attends to the 'cost of air', the aero-economic problem of atmospheric scarcity within modern high-rise, deep-density healthcare architectures.


Empathic communication as a "Risky strength" for health during the COVID-19 pandemic: The case of frontline Italian healthcare workers


title: Incidence and case fatality rate of COVID-19 in patients with active epilepsy

text: OBJECTIVE: This article estimates the incidence and fatality of COVID-19 and identify potential risk factors to fatality in patients with active epilepsy. MATERIAL AND METHODS: This is a cross-sectional observational study of patients with active epilepsy and COVID-19. A control group was used to compare the cumulative incidence and case fatality rate (CFR). The main outcomes of the study were cumulative incidence, defined as number of patients with active epilepsy and COVID-19 admitted in emergency department divided by the total number of patients with epilepsy at risk; and CFR based on the number of deaths during the enrolment period. Multiple logistic regression analysis was performed to investigate risk factors for fatality in patients with active epilepsy. RESULTS: Of the 1537 patients who fulfilled the inclusion criteria, 21 (1.3%) had active epilepsy. The cumulative incidence (95% CI) of COVID-19 in epilepsy patients was higher (1.2% [0.6-2.4]) compared to population without epilepsy (0.5% [0.5-0.5]). In RT-PCR positive patients there were no significant differences in CFR in patients with active epilepsy compared to patients without epilepsy (33.3% vs. 8.3%; p =0.266). Of the 21 active epilepsy patients, 5 (23%) died. In multivariate analysis, the factor associated with fatality in patients with active epilepsy was hypertension (OR [95%CI], 2.8 [1.3-21.6]). In other model age (OR [95%CI], 1.0 [1.0-1.1]) and epilepsy (OR [95%CI], 5.1 [1.3-24.0]) were associated with fatality during hospitalization. CONCLUSION: COVID-19 cumulative incidence were higher in patients with active epilepsy. Epilepsy was associated with fatality during hospitalization. Hypertension was associated with fatality in patients with epilepsy.


title: Does the protein corona take over the selectivity of molecularly imprinted nanoparticles? The biological challenges to recognition

text: "Plastic antibodies" are nano-sized biomimetics prepared by the molecular imprinting technology, which have the robustness of polymers, but specificity and selectivity alike natural receptors making them ideal for analytical uses. The current challenge is to translate plastic antibodies to in vivo applications for diagnosis, drug delivery, theranostic, therefore it is crucial to evaluate the effect of the biological sample complexity on the selectivity and the formation of protein corona (PCs), which ultimately dictate the fate of circulating nanoparticles. A set (n = 4) of plastic antibodies (nanoMIPs) against different proteins was prepared. Quantitative (iBAC) shotgun proteomics permitted to define the PC composition of nanoMIPs in human plasma, the relative protein abundances, the correlation between PC and the plasma dilution. NanoMIPs showed >200 proteins PC, while ~150 proteins were found on controls, suggesting the imprinting process influences the nanoparticle's structure hence the protein uptake. NanoMIPs and controls shared the 44% of the PC, but PC iBAQ values on nanoMIPs were 10-100 times higher than controls, suggesting PC/nanoMIPs interactions were far stronger than PC/non imprinted particles. PCs were richer in small proteins and in immunoglobulins, indicating a defensive response, while the selectivity was negatively challenged in the crowded plasma sample. SIGNIFICANCE: The formation and the composition of the protein corona (PC) is key to decide the fate of nanoparticles when in vivo, therefore there is the strong need to study the composition of the PC. To enable and to support the translation of the use of plastic antibodies (nanoMIPs), prepared by means of the molecular imprinting technique, to the clinical practice and to in vivo uses, the present work evaluates the effects of the complexity of the biological sample (plasma) on nanoMIPs composed of highly crosslinked polyacrylamide and acrylamide derivatives. Proteomic study offers an in depth insight of the protein corona formed in plasma on nanoMIPs. A set of nanoMIPs synthesized and raised to recognize either small or large proteins was tested. The selection abilities of the nanoMIPs when placed in plasma at different dilutions was studied. Quantitative shotgun proteomics allowed to define the composition of the formed protein corona (PC) enabling to detail the protein compositions, the relative abundances, its correlation to the biological sample composition and the correlation between PC and nanoMIP's imprinted template. In plasma, all the nanoMIPs gained a PC composed of more than 200 proteins. Type of protein recruited for the corona, molecular weight and abundance in the PC were studied. The PC on the nanoMIPs appeared to be driven by the protein composition of the plasma, while the template protein, towards which a nanoMIP was imprinted and that was proven to have high affinity for, did not influence the PC.


Recomendaciones sobre exposición solar y fotoprotección del Grupo Español de Fotobiología de la AEDV adecuadas al periodo de desconfinamiento durante la pandemia por SARS-CoV-2./ Recomendaciones sobre exposición solar y fotoprotección del Grupo Español de Fotobiología de la AEDV adecuadas al periodo de desconfinamiento durante la pandemia por SARS-CoV-2./ Recommendations on Sun Exposure and Photoprotection Following Easing of the COVID-19 Pandemic Lockdown: Spanish Photobiology Group of the Spanish Academy of Dermatology and Venerology (AEDV)


title: Temporal rise in the proportion of younger adults and older adolescents among coronavirus disease (COVID-19) cases following the introduction of physical distancing measures, Germany, March to April 2020

text: Using data on coronavirus disease (COVID-19) cases in Germany from the Robert Koch Institute, we found a relative increase with time in the prevalence in 15-34 year-olds (particularly 20-24-year-olds) compared with 35-49- and 10-14-year-olds (we excluded older and younger ages because of different healthcare seeking behaviour). This suggests an elevated role for that age group in propagating the epidemic following the introduction of physical distancing measures.


title: Covid-19 pandemic and the unprecedented mobilisation of scholarly efforts prompted by a health crisis: Scientometric comparisons across SARS, MERS and 2019-nCov literature

text: During the current century, each major coronavirus outbreak has triggered a quick surge of academic publications on this topic. The spike in research publications following the 2019 Novel Coronavirus (Covid-19), however, has been like no other. The global crisis caused by the Covid-19 pandemic has mobilised scientific efforts in an unprecedented way. In less than five months, more than 12,000 research items have been indexed while the number increasing every day. With the crisis affecting all aspects of life, research on Covid-19 seems to have become a focal point of interest across many academic disciplines. Here, scientometric aspects of the Covid-19 literature are analysed and contrasted with those of the two previous major Coronavirus diseases, i.e. SARS and MERS. The focus is on the co-occurrence of key-terms, bibliographic coupling and citation relations of journals and collaborations between countries. Certain recurring patterns across all three literatures were discovered. All three outbreaks have commonly generated three distinct and major cohort of studies: (i) studies linked to the public health response and epidemic control, (ii) studies associated with the chemical constitution of the virus and (iii) studies related to treatment, vaccine and clinical care. While studies affiliated with the category (i) seem to have been the first to emerge, they overall received least numbers of citations compared to those of the two other categories. Covid-19 studies seem to have been distributed across a broader variety of journals and subject areas. Clear links are observed between the geographical origins of each outbreak or the local geographical severity of each outbreak and the magnitude of research originated from regions. Covid-19 studies also display the involvement of authors from a broader variety of countries compared to SARS and MRS.


title: Psychological adjustment during the global outbreak of COVID-19: A resilience perspective

text: Amid the global outbreak of COVID-19, resilience is likely to be one of the many possible outcomes. Studies pertaining to resilience following potentially traumatic events including disease outbreak have shown that the vast majority of individuals are resilient, and that outcomes depend on a combination of resilience factors including exposure severity, individual differences, family context, and community characteristics. To better understand psychological dysfunction and resilience during the global outbreak of COVID-19, researchers are encouraged to investigate long-term patterns of mental health rather than cross-sectional prevalence rates, adopt prospective designs and analyses, integrate multiple risk and resilience factors to enhance outcome prediction, and consider the importance of flexibility as the situation unfolds. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


title: eHealth During a Pandemic

text: eHealth applications will become a more prevalent operational component of the standard of care. They will continue to be reliable methods to expedite patient-provider communication, meet surveillance milestones, and provide timely symptom management.


title: Gene of the month: the 2019-nCoV/SARS-CoV-2 novel coronavirus spike protein

text: The year 2020 has seen a major and sustained outbreak of a novel betacoronavirus (severe acute respiratory syndrome (SARS)-coronavirus (CoV)-2) infection that causes fever, severe respiratory illness and pneumonia, a disease called COVID-19. At the time of writing, the death toll was greater than 120 000 worldwide with more than 2 million documented infections. The genome of the CoV encodes a number of structural proteins that facilitate cellular entry and assembly of virions, of which the spike protein S appears to be critical for cellular entry. The spike protein guides the virus to attach to the host cell. The spike protein contains a receptor-binding domain (RBD), a fusion domain and a transmembrane domain. The RBD of spike protein S binds to Angiotensin Converting Enzyme 2 (ACE2) to initiate cellular entry. The spike protein of SARS-CoV-2 shows more than 90% amino acid similarity to the pangolin and bat CoVs and these also use ACE2 as a receptor. Binding of the spike protein to ACE2 exposes the cleavage sites to cellular proteases. Cleavage of the spike protein by transmembrane protease serine 2 and other cellular proteases initiates fusion and endocytosis. The spike protein contains an addition furin cleavage site that may allow it to be 'preactivated' and highly infectious after replication. The fundamental role of the spike protein in infectivity suggests that it is an important target for vaccine development, blocking therapy with antibodies and diagnostic antigen-based tests. This review briefly outlines the structure and function of the 2019 novel CoV/SARS-CoV-2 spike protein S.


Anti-TNF-α Agents in Inflammatory Bowel Disease and Course of COVID-19


title: Towards effective COVID19 vaccines: Updates, perspectives and challenges (Review)

text: In the current context of the pandemic triggered by SARS-COV-2, the immunization of the population through vaccination is recognized as a public health priority. In the case of SARSCOV2, the genetic sequencing was done quickly, in one month. Since then, worldwide research has focused on obtaining a vaccine. This has a major economic impact because new technological platforms and advanced genetic engineering procedures are required to obtain a COVID19 vaccine. The most difficult scientific challenge for this future vaccine obtained in the laboratory is the proof of clinical safety and efficacy. The biggest challenge of manufacturing is the construction and validation of production platforms capable of making the vaccine on a large scale.


title: Prolate-to-oblate transition and backbending along the yrast line induced by quasiparticle alignment

text: The yrast lines in Kr isotopes with $N=42$, 44, and 46 are investigated in a beyond mean field framework with both prolate-oblate coexistence and quasiparticle alignment taken into account. Quasiparticle orbitals with high-$j$ and low-$\Omega$ on the oblate side are shown to be responsible for the sharp backbending observed in $^{82}$Kr, by driving the yrast shape from prolate to oblate. This suggests that quasiparticle alignment may not be neglected in the investigation of the shape evolution along the yrast line.


title: The impact of COVID-19 pandemic on orthopaedic resident education: a nationwide survey study in South Korea

text: PURPOSE: There have not been well-designed survey studies investigating the impact of the coronavirus disease 2019 (COVID-19) pandemic on orthopaedic resident education. METHODS: A 58-question, web-based survey was administered to orthopaedic residents in South Korea. A total of 229 orthopaedic residents from 43 hospitals completed the survey questionnaire. RESULTS: The average working time of 72.7 hours/week before the pandemic was decreased to 65.6 hours/week during the pandemic (p < 0.001). The time working in the operating room was significantly decreased during the pandemic, but not in the emergency centre and outpatient clinic. The education times for lecture and clinical case discussion were decreased during the pandemic (both, p < 0.001), respectively. While the use of traditional teaching methods was decreased, the use of online-based teaching methods was increased (p < 0.001). However, satisfaction level with online-based teaching methods was significantly lower compared with that of traditional teaching methods. The average working time exposed to the patients with COVID-19 was 9.7 hours/week. About 47.6% of orthopaedic residents experienced isolation or quarantine. The average score for quality of life, which was 68.9 out of 100 scores before the pandemic, decreased to 61.7 during the pandemic (p < 0.001). The most stressful factor for orthopaedic residents during the pandemic was family/relative health, followed by their own health and residency program. CONCLUSION: The COVID-19 pandemic had a significant impact on orthopaedic resident education in South Korea. Therefore, flexible and sustainable strategies are necessary to prepare for the future as well as the current pandemic situation.


Utility of Substandard Face Mask Options for Health Care Workers During the COVID-19 Pandemic


The Impact of COVID-19 on Endoscopic Training


SARS-CoV-2 detection in the pericardial fluid of a patient with cardiac tamponade


title: Patient safety and litigation in the NHS post-COVID-19

text: John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses patient safety during the present coronavirus pandemic.


title: Trained Immunity: a Tool for Reducing Susceptibility to and the Severity of SARS-CoV-2 Infection

text: SARS-CoV-2 infection is mild in the majority of individuals but progresses into severe pneumonia in a small proportion of patients. The increased susceptibility to severe disease in the elderly and individuals with co-morbidities argues for an initial defect in anti-viral host defense mechanisms. Long-term boosting of innate immune responses, also termed "trained immunity," by certain live vaccines (BCG, oral polio vaccine, measles) induces heterologous protection against infections through epigenetic, transcriptional, and functional reprogramming of innate immune cells. We propose that induction of trained immunity by whole-microorganism vaccines may represent an important tool for reducing susceptibility to and severity of SARS-CoV-2.


Global Effort to Collect Data on Ventilated Patients With COVID-19


Qua pote quisque, in ea conterat arte diem: COVID-19 and Australian and New Zealand intensive care


title: Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study

text: BACKGROUND: We aimed to report the clinical characteristics of imported coronavirus disease-19 (COVID-19) in Jiangsu Province. METHODS: We retrospectively investigated the clinical, imaging, and laboratory characteristics of confirmed cases of COVID-19 with WHO interim guidance in three Grade â ¢A hospitals of Jiangsu from Jan 22 to Feb 14, 2020. Real time RT-PCR was used to detect the new coronavirus in respiratory samples. RESULTS: Of the 80 patients infected with COVID-19, 41 patients were female, with a median age of 46.1 years. Except for 3 severe patients, the rest of the 77 patients exhibited mild or moderate symptoms. 9 patients were unconfirmed until a third-time nucleic acid test. 38 cases had a history of chronic diseases. The main clinical manifestations of the patients were fever and cough, which accounted for 63 cases (78.75%) and 51 cases (-63.75%) respectively. Only 3 patients (3.75%) showed liver dysfunction. Imaging examination showed that 55 patients (-68.75%) showed abnormal, 25 cases (31.25%) had no abnormal density shadow in the parenchyma of both lungs. Up to now, 21 cases were discharged from the hospital, and no patient died. The average length of stay for discharged patients was 8 days. CONCLUSIONS: Compared with the cases in Wuhan, the cases in Jiangsu exhibited mild or moderate symptoms and no obvious gender susceptivity. The proportion of patients having liver dysfunction and abnormal CT imaging was relatively lower than that of Wuhan. Notably, infected patients may be falsely excluded based on two consecutively negative respiratory pathogenic nucleic acid test results.


Screening for SARS-CoV-2 infection in pediatric oncology patients during the epidemic peak in Italy


title: Erythema multiforme-like lesions in children and COVID-19

text: During examination of cases of chilblains in children and adolescents, we identified four patients who also showed skin lesions similar to erythema multiforme (EM). They had no other known triggers for EM. One of them had a positive PCR for SARS-CoV-2, while the other three were negative. Skin biopsies from two patients showed features not typical of EM, such as deep perivascular and perieccrine infiltrate and absence of necrosis of keratinocytes. Immunohistochemistry for SARS-CoV/SARS-CoV-2 spike protein showed granular positivity in endothelial cells and epithelial cells of eccrine glands in both biopsies. All patients had an excellent outcome, and had minimal or no systemic symptoms. The coincidence of EM, a condition commonly related to viruses, and chilblains in the setting of COVID-19, and the positivity for SARS-CoV/SARS-CoV-2 spike protein by immunohistochemistry strongly suggest a link between EM-like lesions and SARS-CoV-2.


Newly diagnosed diabetes and diabetic ketoacidosis precipitated by COVID-19 infection


title: Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic

text: The outbreak of the coronavirus disease 2019 (COVID-19) and its rapid global spread have created unprecedented challenges to health care systems. Significant and sustained efforts have focused on mobilization of personal protective equipment, intensive care beds, and medical equipment, while substantially less attention has focused on preserving the psychological health of the medical workforce tasked with addressing the challenges of the pandemic. And yet, similar to battlefield conditions, health care workers are being confronted with ongoing uncertainty about resources, capacities, and risks; as well as exposure to suffering, death, and threats to their own safety. These conditions are engendering high levels of fear and anxiety in the short term, and place individuals at risk for persistent stress exposure syndromes, subclinical mental health symptoms, and professional burnout in the long term. Given the potentially wide-ranging mental health impact of COVID-19, protecting health care workers from adverse psychological effects of the pandemic is critical. Therefore, we present an overview of the potential psychological stress responses to the COVID-19 crisis in medical providers and describe preemptive resilience-promoting strategies at the organizational and personal level. We then describe a rapidly deployable Psychological Resilience Intervention founded on a peer support model (Battle Buddies) developed by the United States Army. This intervention-the product of a multidisciplinary collaboration between the Departments of Anesthesiology and Psychiatry & Behavioral Sciences at the University of Minnesota Medical Center-also incorporates evidence-informed "stress inoculation" methods developed for managing psychological stress exposure in providers deployed to disasters. Our multilevel, resource-efficient, and scalable approach places 2 key tools directly in the hands of providers: (1) a peer support Battle Buddy; and (2) a designated mental health consultant who can facilitate training in stress inoculation methods, provide additional support, or coordinate referral for external professional consultation. In parallel, we have instituted a voluntary research data-collection component that will enable us to evaluate the intervention's effectiveness while also identifying the most salient resilience factors for future iterations. It is our hope that these elements will provide guidance to other organizations seeking to protect the well-being of their medical workforce during the pandemic. Given the remarkable adaptability of human beings, we believe that, by promoting resilience, our diverse health care workforce can emerge from this monumental challenge with new skills, closer relationships, and greater confidence in the power of community.


Milan 2020: COVID-19, neuro-oncology and much more


title: Derivation of a bedside score (MASH-P) to predict 6-month mortality in tuberculous meningitis

text: BACKGROUND: Tuberculous meningitis is commonly associated with a poor outcome. Simple bedside prognostic scores can help immensely in predicting the outcome. MATERIALS AND METHOD: A total of 721 patients, from 5 of our previous studies, were included. With primary outcome measure as death, a prognostic model was derived using binary logistic regression. The model was assessed using discrimination and calibration, and internally validated using the bootstrap method. A bedside prognostic score was derived by rounding of the regression coefficients to the nearest integers. RESULTS: A total of 126 (17.48%) patients died. The final model found that higher age, stage III disease, baseline MBI ≤ 12, papilledema and hydrocephalus were significant predictors of death. The final model showed good discrimination as evident by an AUC = 83.1% (95% confidence interval 79.5%-86.7%, P < .001) and good calibration (Hosmer and Lemeshow test P = .579). The model remained valid after internal validation by boot strapping. A simple bedside score with the acronym MASH-P to denote variables baseline MBI (M), age (A), stage (S), hydrocephalus (H) and papilledema (P), was thus derived. The score can range from 0 to 10. Higher the score, higher is the probability of death; a score of 0 carries a predicted probability of just 1.7% while a score of 10 corresponds to a predicted probability of 65%. An electronic ready reckoner has also been developed to aid prognostication on the go. CONCLUSION: MASH-P is a simple prognostic scoring model that can be used at bedside and aid in decision making as well as counselling.


title: Coronary and structural heart disease interventions during COVID-19 pandemic: A road map for clinicians and health care delivery systems

text: BACKGROUND: Because of the COVID-19 pandemic, cath labs have had to modify their workflow for elective and urgent patients. METHODS: We surveyed 16 physicians across 3 hospitals in our healthcare system to address COVID-19 related concerns in the management of interventional and structural heart disease patients, and to formulate system wide criteria for deferring cases till after the pandemic. RESULTS: Our survey yielded common concerns centered on the need to protect patients, cath lab staff and physicians from unnecessary exposure to COVID-19; for COVID-19 testing prior to arrival to the cath lab; for clear communication between the referring physician and the interventionalist; but there was initial uncertainty among physicians regarding the optimal management of ST elevation myocardial infarction (STEMI; percutaneous coronary intervention versus thrombolytics). Patients with stable angina and hemodynamically stable acute coronary syndromes were deemed suitable for initial medical management, except when they had large ischemic burden. Most transcatheter aortic valve implantations (TAVI) were felt appropriate for postponement except in symptomatic patients with aortic valve area <0.5 cm2 or recent hospitalization for heart failure (HF). Most percutaneous mitral valve repair (pMVR) procedures were felt appropriate for postponement except in patients with HF. All left atrial appendage closure (LAAC) and patent foramen ovale (PFO)/atrial septal defect (ASD) closure procedures were felt appropriate for postponement. CONCLUSION: Our survey of an experienced team of clinicians yielded concise guidelines to direct the management of CAD and structural heart disease patients during the initial phases of the COVID-19 pandemic.


Improving antibiotic stewardship in COVID-19: Bacterial co-infection is less common than with influenza


Arthralgia as an initial presentation of COVID-19: observation


title: [Exploring the Stress, Psychological Distress, and Stress-relief Strategies of Taiwan Nursing Staffs Facing the Global Outbreak of COVID-19]

text: BACKGROUND: The global outbreak of coronavirus disease (COVID-19) began in December 2019. The high levels of stress experienced by nurses during this pandemic may have immediate and long-term effects on their mental health. PURPOSE: To explore the stress and psychological problems of nurses during this pandemic and to identify strategies used by these nurses to relieve stress. METHODS: A cross-sectional online survey was conducted that included a basic information datasheet, stress of nursing staff during COVID-19 outbreak scale, psychological distress scale, and stress relief methods survey form. Convenience sampling was used and a total of 469 practicing nurses participated in this study. RESULTS: Most of the participants expressed concerns about living problems (72.7%). On the stress questionnaire, the facets of "burden of taking care of patients" and "worries about social isolation" earned the first and second highest scores, respectively. In terms of items, "worrying about infecting family members and friends" and "worrying about being separated from family after being infected" earned the two highest scores (2.35 ± 0.79 and 2.17 ± 0.92, respectively). Scores for psychological distress averaged 5.49 ± 3.83, with stress anxiety (1.32 ± 0.84) earning the highest mean subscale score followed by distress and irritability (1.17 ± 0.92) and depression (1.12 ± 0.94). Nearly two-thirds (61.8%) of the participants earned psychological and emotional distress scores within the 'normal' range, and 3.4% earned scores indicating severe distress. "Receiving education and training" was the most common method used by the participants to relieve stress (2.27 ± 0.51). CONCLUSIONS: The following six strategies are proposed based on the above findings: (1) Caring: provide psychological assessment and care; (2) Supporting: create a friendly team atmosphere and provide support; (3) Inquiring: recruit volunteers with relevant experience; (4) Informing: provide timely, open, and transparent epidemic-prevention information; (5) Equipping: provide complete and appropriate epidemic-prevention education and training; (6) Assisting: establish a strategy for family support and caring to reduce the stress and worries of nurses.


title: Mental Health Interventions during the COVID-19 Pandemic: A Conceptual Framework by Early Career Psychiatrists

text: The emergence of mental health (MH) problems during a pandemic is extremely common, though difficult to address due to the complexities of pandemics and the scarcity of evidence about the epidemiology of pandemic-related MH problems and the potential interventions to tackle them. Little attention has been devoted so far to this topic from policymakers, stakeholders and researchers, resulting in a lack of replicable, scalable and applicable frameworks to help plan, develop and deliver MH care during pandemics. As a response, we have attempted to develop a conceptual framework (CF) that could guide the development, implementation, and evaluation of MH interventions during the ongoing COVID-19 pandemic. This CF was developed by early career psychiatrists from 16 countries that cover all the WHO regions. Their opinions were elicited via a semi-structured questionnaire. They were asked to provide their views about the current MH situation in their countries and to elaborate on existing 'myths' and misinformation. They were also asked to name the resources available and to propose solutions and approaches to provide accessible and affordable care. The CF was prepared based on the extant literature and the views discussed in this group; it illustrates the epidemiology of MH problems, preparedness plans, stage-specific plans or innovative solutions, opportunities to integrate those plans and possible outcomes at policy level. This CF can serve as a technical guide for future research regarding pandemics. It can be used to monitor trends and to optimize efforts, and to develop evidence based MH interventions. Still, further research focusing on the individual components of this framework is needed.


A novel clinical set-up for examining healthy dermatology outpatients during the COVID-19 pandemic


title: Back to the basics: Propolis and COVID-19

text: The epidemiological burden of COVID-19 is a healthcare challenge throughout the world, not only in terms of testing the limits of medical capacities, but also as an enigma considering preventive strategies and methods. The upper respiratory tract mucosa is the first line of defense, as a physical barrier, as well as through multiple innate and adaptive immune mechanisms which are crucial for efficient antiviral responses. Identifying methods able to reduce or prevent colonization, viral adhesion, and promote virus shedding on mucous membranes or have the ability to inactivate pathogens and thus reduce virus dose and/or increase immune response would be essential in the management of COVID-19 outbreak and help in flattening the curve. We review the effects of propolis, an old remedy with proven antiviral properties, as a possible low-cost inhibitor of SARS-CoV-2 in the oropharyngeal niche, prophylaxis, or adjuvant therapy.


Back to the Basics: Propolis and COVID-19


Oncology Practice During the COVID-19 Pandemic


Pediatric Peri-Operative Care in the COVID-19 Era


title: Systemic sclerosis and the COVID-19 pandemic: World Scleroderma Foundation preliminary advice for patient management

text: Due to the frequent presence of interstitial lung disease and widespread use of immunosuppressive treatment, systemic sclerosis (SSc) patients may be considered at risk for a more severe disease course and higher mortality when they develop Severe Acute Respiratory Syndrome - Coronavirus - 2 (SARS-CoV-2) virus infection. Therefore, with World Scleroderma Foundation endorsement, experts from different specialties including rheumatology, virology and clinical immunology gathered virtually to answer to the main practical clinical questions regarding SARS-CoV-2 infection coming from both patients and physicians. This preliminary advice is aligned with other national and international recommendations, adapted for SSc patients.


title: Attenuated early inflammatory response in solid organ recipients with COVID-19

text: Immunosuppression leaves transplanted patients at particular risk for severe acute respiratory syndrome 2 (SARS-CoV-2) infection. The specific features of coronavirus disease 2019 (COVID-19) in immunosuppressed patients are largely unknown and therapeutic experience is lacking. Seven transplanted patients (two liver, three kidneys, one double lung, one heart) admitted to the Ludwig-Maximilians-University Munich because of COVID-19 and tested positive for SARS-CoV-2 were included. The clinical course and the clinical findings were extracted from the medical record. The two liver transplant patients and the heart transplant patient had an uncomplicated course and were discharged after 14, 18 and 12 days, respectively. Two kidney transplant recipients were intubated within 48 hours. One kidney and the lung transplant recipients were required to intubate after ten and 15 days, respectively. Immunosuppression was adapted in five patients, but continued in all patients. Compared to non-transplanted patients at the ICU (n=19) the inflammatory response was attenuated in transplanted patients, which was proven by decreased IL-6 blood values. This analysis might provide evidence that continuous immunosuppression is safe and probably beneficial since there was no hyperinflammation evident. Although transplanted patients might be more susceptible to an infection with SARS-CoV-2, their clinical course seems to be similar to immunocompetent patients.


Reply to "CT Is Not a Screening Tool for Coronavirus Disease (COVID-19) Pneumonia"


title: COVID19 Prevention & Care; A Cancer Specific Guideline

text: On March 11th 2020, the coronavirus outbreak was declared a pandemic by the WHO. One of the groups that is considered high risk in this pandemic are cancer patients as they are treated with a variety of immune system suppressor treatment modalities and this puts them in a great risk for infectious disease (including COVID-19). Therefore, cancer patients require higher level measures for preventing and treating infectious diseases. furthermore, cancer patients may bear additional risk due to the restriction of access to the routine diagnostic and therapeutic services during such epidemic. Since most of the attention of health systems is towards patients affected with COVID-19, the need for structured and unified approaches to COVID-19 prevention and care specific to cancer patients and cancer centers is felt more than ever. This article provides the recommendations and possible actions that should be considered by patients, their caregivers and families, physician, nurses, managers and staff of medical centers involved in cancer diagnosis and treatment. We pursued two major goals in our recommendations: first, limiting the exposure of cancer patients to medical environments and second, modifying the treatment modalities in a manner that reduces the probability of myelosuppression such as delaying elective diagnostic and therapeutic services, shortening the treatment course, or prolonging the interval between treatment courses.


Potential TRPV1 blockade to treat severe lung dysfunction in COVID-19 infection


An effective model for the outpatient management of COVID-19


title: Mild COVID-19 in a pediatric renal transplant recipient

text: As of mid-April 2020, the coronavirus disease of 2019 (COVID-19) pandemic has affected more than 2 million people and caused 135 000 deaths worldwide. Not much is known about the effect of this disease in immunosuppressed children with renal transplantation (RT). Here we report a 13-year-old child with multiple comorbidities who acquired COVID-19 5 years post-RT in the United States. Maintenance immunosuppression (IS) consisted of sirolimus and mycophenolate. There was no history of travel or exposure to sick contacts. The presenting features were fever, cough, rhinorrhea, and hypoxemia. Diarrhea was the only extrapulmonary manifestation. Chest X-ray was normal. He did not require intensive care unit care or ventilation. There was a transient rise in his serum creatinine without change in urine output; dialysis was not required. Slight reduction in IS was done. He had an excellent clinical recovery within 4 days and was able to be discharged home. His respiratory symptoms resolved but the diarrhea persisted during a 4-week follow-up period. This report provides a brief perspective on the short-term COVID-19 clinical course in an immunosuppressed child. More reports will add valuable information on the potential variety of spectrum of the illness in this subset of children.


title: Rapid Reorganization of an Academic Infectious Diseases Program During the COVID-19 Pandemic in Detroit: A Novel Unit-Based Group Rounding Model

text: The surge of coronavirus disease 2019 (COVID-19) hospitalizations at our 877-bed quaternary care hospital in Detroit led to an emergent demand for Infectious Diseases (ID) consultations. The traditional one-on-one consultation model was untenable. Therefore, we rapidly restructured our ID division to provide effective consultative services. We implemented a novel unit-based group rounds model that focused on delivering key updates to teams and providing unit-wide consultations simultaneously to all team members. Effectiveness of the program was studied using Likert-scale survey data. The survey captured data from the first month of the Detroit COVID-19 pandemic. During this period there were approximately 950 patients hospitalized for treatment of COVID-19. The survey of trainees and faculty reported an overall 95% positive response to delivery of information, new knowledge acquisition, and provider confidence in the care of COVID-19 patients. This showed that the unit-based consult model is a sustainable effort to provide care during epidemics.


title: Detection of cryptic CCND1 rearrangements in mantle cell lymphoma by next generation sequencing

text: The accurate detection of recurrent genetic abnormalities for most hematologic neoplasms is critical for diagnosis, prognosis and/or treatment. Rearrangements involving CCND1 are observed in a subset of mature B-cell neoplasms and can be reliably detected by fluorescence in situ hybridization (FISH) in most cases. However, cryptic and complex chromosomal rearrangements may pose a technical challenge for accurate diagnosis. Herein, we describe two patients with suspected mantle cell lymphoma that lacked obvious CCND1 rearrangements by FISH studies. A next generation sequencing (NGS) based assay, mate-pair sequencing (MPseq), was utilized in each case to investigate potential cryptic CCND1 rearrangements and revealed cryptic insertional events resulting in CCND1/IGH and CCND1/IGK rearrangements. These cases demonstrate that NGS-based assays, including MPseq, are a powerful approach to identify cryptic rearrangements of clinical importance that are not detected by current clinical genomics evaluation.


title: Doubt, Disorientation, and Death in the Plague Time

text: An account of an experience with contracting an illness that may well have been Covid-19 gives rise to reflections on doubt and on the art of dying well. The upshot: our mortality remains a fundamentally disorienting condition of our existence. If there's any wisdom to be had concerning our deaths, it likely lies in the direction of accepting their deranging character, rather than in searching for the philosophical insight that will reconcile us to our fate.


Fibrinolysis Shutdown and Thrombosis in Severe COVID-19


Is the HScore useful in COVID-19?


Societal considerations in host genome testing for COVID-19


Lower detection rates of SARS-COV2 antibodies in cancer patients versus health care workers after symptomatic COVID-19


title: Why lockdown : On the spread of SARS-CoV-2 in India, a network approach

text: We analyze the time series data of number of districts or cities in India that are affected by COVID-19 from March 01, 2020 to April 17, 2020. We study the data in the framework of time series network data. The networks are defined by using the geodesic distances of the districts or cities specified by the latitude and longitude coordinates. We particularly restrict our analysis to all but districts in the north-eastern part of India. Unlike recent studies on the projection of the number of people infected with SARS-CoV-2 in the near future, in this note, the emphasis is on understanding the dynamics of the spread of the virus across the districts of India. We perform spectral and structural analysis of the model networks by considering several measures, notably the spectral radius, the algebraic connectivity, the average clustering coefficient, the average path length and the structure of the communities. Furthermore, we study the overall expansion properties given by the number of districts or cities before and after lockdown. These studies show that lockdown has a significant impact on the spread of SARS-CoV-2 in districts or cities over long distances. However, this impact is only observed after approximately two weeks of lockdown. We speculate that this happened due to the insufficient number of tests for COVID-19 before the lockdown which could not stop the movement of people infected with the virus but not detected, over long distances.


Drug repurposing in the era of COVID-19: a call for leadership and government investment


title: Study on the effect of nursing-technology integrated in the imaging examination of Novel coronavirus pneumonia/ 重庆医学

text: Currently, the outbreak of the new coronary pneumonia has entered a critical period of screening, prevention and control.In order to block the transmission of the virus in the radiology department, it is particularly important to effectively protect the medical servant while speeding up the flow of inspection.Based on the basis of notification of the bureau of disease control and prevention, the expert consensus of the CMA and CMDA, and the literature review, combined with the previous practical work experience,this article puts forward the recommendations on the important effect of nursing-technology integrated in the imaging examination of novel coronavirus pneumonia, in order to provide reference for the protection of medical servant in the radiology department at the front line of anti-epidemic.


title: Lessons to Europe from China for cancer treatment during the COVID-19 pandemic

text: During the COVID-19 era, Chinese hospitals have developed a system that enables vulnerable cancer patients to continue to receive high-quality medical care, optimising their survival whilst protecting them. This includes use of digital quick codes, fever clinics and optimal scheduling. We wish to share our experiences working with patients during the pandemic.


title: Half of Rural Residents at High Risk of Serious Illness Due to COVID-19, Creating Stress on Rural Hospitals

text: PURPOSE: During the COVID-19 epidemic, it is critical to understand how the need for hospital care in rural areas aligns with the capacity across states. METHODS: We analyzed data from the 2018 Behavioral Risk Factor Surveillance System to estimate the number of adults who have an elevated risk of serious illness if they are infected with coronavirus in metropolitan, micropolitan, and rural areas for each state. Study data included 430,949 survey responses representing over 255.2 million noninstitutionalized US adults. For data on hospital beds, aggregate survey data were linked to data from the 2017 Area Health Resource Files by state and metropolitan status. FINDINGS: About 50% of rural residents are at high risk for hospitalization and serious illness if they are infected with COVID-19, compared to 46.9% and 40.0% in micropolitan and metropolitan areas, respectively. In 19 states, more than 50% of rural populations are at high risk for serious illness if infected. Rural residents will generate an estimated 10% more hospitalizations for COVID-19 per capita than urban residents given equal infection rates. CONCLUSION: More than half of rural residents are at increased risk of hospitalization and death if infected with COVID-19. Experts expect COVID-19 burden to outpace hospital capacity across the country, and rural areas are no exception. Policy makers need to consider supply chain modifications, regulatory changes, and financial assistance policies to assist rural communities in caring for people affected by COVID-19.


title: Gender Analysis of COVID-19 Outbreak in South Korea: A Common Challenge and Call for Action

text: This study aims to analyze South Korea's experience during the COVID-19 outbreak through a gendered lens. We briefly introduce the COVID-19 outbreak in Korea, scrutinize gendered vulnerability in contracting the virus, and then analyze the gendered aspects of the pandemic response in two phases: quarantine policy and mitigation policy. The authors elicit four lessons from the analysis. First, gender needs to be mainstreamed at all stages of a public health emergency response. Second, in addition to medical care, all formal and informal care work should be considered as an essential component of health care systems. Third, a people-centered approach in health governance should be prioritized to make women's voices heard at every level. Fourth, medical technology and resources to cope with pandemic should be produced and distributed in an equitable manner, acknowledging differential vulnerability and susceptibility.


title: Decoding asymptomatic COVID-19 infection and transmission

text: Coronavirus disease 2019 (COVID-19) is a continuously devastating public health and the world economy. One of the major challenges in controlling the COVID-19 outbreak is its asymptomatic infection and transmission, which are elusive and defenseless in most situations. The pathogenicity and virulence of asymptomatic COVID-19 remain mysterious. Based on the genotyping of 20656 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) genome isolates, we reveal that asymptomatic infection is linked to SARS-CoV-2 11083G>T mutation, i.e., leucine (L) to phenylalanine (F) substitution at the residue 37 (L37F) of nonstructure protein 6 (NSP6). By analyzing the distribution of 11083G>T in various countries, we unveil that 11083G>T may correlate with the hypotoxicity of SARS-CoV-2. Moreover, we show a global decaying tendency of the 11083G>T mutation ratio indicating that 11083G>T hinders SARS-CoV-2 transmission capacity. Sequence alignment found both NSP6 and residue 37 neighborhoods are relatively conservative over a few coronaviral species, indicating their importance in regulating host cell autophagy to undermine innate cellular defense against viral infection. Using machine learning and topological data analysis, we demonstrate that mutation L37F has made NSP6 energetically less stable. The rigidity and flexibility index and several network models suggest that mutation L37F may have compromised the NSP6 function, leading to a relatively weak SARS-CoV subtype. This assessment is a good agreement with our genotyping of SARS-CoV-2 evolution and transmission across various countries and regions over the past few months.


Extubation of patients with COVID-19


Postnatally-Acquired COVID-19 in Central India


Covid-19 during pregnancy: A case series from an universally tested population from the north of Portugal


title: SARS-CoV-2 outbreak: How can pharmacists help?

text: Coronaviruses (CoVs) are a large family of viruses that cause disorders ranging from a mild cold to severe disease. Some of the CoVs are zoonotic, meaning they can be transmitted from animals to humans. In December 2019, the world awoke to a new zoonotic strain of CoV that was named SARS-CoV-2 (standing for severe acute respiratory syndrome coronavirus 2), which has been classified as a high-consequence infectious disease. In addition, serious complications related to COVID-19 have been reported in some patients. These include acute respiratory distress syndrome, acute renal failure, septic shock and ventilator-associated pneumonia. The pharmacist, as a healthcare practitioner, can play an important role in hindering the spread of COVID-19, and can be an active participant in national and community efforts to fight and contain this outbreak.


Strategies for Disseminating and Implementing COVID-19 Public Health Prevention Practices in Rural Areas


Rationale for universal face masks in public against COVID-19


Can Global Pharmaceutical Supply Chains Scale Up Sustainably for the COVID-19 Crisis?


title: COVID-19: Avoiding a second tragedy in a tuberculosis burdened country

text: To the Editor Novel Coronavirus disease (COVID-19) was first notified in December 2019 from Wuhan, China. Now, it has spread rapidly and has been declared a pandemic affecting over 200 countries with widespread morbidity and mortality. It has been postulated that the most vulnerable population are the elderly, people living in crowded areas, children and immune-compromised individuals, such as people living with human immunodeficiency virus (HIV). The correlation of tuberculosis (TB), HIV and malnutrition are well documented and hence, people with tuberculosis should be considered as special population in this pandemic. TB is an ancient disease among humans recorded as far back as seventy thousand years which was declared a global public health emergency in 1993 by the World Health Organisation (WHO). India has the highest TB burden in the world.


Asymptomatic cases in a family cluster with SARS-CoV-2 infection


title: How we make choices and sacrifices in medical education during the COVID-19 pandemic

text: In this commentary, we highlight some of the pressing choices and sacrifices we must make in medical education during the COVID-19 pandemic.


title: Utilitarianism and the pandemic

text: There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritize the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory that states that the right action is the action that is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic: (a) Triage: which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? (b) Lockdown: how should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reductions in well-being from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay.


COVID-19: A personal thank you to all perioperative practitioners and other key workers


title: Deep learning for classification and localization of COVID-19 markers in point-of-care lung ultrasound

text: Deep learning (DL) has proved successful in medical imaging and, in the wake of the recent COVID-19 pandemic, some works have started to investigate DLbased solutions for the assisted diagnosis of lung diseases. While existing works focus on CT scans, this paper studies the application of DL techniques for the analysis of lung ultrasonography (LUS) images. Specifically, we present a novel fully-annotated dataset of LUS images collected from several Italian hospitals, with labels indicating the degree of disease severity at a frame-level, videolevel, and pixel-level (segmentation masks). Leveraging these data, we introduce several deep models that address relevant tasks for the automatic analysis of LUS images. In particular, we present a novel deep network, derived from Spatial Transformer Networks, which simultaneously predicts the disease severity score associated to a input frame and provides localization of pathological artefacts in a weakly-supervised way. Furthermore, we introduce a new method based on uninorms for effective frame score aggregation at a video-level. Finally, we benchmark state of the art deep models for estimating pixel-level segmentations of COVID-19 imaging biomarkers. Experiments on the proposed dataset demonstrate satisfactory results on all the considered tasks, paving the way to future research on DL for the assisted diagnosis of COVID-19 from LUS data.


title: Understanding the Effects of Tennessee's Open Covid-19 Testing Policy: Bounding Policy Effects with Nonrandomly Missing Data

text: Increased testing for Covid-19 is seen as one of the most important steps to re-open the economy. The current paper considers Tennessee's"open-testing"policy where the state substantially increased testing while removing symptom requirements for individuals to be tested. To understand the effect of the policy, we combine standard identifying assumptions with additional weak assumptions to deal with non-random testing that lead to bounds on policy effects of interest. Our results suggest that Tennessee's open-testing policy has reduced total cases (which are not fully observed), confirmed cases, and trips to work among counties with a fast-growing number of confirmed cases.


title: Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID-19: Meta-analysis and sensitivity analysis

text: The coronavirus disease-2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscript conducts a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% CI (2.41-3.90), the average incubation time to be 5.08 days with the 95% CI (4.77-5.39) (in day), the asymptomatic infection rate to be 46% with the 95% CI (18.48%-73.60%), and the case fatality rate to be 2.72% with 95% CI (1.29%-4.16%) where asymptomatic infections are accounted for.


title: Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis

text: OBJECTIVES: Pandemic COVID-19 has become a seriously public health priority worldwide. Comprehensive strategies including travel restrictions and mask-wearing have been implemented to mitigate the virus circulation. However, detail information on community transmission is unavailable yet. METHODS: From January 23 to March 1, 2020, 127 patients (median age: 46 years; range: 11-80) with 71 male and 56 female, were confirmed to be infected with the SARS-CoV-2 in Taizhou, Zhejiang, China. Epidemiological trajectory and clinical features of these COVID-19 cases were retrospectively retrieved from electronic medical records and valid individual questionnaire. RESULTS: The disease onset was between January 9 to February 14, 2020. Among them, 64 patients are local residents, and 63 patients were back home from Wuhan from January 10 to 24, 2020 before travel restriction. 197 local residents had definite close-contact with 41 pre-symptomatic patients back from Wuhan. 123 and 74 of them contact with mask-wearing or with no mask-wearing pre-symptomatic patients back from Wuhan, respectively. Data showed that incidence of COVID-19 was significantly higher for local residents close-contact with no mask-wearing Wuhan returned pre-symptomatic patients (19.0% vs. 8.1%, pâ¯<â¯0.001). Among 57 close-contact individuals, 21 sequential local COVID-19 patients originated from a pre-symptomatic Wuhan returned couple, indicated dense gathering in congested spaces is a high risk for SARS-CoV-2 transmission. CONCLUSIONS: Our findings provided valuable details of pre-symptomatic patient mask-wearing and restriction of mass gathering in congested spaces particularly, are important interventions to mitigate the SARS-CoV-2 transmission.


title: Influenza and obesity: its odd relationship and the lessons for COVID-19 pandemic

text: AIMS: Analyze the relationship between obesity and influenza. METHODS: Basal hormone milieu, defective response of both innate and adaptive immune system and sedentariness are major determinants in the severity of influenza viral infection in obese patients. Being overweight not only increases the risk of infection and of complications for the single obese person, but a large prevalence of obese individuals within the population might increase the chance of appearance of more virulent viral strain, prolongs the virus shedding throughout the total population and eventually might increase overall mortality rate of an influenza pandemic. RESULTS: Waiting for the development of a vaccination against COVID-19, isolation of positive cases and social distancing are the primary interventions. Nonetheless, evidence from previous influenza pandemics suggests the following interventions aimed at improving immune response: (1) lose weight with a mild caloric restriction; (2) include AMPK activators and PPAR gamma activators in the drug treatment for obesity associated with diabetes; and (3) practice mild-to-moderate physical exercise. CONCLUSIONS: Due to prolonged viral shedding, quarantine in obese subjects should likely be longer than normal weight individuals.


Recommendations for personal protective equipment and smoke evacuation for dermatologic surgeries amid the COVID-19 crisis


title: Comparison of clinical characteristics and outcomes of patients with coronavirus disease 2019 at different ages

text: BACKGROUND: Information about the clinical characteristics and mortality of patients with coronavirus disease 2019 at different ages is limited. RESULTS: The older group had more patients with dyspnea and fewer patients with fever and muscle pain. Older patients had more underlying diseases, secondary infection, myocardial injury, renal dysfunction, coagulation dysfunction, and immune dysfunction on admission. More older patients received immunoglobulin therapy and mechanical ventilation. The proportions of patients with multiple organ injuries, critically ill patients and death increased significantly with age. The older groups had higher cumulative death risk than the younger group. Hypertension, cerebrovascular disease, comorbidities, acute cardiac injury, shock and complications are independent predictors of death. CONCLUSIONS: The symptoms of the elderly patients were more atypical, with more comorbidities, secondary infection, organ injuries, immune dysfunction and a higher risk of critical illness. Older age was an important risk factor for mortality. METHODS: 1000 patients diagnosed with coronavirus disease 2019 from January 1, 2020 to February 14, 2020 were enrolled. According to age, patients were divided into group 1 (<60 years old), group 2 (60-74 years old) and group 3 (≥75 years old). The clinical symptoms, first laboratory results, CT findings, organ injuries, disease severity and mortality were analyzed.


title: Frequency and severity of general surgical emergencies during the COVID-19 pandemic: single-centre experience from a large metropolitan teaching hospital

text: INTRODUCTION: The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown. MATERIALS AND METHODS: This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown. RESULTS: A total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, p = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, p = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, p = 0.04). CONCLUSION: Fewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.


title: COVID-19: Should We Test Everyone?

text: Since the beginning of 2020, the coronavirus disease 2019 (COVID-19) has spread rapidly in the city of Wuhan, P.R. China, and subsequently, across the world. The swift spread of the virus is largely attributed to its stealth transmissions in which infected patients may be asymptomatic. Undetected transmissions present a remarkable challenge for the containment of the virus and pose an appalling threat to the public. An urgent question that has been asked by the public is"Should I be tested for COVID-19 if I am sick?". While different regions established their own criteria for screening infected cases, the screening criteria have been modified based on new evidence and understanding of the virus as well as the availability of resources. The shortage of test kits and medical personnel has considerably limited our ability to do as many tests as possible. Public health officials and clinicians are facing a dilemma of balancing the limited resources and unlimited demands. On one hand, they are striving to achieve the best outcome by optimizing the usage of the scant resources. On the other hand, they are challenged by the patients' frustrations and anxieties, stemming from the concerns of not being tested for COVID-19 for not meeting the definition of PUI (person under investigation). In this paper, we evaluate the situation from the statistical viewpoint by factoring into the considerations of the uncertainty and inaccuracy of the test, an issue that is often overlooked by the general public. We aim to shed light on the tough situation by providing evidence-based reasoning from the statistical angle, and we expect this examination will help the general public understand and assess the situation rationally. Most importantly, the development offers recommendations for physicians to make sensible evaluations to optimally use the limited resources for the best medical outcome.


title: SARS-CoV-2 host diversity: An update of natural infections and experimental evidence

text: Coronavirus disease-19 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is now a pandemic threat. This virus is supposed to be spread by human to human transmission. Cellular angiotensin-converting enzyme 2 (ACE2) is the receptor of SARS-CoV-2 which is identical or similar in different species of animals such as pigs, ferrets, cats, orangutans, monkeys, and humans. Moreover, a recent study predicted that dogs might be secondary hosts during the evolution of SARS-CoV-2 from bat to human. Therefore, there is a possibility of spreading SARS-CoV-2 through domestic pets. There are now many reports of SARS-CoV-2 positive cases in dogs, cats, tigers, lion, and minks. Experimental data showed ferrets and cats are highly susceptible to SARS-CoV-2 as infected by virus inoculation and can transmit the virus directly or indirectly by droplets or airborne routes. Based on these natural infection reports and experimental data, whether the pets are responsible for SARS-CoV-2 spread to humans; needs to be deeply investigated. Humans showing clinical symptoms of respiratory infections have been undergoing for the COVID-19 diagnostic test but many infected people and few pets confirmed with SARS-CoV-2 remained asymptomatic. In this review, we summarize the natural cases of SARS-CoV-2 in animals with the latest researches conducted in this field. This review will be helpful to think insights of SARS-CoV-2 transmissions, spread, and demand for seroprevalence studies, especially in companion animals.


title: Use of Tocilizumab for COVID-19-Induced Cytokine Release Syndrome: A Cautionary Case Report

text: Novel coronavirus disease 2019 (COVID-19) emerged in late December 2019 in Wuhan, China. Since then, COVID-19 has become a pandemic affecting more than 4.1 million people worldwide. Patients with COVID-19 have a wide spectrum of manifestations, one being cytokine release syndrome (CRS) and its fatal correlate, secondary hemophagocytic lymphohistiocytosis (sHLH). Anti-cytokine therapy such as tocilizumab, an IL-6 receptor antagonist, is a potential treatment for COVID-19; however, data regarding the efficacy of this anti-IL-6 therapy are currently lacking. We report two cases of patients who received a diagnosis of COVID-19 complicated by CRS and were treated with tocilizumab. Both patients progressed to sHLH despite treatment with tocilizumab, and one developed viral myocarditis, challenging the safety and clinical usefulness of tocilizumab in the treatment of COVID-19-induced CRS. These cases highlight the need for clinical trials to determine optimal patient selection and timing for the use of tocilizumab during this disease process.


text: Novel coronavirus disease 2019 (COVID-19) emerged in late December 2019 in Wuhan, China. Since then, COVID-19 has become a pandemic affecting more than 1.5 million people worldwide. Patients with COVID-19 have a wide spectrum of manifestations, one being cytokine release syndrome (CRS) and its fatal correlate, secondary hemophagocytic lymphohistiocytosis (sHLH). Anti-cytokine therapy such as tocilizumab, an IL-6 receptor antagonist, is a potential treatment for COVID-19; however, data regarding the efficacy of this anti-IL-6 therapy are currently lacking. We report two cases of patients who received a diagnosis of COVID-19 complicated by CRS and were treated with tocilizumab. Both patients progressed to sHLH despite treatment with tocilizumab, and one developed viral myocarditis, challenging the safety and clinical usefulness of tocilizumab in the treatment of COVID-19-induced CRS. These cases highlight the need for clinical trials to determine optimal patient selection and timing for the use of tocilizumab during this disease process.


Complicated coronavirus disease 2019 (COVID-19) in a psoriatic patient treated with ixekizumab


title: Interdisciplinary Perspectives on Health Literacy Research Around the World: More Important Than Ever in a Time of COVID-19

text: As we write our editorial for a health literacy special issue in the midst of the international COVID-19 crisis, we take this opportunity to highlight the importance of individual, community, and population health literacy. We are not only in a "pandemic" but also an "infodemic". Health literacy is more important than ever in the face of these global health threats, which have impacted outcomes across the levels of the socio-ecological model (SEM), including individual health behaviors, family relationships, organizational behavior, state policy-making, national mortality statistics, and the international economy in the span of weeks. Our special issue sought to pull together interdisciplinary threads guided by two principles. The first was defining health literacy as essential skills and situational resources needed for people to find, understand, evaluate, communicate, and use information and services in a variety of forms across various settings throughout their life course to promote health and wellbeing. The second was the idea that enhancing health literacy in populations and systems is critical to achieving health equity. In this time of public health need across traditional borders, the inter-sectoral and international perspectives of special issue articles are more urgent than ever. A greater understanding, appreciation, and application of health literacy can support policy action on multiple levels to address major public health challenges. Health literacy should be built deliberately as a population-level resource and community asset. We have summarized the set of articles in this special issue across the levels of the SEM, hoping their thoughtful considerations and interesting findings will help to support global health and wellness and inspire future research, policy, and practice in this global public health emergency and beyond.


Covid-19 digestive system involvement and clinical outcomes in a large academic hospital in Milan, Italy


COVID-19 Digestive System Involvement and Clinical Outcomes in a Large Academic Hospital in Milan, Italy


Non-Invasive versus Invasive Ventilation in COVID-19: One Size Does Not Fit All!


Pulmonary intravascular coagulation in COVID-19: possible pathogenesis and recommendations on anticoagulant/thrombolytic therapy


Riesgo de reactivación de la hepatitis B asociado al tratamiento con corticoides frente a SARS-CoV-2 (COVID-19)./ [Risk of hepatitis B reactivation associated with treatment against SARS-CoV-2 (COVID-19) with corticosteroids]


COVID-19 patients with hypertension have more severity condition, and ACEI/ARB treatment have no infulence on the clinical severity and outcome


title: COVID-19 epidemic outcome predictions based on logistic fitting and estimation of its reliability

text: Since the first outbreak of the COVID-19 epidemic at the end of 2019, data has been made available on the number of infections, deaths and recoveries for all countries of the World, and that data can be used for statistical analysis. The primary interest of this paper is how well the logistic equation can predict the outcome of COVID-19 epidemic in any regions of the World assuming that the methodology of the testing process, namely the data collection method and social behavior is not changing over the course of time. Besides the social relevance, this study has two scientific purposes: we investigate if a simple saturation model can describe the trend of the COVID-19 epidemic and if so, we would like to determine, from which point during the epidemic the fitting parameters provide reliable predictions. We also give estimations for the outcome of this epidemic in several countries based on the logistic model and the data available on 27 March, 2020. Based on the saturated cases in China, we have managed to find some criteria to judge the reliability of the predictions.


title: Projecting and comparing non-pharmaceutical interventions to contain COVID-19 in major economies

text: Non-pharmaceutical interventions (NPIs) such as quarantine, self-isolation, social distancing, and virus-contact tracing can greatly reduce the spread of the virus during a pandemic. In the wave of the COVID-19 pandemic, many countries have implemented various NPIs for infection control and mitigation. However, the stringency of the NPIs and the resulting impact among different countries remain unclear due to the lack of quantitative factors. In this study we took a further step to incorporate the effect of the NPIs into the pandemic dynamics model using the concept of policy intensity factor (PIF). This idea enables us to characterize the transition rates as time varying quantities instead of constant values, and thus capturing the dynamical behavior of the basic reproduction number variation in the pandemic. By leveraging a great amount of data reported by the governments and the World Health Organization, we projected the dynamics of the pandemic for the major economies in the world, including the numbers of infected, susceptible, and recovered cases, as well as the pandemic durations. It is observed that the proposed variable-rate susceptible-exposed-infected-recovered (VR-SEIR) model fits and projects the pandemic dynamics very well. We further showed that the resulting PIFs correlate with the stringency of NPIs, which allows us to project the final affected numbers of people in those countries when their current NPIs have been imposed for 90, 180, 360 days. It provides a quantitative insight into the effectiveness of the implemented NPIs, and sheds a new light on minimizing both affected people from COVID-19 and the economic impact.


Low risk of SARS-CoV-2 transmission through the ocular surface


title: A Note on Early Epidemiological Analysis of Coronavirus Disease 2019 Outbreak using Crowdsourced Data

text: Crowdsourcing data can prove of paramount importance in monitoring and controlling the spread of infectious diseases. The recent paper by Sun, Chen and Viboud (2020) is important because it contributes to the understanding of the epidemiology and of the spreading of Covid-19 in a period when most of the epidemic characteristics are still unknown. However, the use of crowdsourcing data raises a number of problems from the statistical point of view which run the risk of invalidating the results and of biasing estimation and hypothesis testing. While the work by Sun, Chen and Viboud (2020) has to be commended, given the importance of the topic for worldwide health security, in this paper we deem important to remark the presence of the possible sources of statistical biases and to point out possible solutions to them


title: COVID-19 Crisis Creates Opportunities for Community-Centered Population Health: Community Health Workers at the Center

text: Dealing with the COVID-19 coronavirus requires a coordinated transnational effort. We propose a 2-stage state-led effort that utilizes community health workers (CHWs). We spell out what is beginning to occur in states to control and suppress COVID-19. In the second stage, we suggest working with these CHWs as a key element in the next evolution of our health care system: community-centered population health.


title: Glycosylated hemoglobin is associated with systemic inflammation, hypercoagulability, and prognosis of COVID-19 patients

text: BACKGROUND: Diabetes is a risk factor for the progression and prognosis of coronavirus disease (COVID-19), but the relationship between glycosylated hemoglobin (HbA1c) level, inflammation, and prognosis of COVID-19 patients has not been explored. METHODS: This was a retrospective study of COVID-19 patients who underwent an HbA1c test. Their demographic data, medical history, signs and symptoms of COVID-19, laboratory test results, and final outcomes of COVID-19 treatment were collected and analyzed. RESULTS: A total of 132 patients were included and divided into three groups based on their blood glucose status. There were significant differences in SaO2, serum ferritin level, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen (Fbg) level, and IL6 level among the three groups. A pairwise comparison of the groups showed that groups B and C were significantly different from group A in terms of CRP, ESR, and Fbg, IL6, and serum ferritin levels (P < 0.05). Correlation analysis showed that there was a linear negative correlation between SaO2 and HbA1c (r = -0.22, P = 0.01), while there was a linear positive correlation between serum ferritin, CRP, Fbg, and ESR levels and HbA1c (P < 0.05). CONCLUSIONS: High HbA1c level is associated with inflammation, hypercoagulability, and low SaO2 in COVID-19 patients, and the mortality rate (27.7%) is higher in patients with diabetes. Determining HbA1c level after hospital admission is thus helpful assessing inflammation, hypercoagulability, and prognosis of COVID-19 patients.


The traps of calling the public health response to COVID-19 "an unexpected war against an invisible enemy"


Covid-19: Health and care workers will be "highest priority" for vaccination, says JCVI


title: Cardiac manifestations in COVID-19 patients-A systematic review

text: OBJECTIVES: The coronavirus disease-2019 (COVID-19) pandemic has resulted in the worst global pandemic of our generation, affecting 215 countries with nearly 5.5 million cases. The association between COVID-19 and the cardiovascular system has been well described. We sought to systematically review the current published literature on the different cardiac manifestations and the use of cardiac-specific biomarkers in terms of their prognostic value in determining clinical outcomes and correlation to disease severity. METHODS: A systematic literature review across PubMed, Cochrane database, Embase, Google Scholar, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed risk factors for cardiovascular manifestations, cardiac manifestations in COVID-19 patients, and cardiac-specific biomarkers with their clinical implications on COVID-19. RESULTS: Sixty-one relevant articles were identified which described risk factors for cardiovascular manifestations, cardiac manifestations (including heart failure, cardiogenic shock, arrhythmia, and myocarditis among others) and cardiac-specific biomarkers (including CK-MB, CK, myoglobin, troponin, and NT-proBNP). Cardiovascular risk factors can play a crucial role in identifying patients vulnerable to developing cardiovascular manifestations of COVID-19 and thus help to save lives. A wide array of cardiac manifestations is associated with the interaction between COVID-19 and the cardiovascular system. Cardiac-specific biomarkers provide a useful prognostic tool in helping identify patients with the severe disease early and allowing for escalation of treatment in a timely fashion. CONCLUSION: COVID-19 is an evolving pandemic with predominate respiratory manifestations, however, due to the interaction with the cardiovascular system; cardiac manifestations/complications feature heavily in this disease, with cardiac biomarkers providing important prognostic information.


title: COVID-19, Australia: Epidemiology Report 12 (Reporting week to 23:59 AEST 19 April 2020)

text: Confirmed cases in Australia notified up to 19 April 2020: notifications = 6,606; deaths = 69. The reduction in international travel and domestic movement, social distancing measures and public health action have likely slowed the spread of the disease. Notifications in Australia remain predominantly among people with recent overseas travel, with some locally-acquired cases being detected. Most locally-acquired cases can be linked back to a confirmed case, with a small portion unable to be epidemiologically linked. The distribution of overseas-acquired cases to locally-acquired cases varies by jurisdiction. The crude case fatality rate (CFR) in Australia remains low (1.0%) compared to the World Health Organization's globally-reported rate (6.8%) and to other comparable high-income countries such as the United States of America (4.7%) and the United Kingdom (13.5%). The low CFR is likely reflective of high case ascertainment including detection of mild cases. High case ascertainment enables public health response and reduction of disease transmission. Internationally, cases continue to increase. The rates of increase have started to slow in several regions, although it is too soon to tell whether this trend will be sustained. Interpretation of international epidemiology should be conducted with caution as it differs from country to country depending not only on the disease dynamics, but also on differences in case detection, testing and implemented public health measures.


Priority plan for invasive cardiac electrophysiology procedures during the coronavirus disease 2019 (COVID-19) pandemic


Effect of the COVID-19 pandemic on cancer treatment and research


Risk of hospitalization and death from COVID-19 infection in patients with chronic plaque psoriasis receiving a biologic treatment and renal transplant recipients in maintenance immunosuppressive treatment


From the Desk of the Editor in Chief


COVID-19 Interference with Renin-Angiotensin System in the Context of Heart Failure


Risk factors for severe COVID-19 illness in healthcare workers: Too many unknowns


title: Telemedicine During the COVID-19 Pandemic: Experiences From Western China

text: Disasters and pandemics pose unique challenges to health care delivery. As health care resources continue to be stretched due to the increasing burden of the coronavirus disease (COVID-19) pandemic, telemedicine, including tele-education, may be an effective way to rationally allocate medical resources. During the COVID-19 pandemic, a multimodal telemedicine network in Sichuan Province in Western China was activated immediately after the first outbreak in January 2020. The network synergizes a newly established 5G service, a smartphone app, and an existing telemedicine system. Telemedicine was demonstrated to be feasible, acceptable, and effective in Western China, and allowed for significant improvements in health care outcomes. The success of telemedicine here may be a useful reference for other parts of the world.


title: Mobility restrictions for the control of epidemics: When do they work?

text: Mobility restrictions - travel advisories, trade and travel bans, border closures and, in extreme cases, area quarantines or cordons sanitaires - are among the most widely used measures to control infectious diseases. Restrictions of this kind were important in the response to epidemics of SARS (2003), H1N1 influenza (2009), and Ebola (2014). However, they do not always work as expected. The imposition of a cordon sanitaire to control the 2014 West African Ebola outbreak, for example, is argued to have led to a higher-than-expected number of cases in the quarantined area. To determine when mobility restrictions reduce the size of an epidemic, we use a model of disease transmission within and between economically heterogeneous locally connected communities. One community comprises a low-risk, resource-rich, low-density population with access to effective medical resources. The other comprises a high-risk, resource-poor, high-density population without access to effective medical resources. We find that the overall size of an epidemic centered in the high-risk community is sensitive to the stringency of mobility restrictions between the two communities. Unrestricted mobility between the two risk communities increases the number of secondary cases in the low-risk community but reduces the overall epidemic size. By contrast, the imposition of a cordon sanitaire around the high-risk community reduces the number of secondary infections in the low-risk community but increases the overall epidemic size. The degree to which mobility restrictions increase or decrease the overall epidemic size depends on the level of risk in each community and the characteristics of the disease.


text: BACKGROUND: Mobility restrictions-trade and travel bans, border closures and, in extreme cases, area quarantines or cordons sanitaires-are among the most widely used measures to control infectious diseases. Restrictions of this kind were important in the response to epidemics of SARS (2003), H1N1 influenza (2009), Ebola (2014) and, currently in the containment of the ongoing COVID-19 pandemic. However, they do not always work as expected. METHODS: To determine when mobility restrictions reduce the size of an epidemic, we use a model of disease transmission within and between economically heterogeneous locally connected communities. One community comprises a low-risk, low-density population with access to effective medical resources. The other comprises a high-risk, high-density population without access to effective medical resources. FINDINGS: Unrestricted mobility between the two risk communities increases the number of secondary cases in the low-risk community but reduces the overall epidemic size. By contrast, the imposition of a cordon sanitaire around the high-risk community reduces the number of secondary infections in the low-risk community but increases the overall epidemic size. INTERPRETATION: Mobility restrictions may not be an effective policy for controlling the spread of an infectious disease if it is assessed by the overall final epidemic size. Patterns of mobility established through the independent mobility and trade decisions of people in both communities may be sufficient to contain epidemics.


title: Re-analysis of SARS-CoV-2-infected host cell proteomics time-course data by impact pathway analysis and network analysis: a potential link with inflammatory response

text: Coronavirus disease 2019 (COVID-19), caused by an outbreak of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in Wuhan, China, has led to an unprecedented health and economic crisis worldwide. To develop treatments that can stop or lessen the symptoms and severity of SARS-CoV-2 infection, it is critical to understand how the virus behaves inside human cells, and so far studies in this area remain scarce. A recent study investigated translatome and proteome host cell changes induced in vitro by SARS-CoV-2. Here, we use the publicly available proteomics data from this study to re-analyze the in vitro cellular consequences of SARS-CoV-2 infection by impact pathways analysis and network analysis. Notably, proteins linked to the inflammatory response, but also proteins related to chromosome segregation during mitosis, were found to be altered in response to viral infection. Upregulation of inflammatory response proteins is in line with the propagation of inflammatory reaction and lung injury that is observed in advanced stages of COVID-19 patients and which worsens with age.


title: Forecasting the Spread of Covid-19 Under Control Scenarios Using LSTM and Dynamic Behavioral Models

text: To accurately predict the regional spread of Covid-19 infection, this study proposes a novel hybrid model which combines a Long short-term memory (LSTM) artificial recurrent neural network with dynamic behavioral models. Several factors and control strategies affect the virus spread, and the uncertainty arisen from confounding variables underlying the spread of the Covid-19 infection is substantial. The proposed model considers the effect of multiple factors to enhance the accuracy in predicting the number of cases and deaths across the top ten most-affected countries and Australia. The results show that the proposed model closely replicates test data. It not only provides accurate predictions but also estimates the daily behavior of the system under uncertainty. The hybrid model outperforms the LSTM model accounting for limited available data. The parameters of the hybrid models were optimized using a genetic algorithm for each country to improve the prediction power while considering regional properties. Since the proposed model can accurately predict Covid-19 spread under consideration of containment policies, is capable of being used for policy assessment, planning and decision-making.


title: Gastrointestinal endoscopy in the era of the acute pandemic of coronavirus disease 2019: Recommendations by Japan Gastroenterological Endoscopy Society (Issued on April 9th, 2020)

text: All gastrointestinal endoscopic procedures have a high risk of aerosol contamination of the coronavirus disease 2019 (COVID-19) to endoscopists, nurses, and healthcare assistants. Given the current pandemic situation of COVID-19, the Japan Gastroenterological Endoscopy Society issued the recommendation for gastrointestinal (GI) endoscopy based on the status of COVID-19 as of April 9, 2020, in Japan: (i) indications for GI endoscopy in the pandemic of COVID-19; (ii) practical protective equipment for medical personnel depending on the risk for COVID-19; (iii) preprocedural management, such as pharyngeal local anesthesia using lidocaine spray which has a potential to generate the aerosols; (iv) ideal settings of the endoscopy room including the numbers of the staff and the patients; (v) postprocedural management, such as undressing and follow-up of the patients, as well as the involved staff, were documented to fit the practical scenarios in GI endoscopy, with the available data in Japan and the world. We believe that certain measures will prevent further spread of COVID-19.


title: Screen time for children and adolescents during the COVID-19 pandemic

text: The coronavirus 2019 (COVID-19) pandemic has led to laws and policies including national school closures, lockdown or shelter in place laws, and social distancing recommendations that may translate to higher overall screen time among children and adolescents for the duration of these laws and policies. These policies may need to be periodically re-instated to control future COVID-19 recurrences or other national emergencies. Excessive screen time is associated with cardiovascular disease risk factors such as obesity, high blood pressure, and insulin resistance because it increases sedentary time and is associated with snacking.


The COVID-19 pandemic and suicide by self-immolation: Is risk increasing?


How to help the free market fight coronavirus


A plague on both your houses: European and Asian responses to Coronavirus


title: Understanding SARS-CoV-2 endocytosis for COVID-19 drug repurposing

text: The quest for the effective treatment against coronavirus disease 2019 pneumonia caused by the severe acute respiratory syndrome (SARS)-coronavirus 2(CoV-2) coronavirus is hampered by the lack of knowledge concerning the basic cell biology of the infection. Given that most viruses use endocytosis to enter the host cell, mechanistic investigation of SARS-CoV-2 infection needs to consider the diversity of endocytic pathways available for SARS-CoV-2 entry in the human lung epithelium. Taking advantage of the well-established methodology of membrane trafficking studies, this research direction allows for the rapid characterisation of the key cell biological mechanism(s) responsible for SARS-CoV-2 infection. Furthermore, 11 clinically approved generic drugs are identified as potential candidates for repurposing as blockers of several potential routes for SARS-CoV-2 endocytosis. More broadly, the paradigm of targeting a fundamental aspect of human cell biology to protect against infection may be advantageous in the context of future pandemic outbreaks.


SARS-CoV-2 infection in two pediatric patients with immune cytopenias: A single institution experience during the pandemic


COVID-19 Cases and Deaths in Federal and State Prisons


title: Analyzing the Impact of Covid-19 Control Policies on Campus Occupancy and Mobility via Passive WiFi Sensing

text: The outbreak of virus has resulted in many different policies being enacted across the world to reduce the spread of the virus. These efforts range from increased social awareness and social distancing (Sweden) to full country-wide lockdowns (Singapore, most of Europe, many states in the US). The effectiveness of various policies in containing the spread of the disease is still being studied by researchers. In this paper, using WiFi data collected directly from the infrastructure, we present a detailed analysis of the impact of virus related policies on the staff and students of three different college campuses. Two of these campuses are in Singapore, while the third is in the Northeastern United States. Our study focuses on two different key metrics, 1) Occupancy, defined as the number of people in a building, on average, in a specific hour, and 2) Mobility, defined as the number of places visited by an individual, on average, in a specific hour. We use these two metrics since they provide a strong indicator of how likely it is for virus to spread if there is an outbreak. Our results show that online learning, split-team, and other space management policies are effective at lowering Occupancy. However, they do not change the Mobility patterns for individuals who are still moving around. Reducing Mobility requires introducing strict stay-at-home or lockdown orders, but doing so increases Occupancy in residential spaces. We present our results and then discuss the implications of the findings for policymakers.