title: Iran confronts coronavirus amid a ‘battle between science and conspiracy theories’

text: When Mehdi Variji fell ill with COVID-19 in early March, he holed up in his apartment in Tehran to ride it out The comforts of home didn’t seem to help As he grew short of breath and oxygen levels in his blood ebbed, Variji, a 43-year-old physician who ran Tehran’s 21st District Clinic, knew he faced a bleak prognosis “I’m taking three medicines, but they are not working on me,” he said in a cellphone video he shot a few days before his death A somber cell-phone video shot on 20 March shows four gowned and masked workers preparing his grave in the courtyard of a shrine in his hometown, Sari His wife and children stayed away because of the infection risk It was just after midnight on Nowruz, the first day of the Persian new year and normally the beginning of a joyous festival


title: Spatial Visualization of Cluster-Specific COVID-19 Transmission Network in South Korea During the Early Epidemic Phase

text: Background Coronavirus disease 2019 (COVID-19) has been rapidly spreading throughout China and other countries including South Korea. As of March 12, 2020, a total number of 7,869 cases and 66 deaths had been documented in South Korea. Although the first confirmed case in South Korea was identified on January 20, 2020, the number of confirmed cases showed a rapid growth on February 19, 2020 with a total number of 1,261 cases with 12 deaths based on the Korea Centers for Disease Control and Prevention (KCDC). Method Using the data of confirmed cases of COVID-19 in South Korea that are publicly available from the KCDC, this paper aims to create spatial visualizations of COVID-19 transmission between January 20, 2020 and February 19, 2020. Results Using spatial visualization, this paper identified two early transmission clusters in South Korea (Daegu cluster and capital area cluster). Using a degree-weighted centrality measure, this paper proposes potential super-spreaders of the virus in the visualized clusters. Conclusion Compared to various epidemiological measures such as the basic reproduction number, spatial visualizations of the cluster-specific transmission networks and the proposed centrality measure may be more useful to characterize super-spreaders and the spread of the virus especially in the early epidemic phase.


title: Predicting Covid-19's spread in Africa: rural and relatively young population may limit the spread and severity

text: Introduction: A novel coronavirus disease 2019 (COVID-19) has spread to all regions of the world. There is great uncertainty regarding how countries characteristics will affect the spread of the epidemic; to date, there are few studies that attempt to predict the spread of the epidemic in African countries. In this paper, we investigate the role of demographic patterns, urbanization and co-morbidities on the possible trajectories of COVID-19 in Ghana, Kenya, and Senegal. Methods: We use an augmented deterministic SIR model to predict the true spread of the disease, under the containment measures taken so far. We dis-aggregate the infected compartment into asymptomatic, mildly symptomatic, and severely symptomatic to match observed clinical development of COVID-19. We also account for age structures, urbanization, and co-morbidities (HIV, tuberculosis, anemia). Results: In our baseline model, we project that the peak of active cases will occur in July, subject to the effectiveness of policy measures. When accounting for the urbanization, and factoring-in co-morbidities, the peak may occur between June 2nd and June 17th (Ghana), July 22 and August 29 (Kenya), and finally May 28th and June15th. Successful containment policies could lead to even lower rates of severe infections. While most cases will be mild, we project accounting for rural areas and comorbidities and in the absence of policies further containing the spread that between 0.78 and 1.03%, 0.61 and 1.22%, and 0.60 and 0.84% of individuals in Ghana, Kenya, and Senegal will be actively infected and develop severe symptoms at the peak of the epidemic. Conclusion: Compared to Europe, Africa's younger and rural population may modify the severity of the epidemic. The large youth population may lead to more infections but most of these infections will be asymptomatic or mild, and will probably go undetected. The higher prevalence of underlying conditions must be considered.


title: Performance verification of detecting COVID-19 specific antibody by using four chemiluminescence immunoassay systems

text: Background The purpose of current study is to evaluate the analytical performance of seven kits for detecting IgM/IgG antibody of corona virus (2019-nCoV) by using four chemiluminescence immunoassay systems. Methods 50 patients diagnosed with 2019-nCoV infection and 130 controls without corona virus infection from the people's hospital of Chongqing were enrolled in current retrospective study. Four chemiluminescence immunoassay systems including seven IgM/IgG antibody detection Kits for 2019-nCoV (A_IgM, A_IgG, B_IgM, B_IgG, C_IgM, C_IgG, D_Ab) were employed to detecting antibody concentration. Chi-square test,receiver operating characteristic (ROC) curve and Youden's index were demonstrated to verify the cutoff value of each detection system. Results The repeatability verification results of the A, B, C, and D system are all qualified. D-Ab performances best (92% sensitivity and 99.23% specificity), and B_IgM worse than other systems. Except for the system of A_IgM and C_IgG, the optimal diagnostic thresholds and cutoff value of other kits from recommendations are inconsistent with each other. B_IgM got the worst AUC and C_IgG had the best diagnostic accuracy. More importantly, B_IgG system have the highest false positive rate for testing patients with AIDS, tumor and pregnant. A_IgM system test showed highest false positive rates among elder over 90 years old. Conclusions Systems for CoVID-2019 IgM/IgG antibody test performance difference. Serum diagnosis kit of D-Ab is the most reliable detecting system for 2019-nCoV antibody, which can be used as an alternative method for nucleic acid testing.


The importance of knowledge in respiratory physiotherapy–Editorial


title: Double COVID-19 Confirmed Case Fatality Rate in Countries with High Elderly Female Vitamin D Deficiency Prevalence

text: A number of clues point to a possible role of vitamin D in fighting COVID-19: a reduction in case growth speed with solar zenith angle, higher fatality rate in black people, lower fatality rate in populations that spend more time outdoors. Yet a direct demonstration that vitamin D deficiency is associated with COVID-19 fatalities has remained elusive. We show here in a comparison of 32 countries that countries with high prevalence of vitamin D deficiency among elderly females show a confirmed case fatality rate twice as high as those with low prevalence. We then show that this effect cannot be explained by differences in life expectancy between countries. A mechanistic role for vitamin D in the severity of COVID-19 is proposed.


title: Persistent SARS-CoV-2 replication in severe COVID-19

text: Background: The diagnosis of SARS-CoV-2 infection is based on viral RNA detection by real-time RT-PCR (rRT-PCR) in respiratory samples. This detection can remain positive for weeks without implying virus viability. Methods: We have performed cell culture to assess viral replication in 106 respiratory samples rRT-PCR positive for SARS-CoV-2 from 105 patients with COVID-19. Fifty were samples from 50 patients with mild forms of COVID-19 who did not require hospital admission. Fifty-six samples were obtained from 55 hospitalized patients with severe pneumonia. Samples were obtained at different time points covering the time from clinical diagnosis to the follow up during hospital care. Results: In 49 samples (49/106, 46.2%) a cytopathic effect (CPE) was detected in cell culture. Our study demonstrates that while in patients with mild COVID-19, viral viability is maintained in fact up to 10 days in patients with severe COVID-19 the virus can remain viable for up to 32 days after the onset of symptoms. Patients with severe COVID-19 as compared with mild cases, presented infective virus in a significantly higher proportion in samples with moderate or low viral load (Ct value > 26): 22/46 (47.8%) versus 7/38 (18.4%), (p <0.01), respectively. Conclusions: Persistent SARS-CoV-2 replication could be demonstrated in severe COVID-19 cases for periods up to 32 days after the onset of symptoms and even at high Ct values. COVID-19 severity is a more determining factor for viral viability than the time elapsed since the onset of symptoms or the Ct value obtained in the RT-PCR assay.


title: A Logistic Curve in the SIR Model and Its Application to Deaths by COVID-19 in Japan

text: Approximate solutions of SIR equations are given, ased on a logistic growth curve in the Biology. These solutions are applied to fix the basic reproduction number $alpha$ and the removed ratio $c$, especially from data of accumulated number of deaths in Japan COVID-19. We then discuss the end of the epidemic. These logistic curve results are compared with the exact results of the SIR model. }


title: log(x+1)* and log(1+x)*

text: Single-cell RNA-seq technologies have been successfully employed over the past decade to generate many high resolution cell atlases. These have proved invaluable in recent efforts aimed at understanding the cell type specificity of host genes involved in SARS-CoV-2 infections. While single-cell atlases are based on well-sampled highly-expressed genes, many of the genes of interest for understanding SARS-CoV-2 can be expressed at very low levels. Common assumptions underlying standard single-cell analyses don’t hold when examining low-expressed genes, with the result that standard workflows can produce misleading results.


title: The impact of containment measures and air temperature on mitigating the transmission of COVID-19: a novel data-based comprehensive modeling analysis

text: Background The COVID-19 is spreading worldwide, early non-pharmaceutical Interventions (NPIs) is crucial for mitigating COVID-19 epidemic. We aim to evaluate the impact of containment measures and the epidemic features of COVID-19 under social NPIs in Mainland China. Methods Under the strict social NPIs, the spreading pattern of COVID-19 in China has changed into mostly clustered intra-household or intro-acquaintance transmission, and we established a stochastic NPIs model, named ScEIQRsh to fit the epidemic and NPIs data of each province in China. Results This ScEIQRsh model could be well fitted with both the reported number of accumulative confirmed cases and epidemiological survey (EPS)-based quarantined cases of each province in China. We found that the median transmission rate of COVID-19 among acquaintances was 10.22 (IQR 8.47, 12.35) across Mainland China and the COVID-19 spreading was prevented by NPIs implementation within 25-30 days. Among NPIs, measures to diminish contactable susceptible (Sc), such as staying home, travel constraint etc. and measures to avoid delay of diagnosis and hospitalized isolation ({eta}) were more effective than EPS-based quarantine ({kappa},{rho} or surveyQ). Upon the fitted models, the proportion of asymptomatic infectors was determined to be 14.88% (IQR 8.17%, 25.37%). The median incubation period and communicable period of COVID-19 under NPIs were 4.16 (IQR 3.60, 4.71) and 6.77 (IQR 4.53, 10.36) days respectively, and the median time from exposed to being contagious was 2.39 (IQR 2.26, 2.56) days. Besides, we identified that the optimal temperature for COVID-19 spreading was in the range of 5{degrees}C-14{degrees}C. Conclusion This study provided useful suggestions about NPI strategy for the prevention of COVID-19 spreading, which should be helpful for the control of COVID-19, as well as other similar infectious disease.


title: Extensions of the SEIR Model for the Analysis of Tailored Social Distancing and Tracing Approaches to Cope with COVID-19

text: In the context of the COVID-19 pandemic, governments worldwide face the challenge of designing tailored measures of epidemic control to provide reliable health protection while allowing more societal and economic activity. In this paper, we propose an extension of the epidemiological SEIR model to enable a detailed analysis of commonly discussed tailored measures of epidemic control - among them group-specific protection and the use of tracing apps. We introduce groups into the SEIR model that may differ both, in their underlying parameters as well as in their behavioral response to public health interventions. We allow for different infectiousness parameters within and across groups, different asymptomatic, hospitalization, and lethality rates, as well as different take-up rates of tracing apps. Our results visualize the sharp trade-offs between different goals of epidemic control, namely a low death toll, avoiding overload of the health system, and a short duration of the epidemic. We show that a combination of tailored mechanisms, e.g., the protection of vulnerable groups together with a “trace & isolate” approach, can be effective in preventing a high death toll. Protection of vulnerable groups without further measures requires unrealistically strict isolation. A key insight is that high compliance is critical for the effectiveness of a “trace & isolate” approach. Our model allows to analyze the interplay of group-specific social distancing and tracing also beyond our case study in scenarios with a large number of groups reflecting, e.g., sectoral, regional, or age differentiation and group-specific take-up rates for tracing apps.


title: Cost and Environmental Impact Assessment of Stainless Steel Microreactor Plates using Binder Jetting and Metal Injection Molding Processes

text: Abstract Modular chemical process intensification provides a platform for down-scaling chemical process equipment and reducing the number of chemical process steps through increased surface area-to-volume ratios and increased heat and mass transfer rates. In turn, these improvements reduce capital investment and operating costs, facility size, feedstock consumption, and emissions from chemical processing. However, conventional microreactor fabrication has employed inefficient material removal and bonding processes to create devices formed of layers of metal shim stock. This research investigates the relative costs and environmental impacts of metal additive manufacturing and powder metallurgy processes for making microreactor components for a range of market sizes. Binder jetting additive technology and metal injection molding were studied for producing two plates for a microscale chemical reactor used in dimethyl ether production. The manufacturing process design method was applied to quantify the cost of goods sold, and life cycle assessment was applied to model environmental impacts. The manufacturing process design analysis showed that metal injection molding would have better cost performance than binder jetting for a greenfield facility due to lower capital tooling cost and shorter cycle time in making the green part. However, the life cycle assessment indicated, at lower annual production volumes, metal injection molding would have higher cumulative energy demand, global warming potential, and other impacts due to the mold plates and solvent use. While this work reports on model development and a single use case, it motivates a focus on validating analysis results for a range of part sizes and geometries, as well as alternative production routes. This future work would provide design and manufacturing decision makers with richer information regarding process capabilities, production costs, and product environmental impacts for a range of product complexities.


title: APPENDIX A CDC™ Severe Acute Respiratory Syndrome

text: Unknown


title: Comprehensive evolution and molecular characteristics of a large number of SARS-CoV-2 genomes revealed its epidemic trend and possible origins

text: Objectives To reveal epidemic trend and possible origins of SARS-CoV-2 by exploring its evolution and molecular characteristics based on a large number of genomes since it has infected millions of people and spread quickly all over the world. Methods Various evolution analysis methods were employed. Results The estimated Ka/Ks ratio of SARS-CoV-2 is 1.008 or 1.094 based on 622 or 3624 SARS-CoV-2 genomes, and the time to the most recent common ancestor (tMRCA) was inferred in late September 2019. Further 9 key specific sites of highly linkage and four major haplotypes H1, H2, H3 and H4 were found. The Ka/Ks, detected population size and development trends of each major haplotype showed H3 and H4 subgroups were going through a purify evolution and almost disappeared after detection, indicating H3 and H4 might have existed for a long time, while H1 and H2 subgroups were going through a near neutral or neutral evolution and globally increased with time. Notably the frequency of H1 was generally high in Europe and correlated to death rate (r>0.37). Conclusions In this study, the evolution and molecular characteristics of more than 16000 genomic sequences provided a new perspective for revealing epidemiology of SARS-CoV-2.


title: The initial response of the laboratory diagnosis team to SARS-CoV-2 in Japan and the current situation

text: In December 2019 a pneumonia outbreak by the novel coronavirus, SARS-CoV-2, occurred in Wuhan City, China The disease was named as COVID-19 Information on the SARS-CoV-2 genomic sequence was first released on 10 January 2020 We urgently started development of genetic diagnostic methods for SARS-CoV-2 On 14 January, soon after receiving the prototype designed primers, we have received the first clinical specimens suspected for COVID-19 We urgently started assessment of the primers and the laboratory diagnosis testing for SARS-CoV-2 in a parallel way After the nightlong assessment/testing, the first COVID19 case in Japan was confirmed The patient was a returnee from Wuhan Until 22 January, we have established the nested RT-PCR diagnostic method/protocol for SARS-CoV-2, and urgently distributed the primer set/protocol to ～ 80 prefectural public health laboratories (PHLs) nationwide, because the Chun Jie holidays starts in China on 24 January and many Chinese tourists visit Japan As we concerned, sporadic COVID-19 cases with an epidemiological linkage to Wuhan have detected in Tokyo, Aichi, Nara, Hokkaido, and Osaka prefectures after 24 January Following the nested RT-PCR method, we have established the real-time RT-PCR diagnostic methods for SARS-CoV-2, and distributed the primer/probe set to ～ 80 PHLs on 30–31 January However, the laboratory workload increased dramatically, because Japan has started to accept 829 returnees (15 were shown to be SARS-CoV-2-positive later) from Wuhan using government chartered flights on 29 January and screen ～3,500 passengers and crew (>600 were shown to be SARS-CoV-2-positive later) on a cruise ship quarantined in Yokohama for SARS-CoV-2 About one month and a half has passed, a significant number of COVID-19 cases via unknown infection route are currently detected in many prefectures in Japan (total 239 cases, as of 2 March 2020)


title: Reconstructing SARS-CoV-2 response signaling and regulatory networks

text: Several molecular datasets have been recently compiled to characterize the activity of SARS-CoV-2 within human cells. Here we extend computational methods to integrate several different types of sequence, functional and interaction data to reconstruct networks and pathways activated by the virus in host cells. We identify the key proteins in these networks and further intersect them with genes differentially expressed at conditions that are known to impact viral activity. Several of the top ranked genes do not directly interact with virus proteins though some were shown to impact other coronaviruses highlighting the importance of large scale data integration for understanding virus and host activity.


title: Food Safety and COVID-19: Precautionary Measures to Limit the Spread of Coronavirus at Food Service and Retail Sector

text: Coronavirus pandemic has drastically upended the daily life routines of human beings and has wide wide-ranging effects on entire sectors of society The food sector is also susceptible and substantially harmed by the influence of intensive effects of coronavirus To ensure food safety and limit the spread of coronavirus at food services and retail sector has become a challenge where delicate and fresh food items are served and delivered to the customers, which have passed through a series of operational steps from order taking, food receiving, preparation of food, packing, delivery to customers At each step, there is a possibility of food handlers to touch the food surface or food directly and if food handler is not following appropriate precautionary measures e g hand hygiene, sanitization and disinfection, social distances, and is touching, then it can be a possible source of coronavirus spread Since there is no evidence that food is a coronavirus transmission route but during the food operations, improper sanitization and disinfection of key touchpoints, food contact, nonfood contact, equipment and cleaning tools surfaces and close contact of food handlers with staff and customers not only can put themselves on risk but can also be a risk for customers Food services and the retail sector should make sure proper hand hygiene, approved sanitizers and disinfectants in use, follow social distances at workstations and while interacting with the customers Finally, the business should be vigilant to monitor the temperature of staff and incoming guests to identify if there may any sick person to avoid from further spread of coronavirus and shall report to concerned health authorities if anyone symptoms matching with COVID-19


title: Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 45,000 UK adults

text: There are concerns that both the experience of adversities during the COVID-19 pandemic and worries about experiencing adversities will have substantial and lasting effects on physical and mental health. One pathway through which both experience of and worries about adversity may impact health is through effects on sleep. Psychosocial stress can reduce sleep length and increase sleep disturbance, which can in turn reduce individuals ability to cope and respond to stressors, and worsen health outcomes. Therefore this study explored whether either worries about adversities during the pandemic or the experience of adversities were associated with impaired sleep. We used data from 45,109 adults in the COVID-19 Social Study assessed weekly from 01/04/2020-11/05/2020 in the UK during the pandemic. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. We used random-effect within-between models that automatically account for all time-invariant confounders. Both the total number of adversity experiences and total number of adversity worries were associated with lower quality sleep. Each additional experience was associated with a 1.17 (95% CI = 1.11, 1.24) times higher odds of poor quality sleep while each additional worry was associated with a 1.20 (95% CI = 1.17, 1.23) times higher odds of poor quality sleep. When considering specific experiences and worries, all worries and experiences were significantly related to poorer quality sleep except experiences relating to employment and finances. Having a larger social network offered some buffering effects on associations but there was limited further evidence of moderation by social or psychiatric factors. Results suggest that poor sleep may be a mechanism by which adversities are affecting mental health and highlight the importance of interventions that seek to reassure individuals and support adaptive coping strategies during the pandemic.


title: Deep Learning-Based Intelligent Process Monitoring of Directed Energy Deposition in Additive Manufacturing with Thermal Images

text: Abstract Additive manufacturing (AM) techniques have been successfully developed in the past years with the great potential of overcoming the existing obstacles in traditional manufacturing. In order to improve the quality of the manufactured parts and reduce costs, it is important to timely and accurately monitor the AM process during manufacturing. However, it remains a challenging task due to the high complexity of the AM process and the difficulty in processing the condition monitoring data. This paper proposes a deep learning-based process monitoring method for directed energy deposition in AM. The thermal images collected during manufacturing are used to identify the process condition, and a deep convolutional neural network model is proposed to build an end-to-end condition monitoring framework. Experiments on a real directed energy deposition dataset in AM are carried out for validation. The results suggest the proposed method offers a promising approach in process monitoring based on the industrial images. Furthermore, little prior knowledge on signal processing and AM is required, that largely facilitates the potential applications in the real industrial scenarios.


title: Nonlinear Markov Chain Modelling of the Novel Coronavirus (Covid-19) Pandemic

text: Almost all countries around the world are struggling against the novel coronavirus (Covid-19) pandemic. In this paper, a nonlinear Markov chains model is proposed in order to analyse and to understand the behaviour of the Covid-19 pandemic. The data from China was used to build up the presented model. Thereafter, the nonlinear Markov chain model is employed to estimate the daily new Covid-19 cases in some countries including Italy, Spain, France, UK, the USA, Germany, Turkey, and Kuwait. In addition, the correlation between the daily new Covid-19 cases and the daily number of deaths is examined.


title: Rapid SARS-CoV-2 whole genome sequencing for informed public health decision making in the Netherlands

text: SARS-CoV-2 is a novel coronavirus that has rapidly spread across the globe. In the Netherlands, the first case of SARS-CoV-2 has been notified on the 27th of February. Here, we describe the first three weeks of the SARS-CoV-2 outbreak in the Netherlands, which started with several different introductory events from Italy, Austria, Germany and France followed by local amplification in, and later also, outside the South of the Netherlands. The timely generation of whole genome sequences combined with epidemiological investigations facilitated early decision making in an attempt to control local transmission of SARS-CoV-2 in the Netherlands.


Ethnographic fieldwork quarantined


title: Reconnecting tourism after COVID-19: the paradox of alterity in tourism areas

text: One of the transformations induced by the almost complete halt of tourism due to the COVID-19 pandemic has been a turning of the tourism sectors to a greater orientation towards their host communities. The enclavic tendencies of tourism areas, along with a multilayered approach to alterity gives insight into ongoing changes in the Quebec, Canada, tourism industry that have been enhanced by the COVID-19 pandemic. These changes points to a relinking of tourism to the needs of the host communities as part of a survival strategy in a time when there are no tourists, and could become, in the long run, a resilience strategy. On the other hand, there is a possibility of a reinforcement of the alterity and a further delinking of tourism in a “6 foot-tourism world” where sanitary safety would be at the core of a closed and controlled tourism development.


title: Utility of Pan-Family Assays for Rapid Viral Screening: Reducing Delays in Public Health Responses During Pandemics

text: Background The SARS-CoV-2 pandemic has highlighted deficiencies in the testing capacity of many developed countries during the early stages of emerging pandemics. Here we describe the potential for pan-family viral assays to improve early accessibility of large-scale nucleic acid testing. Methods Coronaviruses and SARS-CoV-2 were used as a case-study for investigating the utility of pan-family viral assays during the early stages of a novel pandemic. Specificity of a pan-coronavirus (Pan-CoV) assay for viral detection was assessed using the frequency of common human coronavirus (HCoV) species in key populations. A reported Pan-CoV assay was assessed to determine sensitivity to SARS-CoV-2 and 59 other coronavirus species. The resilience of the primer target regions of this assay to mutation was assessed in 8893 high quality SARS-CoV-2 genomes to predict ongoing utility during pandemic progression. Findings Due to infection with common HCoV species, a Pan-CoV assay would return a false positive for as few as 1% of asymptomatic adults, but up to 30% of immunocompromised patients displaying symptoms of respiratory disease. Two of the four reported pan-coronavirus assays would have identified SARS-CoV-2 and we demonstrate that with small adjustments to the primers, these assays can accommodate novel variation observed in animal coronaviruses. The assay target region of one well established Pan-CoV assay is highly resistant to mutation compared to regions targeted by other widely applied SARS-CoV-2 RT-PCR assays. Interpretation Pan-family assays have the potential to greatly assist management of emerging public health emergencies through prioritization of high-resolution testing or isolation measures, despite limitations in test specificity due to cross-reactivity with common pathogens. Targeting highly conserved genomic regions make pan-family assays robust and resilient to mutation of a given virus. This approach may be applicable to other viral families and has utility as part of a strategic stockpile of tests maintained to better contain spread of novel diseases prior to the widespread availability of specific assays.


title: The infection fatality rate of COVID-19 inferred from seroprevalence data

text: Objective To estimate the infection fatality rate of coronavirus disease 2019 (COVID-19) from data of seroprevalence studies. Methods Population studies with sample size of at least 500 and published as peer-reviewed papers or preprints as of May 12, 2020 were retrieved from PubMed, preprint servers, and communications with experts. Studies on blood donors were included, but studies on healthcare workers were excluded. The studies were assessed for design features and seroprevalence estimates. Infection fatality rate was estimated from each study dividing the number of COVID-19 deaths at a relevant time point by the number of estimated people infected in each relevant region. Correction was also attempted accounting for the types of antibodies assessed. Results Twelve studies were identified with usable data to enter into calculations. Seroprevalence estimates ranged from 0.113% to 25.9% and adjusted seroprevalence estimates ranged from 0.309% to 33%. Infection fatality rates ranged from 0.03% to 0.50% and corrected values ranged from 0.02% to 0.40%. Conclusions The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients as well as multiple other factors. Estimates of infection fatality rates inferred from seroprevalence studies tend to be much lower than original speculations made in the early days of the pandemic.


title: SARS-CoV-2 envelope protein causes acute respiratory distress syndrome (ARDS)-like pathological damage and constitutes an antiviral target

text: Cytokine storm and multi-organ failure are the main causes of SARS-CoV-2-related death. However, the origin of the virus’ excessively damaging abilities remains unknown. Here we show that the SARS-CoV-2 envelope (2-E) protein alone is sufficient to cause acute respiratory distress syndrome (ARDS)-like damage in vitro and in vivo. Overexpression of 2-E protein induced rapid pyroptosis-like cell death in various susceptible cells and robust secretion of cytokines and chemokines in macrophages. Intravenous administration of purified 2-E protein into mice caused ARDS-like pathological damage in lung and spleen. Overexpressed 2-E protein formed cation channels in host cell membranes, eventually leading to membrane rupture. Newly identified channel inhibitors exhibited potent anti-SARS-CoV-2 activity and excellent protective effects against the 2-E-induced damage both in vitro and in vivo. Importantly, their channel inhibition, cell protection and antiviral activities were positively correlated with each other, supporting 2-E is a promising drug target against SARS-CoV-2.


title: An integrated deterministic-stochastic approach for predicting the long-term trajectories of COVID-19

text: The ongoing COVID-19 pandemic is one of the major health emergencies in decades that affected almost every country in the world. As of May 10, 2020, it has caused an outbreak with more than 41,78,000 confirmed infections and more than 2,83,000 reported deaths globally. Due to the unavailability of an effective treatment (or vaccine) and insufficient evidence regarding the transmission mechanism of the epidemic, the world population is currently in a vulnerable position. The daily cases data sets of COVID-19 for profoundly affected countries represent a stochastic process comprised of deterministic and stochastic components. This study proposes an integrated deterministic-stochastic approach to predict the long-term trajectories of the COVID-19 cases for Italy and Spain. The deterministic component of the daily-cases univariate time-series is assessed by an extended SIR (SIRCX) model whereas its stochastic component is modeled using an autoregressive (AR) time series model. The proposed integrated SIRCX-AR (ISA) approach based on two operationally distinct modeling paradigms utilizes the superiority of both the deterministic SIRCX and stochastic AR models to find the long-term trajectories of the epidemic curves. Experimental analysis based on the proposed ISA model suggests that the estimated numbers of cases in Italy and Spain between 11 May, 2020 -- 09 June, 2020 will be 10982 (6383--15582) and 13731 (3395--29013), respectively. Additionally, the expected number of daily cases on 09 July, 2020 for Italy and Spain are estimated to be 30 (0--183) and 92 (0--602), respectively. These log-term forecasts for Italy and Spain of the coming outbreaks will be very useful for the effective allocation of health care resources to mitigate COVID-19.


title: Confirmation Bias in the Era of Mobile News Consumption: The Social and Psychological Dimensions

text: Confirmation bias is the predisposition to only consume the news, or what appears to be news, that confirms our pre-existing attitudes and beliefs, e.g. anti-vaxxers reading only anti-vaccination material. This plays out, for example, in reading only the news/postings that fit our political or social leaning. It is done to avoid cognitive dissonance as well as eventual disfavor from our social network. Confirmation bias is an important element supporting the diffusion of false news via digital platforms. It is important that we understand the underlying cognitive as well as the social mechanisms and dynamics, e.g. can the news of COVID-19 disrupt or eventually further entrench the cognitive and social dynamics of anti-vaxxer individuals and groups?.


title: COVID-19 research in Wikipedia

text: Wikipedia is one of the main sources of free knowledge on the Web. During the first few months of the pandemic, over 5,200 new Wikipedia pages on COVID-19 have been created and have accumulated over 400M pageviews by mid June 2020.1 At the same time, an unprecedented amount of scientific articles on COVID-19 and the ongoing pandemic have been published online. Wikipedia’s contents are based on reliable sources, primarily scientific literature. Given its public function, it is crucial for Wikipedia to rely on representative and reliable scientific results, especially so in a time of crisis. We assess the coverage of COVID-19-related research in Wikipedia via citations to a corpus of over 160,000 articles. We find that Wikipedia editors are integrating new research at a fast pace, and have cited close to 2% of the COVID-19 literature under consideration. While doing so, they are able to provide a representative coverage of COVID-19-related research. We show that all the main topics discussed in this literature are proportionally represented from Wikipedia, after accounting for article-level effects. We further use regression analyses to model citations from Wikipedia and show that Wikipedia editors on average rely on literature which is highly cited, widely shared on social media, and has been peer-reviewed.


title: Molecular analysis of several in-house rRT-PCR protocols for SARS-CoV-2 detection in the context of genetic variability of the virus in Colombia.

text: The COVID-19 pandemic caused by SARS-CoV-2 is a public health problem unprecedented in the recent history of humanity. Different in-house real-time RT-PCR (rRT-PCR) methods for SARS-CoV-2 diagnosis and the appearance of genomes with mutations in primer regions have been reported. Hence, whole-genome data from locally-circulating SARS-CoV-2 strains contribute to the knowledge of its global variability and the development and fine-tuning of diagnostic protocols. To describe the genetic variability of Colombian SARS-CoV-2 genomes in hybridization regions of oligonucleotides of the main in-house methods for SARS-CoV-2 detection, RNA samples with confirmed SARS-CoV-2 molecular diagnosis were processed through next-generation sequencing. Primers/probes sequences from 13 target regions for SARS-CoV-2 detection suggested by 7 institutions and consolidated by WHO during the early stage of the pandemic were aligned with Muscle tool to assess the genetic variability potentially affecting their performance. Finally, the corresponding codon positions at the 3' end of each primer, the open reading frame inspection was identified for each gene/protein product. Complete SARS-CoV-2 genomes were obtained from 30 COVID-19 cases, representative of the current epidemiology in the country. Mismatches between at least one Colombian sequence and five oligonucleotides targeting the RdRP and N genes were observed. The 3' end of 4 primers aligned to the third codon position, showed high risk of nucleotide substitution and potential mismatches at this critical position. Genetic variability was detected in Colombian SARS-CoV-2 sequences in some of the primer/probe regions for in-house rRT-PCR diagnostic tests available at WHO COVID-19 technical guidelines; its impact on the performance and rates of false-negative results should be experimentally evaluated. The genomic surveillance of SARS-CoV-2 is highly recommended for the early identification of mutations in critical regions and to issue recommendations on specific diagnostic tests to ensure the coverage of locally-circulating genetic variants.


title: Review of evidence available on hesperidin-rich products as potential tools against COVID-19 and hydrodynamic cavitation-based extraction as a method of increasing their production

text: Based on recent computational and experimental studies, hesperidin, a bioactive flavonoid abundant in citrus peel, stands out for its high binding affinity to the main cellular receptors of SARS-CoV-2, outperforming drugs already recommended for clinical trials. Thus, it is very promising for prophylaxis and treatment of COVID-19, along with other coexistent flavonoids such as naringin, which could help restraining the proinflammatory overreaction of the immune system. Controlled hydrodynamic cavitation processes showed the highest speed, effectiveness and efficiency in the integral and green aqueous extraction of flavonoids, essential oils and pectin from citrus peel waste. After freeze-drying, the extracted pectin showed high quality and excellent antioxidant and antibacterial activities, attributed to flavonoids and essential oils adsorbed and concentrated on its surface. This study reviews the recent evidence about hesperidin as a promising molecule, and proposes a feasible and affordable process based on hydrodynamic cavitation for the integral aqueous extraction of citrus peel waste resulting in hesperidin-rich products, either aqueous extracts or pectin tablets. The uptake of this process on a relevant scale is urged, in order to achieve large-scale production and distribution of hesperidin-rich products. Meanwhile, experimental and clinical studies could determine the effective doses either for therapeutic and preventive purposes.


title: Projection of COVID-19 Pandemic in Uganda

text: COVID-19 (Corona Virus) is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-COV-2). The virus that was first discovered in China Wuhan Province about 3 months ago (first cases were reported in Wuhan on December 31st, 2019) has spread world wide. The six (6) top countries (excluding China) most affected so far include; USA, Italy, Spain, Germany, France, and Iran. With Italy showing the highest death toll. In Uganda where it was discovered on 19/3/2020 with one (01) case has just in nine (9) days, increased to thirty (30) infected individuals. This model is a wake-up call over the rate at which COVID-19 is likely to spread throughout the country. Thus it is a guide for policymakers and planners to benchmark on for solutions to this deadly virus.


title: An international assessment of the COVID-19 pandemic using ensemble data assimilation

text: This work shows how one can use iterative ensemble smoothers to effectively estimate parameters of an SEIR model with age-classes and compartments of sick, hospitalized, and dead. The data conditioned on are the daily numbers of accumulated deaths and the number of hospitalized. Also, it is possible to condition on the number of cases obtained from testing. We start from a wide prior distribution for the model parameters; then, the ensemble conditioning leads to a posterior ensemble of estimated parameters leading to model predictions in close agreement with the observations. The updated ensemble of model simulations have predictive capabilities and include uncertainty estimates. In particular, we estimate the effective reproductive number as a function of time, and we can assess the impact of different intervention measures. By starting from the updated set of model parameters, we can make accurate short-term predictions of the epidemic development given knowledge of the future effective reproductive number. Also, the model system allows for the computation of long-term scenarios of the epidemic under different assumptions. We have applied the model system on data sets from several countries with vastly different developments of the epidemic, and we can accurately model the development of the COVID-19 outbreak in these countries. We realize that more complex models, e.g., with regional compartments, may be desirable, and we suggest that the approach used here should be applicable also for these models.


title: Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China

text: Coronavirus disease 2019 (COVID-19) is a respiratory disorder caused by the highly contagious SARS-CoV-2. The immunopathological characteristics of COVID-19 patients, either systemic or local, have not been thoroughly studied. In the present study, we analyzed both the changes in the cellularity of various immune cell types as well as cytokines important for immune reactions and inflammation. Our data indicate that patients with severe COVID-19 exhibited an overall decline of lymphocytes including CD4+ and CD8+ T cells, B cells, and NK cells. The number of immunosuppressive regulatory T cells was moderately increased in patients with mild COVID-19. IL-2, IL-6, and IL-10 were remarkably up-regulated in patients with severe COVID-19. The levels of IL-2 and IL-6 relative to the length of hospital stay underwent a similar "rise-decline" pattern, probably reflecting the therapeutic effect. In conclusion, our study shows that the comprehensive decrease of lymphocytes, and the elevation of IL-2 and IL-6 are reliable indicators of severe COVID-19.


title: Recovery from COVID-19 Pneumonia in a Patient with Acute Severe Colitis

text: Introduction: The coronavirus disease 2019 (COVID-19) pandemic has increased concern regarding SARS-CoV-2 infection in inflammatory bowel disease (IBD) patients, especially those on immunosuppressive therapies or with active disease. There are limited reports describing the clinical features of COVID-19 in an IBD population, and the impact of immunosuppression on the severity of the infection remains unclear. Case Report: A 33-year-old female patient with a long history of ulcerative colitis, poorly controlled, was admitted with COVID-19 a few days after being discharged from the hospital for treatment of acute severe ulcerative colitis. High-risk factors for COVID-19 complications, i.e., high-dose steroids (40 mg prednisone) and severe active disease, were present at admission. Despite the development of extensive pulmonary involvement, the patient had a favorable outcome. Discussion: Management of IBD patients during the COVID-19 pandemic has been challenging. Measures to minimize the potential risk of SARS-CoV-2 infection, including strict social distancing and self-isolation, in the IBD population have been recommended, especially for high-risk patients. Although steroid tapering and persistence of biologics are advised by professional groups, the best treatment strategy for IBD patients presenting a flare during the outbreak has yet to be defined.


Cancer and COVID-19: A war on multiple fronts


title: Reflection of connectivism in medical education and learning motivation 4 during COVID-19

text: The COVID-19 pandemic has not only affected the global healthcare and economy but threatened the world of education altogether. Malaysia is not spared from this pandemic as all universities were forced to close and initiate online learning with the implementation of Movement Control Order since mid-March 2020.The abrupt shift from conventional medical education to fully virtual learning definitely deserves a reflection on how it affects the learning motivation among medical students. Hence, this is the first study that compares the effect of digital learning on learning motivation among medical students in Universiti Kebangsaan Malaysia (UKM) prior to and during the COVID-19 pandemic period. A modified Students Motivation towards Science Learning (SMTSL) was used to assess the learning motivation of UKM medical students throughout Year 1-5. The number of students that use digital learning during COVID-19 is significantly higher compared to before COVID-19 (p<0.05). However, there is no significant difference (p=0.872) in learning motivation among medical students before and during COVID-19 crisis. Higher frequency in digital learning usage frequency does not exert a great impact on learning motivation. Reflections from each participant were collated to justify the current situation. This could be due to motivation coming from the very choice to pursue medicine as a doctor, which is mainly influenced by intrinsic motivation, and ability to adapt in difficult situations. Thus, medical educators should be creative in enhancing extrinsic motivation by making use of digital learning as a platform so that medical students are able to independently fish for information in the vast pool of digital information and apply in actual medical practice in the future for life-long learning.


title: Monitoring Health Systems by Estimating Excess Mortality

text: Monitoring health systems during and after natural disasters, epidemics, or outbreaks is critical for guiding policy decisions and interventions. In the case of natural disasters the effects on public health can be direct or indirect. Direct effects are defined as those resulting from the immediate destruction such as drowning and trauma from flying debris, while indirect effects are delayed, longer lasting, and, often harder to measure or detect. In the case of outbreaks and epidemics, lack of comprehensive testing or reporting can lead to challenges in measuring direct effects, while indirect effects can arise due to, for example, increased stress levels or reduced access to health services. When the effects are long lasting and difficult to detect in the short term, the accumulated effects can actually be devastating. Improved access to mortality data provides an opportunity to develop data-driven approaches that can help monitor health systems and quantify the effects of natural disasters, epidemics, or outbreaks. Here we describe a statistical methodology and software that facilitates data-driven approaches. Our work was motivated by events occurring in Puerto Rico after the passage of Hurricane Maria, but can be applied in other contexts such as estimating the effects of an epidemic in the presence of inaccurate reporting of cases. We demonstrate the utility of our tools by applying it to data related to six hurricanes and data related to the COVID-19 pandemic. We also searched for other unusual events during the last 35 years in Puerto Rico. We demonstrate that the effects of hurricanes in Puerto Rico are substantially worse than in other states, that the 2014 Chikungunya outbreak resulted in an unusually high mortality rate in Puerto Rico, that in the United States the excess mortality during the COVID-19 pandemic already exceeded 100,000 on May 9, 2020, and that the effects of this pandemic was worse for elderly black individuals compared to whites of the same age. We make our tools available through free and open source excessmort R package.


title: Bibliometric Analysis of Global Scientific Research on SARSCoV-2 (COVID-19)

text: Background and Aim: Since late 2019, an unknown-origin pneumonia outbreak detected in Wuhan city, Hubei Province, China. We aimed to build a model to qualitatively and quantitatively assess publications of research of COVID-19 from 2019 to 2020. Materials and Methods: Data were obtained from the Web of Science (WOS), PubMed, and Scopus Core Collection on March 02, 2020, and updated on March 10. We conducted a qualitative and quantitative analysis of publication outputs, journals, authors, institutions, countries, cited references, keywords, and terms according to bibliometric methods using VOS viewer c software packages. Results: Initially, we identified 227 papers, of which after an exclusion process, 92 studies were selected for statistical analyses. China accounted for the highest proportion of published research (44 papers, 40.48%), followed by the United States (21 papers, 19.32%), and Canada (7 papers, 6.44%). Adjusted by gross domestic product (GDP), ranked first, with 0.003 articles per billion GDP. In total, the top 10 journals published 47 articles, which accounted for 51.08% of all publications in this Feld. A total of 6 studies (05.52%) were supported by National Natural Science Foundation of China. Chinese Academy of Sciences ranked second 2, 2.76%). Conclusion: Bibliometric and visualized mapping may quantitatively monitor research performance in science and present predictions. The subject of this study was the fast growing publication on COVID-19. Most studies are published in journals with very high impact factors (IFs) and other journals are more interested in this type of research.


title: Simulating the progression of the COVID-19 disease in Cameroon using SIR models

text: This paper analyses the evolution of COVID 19 disease in Cameroon over the period March 6 April 2020 using SIR model. Specifically, 1) we evaluate the basic reproduction number of the virus. 2) Determine the peak of the infection and the spread-out period of the disease. 3) Simulate the interventions of public health authorities. Data used in this study is obtained from the Ministry of Health of Cameroon. The results suggest that over the period, the reproduction number of the COVID 19 in Cameroon is about 1.5 and the peak of the infection could occur at the end of May 2020 with about 7.7% of the population infected. Besides, implementation of efficient public health policies could help flattens the epidemic curve.


title: Population matched (PM) germline allelic variants of immunoglobulin (IG) loci: New pmIG database to better understand IG repertoire and selection processes in disease and vaccination

text: At the population level, immunoglobulin (IG) loci harbor inter-individual allelic variants in the many different germline IG variable (V), Diversity (D) and Joining (J) genes of the IG heavy (IGH), IG kappa (IGK) and IG lambda (IGL) loci, which together form the genetic basis of the highly diverse antigen-specific B-cell receptors. These inter-individual allelic variants can be shared between or be specific to human populations. The current IG databases IMGT, VBASE2 and IgPdb hold information about germline alleles, most of which are partial sequences, obtained from a mixture of human (B-cell) samples, many with sequence errors and/or acquired (non-germline) IG variations, induced by somatic hypermutation (SHM) during antigen-specific B-cell responses. We systematically identified true germline alleles (without SHM) from 26 different human populations around the world, profiled by the “1000 Genomes data”. Our resource is uniquely enriched with complete IG allele sequences and their frequencies across human populations. We identified 409 IGHV, 179 IGKV, and 199 IGLV germline alleles supported by at least seven haplotypes (= minimum of four individuals), after removal of potential false-positives, based on using other genomic databases, i.e. ENSEMBL, TopMed, ExAC, ProjectMine. Remarkably, the positions of the identified variant nucleotides of the different alleles are not at random (as observed in case of SHM), but show striking patterns, restricted to limited nucleotide positions, the same as found in other IG data bases, suggesting over-time evolutionary selection processes. The identification of these specific patterns provides extra evidence that the identified variant nucleotides are not sequencing errors, but genuine allelic variants. The diversity of germline allelic variants in IGH and IGL loci is the highest in Africans, while the IGK locus is most diverse in Europeans. We also report on the presence of recombination signal sequences (RSS) in V pseudogenes, explaining their usage in V(D)J rearrangements. We propose that this new set of genuine germline IG sequences can serve as a new population-matched IG (pmIG) database for better understanding B-cell repertoire and B-cell receptor selection processes in disease and vaccination within and between different human populations. The database in format of fasta is available via GitHub (https://github.com/InduKhatri/pmIG). Contribution to the Field Statement We present a catalogue of immunoglobulin (IG) germline-alleles of unprecedented completeness and accuracy from 26 different human populations belonging to five different large ethnicities (Source: 1000 Genomes). We identified the population distribution of several known germline alleles and identified multiple new alleles, especially in African populations, indicative of high allelic diversity of IG genes in Africa. Strikingly, the identified variant nucleotides of the different alleles are not at random, but show striking patterns, restricted to limited nucleotide positions, the same as found in other IG databases, suggesting over-time evolutionary selection processes. Furthermore, we identified recombination signal sequences in pseudogenes (previously not known). We provide an overview of IG germline alleles shared with and between known databases and also point to potential sources of non-germline variation and incompleteness of the existing IG databases. More importantly, we believe that this information can serve as a novel population-matched IG (pmIG) database, highly valuable for the research community in supporting the dissection and understanding of differences in effectiveness of antibody-based immune responses in infectious diseases, other (immune) diseases and vaccination within and between human populations. Such knowledge might be used in developing population-specific vaccination strategies e.g. for currently ongoing SARS-CoV2 pandemic.


Editorial corner – a personal view the role of electrospun nanofibers in the fight against the COVID-19


title: Generating Nanotopography on PCL Microfiber Surface for Better Cell-Scaffold Interactions

text: Abstract To understand the behavior of cells in natural environment, 3D scaffolds are needed to provide biomimetic environment for routine cell growth in vitro. Electrohydrodynamic jet (EHDJ) printing, one of the emerging 3D printing techniques, is capable of fabricating 3D scaffolds with oriented fibers and customized microscale structures. However, most of the EHDJ-printed scaffolds lack of hierarchical structures such as nanotopographies present in native tissues. In this study, we propose a novel approach that combine EHDJ printing of poly(ε-caprolactone) (PCL)/gliadin composite inks to produce scaffolds with oriented microfibers. The nanoscale pores and flaws (fiber nanotopography) could be generated on the printed fibers by simply leaching the gliadin phase from the printed PCL/gliadin scaffolds. The density and size of nanotopographical features could be controlled by adjusting the gliadin ratio. Furthermore, by seeding mouse embryonic fibroblasts (NIH/3T3) cells, it clearly manifested that such scaffolds are favorable to cell adhesion, migration and proliferation efficiently. Thus, the newly designed PCL scaffolds with both micro- and nano-scale topographies can be a promising 3D cell culture platform with improved cell-scaffold interactions.


title: Predicting community mortality risk due to CoVID-19 using machine learning and development of a prediction tool

text: Background: The recent pandemic of CoVID-19 has emerged as a threat to global health security. There are a very few prognostic models on CoVID-19 using machine learning. Objectives: To predict mortality among confirmed CoVID-19 patients in South Korea using machine learning and deploy the best performing algorithm as an open-source online prediction tool for decision-making. Materials and methods: Mortality for confirmed CoVID-19 patients (n=3,022) between January 20, 2020 and April 07, 2020 was predicted using five machine learning algorithms (logistic regression, support vector machine, K nearest neighbor, random forest and gradient boosting). Performance of the algorithms was compared, and the best performing algorithm was deployed as an online prediction tool. Results: The gradient boosting algorithm was the best performer in terms of discrimination (area under ROC curve=0.966), calibration (Matthews Correlation Coefficient=0.656; Brier Score=0.013) and predictive ability (accuracy=0.987). The best performer algorithm (gradient boosting) was deployed as the online CoVID-19 Community Mortality Risk Prediction tool named CoCoMoRP (https://ashis-das.shinyapps.io/CoCoMoRP/). Conclusions: We describe the framework for the rapid development and deployment of an open-source machine learning tool to predict mortality risk among CoVID-19 confirmed patients using publicly available surveillance data. This tool can be utilized by potential stakeholders such as health providers and policy makers to triage patients at the community level in addition to other approaches.


title: COVID-19 in India: State-wise Analysis and Prediction

text: Coronavirus disease 2019 (COVID-19), a highly infectious disease, was first detected in Wuhan, China, in December 2019. The disease has spread to 210 countries and territories around the world and infected (confirmed) more than two million people. In India, the disease was first detected on 30 January 2020 in Kerala in a student who returned from Wuhan. The total (cumulative) number of confirmed infected people is 17615 till now across India (19 April 2020). Most of the research and newspaper articles focus on the number of infected people in entire India. However, given the size and diversity of India, it may be a good idea to look at the spread of the disease in each state separately, along with the entire country. For example, currently, Maharashtra has more than 2500 confirmed cumulative infected cases, whereas West Bengal has less than 300 confirmed infected cases (16 April 2020). The approaches to address the pandemic in the two states must be different due to limited resources. In this article, we will focus the infected people in each state (restricting to only those states with enough data for prediction) and build three growth models to predict infected people for that state in the next 30 days. The impact of preventive measures on daily infected-rate is discussed for each state.


title: Predictors of misconceptions, knowledge, attitudes, and practices of COVID-19 pandemic among a sample of Saudi population and its impact: a cross-sectional study

text: Objectives: To explore the predictors of misconceptions, knowledge, attitudes, and practices of the COVID-19 pandemic among a sample of the Saudi population and its impact. Design: An online cross-sectional study. Setting: Jeddah, Saudi Arabia. Participants: A total of 2006 participants [953(47.5%) females, and 1053(52.5%) males], and more than 18 years of age were included in the study. Data collection and analysis: This cross-sectional survey was conducted at the Faculty of Medicine, Rabigh, King Abdulaziz University (KAU). The participants were approached by social media (SM). An online questionnaire was administered, and the data were analyzed on SPSS-26. Results: The SM was the leading source of information 889(43.9%). Two-thirds of the participants, 1250(66.9%) had various misconceptions, and about one-third of the study participants 637(31.7%) had disturbed social, mental, and psychological wellbeing, and many participants became more religious. Two-thirds of the study participants, 1292(68.1%) had good knowledge score. The attitude was highly positive in 1867(93.1%) participants, and the practice score was adequate in 1939(97.7%). The participants educational status was the predictor of good knowledge. Male gender and divorced ones were the predictor of poor practice scores and age 51-60 years, private jobholders, and students were the predictors of the good practice scores. The Saudi nationality was the predictor of participants positive attitude, while the male gender and divorced ones were predictors of a negative attitude. The male gender and higher education status were the predictors of good concepts, while the older age and job (own business) were the predictors of misconceptions. Conclusion: Our study observed several predictors of misconceptions, knowledge, attitudes, and practices among the Saudi population. Our participants had a good realization of the impact of this pandemic.


title: Development of a Multivariate Prediction Network Model for epidemic progression in order to study the effects of lockdown time and coverage on a closed community of non-immune individuals.

text: The aim of this study was to develop a realistic network model to predict qualitatively the relationship between lockdown duration and coverage in controlling the progression of the incidence curve of an epidemic with the characteristics of COVID-19 in a closed and non-immune population. Effects of lockdown time and rate on the progression of an epidemic incidence curve in a virtual closed population of 10 thousand subjects. Predictor variables were R0 values established in the most recent literature (2.7 and 5.7), without lockdown and with coverages of 25%, 50%, and 90% for 21, 35, 70, and 140 days in 13 different scenarios for each R0, where individuals remained infected and transmitters for 14 days. We estimated model validity by applying an exponential model on the incidence curve with no lockdown, with growth rate coefficient observed in realistic scenarios. Pairwise comparisons were performed using Wilcoxon test with Bonferroni correction between peak amplitude, peak latency, and total number of cases for each R0 used. For R0=5.7, the flattening of the curve occurs only with long lockdown periods (70 and 140 days) with a 90% coverage. For R0=2.7, coverages of 25 and 50% also result in curve flattening and reduction of total cases, provided they occur for a long period (70 days or more). Short and soft lockdowns had no relevant effect on incidence or casuistry. These data corroborate the importance of lockdown duration regardless of virus transmission.


title: Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed COVID-19 infection to improve patient outcomes and to protect healthcare workers treating them

text: Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the benefits and harms of antimicrobial mouthwashes and nasal sprays administered to patients with suspected or confirmed COVID-19 infection in order to protect the healthcare workers (HCWs) caring for them. To assess the benefits and harms of antimicrobial mouthwashes and nasal spray in improving outcomes for patients with suspected or confirmed COVID-19 infection.


title: Pooling RT-PCR or NGS samples has the potential to cost-effectively generate estimates of COVID-19 prevalence in resource limited environments

text: Background: COVID-19 originated in China and has quickly spread worldwide causing a pandemic. Countries need rapid data on the prevalence of the virus in communities to enable rapid containment. However, the equipment, human and laboratory resources required for conducting individual RT-PCR is prohibitive. One technique to reduce the number of tests required is the pooling of samples for analysis by RT-PCR prior to testing. Methods: We conducted a mathematical analysis of pooling strategies for infection rate classification using group testing and for the identification of individuals by testing pooled clusters of samples. Findings: On the basis of the proposed pooled testing strategy we calculate the probability of false alarm, the probability of detection, and the average number of tests required as a function of the pool size. We find that when the sample size is 256, with a maximum pool size of 64, with only 7.3 tests on the average, we can distinguish between prevalences of 1% and 5% with a probability of detection of 95% and probability of false alarm of 4%. Interpretation: The pooling of RT-PCR samples is a cost-effective technique for providing much-needed course-grained data on the prevalence of COVID-19. This is a powerful tool in providing countries with information that can facilitate a response to the pandemic that is evidence-based and saves the most lives possible with the resources available.


title: Backing up emergency teams in healthcare and law enforcement organizations: strategies to socialize newcomers in the time of COVID-19

text: The COVID-19 pandemic is putting significant pressure on emergency teams in healthcare and law enforcement organizations In order to provide rapid backup, new workers must be socialized rapidly an


title: Serum proteomics in COVID-19 patients: Altered coagulation and complement status as a function of IL-6 level

text: Over 5 million people around the world have tested positive for the beta coronavirus SARS-CoV-2 as of May 29, 2020, a third of which in the United States alone. These infections are associated with the development of a disease known as COVID-19, which is characterized by several symptoms, including persistent dry cough, shortness of breath, chills, muscle pain, headache, loss of taste or smell, and gastrointestinal distress. COVID-19 has been characterized by elevated mortality (over 100 thousand people have already died in the US alone), mostly due to thromboinflammatory complications that impair lung perfusion and systemic oxygenation in the most severe cases. While the levels of pro-inflammatory cytokines such as interleukin-6 (IL-6) have been associated with the severity of the disease, little is known about the impact of IL-6 levels on the proteome of COVID-19 patients. The present study provides the first proteomics analysis of sera from COVID-19 patients, stratified by circulating levels of IL-6, and correlated to markers of inflammation and renal function. As a function of IL-6 levels, we identified significant dysregulation in serum levels of various coagulation factors, accompanied by increased levels of anti-fibrinolytic components, including several serine protease inhibitors (SERPINs). These were accompanied by up-regulation of the complement cascade and antimicrobial enzymes, especially in subjects with the highest levels of IL-6, which is consistent with an exacerbation of the acute phase response in these subjects. Although our results are observational, they highlight a clear increase in the levels of inhibitory components of the fibrinolytic cascade in severe COVID-19 disease, providing potential clues related to the etiology of coagulopathic complications in COVID-19 and paving the way for potential therapeutic interventions, such as the use of pro-fibrinolytic agents.


title: Guillain Barr e syndrome in COVID-19:A scoping review

text: Introduction The novel coronavirus (COVID19) can result in several neurological complications. Guillain-Barre Syndrome (GBS) is one of them and has been reported from different parts of the world in this pandemic. It is an acute post-infectious polyneuropathy. The review aims to summarize the demographic features, clinical presentation, diagnostics workup, and management strategies of COVID-19 associated GBS reported in the literature. Material and method We searched Medline, PubMed Central, SCOPUS, and Google Scholar using pre-defined keywords, with no time limits and in the English language only. We aimed to include all kinds of manuscripts. The last search was done on 18th May 2020. Demographics, clinical features, diagnostic workup, management, and outcomes were documented in the datasheet. Results We identified 24 cases of COVID-19 associated GBS. Most of the cases were reported from Italy followed by the USA. The majority were males (18 /24) The age ranged from 23 -84 years. The clinical presentation was typical sensory-motor GBS in most. Nine patients had facial palsy of which five had bilateral involvement. Two patients had bilateral abducent nerve palsy while two presented as paraparetic GBS variant with autonomic dysfunction. Electrodiagnostics was performed in 17 patients only and 12 had typical features of acute inflammatory demyelinating polyneuropathy. Intravenous immunoglobulins were the preferred mode of treatment in most of the patient. There was one death, and most were discharged to rehabilitation or home. Conclusion GBS is a frequent neurological complication associated with COVID-19. There is no clear causative relationship between GBS, and COVID-19 at present, and more data are needed to establish the casualty. However, most cases have a post-infectious onset with male preponderance. Most of the cases have a typical presentation but some may present in an atypical way. Prognosis is generally good.


title: Organizational reliability model verification in the crisis escalation phase caused by the COVID-19 pandemic

text: This article concerns the Organizational Reliability Model (ORM) verification in the crisis escalation phase caused by critical conditions of organization functioning induced by the COVID-19 pandemic. ORM is constituted by three reliabilities, human resources, information technology, and management, which are mediators through which Type-1 and Type-2 reliability capabilities influence organizational reliability. Organizational reliability is a prerequisite for sustainability of contemporary organizations. The model was developed and verified for a variety of operating conditions. However, crisis induced by a Black Swan type of event creates conditions so critical that it calls for verification of known paradigms and models, as an element of crisis-state theory building. This is why this paper's aim was to verify the ORM and explain the mechanisms of shaping organizational reliability in such conditions in order to contribute to both theory (verifying the organizational reliability paradigm among organizations in crisis) and practice (proposing mechanisms, potentially helping them survive). The ORM is empirically verified based on the sample of 115 employees from Italy operating under critical conditions of the COVID-19 pandemic (research carried out in the week of 18-22 March 2020). In order to verify the hypothesis, the path analysis was executed using SPSS AMOS. The results confirmed that in the extreme critical conditions causing crisis escalation for the organizations, there is a need to redefine the existing paradigms, including ORM. The results show that the HR reliability role in the ORM has drastically changed and the mechanism of its influence on organizational reliability is significantly different in crisis influenced by critical conditions of organization functioning. They also confirmed that IT together with HR is dependent on management to change the way of working and until that, its reliability may be counterproductive for the reliability of organizational as a whole. Therefore, obtaining sustainability in the crisis escalation phase requires redefining the mechanisms for securing organizational reliability.


Practical recommendations for staying physically active during the COVID-19 pandemic: A systematic literature review


title: Generation of kidney ureteric bud and collecting duct organoids that recapitulate kidney branching morphogenesis

text: Kidney organoids model development and diseases of the nephron but not the contiguous epithelial network of the kidney’s collecting duct (CD) system. Here, we report the generation of an expandable, 3D branching ureteric bud (UB) organoid culture model that can be derived from primary UB progenitors from mouse and human fetal kidneys, or generated de novo from pluripotent human stem cells. UB organoids differentiate into CD organoids in vitro, with differentiated cell types adopting spatial assemblies reflective of the adult kidney collecting system. Aggregating 3D-cultured nephron progenitor cells with UB organoids in vitro results in a reiterative process of branching morphogenesis and nephron induction, similar to kidney development. Combining efficient gene editing with the UB organoid model will facilitate an enhanced understanding of development, regeneration and diseases of the mammalian collecting system. One sentence summary Collecting duct organoids derived from primary mouse and human ureteric bud progenitor cells and human pluripotent stem cells provide an in vitro platform for genetic dissection of development, regeneration and diseases of the mammalian collecting system.


title: Athletes as role models during the COVID-19 pandemic

text: Athletes are considered potential role models for young adults even though some of them exhibit inappropriate behaviours. In this commentary, the paper begins with a description of inappropriate behaviours of some athletes during the current COVID-19 pandemic. In this age of social media, news of such inappropriate behaviour can spread very quickly, particularly when the behaviour evokes an emotive response. However, social media can also be leveraged to spread positive messages. During this pandemic, athletes like other celebrities can be role models. They can encourage appropriate behaviours including social distancing to stem the spread of the virus through social media. The paper ends with a short discussion on the future of athletes as role models during a pandemic.


Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data


The Impact of COVID-19 Pandemic on the Elimination of Viral Hepatitis in Duhok City, Kurdistan Region of Iraq


Ethik der Reanimation und Entscheidungen am Lebensende: COVID-19-Leitlinien des European Resuscitation Council


title: Mechanical Ventilator Milano (MVM):A Novel Mechanical Ventilator Designed for Mass Scale Production in response to the COVID-19 Pandemics

text: We present here the design of the Mechanical Ventilator Milano (MVM), a novel mechan- ical ventilator designed for mass scale production in response to the COVID-19 pandemics, to compensate for the dramatic shortage of such ventilators in many countries. This venti- lator is an electro-mechanical equivalent of the old, reliable Manley Ventilator. Our design is optimized to permit large sale production in short time and at a limited cost, relying on off-the-shelf components, readily available worldwide from hardware suppliers. Operation of the MVM requires only a source of compressed oxygen (or compressed medical air) and electrical power. The MVM control and monitoring unit can be connected and networked via WiFi so that no additional electrical connections are necessary other than the connection to the electrical power. At this stage the MVM is not a certified medical device. Construction of the first proto- types is starting with a team of engineers, scientists and computing experts. The purpose of this paper is to disseminate the conceptual design of the MVM broadly and to solicit feed- back from the scientific and medical community to speed the process of review, improvement and possible implementation.


title: QuoVidi: a open-source web application for the organisation of large scale biological treasure hunts

text: Learning biology, and in particular systematics, requires learning a substantial amount of specific vocabulary, both for botanical and zoological studies. While crucial, the precise identification of structures serving as evolutionary traits and systematic criteria is not per se a highly motivating task for students. Teaching this in a traditional teaching setting is quite challenging especially with a large crowd of students to be kept engaged. This is even more difficult if, as during the COVID-19 crisis, students are not allowed to access laboratories for hands-on observation on fresh specimens and sometimes restricted to short-range movements outside their home. Here we present QuoVidi, a new open-source web platform for the organisation of large scale treasure hunts. The platform works as follows: students, organised in teams, receive a list of quests that contain morphologic, ecologic or systematic terms. They have to first understand the meaning of the quests, then go and find them in the environment. Once they find the organism corresponding to a quest, they upload a geotagged picture of their finding and submit this on the platform. The correctness of each submission is evaluated by the staff. During the COVID-19 lockdown, previously validated pictures were also submitted for evaluation to students that were locked in low-biodiversity areas. From a research perspective, the system enables the creation of large image databases by the students, similar to citizen-science projects. Beside the enhanced motivation of students to learn the vocabulary and perform observations on self-found specimens, this system allows faculties to remotely follow and assess the work performed by large numbers of students. The interface is freely available, open-source and customizable. It can be used in other disciplines with adapted quests and we expect it to be of interest in many classroom settings.


title: Coronavirus Disease (COVID‐19) and Immunity Booster Green Foods: A Mini Review

text: This review focused on the use of plant based foods for enhancing the immunity of all aged groups against COVID‐19. In humans, coronaviruses are included in the spectrum of viruses that cause the common cold and, recently, severe acute respiratory syndrome (SARS). Emerging infectious diseases, such as SARS present a major threat to public health. The novel coronavirus has spread rapidly to multiple countries and has been declared a pandemic by the World Health Organization. COVID‐19 is usually caused a virus to which most probably the people with low immunity response are being effected. Plant based foods increased the intestinal beneficial bacteria which are helpful and makes up of 85% of the immune system. By the use of plenty of water, minerals like magnesium and Zinc, micronutrients, herbs, food rich in vitamins C, D & E and better life style one can promote the health and can overcome this infection. Various studies investigated that a powerful antioxidant Glutathione and a bioflavonoid Quercetin may prevent various infections including COVID‐19. In conclusion, the plant based foods play a vital role to enhance the immunity of people to control of COVID‐19.


title: A Machine Learning Explanation of Incidence Inequalities of SARS-CoV-2 Across 88 Days in 157 Countries

text: Because the SARS-CoV-2 (COVID-19) pandemic viral outbreaks will likely continue until effective vaccines are widely administered, (1) new capabilities to accurately predict incidence rates by location and time to know in advance the disease burden and specific needs for any given population are valuable to minimize morbidity and mortality. In this study, a random forest of 9,250 regression trees was applied to 6,941 observations of 13 statistically significant predictor variables targeting SARS-CoV-2 incidence rates per 100,000 across 88 days in 157 countries. One key finding is an algorithm that can predict the incidence rate per day of a SARS-CoV-2 epidemic cycle with a pseudo-R2 accuracy of 98.5% and explain 97.4% of the variances. Another key finding is the relative importance of 13 demographic, economic, environmental, and public health modulators to the SARS-CoV-2 incidence rate. Four factors proposed in earlier research as potential modulators have no statistically significant relationship with incidence rates (2)(3). These findings give leaders new capabilities for improved capacity planning and targeting stay-at-home interventions and prioritizing programming by knowing the atypical social determinants that are the root causes of SARS-CoV-2 incidence variance. This work also proves that machine learning can accurately and quickly explain disease dynamics for zoonoses with pandemic potential.


title: HiDRA-seq: High-Throughput SARS-CoV-2 Detection by RNA Barcoding and Amplicon Sequencing

text: The recent outbreak of a new coronavirus that causes a Severe Acute Respiratory Syndrome in humans (SARS-CoV-2) has developed into a global pandemic with over 6 million reported cases and more than 375,000 deaths worldwide. Many countries have faced a shortage of diagnostic kits as well as a lack of infrastructure to perform necessary testing. Due to these limiting factors, only patients showing symptoms indicating infection were subjected to testing, whilst asymptomatic individuals, who are widely believed to be responsible for the fast dispersion of the virus, were largely omitted from the testing regimes. The inability to implement high throughput diagnostic and contact tracing strategies has forced many countries to institute lockdowns with severe economic and social consequences. The World Health Organization (WHO) has encouraged affected countries to increase testing capabilities to identify new cases, allow for a well-controlled lifting of lockdown measures, and prepare for future outbreaks. Here, we propose HiDRA-seq, a rapidly implementable, high throughput, and scalable solution that uses NGS lab infrastructure and reagents for population-scale SARS-CoV-2 testing. This method is based on the use of indexed oligo-dT primers to generate barcoded cDNA from a large number of patient samples. From this, highly multiplexed NGS libraries are prepared targeting SARS-CoV-2 specific regions and sequenced. The low amount of sequencing data required for diagnosis allows the combination of thousands of samples in a sequencing run, while reducing the cost to approximately 2 CHF/EUR/USD per RNA sample. Here, we describe in detail the first version of the protocol, which can be further improved in the future to increase its sensitivity and to identify other respiratory viruses or analyze individual genetic features associated with disease progression.


title: Is there a link between temperatures and COVID-19 contagions? Evidence from Italy

text: This study analyzes the link between temperatures and COVID-19 contagions in a sample of Italian regions during the period ranging from February 24 to April 15. To that end, Bayesian Model Averaging techniques are used to analyze the relevance of the temperatures together with a set of additional climate, environmental, demographic, social and policy factors. The robustness of individual covariates is measured through posterior inclusion probabilities. The empirical analysis provides conclusive evidence on the role played by the temperatures given that it appears as the most relevant determinant of contagions. This finding is robust to (i) the prior distribution elicitation, (ii) the procedure to assign weights to the regressors, (iii) the presence of measurement errors in official data due to under-reporting, (iv) the employment of different metrics of temperatures or (v) the inclusion of additional correlates. In a second step, relative importance metrics that perform an accurate partitioning of the R2 of the model are calculated. The results of this approach support the evidence of the model averaging analysis, given that temperature is the top driver explaining 45% of regional contagion disparities. The set of policy-related factors appear in a second level of importance, whereas factors related to the degree of social connectedness or the demographic characteristics are less relevant.


title: Depression, Anxiety and Depression-anxiety comorbidity amid COVID-19 Pandemic: An online survey conducted during lockdown in Nepal

text: Background: Little is known about the effect of the COVID-19 pandemic on mental health status during the lock-down period. Therefore, this study was conducted to assess prevalence of depression, anxiety and depression-anxiety comorbidity, and associated factors during the COVID-19 lock-down in Nepal. Methods A quantitative cross-sectional study was conducted among the general population of Nepal. Data was collected from April 9 to April 16, 2020 using an e-questionnaire which was shared through different popular social media. A total of 349 participants were included. Self-reported depression and anxiety were assessed using the Patient Health Questionnaire and Generalized Anxiety tools respectively. Logistic regression analysis was conducted to identify the factors associated with depression, anxiety and depression and anxiety co-morbidity. Results The prevalence rates of depression, anxiety and depression-anxiety co-morbidity were found to be 34.0%, 31.0% and 23.2% respectively. The multi-variate analysis showed that females, those living alone, health professionals and those who spent more time in accessing information about COVID-19 were significantly more likely to have depression, anxiety and depression-anxiety co-morbidity. Conclusions High rates of depression and anxiety and co-morbidity were found to be prevailing among the general population during the COVID-19 pandemic lock-down in Nepal. The results suggest that only the scientific, but contextually appropriate messages about the disease should be disseminated to reduce unnecessary fears and anxiety. Awareness interventions to promote mental well-being need to be integrated into the response interventions. Community mental health care should be made accessible to at-risk groups.


title: COVID-19 excess deaths in the United States during April 2020

text: Background: Some have claimed that the number of COVID-19 deaths is not much greater than would be experienced in the usual course of events. We sought to estimate the number of deaths due to COVID-19 in the United States during April 2020 and compare that to the number of expected deaths in the same time period. Methods: The Institute for Health Metrics and Evaluation (IHME) predicts that 67,212 COVID-19 deaths will occur during April 2020. To obtain the number of excess COVID-19 deaths, we multiplied published infection fatality rates by age by population numbers to obtain assumed infection rates. We then subtracted the expected number of deaths calculated using life table mortality rates. Results: During April 2020 there may be 61,690 to 62,526 excess deaths. Population infection rates of 3.6% to 4.3% by mid-April 2020 would generate the number of COVID-19 deaths predicted by IHME. Conclusions: During April 2020 over 90% of the COVID-19 deaths can be classified as excess deaths. These deaths would normally occur over 11.2 to 13.3 months instead of being concentrated in 1 month.


title: Mapping COVID-19: How web-based maps contribute to the infodemic

text: A proliferation of web-based maps have appeared depicting many different aspects of the spread of the novel coronavirus (SARS-CoV-2). In this commentary, we consider the usage of web-based mapping during the COVID-19 pandemic and argue that web maps have been widely misused for delivering public information on this fast moving, epidemiologically complex, and geographically unbounded process.


title: Pathogen Reduction of SARS-CoV-2 Virus in Plasma and Whole Blood using Riboflavin and UV Light

text: BACKGROUND Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has recently been identified as the causative agent for Coronavirus Disease 2019 (COVID-19). The ability of this agent to be transmitted by blood transfusion has not been documented, although viral RNA has been detected in serum. Exposure to treatment with riboflavin and ultraviolet light (R + UV) reduces blood-borne pathogens while maintaining blood product quality. Here, we report on the efficacy of R + UV in reducing SARS-CoV-2 infectivity when tested in human plasma and whole blood products. STUDY DESIGN AND METHODS SARS-CoV-2 (isolate USA-WA1/2020) was used to inoculate plasma and whole blood units that then underwent treatment with riboflavin and UV light (Mirasol Pathogen Reduction Technology System, Terumo BCT, Lakewood, CO). The infectious titers of SARS-CoV-2 in the samples before and after R + UV treatment were determined by plaque assay on Vero cells. Each plasma pool (n=9) underwent R + UV treatment performed in triplicate using individual units of plasma and then repeated using individual whole blood donations (n=3). RESULTS Riboflavin and UV light reduced the infectious titer of SARS-CoV-2 below the limit of detection for plasma products at 60-100% of the recommended energy dose. At the UV light dose recommended by the manufacturer, the mean log reductions in the viral titers were ≥ 4.79 ± 0.15 Logs in plasma and 3.30 ± 0.26 in whole blood units. CONCLUSION Riboflavin and UV light effectively reduced the titer of SARS-CoV-2 to the limit of detection in human plasma and by 3.30 ± 0.26 on average in whole blood. Two clades of SARS-CoV-2 have been described and questions remain about whether exposure to one strain confers strong immunity to the other. Pathogen-reduced blood products may be a safer option for critically ill patients with COVID-19, particularly those in high-risk categories.


title: Activity and Health During the SARS-CoV2 Pandemic (ASAP): Study Protocol for a Multi-National Network Trial

text: Introduction: The worldwide spread of the novel coronavirus (SARS-CoV2) has prompted numerous countries to restrict public life. Related measures, such as limits on social gatherings, business closures, or lockdowns, are expected to considerably reduce the individual opportunities to move outside the home. As physical activity (PA) and sport participation significantly contribute to health, this study has two objectives. The objectives of this study are to assess changes in PA and well-being since the coronavirus outbreak in affected countries. Additionally, we will evaluate the impact of digital home-based exercise programs on PA as well as physical and mental health outcomes. Method: A multinational network trial will be conducted with three planned phases (A, B, and C). Part A consists of administering a structured survey. It investigates changes in PA levels and health during the coronavirus outbreak and measures the preferences of the participants regarding online training programs. Part B is a two-armed randomized-controlled trial. Participants assigned to the intervention group (IG) will complete a digital 4-week home exercise training (live streaming via internet) guided by the survey results on content and time of program. The control group (CG) will not receive the program. Part C is 4-week access of both CG and IG to a digital archive of pre-recorded workouts from Part B. Similar to Part A, questionnaires will be used in both Part B and C to estimate the effects of exercise on measures of mental and physical health. Results and Discussion: The ASAP project will provide valuable insights into the importance of PA during a global pandemic. Our initial survey is the first to determine how governmental confinement measures impact bodily and mental well-being. Based on the results, the intervention studies will be unique to address health problems potentially arising from losses in PA. If proven effective, the newly developed telehealth programs could become a significant and easy-to-distribute factor in combating PA decreases. Results of the study may hence guide policy makers on methods to maintain PA and health when being forced to restrict public life. Study Register: DRKS00021273.


title: Reconstructing the global dynamics of under-ascertained COVID-19 cases and infections

text: Background: Asymptomatic or subclinical SARS-CoV-2 infections are often unreported, which means that confirmed case counts may not accurately reflect underlying epidemic dynamics. Understanding the level of ascertainment (the ratio of confirmed symptomatic cases to the true number of symptomatic individuals) and undetected epidemic progression is crucial to informing COVID-19 response planning, including the introduction and relaxation of control measures. Estimating case ascertainment over time allows for accurate estimates of specific outcomes such as seroprevalence, which is essential for planning control measures. Methods: Using reported data on COVID-19 cases and fatalities globally, we estimated the proportion of symptomatic cases (i.e. any person with any of fever >= to 37.5C, cough, shortness of breath, sudden onset of anosmia, ageusia or dysgeusia illness) that were reported in 210 countries and territories, given those countries had experienced more than ten deaths. We used published estimates of the case fatality ratio (CFR) as an assumed baseline. We then calculated the ratio of this baseline CFR to an estimated local delay-adjusted CFR to estimate the level of under-ascertainment in a particular location. We then fit a Bayesian Gaussian process model to estimate the temporal pattern of under-ascertainment. Results: We estimate that, during March 2020, the median percentage of symptomatic cases detected across the 84 countries which experienced more than ten deaths ranged from 2.38% (Bangladesh) to 99.6% (Chile). Across the ten countries with the highest number of total confirmed cases as of 6th July 2020, we estimated that the peak number of symptomatic cases ranged from 1.4 times (Chile) to 17.8 times (France) larger than reported. Comparing our model with national and regional seroprevalence data where available, we find that our estimates are consistent with observed values. Finally, we estimated seroprevalence for each country. Despite low case detection in some countries, our results that adjust for this still suggest that all countries have had only a small fraction of their populations infected as of July 2020. Conclusions: We found substantial under-ascertainment of symptomatic cases, particularly at the peak of the first wave of the SARS-CoV-2 pandemic, in many countries. Reported case counts will therefore likely underestimate the rate of outbreak growth initially and underestimate the decline in the later stages of an epidemic. Although there was considerable under-reporting in many locations, our estimates were consistent with emerging serological data, suggesting that the proportion of each country's population infected with SARS-CoV-2 worldwide is generally low.


title: Contracting and Reporting Conservatism around a Change in Fiduciary Duties

text: ABSTRACT We exploit an influential 1991 Delaware court ruling to examine simultaneously two types of conservatism that play important roles in resolving creditor-owner agency conflicts: contracting conservatism and reporting conservatism The ruling expanded managerial fiduciary duties in favor of creditors for Delaware-incorporated firms in the vicinity of insolvency In those firms, following the ruling, debt contracts are less likely to include conservative adjustments to accounting numbers used for covenant compliance (i e , contracting conservatism decreases), while public financial reporting becomes more conservative (i e , reporting conservatism increases) The decrease in contracting conservatism is concentrated in firms that exhibit a greater increase in reporting conservatism, suggesting that reporting conservatism is more cost effective in resolving agency conflicts In addition, the substitution effect is more pronounced in firms facing greater business uncertainty and firms with greater board independence This article is protected by copyright All rights reserved