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OBJECTIVE: There is a lack of information concerning the impact of COVID-19 on rural populations This report shares key results from a cross-sectional survey of South Dakota residents' perceptions on the impact and knowledge of COVID-19 during the early phases of the pandemic METHODS: From March 24 to April 14, 2020, South Dakota residents (n = 4,761) reported on their psychological symptoms, pandemic-related stressful experiences, top concerns regarding the pandemic, attitudes towards COVID-19, and social distancing behaviors, and where residents were getting COVID information and who they trust to provide accurate information RESULTS: Most participants were engaging in at least some social distancing and indicated at least moderate concern about COVID-19 Across age groups, getting sick from the coronavirus was the most frequently endorsed concern Younger adults endorsed concerns about not being able to work, whereas older adults endorsed concerns about accessing medical care The majority of the sample reported anxiety, worry, and sleep problems;about half the sample reported depressed mood, anhedonia, and appetite problems Results highlight the importance of engaging public health experts and physicians in COVID-19 health messaging campaigns CONCLUSIONS: These data provide insight into the specific challenges experienced by adults and youth in a rural state during the early phase of the pandemic Public Health professionals and medical doctors are in a unique position to guide targeted interventions and health messaging | Knowledge, Attitudes, and Needs: Assessing the COVID-19 Impact in Rural America |
BACKGROUND: Plasmodium falciparum strains that are resistant to standard-dose chloroquine can be treated by higher chloroquine concentrations maintained for a longer time in vivo. OBJECTIVES: To determine the relative importance of chloroquine concentrations versus exposure time for elimination of chloroquine-susceptible and -resistant P. falciparum in vitro. METHODS: Chloroquine-susceptible (3D7) and -resistant (FCR3) strains were exposed in vitro to 1, 2, 4, 8, 16 or 32 times their respective 90% inhibitory chloroquine concentrations for 3, 5, 7 or 14â days and then followed until recrudescence, or not, by 42â days after the end of exposure. RESULTS: Exposure to chloroquine appeared to eliminate susceptible and resistant parasites, leaving small pyknotic apparently dead parasites. Chloroquine-susceptible and -resistant parasites recrudesced after 3 and 5â days of chloroquine exposure. Recrudescence occurred in one out of four 7â day exposure series but not after 14â days exposure. The median time to recrudescence was 13 to 28â days with a range of 8 to 41â days after the end of exposure. Time to recrudescence after the end of exposure increased with duration of exposure for susceptible and resistant strains (Pâ<â0.001). Time to recrudescence did not correlate with concentrations greater than 1× IC90. CONCLUSIONS: Chloroquine-susceptible and -resistant P. falciparum probably become dormant. Elimination of dormant parasites is primarily dependent upon the duration of chloroquine exposure. Exposure to effective drug concentrations for 7â days eliminates most parasites in vitro. The results support in vivo data indicating that elimination of chloroquine-resistant P. falciparum correlates with Day 7 chloroquine concentrations. | Chloroquine-susceptible and -resistant Plasmodium falciparum strains survive high chloroquine concentrations by becoming dormant but are eliminated by prolonged exposure |
Abstract In the midst of the SARS-CoV-2 pandemic and its attendant morbidity and mortality, safe and efficacious vaccines are needed that induce protective and long-lived immune responses. Over 120 vaccine candidates worldwide are in various preclinical, and phase I-III clinical trials that include inactivated, live attenuated, viral vectored replicating and non-replicating), protein and peptide-based, and nucleic acid approaches. Vaccines will be necessary both for individual protection and for the safe development of population-level herd immunity. Public-private partnership collaborative efforts, such as the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) mechanism, are key to rapidly identifying safe and effective vaccie candidates as quickly and efficiently as possible. In this article, we review the major vaccine approaches being taken and issues that must be resolved in the quest for vaccines to prevent COVID-19. We scanned the PubMed database from 1963–2020 for all publications using the following search terms in various combinations: SARS, MERS, COVID-19, SARS-CoV-2, vaccine, clinical trial, coronavirus, pandemic, vaccine development. We also did a web search for these same terms. We also examined the World Health Organization, Centers for Disease Control and Prevention, and other public health authority websites. We excluded abstracts and all articles that were not written in English. | SARS-CoV-2 Vaccine Development: Current Status |
Bio-nanoscience research encompasses studies on the interactions of nanomaterials with biological structures or what is commonly referred to as the biointerface. Fundamental studies on the influence of nanomaterial properties, including size, shape, composition, and charge, on the interaction with the biointerface have been central in bio-nanoscience to assess nanomaterial efficacy and safety for a range of biomedical applications. However, the state of the cells, tissues, or biological models can also influence the behavior of nanomaterials at the biointerface and their intracellular processing. Focusing on the "bio" in bio-nano, this review discusses the impact of biological properties at the cellular, tissue, and whole organism level that influences nanomaterial behavior, including cell type, cell cycle, tumor physiology, and disease states. Understanding how the biological factors can be addressed or exploited to enhance nanomaterial accumulation and uptake can guide the design of better and suitable models to improve the outcomes of materials in nanomedicine. | A Focus on "Bio" in Bio-Nanoscience: The Impact of Biological Factors on Nanomaterial Interactions. |
OBJECTIVES: Since the outbreak of the novel coronavirus disease 2019 (COVID-19), all health services worldwide underwent profound changes, leading to the suspension of many elective surgeries. This study aimed to evaluate the safety of elective colorectal surgery during the pandemic. METHODS: This was a retrospective, cross-sectional, single-center study. Patients who underwent elective colorectal surgery during the COVID-19 pandemic between March 10 and September 9, 2020, were included. Patient data on sex, age, diagnosis, types of procedures, hospital stay, mortality, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preoperative screening tests were recorded. RESULTS: A total of 103 colorectal surgical procedures were planned, and 99 were performed. Four surgeries were postponed due to positive preoperative screening for SARS-CoV-2. Surgical procedures were performed for colorectal cancer (n=90) and inflammatory bowel disease (n=9). Laparoscopy was the approach of choice for 43 patients (43.4%), 53 (53.5%) procedures were open, and 3 (3%) procedures were robotic. Five patients developed COVID-19 in the postoperative period, and three of them died in the intensive care unit (n=3/5, 60% mortality). Two other patients died due to surgical complications unrelated to COVID-19 (n=2/94, 2.1% mortality) (p<0.01). Hospital stay was longer in patients with SARS-CoV-2 infection than in those without (38.4 versushttps://doi.org/10.3 days, respectively, p<0.01). Of the 99 patients who received surgical care during the pandemic, 94 were safely discharged (95%). CONCLUSION: Our study demonstrated that elective colorectal surgical procedures may be safely performed during the pandemic; however, preoperative testing should be performed to reduce in-hospital infection rates, since the mortality rate due to SARS-CoV-2 in this setting is particularly high. | Is it Safe to Perform Elective Colorectal Surgical Procedures during the COVID-19 Pandemic? A Single Institution Experience with 103 Patients |
BACKGROUND: Multisystem Inflammatory Syndrome in Children (MIS-C) is a severe clinical phenotype of SARS-CoV-2 infection that remains poorly understood. METHODS: Hospitalized children <18 years of age with suspected COVID-19 (N=53) were recruited into a prospective cohort study; 32 had confirmed COVID-19, with 16 meeting the U.S. Centers for Disease Control criteria for MIS-C. Differences in nasopharyngeal viral RNA levels, SARS-CoV-2 seropositivity, and cytokine/chemokine profiles were examined, including after adjustments for age and sex. RESULTS: The median ages for those with and without MIS-C were 8.7 years (IQR 5.5-13.9) and 2.2 years (IQR 1.1-10.5), respectively, (p=0.18) and nasopharyngeal levels of SARS-CoV-2 RNA did not differ significantly between the two groups (median 63,848.25 copies/mL versus 307.1 copies/mL, p= 0.66); 75% of those with MIS-C were antibody positive compared to 44% without, p=0.026. Levels of 14 of 37 cytokines/chemokines (IL-1RA, IL-2RA, IL-6, IL-8, TNF-α, IL-10, IL-15, IL-18, MCP-1, IP-10, MIP-1α, MCP-2, MIP-1β, Eotaxin) were significantly higher in children with MIS-C compared to those without, irrespective of age or sex (FDR<0.05; p<0.05). CONCLUSIONS: The distinct pattern of heightened cytokine/chemokine dysregulation observed with MIS-C, compared with acute COVID-19, occurs across the pediatric age spectrum and with similar levels of nasopharyngeal SARS-CoV-2 RNA. | Distinct Cytokine and Chemokine Dysregulation in Hospitalized Children with Acute COVID-19 and Multisystem Inflammatory Syndrome with Similar Levels of Nasopharyngeal SARS-CoV-2 Shedding |
This work describes a bio-potential acquisition system for portable ubiquitous healthcare applications using flexible polydimethylsiloxane dry electrodes (FPDEs) and a low-power recording circuit. This novel FPDE used Au as the skin contact layer, which was made using a CO2 laser and replica method technology. The FPDE was revised from a commercial bio-potential electrode with a conductive snap using dry electrodes rather than wet electrodes that proposed reliable and robust attachment for the purpose of measurement, and attaching velcro made it wearable on the forearm for bio-potential applications. Furthermore, this study proposes a recording device to store bio-potential signal data and provides portability and low-power consumption for the proposed acquisition system. To acquire differential bio-potentials, such as electrocardiogram (ECG) signals, the proposed recording device includes a low-power front-end acquisition chip fabricated using a complementary metal-oxide-semiconductor (CMOS) process, a commercial microcontroller (MSP430F149), and a secure digital (SD) card for portable healthcare applications. The proposed system can obtain ECG signals efficiently and are comfortable to the skin. The power consumption of the system is about 85 mW for continuous working over a 3 day period with two AA batteries. It can also be used as a compact Holter ECG system. | A low-power bio-potential acquisition system with flexible PDMS dry electrodes for portable ubiquitous healthcare applications. |
The global pandemic novel coronavirus 2019 has upended healthcare and medical education, particularly in disease epicenters such as New York City. In this piece, we seek to describe the collective experiences and lessons learned by the New York City pediatric emergency medicine fellowship directors in clinical, educational, investigative, and psychological domains, in hopes of engendering conversation and informing future disaster response efforts. | Lessons From the Frontlines: Pandemic Response Among New York City Pediatric Emergency Medicine Fellowship Programs During COVID-19 |
The coronavirus disease 2019 (COVID-19) is fatal and spreading rapidly. Early detection and diagnosis of the COVID-19 infection will prevent rapid spread. This study aims to automatically detect COVID-19 through a chest computed tomography (CT) dataset. The standard models for automatic COVID-19 detection using raw chest CT images are presented. This study uses convolutional neural network (CNN), Zeiler and Fergus network (ZFNet), and dense convolutional network-121 (DenseNet121) architectures of deep convolutional neural network models. The proposed models are presented to provide accurate diagnosis for binary classification. The datasets were obtained from a public database. This retrospective study included 757 chest CT images (360 confirmed COVID-19 and 397 non-COVID-19 chest CT images). The algorithms were coded using the Python programming language. The performance metrics used were accuracy, precision, recall, F1-score, and ROC-AUC. Comparative analyses are presented between the three models by considering hyper-parameter factors to find the best model. We obtained the best performance, with an accuracy of 94,7%, a recall of 90%, a precision of 100%, and an F1-score of 94,7% from the CNN model. As a result, the CNN algorithm is more accurate and precise than the ZFNet and DenseNet121 models. This study can present a second point of view to medical staff. | COVID-19 Diagnosis with Deep Learning |
COVID-19, caused by the SARS-CoV-2 virus, can lead to massive inflammation in the gastrointestinal tract causing severe clinical symptoms. SARS-CoV-2 infects lungs after binding its spike proteins with alveolar angiotensin-converting enzyme 2 (ACE2), and it also triggers inflammation in the gastrointestinal tract. SARS-CoV-2 invades the gastrointestinal tract by interacting with Toll-like receptor-4 (TLR4) that induces the expression of ACE2. The influx of ACE2 facilitates cellular binding of more SARS-CoV-2 and causes massive gastrointestinal inflammation leading to diarrhea. Diarrhea prior to COVID-19 infection or COVID-19-induced diarrhea reportedly ends up in a poor prognosis for the patient. Flavonoids are part of traditional remedies for gastrointestinal disorders. Preclinical studies show that flavonoids can prevent infectious diarrhea. Recent studies show flavonoids can inhibit the multiplication of SARS-CoV-2. In combination with vitamin D, flavonoids possibly activate nuclear factor erythroid-derived-2-related factor 2 that downregulates ACE2 expression in cells. We suggest that flavonoids have the potential to prevent SARS-CoV-2 induced diarrhea. | Potential role of flavonoids against SARS-CoV-2 induced diarrhea. |
Humanity as a whole faces a single challenge, perhaps for the first time since prehistory. Just as back then we had to react to the adversities of the natural environment, today we must deal with the Covid-19 pandemic. But while at earlier times we developed in response artifacts, practices and thoughts-in other words, Culture-today long-lasting cultural practices are being disrupted and challenged (Fig. 1). The very chore of our interactions is questioned-that complex system of norms and sensitivities that varies individually and collectively, regulates the physical manifestation of human relations and constitutes the field of inquiry of Proxemics. International safety measures, local cultural norms and individual risk perception combine, generating unpredictable effects: the world appears to be a live social experiment that should be analyzed with an ongoing, interdisciplinary study. The wide corpus of this nearly forgotten discipline, in which our Lab is still fully involved, states the theoretical and methodological premises for such a research, which is at once a unique opportunity and a necessary precondition for future policies. We apply the interdisciplinary and multicultural perspective that characterizes Anthropometry, Anthropology and Social Sciences as a whole to analyze via “Participant Observation” the perception of interpersonal space and built interfaces, which are the archetypes that define our species and vary individually, collectively and diachronically. © 2021, Angelo Pontecorboli Editore. All rights reserved. | The Hidden Dimension in Covid Times. An Anthropologist’s Gaze on a Proxemic Experience via “Participant Observation” |
Recently, the rapid transmission of Coronavirus 2019 (COVID-19) is causing a significant health crisis worldwide. The World Health Organization (WHO) issued several guidelines for protection against the spreading of COVID-19. According to the WHO, the most effective preventive measure against COVID-19 is wearing a mask in public and crowded areas. It is quite difficult to manually monitor and determine people with masks and no masks. In this paper, different deep learning architectures were used for better results evaluations. After extensive experimentation, we selected a custom model having the best performance to identify whether people wear a face mask or not and allowing an easy deployment on a small device such as a Jetson Nano. The experimental evaluation is performed on the custom dataset that is developed from the website (See data collection section) after applying different masks on those images. The proposed model in comparison with other methods produced higher accuracy (99% for training accuracy and 99% for validation accuracy). Moreover, the proposed method can be deployed on resource-constrained devices. | Real-Time Face Mask Detection to Ensure COVID-19 Precautionary Measures in the Developing Countries |
Cholangiocarcinoma (CCA) is the second most common primary liver cancer, characterized by a poor prognosis and resistance to chemotherapeutics. The progressive increase in CCA incidence and mortality registered worldwide in the last two decades and the need to clarify various aspects of clinical management have prompted the Italian Association for the Study of the Liver (AISF) to commission the drafting of dedicated guidelines in collaboration with a group of Italian scientific societies. These guidelines have been formulated in accordance with the Italian National Institute of Health indications and developed by following the GRADE method and related advancements. | Italian Clinical Practice Guidelines on Cholangiocarcinoma - Part I: Classification, diagnosis and staging |
The COVID-19 pandemic has shaken the world to its core and has provoked an overnight exodus of developers that normally worked in an office setting to working from home. The magnitude of this shift and the factors that have accompanied this new unplanned work setting go beyond what the software engineering community has previously understood to be remote work. To find out how developers and their productivity were affected, we distributed two surveys (with a combined total of 3,634 responses that answered all required questions) -- weeks apart to understand the presence and prevalence of the benefits, challenges, and opportunities to improve this special circumstance of remote work. From our thematic qualitative analysis and statistical quantitative analysis, we find that there is a dichotomy of developer experiences influenced by many different factors (that for some are a benefit, while for others a challenge). For example, a benefit for some was being close to family members but for others having family members share their working space and interrupting their focus, was a challenge. Our surveys led to powerful narratives from respondents and revealed the scale at which these experiences exist to provide insights as to how the future of (pandemic) remote work can evolve. | A Tale of Two Cities: Software Developers Working from Home During the COVID-19 Pandemic |
The aim of this study was to analyze individual changes in cancer patients’ mental health before and after the COVID-19 outbreak, and to explore predictors of mental health impairment. Over a two-week period (16–30 March 2020), 150 cancer patients in Germany participated in this study. Validated instruments assessed demographic and medical data, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L). All instruments were adapted to measure the individual mental health before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information regarding COVID-19 were measured. Cancer patients showed a significant increase in depression and anxiety symptoms and distress, while health status deteriorated since the COVID-19 outbreak. Increased depression and generalized anxiety symptoms were predicted by COVID-19-related fear. Trust in governmental actions to face COVID-19 and COVID-19-related fear predicted increases in distress. Higher subjective levels of information predicted less increasing anxiety symptoms and distress. Present data suggests that cancer patients experienced a significant increase in mental health burden since the COVID-19 outbreak. Observed predictors of mental health impairment and protective factors should be addressed, and appropriate interventions established, to maintain mental health of cancer patients during the pandemic. | Mental Health Burden of German Cancer Patients before and after the Outbreak of COVID-19: Predictors of Mental Health Impairment |
OBJECTIVE: In response to the 2013-2016 Ebola virus disease outbreak, the US government designated certain healthcare institutions as Ebola treatment centers (ETCs) to better prepare for future emerging infectious disease outbreaks. This study investigated ETC experiences and critical care policies for patients with viral hemorrhagic fever (VHF). DESIGN: A 58-item questionnaire elicited information on policies for 9 critical care interventions, factors that limited care provision, and innovations developed to deliver care. SETTING AND PARTICIPANTS: The questionnaire was sent to 82 ETCs. METHODS: We analyzed ordinal and categorical data pertaining to the ETC characteristics and descriptive data about their policies and perceived challenges. Statistical analyses assessed whether ETCs with experience caring for VHF patients were more likely to have critical care policies than those that did not. RESULTS: Of the 27 ETCs who responded, 17 (63%) were included. Among them, 8 (47%) reported experience caring for persons under investigation or confirmed cases of VHF. Most felt ready to provide intubation, chest compressions, and renal replacement therapy to these patients. The factors most cited for limiting care were staff safety and clinical futility. Innovations developed to better provide care included increased simulation training and alternative technologies for procedures and communication. CONCLUSIONS: There were broad similarities in critical care policies and limitations among institutions. There were several interventions, namely ECMO and cricothyrotomy, which few institutions felt ready to provide. Future studies could identify obstacles to providing these interventions and explore policy changes after increased experience with novel infectious diseases, such as COVID-19. | Institutional policies and readiness in management of critical illness among patients with viral hemorrhagic fever |
OBJECTIVE: The outbreak of COVID-19 that commenced in December 2019 in Wuhan, China, has caused extensive public health concerns and posed substantial challenges to health professionals, especially for those in the center of the epidemic. The current study aimed to assess the prevalence, related factors, and mechanism of Acute Stress Disorder (ASD) among health professionals in Wuhan during this critical period. METHODS: The study used a cross-sectional design. Self-administered questionnaires were distributed to the frontline health professionals in Wuhan hospitals from January 28 to February 1, 2020. Mental health related measurements included ASD, depression, anxiety, conflict experiences, hostility, and psychosomatic symptoms. Structural equation modeling (SEM) was used to analyze the factors associated with ASD among health professionals. RESULTS: A total of 332 frontline health professionals were included in the analysis (mean age 32.21±8.77 years; 78.0% women). ASD was a prominent mental health problem in the health professionals surveyed, with a prevalence of 38.3%. Anxiety (24.7%) and depression (20.2%) were also common. SEM analyses revealed that emotional distress (i.e., anxiety and depressive symptoms) fully mediated the association between conflicts with ASD (the standardized indirect coefficient ß=0.47, p=0.016). The most common reported symptom was chest pain (51.2%). ASD was significantly associated with psychosomatic symptoms. The majority (67.8%) reported being easily annoyed or irritated and ASD was associated with hostility. CONCLUSIONS: During the COVID-19 outbreak, a substantial number of health professionals in Wuhan suffered from ASD. Furthermore, ASD was found to be associated with psychosomatic symptoms as well as the hostility. The poor mental health of health professionals has detrimental impacts both on the wellbeing of staff in healthcare systems and may adversely affect the quality of patient care. We call for interventions that aim to relieve the psychological and occupational stress. Considering most of our participants were young, female frontline health professionals, the results may not be generalized to more heterogenous samples. | Acute stress disorder among frontline health professionals during the COVID-19 outbreak: A structural equation modelling investigation |
BACKGROUND: The germline mutations of DDX41, also known as DEAD box RNA helicase 41, have been found in about 1.5% of myeloid neoplasms (MNs). Development of MDS/AML is relatively common in germline DDX41 mutations. However, a variety of hematological malignancies (HMs) have been reported. CASE PRESENTATION: We report a novel case of bi-alleleic DDX41 mutations in B-cell lymphoblastic leukemia (B-ALL), with unusual location of DDX41 mutations. The gene expression profile (GEP) of Ph + B-ALL with bi-alleleic DDX41 mutations showed heterogeneously transitional GEP and altered gene expression levels of genes involved in the process essential for red blood cells and myeloid cell differentiation were noted. CONCLUSIONS: We report that DDX41 mutations are unusual but can be an underlying event in Ph + B-ALL and screening DDX41 mutations can be also informative for patients awaiting for haploidentical stem cell transplantation and choosing the therapy. | A novel bi-alleleic DDX41 mutations in B-cell lymphoblastic leukemia: case report |
Background: Coronavirus disease 2019 pandemic causes significant strain on healthcare infrastructure and medical resources So, it becomes crucial to identify reliable predictor biomarkers for COVID-19 disease severity and short term mortality Many biomarkers are currently investigated for their prognostic role in COVID-19 patients Our study is retrospective and aims to evaluate role of semi-quantitative CT-severity scoring versus LDH as prognostic biomarkers for COVID-19 disease severity and short-term clinical outcome Results: Two hundred sixty-six patients between April 2020 and November 2020 with positive RT-PCR results underwent non-enhanced CT scan chest in our hospital and were retrospectively evaluated for CT severity scoring and serum LDH level measurement Data were correlated with clinical disease severity CT severity score and LDH were significantly higher in severe and critical cases compared to mild cases (P value < 0 001) High predictive significance of CT severity score for COVID-19 disease course noted, with cut-off value ≥ 13 highly predictive of severe disease (96 96% accuracy);cut-off value ≥ 16 highly predictive of critical disease (94 21% accuracy);and cut-off value ≥ 19 highly predictive of short-term mortality (92 56% accuracy) CT severity score has higher sensitivity, specificity, positive, and negative predictive values as well as overall accuracy compared to LDH level in predicting severe, critical cases, and short-term mortality Conclusion: Semi-quantitative CT severity scoring has high predictive significance for COVID-19 disease severity and short-term mortality with higher sensitivity, specificity, and overall accuracy compared to LDH Our study strongly supports the use of CT severity scoring as a powerful prognostic biomarker for COVID-19 disease severity and short-term clinical outcome to allow triage of need for hospital admission, earlier medical interference, and to effectively prioritize medical resources for cases with high mortality risk for better decision making and clinical outcome © 2021, The Author(s) | Comparative evaluation of semi-quantitative CT-severity scoring versus serum lactate dehydrogenase as prognostic biomarkers for disease severity and clinical outcome of COVID-19 patients |
INTRODUCTION: Acute respiratory distress syndrome (ARDS) secondary to COVID-19 is different from the ARDS caused by other infections. Conventional mechanical ventilation strategies using high levels of PEEP may not be beneficial and can even be harmful to patient with ARDS from COVID-19. So the ventilation strategies should be adjusted in order to improve the pulmonary ventilation function and oxygenation status, and outcomes of the patient. PATIENT CONCERNS: Herein, we present a 76-year-old male patient with ARDS secondary to COVID-19. We describe our experience with mechanical ventilation strategy and the changes in respiratory mechanics in the patient during treatment. DIAGNOSIS: The patient had tested positive for coronavirus (COVID-19) in nucleic acid test. Chest CT showed multiple ground glass shadows in both lungs. INTERVENTIONS: The patient received mechanical ventilation with low tidal volume and low PEEP. OUTCOMES: After treatment, the patients condition, as well as oxygenation status was improved, and he tested negative for the coronavirus several times. CONCLUSION: This case demonstrated that the low tidal volume with low levels of PEEP ventilation strategy may be more suitable for ARDS from COVID-19. | Successful treatment of a critically ill patient with acute respiratory distress syndrome from COVID-19 using mechanical ventilation strategy with low levels of positive end-expiratory pressure: A CARE-compliant case report |
Study Objective: Age and medical co-morbidities are well-known risk factors for need for hospitalization in COVID-19. It is unclear whether, and which, baseline echocardiographic abnormalities may refine triage in the emergency department beyond clinical risk factors, and hence help identify patients at higher risk for need for hospitalization. We aimed to investigate echocardiographic variables associated with risk of hospitalization in COVID-19 patients. Methods: Electronic health records (EHR) were screened retrospectively to identify adults with a positive COVID-19 test throughout St. Luke’s University Health Network from March 1, 2020-October 31, 2020, and had a transthoracic echocardiogram (TTE) within 15-180 days prior. Baseline medical co-morbidities and echocardiographic variables were compared between patients stratified by hospitalization. Continuous variables were compared using Student’s t-test or Mann-Whitney U-test;categorical variables using the χ 2-test or Fisher’s Exact test. Univariate logistic regression was used to select significant predictors for multivariate analysis. Backward stepwise logistic regression was performed to identify predictors of need for hospitalization, a surrogate for mild versus moderate-severe disease. Results: 193 patients met inclusion criteria (83 hospitalized). Mean TTE to COVID19 positivity time was 86±52 days. Hospitalized patients were older and more likely to suffer co-morbidities (Table 1). Age, medical co-morbidities and several echocardiographic variables predicted need for hospitalization. Multivariate analysis revealed age, coronary disease, COPD, and left atrial (LA) enlargement (≥4 cm) independently predicting hospitalization with excellent discrimination (AUC 0.809, figure 1). Estimates plots are depicted in Figure 2. Conclusion: We present, to our knowledge the first cohort indicating that LA enlargement, in a largely unselected population, is an independent marker of need for hospitalization (a surrogate for worse than mild disease) among COVID-19 patients, and could perhaps be considered in addition to clinical risk assessment in the ED, when available. Being “upstream” from the left ventricle (LV), LA enlargement is an indicator of sustained LV pressure and/or volume overload resulting from diverse etiologies, including hypertension, valvular heart disease, and ischemic heart disease. Hence, LA size has long been known to be an independent predictor of cardiovascular events, stroke, and all-cause mortality among patients with underlying cardiovascular disease as well as the general population. Importantly, LA diameter emerged as a more powerful predictor than LV hypertrophy of COVID-19 severity, as indicated by need for hospitalization. [Formula presented] [Formula presented] [Formula presented] | 382 Can Pre-Morbid Echocardiography, Beyond Clinical Risk Factors, Predict Need for Hospitalizing in COVID-19 Patients? |
The world has suffered over the past year under COVID-19. Unfortunately, people still are getting sick from other, also severe, diseases. Although the COVID-19 infection is present, patients need treatment for other life-threatening conditions. We present the case of a 36-year-old patient with severe infective endocarditis with a large abscess of the aortic root, who also is COVID-19 positive. Definitive diagnostics and treatment were avoided due to COVID-19 infection. In the end, emergent surgery was indicated due to acute cardiac decompensation and the development of heart failure symptoms, and the patient recovered uneventfully after surgery. | Trying to Survive A Serious Heart Condition in Time of COVID-19 |
OBJECTIVE: The emergence of the COVID‐19 pandemic compelled many academic institutions to resort to distance learning and online education, requiring a higher degree of student self‐direction and motivation to learn. This study explored self‐directed learning (SDL) readiness among nursing students in Oman, their learning styles (LS), and the association of demographic variables and LS with SDL. METHODS: The study, which followed a descriptive, cross‐sectional design, surveyed 236 Omani nursing students via an online questionnaire containing two standardized scales: the Self‐Directed Learning Readiness Scale for Nursing Education and the Learning Style Scales. RESULTS: Nursing students were identified as having a low level of SDL (mean = 149.58). Probation status (β = −0.165; p = 0.021) was negatively associated with SDL. In terms of LS, solitary (β = 0.217; p = 0.001), competitive (β = 0.201; p = 0.005), imaginative (β = 0.19; p = 0.012), and perceptive LS (β = 0.437; p = 0.0) were positively associated with SDL. An analytical LS was negatively associated with SDL (β = −0.155; p = 0.022). CONCLUSION: Academic probation status and an analytical LS both yielded lower SDL scores. Perceptive, solitary, competitive, or imaginative learners tended to have higher SDL scores. Deliberate planning and strategies are necessary to help probation students cope with academic demands, especially with the advent of intensified digital education. Because no single learning environment can fulfill the needs of every LS, nurse educators must implement SDL‐aimed teaching and learning strategies that appeal to a variety of learners. | Self‐directed learning readiness and learning styles among Omani nursing students: Implications for online learning during the COVID‐19 pandemic |
BACKGROUND: Unavailability or saturation of the intensive care unit may be associated with the fatality of COVID-19. Prioritizing the patients for hospitalization and intensive care may be critical for reducing the fatality of COVID-19. This study aimed to develop and validate a new integer-based scoring system for predicting patients with COVID-19 requiring intensive care, using only the predictors available upon triage. METHODS: This is a retrospective study using cohort data from the Korean Centers for Disease Control and Prevention that included all admitted patients with COVID-19 between January 19 and June 3, 2020, in South Korea. The primary outcome was patients requiring intensive care defined as actual admission to the intensive care unit; at any time use of an extracorporeal life support device, mechanical ventilation, or vasopressors; and death. Patients admitted until March 20 were included for the training dataset to develop the prediction models and externally validated for the patients admitted afterward. Two logistic regression models were developed with different predictors and the predictive performance was compared: one with patient-provided variables and the other with added radiologic and laboratory variables. An integer-based scoring system was developed based on the developed logistic regression model. RESULTS: A total of 5193 patients were considered, with 4663 patients included after excluding patients with age under 18 or insufficient data. For the training dataset, 3238 patients were included. Of the included patients, 444 (9.5%) patients required intensive care. The model developed with only the clinical variables showed an area under the curve of 0.884 for the validation set. The performance did not differ when radiologic and laboratory variables were added. Seven variables were selected for developing an integer-based scoring system: age, sex, initial body temperature, dyspnea, hemoptysis, history of chronic kidney disease, and activities of daily living. The area under the curve of the scoring system was 0.880. CONCLUSIONS: An integer-based scoring system was developed for predicting patients with COVID-19 requiring intensive care, with high performance. This system may aid decision support for prioritizing the patient for hospitalization and intensive care, particularly in a situation with limited medical resources. | Prediction of patients requiring intensive care for COVID-19: development and validation of an integer-based score using data from Centers for Disease Control and Prevention of South Korea |
Criticism on the use of the income/expenditure poverty line to estimate the number of the poor in Indonesia leads to questioning the use of the multidimensional poverty line (MPL) measurement. While current research on the defining variables, dimensions, and indicators to develop the MPL measurement in Indonesia was not based on direct views of the poor and the non-poor household heads, we complement this research gap by examining it based on direct views of the poor and the non-poor household heads. Methods used to collect the empirical data were conducted in four stages. The first stage was by organizing a Focus Group Discussion with twenty-five participants. The second stage was by conducting a pilot for the main survey on thirty poor and non-poor household heads. The third stage was by distributing the main survey questionnaire to 274 non-poor and 315 poor household head respondents in six representative locations in Indonesia. The fourth stage was by taking in-depth interviews with 8–12 key informants in each survey location. These data were further analysed by employing the qualitative technique. The results confirmed that the poor and the non-poor household head respondents, and the interviewees under the survey viewed the MPL measurement as a comprehensive and better poverty measurement. However, dimensions and indicators that were viewed to be important in developing the MPL measurement were mostly in the groups of three variables. These three variables were capability, empowerment, and opportunity. These three variables should be no hierarchy of importance in developing the MPL measurement as well as in formulating policy and programs to eradicate the incidence of poverty in Indonesia. | Variables, Dimensions, and Indicators Important to Develop the Multidimensional Poverty Line Measurement in Indonesia |
Pumpkin is an important vegetable, which has potential to be used as medicinal and functional food. Not only the pulp but also the peel and seeds of pumpkin are good sources of phytochemicals and minerals. Pumpkin peel, flesh, and seeds were dried to obtain powders, and 80% of methanolic extracts were prepared for further analyses. Among three fractions of pumpkin, higher content of total phenolics (224.61 ± 1.60‐mg GAE/100‐g powder) and total flavonoids (139.37 ± 1.07‐mg CE/100‐g powder) were recorded in pumpkin seeds as compared with peel and flesh, whereas higher carotenoids (35.2 ± 0.49 mg/100‐g powder) and β‐carotene (6.18 ± 0.04 mg/100‐g powder) were present in pumpkin flesh extract, when compared with peel and seeds. Pumpkin flesh, as compared with peel and seeds, contained higher values of Na, K, and Fe (17.87 ± 0.22, 1592 ± 20.3, and 41.50 ± 0.45 mg/100‐g powder, respectively). Valuable amount of Zn (15.21 ± 0.07 mg/100‐g powder) was present in pumpkin seeds powder.Pumpkin parts (peel, flesh, and seeds) own high nutritional significance due to the presence of total phenolics, flavonoids, total carotenoids, and appreciable amount of macroelements and microelements. Organic waste generated as a result of pumpkin processing could effectively be utilized in different food products for the development of functional and medicinal foods. Notably, pumpkin seeds are high in zinc content, and in this situation of COVID‐19 pandemic, scientific community is well aware of oxidation and mediating role of zinc for activation of enzymes in the body. Phytochemicals present in pumpkin peel, flesh, and seeds can fight against antiaging and enhance immunity. These low‐cost powders from pumpkin parts can be used as a potential source of functional foods and nutraceuticals in food and medicinal industries. [ABSTRACT FROM AUTHOR] Copyright of Journal of Food Processing & Preservation is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | Determination of total phenolic, flavonoid, carotenoid, and mineral contents in peel, flesh, and seeds of pumpkin (Cucurbita maxima) |
Intestinal organoids are 3D cell structures that replicate some aspects of organ function and are organized with a polarized epithelium facing a central lumen. To enable more applications, new technologies are needed to access the luminal cavity and apical cell surface of organoids. We developed a perfusion system utilizing a double-barrel glass capillary with a pressure-based pump to access and modify the luminal contents of a human intestinal organoid for extended periods of time while applying cyclic cellular strain. Cyclic injection and withdrawal of fluorescent FITC-Dextran coupled with real-time measurement of fluorescence intensity showed discrete changes of intensity correlating with perfusion cycles. The perfusion system was also used to modify the lumen of organoids injected with GFP-expressing E. coli. Due to the low concentration and fluorescence of the E. coli, a novel imaging analysis method utilizing bacteria enumeration and image flattening was developed to monitor E. coli within the organoid. Collectively, this work shows that a double-barrel perfusion system provides constant luminal access and allows regulation of luminal contents and luminal mixing. | Perfusion System for Modification of Luminal Contents of Human Intestinal Organoids and Realtime Imaging Analysis of Microbial Populations |
Invited Commentary: Cremer et al, Double-Blind Randomised Proof-of-Concept Trial of Canakinumab in Patients with COVID-19 Associated Cardiac Injury and Heightened Inflammation, Eur Heart J Open (in press 2021) | Targeting Cytokine Storm in COVID-19: What Have We Learned? |
COVID-19 has caused the closure of university campuses around the world and migration of all learning, teaching, and assessment into online domains. The impacts of this on the academic community as frontline providers of higher education are profound. In this article, we report the findings from a survey of n = 1148 academics working in universities in the United Kingdom (UK) and representing all the major disciplines and career hierarchy. Respondents report an abundance of what we call 'afflictions' exacted upon their role as educators and in far fewer yet no less visible ways 'affordances' derived from their rapid transition to online provision and early 'entry-level' use of digital pedagogies. Overall, they suggest that online migration is engendering significant dysfunctionality and disturbance to their pedagogical roles and their personal lives. They also signpost online migration as a major challenge for student recruitment, market sustainability, an academic labour-market, and local economies. | COVID-19 and digital disruption in UK universities: afflictions and affordances of emergency online migration |
ObjectiveIn this large multi-institutional study, we aimed to analyze the prognostic power of computed tomography (CT)-based radiomics models in COVID-19 patients. MethodsCT images of 14,339 COVID-19 patients with overall survival outcome were collected from 19 medical centers. Whole lung segmentations were performed automatically using a previously validated deep learning-based model, and regions of interest were further evaluated and modified by a human observer. All images were resampled to an isotropic voxel size, intensities were discretized into 64-binning size, and 105 radiomics features, including shape, intensity, and texture features were extracted from the lung mask. Radiomics features were normalized using Z-score normalization. High-correlated features using Pearson (R2>0.99) were eliminated. We applied the Synthetic Minority Oversampling Technique (SMOT) algorithm in only the training set for different models to overcome unbalance classes. We used 4 feature selection algorithms, namely Analysis of Variance (ANOVA), Kruskal- Wallis (KW), Recursive Feature Elimination (RFE), and Relief. For the classification task, we used seven classifiers, including Logistic Regression (LR), Least Absolute Shrinkage and Selection Operator (LASSO), Linear Discriminant Analysis (LDA), Random Forest (RF), AdaBoost (AB), Naive Bayes (NB), and Multilayer Perceptron (MLP). The models were built and evaluated using training and testing sets, respectively. Specifically, we evaluated the models using 10 different splitting and cross-validation strategies, including different types of test datasets (e.g. non-harmonized vs. ComBat-harmonized datasets). The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC) were reported for models evaluation. ResultsIn the test dataset (4301) consisting of CT and/or RT-PCR positive cases, AUC, sensitivity, and specificity of 0.83{+/-}0.01 (CI95%: 0.81-0.85), 0.81, and 0.72, respectively, were obtained by ANOVA feature selector + RF classifier. In RT-PCR-only positive test sets (3644), similar results were achieved, and there was no statistically significant difference. In ComBat harmonized dataset, Relief feature selector + RF classifier resulted in highest performance of AUC, reaching 0.83{+/-}0.01 (CI95%: 0.81-0.85), with sensitivity and specificity of 0.77 and 0.74, respectively. At the same time, ComBat harmonization did not depict statistically significant improvement relevant to non-harmonized dataset. In leave-one-center-out, the combination of ANOVA feature selector and LR classifier resulted in the highest performance of AUC (0.80{+/-}0.084) with sensitivity and specificity of 0.77 {+/-} 0.11 and 0.76 {+/-} 0.075, respectively. ConclusionLung CT radiomics features can be used towards robust prognostic modeling of COVID-19 in large heterogeneous datasets gathered from multiple centers. As such, CT radiomics-based model has significant potential for use in prospective clinical settings towards improved management of COVID-19 patients. | COVID-19 Prognostic Modeling Using CT Radiomic Features and Machine Learning Algorithms: Analysis of a Multi-Institutional Dataset of 14,339 Patients |
Baricitinib is a JAK1/2 inhibitor first approved for treating moderate to severe rheumatoid arthritis but later showed considerable efficacy in the control of exaggerated inflammatory responses that occur in a wide range of diseases. There is a growing body of evidence, obtained from clinical trials and case reports, demonstrating clinical and paraclinical improvement in patients following administration of baricitinib including rheumatoid arthritis, systemic lupus erythematosus, psoriasis, atopic dermatitis, alopecia areata, interferon-mediated auto-inflammatory diseases, graft versus host disease, diabetic kidney disease, and recently, coronavirus disease-19. However, despite overall encouraging results, many adverse effects have been observed in baricitinib-treated patients ranging from simple infections to increased risk of malignancies, particularly in long-term use. The significant efficacy of baricitinib on one hand and the probable adverse effects, on the other hand, urge for further investigations before establishing it as a part of standard therapeutic protocols. Herein, we have provided a review of the studies which have used baricitinib for treating various inflammatory disorders and summarized the advantages and disadvantages of its administration. This article is protected by copyright. All rights reserved. | Baricitinib: From Rheumatoid Arthritis to COVID-195 |
Early in the pandemic, concern that cardiovascular effects would accompany COVID-19 was fueled by lessons from the first SARS epidemic, knowledge that the SARS-COV2 entry receptor (Angiotensin-converting enzyme 2, ACE2) is highly expressed in the heart, early reports of myocarditis, and first-hand accounts by physicians caring for those with severe COVID-19. Over 18 months, our understanding of the cardiovascular manifestations has expanded greatly, leaving more new questions than those conclusively answered. Cardiac involvement is common (∼ 20%) but not uniformly observed in those who require treatment in a hospitalized setting. Cardiac MRI studies raise the possibility of manifestations in those with minimal symptoms. Some appear to experience protracted cardiovascular symptoms as part of a larger syndrome of post-acute sequelae of COVID-19 (PASC). Instances of vaccine induced thrombosis and myocarditis are exceedingly rare but illustrate the need to monitor the cardiovascular safety of interventions that induce inflammation. Here, we will summarize the current understanding of potential cardiovascular manifestations of SARS-COV2. To provide proper context, paradigms of cardiovascular injury due to other inflammatory processes will also be discussed. Ongoing research and a deeper understanding COVID-19 may ultimately reveal new insight into the mechanistic underpinnings of cardiovascular disease. Thus, in this time of unprecedented suffering and risk to global health, there exists the opportunity that well conducted translational research of SARS-COV2 may provide health dividends that outlast the current pandemic. | COVID-lateral Damage: Cardiovascular Manifestations of SARS-CoV-2 Infection |
Machine Learning (ML) is becoming an increasingly critical technology in many areas such as health, business but also in everyday applications of significant societal importance However, the lack of explainability or ability of ML systems to offer explanation on how they work, which refers to the model (related to the whole data) and sample explainability (related to specific samples) poses significant challenges in their adoption, verification, and in ensuring the trust among users and general public We present novel integrated Random Forest Model and Sample Explainer – RFEX RFEX is specifically designed for important class of users who are non-ML experts but are often the domain experts and key decision makers RFEX provides easy to analyze one-page Model and Sample explainability summaries in tabular format with wealth of explainability information including classification confidence, tradeoff between accuracy and features used, as well as ability to identify potential outlier samples and features We demonstrate RFEX on two case studies: mortality prediction for COVID-19 patients from the data obtained from Huazhong University of Science and Technology, Wuhan, China, and classification of cell type clusters for human nervous system based on the data from J Craig Venter Institute We show that RFEX offers simple yet powerful means of explaining RF classification at model, sample and feature levels, as well as providing guidance for testing and developing explainable and cost-effective operational prediction models © 2021, Springer Nature Switzerland AG | Random Forest Model and Sample Explainer for Non-experts in Machine Learning – Two Case Studies |
A quantitative, real-time, nested polymerase chain reaction (PCR) method, combining the high sensitivity of nested PCR with time-saving real-time instrumentation, was developed for large-scale screening for severe acute coronavirus (SARS) coronavirus. Forty-six clinical specimens were analyzed by this method, and results were compared with those obtained by conventional, single-round, real-time reverse-transcriptase PCR (RT-PCR) performed in parallel. Of the 17 positive results, 2 identified by our method were not detected by single-round, real-time RT-PCR, which suggests that real-time nested PCR has the potential for increased sensitivity, leading to earlier detection of SARS. | Sensitive and Quantitative Detection of Severe Acute Respiratory Syndrome Coronavirus Infection by Real-Time Nested Polymerase Chain Reaction |
Hepatitis C virus (HCV) has evolved complex strategies to evade host immune responses and establish chronic infection. Since human Vγ9Vδ2 T lymphocytes play a critical role in the immune response against viruses, we analyzed their antiviral functions on Huh7 hepatoma cells carrying the subgenomic HCV replicon (Rep60 cells). In a transwell culture system, Rep60 cells were co-cultured with either PBMCs or highly purified γδ T cells stimulated by non-peptidic antigens. Vγ9Vδ2 T cell activation was associated with a dramatic reduction of HCV RNA levels. Neutralizing antibodies targeting IFN-γ revealed a critical role for this cytokine in the inhibition of HCV replication. Interestingly, drugs already in clinical use, such as Phosphostim and Zoledronate, known to activate γδ T cells, were shown to induce the inhibition of HCV replication mediated by Vγ9Vδ2 T cells of HCV patients. Our data suggest that the therapeutic activation of Vγ9Vδ2 T lymphocytes may represent an additional strategy to inhibit HCV replication and to restore a T(h)1-oriented immune response in HCV-infected patients. | Activation of Vγ9Vδ2 T cells by non-peptidic antigens induces the inhibition of subgenomic HCV replication |
BACKGROUND: The recent work on the modified H5N1 has stirred an intense debate on the risk associated with the accidental release from biosafety laboratory of potential pandemic pathogens. Here, we assess the risk that the accidental escape of a novel transmissible influenza strain would not be contained in the local community. METHODS: We develop here a detailed agent-based model that specifically considers laboratory workers and their contacts in microsimulations of the epidemic onset. We consider the following non-pharmaceutical interventions: isolation of the laboratory, laboratory workers’ household quarantine, contact tracing of cases and subsequent household quarantine of identified secondary cases, and school and workplace closure both preventive and reactive. RESULTS: Model simulations suggest that there is a non-negligible probability (5% to 15%), strongly dependent on reproduction number and probability of developing clinical symptoms, that the escape event is not detected at all. We find that the containment depends on the timely implementation of non-pharmaceutical interventions and contact tracing and it may be effective (>90% probability per event) only for pathogens with moderate transmissibility (reproductive number no larger than R(0) = 1.5). Containment depends on population density and structure as well, with a probability of giving rise to a global event that is three to five times lower in rural areas. CONCLUSIONS: Results suggest that controllability of escape events is not guaranteed and, given the rapid increase of biosafety laboratories worldwide, this poses a serious threat to human health. Our findings may be relevant to policy makers when designing adequate preparedness plans and may have important implications for determining the location of new biosafety laboratories worldwide. | Containing the accidental laboratory escape of potential pandemic influenza viruses |
PURPOSE Postoperative pancreatic fistula (POPF) is a frequent and clinically relevant problem after distal pancreatectomy. A variety of methods have been tested in the attempt to prevent POPF, most of them without convincing results. METHODS A systematic literature search was conducted in PubMed, Embase and the Cochrane Library to identify clinical studies comparing pancreatic stump closure with the addition of Tachosil(®) to conventional stump closure. The identified studies were critically appraised, and meta-analyses were performed using a random-effects model. Dichotomous data were pooled using odds ratios, and weighted mean differences were calculated for continuous outcomes, together with the corresponding 95 % confidence intervals. RESULTS Four studies (two randomised controlled trials and two retrospective clinical studies) reporting data from 738 patients were included in the meta-analysis. Overall POPF, clinically-relevant POPF, mortality, reoperations, intraoperative blood loss and length of hospital stay did not differ significantly between conventional closure and additional covering of the pancreatic stump with Tachosil(®). A sensitivity analysis of only randomised controlled trials confirmed the results. CONCLUSIONS The application of Tachosil(®) to the pancreatic stump after distal pancreatectomy is a safe procedure but provides no relevant benefit in terms of POPF, mortality, reoperation rate, blood loss or length of hospital stay. Future research should concentrate on novel methods of pancreatic stump closure to prevent POPF after distal pancreatectomy. | Effectiveness of Tachosil(®) in the prevention of postoperative pancreatic fistula after distal pancreatectomy: a systematic review and meta-analysis. |
On December 18, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Moderna COVID-19 (mRNA-1273) vaccine (ModernaTX, Inc; Cambridge, Massachusetts), a lipid nanoparticle-encapsulated, nucleoside-modified mRNA vaccine encoding the stabilized prefusion spike glycoprotein of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). This vaccine is the second COVID-19 vaccine authorized under an EUA for the prevention of COVID-19 in the United States (2). Vaccination with the Moderna COVID-19 vaccine consists of 2 doses (100 μg, 0.5 mL each) administered intramuscularly, 1 month (4 weeks) apart. On December 19, 2020, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation* for use of the Moderna COVID-19 vaccine in persons aged ≥18 years for the prevention of COVID-19. To guide its deliberations regarding the vaccine, ACIP employed the Evidence to Recommendation (EtR) Framework,† using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.§ Use of all COVID-19 vaccines authorized under an EUA, including the Moderna COVID-19 vaccine, should be implemented in conjunction with ACIP's interim recommendations for allocating initial supplies of COVID-19 vaccines (3). The ACIP recommendation for the use of the Moderna COVID-19 vaccine under EUA is interim and will be updated as additional information becomes available. | The Advisory Committee on Immunization Practices' Interim Recommendation for Use of Moderna COVID-19 Vaccine - United States, December 2020. |
We propose a new method for six-degree-of-freedom (6-DoF) autonomous camera movement for minimally invasive surgery, which, unlike previous methods, takes into account both the position and orientation information from structures in the surgical scene. In addition to locating the camera for a good view of the manipulated object, our autonomous camera takes into account workspace constraints, including the horizon and safety constraints. We developed a simulation environment to test our method on the"wire chaser"surgical training task from validated training curricula in conventional laparoscopy and robot-assisted surgery. Furthermore, we propose, for the first time, the application of the proposed autonomous camera method in video-based surgical skill assessment, an area where videos are typically recorded using fixed cameras. In a study with N=30 human subjects, we show that video examination of the autonomous camera view as it tracks the ring motion over the wire leads to more accurate user error (ring touching the wire) detection than when using a fixed camera view, or camera movement with a fixed orientation. Our preliminary work suggests that there are potential benefits to autonomous camera positioning informed by scene orientation, and this can direct designers of automated endoscopes and surgical robotic systems, especially when using chip-on-tip cameras that can be wristed for 6-DoF motion. | Orientation Matters: 6-DoF Autonomous Camera Movement for Minimally Invasive Surgery |
BACKGROUND: Coronavirus disease 2019 (COVID-19) has caused a global pandemic that has raised worldwide concern. This study aims to investigate the correlation between the extent of lung infection and relevant clinical laboratory testing indicators in COVID-19 and to analyse its underlying mechanism. METHODS: Chest high-resolution computer tomography (CT) images and laboratory examination data of 31 patients with COVID-19 were extracted, and the lesion areas in CT images were quantitatively segmented and calculated using a deep learning (DL) system. A cross-sectional study method was carried out to explore the differences among the proportions of lung lobe infection and to correlate the percentage of infection (POI) of the whole lung in all patients with clinical laboratory examination values. RESULTS: No significant difference in the proportion of infection was noted among various lung lobes (P > 0.05). The POI of total lung was negatively correlated with the peripheral blood lymphocyte percentage (L%) (r = − 0.633, P < 0.001) and lymphocyte (LY) count (r = − 0.555, P = 0.001) but positively correlated with the neutrophil percentage (N%) (r = 0.565, P = 0.001). Otherwise, the POI was not significantly correlated with the peripheral blood white blood cell (WBC) count, monocyte percentage (M%) or haemoglobin (HGB) content. In some patients, as the infection progressed, the L% and LY count decreased progressively accompanied by a continuous increase in the N%. CONCLUSIONS: Lung lesions in COVID-19 patients are significantly correlated with the peripheral blood lymphocyte and neutrophil levels, both of which could serve as prognostic indicators that provide warning implications, and contribute to clinical interventions in patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-021-05839-9. | Correlation between lung infection severity and clinical laboratory indicators in patients with COVID-19: a cross-sectional study based on machine learning |
The outbreak of the Corona Virus (COVID-19) that has begun in December 2019 drastically affected the world Endemic Coronavirus (COVID-19) is rapidly growing across the globe SARS-CoV-2 is the virus name that causes a highly contagious and deadly disease COVID-19 It also entered India by the end of January 2020 and has significantly influenced India More than two million people worldwide have been confirmed to have been contaminated with this virus as of the date (29 July 2020), and more than 7, 24,000 have died of this disease The governments of most countries, including India, have already taken several measures to reduce the spread of COVID-19, such as lockdown, social distancing, closure of shopping malls, gyms, schools, universities, religious gatherings, etc This lockdown has affected every Indian sector, such as the Economy, Retail Sector, Tourism Industry, etc This paper aims to explore to what extent a 2020 epidemic like Covid-19 had impacted the Indian economy using a machine learning approach The statistical data from esteemed and trustworthy information sources were gathered to realize the impact of the Corona Virus on the Indian economy Based on this trusted data, analysis has been performed using the various regression models © 2021 Institute of Physics Publishing All rights reserved | The Impact of COVID-19 Epidemic on Indian Economy Unleashed By Machine Learning |
CONTEXT Autopsy pathologists including medical examiners provide valuable public health support for infectious disease deaths through surveillance for deaths of public health concern including emerging infections, identifying causative organisms for unexplained deaths, and providing insights into the pathology and pathogenesis of novel or unusual infections. However, autopsy poses biosafety risks to workers within and outside the laboratory. The highest rates of laboratory acquired infections occur in autopsy workers. OBJECTIVE To design and construct an appropriately biosafe autopsy laboratory. DESIGN We conducted a biosafety risk assessment for autopsy workers using the process developed by the U.S. Centers for Disease Control and Prevention and National Institutes of Health and applied these findings as the basis of laboratory design and construction. RESULTS Autopsy workers are unpredictably exposed to a variety of infectious organisms including hepatitis C virus, HIV and M. tuberculosis. Hazardous autopsy procedures include using and encountering sharp objects, and the generation of aerosols from dissection, fluid aspiration, rinsing tissues, and dividing bone with an oscillating saw. CONCLUSIONS Exposure to bloodborne and airborne pathogens from procedures that can cause cutaneous inoculation and inhalation of aerosols indicates that human autopsies should be performed at Biosafety Level 3. We designed a large entirely Biosafety Level 3 medical examiner autopsy laboratory using design principles and characteristics that can be scaled to accommodate smaller academic or other hospital-based autopsy spaces. Containment was achieved through a concentric ring design, with access control at interface zones. As new autopsy laboratories are planned, we strongly recommend that they be designed to function uniformly at Biosafety Level 3. | Design and Construction of a Biosafety Level-3 Autopsy Laboratory. |
OBJECTIVE: In Brazil, telemedicine was allowed as an exception during the coronavirus disease (COVID-19) pandemic. Despite its recognized value and availability, telemedicine is not universally used, suggesting that some barriers prevent its adoption and acceptance within the community. This study aims to describe the implementation of a low-cost telemedicine service in a pediatric hospital in Brazil. METHOD: Retrospective descriptive study reporting the first three months (April to June 2020) of the experience of implementing a low-cost telemedicine emergency care program in a public tertiary hospital. The service was available to patients up to 18 years of age enrolled in this hospital. A tool for assessing the severity of the patient was developed, the aim of standardizing the procedure, while maintaining quality and safety. Guardian's satisfaction was assessed with a questionnaire sent after teleconsultations. RESULTS: 255 teleconsultations were carried out with 140 different patients. Of the total consultations, 182 were from 99 patients that had performed the Real-Time Polymerase Chain Reaction (RT-PCR) test for the new coronavirus (SARS-Cov-2) or had direct contact with a person known to be positive for COVID-19. Only 26 (14%) were referred to an in-person consultation. No deaths, adverse events or delayed diagnosis were recorded. 86% of the patients who answered the satisfaction questionnaire were satisfied and 92% would use telemedicine again. CONCLUSION: This study presents an innovative implementation of a telemedicine program in a public and exclusively pediatric tertiary service, serving as a reference for future implementation in other public services in Brazil and developing countries. | Fast, cheap and feasible: Implementation of pediatric telemedicine in a public hospital during the Covid-19 pandemic |
A qualidade da água e das rações são fatores importantes para o desempenho da atividade avícola. A cadeia de produção de frangos pode proporcionar variadas fontes de contaminação, incluindo a ração e a água utilizada. O presente estudo teve como objetivo avaliar a incidência de indicadores de contaminação microbiológica em ração e água fornecida a frangos de corte em uma granja avícola do município de Januária-MG. Foram realizadas análises microbiológicas da água e ração fornecidas aos frangos, avaliando a contagem de bactérias coliformes totais, coliformes a 45°C e enterobactérias. A elevada contagem de coliformes totais e coliformes a 45°C na água e na ração, assim como, a elevada contagem de enterobactérias na ração pode representar a possibilidade da presença de bactérias patogênicas e consequente risco à saúde dos consumidores das aves comercializadas pela granja pesquisada.(AU) | Contaminação microbiológica da ração e água fornecida a frangos em granja avícola da cidade de Januária, MG |
BACKGROUND: Population mobility is closely associated with COVID-19 transmission, and it could be used as a proximal indicator to predict future outbreaks, which could inform proactive nonpharmaceutical interventions for disease control. South Carolina is one of the US states that reopened early, following which it experienced a sharp increase in COVID-19 cases. OBJECTIVE: The aims of this study are to examine the spatial-temporal relationship between population mobility and COVID-19 outbreaks and use population mobility data to predict daily new cases at both the state and county level in South Carolina. METHODS: This longitudinal study used disease surveillance data and Twitter-based population mobility data from March 6 to November 11, 2020, in South Carolina and its five counties with the largest number of cumulative confirmed COVID-19 cases. Population mobility was assessed based on the number of Twitter users with a travel distance greater than 0.5 miles. A Poisson count time series model was employed for COVID-19 forecasting. RESULTS: Population mobility was positively associated with state-level daily COVID-19 incidence as well as incidence in the top five counties (ie, Charleston, Greenville, Horry, Spartanburg, and Richland). At the state level, the final model with a time window within the last 7 days had the smallest prediction error, and the prediction accuracy was as high as 98.7%, 90.9%, and 81.6% for the next 3, 7, and 14 days, respectively. Among Charleston, Greenville, Horry, Spartanburg, and Richland counties, the best predictive models were established based on their observations in the last 9, 14, 28, 20, and 9 days, respectively. The 14-day prediction accuracy ranged from 60.3%-74.5%. CONCLUSIONS: Using Twitter-based population mobility data could provide acceptable predictions of COVID-19 daily new cases at both the state and county level in South Carolina. Population mobility measured via social media data could inform proactive measures and resource relocations to curb disease outbreaks and their negative influences. | Spatial-Temporal Relationship Between Population Mobility and COVID-19 Outbreaks in South Carolina: Time Series Forecasting Analysis |
RLadyBug is an S4 package for the simulation, visualization and estimation of stochastic epidemic models in R. Maximum likelihood and Bayesian inference can be performed to estimate the parameters in a susceptible-exposed-infectious-recovered (SEIR) model, which is a stochastic model for describing a single outbreak of an infectious disease. The package is thus one step towards statistical software supporting parameter estimation, calculation of confidence intervals and hypothesis testing for transmission models. | RLadyBug—An R package for stochastic epidemic models |
COVID-19 acts as a serious challenge to the whole world. Epidemiological data of COVID-19 is collected through media and web sources to analyze and investigate a system of nonlinear ordinary differential equation to understand the outbreaks of this epidemic disease. We analyze the diseases free and endemic equilibrium point including stability of the model. The certain threshold value of the basic reproduction number R0 is found to observe whether population is in disease free state or endemic state. Moreover, the epidemic peak has been obtained and we expect a considerable number of cases. Finally, some numerical results are presented which show the effect of parameters estimation and different step size on our obtained solutions at the real data of some countries to check the actual behavior of the COVID-19 at different countries. © This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. | Dynamical transmission of coronavirus model with analysis and simulation |
OBJECTIVE: To determine the impact of the 2019 novel coronavirus disease (COVID-19) pandemic on operative case volume in 8 U.S. neurosurgical residency training programs in early 2020 and to survey these programs regarding training activities during this period. METHODS: A retrospective review was conducted of monthly operative case volumes and types for 8 residency programs for 2019 and January through April 2020. Cases were grouped as elective cranial, elective spine, and nonelective emergent cases. Programs were surveyed regarding residents' perceptions of the impact of COVID-19 on surgical training, didactics, and research participation. Data were analyzed for individual programs and pooled across programs. RESULTS: Across programs, the 2019 monthly mean ± SD case volume was 211 ± 82; 2020 mean ± SD case volumes for January, February, March, and April were 228 ± 93, 214 ± 84, 180 ± 73, and 107 ± 45. Compared with 2019, March and April 2020 mean cases declined 15% (P = 0.003) and 49% (P = 0.002), respectively. COVID-19 affected surgical case volume for all programs; 75% reported didactics negatively affected, and 90% reported COVID-19 resulted in increased research time. Several neurosurgery residents required COVID-19 testing; however, to our knowledge, only 1 resident from the participating programs tested positive. CONCLUSIONS: This study documents a significant reduction in operative volume in 8 neurosurgery residency training programs in early 2020. During this time, neurosurgery residents engaged in online didactics and research-related activities, reporting increased research productivity. Residency programs should collect data to determine the educational impact of the COVID-19 pandemic on residents' operative case volumes, identify deficiencies, and develop plans to mitigate any effects. | Early Effects of COVID-19 Pandemic on Neurosurgical Training in the United States: A Case Volume Analysis of 8 Programs |
The EMBL-EBI Expression Atlas is an added value knowledge base that enables researchers to answer the question of where (tissue, organism part, developmental stage, cell type) and under which conditions (disease, treatment, gender, etc) a gene or protein of interest is expressed. Expression Atlas brings together data from >4500 expression studies from >65 different species, across different conditions and tissues. It makes these data freely available in an easy to visualise form, after expert curation to accurately represent the intended experimental design, re-analysed via standardised pipelines that rely on open-source community developed tools. Each study's metadata are annotated using ontologies. The data are re-analyzed with the aim of reproducing the original conclusions of the underlying experiments. Expression Atlas is currently divided into Bulk Expression Atlas and Single Cell Expression Atlas. Expression Atlas contains data from differential studies (microarray and bulk RNA-Seq) and baseline studies (bulk RNA-Seq and proteomics), whereas Single Cell Expression Atlas is currently dedicated to Single Cell RNA-Sequencing (scRNA-Seq) studies. The resource has been in continuous development since 2009 and it is available at https://www.ebi.ac.uk/gxa. | Expression Atlas update: gene and protein expression in multiple species |
Background: The prevalence of anxiety and depression in young students is associated with biosocial factors and scholastic stress. However, few studies have evaluated emotional-affective symptoms that are related to the immune system and antioxidant parameters in young individuals without diagnoses of affective disorders. Aim: This study aims to assess the relationship between emotional-affective symptoms and glutathione concentrations and CD4 and CD8 lymphocyte counts in college students. Methods: College students (n = 177) completed standardized psychometric instruments, including the Perceived Stress Scale, Hamilton Anxiety Scale, Beck Depression Inventory, Familiar Social and Friends Support Scale, and Rosenberg Scale. Blood samples were biochemically analyzed. Analyses of variance were conducted between four groups according to symptom severity. Results: A considerable prevalence of stress, anxiety, and depression symptoms was observed and negatively correlated with self-esteem and socio-familiar support. Perceived stress was sexually dimorphic. Although biochemical parameters were within reference ranges, glutathione, CD4, and CD8 tended to be lower in participants with anxiety and depression symptoms, which may be of predictive value. Conclusion: The relationship between antioxidant/immune parameters and socio-affective scores is latent in undiagnosed college students who might develop affective disorders. The findings suggest that during the initial development of affective disorders, stress management strategies should be implemented to help college students cope with the academic load and monitor negative changes in their physiological state. | Association Between Socio-Affective Symptoms and Glutathione and CD4 and CD8 Lymphocytes in College Students |
We determined the interferon-γ (IFN-γ) cDNA sequence from three porcine breeds, Duroc, Landrance/Duroc hybrid, and Landrance breeds. Five single nucleotide polymorphisms (SNPs) of porcine IFN-γ (PoIFN-γ) were identified, respectively, at positions 269 (A/G), 376 (C/T), 426 (T/C), and 465 (T/C) of the coding sequence in Landrance/Duroc hybrid, and at position 251 (A/G) in Landrance breed. Among them, A269G and A251G polymorphisms resulted in Q67R and K61R replacements in the mature protein. PoIFN-γ cDNAs of Duroc breed (PoIFN-γ-W) and Landrance/Duroc hybrid (PoIFN-γ-M), which, respectively, encoded Q67 and R67, were introduced into a prokaryotic expression vector pET32 to express recombinant PoIFN-γ-W (rPoIFN-γ-W) and rPoIFN-γ-M protein variants in Escherichia coli. The identity of both protein variants was further confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We then compared bioactivities of these two recombinant proteins. Although both recombinant protein variants exhibited comparable activities in antiproliferation of PK-15 cells and in nitric oxide (NO) induction of porcine peripheral monocytes, antiviral activity of rPoIFN-γ-W protein was significantly higher (P < 0.001) than that of rPoIFN-γ-M protein in a plaque inhibition assay using pseudorabies virus (PRV). IC50 values of rPoIFN-γ-W and rPoIFN-γ-M protein in anti-PRV assay were determined as 5.3 ± 1.3 and 9.3 ± 4.3 nM, respectively. In conclusion, we have identified five novel SNPs in PoIFN-γ cDNA, including two missense polymorphisms that result in Q67R and K61R replacements. Our results further demonstrate that Q67R can markedly reduce antiviral activity of the PoIFN-γ protein. This is the first report that shows the functional SNP in the coding region of IFN-γ. In the future, it is imperative to determine whether Q67R replacement in IFN-γ may have disease association. | A missense polymorphism in porcine interferon-γ cDNA affects antiviral activity of the protein variant |
Objective: We evaluated digital consultations at a University Hospital in Switzerland within an integrative medicine outpatient setting. Patients' and treatment providers' (physicians and therapists) evaluated digital conversation-based consultations as well as the digital delivery of practical exercises. Methods: Digital consultations between March 15, 2020 and April 30, 2020 were identified. Between June and July 2020, patients and treatment providers completed online questionnaires addressing challenges and advantages of their digital consultations. Both groups documented their satisfaction and working alliance (Working Alliance Inventory). In addition, semistructured qualitative interviews with treatment providers were conducted. Findings: A total of 82 online surveys (response rate 47%) about the digital consultations were available for analyses, with 60 patients correctly identifying at least one treatment provider, and 9 interviews were performed. Patients and treatment providers overall evaluated the new setting of digital consultation as feasible and an efficient consultation format. Interestingly, the working alliance was rated as good. Technical problems were mentioned as the main challenge and the delivery of practical exercises in digital consultations was seen more challenging than having digital conversation-based consultations. Conclusion: Digital consultations were established with overall positive evaluations and with a good working alliance between patients and providers. For the delivery of practical exercises it might be required to develop more innovative digital settings to overcome shortcomings of the digital format. Hybrid settings that combine the best of both settings could be a good option for future in postpandemic times. | Digital Consultations During COVID-19: A Multiperspective Mixed-Methods Study in an Integrative Medicine Setting in Switzerland |
After the decision to transport by medical air evacuation COVID patients to the western and southern French regions with civilian air vectors and military air vectors, the Samu 94, in collaboration with the services of Paris-Orly airport, opened a medical center of evacuation (CME) at the airport medical service (SMU). The CME under tent, equipped with medical equipment and drug resources, was able to temporarily accommodate 16 patients. The Samu 94 has also established an operational medial coordination center at the level of the SMU. The coordination center was composed of all human resources necessary for the accomplishment of the mission. The coordination center received information from the zonal SAMU about patients to be transferred. The role of the coordination center was to ensure all the logistical chain from the pic-up of the patient at the hospital of origin, to the destination hospital. The coordination center ensures the mobilization of the medical team who take care of the patient either directly by helicopter placed on the DZ of the hospital, or by implementation a land transportation before boarding in a civilian, military plane or helicopter at the Paris-Orly hub. | Feedback on the COVID air coordination and evacuation medical center - Paris-orly |
This pilot study was conducted on the reported hypothesis that the COVID-19 pandemic outbreak had an impact on the accessibility and quality of healthcare services and exacerbated socioeconomic inequalities. The aim was to determine whether economic status and education had an impact on the perception of access and quality to healthcare services during the COVID-19 pandemic and whether, according to patients, accessibility and quality had changed significantly compared to the pre-pandemic period in Poland. The study was based on the authors’ questionnaire and the results were statistically analyzed. Two hundred forty-seven feedback responses were received with a responsiveness rate of 93 percent. Statistically significant differences were found when comparing education level and utilization of healthcare services during the COVID-19 pandemic. A comparison of gender and economic situation, and average monthly income found no statistically significant differences. The outbreak of the COVID-19 pandemic has undoubtedly affected the provision of health services in many countries around the world. One result of the pandemic crisis has been widening socioeconomic inequalities among patients. | Impact of Socioeconomic Status on the Perception of Accessibility to and Quality of Healthcare Services during the COVID-19 Pandemic among Poles—Pilot Study |
As the world grapples with the COVID-19 pandemic, there has been a sudden and abrupt change in global energy landscape Traditional fossil fuels that serve as the linchpin of modern civilization have found their consumption has rapidly fallen across most categories due to strict lockdown and stringent measures that have been adopted to suppress the disease These changes consequently steered various environmental benefits across the world in recent time The present article is an attempt to investigate these environmental benefits and reversals that have been materialized in this unfolding situation due to reduced consumption of fossil fuels The life cycle assessment tool was used hereby to evaluate nine environmental impacts and one energy based impact These impacts include ozone formation (terrestrial ecosystems), terrestrial acidification, freshwater eutrophication, marine eutrophication, terrestrial ecotoxicity, freshwater ecotoxicity, marine ecotoxicity, land use, mineral resources scarcity, and cumulative exergy demand Outcomes from the study demonstrate that COVID-19 has delivered impressive changes in global environment and life cycle exergy demand, with about 11–25% curtailment in all the above-mentioned impacts in 2020 in comparison to their corresponding readings in 2019 | On Reduced Consumption of Fossil Fuels in 2020 and Its Consequences in the Global Environment and Exergy Demand |
Even though SARS-CoV-2’s primary transmission pathway is person-to-person, the role played by surfaces and food contact materials in carrying viral RNA should be further explored For this purpose, the study aimed to investigate the persistence of SARS-CoV-2 using the strain ATCC® VR-1986HK™ on flow pack polyethylene (FPP) and polystyrene food trays (PFT) Samples of FPP and PFT were contaminated with heat-inactivated SARS-CoV-2 and were incubated at a temperature of 24 ± 1°C and at controlled relative humidity (RH 65%) The experimental design included analyses at the time 0, 3, 6, 12, 24, 36, 48 and after every 24 hours until the viral RNA was no longer detectable The results showed a significant decrease (P<0 001) in viral copies number on PFT within 3 hours (24% reduction) and, at 72 hours, the viral RNA had fallen below the limit of detection Regarding the FPP, it was necessary to wait 24 hours for a significant decrease (P=0 015) in the viral load (14% reduction), while the detection threshold was reached at 96 hours These findings showed that the viral RNA persists longer on polyethylene flow pack samples than on polystyrene food trays, thus highlighting the importance of material characteristics in the persistence of SARS-CoV-2 | Evaluation of the persistence of SARS-CoV-2 (ATCC® VR-1986HK™) on two different food contact materials: flow pack polyethylene and polystyrene food trays |
BACKGROUND: In Australia, the COVID-19 pandemic has caused severe social disruptions, including restrictions to the movement of people. Healthcare centres around the world have seen changes in the nature of injuries acquired during the COVID-19 pandemic; we therefore hypothesize that social isolation measures have changed the pattern of plastic and reconstructive surgery presentations. METHODS: A prospective cohort study was designed comparing patient presentations during the enforced COVID-19 lockdown to two previous periods. All emergency referrals requiring operative intervention by the plastic and reconstructive surgery unit of our institution were included. Patient demographics, place and mechanism of injury, drug and alcohol involvement, delays to presentation, length of admission and complication rates were collected. RESULTS: Demographics and complication rates were similar across all groups. A 31.8% reduction in total number of emergency cases was seen during the lockdown period. Increase in do-it-yourself injuries (P = 0.001), bicycle injuries (P = 0.001) and injuries acquired via substance abuse (P = 0.041) was observed. Head and neck injuries, mostly due to animal bites and falls, were also more prevalent compared to the same period the previous year (P = 0.007). As expected, over 80% of plastic surgery operations during the COVID-19 period were due to injuries acquired at home, a significant increase compared to previous periods. CONCLUSION: Despite changes in the pattern of presentations requiring plastic and reconstructive emergency surgery, traumatic injuries continued to occur during the pandemic. Thus, planning will be essential to ensure resource allocation for emergency procedures is sustained as second and third waves of COVID-19 cases emerge worldwide. | Effects of COVID-19 lockdown measures on emergency plastic and reconstructive surgery presentations |
Inflammatory bowel diseases (IBD) refer to a subgroup of chronic, progressive, long-term, and relapsing inflammatory disorders. IBD may spontaneously grow in the colon, and in severe cases may result in tumor lesions such as invasive carcinoma in inflamed regions of the intestine. Recent epidemiological reports indicate that old age and underlying diseases such as IBD contribute to severity and mortality in patients with coronavirus disease 2019 (COVID-19). Currently, the ongoing COVID-19 pandemic caused serious morbidity and mortality worldwide. It has also been shown that the transmembrane serine protease 2 is an essential factor for viral activation and viral engulfment. Generally, viral entry causes a 'cytokine storm' that induces excessive generation of proinflammatory cytokines/chemokines including interleukin (IL)-6, IL-2, IL-7, tumor necrosis factor-α, and interferon-γ. Future research could concentrate on developing inflammatory immunological responses that are efficient to encounter COVID-19. Current analysis elucidates the role of inflammation and immune responses during IBD infection with COVID-19 and provides a list of possible targets for IBD-regulated therapies in particular. Data from clinical, in vitro, and in vivo studies were collected in English from PubMed, Google Scholar, Scopus, and the Cochrane library until May 2021. | Transmembrane serine protease 2 and angiotensin-converting enzyme 2 anti-inflammatory receptors for COVID-19/inflammatory bowel diseases treatment |
The virtual meeting was a success. Several people told us that this was"the best virtual meeting they had seen so far", which, a year into the pandemic and without a commercial provider in the back, is a great success. The biggest point of criticism was the timing: We had programming from UTC 17:00-22:00 (evening and night in central Europe, afternoon on the US East Coast, during the day in South America and on the US West coast, but in the middle of the night for Asia and Australia). There is no good solution, but at least some variation in session time might go a long way to make it easier for all to attend at least some sessions. Feedback also indicates that the schedule was too compressed. Poster sessions and social contacts with the tool Gathertown worked out really well for all that used it. Our way of combining several services (Zoom for plenary and break-out rooms, Zenodo for uploading and viewing posters and proceedings, Google forms for registration and abstract submission, gathertown) allowed for a very low-cost meeting with little overhead (total cost: 600 $ for gathertown, zoom was provided through an institutional subscription, just 4 people on the LOC). | How to organize an online conference -- Lessons learned from Cool Stars 20.5 (virtually cool) |
The development of the nervous system requires precise regulation. Any disturbance in the regulation process can lead to neurological developmental diseases, such as autism and schizophrenia. Histone variants are important components of epigenetic regulation. The function and mechanisms of the macroH2A (mH2A) histone variant during brain development are unknown. Here, we show that deletion of the mH2A isoform mH2A1.2 interferes with neural stem cell differentiation in mice. Deletion of mH2A1.2 affects neurodevelopment, enhances neural progenitor cell (NPC) proliferation, and reduces NPC differentiation in the developing mouse brain. mH2A1.2-deficient mice exhibit autism-like behaviors, such as deficits in social behavior and exploratory abilities. We identify NKX2.2 as an important downstream effector gene and show that NKX2.2 expression is reduced after mH2A1.2 deletion and that overexpression of NKX2.2 rescues neuronal abnormalities caused by mH2A1.2 loss. Our study reveals that mH2A1.2 reduces the proliferation of neural progenitors and enhances neuronal differentiation during embryonic neurogenesis and that these effects are at least in part mediated by NKX2.2. These findings provide a basis for studying the relationship between mH2A1.2 and neurological disorders. | MacroH2A1.2 deficiency leads to neural stem cell differentiation defects and autism-like behaviors. |
BACKGROUND AND AIM: Understanding people's attitudes towards Covid-19 vaccination is crucial to the successful implementation of a vaccination program. Hence this research study seeks to identify critical factors influencing Indian people's attitudes and intentions to take up Covid-19 vaccinations. METHODS: An online questionnaire was administered to a sample (n = 254) drawn from Indian population, to assess the impact of perceived benefits, risk perceptions, social media exposure, social norms, and trust associated with Covid-19 vaccines on people's attitudes towards Covid-19 vaccines and their intentions to take up the Covid-19 vaccinations. RESULTS: The findings showed that the perceived benefits, social norms, and trust correlated significantly with people's attitudes towards Covid-19 vaccinations. In contrast, risk perceptions and social media exposure showed an insignificant influence on people's attitudes towards Covid-19 vaccinations. Social norms, trust, and people's attitudes towards the Covid-19 vaccinations are significantly correlated with their intentions to take up Covid-19 vaccinations. On the contrary, social media exposure was found to have an insignificant influence on people's intentions to take up Covid-19 vaccinations. CONCLUSION: Participants' intentions to take up Covid-19 vaccinations was influenced mainly by their attitudes and perceptions of Covid-19 vaccines in general, which strongly confirms the importance of various dimensions (perceived benefits, trust, social norms) of Covid-19 vaccines in cultivating Covid-19 vaccination acceptance among participants'. | Using structural equation modeling to predict Indian people's attitudes and intentions towards COVID-19 vaccination |
The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional—collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19. | The use of DIY (Do it yourself) sampling and telemonitoring model for COVID-19 qPCR testing scale up |
This paper seeks to understand the role of nationalism in China's policy towards the combat of emerging infectious diseases. By locating nationalism as a factor which facilitates or impedes global governance and international collaboration, this paper explores how nationalism influences China's political decision‐making. Given her historical experience, China has in its national psyche an impulse never to become ‘the sick man of the East’ again. Today, China's willingness to co‐operate with international bodies emanates out of reputational concerns rather than technical‐medical considerations. This was clearly manifested in her handling of two epidemics in recent years: the Severe Acute Respiratory Syndrome (SARS) and HIV/AIDS episodes. This paper concludes that China's nationalism plays an inhibiting role in China's attempts to further incorporate herself into the architecture of global health governance in the long run. | Sovereign Dignity, Nationalism and the Health of a Nation: A Study of China's Response in Combat of Epidemics |
O objetivo desta ferramenta de visualização de dados é facilitar o acesso de gestores de saúde, pesquisadores, estudantes e da população em geral a informações atualizadas sobre as medidas de distanciamento social adotadas em cada Unidade da Federação (UF) em resposta a pandemia de COVID-19 e a evolução dos casos e óbitos por COVID-19 no Brasil, desde os primeiros casos identificados no país no final de fevereiro 2020 | Medidas de distanciamento social e evolução da COVID-19 no Brasil |
Cities have had historically higher mortality and morbidity rates than rural areas. These spiked dramatically after the Industrial Revolution, which led to the first health of cities movement that stimulated the adoption of new public health measures to improve the built-environment in the developed countries. Together with such additional factors as increasing prosperity, hygiene and especially medical advances, the old health disadvantages of cities was reversed. But a new set of medical challenges threatening to reverse previous progress has emerged. These include such problems as bacterial resistances to many of the drugs that reduced communicative diseases, to the effects of indoor living and aging, all of which require urgent attention. In addition, a review of the various health determinants that contribute to ill-health shows that since many of these factors are not within the prevue of current medical practice, they must be addressed if the health and well-being of people in cities are to be improved. A series of other problems that were previously overlooked are being tackled by the new Healthy Cities movement, such as the need for more political and citizen involvement in planning and delivering health care, better ways of promoting health rather than just curing ill-health with a new emphasis on wellness, as well as more effective measures to reduce the persistent pockets of ill-health in many cities. | Healthy Cities: Old and New Solutions |
Background: Medical students play an important role in the prevention and control of COVID-19 by way of disseminating knowledge regarding COVID-19 among the people It is affected by their knowledge, attitude and practices about the disease Objectives: To assess the knowledge, attitudes, and practices (KAP) towards COVID-19 in undergraduate medical students Methodology: A quick online survey was carried out among 316 participants with a self-designed, structured questionnaire in the form of goggle form Cronbach’s alpha of the study instrument was 0 71 Statistical Analysis: Data were analyzed by SPSS, version 25 Chi-square test, Student’s t-test, ANOVA and post hoc analysis were done Results: A total of 316 participants completed the survey questionnaire The mean COVID-19 knowledge scorewas 18 82±2 27 and overall 90% had correct knowledge Knowledge scores significantly (p<0 05) differed across age-groups and semesters In post hoc analysis, mean knowledge score in 2nd semester students (18 11±2 55) was significantly (p<0 05) lower than that of 8th semester (19 56±1 66) Seventy percent respondents agreed that COVID-19 will finally be controlled,77 2% had confidence that India will win the battle against COVID-19, and 90% of the respondents agreed that hand washing with soap water will prevent them from getting the infection 96 2% participants avoid crowded places, 95 2% participants wore face masks while going outside home and 97 5%frequently washed hands with soap and water Conclusion: In this study majority undergraduate students had good knowledge, showed optimistic attitude and appropriate practice towards COVID-19 However, there is need and scope for improving knowledge and practices so that every student adopts preventive and promotive measures against COVID-19 | Knowledge, attitude and practices towards covid-19 among undergraduate students in a medical college of delhi |
The neuroimmune system is required for normal neural processes, including modulation of cognition, emotion, and adaptive behaviors. Aberrant neuroimmune activation is associated with dysregulation of memory and emotion, though the precise mechanisms at play are complex and highly context dependent. Sex differences neuroimmune activation and function further complicate our understanding of its roles in cognitive and affective regulation. Here, we characterized the physiological sickness and inflammatory response of the hippocampus following intracerebroventricular (ICV) administration of a synthetic viral mimic, polyinosinic:polycytidylic acid (poly I:C), in both male and female C57Bl/6 mice. We observed that poly I:C induced weight loss, fever, and elevations of cytokine and chemokines in the hippocampus of both sexes. Specifically, we found transient increases in gene expression and protein levels of IL-1a, IL-1β, IL-4, IL-6, TNFa, CCL2, and CXCL10, where males showed a greater magnitude of response compared with females. Only males showed increased IFNa and IFNγ in response to poly I:C, whereas both males and females exhibited elevations of IFNβ, demonstrating a specific sex difference in the anti-viral response in the hippocampus. This suggests that type I interferons are one potential node mediating sex-specific cytokine responses and neuroimmune effects on synaptic plasticity and cognition. These findings highlight the importance of using both males and females and analyzing a broad set of inflammatory markers in order to identify the precise, sex-specific roles for neuroimmune dysregulation in neurological diseases and disorders including Alzheimer’s Disease and depression. | Sex differences and similarities in the neuroimmune response to central administration of poly I:C |
Since the beginning of the Covid19 pandemic, many efforts have been devoted to identifying approaches to neutralize SARS-CoV-2 replication within the host cell. A promising strategy to block the infection consists of using a mutant of the human receptor angiotensin-converting enzyme 2 (ACE2) as a decoy to compete with endogenous ACE2 for the binding to the SARS-CoV-2 Spike protein, which decreases the ability of the virus to enter the host cell. Here, using a computational framework based on the 2D Zernike formalism we investigate details of the molecular binding and evaluate the changes in ACE2-Spike binding compatibility upon mutations occurring in the ACE2 side of the molecular interface. We demonstrate the efficacy of our method by comparing our results with experimental binding affinities changes upon ACE2 mutations, separating ones that increase or decrease binding affinity with an Area Under the ROC curve ranging from 0.66 to 0.93, depending on the magnitude of the effects analyzed. Importantly, the iteration of our approach leads to the identification of a set of ACE2 mutants characterized by an increased shape complementarity with Spike. We investigated the physico-chemical properties of these ACE2 mutants and propose them as bona fide candidates for Spike recognition. | Computational optimization of angiotensin-converting enzyme 2 for SARS-CoV-2 Spike molecular recognition |
The e-Bintech 5.0 online workshop was held to sharpen the concept of village 5.0 that is a multidisciplinary acculturation-constellation. In this workshop multi platform frameworks were successfully formulated as a basic guideline for village developments towards the glory of Indonesia. Penta Helix platform synergy is needed (academics, business government community media) supported by relevant stakeholders for fostering a futuristic village towards the creation of Indonesia 5.0 especially in terms of ease of investment, simplification of bureaucracy and administration. Key Words: edubioneuroli technopreneurship;Indonesia 5.0;penta helix;village 5.0 Lokakarya daring e-Bintech 5.0 diadakan untuk menajamkan konsep desa 5.0 yang merupakan akulturasi-konstelasi multidisipliner. Dalam lokakarya ini berhasil dirumuskan multiplatform-frameworks sebagai pedoman dasar pengembangan-pembangunan desa menuju kejayaan Indonesia. Diperlukan sinergi platform pentahelix (akademisi bisnis pemerintah komunitas media) didukung stakeholders terkait untuk pembinaan desa futuristik menuju terciptanya Indonesia 5.0 terutama dalam hal kemudahan investasi simplifikasi birokrasi dan administrasi. | E-bintech 5.0: Desa siaga COVID-19 berbasis edu bioneuron technopreneurship menuju Indonesia 5.0 |
With the onset of the Covid-19 pandemic in 2020, numerous disparities in both geriatric mental health care and geriatric mental health education emerged as challenges for medical educators. Many of these disparities were known prior to the onset of pandemic, including unequal access to geriatric psychiatry educators and clinical experts across the country, as well as limited opportunities for clinical experiences in geriatric psychiatry for medical students and residents. Indeed, the Institute of Medicine Report of 2012, “In Whose Hands: The Mental Health and Substance Use Workforce for Older Adults”, had identified the current and projected gaps in geriatric mental health training to meet the needs of an aging population. Since 2020, additional gaps and disparities have been recognized that adversely affect the ability to adequately develop and train the next generation of geriatric psychiatrists, as well as geriatrics-informed general psychiatrists and primary care physicians. The year 2020 also brought to the fore, issues of racism and ageism, both of which may not have been adequately addressed before in geropsychiatry education. Yet, racism and ageism are both now more clearly understood as key factors affecting the lives of elders and adding to disparities in geriatric mental health care. At the same time, the challenges of the pandemic led to new innovations in both the delivery of geropsychiatry education and the content of the education strategies that will help to mitigate disparities for patients and trainees. This symposium will address 3 key areas related to disparities in geropsychiatric education and will share important insights that should inform future approaches to geropsychiatry education. Dr. Susan W. Lehmann will present on: “’In Whose Hands?’: Where are we today?” In her talk, Dr. Lehmann will discuss the 2012 Institute of Medicine Report that described the deficiencies and disparities in geriatric mental health education identified in 2012, and she will provide an update 10 years later about what has changed since the report, and what remains to be done. She will specifically talk about geographic disparities in opportunities for training and the impact of these disparities on the mental health care of older adults. Dr. Lehmann will discuss the need for professional organizations to focus on national approaches to advocacy and change. Dr. Kirsten Wilkins will present on: “Challenges and Opportunities: Preparing the Next Generation of Geropsychiatry Trainees”. In her talk, Dr. Wilkins will discuss disparities in health care that were exposed by the Covid-19 pandemic and which negatively impact geropsychiatry education. She will address the clinical care training challenges presented by unequal access to telemedicine for elders, as well as the challenges of incorporating virtual care into the geropsychiatry curriculum for trainees. Dr. Wilkins will also address the national reckoning on race and racism that emerged during 2020 and its impact on older adults and the learning environment for geropsychiatry trainees. She will discuss the implications for geropsychiatry educators in preparing trainees to be leaders in eliminating the deleterious effects of racism and ageism for older adults. Dr. Michelle Conroy will present on: “Innovations and opportunities within geriatric psychiatry education: lessons learned from the COVID-19” pandemic. She will discuss innovations in geropsychiatry education that were developed during the Covid-19 pandemic in response to identified disparities, and lessons learned for educators that should continue into the future. In particular, she will describe a number of successful new outreach programs, didactics, and educational products developed by geropsychiatry educators in AAGP. | Addressing Disparities in Geropsychiatry Education: Lessons Learned from 2020 |
Although empirical reports draw attention to the pathological aspects of the functioning of the homeless, recent studies show the benefits related to the elevating roles of different positive phenomena in coping with difficulties for this group of people. The main goal was to verify whether there is a direct relationship between religiosity and gratitude among the homeless, and whether this association is moderated by the reported help-seeking since both religiosity and gratitude seem to play an important role in homeless people’s lives. In total, 189 homeless persons participated in the study. Their mean age was M = 56.55 (SD = 12.39; range = 27–86). Most respondents were men (n = 119; 63%). The Scale of Religious Attitude Intensity and the Gratitude Questionnaire were used. The outcomes presented a statistically significant positive correlation between religious attitude and gratitude (r = 0.326***, p = 0.001). Help-seeking played a moderatory role in this relationship. Therefore, it can be assumed that the relationship between religiosity attitude intensity and dispositional gratitude is stronger when homeless persons seek specific help from other people or institutions compared to when they do not look for assistance. Homeless people, overcoming their limitations by actively asking for help, can strengthen their bonds with God (faith, religiosity) and with others (dispositional gratitude). | Moderating Effect of Help-Seeking in the Relationship between Religiosity and Dispositional Gratitude among Polish Homeless Adults: A Brief Report |
Ty3 elements of S. cerevisiae contain two overlapping coding regions, GAG3 and POL3, which are functional homologues of retroviral gag and pol genes, respectively. Pol3 is translated as a Gag3‐Pol3 fusion protein dependent on a +1 programmed frameshift at a site with the overlap between the two genes. We show that the Ty3 frameshift frequency varies up to 10‐fold in S. cerevisiae cells depending on carbon source. Frameshift efficiency is significantly lower in cells growing on glucose as carbon source than in cells growing on poor alternative carbon sources (glycerol/lactate or galactose). Our results indicate that Ty3 programmed ribosomal frameshift efficiency in response to glucose signalling requires two protein kinases: Snf1p and cAMP‐dependent protein kinase A (PKA). Increased frameshifting on alternative carbon sources also appears to require cytoplasmic localization of Snf1p, mediated by the Sip2p protein. In addition to the two required protein kinases, our results implicate that Stm1p, a ribosome‐associated protein involved in nutrient sensing, is essential for the carbon source‐dependent regulation of Ty3 frameshifting. These data indicate that Ty3 programmed ribosomal frameshift is not a constitutive process but that it is regulated in response to the glucose‐signalling pathway. Copyright © 2011 John Wiley & Sons, Ltd. | Glucose signalling pathway controls the programmed ribosomal frameshift efficiency in retroviral‐like element Ty3 in Saccharomyces cerevisiae |
The SARS-CoV-2 pandemic is one of the most concerning health problems around the globe. We reported the emergence of SARS-CoV-2 variant B.1.1.519 in Mexico City. We reported the effective reproduction number (Rt) of B.1.1.519 and presented evidence of its geographical origin based on phylogenetic analysis. We also studied its evolution via haplotype analysis and identified the most recurrent haplotypes. Finally, we studied the clinical impact of B.1.1.519. The B.1.1.519 variant was predominant between November 2020 and May 2021, reaching 90% of all cases sequenced in February 2021. It is characterized by three amino acid changes in the spike protein: T478K, P681H, and T732A. Its Rt varies between 0.5 and 2.9. Its geographical origin remain to be investigated. Patients infected with variant B.1.1.519 showed a highly significant adjusted odds ratio (aOR) increase of 1.85 over non-B.1.1.519 patients for developing a severe/critical outcome (p = 0.000296, 1.33–2.6 95% CI) and a 2.35-fold increase for hospitalization (p = 0.005, 1.32–4.34 95% CI). The continuous monitoring of this and other variants will be required to control the ongoing pandemic as it evolves. | The Evolutionary Landscape of SARS-CoV-2 Variant B.1.1.519 and Its Clinical Impact in Mexico City |
One of the defining issues of the COVID-19 pandemic is controversy over personal protective equipment (PPE) – whether in relation to shortages, difficulties with supply and fit, or confusion over what should be worn. | Nurses’ right to refuse to treat: when is it justified? |
Higher education learning and teaching has faced a significant challenge in 2020 The novel coronavirus pandemic (COVID-19) has required institutions to engage in emergency response teaching and deliver distance, online, or socially distanced delivery in most jurisdictions globally The literature to date has focused on understanding this from the perspective of the institutions and academics primarily For example, institutional case studies and staff critical reflections There has been literature published on student learning, student experience, and student wellbeing during COVID-19, but these are typically constructed through an academic lens (e g a student satisfaction survey) This research offers a co constructed account developed adopting a students as partners philosophy Our research team includes four students from two countries (Australia and Singapore) to independently reflect on their experience and collectively consolidate their learning journey through the pandemic, and be mentored and supported by two academics Our findings indicate that students feel generally disconnected from their experience Students felt their agency was important, self-awareness and accountability enabled this Students also reflected that changes to their learning environment had made it more difficult to create social connections They also include opportunities to change our teaching practice to be more supportive of our students' collective learning during COVID-19 | Enabling cross-cultural student voice during COVID-19: A collective autoethnography |
The COVID-19 pandemic has presented many issues for courts, often requiring immediate consideration and swift delivery of reasons Nevertheless, experience has taught us that, in times of crisis, heightened vigilance must be afforded to the protection of individual rights Two judgments delivered at the peak of the pandemic illuminate the fragility of rights in the face of wider societal concerns Both cases contain statements of purported principle which are legally dubious and, if left unqualified, have the potential to fundamentally dilute the protections afforded by the European Convention on Human Rights © 2020 Thomson Reuters and Contributors | Public health emergencies and human rights: Problematic jurisprudence arising from the covid-19 pandemic |
Supplemental Digital Content is available in the text. | Impact of a Pandemic on Early Career Women |
Abstract Introduction Older adults living in communal spaces, such as nursing or retirement communities are at greater risk of infection due to close proximity to others, advanced aging-related or medical conditions, and engagement with staff that support multiple clients and facilities. Mobility between residents and facilities may result in staff acting as vectors of COVID-19 infection in these spaces. Vaccine uptake has been shown to markedly reduce the spread of COVID-19, yet there is little data on vaccine uptake and the continued COVID-19 risk among residents. Methods Data for this study were extracted from two publicly available. First, Centers for Medicaid and Medicare Services (CMS) public data included characteristics of nursing homes, weekly reported observations of residential COVID-19 cases, and COVID-19 vaccine coverage of staff and residents. Second, the average weekly COVID-19 infection rates from the Missouri Department of Health and Senior Services (MDHSS) were extracted and aggregated. A zero-inflated Poisson (ZIP) regression model was constructed to predict (1) if COVID-19 infections were reported, and if so, (2) the number of cases reported using a priori variables as predictors. ZIP regression was used due to the count nature of the outcome and due to the pre-determined overdispersion of observations when zero COVID-19 cases were reported during the study period. Results A total of 504 nursing homes were included in the study and 1124 COVID-19 infections were reported during the study period. As the percent of vaccinated staff increased, the risk of COVID-19 infections among residents significantly decreased. Percent of residents vaccinated was not significantly associated with whether COVID-19 cases were reported, nor the number of cases reported. Other factors, such as county COVID-19 rate and CMS staff rating, were significantly associated with COVID-19 cases in nursing homes. Discussion This study identified that nursing home staff, likely due to greater mobility, are important to prioritize in vaccination efforts to protect themselves and residents of their facilities from COVID-19 infections. Further, the CMS staff ratings were significant predictors of infection as well, which highlight the structural challenges that exist within and outside the context of a highly infectious and deadly pandemic. These results also provide insights to optimizing vaccination roll-out to best protect vulnerable community residents | The Relationship of Vaccine Uptake and COVID-19 Infections among Nursing Home Staff and Residents in Missouri |
The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients. | Recommendations for the management of critically ill patients with COVID-19 in Intensive Care Units() |
OBJECTIVES: There is increasing evidence that thrombotic events occur in patients with coronavirus disease (COVID-19). We evaluated lung and kidney perfusion abnormalities in patients with COVID-19 by dual-energy computed tomography (DECT) and investigated the role of perfusion abnormalities on disease severity as a sign of microvascular obstruction. METHODS: Thirty-one patients with COVID-19 who underwent pulmonary DECT angiography and were suspected of having pulmonary thromboembolism were included. Pulmonary and kidney images were reviewed. Patient characteristics and laboratory findings were compared between those with and without lung perfusion deficits (PDs). RESULTS: DECT images showed PDs in eight patients (25.8%), which were not overlapping with areas of ground-glass opacity or consolidation. Among these patients, two had pulmonary thromboembolism confirmed by CT angiography. Patients with PDs had a longer hospital stay (p = 0.14), higher intensive care unit admission rates (p = 0.02), and more severe disease (p = 0.01). In the PD group, serum ferritin, aspartate aminotransferase, fibrinogen, D-dimer, C-reactive protein, and troponin levels were significantly higher, whereas albumin level was lower (p < 0.05). D-dimer levels ≥ 0.485 μg/L predicted PD with 100% specificity and 87% sensitivity. Renal iodine maps showed heterogeneous enhancement consistent with perfusion abnormalities in 13 patients (50%) with lower sodium levels (p = 0.03). CONCLUSIONS: We found that a large proportion of patients with mild-to-moderate COVID-19 had PDs in their lungs and kidneys, which may be suggestive of the presence of systemic microangiopathy with micro-thrombosis. These findings help in understanding the physiology of hypoxemia and may have implications in the management of patients with COVID-19, such as early indications of thromboprophylaxis or anticoagulants and optimizing oxygenation strategies. KEY POINTS: • Pulmonary perfusion abnormalities in COVID-19 patients, associated with disease severity, can be detected by pulmonary DECT. • A cutoff value of 0.485 μg/L for D-dimer plasma levels predicted lung perfusion deficits with 100% specificity and 87% sensitivity (AUROC, 0.957). • Perfusion abnormalities in the kidney are suggestive of a subclinical systemic microvascular obstruction in these patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00330-020-07155-3) contains supplementary material, which is available to authorized users. | Lung and kidney perfusion deficits diagnosed by dual-energy computed tomography in patients with COVID-19-related systemic microangiopathy |
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative tauopathy found in individuals with a history of repetitive head impacts (RHI). Previous work has demonstrated that neuroinflammation is involved in CTE pathogenesis, however, the specific inflammatory mechanisms are still unclear. Here, using RNA-sequencing and gene set enrichment analysis (GSEA), we investigated the genetic changes found in tissue taken from the region CTE pathology is first found, the cortical sulcus, and compared it to neighboring gryal crest tissue to identify what pathways were directly related to initial hyperphosphorylated tau (p-tau) deposition. 21 cases were chosen for analysis: 6 cases had no exposure to RHI or presence of neurodegenerative disease (Control), 5 cases had exposure to RHI but no presence of neurodegenerative disease (RHI), and 10 cases had exposure to RHI and low stage CTE (CTE). Two sets of genes were identified: genes that changed in both the sulcus and crest and genes that changed specifically in the sulcus relative to the crest. When examining genes that changed in both the sulcus and crest, GSEA demonstrated an increase in immune related processes and a decrease in neuronal processes in RHI and CTE groups. Sulcal specific alterations were observed to be driven by three mechanisms: anatomy, RHI, or p-tau. First, we observed consistent sulcal specific alterations in immune, extracellular matrix, vascular, neuronal, and endocytosis/exocytosis categories across all groups, suggesting the sulcus has a unique molecular signature compared to the neighboring crest independent of pathology. Second, individuals with a history of RHI demonstrated impairment in metabolic and mitochondrial related processes. Finally, in individuals with CTE, we observed impairment of immune and phagocytic related processes. Overall, this work provides the first observation of biological processes specifically altered in the sulcus that could be directly implicated in CTE pathogenesis and provide novel targets for biomarkers and therapies. | Differential gene expression in the cortical sulcus compared to the gyral crest within the early stages of chronic traumatic encephalopathy. |
BACKGROUND: In the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic. METHODS: A cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI). RESULTS: A total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group. CONCLUSION: The elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated. | Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19 |
This research report explores the impact of Covid-19 on women's football in Buenos Aires. The suspension of all forms of football in Argentina as part of the country's hard lockdown measures threatens to undo significant gains made in women's football in recent years. By focussing on the experiences of key actors in a feminist Civil Society Organization (CSO) and a newly professional women's team, respectively, we examine what the pandemic has meant for women's football and for women football players at different levels of the game. We also consider the potential impact of the current situation on the future of women's football in Argentina, representative of wider social advances for women in the country. | The Impact of Covid-19 on Women's Experiences of and Through Football in Buenos Aires |
The past 18 months have been challenging and difficult for healthcare staff everywhere, with the pandemic forcing nurses at all levels to work in unfamiliar environments and in different roles. | When it’s time to step up to a band 6 role: The pandemic may have given you a taste of more senior roles – so here’s how to consider your next move |
OBJECTIVE: To investigate the clinical characteristics and molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae (CRKP) bloodstream infection at a medical center in northeast China, especially after coronavirus disease (COVID-19) pandemic METHODS: Fifty-one patients were diagnosed with CRKP bloodstream infection between January 2015 and December 2020, among which 42 isolates were available for further study Species identification and antibiotic susceptibilities were tested with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and VITEK 2 systems Carbapenemase genes, virulence genes and MLST genes were detected by polymerase chain reaction Moreover, the string test and serum killing assay were performed to evaluate the virulence of the CRKP isolates RESULTS: During the six-year period, the detection rate of CRKP in bloodstream infection showed an increasing trend, with the intensive care unit, hematology and respiratory medicine wards mainly affected Molecular epidemiology analyses showed that KPC-2 was the dominant carbapenemase gene In addition, the dominant sequence type (ST) of CRKP shifted from ST11 to ST15 strains, which were all sensitive to amikacin in contrast to the ST11 stains Furthermore, ST15 CRKP strains were positive for the KfuB virulence gene and more resistant to serum killing compared to the ST11 CRKP strains Nonetheless, the mortality rate of patients infected with ST11 and ST15 CRKP did not show any significant differences CONCLUSION: A shift in the dominant sequence type of CRKP bloodstream infections from ST11 to ST15 was observed during the years 2015-2020 Compared to ST11, the ST15 CRKP strains showed amikacin sensitivity, positivity for KfuB gene, and serum resistance, which may indicate stronger virulence | Shift in the Dominant Sequence Type of Carbapenem-Resistant Klebsiella pneumoniae Bloodstream Infection from ST11 to ST15 at a Medical Center in Northeast China, 2015-2020 |
BACKGROUND: The COVID-19 pandemic has disrupted cancer services globally. New Zealand has pursued an elimination strategy to COVID-19, reducing (but not eliminating) this disruption. Early in the pandemic, our national Cancer Control Agency (Te Aho o Te Kahu) began monitoring and reporting on service access to inform national and regional decision-making. In this manuscript we use high-quality, national-level data to describe changes in cancer registrations, diagnosis and treatment over the course of New Zealand's response to COVID-19. METHODS: Data were sourced (2018–2020) from national collections, including cancer registrations, inpatient hospitalisations and outpatient events. Cancer registrations, diagnostic testing (gastrointestinal endoscopy), surgery (colorectal, lung and prostate surgeries), medical oncology access (first specialist appointments [FSAs] and intravenous chemotherapy attendances) and radiation oncology access (FSAs and megavoltage attendances) were extracted. Descriptive analyses of count data were performed, stratified by ethnicity (Indigenous Māori, Pacific Island, non-Māori/non-Pacific). FINDINGS: Compared to 2018–2019, there was a 40% decline in cancer registrations during New Zealand's national shutdown in March-April 2020, increasing back to pre-shutdown levels over subsequent months. While there was a sharp decline in endoscopies, pre-shutdown volumes were achieved again by August. The impact on cancer surgery and medical oncology has been minimal, but there has been an 8% year-to-date decrease in radiation therapy attendances. With the exception of lung cancer, there is no evidence that existing inequities in service access between ethnic groups have been exacerbated by COVID-19. INTERPRETATION: The impact of COVID-19 on cancer care in New Zealand has been largely mitigated. The New Zealand experience may provide other agencies or organisations with a sense of the impact of the COVID-19 pandemic on cancer services within a country that has actively pursued elimination of COVID-19. FUNDING: Data were provided by New Zealand's Ministry of Health, and analyses completed by Te Aho o Te Kahu staff. | The impact of the COVID-19 pandemic on cancer diagnosis and service access in New Zealand–a country pursuing COVID-19 elimination |
BACKGROUND: Administration of Hydroxychloroquine and Azithromycin in patients with coronavirus disease 2019 (COVID-19) prolongs QTc corrected interval (QTc). The effect and safety of Lopinavir/Ritonavir in combination with these therapies have seldom been studied. OBJECTIVES: Our aim was to evaluate changes in QTc in patients receiving double (Hydroxychloroquine + Azithromycin) and triple therapy (Hydroxychloroquine + Azithromycin + Lopinavir/Ritonavir) to treat COVID-19. Secondary outcome was the incidence of in-hospital all-cause mortality. METHODS: Patients under treatment with double (DT) and triple therapy (TT) for COVID-19 were consecutively included in this prospective observational study. Serial in-hospital electrocardiograms were performed to measure QTc at baseline and during therapy. RESULTS: 168 patients (±66.2 years old) were included: 32.1% received DT and 67.9% received TT. The mean baseline QTc was 410.33 ms. Patients under DT and TT prolonged QTc interval respect baseline values (p < 0.001), without significant differences between both therapy groups (p = 0.748). Overall, 33 patients (19.6%) had a peak QTc and/or an increase QTc 60 ms from baseline, with a higher prevalence among those with hypokalemia (p = 0.003). All-cause mortality was similar between both strategy groups (p = 0.093) and high risk QTc prolongation was no related to clinical events in this series. CONCLUSIONS: DT and TT prolong the QTc in patients with COVID-19. Addition of Lopinavir/Ritonavir on top of Hydroxychloroquine and Azithromycin did not increase QTc compared to DT. | Effect of hydroxychloroquine, azithromycin and lopinavir/ritonavir on the QT corrected interval in patients with COVID-19 |
The current COVID-19 pandemic has not only greatly burdened healthcare system globally but also exposed the medical and paramedical staff to risk of infection. Although the major mode of transmission of this highly infectious disease is via close contact with an infected person, droplet infection due to coughing/sneezing and aerosol generation, few research articles have shown presence of SARS-CoV-2 in blood and serum. This poses a potential risk to health care professionals who are handling these samples. Once the suspected/confirmed case of COVID-19 is admitted in the hospital, setting it requires a battery of clinical chemistry investigations. Laboratory has a vital and indispensable role to play in the management of COVID-19 patients as several biochemical markers are used for prognostication as well as monitoring and guiding treatment in the critical patients. Hence, this evaluation was undertaken to have protocols based on robust recommendations and guidelines to be followed while handling the potentially infective samples in the clinical laboratories in order to ensure safety of the staff. However, these recommendations are based on the limited and rapidly evolving knowledge available at the moment and hence need to be reviewed periodically. | Safe biochemical testing of COVID-19 samples: A clinical lab perspective |
COVID-19 has become a deadly pandemic in the recent times claiming millions of lives worldwide in a grievous manner Most of the countries in the world have limited number of medical resources (hospitals, beds, ventilators, etc ), and in the case of large outbreak, it becomes very difficult to provide treatment to every infected individual In this study, we propound a mathematical model where we classify the infected into two subcategories-asymptomatic and symptomatic This model further accounts for the effect of limited medical resource for infected people and using face masks in combating the pandemic Focusing on these aspects, we analyze the model and exploit the available data for assessing the pattern in three most affected countries, namely USA, India and Brazil The developed model is calibrated to fit data for these three countries and estimate the transmission rate of symptomatic, asymptomatic individuals The rate at which the individuals who are quarantined recover is estimated as well Along with these estimations, a comparative study based on the basic reproduction number estimated for the three countries is presented Standard methods of sensitivity analysis are performed to analyze the ways in which basic reproduction number is impacted upon due to changes in different parameters of the model Further, we obtain disease-free equilibrium and endemic equilibrium of the model It is observed that backward bifurcation occurs if the capacity of treatment is small and bistable equilibria are shown that makes the system more sensitive to the initial conditions Sufficient conditions for the local asymptomatic stability of the endemic equilibrium and disease-free equilibrium of the system are obtained The results of this study imply that to curb the severity of the increasing cases of the disease in these countries, effective strategies to control disease spread should be implemented so that the basic reproduction number can be decreased below the threshold value which is certainly less than unity The use of protective masks in public is shown to be an important preventive measure to lower disease transmission rate Also, the quantity of medical resources should increase so that every infected person can get better treatment | Modeling of COVID-19 with limited public health resources: a comparative study of three most affected countries |
Lysosomes are membrane-bound organelles with roles in processes involved in degrading and recycling cellular waste, cellular signalling and energy metabolism. Defects in genes encoding lysosomal proteins cause lysosomal storage disorders, in which enzyme replacement therapy has proved successful. Growing evidence also implicates roles for lysosomal dysfunction in more common diseases including inflammatory and autoimmune disorders, neurodegenerative diseases, cancer and metabolic disorders. With a focus on lysosomal dysfunction in autoimmune disorders and neurodegenerative diseases — including lupus, rheumatoid arthritis, multiple sclerosis, Alzheimer disease and Parkinson disease — this Review critically analyses progress and opportunities for therapeutically targeting lysosomal proteins and processes, particularly with small molecules and peptide drugs. | Lysosomes as a therapeutic target |
The outbreak of the 2019 coronavirus disease (COVID-19) created an international public health emergency, challenging the psychological resilience of the general population. Regarding this matter, a web-based survey was performed. Data were collected from the following 1,668 self-selected volunteers: 800 athletes (28.30 ± 10.93 years old); 558 coaches (36.91 ± 11.93 years old); and 310 sports managers (42.07 ± 13.38 years old). To assess the level of psychological stress, an Impact of the Event Scale-Revised (IES-R) questionnaire was used. The results indicated that 34.4% of the participants who were interviewed were affected by subjective distress while 26.4% rated their psychological impact from the sports activity interruption as severe. Separated one-way analysis of variance (ANOVA) tests showed significant differences in the IES-R total score (TS), indicating that the level of stress in terms of gender revealed that women were more stressed than men (p = 0.000), for "sports roles" in which the manager and coaches were more stressed than the athletes (p < 0.05), and "type of sport" in which fitness and individual athletes were more stressed than team athletes (p < 0.01). The middle-level athletes showed significantly more hyperarousal levels than high-level athletes (p = 0.012). The results of this survey may raise awareness of this problem and help athletic associations to have appropriate guidelines in order to better sustain their memberships and organize an optimal resumption of their sports activities. Along these lines, social interactions, which are typical of team sports, are crucial to warrant resilience and psychological health. The athletes by managing independently the new rules and measures, thanks to a clear communication, could improve their adaptive stress reaction. | A national COVID-19 quarantine survey and its impact on the Italian sports community: Implications and recommendations |
AIM: International trade in plants and animals generates significant economic benefits. It also leads to substantial unintended impacts when introduced species become invasive, causing environmental disturbance or transmitting diseases that affect people, livestock, other wildlife or the environment. Policy responses are usually only implemented after these species become established and damages are already incurred. International agreements to control trade are likewise usually based on selection of species with known impacts. We aim to further develop quantitative invasive species risk assessment for bird imports and extend the tool to explicitly address disease threats. LOCATION: United States of America. METHODS: We use a two‐step approach for rapid risk assessment based on the expected biological risks due to both the environmental and health impact of a potentially invasive wildlife species in trade. We assess establishment probability based on a model informed by historical observations and then construct a model of emerging infectious disease threat based on economic and ecological characteristics of the exporting country. RESULTS: We illustrate how our rapid assessment tool can be used to identify high‐priority species for regulation based on a combination of the threat they pose for becoming established and vectoring emerging infectious diseases. MAIN CONCLUSIONS: Our approach can be executed for a species in a matter of days and is nested in an economic decision‐making framework for determining whether the biological risk is justified by trade benefits. | Integrating invasion and disease in the risk assessment of live bird trade |
The establishment of international sanitary institutions, which took place in the context of rivalry among the great European powers and their colonial expansion in Asia, allowed for the development of administrative systems of international epidemiological surveillance as a response to the cholera epidemics at the end of the nineteenth century. In this note, I reflect on how a historical analysis of the inception of international epidemiological surveillance and pandemic management helps us to understand what is happening in the COVID-19 pandemic today. | The past and present of pandemic management: health diplomacy, international epidemiological surveillance, and COVID-19 |
Abstract Objective To identify cell types in the male and female reproductive systems at risk of SARS-CoV-2 infection due to expression of host genes and proteins used by the virus for cell entry. Design Descriptive analysis of transcriptomic and proteomic data. Setting Academic research department and clinical diagnostic laboratory. Patients/Animals None. Focused on previously generated gene and protein expression data. Intervention(s) None. Main Outcome Measure(s) Identification of cell types co-expressing the key ACE2 and TMPRSS2 genes and proteins, as well as other candidates potentially involved in SARS-CoV-2 cell entry. Results Based on single cell RNA sequencing data, co-expression of ACE2 and TMPRSS2 was not detected in testicular cells, including sperm. A subpopulation of oocytes in non-human primate ovarian tissue were found to express ACE2 and TMPRSS2, but co-expression was not observed in ovarian somatic cells. RNA expression of TMPRSS2 in 18 samples of human cumulus cells was shown to be low or absent. There was general agreement between publicly available bulk RNA and protein datasets in terms of ACE2 and TMPRSS2 expression patterns in testis, ovary, endometrial and placental cells. Conclusion These analyses suggest that SARS-CoV-2 infection is unlikely to have long-term effects on male and female reproductive function. While the results cannot be considered definitive they imply that procedures in which oocytes are collected and fertilized in vitro are associated with very little risk of viral transmission from gametes to embryos and may indeed have the potential to minimize exposure of susceptible reproductive cell types to infection when compared to natural conception. | Coronavirus disease (COVID-19) and fertility: viral host entry protein expression in male and female reproductive tissues |
Messages about COVID-19 vaccines need to be more inclusive and appropriate to help reduce vaccination hesitancy among healthcare workers, says the nursing regulator. | NMC says COVID-19 vaccination messages need to be more inclusive and appropriate |
Background International recommendations for the control of the coronavirus disease 2019 (COVID-19) pandemic emphasize the central role of laboratory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent, at scale The availability of testing reagents, laboratory equipment and qualified staff are important bottlenecks to achieving this Elsewhere, pooled testing (i e combining multiple samples in the same reaction) has been suggested to increase testing capacities in the pandemic period Methods We discuss our experience with SARS-CoV-2 pooled testing using real-time reverse transcription polymerase chain reaction (RT-PCR) on the Kenyan Coast Results In mid-May, 2020, our RT-PCR testing capacity for SARS-CoV-2 was improved by ~100% as a result of adoption of a six-sample pooled testing strategy This was accompanied with a concomitant saving of ~50% of SARS-CoV-2 laboratory test kits at both the RNA extraction and RT-PCR stages However, pooled testing came with a slight decline of test sensitivity The RT-PCR cycle threshold value (ΔCt) was ~1 59 higher for samples tested in pools compared to samples tested singly Conclusions Pooled testing is a useful strategy to increase SARS-CoV-2 laboratory testing capacity especially in low-income settings | Pooled testing conserves SARS-CoV-2 laboratory resources and improves test turn-around time: experience on the Kenyan Coast |
The Covid-19 disease has caused a world-wide pandemic with more than 60 million positive cases and more than 1.4 million deaths by the end of November 2020. As long as effective medical treatment and vaccination are not available, non-pharmaceutical interventions such as social distancing, self-isolation and quarantine as well as far-reaching shutdowns of economic activity and public life are the only available strategies to prevent the virus from spreading. These interventions must meet conflicting requirements where some objectives, like the minimization of disease-related deaths or the impact on health systems, demand for stronger counter-measures, while others, such as social and economic costs, call for weaker counter-measures. Therefore, finding the optimal compromise of counter-measures requires the solution of a multi-objective optimization problem that is based on accurate prediction of future infection spreading for all combinations of counter-measures under consideration. We present a strategy for construction and solution of such a multi-objective optimization problem with real-world applicability. The strategy is based on a micro-model allowing for accurate prediction via a realistic combination of person-centric data-driven human mobility and behavior, stochastic infection models and disease progression models including micro-level inclusion of governmental intervention strategies. For this micro-model, a surrogate macro-model is constructed and validated that is much less computationally expensive and can therefore be used in the core of a numerical solver for the multi-objective optimization problem. The resulting set of optimal compromises between counter-measures (Pareto front) is discussed and its meaning for policy decisions is outlined. | Prediction of Covid-19 spreading and optimal coordination of counter-measures: From microscopic to macroscopic models to Pareto fronts |
In this number, we begin publication of case series devoted to epidemiology, clinical picture, diagnosis, treatment, prevention, medical and social consequences of COVID-19 Taking into account the situation anxiety, infection scope and spread rate, involvement of the whole nation into the problem irrespective of gender, age, social affiliations along with comprehensive observing social and medical prevention measures, preemptive training and continuing education of medical specialists are essential considering that novel coronavirus is new not only viewed from its molecular biological features perspective but also from the perspective of possible difficulties of diagnosis and treatment, clinical features, high risk of development of critical conditions and complications, high mortality rate that has been shown by an example of China, USA, and European Countries In the first report, we tried to highlight the experience gained in the study of novel coronavirus nature, epidemiology, pathogenesis and clinical manifestations, give information from literature sources based on the experience of our colleagues in coping with serious disease and its consequences © 2020 Baltic Medical Educational Center | Coronavirus infectious disease covid-19. nature of virus, pathogenesis, clinical manifestations, report 1 |
Palabras clave: conciliación familia-trabajo, trabajo de cuidados, trabajo remunerado, división sexual del trabajo, profesoras This paper aims to analyze the differences between female and male teachers from the National Autonomous University of Mexico (UNAM) to conciliate their academic and caredomestic work in the context of the COVID-19 pandemic. Methodologically, the data were obtained from a closed response questionnaire applied in the last two weeks of June 2020 on an effective sample of 395 female and male teachers from upper and upper secondary level. The results of the analysis show that women dedicate more time to domestic and care work, as well as to activities that are part of academic work compared to male teachers. The main conclusion is that the gender order and sexual distribution of work is a phenomenon reproduced in the field of university teaching and continues to be present in the organization of teaching tasks in the context of emergency remote education. | Diferencias entre profesoras y profesores de la Universidad Nacional Autónoma de México en el trabajo docente y de cuidados durante la pandemia |
Channel-forming proteins are found in a number of viral genomes. In some cases, their role in the viral life cycle is well understood, in some cases it needs still to be elucidated. A common theme is that their mode of action involves a change of electrochemical or proton gradient across the lipid membrane which modulates the viral or cellular activity. Blocking these proteins can be a suitable therapeutic strategy as for some viruses this may be “lethal.” Besides the many biological relevant questions still to be answered, there are also many open questions concerning the biophysical side as well as structural information and the mechanism of function on a molecular level. The immanent biophysical issues are addressed and the work in the field is summarized. | Chapter 2 Viral Channel-Forming Proteins |
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