Datasets:

mystic-leung

/

medical_cord19

like 4

COVID-19 has emerged as one of the most significant illnesses of the current century. It is caused by severe acute respiratory syndrome coronavirus 2. The world was initially viewing it as a localized outbreak in Wuhan city of China; however, it started spreading quickly to other parts of the world. Globally, half-hearted containment measures and a false sense of safety against this novel coronavirus led to the dissemination of disease. Currently, no effective therapy or vaccine is available to manage this illness. After learning a huge lesson, global efforts would hopefully lead to effective control of this pandemic.

Severe acute respiratory syndrome-coronavirus 2 and novel coronavirus disease 2019: An extraordinary pandemic

For sustainable sea buckthorn (Hippophae rhamnoides) berry production, the task at hand is to find an application for the large amount of biomass waste arising at harvesting. Sea buckthorn (SBT) vegetation is currently poorly studied. The purpose of this research was to assess the composition and potential of SBT twigs as a source of valuable biologically active substances. Water and 50% EtOH extracts of twigs of three Latvian SBT cultivars with a high berry yield and quality, popular for cultivation in many countries (H. rhamnoides 'Maria Bruvele', 'Tatiana', 'Botanicheskaya Lubitelskaya'), were investigated for the first time. The phytochemical composition (UHPLC-ESI-MS/MS analysis) and biological activity of the obtained hydrophilic extracts were determined. The highest yield of polyphenolic compounds and serotonin was observed for 'Maria Bruvele'. Hydrophilic extracts were investigated for radical scavenging activity (DPPH˙ test), antibacterial/antifungal activity against five pathogenic bacteria/yeast, cytotoxicity, and the enzymatic activity of alpha-amylase (via in vitro testing), which is extremely important for the treatment of people with underweight, wasting, and malabsorption. The results showed a high potential of sea buckthorn biomass as a source of valuable biologically active compounds for the creation of preparations for the food industry, nutraceuticals, and cosmetics.

Sea Buckthorn (Hippophae rhamnoides) Waste Biomass after Harvesting as a Source of Valuable Biologically Active Compounds with Nutraceutical and Antibacterial Potential.

The World Health Organization declared COVID-19 as a pandemic on the 11thof March 2020. Since then, many efforts are being carried out to contain the virus. Knowledge and attitude of people should be directed towards strict preventive practices in order to halt the spread of the virus. The aim of the current cross-sectional study is to assess the knowledge, practice and attitude of university students from medical and non-medical colleges in Jordan using a structured questionnaire involving a total number of 592 students. A positive response regarding the overall knowledge about the symptoms of COVID-19 was observed in more than 90% of the students. In response to the attitude and practice, a good number of students nearly 99.7% agreed that hand washing is necessary for prevention of infection whereas 68.4% believed that mask wearing would prevent the infection. Around 6-7% students considered the virus as a stigma hence would not visit hospital. Also, around 10% students believed that their religious beliefs and body immunity might protect them from infection. More dangerously, 20.6% and 19.2% students believed antibiotics and smoking to be a protective measure against the infection respectively. Also, 96.8% do avoid hand shaking, 98.8% wash their hands and 93.3% use alcoholic rub, 95.8% cough or sneeze in a tissue and dispose it in waste bin, 51% will drink ginger with honey and 42.7% eat garlic for infection prevention. The main sources of knowledge were social media, internet and television. No significant difference was noticed between medical and non medical colleges. Thus, there is a need for more detailed and directed measures and awareness campaigns to improve the knowledge, attitude and practice in some critical aspects to contain the virus.

Covid-19 - Knowledge, attitude and practice among medical and non-medical university students in Jordan

Steen Ethelberg and his colleagues at the State Serum Institute in Copenhagen mined data from polymerase chain reaction tests, which are the gold-standard method for detecting SARS-CoV-2 infection, conducted in Denmark (C H Hansen et al FORMER SENATOR WILL LEAD NASA US President Joe Biden has appointed Bill Nelson, a former Democratic senator from Florida, as the new head of NASA Nelson is a strong supporter of conventional space-flight programmes, including the Space Launch System (SLS), NASA's long-delayed effort to build a heavy-lift rocket to carry astronauts beyond Earth orbit

News in brief

The advent of biopharmaceuticals in modern medicine brought enormous benefits to the treatment of numerous human diseases and improved the well-being of many people worldwide First introduced in the market in the early 1980s, the number of approved biopharmaceutical products has been steadily increasing, with therapeutic proteins, antibodies, and their derivatives accounting for most of the generated revenues The success of pharmaceutical biotechnology is closely linked with remarkable developments in DNA recombinant technology, which has enabled the production of proteins with high specificity Among promising biopharmaceuticals are interferons, first described by Isaacs and Lindenmann in 1957 and approved for clinical use in humans nearly thirty years later Interferons are secreted autocrine and paracrine proteins, which by regulating several biochemical pathways have a spectrum of clinical effectiveness against viral infections, malignant diseases, and multiple sclerosis Given their relevance and sustained market share, this review provides an overview on the evolution of interferon manufacture, comprising their production, purification, and formulation stages Remarkable developments achieved in the last decades are herein discussed in three main sections: (i) an upstream stage, including genetically engineered genes, vectors, and hosts, and optimization of culture conditions (culture media, induction temperature, type and concentration of inducer, induction regimens, and scale);(ii) a downstream stage, focusing on single- and multiple-step chromatography, and emerging alternatives (e g , aqueous two-phase systems);and (iii) formulation and delivery, providing an overview of improved bioactivities and extended half-lives and targeted delivery to the site of action This review ends with an outlook and foreseeable prospects for underdeveloped aspects of biopharma research involving human interferons

Interferon-Based Biopharmaceuticals: Overview on the Production, Purification, and Formulation

The implementation of these simultaneous regional elections is certainly a separate discourse that is interesting to be learned, especially concerning the enforcement of democracy and human rights. The main objectives of this research focus on the analysis related to the relationship between democracy and human rights, the fundamental dignity of democracy and human rights after the implementation of the regional leader’s elections in 2020, and also the government’s responsibility in case of an increase in cases of COVID-19 resulting from the implementation of simultaneous regional elections. In this research, the method used is normative juridical using statutory, conceptual, and historical approaches. The research results centered on a conception of democracy and human rights as a conception of humanity born from the history of human civilization. This conception of human rights and democracy in its development is significantly related to the conception of state law. Thus, the existence of Indonesia as a legal state places the law as a hierarchical unity of the legal norms that culminate in the constitution, and the constitution has clearly and clearly stated in Article 28I paragraph (4) of the Constitution that: “The protection, promotion, enforcement, and fulfillment of human rights is the responsibility of the state, especially the government." Therefore, the state is responsible for ensuring the enforcement of the human rights of citizens, especially after the implementation of the 2020 regional leader elections (hereinafter as Pilkada) amid the COVID-19 pandemic era.

Legal discourse: the spirit of democracy and human rights post simultaneous regional elections 2020 in the COVID-19 pandemic era

Despite numerous studies investigating various aspect of online learning amidst the Covid-19 pandemic, the empirical findings reporting about student(s)-student(s) interaction in micro-level of language teaching learning process is inadequately documented. Thus, this current study was in attempt to address this void by exploring how the students interact in online learning, identify the perception of the student about student-student interaction in online learning for effectiveness in online learning English teaching process. Framed in a case study, 5 students of a public University in West Nusa Tenggara participating in Teaching English for Young Learner (TEYL) course were purposefully recruited to participate in this study. The data were garnered from a series of semi-structured interviews and a 4-month virtual classroom observation and were analyzed using thematic analysis. The finding elucidates that students enjoyed their online learning interactions and they perceived that their language skills and knowledge increased significantly. The teacher was seen to have pivotal role in facilitating students to have effective interactions by providing various activities, prepared materials, and support. Practically, this study proposes some suggestions for teachers and students on how to establish effective student-student interaction in a language online classroom.

Student-Student Interaction in Online Learning during the COVID-19 Pandemic: A Case Study (preprint)

Children have the right to give their opinions freely on issues that affect them and the right to share freely with others what they learn, think, and feel Photography can be a very effective way of providing young people opportunities to share their voice © 2021 Childhood Education International

Student Voice: Photography, COVID-19, and our collective memory

To prevent and control the outbreak of coronavirus disease, in the spring of 2020 the Ministry of Education in China announced an initiative for universities to postpone the back-to-school season and start nationwide online teaching. This paper first summarizes the literature review of research on online teaching at home and abroad. Then it introduces the application of smart teaching tool Rain Classroom in College English course at Huazhong Agricultural University and the teaching design before, during, and after class. After comparative teaching experiments, empirical data suggest that students achieved notable progress in academic performance in classes using smart teaching tools. In the questionnaire survey, students show high level of adaptability and satisfaction to the teaching model and learning outcomes. Thus it can be concluded that smart teaching tools guaranteed the high quality of online teaching during the coronavirus pandemic. At last, the author proposes suggestions on the R D of smart teaching tools and faculty teaching development. It is hoped that this paper can provide reference for future research on online teaching. © 2021 IEEE.

Intelligent Evaluation and Reflection Model Applied in Internet Smart Teaching Tools by Computer Remote Video Technology

Without vaccines and treatments, societies must rely on non-pharmaceutical intervention strategies to control the spread of emerging diseases such as COVID-19. Though complete lockdown is epidemiologically effective, because it eliminates infectious contacts, it comes with significant costs. Several recent studies have suggested that a plausible compromise strategy for minimizing epidemic risk is periodic closure, in which populations oscillate between wide-spread social restrictions and relaxation. However, no underlying theory has been proposed to predict and explain optimal closure periods as a function of epidemiological and social parameters. In this work we develop such an analytical theory for SEIR-like model diseases, showing how characteristic closure periods emerge that minimize the total outbreak, and increase predictably with the reproductive number and incubation periods of a disease, as long as both are within predictable limits. Using our approach we demonstrate a sweet-spot effect in which optimal periodic closure is maximally effective for diseases with similar incubation and recovery periods. Our results compare well to numerical simulations, including in COVID-19 models where infectivity and recovery show significant variability.

Optimal periodic closure for minimizing risk in emerging disease outbreaks

Mouse models have been essential to generate supporting data for the research of infectious diseases. Burkholderia pseudomallei, the etiological agent of melioidosis, has been studied using mouse models to investigate pathogenesis and efficacy of novel medical countermeasures to include both vaccines and therapeutics. Previous characterization of mouse models of melioidosis have demonstrated that BALB/c mice present with an acute infection, whereas C57BL/6 mice have shown a tendency to be more resistant to infection and may model chronic disease. In this study, either BALB/c or C57BL/6 mice were exposed to aerosolized human clinical isolates of B. pseudomallei. The bacterial strains included HBPUB10134a (virulent isolate from Thailand), MSHR5855 (virulent isolate from Australia), and 1106a (relatively attenuated isolate from Thailand). The LD50 values were calculated and serial sample collections were performed in order to examine the bacterial burdens in tissues, histopathological features of disease, and the immune response mounted by the mice after exposure to aerosolized B. pseudomallei. These data will be important when utilizing these models for testing novel medical countermeasures. Additionally, by comparing highly virulent strains with attenuated isolates, we hope to better understand the complex disease pathogenesis associated with this bacterium.

Disease progression in mice exposed to low-doses of aerosolized clinical isolates of Burkholderia pseudomallei.

During the COVID-19 epidemic, our national guidelines have suggested that surgical patients should wear a mask to decrease the potential transmission of COVID-19 in the operating room, as long as the condition allows However, so far, there is no study to discuss the influence of wearing a mask on the ventilation and blood oxygenation status in patients of spontaneous breathing with supplementary oxygen through an anesthetic facemask This is a before-after study in the same patient, and 10 healthy volunteers were recruited, by testing the arterial blood gas parameters at key time points before and after oxygen inhalation to evaluate the effects of two different supplementary oxygen methods ('disposable medical mask + anesthetic facemask' and 'anesthetic facemask only') on the oxygenation of subjects Our data demonstrated whether wearing a disposable medical mask or not could effectively increase the oxygen supply of the subjects compared with the basic value before oxygen inhalation;however, compared with the group without mask, the arterial oxygen partial (PaO 2) reduced significantly at each time points when subjects wearing a disposable medical mask There was no significant difference in other parameters, and our data showed that age growth and smoking had no significant effects on the difference of PaO 2 between the groups with and without masks This study demonstrates effective oxygen supplementation through anesthetic facemask in subjects with spontaneous breathing who is wearing a disposable medical mask, whose pulse oxygen saturation and arterial oxygen saturation can reach 100% rapidly, and this provides a theoretical basis for the management of patients with disseminated respiratory diseases to wear masks in the operating room;however, the rate and amount of PaO 2 increase are both decreased as compared to those who is not wearing a disposable medical mask during supplementary oxygenation Whether this difference will affect the clinical outcome needs further study

[Effects of wearing a mask on oxygenation of subjects with spontaneous breathing during supplementary oxygen through facemask]

INTRODUCTION: With France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17-May 10). This study explored the perception of the adult population about the need for-and access to-psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown. MATERIAL AND METHOD: This online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7-10, 2020). RESULTS: One in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35-64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019. CONCLUSION: The perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities' understanding of the population's psychological needs in this situation and to enhance HCPs' abilities to meet them. In particular, further research of its specific impact on youth is necessary.

Psychological support in general population during the COVID-19 lockdown in France: Needs and access

The escape from a potential well is an archetypal problem in the study of stochastic dynamical systems, representing real-world situations from chemical reactions to leaving an established home range in movement ecology. Concurrently, Lévy noise is a well-established approach to model systems characterized by statistical outliers and diverging higher order moments, ranging from gene expression control to the movement patterns of animals and humans. Here, we study the problem of Lévy noise-driven escape from an almost rectangular, arctangent potential well restricted by two absorbing boundaries, mostly under the action of the Cauchy noise. We unveil analogies of the observed transient dynamics to the general properties of stationary states of Lévy processes in single-well potentials. The first-escape dynamics is shown to exhibit exponential tails. We examine the dependence of the escape on the shape parameters, steepness, and height of the arctangent potential. Finally, we explore in detail the behavior of the probability densities of the first-escape time and the last-hitting point.

Lévy noise-driven escape from arctangent potential wells.

The World Health Organization (WHO) has recently announced the novel coronavirus 2019 as a pandemic Many preventative plans and non-pharmaceutical efforts have emerged and been in use to manage and control the spread of the disease which includes infection control, proper isolation of patients, and social distancing The main test used to confirm a COVID-19 case is the RT-PCR test However, this approach needs analysis time and specimen collection Therefore, the importance of medical imaging is increased to screen COVID-19 cases Hence radiology has a pivotal role in managing COVID-19 infection using CT scans and chest X-ray (CXR) throughout the screening, diagnosis, and prognostication processes of the disease In this paper, a new model using the transfer learning method and InceptionV3 algorithm has been presented to classify the X-ray images into COVID-19, Normal, and Pneumonia classes The experimental results show that the proposed model achieved 98% Accuracy on the test set for classifying the images from the 3 different classes © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG

Classification of COVID19 X-ray images based on transfer learning INCEPTIONV3 deep learning model

Background Perioperative hyperglycemia can have an even more detrimental effect on postoperative outcomes in patients without diabetes than in patients with diabetes, but it has not been established if the treatment of patients without diabetes is safe and effective. We hypothesized that sliding-scale insulin for severe postoperative hyperglycemia (glucose ≥180 mg/dL) could lower mean postoperative glucose levels and minimize short-term complications in patients without diabetes undergoing major joint replacement. Methods In a prospective study group, 1,398 consecutive patients, with and without diabetes, undergoing joint replacement were monitored and treated for hyperglycemia and were compared with 886 historical, less frequently monitored controls. The primary outcome was the mean glucose level in patients with and without diabetes within 48 hours after the surgical procedure. Two secondary outcomes could be examined only in the prospective study group, which, by design, had much more frequent glucose sampling and insulin use than the historical controls. First, the contribution of comorbidities and procedural factors to postoperative hyperglycemia in patients without diabetes was assessed with multivariable linear regression. Second, the ability of insulin treatment to reduce complications in patients without diabetes who developed hyperglycemia was evaluated. Results In comparison with 886 historical controls, enhanced glucose management lowered the mean glucose (and standard deviation) from 129 ± 28 mg/dL to 123 ± 23 mg/dL for patients without diabetes (p = 0.041). Multivariable linear regression revealed factors that contributed to elevated mean glucose in patients without diabetes: preoperative fasting glucose (p < 0.001), perioperative steroid use (p < 0.001), general anesthesia (p < 0.001), procedure duration (p = 0.003), and transfusion (p 0.008). Of 968 patients without diabetes, 203 developed severe hyperglycemia. The recommended insulin coverage was given to 129 of these patients, and 74 patients did not receive it for various clinical reasons. Insulin treatment reduced the frequency of positive cultures from any site (p = 0.025) and a composite of positive cultures and readmissions (p = 0.006) in comparison with no insulin treatment. No patient without diabetes who received insulin experienced mild or severe hypoglycemia. Conclusions Postoperative hyperglycemia is frequent in patients without diabetes after orthopaedic surgery, but an enhanced glucose management program can lower mean postoperative glucose levels. The treatment of hyperglycemia in patients without diabetes reduced short-term complications and was associated with minimal side effects. Level of Evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Postoperative Hyperglycemia in Patients with and without Diabetes After Major Joint Replacement: The Impact of an Enhanced Glucose Management Program.

Diabetes mellitus (DM) is cited as a serious worldwide health problem that occupies second place in causes of annual mortality in Mexico. Among Mexican flora, nearly 300 plant species have been employed as hypoglycemic in popular use. Thus, their study entertains great relevance In this context, this work contributes a clear and timely review of the plant species utilized in Traditional Mexican Medicine and experimental biological models in which not only have the hypoglycemic properties of the extracts and the isolated compounds been considered, but also the anti-inflammatory and antioxidant properties, taking into account an integral focus based on the complex mechanisms involved in the pathogenesis and physiopathology of DM. Among the species reviewed, we highlight Psacalium decompositum (Asteraceae), due to the potent hypoglycemic, anti-inflammatory, and antioxidant activity of the sesquiterpenes identified as majority compounds isolated from the root, such as cacalol and cacalone that also possess the capacity of increasing insulin levels. In this manner, the present manuscript attempts to contribute necessary information for the future study of bioactive molecules that are useful in the treatment of DM, as well as also being a contribution to the knowledge and diffusion of Mexican Traditional Medicine.

Contributions from Mexican Flora for the Treatment of Diabetes Mellitus: Molecules of Psacalium decompositum (A. Gray) H. Rob & Brettell

Naegleria fowleri is a pathogenic free-living amoeba which causes primary amoebic meningoencephalitis in humans and experimental animals. To investigate the mechanisms of such inflammatory diseases, potential chemokine gene activation in human astroglial cells was investigated following treatment with N. fowleri lysates. We demonstrated that N. fowleri are potent inducers for the expression of interleukin-8 (IL-8) genes in human astroglial cells which was preceded by activation of extracellular signal-regulated kinase (ERK). In addition, N. fowleri lysates induces the DNA binding activity of activator protein-1 (AP-1), an important transcription factor for IL-8 induction. The specific mitogen-activated protein kinase kinase/ERK inhibitor, U0126, blocks N. fowleri-mediated AP-1 activation and subsequent IL-8 induction. N. fowleri-induced IL-8 expression requires activation of ERK in human astroglial cells. These findings indicate that treatment of N. fowleri on human astroglial cells leads to the activation of AP-1 and subsequent expression of IL-8 which are dependent on ERK activation. These results may help understand the N. fowleri-mediated upregulation of chemokine and cytokine expression in the astroglial cells.

Induction of interleukin-8 by Naegleria fowleri lysates requires activation of extracellular signal-regulated kinase in human astroglial cells

During humanitarian crises, a large amount of information is circulated in a short period of time, either to withstand or respond to such crises. Such crises also give rise to misinformation that spreads within and outside the affected community. Such misinformation may result in information harms that can generate serious short term or long-term consequences. In the context of humanitarian crises, we propose a synthesis of misinformation harms and assess people’s perception of harm based on their work experience in the crisis response arena or their direct exposure to crises.

An Investigation of Misinformation Harms Related to Social Media during Two Humanitarian Crises

The COVID-19 pandemic has caused extensive disruption to economies and societies across the world. In terms of demographic processes, mortality has risen in many countries, international migration and mobility has been widely curtailed, and rising unemployment and job insecurity is expected to lower fertility rates in the near future. This paper attempts to examine the possible effects of COVID-19 on Australia's demography over the next two decades, focusing in particular on population ageing. Several population projections were prepared for the period 2019-41. We formulated three scenarios in which the pandemic has a short-lived impact of 2-3 years, a moderate impact lasting about 5 years, or a severe impact lasting up to a decade. We also created two hypothetical scenarios, one of which illustrates Australia's demographic future in the absence of a pandemic for comparative purposes, and another which demonstrates the demographic consequences if Australia had experienced excess mortality equivalent to that recorded in the first half of 2020 in England & Wales. Our projections show that the pandemic will probably have little impact on numerical population ageing but a moderate effect on structural ageing. Had Australia experienced the high mortality observed in England & Wales there would have been 19,400 excess deaths. We caution that considerable uncertainty surrounds the future trajectory of COVID-19 and therefore the demographic responses to it. The pandemic will need to be monitored closely and projection scenarios updated accordingly.

Will the COVID-19 pandemic affect population ageing in Australia?

BACKGROUND: Platelets are associated with HIV in the blood of infected individuals and might modulate viral dissemination, particularly if the virus is directly transmitted into the bloodstream. The C-type lectin DC-SIGN and the novel HIV attachment factor CLEC-2 are expressed by platelets and facilitate HIV transmission from platelets to T-cells. Here, we studied the molecular mechanisms behind CLEC-2-mediated HIV-1 transmission. RESULTS: Binding studies with soluble proteins indicated that CLEC-2, in contrast to DC-SIGN, does not recognize the viral envelope protein, but a cellular factor expressed on kidney-derived 293T cells. Subsequent analyses revealed that the cellular mucin-like membranous glycoprotein podoplanin, a CLEC-2 ligand, was expressed on 293T cells and incorporated into virions released from these cells. Knock-down of podoplanin in 293T cells by shRNA showed that virion incorporation of podoplanin was required for efficient CLEC-2-dependent HIV-1 interactions with cell lines and platelets. Flow cytometry revealed no evidence for podoplanin expression on viable T-cells and peripheral blood mononuclear cells (PBMC). Podoplanin was also not detected on HIV-1 infected T-cells. However, apoptotic bystander cells in HIV-1 infected cultures reacted with anti-podoplanin antibodies, and similar results were obtained upon induction of apoptosis in a cell line and in PBMCs suggesting an unexpected link between apoptosis and podoplanin expression. Despite the absence of detectable podoplanin expression, HIV-1 produced in PBMC was transmitted to T-cells in a CLEC-2-dependent manner, indicating that T-cells might express an as yet unidentified CLEC-2 ligand. CONCLUSIONS: Virion incorporation of podoplanin mediates CLEC-2 interactions of HIV-1 derived from 293T cells, while incorporation of a different cellular factor seems to be responsible for CLEC-2-dependent capture of PBMC-derived viruses. Furthermore, evidence was obtained that podoplanin expression is connected to apoptosis, a finding that deserves further investigation.

Incorporation of podoplanin into HIV released from HEK-293T cells, but not PBMC, is required for efficient binding to the attachment factor CLEC-2

BACKGROUND: Although reports suggest that most individuals with COVID-19 develop detectable antibodies post infection, the kinetics, durability, and relative differences between IgM and IgG responses beyond the first few weeks after symptom onset remain poorly understood. METHODS: Within a large, well-phenotyped, diverse, prospective cohort of subjects with and without SARS-CoV-2 PCR-confirmed infection and historical controls derived from cohorts with high prevalence of viral coinfections and samples taken during prior flu seasons, we measured SARS-CoV-2 serological responses (both IgG and IgM) using commercially available assays. We calculated sensitivity and specificity, relationship with disease severity and mapped the kinetics of antibody responses over time using generalised additive models. RESULTS: We analysed 1,001 samples from 752 subjects, 327 with confirmed SARS-CoV-2 (29.7% with severe disease) spanning a period of 90 days from symptom onset. Sensitivity was lower (44.1-47.1%) early (<10 days) after symptom onset but increased to >80% after 10 days. IgM positivity increased earlier than IgG-targeted assays but positivity peaked between day 32 and 38 post onset of symptoms and declined thereafter, a dynamic that was confirmed when antibody levels were analysed, with more rapid decline observed with IgM. Early (<10 days) IgM but not IgG levels were significantly higher in those who subsequently developed severe disease (signal / cut-off 4.20 (0.75-17.93) versus 1.07 (0.21-5.46), P=0.048). CONCLUSIONS: This study suggests that post-infectious antibody responses in those with confirmed COVID-19 begin to decline relatively early post infection and suggests a potential role for higher IgM levels early in infection predicting subsequent disease severity

Dynamic change and clinical relevance of post-infectious SARS-CoV-2 antibody responses

The purpose of this sequential, explanatory mixed methods study is to determine changes in attitudes towards research, trust in medical researchers and the process, and willingness to participate in research among African Americans immediately after receiving past study findings in a community listening session (CLS). We developed and implemented four CLSs with a total of 57 African Americans who were either past research participants or members of the community-at-large. In the quantitative (dominant) phase, 32 participants completed pre-post surveys and 10 of those participants completed the follow-up semi-structured interviews. Paired samples t-tests and McNemar’s test determined bivariate differences between pre- and post-surveys. Thematic analyses determined emerging themes to further understand these differences. There was a significant increase in: (1) perceived advantages of clinical trials pretest (M = 26.63, SD = 5.43) and post-test (M = 28.53, SD = 4.24, p < .01); and (2) in trust in medical researchers from pre to post (M = 36.16, SD = 10.40 vs. M = 27.53, SD = 9.37, p < 0.001). There was no significant difference in pre- and post-tests as it relates to perceived disadvantages of clinical trials and willingness to participate. Qualitative analysis yielded the following themes: (1) sharing research results and the impact on attitudes towards research; (2) community listening sessions: a trust building strategy; and (3) satisfaction with the community listening session. Community listening sessions hold promise as a method that researchers can use to simultaneously disseminate research findings and positively impact research perceptions and potentially participation among racial and ethnic minorities.

Use of Community Listening Sessions to Disseminate Research Findings to Past Participants and Communities

In an attempt to properly address one of the greatest challenges for prison administrations around the world facing Covid-19, namely, to ensure regular communication between the inmates and their families, the Serbian Penal Administration, supported by German NGO Help e.V, procured the ICT equipment aimed at substituting the in-person visits. The author decided to assess the impact of this pilot project on the right of inmates to communicate with their family members, exploring their attitudes and the attitudes of professionals/prison staff that work with them, to get both perspectives. The results of the research showed that the online communication ensured through the pilot project has significantly contributed to preserving contacts and family relations in the changing environment of the Covid-19 restrictive measures, although it cannot completely replace family visits based on, in-person contact. However, the research also led to some of the remaining obstacles to a wider application of this, substitutive approach, among others, concerning the lack of IT literacy and the both of inmates and their family members, and to the life in poverty and/or in remote country areas. Additionally, this research identified a remaining need for further financial investment in the IT equipment to ensure adequate frequency and duration of communication, but also the need to revise/upgrade an existing treatment approach to integrating modern technologies/IT literacy as tools to contribute to the effectiveness of inmates‟ reintegration. © 2021 The Author/s.

Information and communications technology as a tool to substitute in-person visits in the serbian prison system during the covid-19 restrictive measures

Most strains of murine coronavirus mouse hepatitis virus (MHV) express a cleavable spike glycoprotein that mediates viral entry and pH-independent cell-cell fusion. The MHV type 2 (MHV-2) strain of murine coronavirus differs from other strains in that it expresses an uncleaved spike and cannot induce cell-cell fusion at neutral pH values. We show here that while infection of the prototype MHV-A59 strain is not sensitive to pretreatment with lysosomotropic agents, MHV-2 replication is significantly inhibited by these agents. By use of an A59/MHV-2 chimeric virus, the susceptibility to lysosomotropic agents is mapped to the MHV-2 spike, suggesting a requirement of acidification of endosomes for MHV-2 spike-mediated entry. However, acidification is likely not a direct trigger for MHV-2 spike-mediated membrane fusion, as low-pH treatment is unable to overcome ammonium chloride inhibition, and it also cannot induce cell-cell fusion between MHV-2-infected cells. In contrast, trypsin treatment can both overcome ammonium chloride inhibition and promote cell-cell fusion. Inhibitors of the endosomal cysteine proteases cathepsin B and cathepsin L greatly reduce MHV-2 spike-mediated entry, while they have little effect on A59 entry, suggesting that there is a proteolytic step in MHV-2 entry. Finally, a recombinant virus expressing a cleaved MHV-2 spike has the ability to induce cell-cell fusion at neutral pH values and does not require low pH and endosomal cathepsins during infection. These studies demonstrate that endosomal proteolysis by cathepsins is necessary for MHV-2 spike-mediated entry; this is similar to the entry pathway recently described for severe acute respiratory syndrome coronavirus and indicates that coronaviruses may use multiple pathways for entry.

Endosomal proteolysis by cathepsins is necessary for murine coronavirus mouse hepatitis virus type 2 spike-mediated entry.

Nanoparticles can acquire a plasma protein corona defining their biological identity. Corona functions were previously considered for cell‐derived extracellular vesicles (EVs). Here we demonstrate that nano‐sized EVs from therapy‐grade human placental‐expanded (PLX) stromal cells are surrounded by an imageable and functional protein corona when enriched with permissive technology. Scalable EV separation from cell‐secreted soluble factors via tangential flow‐filtration (TFF) and subtractive tandem mass‐tag (TMT) proteomics revealed significant enrichment of predominantly immunomodulatory and proangiogenic proteins. Western blot, calcein‐based flow cytometry, super‐resolution and electron microscopy verified EV identity. PLX‐EVs partly protected corona proteins from protease digestion. EVs significantly ameliorated human skin regeneration and angiogenesis in vivo, induced differential signalling in immune cells, and dose‐dependently inhibited T cell proliferation in vitro. Corona removal by size‐exclusion or ultracentrifugation abrogated angiogenesis. Re‐establishing an artificial corona by cloaking EVs with fluorescent albumin as a model protein or defined proangiogenic factors was depicted by super‐resolution microscopy, electron microscopy and zeta‐potential shift, and served as a proof‐of‐concept. Understanding EV corona formation will improve rational EV‐inspired nano‐therapy design.

A functional corona around extracellular vesicles enhances angiogenesis, skin regeneration and immunomodulation

In an era of increasing division and conflict, education innovations that focus on building compassion and understanding hold a promise for true transformative power.

Reimagining Classrooms for an Interconnected Post-Pandemic World

Background In 2020, Victoria introduced multiple interventions aimed at containing the spread of coronavirus disease 2019 (COVID-19). We examine the effect of these restrictions on other vaccine preventable diseases (VPDs). Methods We analysed the mandatory reporting data, notified to the Victorian Department of Health, for VPDs from January 2015 to December 2021. Results Reductions in notifications were seen for most notifiable VPDs. A precipitous decline in influenza and measles notifications was recorded in April 2020, which was sustained for both diseases throughout 2020-2021. Notifications for chickenpox, invasive meningococcal disease, invasive pneumococcal disease, and pertussis were reduced by greater than 50% from the 2015-2019 average. No notified cases of diphtheria, poliomyelitis, or rubella were reported in 2020-2021. Conclusion Restrictions placed to mitigate the effects of the COVID-19 pandemic were associated with significant reductions in other VPDs, which were sustained into 2021. Nevertheless, it is important that high levels of population vaccine coverage continue, to prevent a rebound increase in VPDs as restrictions are eased, and to maximise protection against VPDs for all Australians.

Effect of COVID-19 restrictions and border closures on vaccine preventable diseases in Victoria, Australia, 2020-2021.

Covid-19 [Corona virus diseases] has emerged as one of the most critical global disaster over the last few years. Numerous research are going on to ascertain the various dynamics of evolution and spread of the disease. There are evidences that bats were host of similar kind of viruses, previously. The remarkable resemblance of the RNA of the SARS-CoV-2 virus with the RNA of bat coronavirus. The chief mode of transmission of the virus is droplets form an infected patient via cough, sneezing or talking. Different measures were taken to control the spread of the virus including lockdown in the various parts of the affected countries. Few medications also helped to treat the infected patients. However, trials of vaccinations are still in progress. The pandemic has affected all aspects of life be it social, economical, health or environment.

Chapter 1 - Introduction to COVID-19

BACKGROUND: Teleradiology has become one of the most important approaches to virtual clinical diagnosis; its importance has only grown during the coronavirus 2019 pandemic. In developing countries, asking patients to take photographs of their images using a smartphone can facilitate the process and help keep its costs down. However, the images taken by patients with smartphones often are of poor quality, and there is no regulation or standard instruction about how to use smartphones to take photographs of medical examination images effectively. These problems limit the use of smartphones in remote diagnosis and treatment. QUESTIONS/PURPOSES: To formulate a set of guidelines for the most appropriate and effective use of smartphones to capture images (radiographs, CT images, and MR images), and to determine whether these guidelines are more effectively adopted by patients of differing ages and genders. METHODS: In this prospective study, a set of step-by-step instructions was created with the goal of helping patients take better smartphone photographs of orthopaedic diagnostic images for transfer to telemedicine services. Following the advice of surgeons, experts in smartphone technology, imaging experts, and suggestions from patients, the instructions were modified based on clinical experience and finalized with the goals of simplicity, clarity, and convenience. Potentially eligible patients were older than 18 years, had no cognitive impairment, and used smart phones. Based on that, 256 participants (patients or their relatives and friends) who visited the orthopaedic department of our hospital from June to October 2020 potentially qualified for this study. A total of 11% (29) declined to participate, leaving 89% (227) for analysis here. Their mean age was 36 ± 11 years, 50% were women (113 of 227), and the patient himself/herself represented in 34% (78 of 227) of participants while relatives or friends of patients made up 66% (149 of 227) of the group. In this study, the diagnoses included spinal stenosis (47% [107 of 227]), disc herniation without spinal stenosis (31% [71 of 227]), vertebral fractures (14% [32 of 227]), and other (7% [17 of 227]). Each study participant first took photographs of their original medical images based on their own knowledge of how to use the smartphone camera function; each participant then took pictures of their original images again after receiving our instructional guidance. Three senior spine surgeons (YZ, TQL, TCM) in our hospital analyzed, in a blinded manner, the instructed and uninstructed imaging files based on image clarity (the content of the image is complete, the text information in the image is clearly visible, there is neither reflection nor shadow in the image) and image position (it is not tilted, curled, inverted, or reversed). If either of these conditions was not satisfied, the picture quality was deemed unacceptable; two of three judges' votes determined the outcome. Interobserver reliability with kappa values for the three judges were 0.89 (YZ versus TQL), 0.92 (YZ versus TCM), and 0.90 (TQL versus TCM). RESULTS: In this study, the overall proportion of smartphone medical images deemed satisfactory increased from 40% (91 of 227) for uninstructed participants to 86% (196 of 227) for instructed participants (risk ratio 2.15 [95% CI 1.82 to 2.55]; p＜0.001). The proportion of acceptable-quality images in different age groups improved after instruction, except for in patients aged 51 years or older (3 of 17 uninstructed participants versus 8 of 17 instructed participants; RR 2.67 [95% CI 0.85 to 8.37]; p = 0.07). The proportion of acceptable-quality images in both genders improved after instruction, but there was no difference between the genders. CONCLUSION: We believe our guidelines for patients who wish to take smartphone photographs of their medical images will decrease image transmission cost and facilitate orthopaedic telemedicine consultations. However, it appears that patients older than 50 years are more likely to have difficulty with this approach, and if so, they may benefit from more hands-on assistance from clinic staff or younger relatives or friends. The degree to which our findings are culture-specific should be verified by other studies in other settings, but on the face of it, there is little reason to believe our findings would not generalize to a reasonable degree. Other studies in more heterogeneous populations should also evaluate factors related to levels of educational attainment and wealth differences, but in the meantime, our findings can give clinical teams an idea of which patients may need a little extra assistance. LEVEL OF EVIDENCE: Level II, therapeutic study.

What Is the Best Way for Patients to Take Photographs of Medical Images (Radiographs, CT, and MRI) Using a Smartphone?

Understanding how immunological memory lasts a lifetime requires quantifying changes in the number of memory cells as well as how their division and death rates change over time. We address these questions by using a statistically powerful mixed-effects differential equations framework to analyze data from two human studies that follow CD8 T cell responses to the yellow fever vaccine (YFV-17D). Models were first fit to the frequency of YFV-specific memory CD8 T cells and deuterium enrichment in those cells 42 days to 1 year post-vaccination. A different dataset, on the loss of YFV-specific CD8 T cells over three decades, was used to assess out of sample predictions of our models. The commonly used exponential and bi-exponential decline models performed relatively poorly. Models with the cell loss following a power law (exactly or approximately) were most predictive. Notably, using only the first year of data, these models accurately predicted T cell frequencies up to 30 years post-vaccination. Our analyses suggest that division rates of these cells drop and plateau at a low level (0.1% per day, ∼ double the estimated values for naive T cells) within one year following vaccination, whereas death rates continue to decline for much longer. Our results show that power laws can be predictive for T cell memory, a finding that may be useful for vaccine evaluation and epidemiological modeling. Moreover, since power laws asymptotically decline more slowly than any exponential decline, our results help explain the longevity of immune memory phenomenologically.

Dynamics and turnover of memory CD8 T cell responses following yellow fever vaccination

BACKGROUND: Uncertainty in patients' COVID-19 status contributes to treatment delays, nosocomial transmission, and operational pressures in hospitals. However, the typical turnaround time for laboratory PCR remains 12–24 h and lateral flow devices (LFDs) have limited sensitivity. Previously, we have shown that artificial intelligence-driven triage (CURIAL-1.0) can provide rapid COVID-19 screening using clinical data routinely available within 1 h of arrival to hospital. Here, we aimed to improve the time from arrival to the emergency department to the availability of a result, do external and prospective validation, and deploy a novel laboratory-free screening tool in a UK emergency department. METHODS: We optimised our previous model, removing less informative predictors to improve generalisability and speed, developing the CURIAL-Lab model with vital signs and readily available blood tests (full blood count [FBC]; urea, creatinine, and electrolytes; liver function tests; and C-reactive protein) and the CURIAL-Rapide model with vital signs and FBC alone. Models were validated externally for emergency admissions to University Hospitals Birmingham, Bedfordshire Hospitals, and Portsmouth Hospitals University National Health Service (NHS) trusts, and prospectively at Oxford University Hospitals, by comparison with PCR testing. Next, we compared model performance directly against LFDs and evaluated a combined pathway that triaged patients who had either a positive CURIAL model result or a positive LFD to a COVID-19-suspected clinical area. Lastly, we deployed CURIAL-Rapide alongside an approved point-of-care FBC analyser to provide laboratory-free COVID-19 screening at the John Radcliffe Hospital (Oxford, UK). Our primary improvement outcome was time-to-result, and our performance measures were sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic curve (AUROC). FINDINGS: 72 223 patients met eligibility criteria across the four validating hospital groups, in a total validation period spanning Dec 1, 2019, to March 31, 2021. CURIAL-Lab and CURIAL-Rapide performed consistently across trusts (AUROC range 0·858–0·881, 95% CI 0·838–0·912, for CURIAL-Lab and 0·836–0·854, 0·814–0·889, for CURIAL-Rapide), achieving highest sensitivity at Portsmouth Hospitals (84·1%, Wilson's 95% CI 82·5–85·7, for CURIAL-Lab and 83·5%, 81·8–85·1, for CURIAL-Rapide) at specificities of 71·3% (70·9–71·8) for CURIAL-Lab and 63·6% (63·1–64·1) for CURIAL-Rapide. When combined with LFDs, model predictions improved triage sensitivity from 56·9% (51·7–62·0) for LFDs alone to 85·6% with CURIAL-Lab (81·6–88·9; AUROC 0·925) and 88·2% with CURIAL-Rapide (84·4–91·1; AUROC 0·919), thereby reducing missed COVID-19 cases by 65% with CURIAL-Lab and 72% with CURIAL-Rapide. For the prospective deployment of CURIAL-Rapide, 520 patients were enrolled for point-of-care FBC analysis between Feb 18 and May 10, 2021, of whom 436 received confirmatory PCR testing and ten (2·3%) tested positive. Median time from arrival to a CURIAL-Rapide result was 45 min (IQR 32–64), 16 min (26·3%) sooner than with LFDs (61 min, 37–99; log-rank p<0·0001), and 6 h 52 min (90·2%) sooner than with PCR (7 h 37 min, 6 h 5 min to 15 h 39 min; p<0·0001). Classification performance was high, with sensitivity of 87·5% (95% CI 52·9–97·8), specificity of 85·4% (81·3–88·7), and negative predictive value of 99·7% (98·2–99·9). CURIAL-Rapide correctly excluded infection for 31 (58·5%) of 53 patients who were triaged by a physician to a COVID-19-suspected area but went on to test negative by PCR. INTERPRETATION: Our findings show the generalisability, performance, and real-world operational benefits of artificial intelligence-driven screening for COVID-19 over standard-of-care in emergency departments. CURIAL-Rapide provided rapid, laboratory-free screening when used with near-patient FBC analysis, and was able to reduce the number of patients who tested negative for COVID-19 but were triaged to COVID-19-suspected areas. FUNDING: The Wellcome Trust, University of Oxford Medical and Life Sciences Translational Fund.

Real-world evaluation of rapid and laboratory-free COVID-19 triage for emergency care: external validation and pilot deployment of artificial intelligence driven screening

The COVID-19 pandemic resulted in the most abrupt changes in U.S. labor force participation and unemployment since the Second World War, with different consequences for men and women. This paper models the U.S. labor market to help to interpret the pandemic’s effects. After replicating and extending Emerson’s (2011) model of the labor market, we formulate a joint model of male and female unemployment and labor force participation rates for 1980–2019 and use it to forecast into the pandemic to understand the pandemic’s labor market consequences. Gender-specific differences were particularly large at the pandemic’s outset;lower labor force participation persists.

Jointly Modeling Male and Female Labor Participation and Unemployment

Background: Pharmacists are recommended members of the CF care team per the CF Foundation (CFF) center accreditation guidelines Our CF center has two integrated outpatient specialty pharmacists Our primary objective was to measure change in average patient satisfaction score before and after a pharmacist annual exam Secondarily, we quantified and categorized the interventions documented during the exam Methods: This is an ongoing prospective cohort study approved by our institutional internal review board The cohort is adult and pediatric patients at our CF center Before the exam, patients or caregivers (subjects) receive a satisfaction survey with 10 questions about pharmacy services;nine have a four-option Likert scale selection (strongly agree, agree, disagree, strongly disagree), two have a not-applicable option The tenth rates the interaction with the pharmacist from poor to excellent Responses are translated to numerical scores of 1-4 The survey is completed during the subject's scheduled visit at our CF center After the initial survey, the pharmacist performs a comprehensive annual exam The exam follows a standard format focusing on drug therapy optimization, medication access, medication reconciliation and patient education Immediately after the annual exam, the subject is given the same survey for data collection We performed a paired t-test on the total mean of the pre- and post-annual survey scores for statistical analysis of the primary endpoint We also tracked interventions and categorized them into four categories: drug therapy optimization, medication access, medication reconciliation, or patient education The pharmacist defines their intervention as an educational, logistical, or clinical action during the annual exam Results: Results are presented (Table) We collected 29 patient satisfaction surveys between 1/8/20-3/2/20 Mean overall satisfaction improved by 49% after an annual exam with a pharmacist The question, “After talking with the clinic pharmacist, I feel more confident to manage my medications” showed the greatest change Pharmacists made an average of 6 5 interventions per patient, with a total of 189 interventions across 29 patient exams Medication reconciliation was the most frequent intervention;modifying the electronic medical record medication list to reflect accurate use Conclusion: A pharmacist annual exam improves patient satisfaction These data suggest that patients find it beneficial to have a pharmacist in clinic as a required member of the care team The quantity of interventions suggest pharmacists should complete an annual exam as the CFF outlines for other required disciplines Limitations include survey bias due to the presence of the pharmacist in the exam room, a small cohort due to the COVID-19 pandemic, and investigator intervention identification

Collaborative cystic fibrosis care: Implementation of a pharmacist annual exam

In the eary periods of distance education when it was considered as a separate field. During the pandemic process, even the education - training and evaluation processes have started to be done through distance education. The present research tries to reveal research trends including the development of distance education and the pandemic process. The research was carried out in qualitative research design with document analysis. 333 articles published in the field of distance education between 2017-2020 in the Dergipark database constitute the sample of the present research. These articles are examined in terms of form, methodology and content. Data analysis for the present research was conducted by descriptive analysis method. While the trend of quantitative research was at the forefront in the distance education researches until the pandemic process;in 2020, which covers the pandemic process, the qualitative research trend has come to the fore and the interviews were conducted from afar;there are also studies that try to reveal the problems related to distance education, and the use of online tools has increased. In addition, it has been observed that studies on distance education have started to be published in many other fields apart from the field of distance education. © 2021. Pegem Egitim ve Ogretim Dergisi. All rights reserved.

The literature review on changes in research trends regarding distance education before and during the COVID-19 pandemic (2017-2020)

Background: Pinang yaki has bioactive compounds that have potential as a new herbal supplement. A better understanding of the bioactive compounds of pinang yaki using untargeted metabolomic profiling studies will provide clearer insight into the health benefits of pinang yaki and in particular its potential for the therapy and prevention of Covid-19. Methods: : Fresh samples of pinang yaki ( Areca vestiaria ) are obtained from forests in North Sulawesi Province, Indonesia. Samples were used for untargeted metabolomics analysis by UPLC-MS. Results: : Based on an untargeted metabolomic profiling study of pinang yaki, 2504 compounds in ESI- and 2645 compounds in ESI+ were successfully obtained. After the analysis, 356 compounds in ESI- and 543 compounds in ESI+ were identified successfully. Major compounds Alpha-Chlorohydrin (PubChem ID: 7290) and Tagatose (PubChem ID: 439312) were found in ESI+ and ESI-. Discussion: The Top 10 metabolites from pinang yaki extract (ESI+) juga have been indicated in preventing SARS Cov2 infection and have exhibited good neuroprotective immunity. Benzothiazole (PubChem ID: 7222), L-isoleucine (PubChem ID: 6306), D-glucono-delta-lactone (PubChem ID: 736), Diethylpyrocarbonate (PubChem ID: 3051), Bis(2-Ethylhexyl) amine (PubChem ID: 7791), Cinnamic acid (PubChem ID: 444539), and Trigonelline (PubChem ID: 5570) also had potential effects as an antiviral, anti-inflammatory, and anti-Covid19. Conclusion: Untargeted metabolomic profiling showed many bioactive compounds contained in pinang yaki ( Areca vestiaria ) extract. The top 10 compounds have been identified and explored for their potential benefits as anti-Covid19 supplement products. This is a preliminary study which still needs further research such as preclinical and clinical trials.

New Discovery of Covid-19 Natural-Based Potential Antivirus Herbal Supplement Products from Pinang Yaki (Areca vestiaria) Extract: A Preliminary Study by Untargeted Metabolomic Profiling (preprint)/ en

PURPOSE: Intensive care unit survivors suffer from prolonged impairment, reduced quality of life, and higher mortality rates after discharge compared to the general population. Socioeconomic status may play a partial but important role in mortality and recovery. Therefore, the detection of factors that are responsible for poor long-term outcomes would be beneficial in designing targeted interventions for at-risk populations. METHODS: For an endpoint analysis, 1834 intensive care unit patients with known French Deprivation Index (FDep) scores were included from the French and euRopean Outcome reGistry in Intensive Care Units (FROG-ICU) study, which was a prospective, observational, multicenter cohort study performed in 20 French intensive care units in 13 different hospitals. Socioeconomic status was defined by using the FDep score [represented as quintiles when referring to the general French population, as quintiles when referring to the FROG-ICU cohort, or as dichotomized data (which was defined as a FDep ≤ 0 for nondeprived patients)] and by using a detailed social questionnaire that was completed 3 months after discharge. The primary outcome included an all-cause, 1-year mortality after ICU discharge when regarding socioeconomic status. The secondary outcomes included both ICU and hospital lengths of stay, both short- and medium-term mortality, and the quality of life, as assessed during the 1-year follow-up by using the Medical Outcome Survey Short Form-36 (SF-36). The Revised Impact of Event Scale (IES-R) was used to evaluate the symptoms of post-traumatic stress disorder, and the Hospital Anxiety and Depression Scale (HADS) was used to screen for anxiety and depression. RESULTS: Of the 1447 patients who were discharged alive from the ICU, 19.2% died over the following year. No association was found between 1-year mortality and socioeconomic status, regardless of whether this association was analyzed in quintiles (p = 0.911 in the quintiles of the general French population; p = 0.589 in the quintiles of the FROG-ICU cohort itself) or as dichotomized data [nondeprived (n = 177; 1-year mortality of 18.2%) versus deprived (n = 97; 1-year mortality of 20.5%; p = 0.304)]. Moreover, no differences were found between the nondeprived and the deprived patients in the ICU and hospital lengths of stay, ICU mortalities, in-hospital mortalities, or 28-day mortalities. The SF-36 was below the score for the normal French population throughout the follow-up period. Socially deprived patients showed significantly lower median scores in the physical function subscale [55, interquartile range (IQR) (28.8–80) vs. 65, IQR (35–90); p = 0.014], the physical role subscale [25, IQR (0–75) vs. 33.3, IQR (0–100); p = 0.022], and the overall physical component scale [47.5, IQR (30–68.8) vs. 54.4, IQR (35–78.8); p = 0.010]. Up to 31.6% of survivors presented symptoms that indicated post-traumatic stress disorder, and up to 31.5% of survivors reported clinically meaningful symptoms of anxiety or depression. CONCLUSIONS: A lower socioeconomic status was associated with lower self-reported physical component scores in the nondeprived patients. Psychiatric symptoms are frequently reported after an ICU stay, and subsequent interventions should target those fields. TRIAL REGISTRATION: ClinicalTrials.gov NCT01367093; registered on June 6, 2011. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-018-5412-5) contains supplementary material, which is available to authorized users.

Association of social deprivation with 1-year outcome of ICU survivors: results from the FROG-ICU study

OBJECTIVE The objective of this systematic review and meta-analysis was to evaluate the diagnostic performance of the second-generation molecular tests in the diagnosis of thyroid nodules with indeterminate fine-needle aspiration biopsy results. METHODS We searched PubMed, Google Scholar, Scopus, and Cochrane Library for studies published between January 2017 and March 2021. Inclusion criteria were indeterminate thyroid results from fine-needle aspiration (FNA) that included Bethesda categories III and IV, use of Afirma GSC, Thyroseq v3, and ThyGeNext as an index test, and conclusive histopathological results. Studies with no post-surgical diagnoses were excluded. For each included study, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were obtained. Sensitivity and specificity were pooled jointly using a bivariate binomial random-effects model. Statistical significance was indicated at p-value less than 0.05. RESULTS Our search yielded 431 non-duplicate articles, of which 15 were included in the study (7 GSC, 6 Thyroseq v3, and 2 ThyGeNext). ThyGeNext studies were excluded from the meta-analysis due to the small sample size. Pooled data for GSC studies on 472 thyroid nodules showed a sensitivity of 96.6 (95% confidence interval: 89.7-98.9%), specificity of 52.9% (23.4-80.5%), PPV of 63% (51-74%), and NPV of 96% (94-98%). Pooled data for ThyroSeq studies on 530 thyroid nodules showed a sensitivity of 95.1% (91.1-97.4%), specificity of 49.6% (29.3-70.1%), PPV of 70% (55-83%), and NPV of 92% (86-97%). There was no statistically significant difference in diagnostic performances of the two tests (p-values for sensitivity = 0.89, specificity = 0.82, PPV = 0.43, NPV = 0.17). CONCLUSION High sensitivity and high NPV in GSC and Thyroseq v3 have potential to help rule out malignancy among thyroid nodules with indeterminate cytology results. There was no difference in diagnostic performances between the two molecular tests indicating that either test is appropriate to determine the malignancy of thyroid nodules. Further long-term outcome data are warranted to make a clear recommendation.

Diagnostic performance of the second-generation molecular tests in the assessment of indeterminate thyroid nodules: A systematic review and meta-analysis.

INTRODUCTION: This case series describes 12 patients who developed opioid use disorder after ingesting a prohibited, imported herbal product, Kamini, which contains Papaver somniferum. They appeared unaware of the risk of dependence from Kamini and most had struggled to manage their use for many months before presenting for treatment. METHODS: After two cases were presented at a clinical meeting, a chart review was conducted of cases across four public opioid treatment clinics in south-east Queensland with about 1500 patients registered, identifying 10 further cases. RESULTS: Twelve patients presented with features of opioid withdrawal, seeking treatment after use of Kamini for periods between 6 months and 8 years. Eleven patients were born in India. Nine patients stabilised on buprenorphine maintenance treatment, three of whom commenced long-acting injectable buprenorphine. One patient left after 1 day and subsequently began methadone treatment with a private prescriber. Two patients on smaller doses and shorter-term use undertook withdrawal with prescribed (off-label) trans-dermal buprenorphine. One patient, initially lost to follow-up, later stabilised on long-acting injectable buprenorphine. Reasons for presenting included supply shortages and financial distress during the COVID-19 pandemic. DISCUSSION AND CONCLUSION: Kamini represents an illicit source of non-prescription opioid in Australia. Although classified as an illegal import by the Therapeutic Goods Administration, patients confirm that it is readily available in Brisbane. Targeted efforts are needed to prevent further patients developing opioid dependence from use of Kamini and also to highlight treatment options for those seeking to stop Kamini use.

Kamini, a little recognised source of illicit opioid: A case series of 12 patients

INTRODUCTION: Alongside the emergence of COVID-19 in the United States, several reports highlighted increasing rates of opioid overdose from preliminary data. Yet, little is known about how state-level opioid overdose death trends and decedent characteristics have evolved using official death records. METHODS: We requested vital statistics data from 2018–2020 from all 50 states and the District of Columbia, receiving data from 14 states. Accounting for COVID-19, we excluded states without data past March 2020, leaving 11 states for analysis. We defined state-specific analysis periods from March 13 until the latest reliable date in each state’s data, then conducted retrospective year-over-year analyses comparing opioid-related overdose death rates, the presence of specific opioids and other psychoactive substances, and decedents’ sex, race, and age from 2020 to 2019 and 2019 to 2018 within each state’s analysis period. We assessed whether significant changes in 2020 vs. 2019 in opioid overdose deaths were new or continuing trends using joinpoint regression. RESULTS: We found significant increases in opioid-related overdose death rates in Alaska (55.3%), Colorado (80.2%), Indiana (40.1%), Nevada (50.0%), North Carolina (30.5%), Rhode Island (29.6%), and Virginia (66.4%) – all continuing previous trends. Increases in synthetic opioid-involved overdose deaths were new in Alaska (136.5%), Indiana (27.6%), and Virginia (16.5%), whilst continuing in Colorado (44.4%), Connecticut (3.6%), Nevada (75.0%), and North Carolina (14.6%). We found new increases in male decedents in Indiana (12.0%), and continuing increases in Colorado (15.2%). We also found continuing increases in Black non-Hispanic decedents in Massachusetts (43.9%) and Virginia (33.7%). CONCLUSION: KEY MESSAGES: Our results highlight shifts in opioid overdose trends during the COVID-19 pandemic that cannot otherwise be extracted from aggregated or provisional opioid overdose death data such as those published by the Centres for Disease Control and Prevention. Fentanyl and other synthetic opioids continue to drive increases in fatal overdoses, making it difficult to separate these trends from any possible COVID-19-related factors. Black non-Hispanic people are making up an increasing proportion of opioid overdose deaths in some states. State-specific limitations and variations in data-reporting for vital statistics make it challenging to acquire and analyse up-to-date data on opioid-related overdose deaths. More timely and comprehensive data are needed to generate broader insights on the nature of the intersecting opioid and COVID-19 crises.

Opioid overdose decedent characteristics during COVID-19

Obstetric population because of its unique and varying needs specific for different gestations justifies for distinctive considerations in times of pandemic like COVID-19 Healthcare facilities providing obstetric care need to develop contingency plans for minimizing antenatal visits to limit exposure of both healthy pregnant women and care providers from ill people However, to mitigate any potential adverse effects of reduced antenatal visits, intelligent and smart use of evolving telemedicine capabilities can provide the continuum of care despite overwhelming burden due to pandemic A collaborative work-model involving health workers in the community and the regional levels of health centres also has the potential to prevent the catastrophic collapse of obstetric care services during any pandemic like COVID-19

Redesigning routine antenatal care in low resource setting during COVID-19 pandemic

For many patients and healthcare providers, the move to virtual psychiatric care has been fast-tracked by the COVID-19 pandemic. In this article, we consider a patient perspective and a provider perspective on the transition to virtual psychiatric care and its strengths and limitations, as well as a call for much-needed future research.

Virtual psychiatric care fast-tracked: reflections inspired by the COVID-19 pandemic

The global dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has seriously endangered human health. The number of confirmed cases is still increasing; however, treatment options are limited. Transmembrane protease serine 2 (TMPRSS2), as a key protease that primes the binding of SARS-CoV-2 spike protein and angiotensin-converting enzyme 2 (ACE2), has become an attractive target and received widespread attention. Thus, four potential drugs (bromhexine, camostat, gabexate, and nafamostat) were used to explore the mechanism of binding with TMPRSS2 in this work. A 65 ns molecular dynamics simulation was performed three times for each drug-TMPRSS2 system for reliable energy calculation and conformational analysis, of which the simulations of nafamostat-TMPRSS2 systems were further extended to 150 ns three times due to the discovery of two binding modes. Through the results of calculating binding free energy by nine methods, the binding affinity of camostat, gabexate, and nafamostat to TMPRSS2 showed great advantages compared with bromhexine, where the nafamostat was surprisingly found to present two reasonable binding conformations (forward and reverse directions). Two negatively charged amino acids (Asp435 and Glu299) can clamp the two positively charged groups (guanidinium group and amidinium group) in either forward or reverse fashion, and the forward one is more stable than the reverse. In addition, compared with gabexate, the dimethylamino group in camostat forms more van der Waals interactions with surrounding hot-spots His296 and Val280, resulting in a stronger affinity to TMPRSS2. For bromhexine, multiple binding sites are displayed in the binding pocket due to its small molecular structure, and van der Waals interactions play the dominant role in the binding process. In particular, six typical hot-spots were identified in the last three serine protease inhibitor systems, i.e., Asp435, Ser436, Gln438, Trp461, Ser463, and Gly464. The guanidinium groups of the drugs have powerful interactions with adjacent residues due to the formation of more hydrogen bonds, suggesting that this may be the critical site for drug design against TMPRSS2. This work provides valuable molecular insight into these four drug-TMPRSS2 binding mechanisms and is helpful for designing and screening drugs targeting TMPRSS2.

Targeting mechanism for SARS-CoV-2 in silico: interaction and key groups of TMPRSS2 toward four potential drugs.

Laryngeal high-speed videoendoscopy (LHSV) is an imaging technique offering novel visualization quality of the vibratory activity of the vocal folds. However, in most image analysis methods, the interaction of the medical personnel and access to ground truth annotations are required to achieve accurate detection of vocal folds edges. In our fully automatic method, we combine video and acoustic data that are synchronously recorded during the laryngeal endoscopy. We show that the image segmentation algorithm of the glottal area can be optimized by matching the Fourier spectra of the pre-processed video and the spectra of the acoustic recording during the phonation of sustained vowel /i:/. We verify our method on a set of LHSV recordings taken from subjects with normophonic voice and patients with voice disorders due to glottal insufficiency. We show that the computed geometric indices of the glottal area make it possible to discriminate between normal and pathologic voices. The median of the Open Quotient and Minimal Relative Glottal Area values for healthy subjects were 0.69 and 0.06, respectively, while for dysphonic subjects were 1 and 0.35, respectively. We also validate these results using independent phoniatrician experts.

Segmentation of Glottal Images from High-Speed Videoendoscopy Optimized by Synchronous Acoustic Recordings

By August 2020, non-Hawaiian Pacific Islanders-4% of Hawaii's population-accounted for 30% of the cumulative COVID-19 cases in the state. Micronesians, mostly Chuukese and Marshallese, were the most severely affected. Disproportionate COVID-19 infection in racial or ethnic groups in the US occur because of socioeconomic factors. The COVID-19 pandemic can be thought of as a syndemic-where cases cluster "on a background of social and economic disparity". In this brief report, we describe factors that put Chuukese and Marshallese at increased risk for COVID-19 in Hawaii. We show that Micronesians had increased risk for COVID-19 due to limited employment opportunities, housing insecurity, and underlying comorbid conditions in the context of rescinded federal health insurance and broken government promises. We also highlight the resiliency that many community members demonstrated in preventing new infections and supporting those infected. We conclude that COVID-19 in Hawaii should be understood as a syndemic, where Micronesians were disproportionately affected due to disparities in housing, employment, and health access. Our work supports efforts to continue addressing underlying socioeconomic disparities in creating a more equitable future for our Micronesian community in Hawaii.

Structural Racism and Micronesians in Hawaii: The COVID-19 Syndemic

This article reviews recent studies that address water sustainable management opportunities and challenges in megacities around the world, with an emphasis on the case of Rio de Janeiro Metropolitan Region, one of the two megacities in Brazil. With reference to recent debates on water, megacities, and the climate crisis, as well as UN Water and Global Report Initiative documents, we focused on the implementation of the 2030 Agenda Sustainable Development Goal 6: Clean Water and Sanitation for All. The new Brazilian sanitation legal framework regulates public–private partnerships. In this context, the manuscript discusses the main question concerning water, sanitation, and hygiene that arises in the Brazilian case study: is universality possible in profit-oriented models? Through the current technical and academic literature consulted, the paper compares initiatives involving multiple stakeholder governance models that depend on private resources to implement universal access to drinking water, sanitation, and water-related extreme event controls, pointing out alternatives that can help to achieve the targets of SDG. Validation by key informants supports the synthesis of the reviewed documents, and the findings illustrate that concerted public efforts together with market mechanisms can help to overcome challenges and surpass the profit-oriented logics of private companies to achieve access to healthy and safe water, adequate sanitation, and improved hygiene, especially for vulnerable populations. This finding has transferability to other megacities in emerging countries that are facing public–private partnership debates on the provision of clean water and sanitation for all.

The Private Sector as a Partner for SDG 6-Related Issues in Megacities: Opportunities and Challenges in Rio de Janeiro, Brazil

BACKGROUND: Understanding the physical and mental changes in community‐dwelling elderly people is very important during the coronavirus disease 2019 (COVID‐19) pandemic when considering preventive measures. The purpose of this study was to clarify the changes of physical function and anxiety for activities of daily living in community‐dwelling older adults, focusing on locomotor function during the COVID‐19 pandemic. METHODS: The study participants were 127 older people who participated in successive surveys, in the summers of 2019 and again in 2020, after the state of emergency. The Locomo 25 questionnaire, Geriatric Depression Scale‐15 (GDS‐15) questionnaire, medical history, and number of people living together were self‐reported. The Locomo 25 covers six aspects of physical pain, movement‐related difficulty, usual care, daily activity, social activities, and anxiety. RESULTS: The paired samples t‐test revealed that Locomo 25 total scores in 2020 were significantly higher than those in 2019. The GDS‐15 score showed no significant difference. The comparison of scores for each item of the Locomo 25 revealed significantly higher scores in 2020 on Q21 (‘difficult to perform sports activity’, P = 0.0021), Q22 (‘restricted from meeting own friends’, P < 0.001), Q23 (‘restricted from joining social activities’, P < 0.001), Q24 (‘anxious about falling in own house’, P = 0.0023), and Q25 (‘anxious about being unable to walk in the future’, P = 0.0016). CONCLUSIONS: About 2 months after declaration of the first state of emergency due to the COVID‐19 pandemic in Japan, social activity was severely restricted. Older adults showed almost no changes in body pain and locomotive disabilities, but increases in their anxieties about walking ability and falling were remarkable.

Increased anxiety about falls and walking ability among community‐dwelling Japanese older adults during the COVID‐19 pandemic

The pandemic outbreaks of coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), spread all over the world in a short period of time. Efficient identification of the infection by SARS‐CoV‐2 has been one of the most important tasks to facilitate all the following counter measurements in dealing with the infectious disease. In Taiwan, a COVID‐19 Open Science Platform adheres to the spirit of open science: sharing sources, data, and methods to promote progress in academic research while corroborating findings from various disciplines has established in mid‐February 2020, for collaborative research in support of the development of detection methods, therapeutics, and a vaccine for COVID‐19. Research priorities include infection control, epidemiology, clinical characterization and management, detection methods (including viral RNA detection, viral antigen detection, and serum antibody detection), therapeutics (neutralizing antibody and small molecule drugs), vaccines, and SARS‐CoV‐2 pathogenesis. In addition, research on social ethics and the law are included to take full account of the impact of the COVID‐19 virus.

Molecular Targets for the Testing of COVID‐19

The advancements in automated diagnostic tools allow researchers to obtain more and more information from medical images. Recently, to obtain more informative medical images, multi-modality images have been used. These images have significantly more information as compared to traditional medical images. However, the construction of multi-modality images is not an easy task. The proposed approach, initially, decomposes the image into sub-bands using a non-subsampled contourlet transform (NSCT) domain. Thereafter, an extreme version of the Inception (Xception) is used for feature extraction of the source images. The multi-objective differential evolution is used to select the optimal features. Thereafter, the coefficient of determination and the energy loss based fusion functions are used to obtain the fused coefficients. Finally, the fused image is computed by applying the inverse NSCT. Extensive experimental results show that the proposed approach outperforms the competitive multi-modality image fusion approaches.

Multi-modality medical image fusion technique using multi-objective differential evolution based deep neural networks

BACKGROUND: The utilization of mobile health (m-health) has rapidly expanded during the COVID-19 pandemic, and there is still a lack of relevant clinical data pertaining to chronic low-back pain (CLBP) management. This study was designed to compare the effectiveness of m-health-based exercise (via guidance plus education) versus exercise (via guidance) during CLBP management. METHODS: Participants (n = 40) were randomly assigned to intervention and control groups. The intervention group received m-health-based exercise (via guidance plus education), whereas the control group received m-health-based exercise (via guidance). The exercise prescription video and educational content were sent to participants by the application (app), Ding Talk. Repeated-measures analysis of variance was used to test the baseline’s intervention effects, 6-week follow-up, and 18-week follow-up. We selected function (Roland and Morris Disability Questionnaire) and pain intensity (current, mean, and most severe Numeric Rating Scale in the last 2 weeks) as the primary outcomes, changes of negative emotion (depression, anxious), and quality of life as the secondary outcomes. RESULTS: Time’s significant effect was found in pain, function, and health-related quality of life in both groups, but time did not show significant interaction effects. Participants were able to use m-based education with their anxiety and depression after treatment, but the relief only lasted until week 6. No differences were found on the aspect of mental health-related quality of life. CONCLUSION: Preliminary findings suggest that m-health-based exercise (via guidance) may be a convenient and effective method to treat CLBP. However, additional health education didn't help more. More rigorous controlled trials are needed to improve the therapeutic effect in future studies. TRIAL REGISTRATION: Chinese Clinical Trials Registry Number ChiCTR2000041459. Registered on December 26, 2020.

Does m-health-based exercise (guidance plus education) improve efficacy in patients with chronic low-back pain? A preliminary report on the intervention’s significance

The majority of SARS-CoV-2 infections among healthy individuals result in asymptomatic to mild disease. However, the immunological mechanisms defining effective lung tissue protection from SARS-CoV-2 infection remain elusive. Unlike mice solely engrafted with human fetal lung xenograft (fLX), mice co-engrafted with fLX and a myeloid-enhanced human immune system (HNFL mice) are protected against SARS-CoV-2 infection, severe inflammation, and histopathology. Effective control of viral infection in HNFL mice associated with significant macrophage infiltration, and the induction of a potent macrophage-mediated interferon response. The pronounced upregulation of the USP18-ISG15 axis (a negative regulator of IFN responses), by macrophages was unique to HNFL mice and represented a prominent correlate of reduced inflammation and histopathology. Altogether, our work shed light on unique cellular and molecular correlates of lung tissue protection during SARS-CoV-2 infection, and underscores macrophage IFN responses as prime targets for developing immunotherapies against coronavirus respiratory diseases. HIGHLIGHTSO_LIMice engrafted with human fetal lung xenografts (fLX-mice) are highly susceptible to SARS-CoV-2. C_LIO_LICo-engraftment with a human myeloid-enriched immune system protected fLX-mice against infection. C_LIO_LITissue protection was defined by a potent and well-balanced antiviral response mediated by infiltrating macrophages. C_LIO_LIProtective IFN response was dominated by the upregulation of the USP18-ISG15 axis. C_LI

Macrophages govern antiviral responses in human lung tissues protected from SARS-CoV-2 infection

Pandemics are associated with panic buying (PB) of groceries and other supplies. During the COVID-19 pandemic, community leaders expressed frustration and bewilderment about PB. Psychological explanatory concepts, including those from social learning theory and the concept of the behavioral immune system, along with recent research, suggests the following account of pandemic-related PB. PB arises when people are told to go into self-isolation as part of pandemic containment interventions. Empirically, episodes of PB typically last 7-10 days and are likely initiated by highly fearful people. PB by an anxious minority of shoppers leads to fear contagion among other shoppers, amplified by widespread dissemination, via social media, of images and videos of PB and empty shelves in stores. Thus, a snow-balling effect arises where fear of scarcity creates real but short-term scarcity. People who are highly frightened of infection tend to have heightened disgust proneness. Toilet paper is a means of escaping disgust stimuli, and for this and other reasons, toilet paper became a target of PB for people frightened of contracting COVID-19. Exploitative or selfish over-purchasing also occurred, motivated by “dark” (e.g., psychopathic) personality traits. “Don’t panic!” messages from community leaders were ineffective or counter-productive. Alternative forms of messaging are discussed.

Understanding and Managing Pandemic-Related Panic Buying

The outbreak of coronavirus disease 2019 (COVID-19) caused by 2019 novel coronavirus has become a global public health challenge In addition to the typical respiratory symptoms, COVID-19 can induce damage to testicular spermatogenesis This study focuses on the possible causes and follow-up monitoring of testicular injury induced by COVID-19

[Novel coronavirus induces testicular injury: Analysis of causes and follow-up monitoring]

Patients with autoimmune rheumatic diseases (AIRD) are suspected to have less robust immune responses during COVID-19 due to underlying immune dysfunction and the use of immune-suppressive drugs. Fifty consecutive patients with a diagnosis of AIRD on disease-modifying drugs were included at around 30 days after a confirmatory test for COVID-19. Fifty controls matched one to one for age, sex, and severity of COVID-19 were also included at around 30 days after testing positive for COVID-19. Antibody titers for anti-spike protein IgG and anti-nucleocapsid protein IgG were estimated. Cases (mean age 45.9 ± 13; 76% females) and controls (mean age 45.9 ± 13; 76% females) had similar proportion of comorbidities. Of the cases, 4 had moderate and 1 had severe COVID-19, while 3 and 1 of controls had moderate and severe COVID-19 respectively. Positivity of anti-N IgG was similar between patients (80%) and controls (90%) (p = 0.26). Similarly, anti-S IgG was positive in 82% of patients and 86% of controls (p = 0.79). Both the antibodies were negative in seven (14%) patients and five (10%) of controls (p = 0.76, Fischer exact test). Only anti-N IgG titers were lower in patients as compared to controls. In four patients with rheumatoid arthritis, two with spondyloarthritis and one with eosinophilic fasciitis both antibodies were not detectable. They did not differ from the rest of the cohort in clinical characteristics. The patients with AIRD had adequate protective antibody responses to COVID-19 at a median of 30 days post-infection. Thus, the presence of AIRD or the use of immunosuppressants does not seem to influence the development of humoral immune response against COVID-19. Key Points • Patients with autoimmune rheumatic diseases (AIRD) are suspected to have less robust immune responses. • In our cohort of 50 patients with AIRD with confirmed COVID-19, only seven did not have detectable protective antibodies at 30 days post infection. • Patients with AIRD on immunosuppressants have adequate protective antibodies post COVID-19 disease, at rates similar to that in health controls.

Antibody responses after documented COVID-19 disease in patients with autoimmune rheumatic disease

The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must first understand the distribution of risk. Previously, we have used psychometric methods applied to two epidemiologically-principled samples of people aged 14–24 to establish a robust, latent common mental distress (CMD) factor of depression and anxiety normally distributed across the population. This was linearly associated with suicidal thoughts and non-suicidal self-harm such that effective interventions to reduce CMD across the whole population could have a greater total benefit than those that focus on the minority with the most severe scores. In a randomised trial of mindfulness interventions in university students (the Mindful Student Study), we demonstrated a population-shift effect whereby the intervention group appeared resilient to a universal stressor. Given these findings, and in light of the COVID-19 pandemic, we argue that population-based interventions to reduce CMD are urgently required. To target all types of mental health determinants, these interventions must be multi-level. Careful design and evaluation, interdisciplinary work, and extensive local stakeholder involvement are crucial for these interventions to be effective.

Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People

BACKGROUND: The COVID‐19 pandemic has led the international community to conduct extensive research into potential negative effects of the disease on multiple organs and systems in the human body. One of the most discussed areas is potential of the virus to compromise the testicular function. However, the lack of prospective studies on this topic makes it impossible to draw reliable conclusions on whether the disease affects the male reproductive system and, if so, to what extent. OBJECTIVES: The current trial is aimed at investigating the effect of SARS‐CoV‐2 on the testicular function, hormone levels and determining the extent of impact on spermatogenesis and damage to testicular tissue. MATERIALS AND METHODS: This prospective study included healthy controls and cases of patients suffering from viral pneumonia based on chest computed tomography (CT) and a positive SARS‐CoV‐2 throat swab exhibited moderate symptoms (World Health Organization (WHO) classification). Epidemiological, clinical, laboratory and ultrasound data were collected. A semen analysis was performed in cases during their hospital stay and 3 months after the discharge home. We also assessed the testicles obtained during autopsies of patients who died of COVID‐19 (n = 20). RESULTS: A total of 88 participants were included (44 controls and 44 cases). Blood testosterone levels were significantly decreased in 27.3% of the cases (12/44). The mean level (7.3±2.7 nmol/L) was lower than that in the healthy controls (13.5±5.2 nmol/L, p < 0.001). An increase in luteinizing hormone (LH) and follicle‐stimulating hormone (FSH) was also detected compared to the healthy controls (p = 0.04 and p = 0.002). The semen analysis revealed decreased motility in COVID‐19 patients (p = 0.001), and a higher number of immobile sperm (during COVID‐19: 58.8% and at 3 months 47.4%, p = 0.005). All parameters returned to normal at 3 months after discharge. Direct mixed agglutination reaction (MAR) test at 3 months showed an increase of Ig A (p = 0.03). In the majority of autopsies (18/20), structural disorders of the testicular tissue, with signs of damage to germ cells were observed. DISCUSSION AND CONCLUSION: COVID‐19 and its management strategies significantly affect male hormone levels and sperm quality at the onset of the disease. Postmortem examination of testicular tissue confirmed inflammation and viral infiltration of the testicles. However, in patients with moderate to severe disease, the studied parameters of the testicular function returned to normal values within 3 months.

Prospective two‐arm study of the testicular function in patients with COVID‐19

BACKGROUND Upper gastrointestinal (GI) disorders and abdominal pain afflict between 12 and 30% of the worldwide population and research suggests these conditions are linked to the gut microbiome. Although large-intestine microbiota have been linked to several GI diseases, the microbiota of the human small intestine and its relation to human disease has been understudied. The small intestine is the major site for immune surveillance in the gut, and compared with the large intestine, it has greater than 100 times the surface area and a thinner and more permeable mucus layer. RESULTS Using quantitative sequencing, we evaluated total and taxon-specific absolute microbial loads from 250 duodenal-aspirate samples and 21 paired duodenum-saliva samples from participants in the REIMAGINE study. Log-transformed total microbial loads spanned 5 logs and were normally distributed. Paired saliva-duodenum samples suggested potential transmission of oral microbes to the duodenum, including organisms from the HACEK group. Several taxa, including Klebsiella, Escherichia, Enterococcus, and Clostridium, seemed to displace strict anaerobes common in the duodenum, so we refer to these taxa as disruptors. Disruptor taxa were enriched in samples with high total microbial loads and in individuals with small intestinal bacterial overgrowth (SIBO). Absolute loads of disruptors were associated with more severe GI symptoms, highlighting the value of absolute taxon quantification when studying small-intestine health and function. CONCLUSION This study provides the largest dataset of the absolute abundance of microbiota from the human duodenum to date. The results reveal a clear relationship between the oral microbiota and the duodenal microbiota and suggest an association between the absolute abundance of disruptor taxa, SIBO, and the prevalence of severe GI symptoms. Video Abstract.

Quantitative sequencing clarifies the role of disruptor taxa, oral microbiota, and strict anaerobes in the human small-intestine microbiome.

The COVID-19 global pandemic starting in January 2020 disrupted international collaborations in scholarly exchange, reducing mobility and connections across the globe. An examination of Web of Science-indexed publications from China, the European Union-28 and the United States of America shows a drop in publications numbers coming from the EU-28 and the United States in 2021. Importantly, cooperation between China and the United States drops without a corresponding drop between China and the EU-28. Moreover, the drop in China-USA cooperation can be seen beginning in 2019, before the pandemic, at a time when political tensions around science, technology, and innovation arose, with the United States claiming that China was violating intellectual property norms. The patterns suggest that political tensions, more than the pandemic, influenced the drop in China-USA cooperation.

Changes in co-publication patterns among China, the European Union (28) and the United States of America, 2016-2021

The outbreak of coronavirus disease 2019 (COVID-19) has had a considerable impact on every industrial sector. As a pillar of economic development, the energy sector is experiencing difficult times during the global pandemic. This paper reviews the impact of the pandemic on the global energy sector in terms of demand, price, employment, government policy, counter-measures, and academic research, and focuses on the two largest energy countries in the world: China and the United States. Although the virus has dramatically impacted the energy sector, action to address climate issues has not been suspended, but has become more urgent than ever. Experts have pointed out that it is time to promote the transition to clean energy vigorously. Thus, here we discuss progress towards clean energy transition, including bioenergy, mineral resources for clean energy techniques, batteries, and electrolyzers. The results indicate that supply chain stability, energy storage, and policymaking during the epidemic period and post-epidemic period are significant challenges for the transition to clean energy. However, the transition can also bring new opportunities for employment, economic recovery, and the human living environment.

Impacts of the COVID-19 pandemic on the energy sector 新型冠状病毒大流行对能源领域的影响

Molecular databases have enabled scientists across the globe to collaborate and contribute to the growth of the databases The current form of the databases involves researcher input which is acted upon by algorithms developed by bioinformaticians leading to outputs for researchers the database The rapid rise of artificial intelligence (Al) can be used to enhance molecular databases through incorporation of deep learning and deep reasoning to enable the molecular databases to partially self-maintain, bringing novel applications and the potential for an improved user-friendly interface for researchers who are not trained in bioinformatics to generate data that require bioinformatics-related analysis The current challenge of big data analysis may be ameliorated by development of Al that performs a comparative analysis of recently submitted big data sets against existing similar data sets and possibly suggests areas that need modification in terms of analysis for bioinformaticians to develop

Artificial intelligence enhanced molecular databases can enable improved user-friendly bioinformatics and pave the way for novel applications

The Covid-19 pandemic presents a serious threat to people's health, resulting in over 250 million confirmed cases and over 5 million deaths globally. In order to reduce the burden on national health care systems and to mitigate the effects of the outbreak, accurate modelling and forecasting methods for short- and long-term health demand are needed to inform government interventions aiming at curbing the pandemic. Current research on Covid-19 is typically based on a single source of information, specifically on structured historical pandemic data. Other studies are exclusively focused on unstructured online retrieved insights, such as data available from social media. However, the combined use of structured and unstructured information is still uncharted. This paper aims at filling this gap, by leveraging historical as well as social media information with a novel data integration methodology. The proposed approach is based on vine copulas, which allow us to improve predictions by exploiting the dependencies between different sources of information. We apply the methodology to combine structured datasets retrieved from official sources and to a big unstructured dataset of information collected from social media. The results show that the proposed approach, compared to traditional approaches, yields more accurate estimations and predictions of the evolution of the Covid-19 pandemic.

A New Data Integration Framework for Covid-19 Social Media Information

INTRODUCTION: Previous novel COVID-19 pandemics, SARS and middle east respiratory syndrome observed an association of infection in pregnancy with preterm delivery, stillbirth and increased maternal mortality. COVID-19, caused by SARS-CoV-2 infection, is the largest pandemic in living memory. Rapid accrual of robust case data on women in pregnancy and their babies affected by suspected COVID-19 or confirmed SARS-CoV-2 infection will inform clinical management and preventative strategies in the current pandemic and future outbreaks. METHODS AND ANALYSIS: The pregnancy and neonatal outcomes in COVID-19 (PAN-COVID) registry are an observational study collecting focused data on outcomes of pregnant mothers who have had suspected COVID-19 in pregnancy or confirmed SARS-CoV-2 infection and their neonates via a web-portal. Among the women recruited to the PAN-COVID registry, the study will evaluate the incidence of: (1) miscarriage and pregnancy loss, (2) fetal growth restriction and stillbirth, (3) preterm delivery, (4) vertical transmission (suspected or confirmed) and early onset neonatal SARS-CoV-2 infection. Data will be centre based and collected on individual women and their babies. Verbal consent will be obtained, to reduce face-to-face contact in the pandemic while allowing identifiable data collection for linkage. Statistical analysis of the data will be carried out on a pseudonymised data set by the study statistician. Regular reports will be distributed to collaborators on the study research questions. ETHICS AND DISSEMINATION: This study has received research ethics approval in the UK. For international centres, evidence of appropriate local approval will be required to participate, prior to entry of data to the database. The reports will be published regularly. The outputs of the study will be regularly disseminated to participants and collaborators on the study website (https://pan-covid.org) and social media channels as well as dissemination to scientific meetings and journals. STUDY REGISTRATION NUMBER: ISRCTN68026880.

Pregnancy and neonatal outcomes in COVID-19: study protocol for a global registry of women with suspected or confirmed SARS-CoV-2 infection in pregnancy and their neonates, understanding natural history to guide treatment and prevention

Bony Bankart lesions are anteroinferior glenoid rim fractures associated with capsulolabral tears. Untreated bony Bankart lesion can cause recurrent dislocation. So, the large bony Bankart lesions should be treated by anatomical reduction and stabilization. This Technical Note describes an arthroscopic bony Bankart lesion repair using suture suspension to increase contact area to gain more contact area and tissue compression to maximize the stability of the repair.

Arthroscopic Bony Bankart Repair Using Suture Suspension to Increase Bone Contact Area

The coronavirus disease 2019 (COVID-19) pandemic launched in the third decade of the twenty-first century and continued to present time to cause the worst challenges the modern medicine has ever encountered. Medical imaging is an essential part of the universal fight against this pandemic. In the absence of documented treatment and vaccination, early accurate diagnosis of infected patients is the backbone of this pandemic management. This chapter reviews different aspects of medical imaging in the context of COVID-19.

The Role of Medical Imaging in COVID-19.

The emergence of novel SARS-CoV-2 variants of concern (VOC), in late 2020, with selective transmission advantage and partial immunity escape potential, threatens a pandemic resurgence. The timing of mutational evolution and its limits are thus of paramount importance in preparedness planning. Here, we present a model predicting the pattern of epidemic growth including the emergence of variants through mutation. It is based on the SEIR (Susceptible, Exposed, Infected, Removed) model, but its equations are modifiable according to the transmission parameters of novel variants. Since more transmissible strains will drive a further increase in the number of cases, they will also lead to further novel mutations. As one cannot predict whether there is a viral mutational evolutionary limit, we model a cascade that could lead to hyper-exponential growth involving the emergence of even more transmissible mutants that could overwhelm systemic response. Our results are consistent with the timing, since the beginning of the pandemic, of the concurrent and independent emergence of the VOCs. We examine conditions that favor the expected appearance of similar variants, thus enabling better preparedness and relevant research.

Evolving SARS-CoV-2 variants and mutational cascades

The lungs are the main site that is affected in severe COVID-19, and post-mortem lung tissue provides crucial insights into the pathophysiology of severe disease. From basic histology to state-of-the-art multiparameter digital pathology technologies, post-mortem lung tissue provides snapshots of tissue architecture, and resident and inflammatory cell phenotypes and composition at the time of death. Contrary to early assumptions that COVID-19 in the lungs is a uniform disease, post-mortem findings have established a high degree of disease heterogeneity. Classic diffuse alveolar damage represents just one phenotype, with disease divisible by early and late progression as well as by pathophysiological process. A distinct lung tissue state occurs with secondary infection; extrapulmonary causes of death might also originate from a pathological process in the lungs linked to microthrombosis. This heterogeneity of COVID-19 lung disease must be recognised in the management of patients and in the development of novel treatment strategies.

Post-mortem lung tissue: the fossil record of the pathophysiology and immunopathology of severe COVID-19

BACKGROUND & OBJECTIVES: In the present scenario, the most common sample for diagnosis of COVID-19 by reverse transcription polymerase chain reaction (RT-PCR) is nasal and throat swab (NTS). Other sampling options such as gargle lavage have found limited application in clinical use mostly because of unavailability of an appropriate gargling liquid. This study was conducted to assess the stability of SARS-CoV-2 RNA in normal saline at 4°C that can serve as a gargling liquid as well as a transport medium. The study also looked at the agreement between NTS and gargle lavage/saliva for the detection of SARS-CoV-2. METHODS: In 29 consecutive real-time RT-PCR (rRT-PCR) positive COVID-19 patients, paired NTS, gargle and saliva samples were taken. Samples were processed by rRT-PCR for the detection of SARS-CoV-2 RNA. To assess the SARS-CoV-2 RNA stability in normal saline, gargle lavage specimens were divided into two aliquots; one subset of the specimen was run within 4-6 h along with the routine samples (NTS and saliva) and the other subset was stored at 4°C and processed after 24-30 h. Agreement between cycle threshold (Ct) values from both the runs was compared using Bland–Altman (BA) analysis. RESULTS: The positivity rates of rRT-PCR in NTS, saliva and gargle lavage samples were 82.7 (24/29), 79.3 (23/29) and 86.2 per cent (25/29), respectively. BA plot showed a good agreement between the Ct values of fresh and stored gargle samples, stipulating that there were no significant differences in the approximate viral load levels between the fresh and stored gargle lavage samples (bias: E gene −0.64, N gene −0.51, ORF gene −0.19). INTERPRETATION & CONCLUSIONS: Our study results show stability of SARS-CoV-2 RNA in the gargle samples collected using normal saline up to 24-30 h. Gargle lavage and saliva specimen collection are cost-effective and acceptable methods of sampling for the detection of SARS-CoV-2 RNA by rRT-PCR. These simplified, inexpensive and acceptable methods of specimen collection would reduce the cost and workload on healthcare workers for sample collection.

Gargle lavage & saliva: Feasible & cheaper alternatives to nasal & throat swabs for diagnosis of COVID-19

BACKGROUND: Lung ultrasound can adequately monitor disease severity in pneumonia and acute respiratory distress syndrome. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia in critically ill patients. METHODS: Adult patients with COVID-19 pneumonia admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death or ICU stay > 30 days were recorded. Lung ultrasound and CT images were quantified as a lung ultrasound score involvement index (LUSI) and CT severity involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints. RESULTS: We included 55 ultrasound examinations in 34 patients, which were 88% were male, with a mean age of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r = 0.795), with an overall 15% bias, and limits of agreement ranging − 40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor. CONCLUSIONS: Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease, and predict death or ICU stay > 30 days. Trial registration: NTR, NL8584. Registered 01 May 2020—retrospectively registered, https://www.trialregister.nl/trial/8584

Lung ultrasound and computed tomography to monitor COVID-19 pneumonia in critically ill patients: a two-center prospective cohort study

Correction to the entitled “AI-Enabled Global Longitudinal Strain Quantification in Hospitalized COVID-19 Patients with Myocardial Injury” by Hawkes et al. in the paper “ASE 2021 Original Science Presentations,” published in the June 2021 issue of JASE (J Am Soc Echocardiogr 2021;34: e51). The author list for EP-79 was incomplete. The full author list is provided below: Will Hawkes1, Ritu Thamman2, Salima Qamruddin3, Austen Tutor3, Tasneem Naqvi4, Deepa Mandale4, Martin G. Keane5, Benjamin Khazan5, Jordan B. Strom6, Gabriel Pajares Hurtado6, Eric Peterson7, Fahad Gul7, Shivani Watson2, Katherine Tilkes8, Halley Davison8, Christopher Scott8, Hania Piotrowska1, William Hansen1, Jeremy Thaden8, Gary Woodward1, Patricia Pellikka8 1Ultromics LTD, Oxford, UK;2University of Pittsburgh Medical Center, Pittsburgh, PA;3Ochsner Heart and Vascular Institute, New Orleans, LA;4Mayo Clinic, Scottsdale, AZ;5Temple Heart and Vascular Center, Philadelphia, PA;6Beth Israel Deaconess Medical Center, Boston, MA;7Einstein Medical Center Philadelphia, PA;8Mayo Clinic, Rochester, MN.

Correction

Iran is the country in Western Asia most impacted by the COVID-19 outbreak. A survey was conducted among the general public in Iran aimed at investigating psychobehavioural issues related to the COVID-19 outbreak, namely (a) barriers to preventive measures against SARS-CoV-2 infection; (b) negative emotions towards SARS-CoV-2 infection; and (c) anxiety levels among the general public in Iran. A cross-sectional, web-based survey using an online questionnaire was carried out between 16 March and 1 April 2020. The six-item version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety levels. A total of 1,789 complete responses were received. Nearly 60% reported having difficulty in wearing a face mask to protect against SARS-CoV-2 infection. The mean and standard deviation (SD) for the total prevention barrier score was 35.8 (SD ± 7.1; range 18-68) out of a possible score of 72. Male respondents [odds ratio (OR) = 1.25; 95% confidence interval (CI) 1.03-1.51] and respondents who perceived their health status as poor/fair (OR = 1.49; 95% CI 1.31-1.82) were predictors of high prevention barriers. Negative emotions such as fear (74.6%) followed by depression (43.4%) and stigma (23.0%) associated with SARS-CoV-2 infection were reported. Respondents who perceived their health as poor/fair (OR = 2.19; 95% CI 1.57-3.04) reported a higher likelihood of having higher negative emotions. Findings on anxiety level revealed 68.0% (95% CI 65.8-70.1) reported moderate to severe anxiety. Respondents who perceived their health as poor/fair (OR = 3.46; 95% CI 12.22-5.40) and who were females (OR = 1.91; 95% CI 1.55-2.36) were predictors of moderate to severe anxiety. In conclusion, psychobehavioural interventions are needed to facilitate management and control of the COVID-19 outbreak.

Uncovering psychobehavioural implications of SARS-CoV-2 infection in Iran

Sphingolipids are important structural membrane components and, together with cholesterol, are often organized in lipid rafts, where they act as signaling molecules in many cellular functions. They play crucial roles in regulating pathobiological processes, such as cancer, inflammation, and infectious diseases. The bioactive metabolites ceramide, sphingosine-1-phosphate, and sphingosine have been shown to be involved in the pathogenesis of several microbes. In contrast to ceramide, which often promotes bacterial and viral infections (for instance, by mediating adhesion and internalization), sphingosine, which is released from ceramide by the activity of ceramidases, kills many bacterial, viral, and fungal pathogens. In particular, sphingosine is an important natural component of the defense against bacterial pathogens in the respiratory tract. Pathologically reduced sphingosine levels in cystic fibrosis airway epithelial cells are normalized by inhalation of sphingosine, and coating plastic implants with sphingosine prevents bacterial infections. Pretreatment of cells with exogenous sphingosine also prevents the viral spike protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) from interacting with host cell receptors and inhibits the propagation of herpes simplex virus type 1 (HSV-1) in macrophages. Recent examinations reveal that the bactericidal effect of sphingosine might be due to bacterial membrane permeabilization and the subsequent death of the bacteria.

The Anti-Infectious Role of Sphingosine in Microbial Diseases

Subscription services face a difficult problem when estimating the causal impact of content launches on acquisition. Customers buy subscriptions, not individual pieces of content, and once subscribed they may consume many pieces of content in addition to the one(s) that drew them to the service. In this paper, we propose a scalable methodology to estimate the incremental acquisition impact of content launches in a subscription business model when randomized experimentation is not feasible. Our approach uses simple assumptions to transform the problem into an equivalent question: what is the expected consumption rate for new subscribers who did not join due to the content launch? We estimate this counterfactual rate using the consumption rate of new subscribers who joined just prior to launch, while making adjustments for variation related to subscriber attributes, the in-product experience, and seasonality. We then compare our counterfactual consumption to the actual rate in order to back out an acquisition estimate. Our methodology provides top-line impact estimates at the content / day / region grain. Additionally, to enable subscriber-level attribution, we present an algorithm that assigns specific individual accounts to add up to the top-line estimate. Subscriber-level attribution is derived by solving an optimization problem to minimize the number of subscribers attributed to more than one piece of content, while maximizing the average propensity to be incremental for subscribers attributed to each piece of content. Finally, in the absence of definitive ground truth, we present several validation methods which can be used to assess the plausibility of impact estimates generated by these methods.

Estimating Incremental Acquisition of Content Launches in a Subscription Service

Even though laboratory and epidemiological studies have demonstrated the effects of ambient temperature on the transmission and survival of coronaviruses, not much has been done on the effects of weather on the spread of COVID-19. This study investigates the effects of temperature, humidity, precipitation, wind speed and the specific government policy intervention of partial lockdown on the new cases of COVID-19 infection in Ghana. Daily data on confirmed cases of COVID-19 from March 13, 2020 to April 21, 2020 were obtained from the official website of Our World in Data (OWID) dedicated to COVID-19 while satellite climate data for the same period was obtained from the official website of NASA's Prediction of Worldwide Energy Resources (POWER) project. Considering the nature of the data and the objectives of the study, a time series generalized linear model which allows for regressing on past observations of the response variable and covariates was used for model fitting. The results indicate significant effects of maximum temperature, relative humidity and precipitation in predicting new cases of the disease. Also, results of the intervention analysis indicate that the null hypothesis of no significant effect of the specific policy intervention of partial lockdown should be rejected (p-value=0.0164) at a 5\% level of significance. These findings provide useful insights for policymakers and the public.

Effects of weather and policy intervention on COVID-19 infection in Ghana

This study has two main objectives. The first aim is to adapt the social distancing scale (SDS) into Turkish. The second aim is to test the mediating roles of depression, anxiety, and stress on the relationship between social distance and psychological resilience. The sampling method of the study was revised as the snowball sampling. The study surveyed 843 people (481 female and 362 male) between the ages of 18 and 70 (average age 31.95) living in 51 different cities if Turkey. In the study, back-translation method was used to prepare the SDS-Turkish version. Confirmatory factor analysis results for the study showed that the single-dimension structure fits very well, as in the original form. Cronbach’s alpha reliability coefficient for the scale was calculated as 0.70. In line with the second aim of the study, the data were tested using a structural equation model analysis. Research results showed that depression, anxiety, and stress have a full mediator role in the relationship between social distancing and resilience for Turkish residents. In other words, this study eliminates social distancing’s predictability of resilience by the insertion of the mediatory variable of depression, anxiety, and stress into the structural equation model.

Adaptation of the Social Distancing Scale in the Covid-19 Era: Its Association with Depression, Anxiety, Stress, and Resilience in Turkey

BACKGROUND: Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. METHODS: This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. RESULTS: The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [- 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [- 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [- 25;33] vs 17% [- 8;50], P = .584). CONCLUSIONS: The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.

Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is arranged as a trimer on the virus surface, composed of three S1 and three S2 subunits. Infected and vaccinated individuals generate antibodies against spike, which can neutralize the virus. Most antibodies target the receptor-binding domain (RBD) and N-terminal domain (NTD) of S1; however, antibodies against other regions of spike have also been isolated. The interhost variability in domain specificity and relative neutralization efficacy of the antibodies is still poorly characterized. To this end, we tested serum and plasma samples collected from 85 coronavirus disease 2019 (COVID-19) convalescent subjects. Samples were analyzed using seven immunoassays that employ different domains, subunits, and oligomeric forms of spike to capture the antibodies. Samples were also tested for their neutralization of pseudovirus containing SARS-CoV-2 spike and of replication-competent SARS-CoV-2. While the total amount of anti-spike antibodies produced varied among convalescent subjects, we observed an unexpectedly fixed ratio of RBD- to NTD-targeting antibodies. The relative potency of the response (defined as the measured neutralization efficacy relative to the total level of spike-targeting antibodies) also exhibited limited variation between subjects and was not associated with the overall amount of antispike antibodies produced. These studies suggest that host-to-host variation in the polyclonal response elicited against SARS-CoV-2 spike in early pandemic subjects is primarily limited to the quantity of antibodies generated rather than their domain specificity or relative neutralization potency. IMPORTANCE Infection by SARS-CoV-2 elicits antibodies against various domains of the spike protein, including the RBD and NTD of subunit S1 and against subunit S2. The antibody responses of different infected individuals exhibit different efficacies to inactivate (neutralize) the virus. Here, we show that the observed variation in the neutralizing activity of the antibody responses in COVID-19 convalescent subjects is caused by differences in the amounts of antibodies rather than their recognition properties or the potency of their antiviral activity. These findings suggest that COVID-19 vaccine strategies that focus on enhancing the overall level of the antibodies will likely elicit a more uniformly efficacious protective response.

Limited Variation between SARS-CoV-2-Infected Individuals in Domain Specificity and Relative Potency of the Antibody Response against the Spike Glycoprotein

This contribution describes the initial response of the KB, the National Library of the Netherlands, to the Corona / COVID-pandemic

The KB and Corona

A study of 7-fold tilings that use a set of three proto-rhombs in a substitution scheme to tile a large area. A set is discovered that is thought to be the most minimal or smallest one. The scheme uses 11 proto-rhombs to tile the next generation of inflated tiles. The general form of 7-fold substitutions is shown and the role of the 7-fold magic number phi is derived. The figures include a number of newly discovered 7-fold tilings.

A Minimal 7-Fold Rhombic Tiling

What will be the role of theragnostic patents in upstream and downstream biomarker research?

Shifting emphasis from pharmacogenomics to theragnostics

Importance: With the increasing number of infections for COVID-19, the global health resources are deficient. At present, we don't have specific medicines or vaccines against novel coronavirus pneumonia (NCP) and our assessment of risk factors for patients with severe pneumonia was limited. In order to maximize the use of limited medical resources, we should distinguish between mild and severe patients as early as possible. Objective: To systematically review the evidence of risk factors for severe corona virus disease 2019 (COVID-19) patients. Evidence Review: We conducted a comprehensive search for primary literature in both Chinese and English electronic bibliographic data bases including China National Knowledge Infrastructure (CNKI), Wanfang, Weipu, Chinese Biomedicine Literature Database (CBM-SinoMed), MEDLINE (via PubMed), EMBASE, Cochrane Central Register, and Web of science. The American agency for health research and quality (AHRQ) tool were used for assessing risk of bias. Mata-analysis was undertaken using STATA version 15.0. Results: 20 articles (N=4062 participants) were eligible for this systematic review and meta-analysis. First in this review and meta-analysis, we found that elderly male patients with a high body mass index, high breathing rate and a combination of underlying diseases (such as hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease) were more likely to develop into critically ill patients. second, compared with ordinary patients, severe patients had more significant symptom such as fever and dyspnea. Besides, the laboratory test results of severe patients had more abnormal than non-severe patients, such as the elevated levels of white-cell counts, liver enzymes, lactate dehydrogenase, creatine kinase, c-reactive protein and procalcitonin, etc, while the decreased levels of lymphocytes and albumin, etc. Interpretation: This is the first systematic review investigating the risk factors for severe corona virus disease 2019 (COVID-19) patients. The findings are presented and discussed by different clinical characteristics. Therefore, our review may provide guidance for clinical decision-making and optimizes resource allocation.

Risk factors for severe corona virus disease 2019 (COVID-19) patients : a systematic review and meta analysis

Abdominal muscles, such as the oblique- and transverse muscles, find their blood supply from multiple segmental pedicles from the iliac artery. Besides its superior vascularization, its release is simple, leaving two abdominal muscles for securing abdominal wall strength. The release of the muscle and coverage of the graft requires partial muscle mobilization and is a minor reconstruction, but extension of the mobilization cranially enables coverage of larger defects. We present a case of an infected vascular graft in the groin successfully preserved through coverage with an external oblique muscle flap.

Covering of an exposed vascular graft in the groin with an external oblique muscle rotational flap.

Aims This project aimed to assess the effects of COVID-19 on the mental health of adolescents, reflected through their presentations to A&E departments in NHS Lanarkshire. Method The psychiatry liaison database was searched for referrals of 17 year olds and under from April until August 2020. All referrals to all acute hospital sites in Lanarkshire received from any source were included. The only exclusion criteria applied were age over 17 and unavailable assessment information. The sources searched for information were: patient's electronic notes, Mental Health Assessment forms, Mental Health Risk Assessment forms and electronic letters. The following information was gathered: patient's age date, source and reason for referral hospital site of assessment outcome of assessment Result Between April and August 2020, the number of CAMHS A&E referrals increased every month except in July. The age range of CAMHS patients presenting to A&E were 12-17 years, with 17 being the most common age seen. 87% of referrals were from A&E. The two most common reasons for referrals were drug overdose and suicidal ideation. The most common outcome of assessment was a CAMHS referral. COVID-19 was a trigger for an adolescent's presentation to A&E in 31% of cases, the most common cause being struggling with the lockdown/restrictions. Conclusion The mental health charity YoungMinds carried out several surveys throughout the COVID-19 pandemic's first wave. They demonstrated a detrimental effect on young people's mental health in the UK. YoungMinds surveys revealed that 32% and 41% of young people experienced “much worse” mental health due to COVID-19. The findings of NHS Lanarkshire were similar, with 31% of adolescents presenting to A&E as a result of COVID-19. No adolescent included in this review had contracted COVID-19 at any point. Their mental health was therefore impacted by the indirect effects of COVID-19 rather than the direct effects of infection. For the 31% of CAMHS presentations to A&E which were due to COVID-19, most young people struggled with the lockdown/restrictions. The number of presentations to A&E increased every month between April and August 2020 except for July. This could be due to people's initial fear of coming to hospital and catching COVID-19. However, as infection and death rates decreased towards the summer, people may have regarded hospitals as safer. The general increase in referrals every month may also be a reflection of the worsening of young people's mental health the longer the pandemic extended.

The effects of the first wave of the COVID-19 pandemic on the presentation of adolescents to acute mental health services in NHS Lanarkshire

Surveillance of genetic diversity of the SARS-CoV-2 is extremely important to detect the emergence of more infectious and deadly strains of the virus. In this study, we evaluated mutational events in the SARS-CoV-2 genomes through whole genome sequencing. The samples were collected from COVID-19 patients in different major cities of Pakistan during the four waves of the pandemic (May 2020 to July 2021) and subjected to whole genome sequencing. Using in silico and machine learning tools, the viral mutational events were analyzed, and variants of concern and of interest were identified during each of the four waves. The overall mutation frequency (mutations per genome) increased during the course of the pandemic from 12.19 to 23.63, 31.03, and 41.22 in the first, second, third, and fourth waves, respectively. We determined that the viral strains rose to higher frequencies in local transmission. The first wave had three most common strains B.1.36, B.1.160, and B.1.255, the second wave comprised B.1.36 and B.1.247 strains, the third wave had B.1.1.7 (Alpha variant) and B.1.36 strains, and the fourth waves comprised B.1.617.2 (Delta). Intriguingly, the B.1.36 variants were found in all the waves of the infection indicating their survival fitness. Through phylogenetic analysis, the probable routes of transmission of various strains in the country were determined. Collectively, our study provided an insight into the evolution of SARS-CoV-2 lineages in the spatiotemporal local transmission during different waves of the pandemic, which aided the state institutions in implementing adequate preventive measures.

Genome sequencing and analysis of genomic diversity in the locally transmitted SARS-CoV-2 in Pakistan

People who use drugs (PWUD) face concurrent public health emergencies from overdoses, HIV, hepatitis C, and COVID-19, leading to an unprecedented syndemic. Responses to PWUD that go beyond treatment--such as decriminalization and providing a safe supply of pharmaceutical-grade drugs--could reduce impacts of this syndemic. Solutions already implemented for COVID-19, such as emergency safe-supply prescribing and providing housing to people experiencing homelessness, must be sustained once COVID-19 is contained. This pandemic is not only a public health crisis but also a chance to develop and maintain equitable and sustainable solutions to the harms associated with the criminalization of drug use.

Addressing the Syndemic of HIV, Hepatitis C, Overdose, and COVID-19 Among People Who Use Drugs: The Potential Roles for Decriminalization and Safe Supply.

Background and Objectives: chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and a history of exposure to noxious stimuli. Cigarette smoking is the most important causal factor for developing COPD. Cadmium, a minor metallic element, is one of the main inorganic components in tobacco smoke. Inhaled cadmium was associated with a decline in lung function, gas exchange impairment, and the development of obstructive lung disease. Patients with COPD who had oxygen desaturation during the 6-min walk test (6MWT) had a significantly worse prognosis than non-desaturation in COPD patients. Nonetheless, few studies have addressed the influence of blood cadmium levels on exercise-induced oxygen desaturation in COPD patients. Our objective was to assess the potential impact of blood cadmium levels on oxygen desaturation during the 6MWT among COPD patients. Materials and Methods: we performed a retrospective analysis of patients with COPD who were examined for blood cadmium levels in a tertiary care referral center in Taiwan, between March 2020 and May 2021. The 6-min walk test was performed. Normal control subjects who had no evidence of COPD were also enrolled. Results: a total of 73 COPD patients were analyzed and stratified into the high-blood cadmium group (13 patients) and low-blood cadmium group (60 patients). A total of 50 normal control subjects without a diagnosis of COPD were enrolled. The high-blood cadmium group had a significantly higher extent of desaturation than the low-blood cadmium group. The frequency of desaturation during 6MWT revealed a stepwise-increasing trend with an increase in blood cadmium levels. A multivariable logistic regression model revealed that blood cadmium levels were independently associated with desaturation during the 6MWT (odds ratio 12.849 [95% CI 1.168–141.329]; p = 0.037). Conclusions: our findings indicate that blood cadmium levels, within the normal range, were significantly associated with desaturation during 6MWT in patients with COPD.

Blood Cadmium Levels and Oxygen Desaturation during the 6-Minute Walk Test in Patients with Chronic Obstructive Pulmonary Disease

The paper examined the role of academic libraries in the evolving paradigm shift in teaching methodologies in Nigerian universities as a result of the outbreak of Covid-19. It x-rayed the current global trends in online education and significant roles libraries can play. Responsive library website design and adoption, adoption of blended librarianship model and use of social networks among others were identified as best practices to adopt in order to secure a place for libraries in Nigeria in the face of the eminent change in teaching methodologies post Covid-19. Furthermore, the study considered perceived challenges libraries may be confronted with in deploying relevant ICT infrastructures geared towards transitioning from traditional to online provision of services in support of teaching and learning. The paper recommended dynamism in library service delivery, urgency in the acquisition of new skill sets by academic librarians in Nigeria, while also calling on relevant stakeholders to provide adequate funding for libraries in order to be able to deploy relevant ICT infrastructures needed to adequately support teaching and learning in a virtual environment.

Covid – 19 pandemic and the future of Nigeria's university system: The quest for libraries' relevance

Based on the existing problems, during the COVID-19 pandemic, students were required to learn from home by learning online (DARING). Thus the researcher aims to develop innovative and valid learning media for students. The method used in this study is to use the R&amp;D method with the ADDIE model (Analysis, Design, Development, Implementation and Evaluation). The results showed that the solar system media was suitable for use by elementary school students as evidenced by the results of the validity of the media expert with a validity value of 90% with the feasible category. The validity of media eligibility is based on the suitability of images, colors, fonts, text layout, images, animation and sound. While the validity of material experts reached 83% based on core competence (KI), indicators, suitability with children's cognitive development. Meanwhile, 87% of linguists were categorized as feasible based on the level of language development of students. Thus the solar system media products are valid and suitable for use in learning in elementary schools.

Pengembangan Media Tata Surya Berbasis Macromedia Flash Sebagai Inovasi Pembelajaran Daring Untuk Siswa Sd

Surfactant treatment is one of the milestones of respiratory distress syndrome (RDS) treatment in preterm infants, but it has been also demonstrated to exert consistent antioxidant and anti-inflammatory activities. Exogenous natural surfactant contains antioxidant enzymes, such as catalase (CAT) and superoxide dismutase (SOD), and nonenzymatic antioxidant molecules, such as plasmalogens and polyunsaturated phospholipids (PUPLs). Moreover, surfactant can contribute to the modulation of intra-alveolar inflammatory processes through the regulation effect of the surfactant A (SP-A) and B (SP-B) proteins. Although less extensively investigated, these functions may contribute to the efficacy of exogenous surfactant administration in preterm neonates with RDS.

Antioxidant Properties of Surfactant

The ongoing outbreak caused by SARS-CoV-2 has become a challenge worldwide Its transmission has been increasing day by day abnormally It has been reported that apart from the standard respiratory disorders, patients are showing signs and symptoms of neurological problems as well In previous outbreaks associated with SARS-CoV, it was proved that CNS is also being targeted as well as PNS with additional reports indicating brain being a target It leads to an important result that the probability of patients with neurological manifestations has increased gradually amidst the COVID-19 outbreak Various potential therapies including convalescent plasma transfusion have been applied for the time being Hence, in this structured and detailed review, the existence of such neural complications along with the potential treatment strategies associated with Covid-19 has been discussed © 2020 World Research Association All rights reserved

Neurological manifestation and treatment strategies of COVID-19: A review

OBJECTIVES: The aim of the study was to find evidence of SARS-CoV-2 infection in UK cats. DESIGN: Tissue samples were tested for SARS-CoV-2 antigen using immunofluorescence and for viral RNA by in situ hybridisation. A set of 387 oropharyngeal swabs that had been submitted for routine respiratory pathogen testing was tested for SARS-CoV-2 RNA using reverse transcriptase quantitative PCR. RESULTS: Lung tissue collected post-mortem from cat 1 tested positive for both SARS-CoV-2 nucleocapsid antigen and RNA. SARS-CoV-2 RNA was detected in an oropharyngeal swab collected from cat 2 that presented with rhinitis and conjunctivitis. High throughput sequencing of the viral genome revealed five single nucleotide polymorphisms (SNPs) compared to the nearest UK human SARS-CoV-2 sequence, and this human virus contained eight SNPs compared to the original Wuhan-Hu-1 reference sequence. An analysis of the viral genome of cat 2 together with nine other feline-derived SARS-CoV-2 sequences from around the world revealed no shared cat-specific mutations. CONCLUSIONS: These findings indicate that human-to-cat transmission of SARS-CoV-2 occurred during the COVID-19 pandemic in the UK, with the infected cats developing mild or severe respiratory disease. Given the ability of the new coronavirus to infect different species, it will be important to monitor for human-to-cat, cat-to-cat and cat-to-human transmission.

Detection of SARS-CoV-2 in respiratory samples from cats in the UK associated with human-to-cat transmission

PurposeReal estate investment trusts (REITs) are historically considered as attractive assets to investors particularly as the underlying assets are properties which are income-producing REITs also distribute substantial amount of profits as dividends to shareholders Stephen and Simon (2005) find that REITs in a mixed asset portfolio of stocks and bonds enhance returns and reduce risk This paper examines the role a pandemic (COVID-19) plays in the performance of global REITs index and REIT sectors Design/methodology/approachTo examine the effects of COVID-19 on REITs, the year-to-date (YTD) returns of global returns index and REITs sectors in the United States are observed and a comparative analysis is employed from January 2020 to May 2020 FindingsBased on a three-month return ending 22 May 2020, FTSE EPRA NAREIT index is the biggest loser at −31 83% whilst the FTSE EPRA Asia–Pacific index has the lowest loss at −23 20% The author examines YTD returns which show disparities on the effect of COVID-19 on REIT sectors The US market is examined;most REIT sectors suffered big losses as at April 2020;the analysis reveals YTD returns for the top three REIT sector losers are lodging/resort REITs (−45 81%), retail REITs (−41 16%) and office REITs (−22 63%) Data centre REITs are the only sector REITs with positive returns at 17 66% Practical implicationsMost sector REITs during the pandemic have lost considerable value based on YTD returns as at May 2020 Flight to quality is expected during this uncertain period to REITs such as data REITs, grocery-anchored REITs and storage REITs These REITs are not as adversely affected by COVID-19 in comparison to other REITs Originality/valueThis paper identified the impact of COVID-19 on the performance of global REITs and US sector REITs during the periods from January 2020 to May 2020

How resilient are REITs to a pandemic? The COVID-19 effect

Although the full impact of the novel coronavirus (COVID-19) pandemic is yet to be realized, New Zealand has suffered comparatively less than other countries, and there were no active cases in the country by June 8, 2020. Building from best practices in emergency management research, several preliminary lessons emerge from the country’s response to the crisis that could be adapted for other settings. In particular, the government acted early and decisively, developed national unity to combat the virus, communicated effectively with the public, and adapted to changing circumstances, especially to address shortcomings in the response. These preliminary lessons provide some guidance in how to effectively respond to the virus through proactive, evidence-based, well-communicated policies.

“Go Hard, Go Early”: Preliminary Lessons From New Zealand’s Response to COVID-19

Viral infectious diseases have resulted in millions of deaths throughout history and have created a significant public healthcare burden. Tremendous efforts have been placed by the scientific communities, health officials and government organizations to detect, treat, and prevent viral infection. However, the complicated life cycle and rapid genetic mutations of viruses demand continuous development of novel medicines with high efficacy and safety profiles. Peptides provide a promising outlook as a tool to combat the spread and re-emergence of viral infection. This article provides an overview of five viral infectious diseases with high global prevalence: influenza, chronic hepatitis B, acquired immunodeficiency syndrome, severe acute respiratory syndrome, and coronavirus disease 2019. The current and potential peptide-based therapies, vaccines, and diagnostics for each disease are discussed.

Peptides to Combat Viral Infectious Diseases

We describe a method for precisely regulating the gradient magnet power supply at the Fermilab Booster accelerator complex using a neural network trained via reinforcement learning. We demonstrate preliminary results by training a surrogate machine-learning model on real accelerator data to emulate the Booster environment, and using this surrogate model in turn to train the neural network for its regulation task. We additionally show how the neural networks to be deployed for control purposes may be compiled to execute on field-programmable gate arrays. This capability is important for operational stability in complicated environments such as an accelerator facility.

Real-time Artificial Intelligence for Accelerator Control: A Study at the Fermilab Booster

PURPOSE OF REVIEW: Using case vignettes, we highlight challenges in communication, prognostication, and medical decision-making that have been exacerbated by the coronavirus disease-19 (COVID-19) pandemic for patients with kidney disease. We include best practice recommendations to mitigate these issues and conclude with implications for interdisciplinary models of care in crisis settings. RECENT FINDINGS: Certain biomarkers, demographics, and medical comorbidities predict an increased risk for mortality among patients with COVID-19 and kidney disease, but concerns related to physical exposure and conservation of personal protective equipment have exacerbated existing barriers to empathic communication and value clarification for these patients. Variability in patient characteristics and outcomes has made prognostication nuanced and challenging. The pandemic has also highlighted the complexities of dialysis decision-making for older adults at risk for poor outcomes related to COVID-19. SUMMARY: The COVID-19 pandemic underscores the need for nephrologists to be competent in serious illness communication skills that include virtual and remote modalities, to be aware of prognostic tools, and to be willing to engage with interdisciplinary teams of palliative care subspecialists, intensivists, and ethicists to facilitate goal-concordant care during crisis settings.

Challenges in communication, prognostication and dialysis decision-making in the COVID-19 pandemic: implications for interdisciplinary care during crisis settings

Up to now, no vaccine has been developed for COVID-19 treatment Although many scientists are working for the rapid development of a vaccine to control this pandemic, nonetheless, it will take time If the vaccine will be developed soon, it will not be available to the entire world instantly since the mass production of the vaccine will take time In this scenario, we will have to take alternative measures to control the COVID-19 pandemic These alternative approaches include the stimulation of the immune system to fight against viral infections Among the different approaches to strengthen the immune system, the use of probiotics is the best one Probiotics can help the body to fight against COVID-19 directly and indirectly In this review, we comprehensively discuss the use of probiotics for the prevention and control of COVID-19

Probiotics: Helpful for the prevention of COVID-19?

As a result of the COVID-19 pandemic, universities worldwide were forced to close their campuses and move instructional delivery to a digital mode. Many argued that this massive emergency digitalisation of instructional delivery was a major move of higher education toward online learning. However, this view overlooks considerations of pedagogy and of online learning design and delivery. Online learning is not just about uploading content to an online space or about moving all lectures online, and there is a whole theory behind designing online learning environments and delivering online learning. This chapter will discuss key theoretical considerations behind online learning design and delivery in relation to the digitalisation of higher education during COVID-19 with a view to make recommendations that will help universities design fulfilling and effective online learning and teaching experiences for their students and faculty. © 2021 by IGI Global. All rights reserved.

From face-to-face to digital learning: Implications for pedagogy, learning design, and instruction

OBJECTIVES Toothbrushing and interdental cleaning are critical to maintaining good oral health. Literature is beginning to suggest that these behaviours may be conducted automatically, although the instigation (deciding to do) and execution ('doing') of these behaviours has never been examined separately. The objective of this study was to test a theoretically informed supposition that oral hygiene behaviours in adults are automatic behaviours. METHODS One hundred and fifty participants attending three types of dental providers covering emergency and routine dental services, completed a questionnaire. The self-reported behavioural automaticity index scale (SRBAI) was used to measure behavioural automaticity. RESULTS Morning toothbrushing SRBAI scores were higher than evening scores (Z=-3.315, p = 0.001). Automaticity scores for instigating both toothbrushing and interdental cleaning were also higher compared to execution (toothbrushing: Z=-2.601, p = 0.009 and interdental cleaning: Z=-2.256. p = 0.024). Toothbrushing automaticity scores were associated with age, gender and self-efficacy, whereas interdental cleaning automaticity scores were associated with intention. Individuals in lower socio-economic status (SES) occupations had significantly higher automaticity scores for interdental cleaning compared to those with higher SES roles. CONCLUSIONS A high proportion of people undertake toothbrushing and interdental cleaning automatically, especially in relation to embarking on these behaviours. This is most pronounced in morning toothbrushing.

Oral hygiene behaviour automaticity: Are tooth-brushing and inter-dental cleaning habitual behaviours?

Researchers worldwide are seeking to repurpose existing drugs or discover new drugs to counter the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A promising source of candidates for such studies is molecules that have been reported in the scientific literature to be drug-like in the context of coronavirus research. We report here on a project that leverages both human and artificial intelligence to detect references to drug-like molecules in free text. We engage non-expert humans to create a corpus of labeled text, use this labeled corpus to train a named entity recognition model, and employ the trained model to extract 10912 drug-like molecules from the COVID-19 Open Research Dataset Challenge (CORD-19) corpus of 198875 papers. Performance analyses show that our automated extraction model can achieve performance on par with that of non-expert humans.

AI- and HPC-enabled Lead Generation for SARS-CoV-2: Models and Processes to Extract Druglike Molecules Contained in Natural Language Text

The rapid spread of the Coronavirus pandemic and its significant health and social impact urges the search for effective and readily available solutions to mitigate the damages. Thus, evaluating the effectiveness of existing vaccines like Bacillus Calmette-Guérin (BCG) has attracted attention. The aim of this review was evidence synthesis on the effect of BCG vaccine in preventing severe infectious respiratory disease including COVD-19, but not tuberculosis. We considered studies conducted on human participants of any study design from any country setting that were published in Enlgish. We did a systematic literature search in MEDLINE, Scopus and Google scholar databases and a free search on Google. The identified studies were appraised and relevant data were extracted using Joanna Briggs Institute tools. The extracted findings were synthesized with tables and narrative summary. Nine studies met the inclusion criteria. The findings indicated that BCG vaccine has a strong protective effect against both upper and lower acute respiratory tract infections. For instance in countries with universal BCG vaccination policy, the incidence of COVID-19 was lower compared to the counterparts. Addtionally, BCG vaccine was found to protect against infections like lethal influenza A virus, pandemic influenza (H1N1), and other acute respiratory tract infections. BCG improved the human body's immune response involving antigen-specific T cells and memory cells. It also induced adaptive functional reprogramming of mononuclear phagocytes that induce protective effects against different respiratory infections other than tuberculosis. In countries with universal BCG vaccination, the incidence and death from acute respiratory viral infection including COVID - 19 is significantly low. However, there is an urgent need for further evidence from well-designed studies to understand the possible role of BCG vaccination over time and across age groups, its possible benefits in special populations such as health workers and cost-savings related to a policy of universal BCG vaccination.

The effect of Bacillus Calmette-Guérin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic