There are as yet no licensed therapeutics for the COVID-19 pandemic. The causal coronavirus (SARS-CoV-2) binds host cells via a trimeric spike whose receptor binding domain (RBD) recognizes angiotensin-converting enzyme 2, initiating conformational changes that drive membrane fusion. We find that the monoclonal antibody CR3022 binds the RBD tightly, neutralizing SARS-CoV-2, and report the crystal structure at 2.4 ? of the Fab/RBD complex. Some crystals are suitable for screening for entry-blocking inhibitors. The highly conserved, structure-stabilizing CR3022 epitope is inaccessible in the prefusion spike, suggesting that CR3022 binding facilitates conversion to the fusion-incompetent post-fusion state. Cryogenic electron microscopy (cryo-EM) analysis confirms that incubation of spike with CR3022 Fab leads to destruction of the prefusion trimer. Presentation of this cryptic epitope in an RBD-based vaccine might advantageously focus immune responses. Binders at this epitope could be useful therapeutically, possibly in synergy with an antibody that blocks receptor attachment.

COVID-19 is a concern in today's world. The large number of infected victims followed by a high death rate has made the country take large-scale social restrictions (PSBB). During the pressure of health and economic problems there is a sense of solidarity among the nation's youth to share and support each other to face the impacts caused by this pandemic. This research focuses on how social solidarity is built by many Indonesians both through social media and on a community basis. Phenomenology is used as the approach used in this study to comprehend a phenomenon comprehensively to know and interpret a phenomenon in-depth not only as a visible surface. From what we can summarize, strengthening social solidarity appears in various domains and actors including netizen activism through social media and other channels;the action of the conventional community (Non-Government Organization Civil Society) and the role of a traditional and Indigenous Peoples.

Severe acute respiratory syndrome (SARS), also called infectious atypical pneumonia, is an emerging infectious disease caused by a novel variant of coronavirus (SARS-associated coronavirus, SARS-CoV). It is mainly characterized by pulmonary infection with a high infectivity and fatality. SARS is swept across almost all the continents of the globe, and has currently involved 33 countries and regions, including the mainland China, Hong Kong, Taiwan, North America and Europe. On June 30, 2003, an accumulative total reached 8450 cases with 810 deaths. SARS epidemic was very rampant in March, April and May 2003 in the mainland of China and Hong Kong. Chinese scientists and healthcare workers cooperated closely with other scientists from all over the world to fight the disease. On April 16, 2003, World Health Organization (WHO) formally declared that SARS-CoV was an etiological agent of SARS. Currently, there is no specific and effective therapy and prevention method for SARS. The main treatments include corticosteroid therapy, anti-viral agents, anti-infection, mechanical ventilation and isolation. This disease can be prevented and controlled, and it is also curable. Under the endeavor of the Chinese Government, medical staffs and other related professionals, SARS has been under control in China, and Chinese scientists have also made a great contribution to SARS research. Other studies in developing new detection assays and therapies, and discovering new drugs and vaccines are in progress. In this paper, we briefly review the current status of SARS in China.

The COVID-19 pandemic substantially impacted the field of telecommunication. It increased the use of media applications that enable teleconferencing, telecommuting, online learning, and social relations. Prolonged time facing screens, tablets, and smart devices increases stress and anxiety. Mental health stressors associated with telecommunication can add to other stressors related to quarantine time and lockdown to eventually lead to exhaustion and burnout. In this review, the effects of the COVID-19 pandemic on communication and education are explored. In addition, the relationship between prolonged exposure to digital devices and mental health is studied. Finally, coping strategies are offered to help relieve the tele-burdens of pandemics.

Background: The new coronavirus disease (COVID-19) has impacted many aspects of life Several studies have investigated the effect of this pandemic on academic activities Yet, no studies addressed the impact of COVID-19 on students in Sudan This study examines the impact of COVID-19 on Sudanese undergraduate pharmacy students Methods: A cross-sectional study was conducted using an online questionnaire delivered to undergraduate pharmacy students Results: A total of 137 students responded to the survey The majority were female (74 5%) and were students in private colleges (60 6%) Majority of the students (95 0%) were affected by COVID-19 crisis and about half of the respondents (54 0%) were depressed and 85 4% reported a decreased level of concentration In spite of these challenges, majority of our respondents were still motivated (85 3%) to continue their education on campus Conclusion: Despite unprecedented challenges posed by the COVID-19 pandemic, pharmacy students in Sudan are motivated to continue their studies, and they want the traditional teaching model to resume It is time to invest more in education and rethink delivery of pharmacy education in Sudan during public health emergencies There is no better time than now

Real-time tracking of epidemic helps governments and health authorities make timely data-driven decisions. Official mortality data, whenever reliable and available, is usually published with a substantial delay. We report results of using newspapers obituaries to "nowcast" the mortality levels observed in Italy during the COVID-19 outbreak between February 24, 2020 and April 15, 2020. Mortality levels predicted using obituaries outperform forecasts based on past mortality according to several performance metrics, making obituaries a potentially valid alternative source of information to deal with epidemic surveillance.

The COVID-19 pandemic has provided medical students around the globe with unique challenges and opportunities. With formal medical school education and training interrupted, medical students sought innovative ways to contribute to their health-care systems and communities. Their responses could be organized into three categories: clinical (remote clinical care and triage, helping in COVID testing or treatment centers, and contact tracing), nonclinical (PPE acquisition, COVID-related policy and research, and supporting vulnerable groups in the community), and educational (creating materials to educate peers, the community, or community health workers). We present examples of responses developed by students from five countries: Brazil, Nepal, the Philippines, Rwanda, and the United States. We discuss the challenges, outcomes, and recommendations for each case. One critical opportunity for growth is strengthening international collaborations. We hope that these examples provide a framework for medical students to plan coordinated and effective responses to the next pandemic, and further medical student engagement in international collaboration.

BACKGROUND: During the ongoing COVID-19 pandemic period, most university courses in Turkey have been taught via distance education. Beyond knowledge of digital technologies, self-efficacy is known to affect the learning motivation and learning goals of students. PURPOSE: This study was conducted to determine the relationship between eHealth literacy and self-efficacy levels in midwifery students receiving distance education during the current COVID-19 pandemic. The research data were collected using a literature-based questionnaire developed by the researchers, the eHealth Literacy Scale for Adolescents, and the Online Technologies Self-Efficacy Scale. The data were analyzed using IBM SPSS Statistics 25.0, with values of p < .05 considered to be significant. METHODS: This cross-sectional study was carried out during the COVID-19 pandemic on a sample of 578 female midwifery students. Snowball sampling method was used for data collection using an online questionnaire. RESULTS: On the basis of the results, eHealth literacy and self-efficacy levels were relatively low in students who were 20 years old or below, who were in their first year, who were from low-income families, who spent less than an hour a day on the Internet, who had a low level of satisfaction with distance education, and who wanted to continue taking theoretical courses via distance education. In addition, self-efficacy related to online technologies was shown to be relatively low in students who found Internet services to be expensive, who had Internet connection problems, and who preferred asynchronous courses. Furthermore, a significant relationship was found between eHealth literacy and self-efficacy levels for online education. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: In the context of distance education, integrating the teaching/promotion of self-efficacy with regard to eHealth literacy and online technologies into midwifery education curriculum should better enable midwives to increase the quality of healthcare they provide and improve patient safety.

Most individuals who consume foods contaminated with the bacterial pathogen Listeria monocytogenes (Lm) develop mild symptoms, while others are susceptible to life-threatening systemic infections (listeriosis). Although it is known that the risk of severe disease is increased in certain human populations, including the elderly, it remains unclear why others who consume contaminated food develop listeriosis. Here, we used a murine model to discover that pulmonary coinfections can impair the host's ability to adequately control and eradicate systemic Lm that cross from the intestines to the bloodstream. We found that the resistance of mice to oral Lm infection was dramatically reduced by coinfection with Streptococcus pneumoniae (Spn), a bacterium that colonizes the respiratory tract and can also cause severe infections in the elderly. Exposure to Spn or microbial products, including a recombinant Lm protein (L1S) and lipopolysaccharide (LPS), rendered otherwise resistant hosts susceptible to severe systemic Lm infection. In addition, we show that this increase in susceptibility was dependent on an increase in the production of interleukin-10 (IL-10) from Ncr1+ cells, including natural killer (NK) cells. Lastly, the ability of Ncr1+ cell derived IL-10 to increase disease susceptibility correlated with a dampening of both myeloid cell accumulation and myeloid cell phagocytic capacity in infected tissues. These data suggest that efforts to minimize inflammation in response to an insult at the respiratory mucosa render the host more susceptible to infections by Lm and possibly other pathogens that access the oral mucosa.

Objective: To evaluate COVID-19 vaccination status in admitted children in 2020C2021 and during the OMICRON variant circulation (2022), a period when children older than 12 years of age had received two doses of COVID-19 vaccines. Design: An observational retrospective study. Patients with confirmed COVID-19 were compared in two different periods: 2020C2021 when adolescents aged 12C18 years had not received the complete COVID-19 vaccine, and 2022 when children older than 12 years had received the complete Pfizer-BioNTech vaccine scheme. Setting: Two pediatric hospitals in Rio de Janeiro city. Patients: Children aged < 18 years with confirmed COVID-19. Intervention: None. Main outcome: Vaccination status for COVID-19 on admission. Results: In total, 300 patients were admitted with confirmed COVID-19 (240 in 2020C2021 and 60 in 2022). The distribution of patients according to the age-groups was: 0C2 years (33.3% in 2020C2021 and 53.4% in 2022), 2C5 years (21.7% in 2020C2021 and 10% in 2022), 5C11 years (29.2% in 2020C2021 and 28.3% in 2022), and 12C18 years (15.8% in 2020C2021 and 8.3% in 2022) (p = 0.076). The median length of stay was six days in 2020C2021 and six days in 2022 (p = 0.423). We verified six deaths in the first analysis period and one death in the second one (p = 0.894). Of the 60 children admitted in 2022, 58 (96.7%) did not receive the complete COVID-19 vaccine scheme available. Conclusions: We verified in a real-world condition the ability of the Pfizer-BioNTech vaccine to prevent hospitalization in children over 12 years of age.

This is an introductory text to a collection of selected papers from the M3E2 2020 Summer: The Special Edition of International Conference on Monitoring, Modeling & Management of Emergent Economy, which was held in Odessa, Ukraine, on the July 13-18, 2020 It consists of short introduction and some observations about the event and its future Copyright ? 2020 for this paper by its authors

Buildings account for nearly 2/5ths of global energy expenditure. Due to this figure, the 90s witnessed the rise of green buildings (GBs) that were designed with the purpose of lowering the demand for energy, water, and materials resources while enhancing environmental protection efforts and human well-being over time. This paper examines recent studies and technologies related to the design, construction, and overall operation of GBs and determines potential future research directions in this area of study. This global review of green building development in the last two decades is conducted through bibliometric analysis on the Web of Science, via the Science Citation Index and Social Sciences Citation Index databases. Publication performance, countries characteristics, and identification of key areas of green building development and popular technologies were conducted via social network analysis, big data method, and S-curve predictions. A total of 5246 articles were evaluated on the basis of subject categories, journals performance, general publication outputs, and other publication characteristics. Further analysis was made on dominant issues through keyword co-occurrence, green building technologies by patent analysis, and S-curve predictions. The USA, China, and the UK are ranked the top three countries where the majority of publications come from. Australia and China had the closest relationship in the global network cooperation. Global trends of the top 5 countries showed different country characteristics. China had a steady and consistent growth in green building publications each year. The total publications on different cities had a high correlation with cities GDP by Baidu Search Index. Also, barriers and contradictions such as cost, occupant comfort, and energy consumption were discussed in developed and developing countries. Green buildings, sustainability, and energy efficiency were the top three hotspots identified through the whole research period by the cluster analysis. Additionally, green building energy technologies, including building structures, materials, and energy systems, were the most prevalent technologies of interest determined by the Derwent Innovations Index prediction analysis. This review reveals hotspots and emerging trends in green building research and development and suggests routes for future research. Bibliometric analysis, combined with other useful tools, can quantitatively measure research activities from the past and present, thus bridging the historical gap and predicting the future of green building development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11356-021-12739-7.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge to health-care systems around the world. As approximately one-third of the worlds population is living under lockdown conditions, medical resources are being reallocated and hospital admissions are limited to emergencies. We examined the decision-making impact of these actions and their effects on access to hospital treatment in patients with neurosurgical conditions. METHODS: This retrospective cohort study analyzes hospital admissions of two major neurosurgical services in Germany during the nationwide lockdown period (March 16(th) to April 16(th), 2020). Spinal or cranial conditions requiring immediate hospital admission and treatment constituted emergencies. RESULTS: A total of 243 in-patients were treated between March 16(th) and April 16(th) 2020 (122 patients at the University Medical Center Mainz, 121 patients at the University Medical Center G?ttingen). Of these, 38.016% qualified as emergency admission. Another 1,688 admissions were reviewed during the same periods in 2018 and 2019, providing a frame of reference. Overall, emergency admissions declined by 44.70.7% during lockdown. Admissions for cranial emergencies fell by 48.14.44%, spinal emergencies by 30.914.6%. CONCLUSION: Above findings indicate that in addition to postponing elective procedures, emergency admissions were dramatically curtailed during the COVID-19 lockdown. As this surely is unexpected and unintended, reasons are undoubtedly complex. As consequences in morbidity and mortality are still unpredictable, efforts should be made to accommodate all patients in need of hospital access going forward.

Melanoma differentiation-associated gene 5 (MDA5) is a member of the retinoic acid-inducible gene I (RIG-I)-like receptors (RLRs) family and plays a pivotal role in the anti-viral innate immune response. As RIG-I is absent in chickens, MDA5 is hypothesized to be important in detecting viral nucleic acids in the cytoplasm. However, the molecular mechanism of the regulation of chicken MDA5 (chMDA5) expression has yet to be fully elucidated. With this in mind, a 2.5 kb chMDA5 gene promoter region was examined and PCR amplified to assess its role in immune response. A chMDA5 promoter reporter plasmid (piggybac-MDA5-DsRed) was constructed and transfected into DF-1 cells to establish a Piggybac-MDA5-DsRed cell line. The MDA5 promoter activity was extremely low under basal condition, but was dramatically increased when cells were stimulated with polyinosinic: polycytidylic acid (poly I:C), interferon beta (IFN-) or Infectious Bursal Disease Virus (IBDV). The DsRed mRNA level represented the promoter activity and was remarkably increased, which matched the expression of endogenous MDA5. However, Infectious Bronchitis Virus (IBV) and Newcastle disease virus (NDV) failed to increase the MDA5 promoter activity and the expression of endogenous MDA5. The results indicated that the promoter and the Piggybac-MDA5-DsRed cell line could be utilized to determine whether a ligand regulates MDA5 expression. For the first time, this study provides a tool for testing chMDA5 expression and regulation.

BACKGROUND: Indonesia provides the largest single source of pilgrims for the Hajj (10%). In the last two decades, mortality rates for Indonesian pilgrims ranged between 200C380 deaths per 100,000 pilgrims over the 10-week Hajj period. Reasons for high mortality are not well understood. In 2008, verbal autopsy was introduced to complement routine death certificates to explore cause of death diagnoses. This study presents the patterns and causes of death for Indonesian pilgrims, and compares routine death certificates to verbal autopsy findings. METHODS: Public health surveillance was conducted by Indonesian public health authorities accompanying pilgrims to Saudi Arabia, with daily reporting of hospitalizations and deaths. Surveillance data from 2008 were analyzed for timing, geographic location and site of death. Percentages for each cause of death category from death certificates were compared to that from verbal autopsy. RESULTS: In 2008, 206,831 Indonesian undertook the Hajj. There were 446 deaths, equivalent to 1,968 deaths per 100,000 pilgrim years. Most pilgrims died in Mecca (68%) and Medinah (24%). There was no statistically discernible difference in the total mortality risk for the two pilgrimage routes (Mecca or Medinah first), but the number of deaths peaked earlier for those traveling to Mecca first (p=0.002). Most deaths were due to cardiovascular (66%) and respiratory (28%) diseases. A greater proportion of deaths were attributed to cardiovascular disease by death certificate compared to the verbal autopsy method (p<0.001). Significantly more deaths had ill-defined cause based on verbal autopsy method (p<0.001). CONCLUSIONS: Despite pre-departure health screening and other medical services, Indonesian pilgrim mortality rates were very high. Correct classification of cause of death is critical for the development of risk mitigation strategies. Since verbal autopsy classified causes of death differently to death certificates, further studies are needed to assess the methods utility in this setting.

In Europe, the respiratory syncytial virus (RSV) surveillance system is very heterogeneous and there is growing evidence of the importance of RSV infections resulting in hospitalization of elderly patients. The aim of this study was to assess the severity of RSV infection in the elderly living in the aged Southern European countries. We conducted a retrospective study of elderly patients ( 65\year old) admitted for laboratory\confirmed RSV infection in three tertiary hospitals in Portugal, Italy, and Cyprus over two consecutive winter seasons (2017C2018). Uni\multivariable analyses were carried out to evaluate the effect of clinical variables on radiologically confirmed pneumonia, use of noninvasive ventilation (NIV), and in\hospital death (IHD). A total of 166 elderly patients were included. Pneumonia was evident in 29.5%. NIV was implemented in 16.3%, length of stay was 11.8 12.2 days, and IHD occurred in 12.1%. Multivariable analyses revealed that the risk of pneumonia was higher in patients with chronic kidney disease (CKD) (odds ratio [OR]: 2.57; 95% confidence interval [CI]: 1.12C5.91); the use of NIV was higher in patients with obstructive sleep apnea or obesity hypoventilation syndrome (OSA or OHS) (OR: 5.38; 95% CI: 1.67C17.35) and CKD (OR: 2.52; 95% CI: 1.01C6.23); the risk of IHD was higher in males (OR: 3.30; 95% CI: 1.07C10.10) and in patients with solid neoplasm (OR: 9.06; 95% CI: 2.44C33.54) and OSA or OHS (OR: 8.39; 95% CI: 2.14C32.89). Knowledge of factors associated with RSV infection severity may aid clinicians to set priorities and reduce disease burden. Development of effective antiviral treatment and vaccine against RSV is highly desirable.

Zika virus (ZIKV) is an emerging mosquito-borne pathogen associated with microcephaly and other congenital abnormalities in newborns as well as neurologic complications in adults. The explosive transmission of the virus in the last ten years put it in the limelight and improved our understanding of its biology and pathology. Currently, no vaccine or drugs are available to prevent or treat ZIKV infections. Knowing the potential of flaviviruses to broaden their geographic distribution, as observed for the West Nile virus, it is of importance to develop novel antiviral strategies. In this work, we identified poly(sodium 4-styrenesulfonate) (PSSNa) as a new polymeric ZIKV inhibitor. We demonstrated that PSSNa inhibits ZIKV replication in vitro both in animal and human cells, while no cytotoxicity is observed. Our mechanistic studies indicated that PSSNa acts mostly through direct binding to ZIKV particle and blocking its attachment to the host cells.

Severe sepsis represents a common, expensive, and deadly health care issue with limited therapeutic options. Gaining insights into the inflammatory dysregulation that causes sepsis would help develop new therapeutic strategies against severe sepsis. In this study, we identified the crucial role of cell-free DNA (cfDNA) in the regulation of the Toll-like receptor 9-mediated proinflammatory pathway in severe sepsis progression. Hypothesizing that removing cfDNA would be beneficial for sepsis treatment, we used polyethylenimine (PEI) and synthesized PEI-functionalized, biodegradable mesoporous silica nanoparticles with different charge densities as cfDNA scavengers. These nucleic acid-binding nanoparticles (NABNs) showed superior performance compared with their nucleic acid-binding polymer counterparts on inhibition of cfDNA-induced inflammation and subsequent multiple organ injury caused by severe sepsis. Furthermore, NABNs exhibited enhanced accumulation and retention in the inflamed cecum, along with a more desirable in vivo safety profile. Together, our results revealed a key contribution of cfDNA in severe sepsis and shed a light on the development of NABN-based therapeutics for sepsis therapy, which currently remains intractable.

Background: Due to the steadily rising case numbers of SARS-CoV-2 infections worldwide, there is an increasing need for reliable rapid diagnostic devices in addition to existing gold standard PCR methods Actually, public attention is focused on antigen assays including lateral flow tests (LFTs) as a diagnostic alternative Therefore, different LFTs were analyzed regarding their performance in a clinical setting Material and Methods: A pilot sample panel of 13 bronchoalveolar fluids (BALFs) and 60 throat washing (TW) samples with confirmed PCR results, as well as eight throat washes invalid by PCR, were tested with the BIOCREDIT test (RapiGEN), the PanbioTM assay (Abbott), and the SARS-CoV-2 rapid antigen test (Roche) Conclusion: The analyzed antigen test showed an interassay correlation of 27 4%, with overall specificities ranging from 19 4% to 87 1%, while sensitivities of the respective tests ranged between 33 3% and 88 1% Because these assays did not entirely meet all high expectations, their benefit has to be carefully evaluated for the respective test strategy and setting

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people's food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants.