China-US relations are the most important bilateral relations in the world Today, China-US relations are neither the same as then Soviet-US relations, nor as their previous situation After the breakout of COVID-19 Pandemic, China-US relations show great differences in terms of public opinions, economic and trade relations and strategic trust It is of great importance to keep sober minded about China-US relations after the outbreak of COVID-19 pandemic and to uphold Deng Xiaop-ing's guiding principle of "hiding your strength and biding your time while trying to accomplish something", which are essential for China to deal with various severe challenges under the new circumstances and to safeguard China's security and development environment

COVID-19 is caused by a newly identified coronavirus, SARS-CoV-2, and has become a pandemic around the world. The illustration of the immune responses against SARS-CoV-2 is urgently needed for understanding the pathogenesis of the disease and its vaccine development. CD8+ T cells are critical for virus clearance and induce long lasting protection in the host. Here we identified specific HLA-A2 restricted T cell epitopes in the spike protein of SARS-CoV-2. Seven epitope peptides (n-Sp1, 2, 6, 7, 11, 13, 14) were confirmed to bind with HLA-A2 and potentially be presented by antigen presenting cells to induce host immune responses. Tetramers containing these peptides could interact with specific CD8+ T cells from convalescent COVID-19 patients, and one dominant epitope (n-Sp1) was defined. In addition, these epitopes could activate and generate epitope-specific T cells in vitro, and those activated T cells showed cytotoxicity to target cells. Meanwhile, all these epitopes exhibited high frequency of variations. Among them, n-Sp1 epitope variation 5L>F significantly decreased the proportion of specific T cell activation; n-Sp1 epitope 8L>V variant showed significantly reduced binding to HLA-A2 and decreased the proportion of n-Sp1-specific CD8+ T cell, which potentially contributes to the immune escape of SAR-CoV-2.

BACKGROUND: Lung rest has been recommended during extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). Whether positive end-expiratory pressure (PEEP) confers lung protection during ECMO for severe ARDS is unclear. We compared the effects of three different PEEP levels whilst applying near-apnoeic ventilation in a model of severe ARDS treated with ECMO. METHODS: Acute respiratory distress syndrome was induced in anaesthetised adult male pigs by repeated saline lavage and injurious ventilation for 1.5 h. After ECMO was commenced, the pigs received standardised near-apnoeic ventilation for 24 h to maintain similar driving pressures and were randomly assigned to PEEP of 0, 10, or 20 cm H(2)O (n=7 per group). Respiratory and haemodynamic data were collected throughout the study. Histological injury was assessed by a pathologist masked to PEEP allocation. Lung oedema was estimated by wet-to-dry-weight ratio. RESULTS: All pigs developed severe ARDS. Oxygenation on ECMO improved with PEEP of 10 or 20 cm H(2)O, but did not in pigs allocated to PEEP of 0 cm H(2)O. Haemodynamic collapse refractory to norepinephrine (n=4) and early death (n=3) occurred after PEEP 20 cm H(2)O. The severity of lung injury was lowest after PEEP of 10 cm H(2)O in both dependent and non-dependent lung regions, compared with PEEP of 0 or 20 cm H(2)O. A higher wet-to-dry-weight ratio, indicating worse lung injury, was observed with PEEP of 0 cm H(2)O. Histological assessment suggested that lung injury was minimised with PEEP of 10 cm H(2)O. CONCLUSIONS: During near-apnoeic ventilation and ECMO in experimental severe ARDS, 10 cm H(2)O PEEP minimised lung injury and improved gas exchange without compromising haemodynamic stability.

BACKGROUND: The recent 2018 Declaration of Astana recognized primary health care (PHC) as a means to achieve universal health coverage (UHC) and the health-related Sustainable Development Goals (SDGs). Following this declaration, country progress on operationalization of the PHC agenda and attainment of UHC has been stalled by the new challenges posed by the COVID-19 pandemic. The pandemic has also disrupted the continuity of essential health service provision and tested the resilience of the regions health systems. METHODS: In accordance with this, the WHO Regional Office for Africa convened the Fifth Health Sector Directors Planning and Policy Meeting across the 47 Member States of the Region. The two-day forum focused on building health system resilience to facilitate service continuity during health threats, PHC revitalization, and health systems strengthening towards UHC. RESULTS: The Regional Forum provided evidence on building resilient health systems in the WHO African Region and engaged participants in meaningful and critical discussion. It is from these discussions that four key themes emerged: (1) working multisectorally/intersectorally, (2) moving from fragmentation to integration, (3) ensuring implementation and knowledge exchange, and (4) rethinking resilience and embracing antifragility. These discussions and associated groupings by thematic areas lend themselves to recommendations for the WHO. CONCLUSIONS: This paper details the proceedings and key findings on building resilient health systems, the four themes that emerged from participant deliberation, and the recommendations that have emerged from the meeting. Deliberations from the Regional Forum are critical, as they have the potential to directly inform policy and program design, given that the meeting convenes health sector technocrats, who are at the helm of policy design, action, and implementation.

This rapid expert consultation responds to a request from the Office of Science and Technology Policy (OSTP) concerning questions about necessary data elements, sources of data, gaps in collection, and suggestions for data system design and integration to improve modeling and decision-making for COVID-19. The National Academies of Sciences, Engineering, and Medicine convened a standing committee of experts to help inform the Office of Science and Technology Policy on critical science and policy issues related to emerging infectious diseases and other public health threats. The standing committee includes members with expertise in emerging infectious diseases, public health, public health preparedness and response, biological sciences, clinical care and crisis standards of care, risk communication, and regulatory issues.

Analysis of the nucleic acid of infectious bronchitis virus by SDS polyacrylamide gel electrophoresis revealed an RNA of molecular weight 9.010(6) Daltons. The RNA was shown to have a sedimentation coefficient of 50.

Angiopoietins Ang1 and Ang2 are secreted ligands for the endothelial receptor tyrosine kinase Tie2 essential for vascular development and maintenance. Ang1 acts as an agonist to maintain normal vessel function, whereas Ang2 acts as a Tie2 antagonist. Ang2 is increased in macular edema, sepsis, and other conditions, in which it blocks Ang1-mediated signaling, causing vascular dysfunction and contributing to disease pathology. Therefore, Ang2 is an attractive therapeutic target. Previously, we reported a Tie2 ectodomain variant that selectively binds Ang2 and acts as soluble ligand trap to sequester Ang2; however, the mechanism of Ang2-binding selectivity is unknown. In the present study, we used directed protein evolution to enhance Ang2-binding affinity of this Tie2 ectodomain trap. We examined contributions of individual residues in the ligand-binding interface of Tie2 to Ang1 and Ang2 binding. Surprisingly, different combinations of Tie2 residues were found to bind each ligand, with hydrophobic residues binding both ligands and polar residues contributing selectively to either Ang1 or Ang2 binding. Our analysis also identified a single Tie2 residue, His168, with a pivotal role in both Ang1 and Ang2 binding, enabling competition between binding ligands. In summary, this study reports an enhanced-affinity Ang2-selective ligand trap with potential for therapeutic development and reveals the mechanism behind its selectivity. It also provides the first analysis of contributions of individual Tie2 residues to Ang1 and Ang2 binding and identifies selectivity-determining residues that could be targeted in the future design of small molecule and other inhibitors of Ang2 for the treatment of vascular dysfunction.

There is tremendous interspecific variability in O3 sensitivity among C3 species, but variation among C4 species has been less clearly documented. It is also unclear whether stomatal conductance and leaf structure such as leaf mass per area (LMA) determine the variation in sensitivity to O3 across species. In this study, we investigated leaf morphological, chemical, and photosynthetic responses of 22 genotypes of four C4 bioenergy species (switchgrass, sorghum, maize and miscanthus) to elevated O3 in side-by-side field experiments using free-air O3 concentration enrichment (FACE). The C4 species varied largely in leaf morphology, physiology, and nutrient composition. Elevated O3 did not alter leaf morphology, nutrient content, stomatal conductance, chlorophyll fluorescence, and respiration in most genotypes, but reduced net CO2 assimilation in maize and photosynthetic capacity in sorghum and maize. Species with lower LMA and higher stomatal conductance tended to show greater losses in photosynthetic rate and capacity in elevated O3 compared to species with higher LMA and lower stomatal conductance. Stomatal conductance was the strongest determinant of leaf photosynthetic rate and capacity. The response of both area- and mass-based leaf photosynthetic rate and capacity to elevated O3 were not affected by LMA directly, but negatively influenced by LMA indirectly through stomatal conductance. These results demonstrate that there is significant variation in O3 sensitivity among C4 species with maize and sorghum showing greater sensitivity of photosynthesis to O3 than switchgrass and miscanthus. Interspecific variation in O3 sensitivity was determined by direct effects of stomatal conductance and indirect effects of LMA. This is the first study to provide a test of unifying theories explaining variation in O3 sensitivity in C4 bioenergy grasses. These findings advance understanding of O3 tolerance in C4 grasses and could aid in optimal placement of diverse C4 bioenergy feedstocks across a polluted landscape.

BACKGROUND The US Department of Veterans Affairs (VA) seeks to achieve interoperability with other organizations, including non-VA community and regional health information exchanges (HIEs). OBJECTIVE This study aims to understand the perspectives of leaders involved in implementing information exchange between VA and non-VA providers via a community HIE. METHODS We interviewed operational, clinical, and information technology leaders at one VA facility and its community HIE partner. Respondents discussed their experiences with VA-HIE, including barriers and facilitators to implementation, and the associated impact on health care providers. Transcribed interviews were coded and analyzed using immersion-crystallization methods. RESULTS VA and community HIE leaders found training to be a key factor when implementing VA-HIE and worked cooperatively to provide several styles and locations of training. During recruitment, a high-touch approach was successfully used to enroll patients and overcome their resistance to opting in. Discussion with leaders revealed the high levels of complexity navigated by VA providers and staff to send and retrieve information. Part of the complexity stemmed from the interconnected web of information systems and human teams necessary to implement VA-HIE information sharing. These interrelationships must be effectively managed to guide organizational decision making. CONCLUSIONS Organizational leaders perceived information sharing to be of essential value in delivering high-quality, coordinated health care. The VA continues to increase access to outside care through the VA Maintaining Internal Systems and Strengthening Integrated Outside Networks (MISSION) Act. Along with this increase in non-VA medical care, there is a need for greater information sharing between VA and non-VA health care organizations. Insights by leaders into barriers and facilitators to VA-HIE can be applied by other national and regional networks that seek to achieve interoperability across health care delivery systems.

The emergence of a novel human coronavirus, SARS-CoV-2, causing severe respiratory tract infections in humans, is affecting all countries of the world and has become a global health concern. Since the virus was first identified in December 2019, the number of deaths have been propagating exponentially, causing countries across the world, including Malaysia, to increase emergency measures to combat the virus. Due to the fact that the COVID-19 pandemic does not discriminate its victims, it is of paramount importance to construct a plan for management of the dead for all suspected or confirmed COVID-19 cases, including the unidentified deceased, as an essential portion of the humanitarian forensic action approach. This document provides an overview on ways to maximize the local collective capacity from various government agencies to manage the dead based on the prevailing regulations and legislation in the country, in preparation for possible large scale deaths from this pandemic. The National Institute of Forensic Medicine Malaysia has improvised procedures and guidelines for management of the dead within the existing regulations in order to achieve a balance between medicolegal requirements and the safety of personnel managing the bodies of the deceased with suspected or confirmed COVID-19 infection; at the site of death, during transport, during postmortem procedures, storage and preparation before and during burial or cremation as well as environmental cleaning and disinfection, involving various agencies in the country. A form of temporary controlled burial is as an option to allow the reinvestigation of a decedent to help formally identify victims of the pandemic such as undocumented migrants or refugees who were previously not identified. Due to the different legal requirements and mortality rates between countries, there is no one-size-fits-all approach to the management of the dead. Whenever possible, every opportunity and assistance must be given to families to mourn their loved ones, even in times of crisis or an outbreak, in order to sustain an appropriate level of dignity and respect.

Black Families and the Recession in the United States goes beyond the massive loss of property among African Americans during the Great Recession of 2007-2009. It connects the housing experience to broader systems of inequality in America. Following the Great Recession of 2007-2009, the US elections of 2008, the impact of COVID-19, and widespread demonstrations resulting from the murder of George Floyd by police, the sociopolitical and economic status of Blacks in the United States is at a critical point in history, with demand for major transformation. The authors reveal a history of racist practices against Blacks in many systems, including education, policing, incarceration, wealth transmission, voting restrictions, and housing segregation. The social costs of the recession are manifested in the daily lives of African American families. In addition to financial losses, African Americans are more likely to be plagued with issues related to poverty, chronic illnesses, and lack of trust of social and economic institutions. Research, policy, and practical implications of this research include identifying social and economic supports unique to African Americans and determining strategies to strengthen families;paramount to addressing racial disparities. The interdisciplinary focus of this book appeals to a wide audience and areas of study. ? 2021 Dorothy Smith-Ruiz and Albert M. Kopak. All rights reserved.

This essay argues that considering disability and disability history needs to be part of any history of epidemics Recent scholarship has shown the many intersections of disability history and history of medicine This essay argues that disability plays many roles in an epidemic from establishing pre-existing conditions, to affecting the acute phase of the disease, to creating lingering disabilities in the long aftermath Histories of epidemics that ignore the many ways in which disability affects the experience of an epidemic are incomplete

Novel coronaviruses (CoV) have emerged periodically around the world in recent years. The recurrent spreading of CoVs imposes an ongoing threat to global health and the economy. Since no specific therapy for these CoVs is available, any beneficial approach (including nutritional and dietary approach) is worth investigation. Based on recent advances in nutrients and phytonutrients research, a novel combination of vitamin C, curcumin and glycyrrhizic acid (VCG Plus) was developed that has potential against CoV infection. System biology tools were applied to explore the potential of VCG Plus in modulating targets and pathways relevant to immune and inflammation responses. Gene target acquisition, gene ontology and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment were conducted consecutively along with network analysis. The results show that VCG Plus can act on 88 hub targets which are closely connected and associated with immune and inflammatory responses. Specifically, VCG Plus has the potential to regulate innate immune response by acting on NOD-like and Toll-like signaling pathways to promote interferons production, activate and balance T-cells, and regulate the inflammatory response by inhibiting PI3K/AKT, NF-B and MAPK signaling pathways. All these biological processes and pathways have been well documented in CoV infections studies. Therefore, our findings suggest that VCG Plus may be helpful in regulating immune response to combat CoV infections and inhibit excessive inflammatory responses to prevent the onset of cytokine storm. However, further in vitro and in vivo experiments are warranted to validate the current findings with system biology tools. Our current approach provides a new strategy in predicting formulation rationale when developing new dietary supplements.

Nipah virus (NiV) is an emerging paramyxovirus that can cause lethal respiratory illness in humans. No vaccine/therapeutic is currently licensed for humans. Human-to-human transmission was previously reported during outbreaks and NiV could be isolated from respiratory secretions, but the proportion of cases in Malaysia exhibiting respiratory symptoms was significantly lower than that in Bangladesh. Previously, we showed that primary human basal respiratory epithelial cells are susceptible to both NiV-Malaysia (M) and -Bangladesh (B) strains causing robust pro-inflammatory responses. However, the cells of the human respiratory epithelium that NiV targets are unknown and their role in NiV transmission and NiV-related lung pathogenesis is still poorly understood. Here, we characterized NiV infection of the human respiratory epithelium using a model of the human tracheal/bronchial (B-ALI) and small airway (S-ALI) epithelium cultured at an air-liquid interface. We show that NiV-M and NiV-B infect ciliated and secretory cells in B/S-ALI, and that infection of S-ALI, but not B-ALI, results in disruption of the epithelium integrity and host responses recruiting human immune cells. Interestingly, NiV-B replicated more efficiently in B-ALI than did NiV-M. These results suggest that the human tracheal/bronchial epithelium is favourable to NiV replication and shedding, while inducing a limited host response. Our data suggest that the small airways epithelium is prone to inflammation and lesions as well as constituting a point of virus entry into the pulmonary vasculature. The use of relevant models of the human respiratory tract, such as B/S-ALI, is critical for understanding NiV-related lung pathogenesis and identifying the underlying mechanisms allowing human-to-human transmission.

In the Western Balkans, as elsewhere around the world, governments took extraordinary measures to effectively contain the spread of COVID-19, measures that entailed serious restrictions to individual freedoms. They also introduced extra powers that upset the ordinary division and balance of governmental power. In this context, several analysts have expressed concern that the authoritarian trend observed in the region during the last decade will become further entrenched. The worst fear, that some of the Western Balkan leaderships may retain extraordinary powers indefinitely, has not been confirmed. However, constitutionally prescribed procedures were disregarded and the operation of formal and informal mechanisms of checks and balances ignored. The article argues that the ease with which the Western Balkan leaders removed any checks and controls over their rule raises the valid question of how they may deal with future circumstances which may endanger their power.

Pooling of samples can increase lab capacity when using Polymerase chain reaction (PCR) to detect diseases such as COVID-19. However, pool testing is typically performed via an adaptive testing strategy which requires a feedback loop in the lab and at least two PCR runs to confirm positive results. This can cost precious time. We discuss a non-adaptive testing method where each sample is distributed in a prescribed manner over several pools, and which yields reliable results after one round of testing. More precisely, assuming knowledge about the overall incidence rate, we calculate explicit error bounds on the number of false positives which scale favourably with pool size and sample multiplicity. This allows for hugely streamlined PCR testing and cuts in detection times for a large-scale testing scenario. A viable consequence of this method could be real-time screening of entire communities, frontline healthcare workers and international flight passengers, for example, using the PCR machines currently in operation.

How do people behave when disasters strike? Popular media accounts depict panic and cruelty, but in fact individuals often cooperate with and care for one another during crises. I summarize evidence for such 'catastrophe compassion', discuss its roots, and consider how it might be cultivated in more mundane times.

The first half of the year 2020 will be well remembered and recollected by historians, researchers, thinkers over the years for the disruption caused the world

The imaging studies of 16 children with pathologically proved nasal encephaloceles (eight), nasal dermal sinuses/nasal dermoids (seven), and nasal cerebral heterotopias, more commonly known as nasal gliomas (one), were retrospectively reviewed and compared with normal control subjects to define the normal anatomy and analyze deformities caused by these lesions. Nasal encephaloceles were always identified as complex masses of mixed soft tissue and CSF intensity that were contiguous with intracranial structures. The nasal glioma appeared as a mixed-intensity mass that, on the basis of the CT scan, appeared to be continuous with intracranial structures. Nasal dermal sinuses could only be identified as they coursed through the skin and subcutaneous soft tissue. They could not be identified when intraosseous. Moreover, on CT and, particularly, on MR, a number of potential diagnostic pitfalls were encountered. The most important of these was the normal fat deposition that occurs within bone during normal maturation and during aeration of the frontal sinuses and nasal bones. These fatty changes can easily be mistaken for fatty tumors if they are not recognized as normal anatomic changes. Interestingly, the classic plain film findings for congenital nasal masses were present only in the encephaloceles and nasal glioma; dermoids and dermal sinuses showed none of the classic plain film findings. In the six patients who had both CT and MR, the masses were easily identified and characterized by each imaging method. Congenital nasal masses are well characterized by both CT and MR. It is important to understand the normal changes in the anatomy of the nasofrontal region in the pediatric age group to avoid false-positive diagnoses in this region.

Background and importanceThe SARS-CoV-2 pandemic has highlighted the need to avoid exposure of patients to places with a high probability of transmission, such as hospitals Home delivery makes this possible, particularly in patients with disabilities and those especially vulnerable to coronavirus infection due to their drug therapy or previous pathology, such as multiple sclerosis (MS)Aim and objectivesTo describe the telepharmacy system implanted in a teaching hospital for MS outpatients, based on telephone consultations and home delivery medication, from 25 March to 30 September Material and methodsA logistic system was organised and implemented to ship medication to patients residence, after a telephone pharmaceutical care interview The following data were recorded: total home deliveries made by the outpatients pharmacy department (OPD), total patients attended by this system, total home deliveries made by OPD for MS patients and total MS patients attended by telepharmacy All deliveries for MS patients requiring refrigeration conditions were also registered ResultsFrom 25 March to 30 September 2020, we performed 2166 home deliveries of 10 different MS medicines (24 0% of the total telepharmacy shipments made by OPD during this period) Up to 772 MS patients benefited from the telepharmacy system (75 0% of the total MS patients attended by our OPD) Almost 20% of these shipments required refrigeration At the beginning, when lockdown was imposed in Spain, shipments for MS outpatients accounted for 23 2% of the total Afterwards, with concrete conditions to maintain this system (reduced mobility, elderly, pluripathology), the percentage of MS patients attended by telepharmacy and also home delivery increased to 32 6% of the total Conclusion and relevanceThe development of telepharmacy has become a useful and necessary tool for the delivery of specialised pharmaceutical care, especially during the pandemic where patients with certain medical conditions, such as MS, were at risk This made it possible to guarantee continuity of care for a large number of MS patients, avoiding hospital visits, and therefore reducing SARS-CoV-2 transmissions Otherwise, to maintain the sustainability of the implanted telepharmacy system, using the resources efficiently, it is necessary to apply patient stratifications tools, which allows access to this service to those patients who need it the most References and/or acknowledgementsConflict of interestNo conflict of interest