In a rapid response published online by the British Medical Journal, Sommerstein and Gr?ni1 pushed forward the hypothesis that angiotensin-converting enzyme (ACE) inhibitors (ACE-Is) could act as a potential risk factor for fatal Corona virus disease 2019 (COVID-19) by up-regulating ACE2 This notion was quickly picked up by the lay press and sparked concerns among physicians and patients regarding the intake of inhibitors of the reninCangiotensinCaldosterone system (RAAS) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infected individuals 1 In this article, we try to shed light on what is known and unknown regarding the RAAS and SARS-CoV2 interaction We find translational evidence for diverse roles of the RAAS, which allows to formulate also the opposite hypothesis, i e that inhibition of the RAAS might be protective in COVID-19 [Truncated]

BACKGROUND: Pulmonary renal syndrome (PRS) is a simultaneous occurrence of diffuse alveolar hemorrhage (DAH) and glomerulonephritis (GN). The diagnosis of PRS not only requires a high index of clinical suspicion and prompt management, but it is often fatal due to rapidly progressive clinical deterioration despite aggressive treatment. The authors, therefore, share the real-world experience of PRS presenting to tertiary care pulmonary center in north India. AIMS: The objectives of the study were to identify etiology, clinical manifestations, treatment modalities and outcomes of patients presenting with PRS. MATERIALS & METHODS: This was a retrospective observational study undertaken at Metro Centre for Respiratory Diseases of patients diagnosed with PRS during the last two years between 2019 and 2021. The patients diagnosed with PRS based on clinical manifestations, serology and biopsies were included in the study. All cases of non-immunological causes of PRS were excluded from the study. Chi-square and Mann-Whitney U tests were done to look for associations obtained between survivors and non-survivors. Cox regression analysis was done to estimate the hazard ratios of clinical variables on survival in PRS patients. RESULTS: A total of 12 patients of PRS were included in the study and diagnosis was made based on clinical manifestations, serology as well as biopsies. The mean age of presentation was 45.4 ( 17.8) years and 66.7% of the patients were females. The most common etiology was anti-nuclear cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) seen in 83.3% of the cases. The most common symptoms were coughing and fever (80%) followed by dyspnea and hemoptysis (70%) with the mean duration of symptoms being 17.1 (8.9) days. The mortality of PRS patients in our study was 41.6% and these patients had a higher acute physiology and chronic health evaluation (APACHE) score (median-26) compared to those patients who survived (median - 15.8). CONCLUSION: The occurrence of PRS, although rare, presents with rapid clinical deterioration leading to a high mortality rate. AAV was the most common cause of PRS as observed in our study. Early recognition and prompt aggressive management strategies with immunosuppressant therapies are essential for better outcomes for the patients.

With more than 100 million confirmed COVID-19 cases as of March 2021, reinfection is still considered to be rare. In light of increasing reports of reinfected COVID-19 patients, the need to better understand the real risk for reinfection is critical, with potential effects on public health policies aimed at containing the spread of SARS-CoV-2. In this descriptive preliminary report, we conducted a large-scale assessment on the country level of the possible occurrence of COVID-19 reinfection within the members of a large healthcare provider in Israel. Out of 149,735 individuals with a documented positive PCR test between March 2020 and January 2021, 154 had two positive PCR tests at least 100 days apart, reflecting a reinfection proportion of 1 per 1000. Given our strict inclusion criteria, we believe these numbers represent true reinfection incidence in MHS and should be clinically regarded as such.

In the last decades, anthropogenic drivers have significantly influenced the natural climate variability of Earths atmosphere. Climate change has become a subject of major interest for different levels of our society, such as national governments, businesses, local administration, or citizens. While national and local policies propose mitigation and adaptation strategies for different sectors, public perception is a key component of any implementation plan. This study investigates the CC perception in Romania, based on a national-scale online survey performed in the spring of 2020, aiming to outline the prominence of environmental and CC issues, level of information and interest, perceived causes, changes perceived in meteorological phenomena at the regional scale, perceived impacts, and the psychological representation of the CC. The study investigates single causal factors of perception. We found that particularly (i) the regional differences on climate change intensity strongly bias the perception of CC causes;(ii) age is very likely to influence the acceptance of CC, the importance of environmental issues, and the levels of information and interest;while (iii) age, gender, and place of residence (ruralCurban) are very likely to control the changes perceived in the occurrence of various meteorological phenomena, and their impact. This research is the first statistically relevant analysis ( 4%, statistical significance) developed at national and regional scales and the only study of climate change perception performed during the COVID-19 pandemic in Romania. Its results may represent the baseline for more in-depth research. Supplementary Information The online version contains supplementary material available at 10.1007/s00704-022-04041-4.

This study aimed to measure the level of awareness of faculty members, staff and students in a female Saudi Arabian university community towards Middle East respiratory syndrome coronvirus (MERS-CoV) following an outbreak. A self-administered questionnaire containing knowledge questions was distributed and completed by the 1541 participants. The overall knowledge score was 43.2%. It was only significantly higher in participants from the health colleges (50.6%). The majority (78.9%) of the respondents recognized the typical symptoms of MERS-CoV but only 67.1% knew the recommended preventive hygiene practices. Awareness of disease epidemiology, severity, fatality rate and treatment was very low. The knowledge of health care workers/ students of the recommended precautions that should be applied when dealing with patients was poor (55.5%). Significant improvement in educational programmes for both the health care and non-health care professionals is warranted, particularly in crowded educational institutions or workplaces.

BACKGROUND: Successful clinical outcomes of faecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection have been reported in humans and a marmoset. However, it has been unclear whether oral FMT was effective for the treatment of C. difficile-associated diarrhoea in dogs. CASE PRESENTATION: An 8-month-old, intact male French bulldog was presented with a 4-month history of intermittent large bowel diarrhoea. Physical and clinical examinations did not identify any specific causes for diarrhoea. Real-time PCR analysis and immunochromatography detected C. difficile antigen and toxin A&B genes and proteins in a faecal sample. Based on these findings, diarrhoea in the dog was considered to be induced by C. difficile-associated colitis. The dog was treated with oral FMT, in which a faecal solution obtained from a healthy beagle was orally administered to the subject. Stool consistency and frequency and faecal blood and mucus became normal 2C3 days after oral FMT, and real-time PCR analysis and immunochromatography was negative for C. difficile antigen and toxin A&B genes and proteins. No adverse events were observed. CONCLUSION: The present case report demonstrated that oral FMT was an effective treatment for C. difficile-associated diarrhoea in a dog. The findings in this report provide a rationale to evaluate clinical efficacy of oral FMT for other gastrointestinal diseases in dogs.

As the coronavirus pandemic evolves, the focus of radiology departments has begun to change. The acute phase of imaging a new disease entity whilst rationalising radiology services in the face of lockdown has passed. Radiologists are now becoming familiar with the complications of COVID-19, particularly the lung parenchymal and pulmonary vascular sequelae and are considering the impact follow-up imaging may have on departments already struggling with a backlog of suspended imaging in the face of reduced capacity. This review from the British Society of Thoracic Imaging explores both the thoracic and extra-thoracic complications of COVID-19, recognising the importance of a holistic approach to patient follow-up. The British Thoracic Society guidelines for respiratory follow-up of COVID-19 will be discussed, together with newly developed reporting templates, which aim to provide consistency for clinicians as well as an opportunity for longer-term data collection.

Context: A product roadmap is an important tool in product development. It sets the strategic direction in which the product is to be developed to achieve the companys vision. However, for product roadmaps to be successful, it is essential that all stakeholders agree with the companys vision and objectives and are aligned and committed to a common product plan. Objective: In order to gain a better understanding of product roadmap alignment, this paper aims at identifying measures, activities and techniques in order to align the different stakeholders around the product roadmap. Method: We conducted a grey literature review according the guidelines to Garousi et al. Results: Several approaches to gain alignment were identified such as defining and communicating clear objectives based on the product vision, conducting cross-functional workshops, shuttle diplomacy, and mission briefing. In addition, our review identified the Behavioural Change Stairway Model that suggests five steps to gain alignment by building empathy and a trustful relationship.

Despite all that is recognized so far on the ongoing SARS-CoV-2 pandemic, many questions remain to be answered, particularly in what concerns pathogen interaction with the human host and whether or not the acquired immune response is protective against reinfection in the long-term The spectrum of COVID-19 ranges from asymptomatic infections to progressive critical states, a direct upshot from the complex interplay between virus pathogenicity and host antiviral defense This review focuses on the immunologic response and disarrangements underlying the SARS-CoV-2 pathophysiology, gathering the information not only from the lessons learnt from SARS and MERS-CoV epidemics but also from what is already known about SARS-CoV-2 to date This knowledge is paramount from the standpoint of disease prevention and control as well as diagnostic pipeline and treatment produzido e dado a conhecer, mas muitas dvidas permanecem por esclarecer acerca da sua interao com o ser humano, nomeadamente sobre se a resposta imune contra este novo coronavrus humano protetora a longo prazo e qual a possibilidade de reinfeo A COVID-19 pode assumir diferentes espetros clnicos, desde infees assintomticas at formas graves da doen?a, que resultam da inter-relao entre a patogenicidade prpria do vrus e a resposta imune do hospedeiro Esta revis?o foca-se na imunologia da infeo, reunindo n?o s o conhecimento acumulado com as epidemias associadas ao SARS-CoV e MERS-CoV, mas tambm o que j se sabe sobre o SARS-CoV-2 Este conhecimento fundamental e tem implicaes quer para o controlo e preveno da doen?a quer para o seu diagnstico e tratamento

The year 2020 has urged Humanity to rethink the sustainable development agenda The COVID-19 pandemic rearticulated the gaps in implementing the Sustainable Development Goals (SDGs) to benefit remote regions and and their populations including Arctic Indigenous Peoples In this brief communication, we want to draw attention to the need of reshaping UN SDGs in light of the new normal to promote sustainable development of Arctic Indigenous communities The UN Agenda 2030 sets priorities that have relevance to the Arctic, with its rapidly changing environmental and social systems that are interlinked to other parts of the globe Successful implementation of SDGs in the Arctic can only be accomplished through an open and pluralistic dialog among global and Arctic stakeholders with the engagement, equal partnership, and under the guidance of the Arctic Indigenous Peoples This process, we argue, could start by revising the existing 17 goals and creating five new ones (Sustainable Governance and Indigenous Rights, Resilient Indigenous Societies, Livelihoods and Knowledge systems, Life on Ice and Permafrost, Equity and Equality in Access to Natural Resources, and Investment in Youth and Future Generations) that represent Indigenous Peoples knowledge and aspirations for sustainable development By indigenizing SDGs in the Arctic, we will not only build the Arctics own sustainable development framework but attain greater equity and expand the knowledge base of sustainable development globally ? 2021 Informa UK Limited, trading as Taylor & Francis Group

BACKGROUND: The acceptability of videoconferencing delivery of yoga interventions in the advanced cancer setting is relatively unexplored. The current report summarizes the challenges and solutions of the transition from an in-person (ie, face-to-face) to a videoconference intervention delivery approach in response to the Coronavirus Disease pandemic. METHOD: Participants included patient-family caregiver dyads who were enrolled in ongoing yoga trials and 2 certified yoga therapists who delivered the yoga sessions. We summarized their experiences using recordings of the yoga sessions and interventionists' progress notes. RESULTS: Out of 7 dyads participating in the parent trial, 1 declined the videoconferenced sessions. Participants were between the ages of 55 and 76 and mostly non-Hispanic White (83%). Patients were mainly male (83%), all had stage III or IV cancer and were undergoing radiotherapy. Caregivers were all female. Despite challenges in the areas of technology, location, and setting, instruction and personal connection, the overall acceptability was high among patients, caregivers, and instructors. Through this transition process, solutions to these challenges were found, which are described here. CONCLUSION: Although in-person interventions are favored by both the study participants and the interventionists, videoconference sessions were deemed acceptable. All participants had the benefit of a previous in-person experience, which was helpful and perhaps necessary for older and advanced cancer patients requiring practice modifications. In a remote setting, the assistance of caregivers seems particularly beneficial to ensure practice safety. CLINICALTRIALS.GOV: NCT03948100; NCT02481349.

BACKGROUND: The 2019 severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic continued into 2020, and the coronavirus disease-2019 (COVID-19) associated death toll increased OBJECTIVES: To analyze COVID-19 death rates in European countries or regions to determine whether there was a significant association between bacillus Calmette-Gurin (BCG) vaccination policy and lower rates of COVID-19 related deaths METHODS: Certain Northern European countries or regions had low death rates regardless of BCG policy The authors assumed the consumption of foods containing salmiak (NH4Cl) was a common and peculiar cause of the reduced COVID-19 related death rates in these countries, because NH4Cl is a known lysosomotropic agent, which has been indicated to inhibit or prevent SARS-CoV infection To check the possible effectiveness of salmiak consumption against COVID-19 related death, the authors used a linear regression model with the death rate as the dependent variable and BCG-policy and salmiak consumption score as independent variables RESULTS: Using least squares regression and a robust standard error algorithm, the authors found a significant effect exerted by the independent variables (P < 0 0005 for BCG and P = 0 001 for salmiak) Salmiak score alone was significant (P = 0 016) when using least squares regression with robust error algorithm CONCLUSIONS: The results seem to confirm an association between BCG-positive vaccination policy and salmiak consumption, and lower death rates from COVID-19 Implementing BCG vaccination policy and fortification of foods with salmiak (NH4Cl) may have a significant impact on the control of SARS-CoV epidemic

COVID-19 has prompted a rise in telecommuting practices in most companies worldwide. Meanwhile, companies are struggling to cope with the new and evolving security threats in telecommuting using old control methods. Specifically, there is an increased danger of hacking attacks in telecommuting environments. Furthermore, corporate concerns regarding telecommuting security have led to a questioning of existing control methods that no longer seem adequate. Significant research has been conducted on the factors that improve the effectiveness of corporate security policies, such as formal control, informal control, and extrarole behaviors. However, these studies did not consider telecommuting environments, which surged after the COVID-19 outbreak. Telecommuting loosens the physical control over employees and eliminates the collegial environment in which employees encourage each other to protect system information. This study determined how the factors that influence the effectiveness of existing information security policies behave in a telecommuting environment. Our study shows that specification and mandatoriness are the most important factors for an effective telecommuting security policy. We conclude that this sudden change in the working environment has rendered existing security controls obsolete, and specification and mandatoriness are likely to receive increasingly more attention in the growing field of telecommuting security policy.

Background and Aim: Anganwadi centers are the epicenters of health services for many Indian children. The study aims to assess the oral health status, treatment needs, and association with demographic variables, oral health behaviors, and parents' perception among preschoolers in these Anganwadis. Methods: A descriptive cross-sectional study was conducted among 1200, 3-5-year-old preschoolers from 48 Anganwadis in Belagavi. They were examined in accordance with the WHO Oral Health Pro forma (2013). A self-administered questionnaire assessed their parents' perception of their oral health. SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-Way ANOVA test was used for multiple group comparisons. P<0.05 was considered statistically significant. Results: The prevalence of dental caries was found to be 76.1% and gingival bleeding was found in 30.4% participants. The most common oral mucosal lesions were ulcers (5.1%) followed by abscess in 4.5% of children. About 67% of the parents perceived their child's oral health as good. A staggering 98.5% of parents had not taken their children to the dentist ever. About 76.8% of the children required prompt treatment. Conclusion: Poor oral health status necessitates prompt action with age-specific targeted interventions for the curtailment of the prevalent oral maladies along with preventive strategies for the rejuvenation and resurrection of the plummeted oral health status for restoring the quality of life, coupled with motivation meted out to utilize the abundant dental services available in Belagavi. Relevance to Patients: Preschool children attending the ICDS Anganwadi centers form a nested cohort of a triangulation of need, presentation, and requirement for a targeted and focused intervention pertaining to oral health hygiene and other important constructs of overall general well-being. This hypothesis generating exploratory study opens up ways and channels for such oral health related translational activities to be planned, implemented and periodically evaluated, as part of the standard procedures and protocols of the machinery.

The COVID-19 pandemic determined the necessity for prompt diagnostics and optimal routing of patients, followed by rehabilitation and secondary prevention, as domestic tourism intensifies The epidemic increased the importance of digital systems for the tourism service market Digitalization took leading positions in the tourism industry and made market participants adapt to these changes for optimizing their activities and increasing revenues Further development of tourism in Russia, giving the ongoing pandemic, would require digital technologies such as multilanguage informational services overcoming language barriers, digital tourist cards, mobile apps introducing cultural and national landmarks online, web services for preparing tourist routes Judging from scientific and practical experience, we can expect that medical, social, physical and psychological rehabilitation supervised by medical personnel will improve body functioning including heart, lungs, central nervous system as well as restore patients quality of life in general ? 2020, ASERS Publishing House All rights reserved

Background Intussusception is the leading cause of intestinal obstruction in children under 4 years of age Viral infections are the associated etiology in most cases, SARS-CoV-2 thereby being a plausible cause, although only 5 cases have been reported worldwide with both entities We report a case of an infant with Intussusception and covid-19, its clinical approach, and surgical outcomes, throughout a retrospective review of electronic medical chart history with the authorization of the Ethics Committee on research of the Hospital Universitario del Valle and endorsement for publication Case report It is an 8-month-old male patient with 72 hours of fever 100 4F;bloody diarrheal stools;episodic abdominal pain;signs of peritoneal irritation and sensation of a mass in the right quadrants of the abdomen Intussusception confirmed by ultrasound led to surgery, with SARS-CoV-2 infection as a possible differential diagnosis Surgical findings reported intussusception of the transverse colon, peritonitis, and intestinal ischemia of distal ileum and right colon, for which intestinal resection with consequent ileostomy and a mucous fistula was performed Positive SARS-CoV-2 RT-PCR test result was confirmed Pediatric intensive care unit support took place at the initial postoperative phase, and eventual intestinal, with enteral feeding tolerance at the fourth day, and respiratory improvement came off within the first week of medical and surgical treatment Conclusion Gastrointestinal symptoms are often the leading manifestations of COVID-19 in children, which can be isolated or as a common sign of a concomitant pathology such as intussusception, and they could also have a causal relationship

OBJECTIVES To report the short- and long-term outcomes and recurrence rate in dogs treated for apparently unilateral perineal hernia with bilateral herniorrhaphy, castration, colopexy, vas deferens pexy with or without cystopexy in single-stage procedures. MATERIALS AND METHODS Thirty-one client-owned dogs with apparently unilateral perineal hernia were included. Perineal hernias were repaired bilaterally, incorporating internal obturator muscle transposition and the sacro-tuberal ligament, combined with colopexy, vas deferens pexy with or without cystopexy. Preoperative pattern of defaecation, pattern of micturition and rectal alignment were recorded. Surgical time, bilateral surgical perineal findings, postoperative complications, short-, middle- and long-term (>24 months) scores and recurrence rate were documented. RESULTS A hernia with ectopic tissue and weakness of the pelvic diaphragm was identified bilaterally in all dogs despite the unilateral clinical presentation. The procedure combination was achieved uneventfully in all dogs in 56 to 113 minutes (mean 73 minutes). Complication rate was low, consisting mostly of urinary disorders, most of which resolved within a few days. In all, 93% of dogs were free of clinical signs related to perineal hernia at long-term follow-up (mean 27 months). Recurrence rate was 0%. CLINICAL SIGNIFICANCE Our surgical findings suggest that perineal hernia in dogs might be considered a bilateral disease, even when the presentation is of apparently unilateral signs. Recurrence is rare following bilateral herniorrhaphy combined with colopexy and deferens pexy with or without cystopexy.

In 1983, a computer search was performed for ovals in a projective plane of order ten. The search was exhaustive and negative, implying that such ovals do not exist. However, no nonexistence certificates were produced by this search, and to the best of our knowledge the search has never been independently verified. In this paper, we rerun the search for ovals in a projective plane of order ten and produce a collection of nonexistence certificates that, when taken together, imply that such ovals do not exist. Our search program uses the cube-and-conquer paradigm from the field of satisfiability (SAT) checking, coupled with a programmatic SAT solver and the nauty symbolic computation library for removing symmetries from the search.

The opening of the checkpoints in April 2003 was the single most important development in recent Cypriot history and inter-communal relations since 1974. The opening of the first checkpoint on the Ledra Palace street marked a moment of truth, a point in history at which Cyprus came of age, with the Greek Cypriot population gaining access to the northern part and the Turkish Cypriot population gaining access to the southern part. Expectedly, a part of both the Greek Cypriot and the Turkish Cypriot population were and still are opposed to the opening of the checkpoints and refuse to cross them. This section of the population, which although substantial is still a minority, served as the political basis and as the social legitimation for using the virus Covid-19 crisis as an opportunity to temporarily close the checkpoints and forbid all crossings in mid-March 2020.

In low-and-middle-income countries, the provisioning of safe drinking water is a challenge that will likely worsen with climate change. Securing water will require more work and time, burdening women and children the most. Currently, the consequences of this time burden to children's development remain understudied. To address this gap, we examine the tradeoff between children's household water collection responsibilities and learning achievement. Using nationally representative data from India, we measure the effect of daily fetching time on primary school children's learning achievement in a two-stage regression model, with rainfall as the instrument. Our analyses indicate that higher fetching times predict lower mathematics (-1.23 standard deviations, 95CI[-2.32, -0.14]), reading (-1.13 standard deviations, 95CI[-2.07, -0.19]), and writing (-1.21 standard deviations, 95CI[-1.89, -0.51]) test scores. These effects are heterogeneous across sex and infrastructure type. For example, we find girls' mathematical and reading skills profit more from reductions in fetching time than boys' (score less affected for boys by amount: mathematics: =0.26 points, 95CI[0.095, 0.42]; reading: =0.27 points, 95CI[0.054, 0.49]). Children using hand pumps, open wells, or tube wells are hurt more academically in mathematics and writing by increases in fetching time than children with mostly off-premises piped access (e.g., writing scores more affected by amount: hand pump: =-0.18, 95CI[-0.29, -0.081]; open well: =-0.18, 95CI[-0.33, -0.040]; tube well: =-0.14, 95CI[-0.29, -0.00072]). Given these results, we recommend off-premises piped infrastructure in the absence of piped-to-premises water in water-insecure contexts and offer guidance for targeting infrastructure investments in India.