BACKGROUND: Impaired immune response has been reported to be the cause of the development of coronavirus disease 2019 (COVID-19)-related respiratory failure Further studies are needed to understand the immunopathogenesis and to enable an improved stratification of patients who are at risk for critical illness METHODS: Thirty-two severely ill patients hospitalized with COVID-19 were recruited in our center at the University Hospital Heidelberg We performed a comprehensive analysis of immune phenotype, cytokine, and chemokine profiling and leukocyte transcripts in patients with severe COVID-19 and compared critically ill patients who required mechanical ventilation and high-flow oxygen therapy and noncritically ill patient who received low-flow oxygen therapy RESULTS: Critically ill patients exhibited low levels of CD8 T cells and myeloid dendritic cells We noted a pronounced CCR6(+) TH17 phenotype in CD4 central memory cells and elevated circulating levels of interleukin-17 in the critical group Gene expression of leukocytes derived from critically ill patients was characterized by an upregulation of proinflammatory cytokines and reduction of interferon (IFN)-responsive genes upon stimulation with Toll-like receptor 7/8 agonist When correlating clinical improvement and immune kinetics, we found that CD8 T-cell subsets and myeloid dendritic cells significantly increased after disconnection from the ventilator CONCLUSION: Critical illness was characterized by a TH17-mediated response and dysfunctional IFN-associated response, indicating an impaired capacity to mount antiviral responses during severe acute respiratory syndrome coronavirus 2 severe infection

In-person safety programs for pre-kindergarten children were not able to go on in their usual way during the summer of 2020 due to the Covid-19 pandemic. While some communities opted to cancel the programs, one organization in Northwest Ohio chose to reformat it, knowing that this education is a critical introduction to lifelong safety habits. Through social media, video-taped education from community safety professionals, and activity packets given to registrants, "Safety City" was able to go on. The new format incorporated all of the childhood safety topics normally presented in the live version of the program. The efforts described here indicate that it is feasible to alter presentation formats from in-person to virtual to connect even young children with important education. As such, similar programs needing to make this transition while the world continues to adjust to pandemic precautions may benefit from understanding the strengths, limitations, and insights from the process.

Long-term protection against SARS-CoV-2 requires effective and durable immunity. In this issue of Cell, two papers closely examine germinal centers, the physiological birthplace of adaptive immunity, to quantify the specificity, breadth, magnitude, and persistence of systemic and local humoral immune responses following natural infection with, or vaccination against, SARS-CoV-2.

Coronavirus disease 2019 (COVID-19), caused by an outbreak of the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) in Wuhan, China, has led to an unprecedented health and economic crisis worldwide. To develop treatments that can stop or lessen the symptoms and severity of SARS-CoV-2 infection, it is critical to understand how the virus behaves inside human cells, and so far studies in this area remain scarce. A recent study investigated translatome and proteome host cell changes induced in vitro by SARS-CoV-2. Here, we use the publicly available proteomics data from this study to re-analyze the in vitro cellular consequences of SARS-CoV-2 infection by impact pathways analysis and network analysis. Notably, proteins linked to the inflammatory response, but also proteins related to chromosome segregation during mitosis, were found to be altered in response to viral infection. Upregulation of inflammatory response proteins is in line with the propagation of inflammatory reaction and lung injury that is observed in advanced stages of COVID-19 patients and which worsens with age.

Despite the fact that making all efforts to deal with COVID-19 outbreak, Korea is in urgent need of moving away from a divided community approach and adopting a total community approach. Further, the nation needs to fully establish and activate the national emergency operation framework.

In late December 2019, SARS-CoV-2 was discovered, which is responsible for a new human disease called COVID-19. Among all laboratory-confirmed COVID-19 cases, 14% were hospitalized, with 2% admitted to intensive care units (ICU) with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation [1]. SARS-CoV-2 has spread quickly across the world, with more than one hundred million confirmed cases and more than 2,500,000 dead. In March 2020, the Hospital of Valenciennes had to admit hundreds of COVID-19 patients, and its capacity was almost exceeded [2]. More recently, in France, thousands of critically ill patients had to be admitted to ICUs. In Europe, the next wave of COVID-19 pandemic could be more severe than the first one, and we already know that, in the case of increasing numbers of critically ill, some of them will die as a result of the unavailability of mechanical ventilators [3]. This shortage may be lessened if one ventilator could service more than one patient. The main worry is that this concept could be not useful and systematically deleterious for the patient. Some concepts have already been proposed to ventilate differently two circuits with a single ventilator, with several limitations like the lack of individualization of ventilation of each circuit [4-6]. More recently, in the face of the COVID-19 pandemic, Clarke et al. [7] described a new concept able to deliver specific ventilation for two different lung tests with a single ventilator. Again, Levin et al. [8] have recently shown that a similar concept of differential ventilation using a single ventilator with flow control valves is feasible in humans.

The proceedings contain 60 papers. The topics discussed include: SGuard: machine learning-based distributed denial-of-service detection scheme for software defined network;5G/4G emerging technologies simulation and hardware implementation;a survey of drowning detection techniques;predicting student performance in an embodied learning environment;a machine learning based approach for student performance evaluation in educational data mining;AI-based flexible online laboratory learning system for post-COVID-19 era: requirements and design;comparative study for stylometric analysis techniques for authorship attribution;investigating performance analysis of a novel low-power efficient area carry-look ahead adder;and generating 3D model for human body shapes from 2D images using deep learning.

South Koreas employment status is characterized by a high rate of self-employment and many small-scale self-employed businesses with no employees. This study explored leisure factors relating to self-employed individuals subjective happiness based on data from the 2019 National Leisure Activity Survey. The extracted data (N = 2343) were analyzed using descriptive statistics, t-test, ANOVA, Pearsons correlation coefficient, Kendalls (b) coefficient, Eta correlation coefficient, phi coefficient, and Cramers V. And a three-step hierarchical regression analysis was performed to identify multidimensional variables that predict happiness more effectively. In Model 3, which additionally inserted positive and intrinsic factors into Model 2, the explanatory power was significantly increased. The predictors of subjective happiness among self-employed people identified in the final regression model were high economic status ( = 0.05), perceived health status ( = 0.32), financial constraints ( = ?0.09), leisure recognition ( = 0.20), and workClife balance (leisure-oriented = 0.09; work-oriented = ?0.13). This studys findings will contribute to the establishment of basic data, to prepare empirical measures to improve self-employed individuals quality of life.

This paper studies the potential spread of infectious disease through passenger encounters in a public transit system using automatic passenger count (APC) data An algorithmic procedure is proposed to evaluate three different measures to quantify these encounters The first two measures quantify the increased possibility of disease spread from passenger interaction when traveling between different origin?destination pairs The third measure evaluates an aggregate measure quantifying the relative risk of boarding at a particular stop of the transit route For calculating these measures, compressed sensing is employed to estimate a sparse passenger flow matrix planted in the underdetermined system of equations obtained from the APC data Using the APC data of Route 5 in Minneapolis/St Paul region during the COVID-19 pandemic, it was found that all three measures grow abruptly with the number of passengers on board The passenger contact network is densely connected, which further increases the potential risk of disease transmission To reduce the relative risk, it is proposed to restrict the number of passengers on-board and analyze the effect of this using a simulation framework It was found that a considerable reduction in the relative risk can be achieved when the maximum number of passengers on-board is restricted below 15 To account for the reduced capacity and still maintain reasonable passenger wait times, it would then be necessary to increase the frequency of the route

BACKGROUND: Untreated streptococcal pharyngitis is a precursor to rheumatic heart disease (RHD) and remains a significant public health issue in many countries. Understanding local determinants of treatment-seeking behaviors can help tailor RHD prevention programs. OBJECTIVE: We sought to elicit perceptions of pharyngitis and related healthcare use in a range of communities in Uganda. METHODS: We conducted six focus group discussions (FGD) in three districts that were representative of the countrys socioeconomic and cultural heterogenetity. Participants were recruited from six villages (two per district), and FGDs were audio recorded, transcribed and translated into English. Deductive and inductive analysis of the transcripts was done via open axial and sequential coding, which informed development of clusters, themes and subthemes. We extracted quotations from the transcripts to illustrate these themes. RESULTS: We identified nine key themes in three major domains: knowledge and perception of pharyngits, treatment practices, and barriers to uptake of formal public-sector healthcare services. Community awareness and understanding of the consequences of pharyngitis were low. Stated barriers to care were usually systemic in nature and included low overall confidence in the healthcare system and substantial costs associated with transportation and medications. CONCLUSION: The FGDs identified several approaches to shape community perceptions of pharyngitis and improve utilization of interventions to prevent RHD. In Uganda, information-education-communication interventions probably need to be combined with structural interventions that make formal public-sector healthcare more accessible to at-risk populations.

On the companion animal side, Kathy Turner, corporate vice president and chief marketing officer at US multinational Idexx, said consumers would shift spending away from nice to have products towards essentials but said the fundamentals underpinning business would not change Rob Kelly, executive vice president and president of international operations at Zoetis, was similarly optimistic that the industry was well placed to weather the economic storm Pig meat producers in Europe had already been seeking to meet increased demand from China, which has been hit hard by the viral pig disease and which is also the worlds largest consumer of pork

Pneumonia is the infection of the distal lower respiratory tract, principally the alveolar space, including the small bronchi and bronchioles. Pneumonia results from the proliferation of microorganisms at these sites in combination with the host response to the presence of microorganisms. A variety of pneumonia syndromes can be defined based on microbial etiology, underlying host defenses, clinical presentation, and site of acquisition. Because of the non-specific nature of the signs and symptoms, the diagnosis of pneumonia rests disproportionately on the presence of an infiltrate on chest radiograph. The frequent lack of a microbiologic diagnosis and the non-specificity of signs, symptoms, and radiographic infiltrates leads to frequent consideration of pneumonia in the differential diagnosis of many other pulmonary diseases. The etiologic spectrum of all types of pneumonia always includes the common community-acquired pathogens, with the spectrum broadening in response to either increasing immunocompromise or greater exposure to broad-spectrum antibiotics. While new or previously unrecognized pathogens can play a role in management decisions, the major issue in pneumonia is the appearance of antibiotic resistant strains of known common bacterial pathogens. Lack of even minimally effective agents is more the issue for nonbacterial pneumonias. Immunomodulation, in the form of less immunosuppressive cancer and transplant chemotherapy, immunization, or specific immunomodulatory drugs holds some hope for improving pneumonia outcome in the future.

In an article published in this journal eight years ago called "Clearing and Collateral Mandates: The New Liquidity Trap?," I challenged the conventional wisdom that a major feature of the Dodd-Frank Act-the one that required clearing of most over-the-counter ("OTC") derivatives and collateralization of those that cannot be cleared would materially reduce the risk of another financial crisis Indeed, I argued that such measures could actually increase systemic risk The gravamen of my argument was that Dodd-Frank, in its attempt to reduce credit risk in derivatives markets, would end up increasing liquidity risk That is, the Act's clearing and collateral mandates would tend to increase demands for funding liquidity during times of market stress Given that historically most financial crises have been at root liquidity crises, this substitution of liquidity risk for credit risk was deeply problematic

Robotic surgeries for cervical cancer have several advantages compared with laparotomic or laparoscopic surgeries. Robotic single-site surgery has many advantages compared with the multiport approach, but its safety and feasibility are not established in radical oncologic surgeries. We report a case of a Federation of Gynecology and Obstetrics (FIGO) stage IB1 cervical carcinoma whose radical hysterectomy, sentinel lymph node mapping, and lymph node dissection were entirely performed by robotic single-site approach. The patient recovered very well, and was discharged from the hospital within 24 hours.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of the newly emerging lung disease pandemic COVID-19. This viral infection causes a series of respiratory disorders, and although this virus mainly infects respiratory cells, the small intestine can also be an important site of entry or interaction, as enterocytes highly express in angiotensin-2 converting enzyme (ACE) receptors. There are countless reports pointing to the importance of interferons (IFNs) with regard to the mediation of the immune system in viral infection by SARS-CoV-2. Thus, this review will focus on the main cells that make up the large intestine, their specific immunology, as well as the function of IFNs in the intestinal mucosa after the invasion of coronavirus-2.

Background The increase in global mortality rates from SARS-COV2 (COVID-19) infection has been alarming thereby necessitating the continual search for viable therapeutic interventions. Due to minimal microbial components, subunit (peptide-based) vaccines have demonstrated improved efficacies in stimulating immunogenic responses by host B- and T-cells. Materials and Methods Integrative immunoinformatics algorithms were used to determine linear and discontinuous B-cell epitopes from the S-glycoprotein sequence. End-point selection of the most potential B-cell epitope was based on highly essential physicochemical attributes. NetCTL-I and NetMHC-II algorithms were used to predict probable MHC-I and II T-cell epitopes for globally frequent HLA-A*O2:01, HLA-B*35:01, HLA-B*51:01 and HLA-DRB1*15:02 molecules. Highly probable T-cell epitopes were selected based on their high propensities for C-terminal cleavage, transport protein (TAP) processing and MHC-I/II binding. Results Preferential epitope binding sites were further identified on the HLA molecules using a blind peptide-docking method. Phylogenetic analysis revealed close relativity between SARS-CoV-2 and SARS-CoV S-protein. LALHRSYLTPGDSSSGWTAGAA242263 was the most probable B-cell epitope with optimal physicochemical attributes. MHC-I antigenic presentation pathway was highly favourable for YLQPRTFLL269-277 (HLA-A*02:01), LPPAYTNSF24-32 (HLA-B*35:01) and IPTNFTISV714-721 (HLA-B*51:01). Also, LTDEMIAQYTSALLA865-881 exhibited the highest binding affinity to HLA-DR B1*15:01 with core interactions mediated by IAQYTSALL870-878. COVID-19 YLQPRTFLL269-277 was preferentially bound to a previously undefined site on HLA-A*02:01 suggestive of a novel site for MHC-I-mediated T-cell stimulation. Conclusion This study implemented combinatorial immunoinformatics methods to model B- and T-cell epitopes with high potentials to trigger immunogenic responses to the S protein of SARS-CoV-2.

The World Organization for Animal Health (OIE) has recently developed a Wildlife Health Framework to respond to the need of members to manage the risk from emerging diseases at the animal-human-ecosystem interface. One of its objectives is to improve surveillance systems, early detection and notification of wildlife diseases. Members share information on disease occurrence by reporting through the OIE World Animal Health Information System (OIE-WAHIS-formerly known as 'WAHIS'). To evaluate the capacity of a surveillance system to detect disease events, it is important to quantify the gap between all known events and those officially notified to the OIE. This study used capture-recapture analysis to estimate the sensitivity of the OIE-WAHIS system for a OIE-listed wildlife disease by comparing information from publicly available sources to identify undetected events. This article presents a case study of the occurrence of tularemia in lagomorphs among selected North American and European countries during the period 2014-2019. First, an analysis using three data sources (OIE-WAHIS, ProMED, WHO-EIOS [Epidemic Intelligence from Open Sources]) was conducted. Subsequent analysis then explored the model integrating information from a fourth source (scientific literature collected in PubMed). Two models were built to evaluate both the sensitivity of the OIE-WAHIS using media reports (ProMED and WHO-EIOS), which is likely to represent current closer to real-time events, and published scientific data, which is more useful for retrospective analysis. Using the three-source approach, the predicted number of tularemia events was 93 (95% CI: 75-114), with an OIE-WAHIS sensitivity of 90%. In the four-source approach, the number of predicted events increased to 120 (95% CI: 99-143), dropping the sensitivity of the OIE-WAHIS to 70%. The results indicate a good sensitivity of the OIE-WAHIS system using the three-source approach, but lower sensitivity when including information from the scientific literature. Further analysis should be undertaken to identify diseases and regions for which international reporting presents a low sensitivity. This will enable evaluation and prioritization of underreported OIE-listed wildlife diseases and identify areas of focus as part of the Wildlife Health Framework. This study also highlights the need for stronger collaborations between academia and National Veterinary Services to enhance surveillance systems for notifiable diseases.

The aerosol transmission was academically recognized as a possible transmission route of Coronavirus disease 2019 (COVID-19). We established an approach to assess the indoor tempo-spatial airborne-disease infection risks through aerosol transmission via real-time CO(2) field measurement and occupancy monitoring. Compared to former studies, the proposed method can evaluate real-time airborne disease infection risks through aerosol transmission routes. The approach was utilized in a university office. The accumulated infection risk was calculated for three occupants with practical working schedules (from occupancy recording) and one hypothesis occupant with a typical working schedule. COVID-19 was used as an example. Results demonstrated that the individual infection risks diversified with different dwell times and working places in the office. For the three occupants with a practical working schedule, their 3-day accumulated infection risks were respectively 0.050%, 0.035%, 0.027% and 0.041% due to 11.6, 9.0 and 13.8 h exposure with an initial infector percentage of 1%. The results demonstrate that location and dwell time are both important factors influencing the infection risk of certain occupant in built environment, whereas existing literature seldom took these two points into consideration simultaneously. On the contrary, our proposed approach treated the infection risks as place-by-place, time-by-time and person-by-person diversified in the built environment. The risk assessment results can provide early warning for building occupants and contribute to the transmission control of air-borne disease.

SARS-CoV-2 infection causes a wide spectrum of disease severity. Identifying the immunological characteristics of severe disease and the risk factors for their development are important in the management of COVID-19. This study aimed to identify and rank clinical and immunological features associated with progression to severe COVID-19 in order to investigate an immunological signature of severe disease. One hundred and eight patients with positive SARS-CoV-2 PCR were recruited. Routine clinical and laboratory markers were measured, as well as myeloid and lymphoid whole-blood immunophenotyping and measurement of the pro-inflammatory cytokines IL-6 and soluble CD25. All analysis was carried out in a routine hospital diagnostic laboratory. Univariate analysis demonstrated that severe disease was most strongly associated with elevated CRP and IL-6, loss of DLA-DR expression on monocytes and CD10 expression on neutrophils. Unbiased machine learning demonstrated that these four features were strongly associated with severe disease, with an average prediction score for severe disease of 0.925. These results demonstrate that these four markers could be used to identify patients developing severe COVID-19 and allow timely delivery of therapeutics.

OBJECTIVES: To provide an insight of the incidence of congenital developmental dysplasia of the hip in newborns from Yucatan born between 2015 and 2019 and analyze its association with maternal sociodemographic characteristics and neonatal, pregnancy and delivery related aspects. METHODS: Retrospective, population-based study from Birth Registries database in Yucatan, Mexico between 2015 and 2019. Presence of hip dysplasia was described and analyzed considering three aspects (I) Maternal information (II) Pregnancy and birth (III) Neonatal examination. We obtained incidence rates from each year and the complete studied period. Association between hip dysplasia and maternal, neonatal and pregnancy/delivery variables was analyzed using logistic regression, unadjusted odds ratio and an adjusted model. RESULTS: Hip dysplasia occurred in 13 per 10 000 live births. Significant associations were found between hip dysplasia and maternal place of residence in a city <50 000 inhabitants, without a local clinic. Propensity to give birth to a neonate with hip dysplasia increased with maternal age and ethnicity, in female newborns and when total number of pregnancy consultations summed <5. Newborns with hip dysplasia were heavier and less susceptible to be delivered vaginally. Congenital developmental hip dysplasia was comparatively more frequent among offspring of Mayan women and suboptimal access to medical care during pregnancy. Female neonates were affected the most, those first-borns. Neonates with hip dysplasia were heavier and more susceptible to be born by cesarean section. CONCLUSION: Maternal, neonatal, and perinatal factors are associated with DDH in Yucatecan infants born during 2015-2019. Factors that describe living conditions seems to have a more important effect on the presence of this condition.