INTRODUCTION: Infection with the new coronavirus responsible for Severe Acute Respiratory Syndrome (SARS-CoV-2) continues to spread worldwide. In Brazil, there are already more than 230 thousand dead, many of these older adults. OBJECTIVE: To present the clinical characteristics of older Brazilian adults infected by COVID-19, in the epidemiological weeks (EW) 34-52, and to verify factors responsible for the increased risk of death. METHODS: Retrospective and observational study conducted with secondary publicly available data, provided by the Brazilian Ministry of Health. 1,544 confirmed cases of registered COVID-19 infection were included between August 16 and December 26, 2020, aged 60 or older. OUTCOMES: Demographic data, comorbidity, symptoms for disease, clinical information: days of hospitalization, chest X-ray, type of RT-PCR. RESULTS: 48% of patients admitted to the ICU with evidence for SARS-CoV-2 died. Symptoms and comorbidities related to increased chance of death (OR) were immunodeficiency (188%), kidney disease (166%), neurological disease (103%), dyspnea (86%), pneumopathy (55%), O2 saturation <95% (53%), respiratory discomfort (49%), age (36%), sore throat (31%), and sex (0.5%). There was a 5% increase in the chance of death for each year of life. CONCLUSION: Heart disease and Diabetes mellitus were the most frequent comorbidities, but did not indicate an increased risk of death from SARS-CoV-2 infection. Age, sex, sore throat, dyspnea, respiratory discomfort, O2 saturation <95%, neurological disease, pneumopathy, immunodeficiency, and kidney disease were significantly associated with risk of death from COVID-19.

OBJECTIVE: To compare maternal and perinatal outcomes between randomized trials and observational studies in which conservative management was performed for more than 48 h in patients with early-onset severe preeclampsia. METHODOLOGY: We searched PubMed, LILACS, Cochrane and Google Scholar. The studies were divided in two groups: randomized and observational studies, from 1990 to 2018 that included patients with severe preeclampsia before 34 weeks of gestation with pregnancy prolongation &#8805;48 h but that did not include fetal growth restriction or HELLP syndrome at the beginning. The main variables recorded were maternal and perinatal complications. MAIN RESULTS: Forty-four studies met the inclusion criteria, and 5 of these were randomized. The average pregnancy prolongation was 9 days, with no difference between groups. Maternal complications were significantly more common in observational studies, RR = 0.71, 95% CI (0.54-0.93), p = .009. Perinatal complications were also significantly more common in observational studies (RR = 0.89, 95% CI (0.80-0.98), p = .01) at the expense of stillbirth and neonatal deaths. The percentages of cesarean sections were significantly higher in randomized studies, RR = 1.54, 95% CI (1.46-1.64). There were 2 maternal deaths, both in observational studies. CONCLUSION: Observational studies in which conservative management of early-onset preeclampsia is performed and do not include patients with fetal growth restriction or patients with HELLP syndrome and where at least 2 days of pregnancy prolongation is achieved are associated with significantly more maternal and perinatal complications.

Background:In recent years, an integrated programme of vector control, screening and treatment of gambiense human African trypanosomiasis (gHAT) infections has led to a rapid decline in cases in the Mandoul disease focus of Chad. In this study, we assess whether elimination of transmission has already been achieved in the region despite low-level case reporting, quantify the role of intensified interventions in transmission reduction, and predict the trajectory of gHAT in Mandoul for the next decade under a range of control scenarios. Method: We utilise human case data (2000-2019) to update a previous model of transmission of gHAT in Mandoul. We also test the updated model, which now has refined assumptions on diagnostic specificity of the current algorithm and an improved fitting method, via a data censoring approach.Results:We conclude that passive detection rates have increased due to improvements in diagnostic availability in fixed health facilities since 2015, by 2.1-fold for stage 1 detection, and by 1.5-fold for stage 2. We find that whilst the diagnostic algorithm for active screening is estimated to be highly specific (99.93%, 95% CI: 99.91-99.95%), the high screening level and limited remaining infection means that some recently reported cases might be false positives, especially the ones that were not parasitologically confirmed. We also find that the focus-wide tsetse vector reduction estimated through model fitting (99.1%, 95% CI: 96.1-99.6%) is comparable to the very high reduction previously measured by the decline in catches of tsetse from monitoring traps. In line with previous results, the model suggests that transmission was likely interrupted in 2015 as a result of intensified interventions. Conclusions: We recommend that additional confirmatory testing is performed in Mandoul in order that the endgame can be carefully monitored now that infection levels are so low. More specific measurement of cases would better inform when it is safe to stop active screening and vector control.

Microanatomy of the vast majority of human organs at birth is characterized by marked differences as compared to adult organs, regarding their architecture and the cell types detectable at histology. In preterm neonates, these differences are even more evident, due to the lower level of organ maturation and to ongoing cell differentiation. One of the most remarkable finding in preterm tissues is the presence of huge amounts of stem/progenitor cells in multiple organs, including kidney, brain, heart, adrenals, and lungs. In other organs, such as liver, the completely different burden of cell types in preterm infants is mainly related to the different function of the liver during gestation, mainly focused on hematopoiesis, a function that is taken by bone marrow after birth. Our preliminary studies showed that the antigens expressed by stem/progenitors differ significantly from one organ to the next. Moreover, within each developing human tissue, reactivity for different stem cell markers also changes during gestation, according with the multiple differentiation steps encountered by each progenitor during development. A better knowledge of stem/progenitor cells of preterms will allow neonatologists to boost preterm organ maturation, favoring the differentiation of the multiple cells types that characterize each organ in at term neonates.

The current COVID-19 pandemic has increased the use of alcohol based hand sanitisers globally. These available alcohol based sanitisers cannot provide an antibacterial effect for an extended period of time, after the evaporation of ethanol. Hence, the need for a sanitiser with an anti-microbial activity combined with a long lasting effect is the need of the hour. In this study, we report the synthesis of a long lasting sanitiser from ozonated omega 9 fatty acid esters in an ethanolic medium. The formed vesicles made of the fatty acids have been characterized by DLS, Zeta potential, and time resolved fluorescence anisotropy studies. Ethanol although, provides an antibacterial effect, the effect is more pronounced in our prepared formulation owing to its high peroxide value that generates additional oxidative stress. Finally, this additional antimicrobial effect will have relevance in the current COVID-19 scenario in providing a long lasting hand sanitiser.

The Covid-19 outbreak of 2020 has required many governments to develop mathematical-statistical models of the outbreak for policy and planning purposes. This work provides a tutorial on building a compartmental model using Susceptibles, Exposed, Infected, Recovered and Deaths status through time. A Bayesian Framework is utilized to perform both parameter estimation and predictions. This model uses interventions to quantify the impact of various government attempts to slow the spread of the virus. Predictions are also made to determine when the peak Active Infections will occur.

The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, with devastating health, business and social impacts. Vaccination is a safe, simple, and effective way of protecting a person against COVID-19. By the end of August 2021, only 24.6% of the world population has received two doses of a COVID-19 vaccine. Since the emergence of COVID-19, several COVID-19 vaccines have been developed and approved for emergency use. Current vaccines have shown efficacy with low risk of adverse effects. However, COVID-19 vaccines have been related to a relatively small number of cases of heart inflammation, anaphylaxis (allergic reactions), and blood clots formation. On the other hand, COVID-19 vaccination is not recommended for children less than 12 years of age. Furthermore, It has been proposed that some new variants (e.g., Lambda and Delta) are proficient in escaping from the antiviral immunity elicited by vaccination. Herein we present current considerations regarding the COVID-19 vaccines including: efficacy against new variants, challenges in distribution, disparities in availability, dosage gender and race difference, COVID-19 vaccine transport and storage, limitations in children and pregnant women. Long-time monitoring is essential in order to find vaccine efficacy and to rule out related side effects.

This study aimed to investigate the relationship between socioeconomic status and COVID\19 mortality in Iran. We performed a retrospective cohort study on data from the hospitalised COVID\19 patients in Qazvin. We collected data on education, self\reported socioeconomic status, and location of residence as a proxy for socioeconomic status (SES). We applied the Blinder\Oaxaca decomposition approach to assess the role of socioeconomic inequality in COVID\19 mortality and determine the main contributors to the observed inequality. Overall, 941 patients (48.96%) had low SES, while only 24.87% (n = 478) were classified in the high SES category. The mortality rate was significantly higher in the low SES group, and we spotted a 17.13% gap in COVID\19 mortality between the high and low SES patients (p < 0.001). Age was the main contributor to the observed inequality, responsible for 6.91% of the gap (p < 0.001). Having co\morbidities (1.53%) and longer length of stay (LOS) in hospitals (0.95%) in the low SES group were other main determinants of the inequality in COVID\19 mortality (p < 0.05). In the unexplained part of our model, the effect of increased age (10.61%) and a positive RT\PCR test result (3.43%) were more substantial in the low SES group compared to the high SES patients (p < 0.05). The low SES people had an increased risk of getting COVID\19, and the disease has been more severe and fatal among them. Increased age, co\morbidities, and LOS were identified as the main drivers of this inequality.

The COVID-19 pandemic has significantly disrupted the delivery of healthcare services, including oncology. To ensure continuity of cancer genetic counseling at a large academic medical center while also promoting the safety of patients and staff, our team transitioned to fully remote telephone genetic counseling and testing services within 48 hr. We compare differences in the six weeks following the shift to telephone genetic counseling (post-COVID) to the six weeks preceding the pandemic (pre-COVID). We maintained 99% of our total visit capacity and saw a decrease in patient no-show rate from 9.5% to 7.3%. Of all patients who received telephone genetic counseling, fewer consented to genetic testing as compared to patients seen in-person prior to the pandemic (79% pre-COVID v. 72% post-COVID; p = .012). Four weeks after this cohort was closed for analysis, 96 out of 303 samples (32%) had not been received by the genetic testing laboratory, despite at least one reminder phone call to the patient. In 13 reported instances, a second sample was required (quality not sufficient, lost or mislabeled sample), thus delaying test results. We conclude that a rapid transition to remote genetic counseling and testing allowed uninterrupted access to cancer genetics services during to the COVID-19 pandemic. Patient compliance with sample return and higher rates of sample failure emerge as potential barriers to timely genetic testing under this service delivery model.

OBJECTIVE: This randomised controlled trial (RCT) aimed to investigate the effects of a simple cognitive task intervention on intrusive memories ("flashbacks") and associated symptoms following a traumatic event. Patients presenting to a Swedish emergency department (ED) soon after a traumatic event were randomly allocated (1:1) to the simple cognitive task intervention (memory cue + mental rotation instructions + computer game "Tetris" for at least 20 min) or control (podcast, similar time). We planned follow-ups at one-week, 1-month, and where possible, 3- and 6-months post-trauma. Anticipated enrolment was N = 148. RESULTS: The RCT was terminated prematurely after recruiting N = 16 participants. The COVID-19 pandemic prevented recruitment/testing in the ED because: (i) the study required face-to-face contact between participants, psychology researchers, ED staff, and patients, incurring risk of virus transmission; (ii) the host ED site received COVID-19 patients; and (iii) reduced flow of patients otherwise presenting to the ED in non-pandemic conditions (e.g. after trauma). We report on delivery of study procedures, recruitment, treatment adherence, outcome completion (primary outcome: number of intrusive memories during week 5), attrition, and limitations. The information presented and limitations may enable our group and others to learn from this terminated study. Trial registration ClinicalTrials.gov: NCT04185155 (04-12-2019).

INTRODUCTION: It is unclear whether smokers are more vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to evaluate the association between smoking and the risk of SARS-CoV-2 infection. METHODS: A matched case-control study was conducted using a large nationwide database. The case group included patients with SARS-CoV-2 infection confirmed by the Korea Centers for Disease Control and Prevention, and the control group was randomly sampled from the general Korean population in the National Health Insurance Service database by matching sex, age, and region of residence. Conditional logistic regression models were used to investigate whether the risk of infection with SARS-CoV-2 was affected by smoking status. RESULTS: A total of 4,167 patients with SARS-CoV-2 infection and 20,937 matched controls were enrolled. The proportion of ex-smokers and current smokers was 26.6% of the total participants. In multivariate analysis, smoking was not associated with an increased risk of SARS-CoV-2 infection (odds ratio [OR] = 0.56, confidence interval [CI] = 0.50-0.62). When ex-smokers and current smokers were analysed separately, similar results were obtained (current smoker OR = 0.33, CI = 0.28-0.38; ex-smoker OR = 0.81, CI = 0.72-0.91). CONCLUSIONS: This study showed that smoking may not be associated with an increased risk of SARS-CoV-2 infection. Smoking tends to lower the risk of SARS-CoV-2 infection; however, these findings should be interpreted with caution. IMPLICATIONS: It is unclear whether smokers are more vulnerable to coronavirus disease 2019. In this large nationwide study in South Korea, smoking tended to lower the risk of infection with severe acute respiratory syndrome coronavirus 2. However, these findings should be interpreted with caution, and further confirmatory studies are required.

The nucleolus is a dynamic subnuclear structure involved in ribosome subunit biogenesis, cell cycle control and mediating responses to cell stress, among other functions. While many different viruses target proteins to the nucleolus and recruit nucleolar proteins to facilitate virus replication, the effect of infection on the nucleolus in terms of morphology and protein content is unknown. Previously we have shown that the coronavirus nucleocapsid protein will localize to the nucleolus. In this study, using the avian infectious bronchitis coronavirus, we have shown that virus infection results in a number of changes to the nucleolus both in terms of gross morphology and protein content. Using confocal microscopy coupled with fluorescent labelled nucleolar marker proteins we observed changes in the morphology of the nucleolus including an enlarged fibrillar centre. We found that the tumour suppressor protein, p53, which localizes normally to the nucleus and nucleolus, was redistributed predominately to the cytoplasm.

The 3C-like proteinase (3CL(pro)) of severe acute respiratory syndrome (SARS) coronavirus is a key target for structure-based drug design against this viral infection. The enzyme recognizes peptide substrates with a glutamine residue at the P1 site. A series of keto-glutamine analogues with a phthalhydrazido group at the alpha-position were synthesized and tested as reversible inhibitiors against SARS 3CL(pro). Attachment of tripeptide (Ac-Val-Thr-Leu) to these glutamine-based "warheads" generated significantly better inhibitors (4a-c, 8a-d) with IC(50) values ranging from 0.60 to 70 microM.

Purpose>This paper explores the challenges of food security from source to consumption of agri-food value chain by considering urbanCrural linkages in city region food systems (CRFSs) and proposes a strategic framework for CRFS identifying strategies to promote urbanCrural linkages among multiple stakeholders.Design/methodology/approach>A qualitative case study approach to a fruit and vegetable value chain from rural source to consumption in the Colombo City region identifies the challenges of food security. A snowballing sampling method was used to gather information from retailers, wholesalers, commission agent, farmers and consumers. The data were collected through face-to-face interviews, observations and secondary data sources. The data were analysed using thematic analysis.Findings>Challenges in food security in the value chain related to five areas: input and production, infrastructure, public institutional support and policy, finance, and food market. Colombo city is heavily dependent on food sourced from other cities due to limited land and lack of locally situated commercially oriented farmers.Research limitations/implications>This research is limited to a selected number of fruits and vegetables in the Colombo city region and leaves out other food items.Originality/value>This study contributes to informing policy and decision-making processes to promote a more balanced rural to city food value chain in Colombo City that could benefit all stakeholders from rural small-scale producers to urban consumers.

BACKGROUND AND AIMS: Vaccine hesitancy is an ongoing major challenge. We aimed to assess the uptake and hesitancy of the COVID-19 vaccination. METHODS: A short online survey was posted between April 12 to July 31, 2021 targeted at health and social care workers (HCWs) across the globe. RESULTS: 275 from 37 countries responded. Most were hospital or primary care physicians or nurses, 59% women, aged 18C60 years, and 21% had chronic conditions with most prevalent being diabetes, hypertension, and asthma. We found that most HCWs (93%) had taken or willing to receive the COVID-19 vaccine. While 7% were vaccine hesitant (mainly women aged 30C39 years), respondents main concerns was the safety or potential side effects. Vaccine willing respondents raised concerns of unequal access to the COVID-19 vaccination in some countries, and highlighted that the only solution to overcoming COVID-19 infections was the vaccine booster doses given annually and free mass vaccination. CONCLUSIONS: This study found that the majority of the frontline HCWs are willing to receive the COVID-19 vaccine. Further promotion of the COVID-19 vaccine would reassure and persuade HCWs to become vaccinated.

Introduction: As COVID-19 develops around the world, numerous publications have described the psychiatric consequences of this pandemic Although clinicians and healthcare systems are mainly focused on managing critically ill patients in an attempt to limit the number of casualties, psychiatric disease burden is increasing significantly In this scenario, increased domestic violence and substance abuse have been recently reported Objective: The objective of this study is to perform a systematic review of the literature regarding the consequences of severe acute respiratory syndrome-CoV-2 infection in terms of domestic violence and substance abuse, and compare incidences found Materials and Methods: We conducted a literature search using the preferred reporting items for systematic reviews and meta-analyses guidelines The keywords included 'domestic violence,' 'substance abuse' AND 'COVID-19,' including multiple variants from December 2019 through June 2020 An extensive bibliographic search was carried out in different medical databases: Pubmed, EMBASE, LILACS, medRxiv, and bioRxiv Titles and abstracts were reviewed according to the eligibility criteria The risk of bias in the retrieved articles was assessed by the Joanna Briggs Institute's critical assessment instrument Results: A total of 1505 papers were initially retrieved after consulting the selected databases After browsing through titles and abstracts, 94 articles were initially included considering the predefined eligibility criteria After a more detailed analysis, only six scientific articles remained in our selection Of these, three were evaluating domestic violence against children, while the other three were about substance abuse Conclusion: There is not enough evidence to support the concept that COVID-19 has led to an increase in the rates of domestic violence and substance abuse The initial decrease in violence reports might not translate into a real reduction in incidence but in accessibility Apparently, there has been a slight increase in alcohol and tobacco abuse, especially by regular users, which also requires confirmatory studies The inconsistency between expert opinon articles and the actual published data could be a result of the limited time since the beginnging of the crisis, the fact that psychitaric patients have been chronically exposed to stressful situatons, and a possible stimulated increase in demand for psychatric consultations

The youth sport system in the United States is not achieving its full potential. There is a need to reimagine this system in ways that are evidence-based, innovative, and coordinated to best safeguard and promote the well-being of young people. The purpose of this expert commentary, composed by the President's Council on Sports, Fitness & Nutrition Science Board, is to propose a set of changes across multiple levels of influence (e.g., individual, family, school, organization) that could cultivate a more developmentally sound youth sport system. By advancing the vision of the National Youth Sports Strategy to provide quality youth sport to all young people in the country, these changes have substantial potential to benefit young people. [The commentary with the 2020-2021 President's Council on Sports, Fitness & Nutrition Science Board.]

Spinal cord injury (SCI) can cause severe trauma to the central nervous system. Resveratrol has been widely studied for several of its medicinal properties, including anti-inflammatory, anti-aging and anti-oxidative effects. The regulation of SIRT-1 is thought to be related to the effects of resveratrol. As a downstream component of SIRT-1, NF-B is one of the important signaling pathways that regulate the inflammatory response. Herein, we explored how treatment with resveratrol promoted recovery of motor function after SCI by activating the SIRT-1/NF-B signaling pathway and inhibiting inflammation in rat models. Recovery of hind limb function was observed using the Basso, Beattie, and Bresnahan locomotor rating scale at different time points after SCI. Western blot analysis, immunofluorescence, Nissl staining and HE staining were utilized to observe the morphological characteristics of spinal cord tissue, as well as the expression of SIRT-1, NF-B, TNF-, IL-1, IL-6 and brain-derived neurotrophic factor. Resveratrol treatment promoted motor function recovery, increased the expression of brain-derived neurotrophic factor, and reduced loss of motor neurons and lesion size among rats after SCI. Meanwhile, inflammatory response was inhibited as the SIRT-1/NF-B signaling pathway was modulated. These results suggest that resveratrol can help achieve neuroprotective effect by inhibiting inflammation, regulated by the SIRT-1/NF-B signaling pathway.

Frontline COVID workers (doctors, nurses, paramedics, law enforcement officers, social workers) have been especially impacted by the pandemic (1). Stigma and fear of job loss often prevent help seeking (2,3). Evidence-based interventions exist but can be hard to navigate, limiting or delaying their timely uptake (4,5). Tools are needed to better identify people in need of treatment and provide care navigation that is timely and tailored to the individuals' needs, preferences, and level of distress and helps to circumnavigate stigma. To address this need, our team is conducting formative and acceptability and feasibility research to inform the development of a chatbot-a conversational interface (e.g. Amazon Alexa) using text or speech in a conversational, human-like manner to deliver information-to screen and refer COVID frontline workers to care. We are conducting interviews with 20 community behavioral health providers, advocates, law enforcement officers, and people living with mental illness. We are then asking 40 na?ve users to test the prototype chatbot. Feedback from na?ve users will be integrated into the fully functional chatbot. Simultaneously, we are conducting a national survey with adults to test the feasibility and acceptability of using chatbot technology for behavioral health screening and referral and examine correlates of mental health chatbot use (i.e. demographics, stigma, and technology readiness). The setting of this study is online with frontline COVID responders and general community members. 20 stakeholder interviews, testing with 40 naive users, and feasibility and acceptability testing with 500 national participants. We will ask participants to test a chatbot that will provide screening for distress (PHQ-9) and referral. The chatbot will require about 5 minutes of time to use. Outcome measures related to feasibility and acceptability of the chatbot include willingness to engage with the chatbot and items from the Technology Acceptance Model. Findings will inform modifications to the chatbot and implementation planning. This work will inform the use of chatbots for mental health screening and referral for various populations. No disclosures to report.

It has been found that a domain composed of 330 amino acids of the N terminus of murine coronavirus spike protein [S1N(330)] is involved in receptor-binding activity (H. Kubo, Y.K. Yamada, and F. Taguchi, J. Virol. 68:5403-5410, 1994). To delineate the amino acid sequences involved in receptor-binding activity, we have compared the S1N(330) proteins of seven different mouse hepatitis virus MHV strains that are able to utilize the MHV receptor protein. Three conserved regions (sites I, II, and III) were found to consist of more than 10 identical amino acids, and they were analyzed for receptor-binding activity by site-directed mutagenesis. S1N(330) with a substitution at position 62 from the N terminus of S1 in region I and that with substitutions at positions 212, 214, and 216 in region II showed no receptor-binding activity. The S1N(330) mutants without receptor-binding activity were not able to prevent virus binding to the receptor. These results suggest that the receptor-binding site on S1N(330) is composed of regions located apart from each other in the protein's primary structure, in which Thr at position 62 as well as amino acids located at positions 212, 214, and 216 are particularly important.