PURPOSE: To report a unique case of intraocular inflammation and outer retinal changes in a patient with coronavirus disease (COVID-19). CASE REPORT: A 57-year-old woman was seen 12 days after COVID-19 symptoms onset confirmed by positive IgM and IgG serological tests. No anterior chamber cells were seen. Color fundus photograph showed a yellowish lesion within the macular area, and fluorescein angiography revealed hyperfluorescence on the topography of the macular lesion in both eyes. Spectral-domain optical coherence tomography demonstrated hyperreflective pinpoints at the level of posterior vitreous hyaloid, corresponding to vitritis, hyperreflective lesions at the level of inner plexiform and ganglion cell layers, and disruption of the ellipsoid zone. CONCLUSION AND IMPORTANCE: COVID-19 is known to affect the inner retinal layers. The current case not only supports but also adds a vitreal and an outer retinal layer involvement that might also be caused by this infectious disease.

SARS-CoV-2 exploits angiotensin-converting enzyme 2 (ACE2) as a receptor to invade cells. It has been reported that the UK and South African strains may have higher transmission capabilities, eventually in part due to amino acid substitutions on the SARS-CoV-2 Spike protein. The pathogenicity seems modified but is still under investigation. Here we used the experimental structure of the Spike RBD domain co-crystallized with part of the ACE2 receptor, several in silico methods and numerous experimental data reported recently to analyze the possible impacts of three amino acid replacements (Spike K417N, E484K, N501Y) with regard to ACE2 binding. We found that the N501Y replacement in this region of the interface (present in both the UK and South African strains) should be favorable for the interaction with ACE2, while the K417N and E484K substitutions (South African strain) would seem neutral or even unfavorable. It is unclear if the N501Y substitution in the South African strain could counterbalance the K417N and E484K Spike replacements with regard to ACE2 binding. Our finding suggests that the UK strain should have higher affinity toward ACE2 and therefore likely increased transmissibility and possibly pathogenicity. If indeed the South African strain has a high transmission level, this could be due to the N501Y replacement and/or to substitutions in regions located outside the direct SpikeCACE2 interface but not so much to the K417N and E484K replacements. Yet, it should be noted that amino acid changes at Spike position 484 can lead to viral escape from neutralizing antibodies. Further, these amino acid substitutions do not seem to induce major structural changes in this region of the Spike protein. This structureCfunction study allows us to rationalize some observations made for the UK strain but raises questions for the South African strain.

Background: There are scanty data on the occurrence of gastric tumours overexpressing human epidermal growth factor receptor 2 (HER2) in Africa. Objective: To assess HER2 protein overexpression in gastric and gastroesophageal junction adenocarcinoma (GGEAC) samples from a single centre in Zambia. Methodology: This was a cross-sectional study of formalin-fixed paraffin-embedded blocks with GGEAC. Prepared slides were first stained with Haematoxylin and Eosin and then evaluated for HER2 protein overexpression by immunohistochemistry. Results: A total of 57 gastric tissues were stained and evaluated for HER2 overexpression. Thirteen (23%) showed overexpression, 41/57 (72%) had negative and 3/57 (5%) had equivocal staining. The equivocal cases were excluded from the final analysis. Of the remaining 54 tissues, 28 (52%) were from females, and 26 (48%) were from males. The mean age was 59 years (SD 15 years). HER2 overexpression was highest in moderately differentiated tumours (p=0.0005). Intestinal type tumours had a higher occurrenc of HER2 overexpression than diffuse or mixed sub-types (p=0.0087). HER2 overexpression was not associated with age (p=0.27), sex (p=1.00) or anatomical location (p=1.00). Conclusion: The occurrence of GGEAC HER2 overexpression in Zambian patients is similar to proportions reported elsewhere, and it is associated with moderately differentiated tumours of the intestinal type.

A smart environment is an assistive technology space that can enable people with motor disabilities to control their equipment (TV, radio, fan, etc.) through a human-machine interface activated by different inputs. However, assistive technology resources are not always considered useful, reaching quite high abandonment rate. This study aims to evaluate the effectiveness of a smart environment controlled through infrared oculography by people with severe motor disabilities. The study sample was composed of six individuals with motor disabilities. Initially, sociodemographic data forms, the Functional Independence Measure (FIMTM), and the Canadian Occupational Performance Measure (COPM) were applied. The participants used the system in their domestic environment for a week. Afterwards, they were reevaluated with regards to occupational performance (COPM), satisfaction with the use of the assistive technology resource (QUEST 2.0), psychosocial impact (PIADS) and usability of the system (SUS), as well as through semi-structured interviews for suggestions or complaints. The most common demand from the participants of this research was 'control of the TV'. Two participants did not use the system. All participants who used the system (four) presented positive results in all assessment protocols, evidencing greater independence in the control of the smart environment equipment. In addition, they evaluated the system as useful and with good usability. Non-acceptance of disability and lack of social support may have influenced the results.

As the COVID-19 pandemic and interventions intended to minimize its spread continue to impact daily life, personality research may help to address the different ways in which people respond to a major global health crisis. The present study assessed the role of dark personality traits in predicting different responses to the pandemic. A nationally representative sample of 412 Americans completed measures of the Dark Tetrad as well as perceptions of COVID-19 threat, emergency beliefs, and positive and negative affect in response to COVID-19. Narcissism and Machiavellianism predicted greater negative affect and perceptions of threat during the pandemic, while psychopathy predicted positive affect. Conversely, sadism predicted greater positive affect. Dark personality also showed some predictive ability in explaining pandemic-related behaviors (e.g., more frequent cleaning) but not others (e.g., social distancing). Our findings provide evidence for differences in how dark personality traits predict individual responses to global crises.

Wellness Wednesdays and yoga breaks aren't sufficient Here's how health care organizations can begin to address physician well-being

Addictovigilance is a safety monitoring targeted at substances with potential for abuse and dependence. This vigilance was involved during the period of COVID-19 epidemic due to the significant changes in access to drugs and psychological disruption caused by the pandemic and lockdown. This article aims to present the different steps implemented by the French Addictovigilance network in collaboration with the French Health authorities from March to May 2020, including monitoring of potential harmful events, and scientific communication. The first events were identified through the continuity of the networking between the French addictovigilance centres and their partners: community pharmacies, general practitioners, specialized structures and emergency wards. As soon as the lockdown began, first cases of overdoses (lethal or not) were reported with opioids, mainly with methadone, and other opioids (heroin, oxycodone, tramadol or antitussive codeine). Lockdown-related noteworthy events consisted in clinical cases or other relevant information for which lockdown clearly played an important role: among the many substances identified at least once, pregabalin, benzodiazepines, cannabis, cocaine and nitrous oxide were the most significant in terms of prevalence, seriousness or particularly specific to the lockdown context. Despite significant decrease in the activity and travel limited to vital needs, community pharmacies continued to identify falsified prescriptions in this period, highlighting an increase in suspicious requests for pregabalin, codeine and tramadol. In parallel, the French addictovigilance network continued its communications efforts in the period, issuing a newsletter on tramadol, a press release on methadone and naloxone, and participating in the COVID-19 frequently asked questions (FAQs) of the French Society of Pharmacology and Therapeutic website (https://sfpt-fr.org/covid19). COVID-19 epidemic has been an important challenge for addictovigilance, and has proved that this monitoring is highly essential for alerting health professionals and health authorities to points of vigilance in the field of psychoactive substances.

OBJECTIVE: To describe and report on the use of virtual clinical competency examinations (VCCEs) for D3 dental students in a radiology clinic during the COVID-19 pandemic and relate the technology to other clinical and educational applications. METHOD AND MATERIALS: Paper-based clinical competency examinations (CCEs) were converted to three different VCCEs to closely replicate the CCEs. Existing grading rubrics were used to assess students' abilities to evaluate technical issues and interpret intraoral full-mouth series and panoramic radiographs. The grading rubrics were modified from their clinical versions to eliminate non-reproducible skills, such as patient management and application of selection criteria. Radiographs were selected from clinic records and anonymized. VCCEs were conducted via WebEx conferences that were scheduled via an appointment app. These experiences can be extended to virtual patient contacts, teleradiology, and telemedicine, as well as continuing dental education experiences. RESULTS: Approximately 200 VCCEs were administered by four oral and maxillofacial radiology faculty over a 10-week period. Both students and faculty managed the technology well, with few missed appointments. All students were successful in challenging the examinations and appeared to be satisfied with the experience. CONCLUSIONS: Although direct comparisons between the CCEs and the new VCCEs are difficult, as there was no time to pilot the VCCEs, students were successful in challenging the examinations and informally reported satisfaction with the experience. Although components of CCEs that could not be replicated on the VCEs could not be assessed, it is felt that the students had adequate experience in selection of radiographs and patient management prior to the COVID-19 lockdown. Additional benefits of the VCCEs included contact with students to check on their well-being. The experience indicates that VCCEs can be used in the future in hybrid models of oral & maxillofacial radiology education, clinical care, patient screening, and telemedicine. Moreover, the success of this demonstration points to potential for personalized distance learning in continuing dental education.

Was the European Central Bank able to assure the relaunch of the European project after the weakening of the post-crisis period? To answer this question, this paper presents an empirical analysis connecting citizen trust in the European Union with a variable intended to be a measure of the monetary policy strategy of the European Central Bank, namely, the interest rate on government bonds extracted from the 1-year maturity yield curve. The dynamic panel technique, applied to nineteen Eurozone countries for the time span of 2004C2018, estimates the presence of a long-run common relationship between the variables despite allowing different short-run adjustment mechanisms. Results are revealed to be not univocal: the easy monetary policy strategy is associated for the whole period with a decline of trust, and therefore, despite its impressiveness, it was not sufficient to relaunch the European Union project. However, when considering the change in strategy of the post-2013 period, it seemed to have contributed to a slight inversion of the decline of trust. These results highlight the importance of non-conventional measures and call for further support from coordinated policy action as a response to the negative shock deriving from the COVID-19 pandemic.

In this paper, a new nature-inspired human-based optimization algorithm is proposed which is called coronavirus herd immunity optimizer (CHIO). The inspiration of CHIO is originated from the herd immunity concept as a way to tackle coronavirus pandemic (COVID-19). The speed of spreading coronavirus infection depends on how the infected individuals directly contact with other society members. In order to protect other members of society from the disease, social distancing is suggested by health experts. Herd immunity is a state the population reaches when most of the population is immune which results in the prevention of disease transmission. These concepts are modeled in terms of optimization concepts. CHIO mimics the herd immunity strategy as well as the social distancing concepts. Three types of individual cases are utilized for herd immunity: susceptible, infected, and immuned. This is to determine how the newly generated solution updates its genes with social distancing strategies. CHIO is evaluated using 23 well-known benchmark functions. Initially, the sensitivity of CHIO to its parameters is studied. Thereafter, the comparative evaluation against seven state-of-the-art methods is conducted. The comparative analysis verifies that CHIO is able to yield very competitive results compared to those obtained by other well-established methods. For more validations, three real-world engineering optimization problems extracted from IEEE-CEC 2011 are used. Again, CHIO is proved to be efficient. In conclusion, CHIO is a very powerful optimization algorithm that can be used to tackle many optimization problems across a wide variety of optimization domains.

Foodborne illness resulting from the consumption of contaminated fresh produce is a common phenomenon and has severe effects on human health together with severe economic and social impacts. The implications of foodborne diseases associated with fresh produce have urged research into the numerous ways and mechanisms through which pathogens may gain access to produce, thereby compromising microbiological safety. This review provides a background on the various sources and pathways through which pathogenic bacteria contaminate fresh produce; the survival and proliferation of pathogens on fresh produce while growing and potential methods to reduce microbial contamination before harvest. Some of the established bacterial contamination sources include contaminated manure, irrigation water, soil, livestock/ wildlife, and numerous factors influence the incidence, fate, transport, survival and proliferation of pathogens in the wide variety of sources where they are found. Once pathogenic bacteria have been introduced into the growing environment, they can colonize and persist on fresh produce using a variety of mechanisms. Overall, microbiological hazards are significant; therefore, ways to reduce sources of contamination and a deeper understanding of pathogen survival and growth on fresh produce in the field are required to reduce risk to human health and the associated economic consequences.

Perforin-deficient [perforin (-/-)] mice were infected with two strains of JHM virus (JHMV) to analyze the role of perforin-mediated cytotoxicity in acute lethal and subacute central nervous system (CNS) infections. During both acute and subacute infections, the overall mortality of the perforin (-/-) mice was not different from that of the controls. Perforin (-/-) mice survived longer than the controls, consistent with reduced morbidity. Both strains of virus were cleared from the perforin (-/-) mice as in the controls; however, the rate of clearance was delayed in the perforin (-/-) mice, indicating that perforin-mediated cytolysis is involved in viral clearance. The absence of perforin-mediated cytolysis did not prevent encephalomyelitis or extensive demyelination. Cells undergoing apoptosis were detected in the CNS of both the perforin (-/-) and control groups, indicating that perforin is not essential for programmed cell death. Neutralizing antibodies were not detected in either group of mice until day 9 postinfection, when the majority of the virus had been cleared. These data further confirm the importance of cell-mediated cytotoxicity and suggest that additional components of the immune response contribute to the clearance of JHMV from the CNS.

Objectives. To directly measure SARS-CoV-2 infection in diverse schools with either remote or onsite learning. Methods. 4 schools participated. Schools A and B served low-income Hispanic learners, school C special needs, and all three provided predominantly remote instruction. School D served middle and upper-middle income, White learners, with predominantly onsite instruction. 320 learners [10.5+/-2.1(SD); 7-17 y.o.]; 86% had phlebotomy. Testing occurred early in the fall (2020), at lower levels of COVID-19, and 6-8 weeks later during the fall-winter surge (tenfold increase in COVID-19 cases). Results: Nasal RT-qPCR for SARS-CoV-2 and 21 respiratory pathogens was performed. Phlebotomy was obtained for circulating immunity. Face covering and physical distancing fidelity was measured by direct observation. 17 learners were SARS-CoV-2 positive during the surge. School A (97% remote) had the highest infection rate (9/70, 12.9%, p<0.01) and IgG positivity rate (13/70, 18.6%). School D had the lowest infection and IgG positive rate (1/86, 1.2%). Mitigation compliance [physical distancing (mean 87.4%) and face covering (91.3%)] was high at all schools. Learners with documented SARS-CoV-2 infection had neutralizing antibodies (94.7%), broad and robust interferon-gamma T cell responses, reduced frequencies of monocytes, and lower levels of circulating inflammatory mediators. Conclusions: Infection in the schools reflected regional rates rather than remote or onsite learning modalities. Schools can implement successful mitigation strategies across a wide range of income, school-type, and student diversity. Reduced monocyte and immune mediator concentrations coupled with robust humoral and cellular immunity may explain the generally milder symptoms in school-aged children.

During January 1, 2020-August 10, 2020, an estimated 5 million cases of coronavirus disease 2019 (COVID-19) were reported in the United States.* Published state and national data indicate that persons of color might be more likely to become infected with SARS-CoV-2, the virus that causes COVID-19, experience more severe COVID-19-associated illness, including that requiring hospitalization, and have higher risk for death from COVID-19 (1-5). CDC examined county-level disparities in COVID-19 cases among underrepresented racial/ethnic groups in counties identified as hotspots, which are defined using algorithmic thresholds related to the number of new cases and the changes in incidence.? Disparities were defined as difference of &#8805;5% between the proportion of cases and the proportion of the population or a ratio &#8805;1.5 for the proportion of cases to the proportion of the population for underrepresented racial/ethnic groups in each county. During June 5-18, 205 counties in 33 states were identified as hotspots; among these counties, race was reported for &#8805;50% of cumulative cases in 79 (38.5%) counties in 22 states; 96.2% of these counties had disparities in COVID-19 cases in one or more underrepresented racial/ethnic groups. Hispanic/Latino (Hispanic) persons were the largest group by population size (3.5 million persons) living in hotspot counties where a disproportionate number of cases among that group was identified, followed by black/African American (black) persons (2 million), American Indian/Alaska Native (AI/AN) persons (61,000), Asian persons (36,000), and Native Hawaiian/other Pacific Islander (NHPI) persons (31,000). Examining county-level data disaggregated by race/ethnicity can help identify health disparities in COVID-19 cases and inform strategies for preventing and slowing SARS-CoV-2 transmission. More complete race/ethnicity data are needed to fully inform public health decision-making. Addressing the pandemic's disproportionate incidence of COVID-19 in communities of color can reduce the community-wide impact of COVID-19 and improve health outcomes.

OBJECTIVE Recent work has attempted to uncover heterogeneity in experiences of victimization. However, few studies have included important trauma-related characteristics such as known perpetrator, fear of life or injury, and negative reactions to disclosure. Little focus on potentially important subgroup differences including sexual/gender identity, race/ethnicity, and socioeconomic status as well as protective factors have been assessed. METHOD Participants (N = 2,880) completed four annual surveys during late adolescence and the transition to young adulthood as part of an ongoing longitudinal study. Latent class analysis was used to extract classes of victimization and trauma-related characteristics. Latent class regression was used to understand how demographic covariates were related to class membership. Finally, discrete-time survival mixture analysis was used to assess latency to opioid use from ages 17 to 24 years, and how demographic and protective factors influenced opioid use across emergent classes. RESULTS The four-class solution fit the data best: sexual abuse and indirect violence + high trauma characteristics (n = 79, 3.6%); high all + high trauma characteristics (n = 177; 8.1%); chronic emotional abuse + trusted perpetrator (n = 263; 12.1%); and low all (n = 1,656; 76.1%). Latent class regression results indicated differential risk of class membership by sexual/gender minority status, sex assigned at birth, race/ethnicity, and socioeconomic status. Survival analysis noted shorter latency to opioid use across all classes compared to the low all class. Self-efficacy and neighborhood cohesion emerged as important protective factors. CONCLUSION Furthermore, results highlight key individual- and community-level protective factors that decrease the risk of opioid use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

PURPOSE OF REVIEW: This paper reviews the literature on the psychological effects of the COVID-19 pandemic on children and the reactions of vulnerable children. RECENT FINDINGS: Research reveals increases in clinically significant depression, suicidal ideation and behavior, and some anxiety symptoms. Substance use studies suggest an inadvertent decrease in substance use in some youth though findings are inconsistent across substances and for males and females. Children with pre-existing emotional and behavioral problems are especially vulnerable though some children appear to improve in the context of public health measures which have decreased the stresses associated with school and socialization. In addition, children with pre-existing problems are likely to have established resources and relationships that may protect them relative to other children. SUMMARY: COVID-19 has had a major effect on the mental health of children around the world, but findings should be considered preliminary until more rigorous research has been conducted.

Respiratory viruses are the single most common causes of asthma exacerbations in children. Rhinovirus-induced wheezing is a risk factor for chronic asthma, but its mechanism has remained unknown. Human bocavirus is a common finding in wheezing children, but its role as a respiratory pathogen is still unclear. Mycoplasma pneumoniae may, like viruses, induce wheezing and asthma exacerbation. Chlamydia pneumoniae and, in recent studies, Chlamydia trachomatis, may not only induce asthma exacerbations but may also be involved in the pathogenesis of chronic asthma. Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are often involved in respiratory infections associated with wheezing, but there is no evidence for their active role in asthma pathogenesis or exacerbation. This review summarizes current knowledge on the association between respiratory infections and asthma in children, with a special focus on the role of antibiotics in incipient asthma, asthma exacerbation and chronic stable asthma.

Resistance mechanisms and heterogeneity in HER2-positive gastric cancers (GC) limit Trastuzumab benefit in 32% of patients, and other targeted therapies have failed in clinical trials. Using patient samples, patient-derived xenografts (PDXs), partially humanized biological models, and HER2-targeted imaging technologies we demonstrate the role of caveolin-1 (CAV1) as a complementary biomarker in GC selection for Trastuzumab therapy. In retrospective analyses of samples from patients enrolled on Trastuzumab trials, the CAV1-high profile associates with low membrane HER2 density and low patient survival. We show a negative correlation between CAV1 tumoral protein levels C a major protein of cholesterol-rich membrane domains C and Trastuzumab-drug conjugate TDM1 tumor uptake. Finally, CAV1 depletion using knockdown or pharmacologic approaches (statins) increases antibody drug efficacy in tumors with incomplete HER2 membranous reactivity. In support of these findings, background statin use in patients associates with enhanced antibody efficacy. Together, this work provides preclinical justification and clinical evidence that require prospective investigation of antibody drugs combined with statins to delay drug resistance in tumors.

PURPOSE OF REVIEW: Over 70 million people worldwide, including those with neurodegenerative disease (NDD), have been diagnosed with coronavirus disease 2019 (COVID-19) to date. We review outcomes in patients with NDD and COVID-19 and discuss the hypothesis that due to putative commonalities of neuropathogenesis, COVID-19 may unmask or trigger NDD in vulnerable individuals. RECENT FINDINGS: Based on a systematic review of published literature, patients with NDD, including dementia, Parkinson's disease, and multiple sclerosis (MS) make up a significant portion of hospitalized COVID-19 patients. Such patients are likely to present with altered mental status or worsening of their preexisting neurological symptoms. Patients with NDD and poor outcomes often have high-risk comorbid conditions, including advanced age, hypertension, diabetes, obesity, and heart/lung disease. Patients with dementia including Alzheimer's disease are at higher risk for hospitalization and death, whereas those with preexisting Parkinson's disease are not. MS patients have good outcomes and disease modifying therapies do not increase the risk for severe disease. Viral infections and attendant neuroinflammation have been associated with the pathogenesis of Alzheimer's disease, Parkinson's disease, and MS, suggesting that COVID-19 may have the potential to incite or accelerate neurodegeneration. SUMMARY: Since patients with Alzheimer's disease are at higher risk for hospitalization and death in the setting of COVID-19, additional precautions and protective measures should be put in place to prevent infections and optimize management of comorbidities in this vulnerable population. Further studies are needed to determine whether COVID-19 may lead to an increased risk of developing NDD in susceptible individuals.

Influenza virus infection is a common respiratory pathogen. Emerging of new atypical influenza is usually a big public health threat. H7N9 bird flu is the newest atypical influenza virus infection that has just been reported since early 2013. The emerging of this new disease occurred in China and becomes the present focus for possible worldwide pandemic. In this specific article, the author will discus and describe on epidemiology, symptomatology, pathology, diagnosis, treatment, and prevention of this new bird flu. The literature researching by PubMed and Google is used for data gathering in this collective review.