PurposeIntranasally administered unfractionated heparin (UFH) and other sulfated polysaccharides are potential prophylactics for COVID-19. The purpose of this research was to measure the safety and pharmacokinetics of clearance of intranasally administered UFH solution from the nasal cavity. MethodsDouble-blinded daily intranasal dosing in C57Bl6 mice with four doses (60 ng to 60 {micro}g) of UFH was carried out for fourteen consecutive days, with both blood coagulation measurements and subject adverse event monitoring. The pharmacokinetics of fluorescent-labeled UFH clearance from the nasal cavity were measured in mice by in vivo imaging. Intranasal UFH at 2000 U/day solution with nasal spray device was tested for safety in a small number of healthy human subjects. ResultsUFH showed no evidence of toxicity in mice at any dose measured. No significant changes were observed in activated partial thromboplastin time (aPTT), platelet count, or frequency of minor irritant events over vehicle-only control. Human subjects showed no significant changes in aPTT time, international normalized ratio (INR), or platelet count over baseline measurements. No serious adverse events were observed. In vivo imaging in a mouse model showed a two-phase clearance of UFH from the nasal cavity. After 12 hours, 2.1% of the initial administered UFH remained in the nasal cavity, decaying to background levels after 24 hours. ConclusionsUFH showed no toxic effects for extended daily intranasal dosing in mice as well as humans. The clearance kinetics of intranasal heparin solution from the nasal cavity indicates potentially protective levels for up to 12 hours after dosing.

Avian infectious bronchitis (IB) causes great economic losses to the chicken industry worldwide. IB virus (IBV) exhibits extensive variability, and differing serotypes are often prevalent in different countries or regions. Therefore, the identification of local circulating strains is essential for the selection of appropriate vaccines. China is a worldwide leader in poultry meat and egg production, and IBV is one of the most important infectious diseases affecting this industry. In this review, the history and current IB occurrence in China, as well as the development and use of vaccines, are summarized. Based on recent epidemics, reasonable vaccination strategies are recommended, and some inadequate measures commonly used in the field are analyzed.

Purpose Drawing upon the communicative ecology theory (CET), this study aims to identify the potential precursors of social media health information seeking intentions (ISI) and examine their effects on health information re-sharing behaviors and PHH during coronavirus (COVID-19) pandemic Design/methodology/approach The data is collected through an online survey conducted in two different universities situated in highly COVID-19-affected cities - Wuhan and Zhengzhou, China The valid data consists of 230 useful responses from WeChat users and to analyze the final data set structural equation modeling (SEM) is used Findings The results indicate that perceived health information credibility (PIC), trust on the medium (TRM) and peer influence (PI) significantly affect health ISI which further affects health information re-sharing behaviors (IRB) and personal health-care habits (PHH) Besides, the results also identify that PI has a direct, positive and significant effect on health IRB via social media during the COVID-19 pandemic Research limitations/implications This study investigates the health information intentional behavior precursors and their consequences via WeChat (taken as social media platform) during COVID-19 pandemic Future studies may conduct research by examining online information behaviors on other social media platforms - Twitter, WhatsApp, Facebook, etc - in health emergency situations Practical implications The health information producers and providers have to deal with communicative ecology sentiments elegantly in emergency situations such as during the COVID-19 pandemic They need to do collective efforts by introducing new tools or social apps which deal with valuable, reliable and accurate health content and information generated by the pandemic experts and health professionals In such a way, the social apps and tools (Information providers) will act as mediators between the health professionals (Information producers) and general social media users (information seekers) Such initiatives will ultimately bring forth positive effect on individuals' PHH as a whole within a network, community, environment or nations during a health emergency - COVID-19 pandemic Originality/value This research is one of the first studies to examine the potential precursors of social media health ISIs and their resultant effects on individual's health IRB and PHH during the COVID-19 pandemic As currently it is noticed, an incredible upsurge of health information via social media has intense impacts on personal health-care research and practice, particularly during health emergency situations such as COVID-19 pandemic conditions

Given that conventional therapies are ineffective for COVID-19, obtained exosomes from stem cells have been proposed as a sustainable and effective treatment. Exosomes are subsets with lengths between 30 and 100 nanometers, and they can be secreted by different cells. Exosomes are containing different types of miRNAs, mRNAs, and different proteins. The role of immune system modulation of exosomes of mesenchymal stem cells has been studied and confirmed in more than one study. Exosome miRNAs detect and reduce cytokines that cause cytokine storms such as IL-7, IL-2, IL-6, etc. These miRNAs include miR-21, miR-24, miR-124, miR-145, etc. The risks associated with treatment with exosomes from different cells are relatively small compared to other treatments because transplanted cells do not stimulate the host immune system and also has reduced infection transmission. Due to the ineffectiveness of existing drugs in reducing inflammation and preventing cytokine storms, the use of immune-boosting systems may be suggested as another way to control cytokine storm.

In this paper, the mathematical modeling of five different classes for coronavirus disease-19 (COVID-19) is considered using the fractional arbitrary order derivative in AtanganaCBaleanu sense. We use nonlinear analysis for the existence theory of the solution for the suggested model. Additionally, the modified AdamCBashforth method is used for the numerical approximation of the assumed model. Finally, we simulate the results for 100 days with the help of data from the literature to display the excellency of the suggested model. [ABSTRACT FROM AUTHOR] Copyright of Fractals is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The clinical management of pregnancy and spontaneous preterm birth (sPTB) relies on estimates of gestational age (GA). Our objective was to evaluate the effect of GA dating uncertainty on the observed performance of a validated proteomic biomarker risk predictor, and then to test the generalizability of that effect in a broader range of GA at blood draw. In a secondary analysis of a prospective clinical trial (PAPR; NCT01371019), we compared two GA dating categories: both ultrasound and dating by last menstrual period (LMP) (all subjects) and excluding dating by LMP (excluding LMP). The risk predictors performance was observed at the validated risk predictor threshold both in weeks 19(1/7)C20(6/7) and extended to weeks 18(0/7)C20(6/7). Strict blinding and independent statistical analyses were employed. The validated biomarker risk predictor showed greater observed sensitivity of 88% at 75% specificity (increases of 17% and 1%) in more reliably dated (excluding-LMP) subjects, relative to all subjects. Excluding dating by LMP significantly improved the sensitivity in weeks 19(1/7)C20(6/7). In the broader blood draw window, the previously validated risk predictor threshold significantly stratified higher and lower risk of sPTB, and the risk predictor again showed significantly greater observed sensitivity in excluding-LMP subjects. These findings have implications for testing the performance of models aimed at predicting PTB.

BACKGROUND: Although efforts to manage coronavirus disease 2019 (COVID-19) pandemic have understandably taken immediate priority, the impacts on traditional healthcare-associated infection (HAI) surveillance and prevention efforts remain concerning. AIM: To describe trends in HAIs in a Tunisian university hospital through repeated point prevalence surveys over 9 years, assess the impact of measures implemented for COVID-19 pandemic, and to identify associated factors of HAI. METHODS: The current study focused on data collected from annual point prevalence surveys conducted from 2012 to 2020. All types of HAIs as defined by the Centers for Disease Control and Prevention (CDC) were included. Data collection was carried out using NosoTun plug. Univariate and multivariate logistic analysis were used to identify HAI risk factors. RESULTS: Overall, 2729 patients were observed in the 9 surveys; the mean age was 48.3 23.3 years and 57.5% were male. We identified 267 infected patients (9.8%) and 296 HAIs (10.8%). Pneumonia/lower respiratory tract infections were the most frequent HAI (24%), followed by urinary tract infection (20.9%).The prevalence of infected patients increased from 10.6% in 2012 to 14.9% in 2020. However, this increase was not statistically significant. The prevalence of HAIs increased significantly from 12.3% to 15.5% (P =.003). The only decrease involved is bloodstream infections (from 2% to 1%). Independent risk factors significantly associated with HAI were undergoing surgical intervention (aOR = 1.7), the use of antibiotic treatment in previous 6 months (aOR = 1.8), peripheral line (aOR=2), parenteral nutrition (aOR=2.4), urinary tract within 7 days (aOR=2.4), central line (aOR = 6.3), and prosthesis (aOR = 12.8), length of stay (aOR = 3), and the year of the survey. Young age was found as protective factor (aOR = .98). CONCLUSION: Contrary to what was expected, we noticed an increase in the HAIs rates despite the preventive measures put in place to control the COVID-19 pandemic. This was partly explained by the vulnerability of hospitalized patients during this period.

Diabetes is considered as an critical comorbidity linked with the latest coronavirus disease 2019 (COVID-19) which spreads through Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2). The diabetic patients have higher threat of infection from novel corona virus. Depending on the region in the globe, 20% to 50% of patients infected with COVID-19 pandemic had diabetes. The current article discussed the risk associated with diabetic patients and also recommendation for controlling diabetes during this pandemic situation. The article also discusses the case study of COVID-19 at various regions around the globe and the preventive actions taken by various countries to control the effect from the virus. The article presents several smart healthcare solutions for the diabetes patients to have glucose insulin control for the protection against COVID-19.

The emergence of SARS-CoV-2 variants stressed the demand for tools allowing to interpret the effect of single amino acid variants (SAVs) on protein function. While Deep Mutational Scanning (DMS) sets continue to expand our understanding of the mutational landscape of single proteins, the results continue to challenge analyses. Protein Language Models (pLMs) use the latest deep learning (DL) algorithms to leverage growing databases of protein sequences. These methods learn to predict missing or masked amino acids from the context of entire sequence regions. Here, we used pLM representations (embeddings) to predict sequence conservation and SAV effects without multiple sequence alignments (MSAs). Embeddings alone predicted residue conservation almost as accurately from single sequences as ConSeq using MSAs (two-state Matthew Correlation Coefficient C MCC - for ProtT5 embeddings of 0.596 0.006 vs. 0.608 0.006 for ConSeq). Inputting the conservation prediction along with BLOSUM62 substitution scores and pLM mask reconstruction probabilities into a simplistic logistic regression (LR) ensemble for Variant Effect Scoring without alignments (VESPA) predicted SAV effect magnitude without any optimization on DMS data. Comparing predictions for a standard set of 39 DMS experiments to other methods (incl. ESM-1v, DeepSequence, and GEMME) revealed our approach as competitive with the state-of-the-art (SOTA) methods using MSA input. No method outperformed all others, neither consistently nor in a statistically significant manner, independently of the performance measure applied (incl. two-state accuracy: Q2, MCC, Spearman and Pearson correlation). Lastly, we investigated binary effect predictions on DMS experiments for four human proteins. Overall, embedding-based methods have become competitive with methods relying on MSAs for SAV effect prediction at a fraction of the costs in computing/energy. Our method predicted SAV effects for the entire human proteome (~ 20k proteins) within 40 minutes on one Nvidia Quadro RTX 8000. All methods and data sets are freely available for local and online execution through bioembeddings.com, https://github.com/Rostlab/VESPA, and PredictProtein.

The outbreak of SARS-CoV-2 began in December 2019 and rapidly became a pandemic. The present study investigated the significance of lymphopenia on disease severity. A total of 115 patients with confirmed COVID-19 from a tertiary hospital in Changsha, China, were enrolled. Clinical, laboratory, treatment and outcome data were gathered and compared between patients with and without lymphopenia. The median age was 42 years (1-75). Fifty-four patients (47.0%) of the 115 patients had lymphopenia on admission. More patients in the lymphopenia group had hypertension (30.8% vs. 10.0%, P = 0.006) and coronary heart disease (3.6% vs. 0%, P = 0.029) than in the nonlymphopenia group, and more patients with leukopenia (48.1% vs 14.8%, P<0.001) and eosinopenia (92.6% vs 54.1%, P<0.001) were observed. Lymphopenia was also correlated with severity grades of pneumonia (P<0.001) and C-reactive protein (CRP) level (P = 0.0014). Lymphopenia was associated with a prolonged duration of hospitalization (17.0 days vs. 14.0 days, P = 0.002). Lymphocyte recovery appeared the earliest, prior to CRP and chest radiographs, in severe cases, which suggests its predictive value for disease improvement. Our results demonstrated the clinical significance of lymphopenia for predicting the severity of and recovery from COVID-19, which emphasizes the need to dynamically monitor lymphocyte count.

The empirical analysis employs a static threshold model using a daily dataset over the six months from the first confirmed European COVID-19 case (25 January 2020). The results indicate that the investigated relationship is non-monotonic ('U-shaped') depending on the intensity of the lockdown measures proxied by the Coronavirus Government Response Tracker Index (CGR).

PURPOSE OF REVIEW: This review presents the most current recommendations for providing nutrition to the neurocritical care population. This includes updates on initiation of feeding, immunonutrition, and metabolic substrates including ketogenic diet, cerebral microdialysis (CMD) monitoring, and the microbiome. RECENT FINDINGS: Little evidence exists to support differences in feeding practices among the neurocritical care population. New areas of interest with limited data include use of immunonutrition, pre/probiotics for microbiome manipulation, ketogenic diet, and use of CMD catheters for substrate utilization monitoring. SUMMARY: Acute neurologic injury incites a cascade of adrenergic and neuroendocrine events resulting in a pro-inflammatory and hypercatabolic state, which is associated with an increase in morbidity and mortality. Nutritional support provides substrates to mitigate the damaging effects of hypermetabolism. Despite this practice, studies on feeding delivery outcomes remain inconsistent. Guidelines suggest use of early enteral nutrition using standard polymeric formulas. Population heterogeneity, variability in interventions, complexities of the metabolic and inflammatory responses, and paucity of nutrition research in patients requiring neurocritical care have led to controversies in the field. It is imperative that more pragmatic and reproducible research be conducted to better understand underlying pathophysiology and develop interventions that may improve outcomes.

OBJECTIVES The primary objective was to describe the clinical characteristics and 30-day mortality rates in emergency department patients with coronavirus disease 2019 (COVID-19) in different diagnostic groupings. MATERIAL AND METHODS Secondary analysis of the COVID-19 registry compiled by the emergency department of Hospital Clnico San Carlos in Madrid, Spain. We selected suspected COVID-19 cases treated in the emergency department between February 28 and March 31, 2020. The cases were grouped as follows: 1) suspected, no polymerase chain reaction (PCR) test (S/no-PCR); 2) suspected, negative PCR (S/PCR-); 3) suspected, positive PCR (S/PCR+); 4) highly suspected, no PCR, or negative PCR (HS/no or PCR-); and 5) highly suspected, positive PCR (HS/PCR+). We collected clinical, radiologic, and microbiologic data related to the emergency visit. The main outcome was 30-day all-cause mortality. Secondary outcomes were hospitalization and clinical severity of the episode. RESULTS A total of 1993 cases (90.9%) were included as follows: S/no-PCR, 17.2%; S/PCR-, 11.4%; S/PCR+, 22.1%; HS/no PCR or PCR-, 11.7%; and HS/PCR+, 37.6%. Short-term outcomes differed significantly in the different groups according to demographic characteristics; comorbidity and clinical, radiographic, analytical, and therapeutic variables. Thirty-day mortality was 11.5% (56.5% in hospitalized cases and 19.6% in cases classified as severe). The 2 HS categories and the S/PCR+ category had a greater adjusted risk for 30-day mortality and for having a clinically severe episode during hospitalization in comparison with S/PCR- cases. Only the 2 HS categories showed greater risk for hospitalization than the S/PCR- cases. CONCLUSION COVID-19 diagnostic groups differ according to clinical and laboratory characteristics, and the differences are associated with the 30-day prognosis.

The SARS\CoV\2 pandemic has rapidly transformed health care delivery around the globe. Because of the heavy impact of COVID\19 spread, cancer treatments have necessarily been de\prioritized, thus exposing patients to increased risk of morbidity and mortality due to delayed care. In this scenario, cancer specialists need to assess critical oncology patients case by case to carefully balance risk vs benefit in treating tumors and preventing SARS\CoV\2 infection. Here, we report early insights into how the management of patients with sinonasal and anterior skull base cancer might be affected by the COVID\19 pandemic. We provide recommendations for preoperative tests, indications for immediate care vs possible delayed treatment, and warnings relating to dural resection and intracranial dissection, given the potential neurotropism of SARS\CoV2 and practical suggestions for managing cancer care in a period of limited resources. We also postulate some thoughts on the promising role of telemedicine in multidisciplinary case discussions and posttreatment surveillance.

The pandemic COVID-19 which requires everyone including students to do activities at home is easier because of technological advances. The most influential technology in education today is the Internet. The internet allows teachers to provide learning materials without having to meet in person. Teachers can upload learning materials for later access by students. Several internet-based applications and sites are also commonly used by teachers and students to hold face-to-face classes via Whatsapp video calls, Google Classroom, Zoom Meetings and other online media. Apart from teaching and learning activities, internet-based technology can also be used to support student productive activities. Due to this work from home policy student activities such as organizations committees clubs and so on are hampered. However, by utilizing internet-based applications and sites such as Google Meet, Zoom, Skype and so on, learning activities in the form of meetings and group discussions can run more optimally. Working on group assignments can be easier by using Google Doc where multiple students can edit a document together directly.

The objective of this study was to evaluate the role of the Rally de Portugal in the tourism destination Porto, thus answering the question What is the role of the Rally de Portugal in the tourism destination Porto?. In this study it was used a qualitative methodology, and the sampling method for convenience, according to the availability of the participants. Therefore, individual interviews were applied to two of the event organisers. The interview guide was divided into two sections: Planning and Organisation of the Rally de Portugal, and Porto as a Tourism Destination. The holding of the Porto Street Stage has several positive impacts, being this event a successful one. However, for that to happen, it is necessary to follow three stages during the planning and organization of the event: budgeting, performance, and evaluation. This procedure takes over a year to manage, concerning the Rally de Portugal, or only a few months, regarding the Porto Street Stage. Events influence the economy, environment, culture, society, and politics of a destination [1]. Therefore, as the Rally de Portugal is an event, such influence is also present. However, there are no studies associated with the perspective of stakeholders on the Rally de Portugal as a promotor for the tourism destination Porto, justifying therefore the relevance of the present study.

Outside the Hubei province, China, the mild form of infection and the progressive recover of the COVID-19 patients suggest the intervention of unconventional biological mechanisms worthy of attention. Based on the high-homology between the Spike protein epitopes of taxonomically-related coronaviruses, we hypothesized that past contact with infected dogs shield humans against the circulating SARS-CoV-2. Elseways, the recurrent virus exposure over a short time-lapse might result in the Antibody Dependent Enhancement, triggering the violent immune reaction responsible for the severe clinical outcomes observed in the Hubei province. Nevertheless, further experimental studies are desired for a confidential evaluation of the postulated hypotheses.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) can cause mild, moderate or severe disease (COVID-19). In severe disease, there is hyperinflammation causing severe symptoms. Severe COVID-19 is an immunological phenomenon, rather than a direct viral damage disease. Therapies for COVID-19 are all investigational therapies. In case of severe disease, treatment with a calcineurin inhibitor could be promising. In this article we explain the mechanisms of calcineurin inhibitor treatment for COVID-19, based on experiences seen in solid organ transplant recipients who suffered from COVID-19.

Children tend to get very mild symptoms of COVID19 and rarely get severely ill (1), and COVID19 has no specific influence on diabetes other than any other infection (2). However, Covid19 may delay diagnosis, and lock-down of society can lead to that patients with diabetes do not get ordinary care causing poor metabolic control with increasing risks for complications (3,4) and excess mortality (5).

BACKGROUND: Nurses are at the forefront of the COVID-19 pandemic. During the pandemic, nurses have faced an elevated risk of exposure and have experienced the hazards related to a novel virus. While being heralded as lifesaving heroes on the front lines of the pandemic, nurses have experienced more physical, mental, and psychosocial problems as a consequence of the COVID-19 outbreak. Social media discussions by nursing professionals participating in publicly formed Facebook groups constitute a valuable resource that offers longitudinal insights. OBJECTIVE: This study aimed to explore how COVID-19 impacted nurses through capturing public sentiments expressed by nurses on a social media discussion platform and how these sentiments changed over time. METHODS: We collected over 110,993 Facebook discussion posts and comments in an open COVID-19 group for nurses from March 2020 until the end of November 2020. Scraping of deidentified offline HTML tags on social media posts and comments was performed. Using subject-matter expert opinions and social media analytics (ie, topic modeling, information retrieval, and sentiment analysis), we performed a human-in-a-loop analysis of nursing professionals key perspectives to identify trends of the COVID-19 impact among at-risk nursing communities. We further investigated the key insights of the trends of the nursing professionals perspectives by detecting temporal changes of comments related to emotional effects, feelings of frustration, impacts of isolation, shortage of safety equipment, and frequency of safety equipment uses. Anonymous quotes were highlighted to add context to the data. RESULTS: We determined that COVID-19 impacted nurses physical, mental, and psychosocial health as expressed in the form of emotional distress, anger, anxiety, frustration, loneliness, and isolation. Major topics discussed by nurses were related to work during a pandemic, misinformation spread by the media, improper personal protective equipment (PPE), PPE side effects, the effects of testing positive for COVID-19, and lost days of work related to illness. CONCLUSIONS: Public Facebook nursing groups are venues for nurses to express their experiences, opinions, and concerns and can offer researchers an important insight into understanding the COVID-19 impact on health care workers.