Acute respiratory distress syndrome is a refractory respiratory syndrome with a high prevalence in the Intensive Care Unit. Though much improvement has been achieved over the last 50 decades, the disease continues to be under-recognized and under-treated, and its mortality remains high. Since the first report, the radiologic examination has been an essential part in evaluating this disease. Chest X-ray radiography and computed tomography are conventional imaging techniques in routine clinical practice. Other image modalities, including lung ultrasound, electrical impedance tomography, positron emission tomography, have demonstrated their respective advantages over recent years but have not yet been broadly applied in clinical practice. Among these modalities, computed tomography and its quantitative analysis have shown an irreplaceable power in diagnosis, intervention evaluation and prognostic prediction. In this review, we briefly introduced the basics of acute respiratory distress syndrome and summarized imaging advances. In addition, we focused on the computed tomography modality and highlighted the value of its quantitative assessment.

On December 14 2020, a variant of SARS-CoV-2 characterized as VOC-202012/01 (lineage B.1.1.7) emerged in the United Kingdom [1] with rapid expansion to over 64 countries as of January 27, 2021. This article is protected by copyright. All rights reserved.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has increased concern regarding SARS-CoV-2 infection in inflammatory bowel disease (IBD) patients, especially those on immunosuppressive therapies or with active disease. There are limited reports describing the clinical features of COVID-19 in an IBD population, and the impact of immunosuppression on the severity of the infection remains unclear. Case Report: A 33-year-old female patient with a long history of ulcerative colitis, poorly controlled, was admitted with COVID-19 a few days after being discharged from the hospital for treatment of acute severe ulcerative colitis. High-risk factors for COVID-19 complications, i.e., high-dose steroids (40 mg prednisone) and severe active disease, were present at admission. Despite the development of extensive pulmonary involvement, the patient had a favorable outcome. Discussion: Management of IBD patients during the COVID-19 pandemic has been challenging. Measures to minimize the potential risk of SARS-CoV-2 infection, including strict social distancing and self-isolation, in the IBD population have been recommended, especially for high-risk patients. Although steroid tapering and persistence of biologics are advised by professional groups, the best treatment strategy for IBD patients presenting a flare during the outbreak has yet to be defined.

Introduction Les manifestations cutanes lies au SARS-coV-2 sont ce jour peu connues et souvent sans gravit. Nous rapportons ici le premier cas de syndrome Stevens-Johnson (SJS) associ une infection SARS-coV-2. Observations Une enfant de 7 ans tait traite par paractamol et oxommazine pour une rhinite allergique. J5, une hyperthermie tait observe, suivie dun rythme des joues. Devant une gnralisation de lruption, la patiente tait prise en charge aux urgences o lexamen clinique mettait en vidence un exanthme bulleux, avec des rosions cutanes touchant majoritairement le tronc, les membres suprieurs et le visage avec signe de Nikolski positif. Des rosions des muqueuses orales, gnitales et une conjonctivite taient observes. Le tableau se compliquait dune dtresse respiratoire la suite dune laryngoscopie, 48h aprs son hospitalisation. La patiente tait alors intube pendant 7jours. En ranimation, la survenue dune kratoconjonctivite rosive fausse membrane et de symblpharons temporaux ncessitait la ralisation dune double greffe de membrane amniotique et la pose danneaux de symplpharon. son paroxysme, lruption touchait 60 % du tgument avec 10 % de surface dcolle. Les hypothses diagnostiques taient celles dun SJS mdicamenteux ou infectieux. Le SJS tait confirm par lhistologie cutane qui trouvait des bulles sous pidermiques avec ncroses kratinocytaires. Dans un contexte de pandmie, chez une patiente avec sympt?mes respiratoires et pyrexie, la PCR SARS-Cov-2 tait ralise et positive. Un scanner objectivait une atteinte pulmonaire compatible avec une infection SARS-Cov-2. Les rsultats srologiques et PCR la recherche de mycoplasma pneumoniae et dautres causes infectieuses taient ngatifs. Lhypothse mdicamenteuse tait improbable au vu du score chronologique, le diagnostic de SJS secondaire une infection SARS-Cov-2 tait retenu. Lvolution cutane tait rapidement favorable. Un symblpharon et une photophobie squellaire persistaient. Discussion Dans les cas pdiatriques de SJS, une origine infectieuse est trouve dans un tiers des cas. Linfection SARS-Cov-2 symptomatique est rare en pdiatrie. Chez lenfant, les manifestations cutanes rapportes sont des engelures, des rythmes polymorphes, des ruptions urticariennes et papulo-vsiculeuses ou encore des exanthmes maculo-papuleux. Des syndromes de Kawasaki atypique en lien avec une infection SARS-Cov-2 ont galement t dcrits. ce jour, aucune ruption cutane grave comme celle prsente par notre patiente na t dcrite. Les manifestations cutanes de la COVID-19 sont le plus souvent bgnines et sans incidence pronostic ou fonctionnelle. Cependant, ce SJS en lien avec une infection SARS-Cov-2 montre limportance de la prise en charge par un dermatologue pour reprer les ventuels signes de gravit et prvenir les squelles.

An 81-year-old female with a past medical history of myasthenia gravis presented to the Emergency Department with difficulty breathing. At presentation, the patient also complained of fatigue, diplopia, and ptosis. Vitals and laboratory tests were largely benign. The patient was diagnosed as having a myasthenia gravis exacerbation, which eventually advanced to myasthenic crisis, with the patient requiring admission to the intensive care unit and supplementation of high-flow oxygen. Throughout the course of the patients hospitalization, the measurements of her negative inspiratory force and vital capacity were found to be normal and unchanged despite shifting and unsteady respiratory symptoms. This uncommon case seeks to highlight the importance of complementing clinical context with the markers of respiratory function to assess the status of myasthenia-related respiratory distress.

Financial markets reacted with a vengeance to the COVID-19 pandemic We argue that while the spread of the pandemic is statistically significant in explaining changes to bond spreads, it has little additional explanatory power over variables that capture financial stress Financial markets reacted as in any international financial crisis by penalizing emerging economies exposing existing vulnerabilities This finding highlights the need for credible, but flexible, sovereign currencies and the need to build up liquidity reserves ? 2020 Walter de Gruyter GmbH, Berlin/Boston 2020

The current coronavirus (COVID-19) pandemic is a particular and rare situation. COVID-19 has affected and is likely to affect people from many countries, in many geographical locations. We are in the midst of a worldwide pandemic, with cities and even entire countries shutting down. The coronavirus has affected nearly every aspect of our lives, from school to work, to sports, to where we eat and what we do. All these changes affected people physically, but also psychologically. It is understandable that during times like this, people may be feeling afraid, worried, anxious, and depressed due to the constantly changing alerts and media coverage regarding the spread of the virus. Hence, the main aim of our paper is to explore the linkage between the coronavirus COVID-19 disease and mental health conditions, such as stress, anxiety and depression. Everyone may experience fear of the consequences of the infection with a potentially fatal new virus, and might experience mental stress, anxiety, loneliness, depression. Based on experience from past global serious viral experiences, the development and implementation of mental health assessment, support, treatment, and services are crucial and pressing goals for the health response to the COVID-19 outbreak. Human beings have an incredible ability to adapt and survive, through altruistic and co-operative means. So for each one of us is important to look after ourselves and each other.

The novel COVID-19 came under limelight few months back (December 2019) and has recently been declared a pandemic by WHO. It has resulted in serious financial implications being faced by dental practices, hospitals and healthcare workers. Dental practice currently is restricted to provision of emergency dental care whereas, many hospitals have also cancelled elective procedures to save finances for COVID-19 treatment which is expensive and unpredictable. In addition, healthcare workers are also facing financial challenges in this difficult time. Competent authorities should step in to help dental practices, hospitals and healthcare workers in order to ensure the provision of all types of healthcare efficiently in these testing times and beyond.

From 29 November to 1 December 2021, an emerging animal infectious disease conference (EAIDC) was held at the Pennsylvania State University. This conference brought together distinguished thought leaders in animal health, veterinary diagnostics, epidemiology and disease surveillance, and agricultural economics. The conferences primary objective was to review the lessons learned from past experiences in dealing with high-consequence animal infectious diseases to inform an action plan to prepare for future epizootics and panzootics. Invited speakers and panel members comprised world-leading experts in animal infectious diseases from federal state agencies, academia, professional societies, and the private sector. The conference concluded that the biosecurity of livestock operations is critical for minimizing the devastating impact of emerging animal infectious diseases. The panel also highlighted the need to develop and benchmark cutting-edge diagnostics for rapidly detecting pathogens in clinical samples and the environment. Developing next-generation pathogen agnostic diagnostics will help detect variants of known pathogens and unknown novel pathogens. The conference also highlighted the importance of the One Health approach in dealing with emerging animal and human infectious diseases. The recommendations of the conference may be used to inform policy discussions focused on developing strategies for monitoring and preventing emerging infectious disease threats to the livestock industry.

AIM: The aim of this study was to investigate the ABO and Rh blood group distribution and clinical characteristics in patients with Covid-19. MATERIALS AND METHODS: The clinical characteristics and blood groups of 1667 patients who were hospitalized due to Covid-19 (with a positive PCR test) between 16 March and 10 July were reviewed cross-sectionally.. RESULTS: When blood groups of patients diagnosed with Covid-19 and control group were compared, it was observed that there was increase in the number of Covid-19 patients with blood groups A and AB, decrease in the number of Covid-19 patients with blood group O, a statistically significant increase in the number of individuals with blood group A in Covid-19 patients compared to healthy individuals, and almost significant increase in the number of Covid-19 patients with blood group AB and a very significant decrease in the number of Covid-19 patients with blood group O. CONCLUSION: Our study has found that having blood group O may be protective, that blood group A may have greater susceptibility to the disease, but this does not affect the course of the disease and is not associated with mortality.

Nursing homes faced serious challenges with large COVID-19 resident infection rates and deaths during the pandemic. This descriptive case study examined the structure, operations, strategies, care outcomes, and owners of The Ensign Group Inc. the second largest U.S. for-profit chain, between 2007 and 2021. Ensign, as a holding company, has a complex organizational structure that uses more than 430 corporate entities to manage its 228 nursing homes and senior living facilities. With mostly Medicare and Medicaid revenues and favorable government COVID-19 relief, Ensign grew rapidly, even during the pandemic, to $2.5 billion (all amounts in U.S. Dollars) in revenues with a market capitalization of $4.5 billion and strong profits and financial metrics in 2020 to 2021. The company used real estate purchasing, debt financing, and spin-off companies, and tax arbitrage to optimize shareholder value. Before and during the pandemic, its 198 nursing homes had low registered nurse and total nurse staffing levels and regulatory violations with below-average ratings, and they had high COVID-19 infection rates during the pandemic. Ensign's small board, executives, and institutional investors protected and enhanced shareholder interests rather than ensuring that its nursing homes met professional standards and regulatory requirements.

We demonstrate a Bayesian method for the "real-time" characterization and forecasting of partially observed COVID-19 epidemic. Characterization is the estimation of infection spread parameters using daily counts of symptomatic patients. The method is designed to help guide medical resource allocation in the early epoch of the outbreak. The estimation problem is posed as one of Bayesian inference and solved using a Markov chain Monte Carlo technique. The data used in this study was sourced before the arrival of the second wave of infection in July 2020. The proposed modeling approach, when applied at the country level, generally provides accurate forecasts at the regional, state and country level. The epidemiological model detected the flattening of the curve in California, after public health measures were instituted. The method also detected different disease dynamics when applied to specific regions of New Mexico.

For every disease, there is a certain set of genes whose mutations increase the risk of illness development. DNA sequencing of sick and healthy individuals results in the determination of genes related to certain diseases. Efficient procedures are described in order to determine point mutations in gene sequences of the examined patients. The optimal Bayesian procedure is used to determine risk groups for certain diseases, including the ones that underlie COVID-19.

BACKGROUND: Sterile Service Department decontamination procedures for surgical instruments struggle to demonstrate efficient removal of the hardiest infectious contaminants, such as prion proteins. A recently designed novel system, which utilises a low pressure ultrasonic activated, cold water stream, has previously demonstrated efficient hard surface cleaning of several biological contaminants. AIM: To test the efficacy of an ultrasonically activated stream for the removal of tissue proteins, including prion-associated amyloid, from surgical stainless steel (SS) surfaces. METHODS: Test surfaces were contaminated with 22L, ME7 or 263K prion infected brain homogenates. The surfaces were treated with the ultrasonically activated water stream for contact times of 5 and 10 seconds. Residual proteinaceous and amyloid contamination were quantified using sensitive microscopic analysis, and immunoblotting was used to characterize the eluted prion residues before and after treatment with the ultrasonically activated stream. FINDINGS: Efficient removal of the different prion strains from the surgical SS surfaces was observed, and reduced levels of protease sensitive and resistant prion protein was detected in recovered supernatant. CONCLUSIONS: This study demonstrated that an ultrasonically activated stream has the potential to be a cost-effective solution to improve current decontamination practices and has the potential to reduce hospital acquired infections.

The COVID-19 epidemic has been a major global public health problem during past months in Italy and in several other Countries and on the date of publication of this article, is still a serious public health problem. The health staff, engaged in the care of the sick and in the prevention of the spread of the infection have been subjected to a further increase in psychological difficulties and work-related stress, related to the workload for the continuous influx of sick and intense and close working shifts for the viral emergency. The SAVE-9 (Stress and Anxiety to Viral Epidemics - 9 items) scale has been developed as a tool for assessing work anxiety and stress in response to the viral epidemic of health professionals working to prevent the spread of the virus and to treat infected people.

The COVID-19 pandemic caused by nonstop infections of SARS-CoV-2 has continued to ravage many countries worldwide. Here we report that suramin, a 100-year-old drug, is a potent inhibitor of the SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) and acts by blocking the binding of RNA to the enzyme. In biochemical assays, suramin and its derivatives are at least 20-fold more potent than remdesivir, the currently approved nucleotide drug for treatment of COVID-19. The 2.6 ? cryo-electron microscopy structure of the viral RdRp bound to suramin reveals two binding sites. One site directly blocks the binding of the RNA template strand and the other site clashes with the RNA primer strand near the RdRp catalytic site, thus inhibiting RdRp activity. Suramin blocks viral replication in Vero E6 cells, although the reasons underlying this effect are likely various. Our results provide a structural mechanism for a nonnucleotide inhibitor of the SARS-CoV-2 RdRp.

Aim: COVID-19 is a pandemic that causes high morbidity and mortality, especially in severe patients. In this study, we aimed to search and explain the relationship between biochemical markers, which are more common, easily available and applicable to diagnose and to stage the disease. Materials & methods: In this study, 609 patients were evaluated retrospectively. 11 biochemical parameters were included in analysis to explain the relationship with severity of disease. Results: Nearly, all the parameters that have been evaluated in this study were statistically valuable as a predictive parameter for severe disease. Areas under the curve of blood urea nitrogen (BUN)/albumin ratio (BAR), CALL score and lymphocyte/C-reactive protein ratio were 0.795, 0.778 and 0.770. The BUN/BAR and neutrophil/albumin ratios provide important prognostic information for decision-making in severe patients with COVID-19. Conclusion: High BUN/BAR and neutrophil/albumin ratios may be a better predictor of severity COVID-19 than other routinely used parameters in admission.

OBJECTIVE: The coronavirus disease 2019 (COVID\19) outbroke in Wuhan, Hubei Province, China, affecting more than 200 countries and regions. This study aimed to predict the development of the epidemic with specific interventional policies applied in China and evaluate their effectiveness. METHODS: COVID\19 data of Hubei Province and the next five most affected provinces were collected from daily case reports of COVID\19 on the Health Committee official website of these provinces. The number of current cases, defined as the number of confirmed cases minus the number of cured cases and those who have died, was examined in this study. A modified Susceptible\Exposed\Infectious\ Removed (SEIR) model was used to assess the effects of interventional policies on the epidemic. In this study, January 28 was day zero of the model. RESULTS: The results of the modified SEIR model showed that the number of current cases in Hubei and Zhejiang provinces tended to be stabilized after 70 days and after 60 days in the four other provinces. The predicted number of current cases without policy intervention was shown to far exceed that with policy intervention. The estimated number of COVID\19 cases in Hubei Province with policy intervention was predicted to peak at 51,222, whereas that without policy intervention was predicted to reach 157,721. CONCLUSION: Based on the results of the model, strong interventional policies were found to be vital components of epidemic control. Applying such policies is likely to shorten the duration of the epidemic and reduce the number of new cases. This article is protected by copyright. All rights reserved.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged into a world of maturing pathogen genomics, with more than 2 million genomes sequenced at the time of writing. The rise of more transmissible variants of concern that impact vaccine and therapeutic effectiveness has led to widespread interest in SARS-CoV-2 evolution. Clinicians are also eager to take advantage of the information provided by SARS-CoV-2 genotyping beyond surveillance purposes. Here, we review the potential role of SARS-CoV-2 genotyping in clinical care. The review covers clinical use cases for SARS-CoV-2 genotyping, methods of SARS-CoV-2 genotyping, assay validation and regulatory requirements, and clinical reporting for laboratories, as well as emerging issues in clinical SARS-CoV-2 sequencing. While clinical uses of SARS-CoV-2 genotyping are currently limited, rapid technological change along with a growing ability to interpret variants in real time foretells a growing role for SARS-CoV-2 genotyping in clinical care as continuing data emerge on vaccine and therapeutic efficacy.

BACKGROUND Unrecognized periprosthetic joint infections are a concern in revision surgery for aseptic failure (AF) after total hip (THA) or knee (TKA) arthroplasties. A gold diagnostic standard does not exist. The aim of the current study was to determine the prevalence of unrecognized periprosthetic joint infection (PJI) in a cohort of revision for AF, using an experimental diagnostic algorithm. METHODS The surgeons' suspicion of AF was based primarily on patient history and clinical evaluation. X-ray imaging was used to reveal mechanical problems. To rule out an infectious aetiology standard blood biochemical tests were ordered in most patients. Evaluation followed the existing practice in the institute. Cases were included if revision surgery was planned for suspected AF. Intraoperatively, five synovial tissue biopsies were obtained routinely. PJI was defined as 3 positive cultures with the same microorganism(s). Patients were followed for 1 year postoperatively. Protocol samples included joint fluid, additional synovial tissue biopsies, bone biopsy, swabs from the implant surface, and sonication of retrieved components. Routine and protocol samples were cultured with extended incubation (14 days) and preserved for batchwise 16S rRNA gene amplification. Patients were stratified based on culture results and a clinical status was obtained at study end. RESULTS A total of 72 revisions were performed on 71 patients (35 THA and 37 TKA). We found five of 72 cases of unrecognized PJI. Extended culture and protocol samples accounted for two of these. One patient diagnosed with AF was treated for a PJI during follow-up. The remaining patients did not change status from AF during follow-up. CONCLUSIONS We found a low prevalence of unrecognized periprosthetic joint infections in patients with an AF diagnosis. The algorithm strengthens the surgeons' preoperative diagnosis of a non-infective condition. Evaluation for a failing TKA or THA is complex. Distinguishing between AF and PJI pre-operatively was a clinical decision. Our data did not support additional testing in routine revision surgery for AF.