Viral infections have gained great attention following the rapid emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic around the globe Even with the continuous research on developing vaccines and antiviral agents against various viral infections, no specific treatment or vaccine has been approved for many enteric or respiratory viral infections;in addition, the efficiency of currently available treatments is still limited One of the most reliable and recommended strategies to control viral infections is prevention Recently, intense studies are focusing on a promising approach for treating/preventing various viral infections using probiotics As per the World Health Organization (WHO), probiotics can be defined as live microorganisms which, when administered in adequate amount, confer a health benefit to the host The use of probiotics is a simple, cost-effective, and safe strategy to prevent viral infections, specifically;respiratory tract and intestinal ones, by different means such as stimulating the hosts immune response or modulating gut microbiota In this rapid review, we emphasize the protective effects of probiotics against viral infections and proposed mechanisms for protection that might offer a novel and cost-effective treatment against current and newly discovered viruses like SARS-CoV-2 ? 2020 Jehan Abdul-Sattar Salman, Nibras Nazar Mahmood, Ban Oday Abdulsattar, Hussein Adil Abid

Introduction: Biodistribution of nanocarriers with a structure consisting of core and shell is most often analyzed using methods based on labeling subsequent compartments of nanocarriers. This approach may have serious limitations due to the instability of such complex systems under in vivo conditions. Methods: The core-shell polyelectrolyte nanocarriers were intravenously administered to healthy BALB/c mice with breast cancer. Next, biodistribution profiles and elimination routes were determined post mortem based on fluorescence measurements performed for isolated blood, tissue homogenates, collected urine, and feces. Results: Despite the surface PEGylation with PLL-g-PEG, multilayer polyelectrolyte nanocarriers undergo rapid degradation after intravenous administration. This process releases the shell components but not free Rhodamine B. Elements of polyelectrolyte shells are removed by hepatobiliary and renal clearance. Conclusion: Multilayer polyelectrolyte nanocarriers are prone to rapid degradation after intravenous administration. Fluorophore localization determines the obtained results of biodistribution and elimination routes of core-shell nanomaterials. Therefore, precise and reliable analysis of in vivo stability and biodistribution of nanomaterials composed of several compartments requires nanomaterials labeled within each compartment.

Aerobic exercise training (ET) produces beneficial adaptations in skeletal muscles, including angiogenesis. The reninCangiotensin system (RAS) is highly involved in angiogenesis stimuli. However, the molecular mechanisms underlying capillary growth in skeletal muscle induced by aerobic ET are not completely understood. This study aimed to investigate the effects of volume-dependent aerobic ET on skeletal muscle angiogenesis involving the expression of miRNAs-27a and 27b on RAS and oxidantCantioxidant balance. Eight-week-old female Wistar rats were divided into three groups: sedentary control (SC), trained protocol 1 (P1), and trained protocol 2 (P2). P1 consisted of 60 min/day of swimming, 5/week, for 10 weeks. P2 consisted of the same protocol as P1 until the 8th week, but in the 9th week, rats trained 2/day, and in the 10th week, trained 3/day. Angiogenesis and molecular analyses were performed in soleus muscle samples. Furthermore, to establish ET-induced angiogenesis through RAS, animals were treated with an AT1 receptor blocker (losartan). Aerobic ET promoted higher VO(2) peak and exercise tolerance values. In contrast, miRNA-27a and -27b levels were reduced in both trained groups, compared with the SC group. This was in parallel with an increase in the ACE1/Ang II/VEGF axis, which led to a higher capillary-to-fiber ratio. Moreover, aerobic ET induced an antioxidant profile increasing skeletal muscle SOD2 and catalase gene expression, which was accompanied by high nitrite levels and reduced nitrotyrosine concentrations in the circulation. Additionally, losartan treatment partially re-established the miRNAs expression and the capillary-to-fiber ratio in the trained groups. In summary, aerobic ET promoted angiogenesis through the miRNA-27a/bCACE1/Ang II/VEGF axis and improved the redox balance. Losartan treatment demonstrates the participation of RAS in ET-induced vascular growth. miRNAs and RAS components are promising potential targets to modulate angiogenesis for combating vascular diseases, as well as potential biomarkers to monitor training interventions and physical performance.

The frequent emergence of diseases with the potential to become threats at local and global scales, such as influenza A(H1N1), SARS, MERS, and recently COVID-19 disease, makes it crucial to keep designing models of disease propagation and strategies to prevent or mitigate their effects in populations. Since isolated systems are exceptionally rare to find in any context, especially in human contact networks, here we examine the susceptible-infected-recovered model of disease spreading in a multiplex network formed by two distinct networks or layers, interconnected through a fraction $q$ of shared individuals (overlap). We model the interactions through weighted networks, because person-to-person interactions are diverse (or disordered);weights represent the contact times of the interactions. Using branching theory supported by simulations, we analyze a social distancing strategy that reduces the average contact time in both layers, where the intensity of the distancing is related to the topology of the layers. We find that the critical values of the distancing intensities, above which an epidemic can be prevented, increase with the overlap $q$. Also we study the effect of the social distancing on the mutual giant component of susceptible individuals, which is crucial to keep the functionality of the system. In addition, we find that for relatively small values of the overlap $q$, social distancing policies might not be needed at all to maintain the functionality of the system.

At the onset of the crisis caused by COVID-19, the Mexican education system chose to join the global context and suspend face-to-face classes for all educational levels. For the continuity of educational processes, a transition from a traditional educational model (face-to-face) to emergency remote teaching (ERT) was made through virtual learning platforms and learning management system (LMS) schemes. Universidad del Valle de Mexico (UVM), in a collaboration agreement with Microsoft Co., chose to use Teams to continue its educational process. In this work, we intend to identify the factors that can be taken into account regarding the level of student satisfaction in the teaching-learning process in ERT using Teams, and validate the established educational strategy. Statistical analysis was carried out to analyze the academic environment for these scenario changes while considering knowledge assessment, and competencies achievement. A combined sampling method was applied with convenience and statistical analysis. The main results established significant percentages, where more than 60% of the students surveyed were manifested in the use of the teams and the organization of the class sessions by the teachers, and the activities developed. Using the Cronbach's Alpha coefficient, the reliability of the data collection instruments was determined. The correlations of each of the survey questions were calculated to determine the relationship between themselves and the total answers, giving results similar to those obtained through data science tools. Taking advantage of the situation, data science tools were applied to compare the results with obtained values from RapidMiner software in the correlation of factors in of 0.440, 0.384, 0.246, 0.048 and 0.384.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) outbreak, multiple studies showed higher rates of severe infection in adults and specifically in male patients, which may be related to differences in androgen receptor (AR) expression. Androgenetic alopecia (AGA) is one of the AR expression manifestations. AIM: To explore AGA severity as a possible risk factor for COVID-19 severity in hospitalized patients. METHODS: A total of 164 subjects (116 men and 48 females) with confirmed COVID-19 in need of hospitalization were included in this study. An experienced dermatologist examined the correlation of clinical signs of COVID-19 severity with AGA types. For evaluation of the association between categorical variables and comparison of the mean age in three groups of COVID-19 patients, the Fisher's exact test and the analysis of variance were used. RESULTS: Our cross-sectional study included 116 male patients (70.7%) with a median age of 65.5 (age range: 22-97) years. Among them, 13.8% required intubation, 15.5% needed intensive care unit (ICU) care, and 70.7% required inward hospitalization. The Hamilton-Norwood Scale (HNS) was as follows: HNS I 14.7%, HNS II 12.1%, HNS III 20.7%, HNS IV 19.8%, HNS IV 29.8%, HNS V 17.2%, HNS VI 13.8%, and HNS VII 1.7%. Also, 29.3% of the patients were female, possessing a median age of 72 (age range: 23-98) years. In this group, 8.3% required intubation, 6.3% required ICU care, and 85.4% needed inpatient ward admission care. The Ludwig Scale (LS) was as follows: LS I 52.1%, LS II 35.4%, and LS III 12.5%. CONCLUSION: The severity of AGA type did not correlate with the severity of COVID-19 among hospitalized patients. Our results were in contrast with other research that suggested AGA severity as a marker of unfavorable outcomes of COVID-19.

In this article we will review the imaging features of COVID-19 across multiple modalities, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography/computed tomography (PET/CT), and ultrasonography (US). Given that COVID-19 primarily affects the lung parenchyma by causing pneumonia, our directive is to focus on thoracic findings associated with COVID-19. We aim to enhance radiologists understanding of this disease in order to help guide diagnosis and management.

According to a recent World Health Organization estimate, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which originated in China in 2019, has spread globally, infecting nearly 100 million people worldwide by January 2021. Patients with chronic liver diseases (CLD), particularly cirrhosis, hepatobiliary malignancies, candidates for liver transplantation, and immunosuppressed individuals after liver transplantation appear to be at increased risk of infections in general, which in turn translates into increased mortality. This is also the case for SARS-CoV-2 infection, where patients with cirrhosis, in particular, are at high risk of a severe COVID-19 course. Therefore, vaccination against various pathogens including SARS-CoV-2, administered as early as possible in patients with CLD, is an important protective measure. However, due to impaired immune responses in these patients, the immediate and long-term protective response through immunisation may be incomplete. The current SARS-CoV-2 pandemic has led to the exceptionally fast development of several vaccine candidates. A small number of these SARS-CoV-2 vaccine candidates have already undergone phase III, placebo-controlled, clinical trials in healthy individuals with proof of short-term safety, immunogenicity and efficacy. However, although regulatory agencies in the US and Europe have already approved some of these vaccines for clinical use, information on immunogenicity, duration of protection and long-term safety in patients with CLD, cirrhosis, hepatobiliary cancer and liver transplant recipients has yet to be generated. This review summarises the data on vaccine safety, immunogenicity, and efficacy in this patient population in general and discusses the implications of this knowledge on the introduction of the new SARS-CoV-2 vaccines.

Older people have been identified to be one of the most vulnerable population groups to the 2019 novel coronavirus (COVID-19). At the same time, more health workers in low-and middle-income countries (LMICs) including Ghana are contracting COVID-19. This poses healthcare utilization concerns for older adults. As a result, many older adults are changing their health-seeking behavior by staying at home and resorting to informal healthcare such as the use of traditional therapies and over-the-counter medicines for self-treatment or to boost their immune system. This commentary calls for social workers to collaborate with health authorities and community pharmacists to develop social and health programs to increase older adults' access to healthcare during the COVID-19 crisis. Policies are also required to deal with the pandemic and its impact on health systems in LMICs for both short and long term. We have suggested in this commentary how governments, health institutions, and local authorities in LMICs can address the healthcare concerns of older adults during this and any future pandemic.

BACKGROUND This study evaluated the association between early tumor response at 8 weeks, previously reported as a positive outcome prognosticator, and health-related quality of life (HRQOL) in advanced gastric cancer (AGC) patients enrolled in the ABSOLUTE trial. METHODS HRQOL was assessed using the EuroQol-5 Dimension (EQ-5D) utility index score in patients with complete response (CR) + partial response (PR) and progressive disease (PD) at 8 weeks, and time-to-deterioration (TtD) of the EQ-5D score, with the preset minimally important difference (MID) of 0.05, was compared between these populations. Among the enrolled patients, 143 and 160 patients were assessable in weekly solvent-based paclitaxel (Sb-PTX) arm and weekly nanoparticle albumin-bound paclitaxel (nab-PTX) arm, respectively. RESULTS Changes of the EQ-5D score from baseline to 8 weeks in the nab-PTX arm were 0.0009 and - 0.1229 in CR + PR and PD patients, respectively; the corresponding values for the Sb-PTX arm were - 0.0019 and - 0.1549. For both treatments, changes of the EQ-5D score from baseline at 8 weeks were significantly larger in patients with PD than in those with CR + PR. The median TtD was 3.9 and 2.2 months in patients with CR + PR and PD, respectively, for nab-PTX [hazard ratio (HR) = 0.595, 95% confidence interval (CI) 0.358-0.989]. For Sb-PTX, the corresponding values were 4.7 and 2.0 months (HR = 0.494, 95% CI 0.291-0.841). CONCLUSIONS Early tumor shrinkage was associated with maintained HRQOL in AGC patients on the second-line chemotherapy with taxanes.

BACKGROUND: COVID\19 virus causes coronavirus disease. AIMS: It is a highly contagious viral infection. PATIENTS/METHODS/RESULTS/CONCLUSION: In this article, we will discuss the potential phototherapy problems and also alternative options for dermatologists, ultraviolet treatment against COVID\19 virus, and vitamin DCassociated problems in these coronavirus days.

Machine learning techniques, also known as artificial intelligence (AI), is about to dramatically change workflow and diagnostic capabilities in diagnostic radiology. The interest in AI in Interventional Radiology is rapidly gathering pace. With this early interest in AI in procedural medicine, IR could lead the way to AI research and clinical applications for all interventional medical fields. This review will address an overview of machine learning, radiomics and AI in the field of interventional radiology, enumerating the possible applications of such techniques, while also describing techniques to overcome the challenge of limited data when applying these techniques in interventional radiology. Lastly, this review will address common errors in research in this field and suggest pathways for those interested in learning and becoming involved about AI.

The concept of frailty as it pertains to aging, health and well-being is poorly understood by older adults and the public-at-large. We developed an aging and frailty education tool designed to improve layperson understanding of frailty and promote behavior change to prevent and/or delay frailty. We subsequently tested the education tool among adults who attended education sessions at 16 community sites. Specific aims were to: 1) determine acceptability (likeability, understandability) of content, and 2) assess the likelihood of behavior change after exposure to education tool content. Results: Over 90% of participants "liked" or "loved" the content and found it understandable. Eighty-five percent of participants indicated that the content triggered a desire to "probably" or "definitely" change behavior. The desire to change was particularly motivated by information about aging, frailty and energy production. Eight focus areas for proactive planning were rated as important or extremely important by over 90% of participants.

As a global city, Hong Kong directly connects more than 120 cities worldwide and transfers nearly 20 million passengers each year The current COVID-19 pandemic has put the major transport hub in Asia under severe threat of potential imported cases This Featured Graphic visualizes inbound confirmed COVID-19 cases to Hong Kong globally from January to June 2020, which could greatly help to assess risks from imported cases and improve air transport control policy for mitigating the global spread of COVID-19

Coronavirus disease 2019 (COVID-19) is a global pandemic that is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus-2. Data from several countries have shown higher morbidity and mortality among individuals with chronic metabolic diseases, such as diabetes mellitus. In this review, we explore the contributing factors for poorer prognosis in these individuals. As a significant proportion of patients with COVID-19 also have diabetes mellitus, this adds another layer of complexity to their management. We explore potential interactions between antidiabetic medications and renin-angiotensin-aldosterone system inhibitors with COVID-19. Suggested recommendations for the use of antidiabetic medications for COVID-19 patients with diabetes mellitus are provided. We also review pertinent clinical considerations in the management of diabetic ketoacidosis in COVID-19 patients. In addition, we aim to increase clinicians' awareness of the metabolic effects of promising drug therapies for COVID-19. Finally, we highlight the importance of timely vaccinations for patients with diabetes mellitus.

OBJECTIVE: To reduce pathogen exposure, conserve personal protective equipment, and facilitate health care personnel work participation in the setting of the COVID-19 pandemic, three affiliated institutions rapidly and independently deployed inpatient telemedicine programs during March 2020. We describe key features and early learnings of these programs in the hospital setting. METHODS: Relevant clinical and operational leadership from an academic medical center, pediatric teaching hospital, and safety net county health system met to share learnings shortly after deploying inpatient telemedicine. A summative analysis of their learnings was re-circulated for approval. RESULTS: All three institutions faced pressure to urgently standup new telemedicine systems while still maintaining secure information exchange. Differences across patient demographics and technological capabilities led to variation in solution design, though key technical considerations were similar. Rapid deployment in each system relied on readily available consumer-grade technology, given the existing familiarity to patients and clinicians and minimal infrastructure investment. Preliminary data from the academic medical center over one month suggested positive adoption with 631 inpatient video calls lasting an average (standard deviation) of 16.5 minutes (19.6) based on inclusion criteria. DISCUSSION: The threat of an imminent surge of COVID-19 patients drove three institutions to rapidly develop inpatient telemedicine solutions. Concurrently, federal and state regulators temporarily relaxed restrictions that would have previously limited these efforts. Strategic direction from executive leadership, leveraging off-the-shelf hardware, vendor engagement, and clinical workflow integration facilitated rapid deployment. CONCLUSION: The rapid deployment of inpatient telemedicine is feasible across diverse settings as a response to the COVID-19 pandemic.

Background: While some risk factors for severe COVID-19 outcomes have been identified for the general population and patients with rheumatic diseases (1-3), what drives these outcomes in specific rheumatic disease remains unclear. In addition, these findings need to be assessed across various observational data sources to ensure external validity. Objectives: To describe the demographics, comorbidities, and severe COVID-19 outcomes among rheumatoid arthritis (RA) patients infected with SARS-CoV-2 in the United States. Methods: A large nationwide electronic health record database (Optum, Inc.) in the United States, with data range between February 1, 2020 and September 17, 2020, was used to describe the demographics, comorbidities, and severe COVID-19 outcomes of RA patients with confirmed COVID-19 diagnosis (diagnosis for COVID-19 or positive PCR or antigen test). Patients with a single diagnosis of RA (ICD-10 code) before the diagnosis of COVID-19 were included. Patients missing age or sex, under 18 years of age on COVID-19 diagnosis date, or having less than 15 months of activity prior to COVID-19 diagnosis in the data source were excluded. We described demographics, comorbidities, and severe COVID-19 outcomes, including death, hospitalization, ICU admission, and acute respiratory insufficiency (ARI) identified between 14 days prior to and 30 days after COVID-19 diagnosis. Mean and standard deviation (SD) was reported for continuous variables. For categorical variables, count (N) and proportion was reported. Results: We identified 2,948 patients diagnosed with RA and infected with SARS-CoV-2 (mean age SD: 62 years 16, 77% female, 68% white). Of all identified patients, 38% were current or former smokers. For the 2,614 patients with BMI recorded, 78% were overweight or obese (mean BMISD: 31.28.3). The mean Charlson comorbidity index (CCI) was 3.6 (SD 3.2), with 87% of the study cohort having one or more comorbid condition, including hypertension (55%), type 2 diabetes (26%), COPD (20%), moderate to severe asthma (17%), coronary artery disease (17%), chronic kidney disease (13%), and heart failure (13%). Severe COVID-19 outcomes occurred in 618 (21%) patients. Among all RA patients with COVID-19, 137 patients (4.6%) experienced ARI, 484 patients (16.4%) were hospitalized (including 174 (5.9%) admitted to the ICU), and 155 patients (5.3%) died. Conclusion: Underlying medical conditions that are known or possible risk factors of severe illness from SARS-CoV-2 infection in the general population are common in this RA cohort from a large national EHR database. However, whether patients with RA are more vulnerable to severe COVID-19 outcome than the general population requires adjustment by age and other important confounders.

BACKGROUND: Respiratory tract infections are often viral and but are frequently treated with antibiotics, providing a significant opportunity for antibiotic de-escalation in patients. We sought to determine whether an automated electronic medical record best practice alert (BPA) based on procalcitonin and respiratory polymerase chain reaction (PCR) results could help reduce inappropriate antibiotic use in patients with likely viral respiratory illness. METHODS: This multisite, preCpost, quasi-experimental study included patients 18 years and older with a procalcitonin level <0.25 ng/mL and a virus identified on respiratory PCR within 48 hours of each other, and 1 or more systemic antibiotics ordered. In the study group, a BPA alerted providers of the diagnostic results suggesting viral infection and prompted them to reassess the need for antibiotics. The primary outcome measured was total antibiotic-days of therapy. RESULTS: The BPA reduced inpatient antibiotic-days of therapy by a mean of 2.2 days compared with patients who met criteria but did not have the alert fire (8.0 vs 5.8 days, respectively, P < .001). The BPA also reduced the percentage of patients prescribed antibiotics on discharge (20% vs 47.8%, P < .001), whereas there was no difference in need for antibiotic escalation after initial discontinuation (7.6% vs 4.3%, P = .198). CONCLUSIONS: The automated antimicrobial stewardship BPA effectively reduced antibiotic use and discharge prescribing rates when diagnostics suggested viral respiratory tract infection, without a higher rate for reinitiation of antibiotics after discontinuation.

The responses of nursing homes to the present pandemic and lock-down reveal and amplify the usual defensive mechanisms deployed by professional caregivers against depression. The danger of death and the need to confine the residents, both coming from the outside world, and the permanent management of physical protective measures do not remove the feeling of uselessness and the anxiety of death that the nursing staff habitually tolerates or avoids. On the contrary, these aspects add to caregivers need to talk and be listened to.

Abstract The COVID-19 pandemic has had severe consequences for the older section of the population In this project, we studied how COVID-19 measures have impacted a group of older persons as users of municipal health and care services in Norway We were specifically concerned with how communication works, in terms of the communication channels used, and what this means for the older We also analyzed the users' experiences during the period of COVID-19 restrictions in terms of quality of life In addition, we looked at the municipal service providers' understanding of the situation of the older The data collection was performed mainly in July 2020 when Norway had relatively strict COVID-19 restrictions in relation to health and care services for older residents Our results indicate that COVID-19 restrictions both impaired the quality of life and security and aggravated loneliness Regarding the older and communication, it was crucial to identify channels of communication with which the older are most comfortable The results of this study clearly show that (a) the older had a definite preference for face-to-face personal communication;(b) although the older were familiar with the audio phone call and used it as a substitute for home visits, it reduced their security and quality of life;and (c) video-based media such as smartphones, tablets, and PC were not desirable alternatives to regular voice-based phones