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by Ahmed Alsoufi, Ali Alsuyihili, Ahmed Msherghi, Ahmed Elhadi, Hana Atiyah, Aimen Ashini, Arwa Ashwieb, Mohamed Ghula, Hayat Ben Hasan, Salsabil Abudabuos, Hind Alameen, Taqwa Abokhdhir, Mohamed Anaiba, Taha Nagib, Anshirah Shuwayyah, Rema Benothman, Ghalea Arrefae, Abdulwajid Alkhwayildi, Abdulmueti Alhadi, Ahmed Zaid, Muhammed Elhadi The Coronavirus Disease 2019 (COVID-19) pandemic has caused an unprecedented disruption in medical education and healthcare systems worldwide. The disease can cause life-threatening conditions and it presents challenges for medical education, as instructors must deliver lectures safely, while ensuring the integrity and continuity of the medical education process. It is therefore important to assess the usability of online learning methods, and to determine their feasibility and adequacy for medical students. We aimed to provide an overview of the situation experienced by medical students during the COVID-19 pandemic, and to determine the knowledge, attitudes, and practices of medical students regarding electronic medical education. A cross-sectional survey was conducted with medical students from more than 13 medical schools in Libya. A paper-based and online survey was conducted using email and social media. The survey requested demographic and socioeconomic information, as well as information related to medical online learning and electronic devices; medical education status during the COVID-19 pandemic; mental health assessments; and e-learning knowledge, attitudes, and practices. A total of 3,348 valid questionnaires were retrieved. Most respondents (64.7%) disagreed that e-learning could be implemented easily in Libya. While 54.1% of the respondents agreed that interactive discussion is achievable by means of e-learning. However, only 21.1% agreed that e-learning could be used for clinical aspects, as compared with 54.8% who disagreed with this statement and 24% who were neutral. Only 27.7% of the respondents had participated in online medical educational programs during the COVID-19 pandemic, while 65% reported using the internet for participating in study groups and discussions. There is no vaccine for COVID-19 yet. As such, the pandemic will undeniably continue to disrupt medical education and training. As we face the prospect of a second wave of virus transmission, we must take certain measures and make changes to minimize the effects of the COVID-19 outbreak on medical education and on the progression of training. The time for change is now, and there should be support and enthusiasm for providing valid solutions to reduce this disruption, such as online training and virtual clinical experience. These measures could then be followed by hands-on experience that is provided in a safe environment.

by Nada Buranarom, Orapin Komin, Oranart Matangkasombut Hyposalivation is an important problem in elders and could interfere with several oral functions and microbial ecology. While the number of independent elders who retain more natural teeth increases worldwide, few studies examined hyposalivation in this population. Thus, this study aims to examine relationships between hyposalivation, oral health conditions and oral Candida colonization in independent dentate elders and evaluate factors associated with salivary flow and Candida carriage. We conducted a cross-sectional study in fifty-three dentate elders (≥65 years old with at least 4 pairs of posterior occlusal contacts) with no, or well-controlled, systemic conditions. Participants were interviewed for medical history, subjective dry mouth symptoms, oral hygiene practices and denture information. Unstimulated and stimulated salivary flow rates, objective dry mouth signs, gingival, tongue-coating, and root-caries indices were recorded. Stimulated saliva was cultured on Sabouraud-dextrose agar for Candida counts. Candida species were identified using chromogenic Candida agar and polymerase chain reaction. Statistical significance level was set at p

by Fatoumata Korika Tounkara, Ibrahima Téguété, Fernand A. Guédou, Ella Goma-Matsétsé, Amadou Koné, Luc Béhanzin, Sidy Traoré, Marlène Aza-Gnandji, Bintou Keita, Julie Guenoun, François Coutlée, Michel Alary Objectives This study aimed to: (1) Estimate HPV prevalence and genotype distribution among female sex workers (FSWs) in Mali and Benin as well as the prevalence of multiple HPV type infections in this group, and (2) Identify potential risk factors associated with high-risk (HR) HPV infections. Methods We analyzed baseline data of 665 FSWs aged ≥ 18 years recruited during a prospective cohort of cervical cancer screening in Cotonou (Benin) and Bamako (Mali) from 2017 to 2018. The Linear Array HPV genotyping test was used to identify HPV genotypes. Descriptive statistics and multivariate log-binomial regression were used. Adjusted prevalence ratios (APR) with 95% confidence intervals (95%CI) were estimated to identify risk factors associated with HR-HPV infections. Results HPV data were available for 659 FSWs (Benin: 309; Mali: 350). The mean age was 35.0 years (± 10.7) in Benin and 26.8 years (± 7.6) in Mali. The overall HPV prevalence rates were 95.5% in Benin and 81.4% in Mali. About 87.7% and 63.4% of FSWs harbored ≥ 2 HPV types in Benin and Mali, respectively. The top three prevalent HR-HPV among FSWs in Benin were: HPV58 (37.5%), HPV16 (36.6%) and HPV52 (28.8%). Corresponding patterns in Mali were HPV16 (15.7%), HPV51 (14.3%) and HPV52 (12.9%). In Benin, the main factors associated with HR-HPV were vaginal douching (APR = 1.17; 95%CI:1.02–1.34) and gonococcal infection (APR = 1.16; 95%CI:1.04–1.28), while in Mali they were sex work duration ≤ 1 year (APR = 1.35; 95%CI:1.10–1.65) and HIV infection (APR = 1.26; 95%CI: 1.06–1.51). Conclusion Our study found a very high prevalence of HPV infection as well as high frequency of multiple HPV type infections in FSWs in two countries in West Africa. These findings suggest the necessity to emphasize cervical cancer prevention in this high-risk group.…

by Jeffrey B. Webb, Aaron Bray, Philip K. Asare, Rachel B. Clipp, Yatin B. Mehta, Sudheer Penupolu, Aalpen A. Patel, S. Mark Poler Background The COVID-19 pandemic is stretching medical resources internationally, sometimes creating ventilator shortages that complicate clinical and ethical situations. The possibility of needing to ventilate multiple patients with a single ventilator raises patient health and safety concerns in addition to clinical conditions needing treatment. Wherever ventilators are employed, additional tubing and splitting adaptors may be available. Adjustable flow-compensating resistance for differences in lung compliance on individual limbs may not be readily implementable. By exploring a number and range of possible contributing factors using computational simulation without risk of patient harm, this paper attempts to define useful bounds for ventilation parameters when compensatory resistance in limbs of a shared breathing circuit is not possible. This desperate approach to shared ventilation support would be a last resort when alternatives have been exhausted. Methods A whole-body computational physiology model (using lumped parameters) was used to simulate each patient being ventilated. The primary model of a single patient with a dedicated ventilator was augmented to model two patients sharing a single ventilator. In addition to lung mechanics or estimation of CO2 and pH expected for set ventilation parameters (considerations of lung physiology alone), full physiological simulation provides estimates of additional values for oxyhemoglobin saturation, arterial oxygen tension, and other patient parameters. A range of ventilator settings and patient characteristics were simulated for paired patients. Findings To be useful for clinicians, attention has been directed to clinically available parameters. These simulations show patient outcome during multi-patient ventilation is most closely correlated to lung compliance, oxygenation index, oxygen saturation index, and end-tidal carbon dioxide of individual patients. The simulated patient outcome metrics were satisfactory when the lung compliance difference between two patients was less than 12 mL/cmH2O, and the oxygen saturation index difference was less than 2 mmHg. Interpretation In resource-limited regions of the world, the COVID-19 pandemic will result in equipment shortages. While single-patient ventilation is preferable, if that option is unavailable and ventilator sharing using limbs without flow resistance compensation is the only available alternative, these simulations provide a conceptual framework and guidelines for clinical patient selection.…

by Anandita Ananthakumar, Yiling Liu, Cristina E. Fernandez, George A. Truskey, Deepak Voora Statins are used to lower cholesterol and prevent cardiovascular disease. Musculoskeletal side effects known as statin associated musculoskeletal symptoms (SAMS), are reported in up to 10% of statin users, necessitating statin therapy interruption and increasing cardiovascular disease risk. We tested the hypothesis that, when exposed to statins ex vivo, engineered human skeletal myobundles derived from individuals with (n = 10) or without (n = 14) SAMS and elevated creatine-kinase levels exhibit statin-dependent muscle defects. Myoblasts were derived from muscle biopsies of individuals (median age range of 62–64) with hyperlipidemia with (n = 10) or without (n = 14) SAMS. Myobundles formed from myoblasts were cultured with growth media for 4 days, low amino acid differentiation media for 4 days, then dosed with 0 and 5μM of statins for 5 days. Tetanus forces were subsequently measured. To model the change of tetanus forces among clinical covariates, a mixed effect model with fixed effects being donor type, statin concentration, statin type and their two way interactions (donor type*statin concentration and donor type* statin type) and the random effect being subject ID was applied. The results indicate that statin exposure significantly contributed to decrease in force (p

by Shona Horter, Jay Achar, Nell Gray, Nargiza Parpieva, Zinaida Tigay, Jatinder Singh, Beverley Stringer Introduction Standard multidrug-resistant tuberculosis (MDR-TB) treatment is lengthy, toxic, and insufficiently effective. New drugs and a shorter treatment regimen (SCR) are now recommended. However, patient and health-care worker (HCW) perspectives regarding the SCR are unknown. We aimed to determine the views and experiences of patients with MDR-TB and HCW regarding the SCR in Karakalpakstan, Uzbekistan. Methods In a qualitative study, we conducted 48 in-depth interviews with 24 people with MDR-TB and 20 HCW, purposively recruited to include those with a range of treatment-taking experiences and employment positions. Data were analysed thematically using Nvivo 12, to identify emergent patterns, concepts, and categories. Principles of grounded theory were drawn upon to generate findings inductively from participants’ accounts. Results All patients viewed the SCR favourably. The SCR was seen as enabling an expedited return to work, studies, and “normality”. This reduced the burden of treatment and difficulties with treatment fatigue. The SCR appeared to improve mental health, ease difficulties with TB-related stigma, and foster improved adherence. While patients wanted shorter treatment, it was also important that treatment be tolerable and effective. However, HCW doubted the appropriateness and effectiveness of the SCR, which influenced their confidence in prescribing the regimen. Conclusion The SCR was said to benefit treatment completion and patients’ lives. HCW concerns about SCR appropriateness and effectiveness may influence who receives the regimen. These are important considerations for SCR implementation and MDR-TB treatment developments, and dissonance between patient and HCW perspectives must be addressed for successful implementation of shorter regimens in the future.…

by Udo Buchholz, Heiko Juergen Jahn, Bonita Brodhun, Ann-Sophie Lehfeld, Marina M. Lewandowsky, Franziska Reber, Kristin Adler, Jacqueline Bochmann, Christina Förster, Madlen Koch, Yvonne Schreiner, Fabian Stemmler, Corinna Gagell, Edith Harbich, Sina Bärwolff, Andreas Beyer, Ute Geuß-Fosu, Martina Hänel, Patrick Larscheid, Lukas Murajda, Klaus Morawski, Uwe Peters, Raimund Pitzing, Andreas von Welczeck, Gudrun Widders, Nicoletta Wischnewski, Inas Abdelgawad, Anke Hinzmann, Denis Hedeler, Birte Schilling, Silvia Schmidt, Jakob Schumacher, Irina Zuschneid, Iskandar Atmowihardjo, Keikawus Arastéh, Steffen Behrens, Petra Creutz, Johannes Elias, Martina Gregor, Stefan Kahl, Henning Kahnert, Viktor Kimmel, Josefa Lehmke, Pascal Migaud, Agata Mikolajewska, Verena Moos, Maria-Barbara Naumann, Wulf Pankow, Hans Scherübl, Bernd Schmidt, Thomas Schneider, Hartmut Stocker, Norbert Suttorp, Dorina Thiemig, Carsten Gollnisch, Uwe Mannschatz, Walter Haas, Benedikt Schaefer, Christian Lück Introduction Sources of infection of most cases of community-acquired Legionnaires’ disease (CALD) are unknown. Objective Identification of sources of infection of CALD. Setting Berlin; December 2016–May 2019. Participants Adult cases of CALD reported to district health authorities and consenting to the study; age and hospital matched controls. Main outcome measure Percentage of cases of CALD with attributed source of infection. Methods Analysis of secondary patient samples for monoclonal antibody (MAb) type (and sequence type); questionnaire-based interviews, analysis of standard household water samples for Legionella concentration followed by MAb (and sequence) typing of Legionella pneumophila serogroup 1 (Lp1) isolates; among cases taking of additional water samples to identify the infectious source as appropriate; recruitment of control persons for comparison of exposure history and Legionella in standard household water samples. For each case an appraisal matrix was filled in to attribute any of three source types (external (non-residence) source, residential non-drinking water (RnDW) source (not directly from drinking water outlet), residential drinking water (RDW) as source) using three evidence types (microbiological results, cluster evidence, analytical-comparative evidence (using added information from controls)). Results Inclusion of 111 study cases and 202 controls. Median age of cases was 67 years (range 25–93 years), 74 (67%) were male. Among 65 patients with urine typable for MAb type we found a MAb 3/1-positive strain in all of them. Compared to controls being a case was not associated with a higher Legionella concentration in standard household water samples, however, the presence of a MAb 3/1-positive strain was significantly associated (odds ratio (OR) = 4.9, 95% confidence interval (CI) 1.7 to 11). Thus, a source was attributed by microbiological evidence if it contained a MAb 3/1-positive strain. A source was attributed by cluster evidence if at least two cases were exposed to the same source. Statistically significant general source types were attributed by calculating the population attributable risk (analytical-comparative evidence). We identified an external source in 16 (14%) cases, and RDW as source in 28 (25%). Wearing inadequately disinfected dentures was the only RnDW source significantly associated with cases (OR = 3.2, 95% CI 1.3 to 7.8) and led to an additional 8% of cases with source attribution, for a total of 48% of cases attributed. Conclusion Using the appraisal matrix we attributed almost half of all cases of CALD to an infectious source, predominantly RDW. Risk for LD seems to be conferred primarily by the type of Legionella rather than the amount. Dentures as a new infectious source needs further, in particular, integrated microbiological, molecular and epidemiological confirmation.…

by Giorgia Borriello, Rubina Paradiso, Carlotta Catozzi, Roberta Brunetti, Paola Roccabianca, Marita Georgia Riccardi, Bianca Cecere, Cristina Lecchi, Giovanna Fusco, Fabrizio Ceciliani, Giorgio Galiero Otitis externa is a common multifactorial disease in dogs, characterized by broad and complex modifications of the ear microbiota. The goal of our study was to describe the ear cerumen microbiota of healthy dogs, within the same animal and between different animals, and to compare the cerumen microbiota of otitis affected dogs with that of healthy animals. The present study included 26 healthy dogs, 16 animals affected by bilateral otitis externa and 4 animals affected by monolateral otitis externa. For each animal cerumen samples from the right and left ear were separately collected with sterile swabs, and processed for DNA extraction and PCR amplification of the 16S rRNA gene. Amplicon libraries were sequenced using an Ion Torrent Personal Genome Machine (PGM), and taxonomical assignment and clustering were performed using QIIME 2 software. Our results indicate that the bacterial community of the cerumen in healthy dogs was characterized by extensive variability, with the most abundant phyla represented by Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes and Fusobacteria. The analysis of both alpha and beta diversity between pairs of left and right ear samples from the same dog within the group of affected animals displayed higher differences than between paired samples across healthy dogs. Moreover we observed reduced bacterial richness in the affected group as compared with controls and increased variability in population structure within otitis affected animals, often associated with the proliferation of a single bacterial taxon over the others. Moreover, Staphylococcus and Pseudomonas resulted to be the bacterial genera responsible for most distances between the two groups, in association with differences in the bacterial community structure. The cerumen microbiota in healthy dogs exhibits a complex bacterial population which undergoes significant modifications in otitis affected animals.

by Steve Goodacre, Ben Thomas, Ellen Lee, Laura Sutton, Amanda Loban, Simon Waterhouse, Richard Simmonds, Katie Biggs, Carl Marincowitz, Jose Schutter, Sarah Connelly, Elena Sheldon, Jamie Hall, Emma Young, Andrew Bentley, Kirsty Challen, Chris Fitzsimmons, Tim Harris, Fiona Lecky, Andrew Lee, Ian Maconochie, Darren Walter Background Hospital emergency departments play a crucial role in the initial assessment and management of suspected COVID-19 infection. This needs to be guided by studies of people presenting with suspected COVID-19, including those admitted and discharged, and those who do not ultimately have COVID-19 confirmed. We aimed to characterise patients attending emergency departments with suspected COVID-19, including subgroups based on sex, ethnicity and COVID-19 test results. Methods and findings We undertook a mixed prospective and retrospective observational cohort study in 70 emergency departments across the United Kingdom (UK). We collected presenting data from 22445 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. Outcomes were admission to hospital, COVID-19 result, organ support (respiratory, cardiovascular or renal), and death, by record review at 30 days. Mean age was 58.4 years, 11200 (50.4%) were female and 11034 (49.6%) male. Adults (age >16 years) were acutely unwell (median NEWS2 score of 4), frequently had limited performance status (46.9%) and had high rates of admission (67.1%), COVID-19 positivity (31.2%), organ support (9.8%) and death (15.5%). Children had much lower rates of admission (27.4%), COVID-19 positivity (1.2%), organ support (1.4%) and death (0.3%). Similar numbers of men and women presented to the ED, but men were more likely to be admitted (72.9% v 61.4%), require organ support (12.2% v 7.7%) and die (18.2% v 13.0%). Black or Asian adults tended to be younger than White adults (median age 54, 50 and 67 years), were less likely to have impaired performance status (43.1%, 26.8% and 51.6%), be admitted to hospital (60.8%, 57.3%, 69.6%) or die (11.6%, 11.2%, 16.4%), but were more likely to require organ support (15.9%, 14.3%, 8.9%) or have a positive COVID-19 test (40.8%, 42.1%, 30.0%). Adults admitted with suspected and confirmed COVID-19 had similar age, performance status and comorbidities (except chronic lung disease) to those who did not have COVID-19 confirmed, but were much more likely to need organ support (22.2% v 8.9%) or die (32.1% v 15.5%). Conclusions Important differences exist between patient groups presenting to the emergency department with suspected COVID-19. Adults and children differ markedly and require different approaches to emergency triage. Admission and adverse outcome rates among adults suggest that policies to avoid unnecessary ED attendance achieved their aim. Subsequent COVID-19 confirmation confers a worse prognosis and greater need for organ support. Registration ISRCTN registry, ISRCTN56149622, http://www.isrctn.com/ISRCTN28342533.…

by Tobias Schlesinger, Benedikt Weißbrich, Florian Wedekink, Quirin Notz, Johannes Herrmann, Manuel Krone, Magdalena Sitter, Benedikt Schmid, Markus Kredel, Jan Stumpner, Lars Dölken, Jörg Wischhusen, Peter Kranke, Patrick Meybohm, Christopher Lotz Background The viral load and tissue distribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remain important questions. The current study investigated SARS-CoV-2 viral load, biodistribution and anti-SARS-CoV-2 antibody formation in patients suffering from severe corona virus disease 2019 (COVID-19) induced acute respiratory distress syndrome (ARDS). Methods This is a retrospective single-center study in 23 patients with COVID-19-induced ARDS. Data were collected within routine intensive care. SARS-CoV-2 viral load was assessed via reverse transcription quantitative polymerase chain reaction (RT-qPCR). Overall, 478 virology samples were taken. Anti-SARS-CoV-2-Spike-receptor binding domain (RBD) antibody detection of blood samples was performed with an enzyme-linked immunosorbent assay. Results Most patients (91%) suffered from severe ARDS during ICU treatment with a 30-day mortality of 30%. None of the patients received antiviral treatment. Tracheal aspirates tested positive for SARS-CoV-2 in 100% of the cases, oropharyngeal swabs only in 77%. Blood samples were positive in 26% of the patients. No difference of viral load was found in tracheal or blood samples with regard to 30-day survival or disease severity. SARS-CoV-2 was never found in dialysate. Serologic testing revealed significantly lower concentrations of SARS-CoV-2 neutralizing IgM and IgA antibodies in survivors compared to non-survivors (p = 0.009). Conclusions COVID-19 induced ARDS is accompanied by a high viral load of SARS-CoV-2 in tracheal aspirates, which remained detectable in the majority throughout intensive care treatment. Remarkably, SARS-CoV-2 RNA was never detected in dialysate even in patients with RNAemia. Viral load or the buildup of neutralizing antibodies was not associated with 30-day survival or disease severity.…

by Lauren Thomaier, Deanna Teoh, Patricia Jewett, Heather Beckwith, Helen Parsons, Jianling Yuan, Anne H. Blaes, Emil Lou, Jane Yuet Ching Hui, Rachel I. Vogel Introduction Cancer care is significantly impacted by the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to evaluate the early effects of the pandemic on the emotional well-being of oncology providers across the United States and explore factors associated with anxiety and depression symptoms. Materials and methods A cross-sectional survey was administered to United States cancer-care physicians recruited over a two-week period (3/27/2020–4/10/2020) using snowball-convenience sampling through social media. Symptoms of anxiety and depression were measured using the Patient Health Questionnaire (PHQ-4). Results Of 486 participants, 374 (77.0%) completed the PHQ-4: median age was 43 years; 63.2% female; all oncologic specialties were represented. The rates of anxiety and depression symptoms were 62.0% and 23.5%, respectively. Demographic factors associated with anxiety included female sex, younger age, and less time in clinical practice. Perception of inadequate personal protective equipment (68.6% vs. 57.4%, p = 0.03) and practicing in a state with more COVID-19 cases (65.8% vs. 51.1%, p = 0.01) were associated with anxiety symptoms. Factors significantly associated with both anxiety and depression included the degree to which COVID-19 has interfered with the ability to provide treatment to cancer patients and concern that patients will not receive the level of care needed for non-COVID-19 illness (all p-values…

by Haonan Chen, Jing He, Wenhui Song, Lianchao Wang, Jiabao Wang, Yijin Chen The Coronavirus Disease 2019 (COVID-19) has proved a globally prevalent outbreak since December 2019. As a focused country to alleviate the epidemic impact, China implemented a range of public health interventions to prevent the disease from further transmission, including the pandemic lockdown in Wuhan and other cities. This paper establishes China’s mobility network by a flight dataset and proposes a model without epidemiological parameters to indicate the spread risks through the network, which is termed as epidemic strength. By simply adjusting an intervention parameter, traffic volumes under different travel-restriction levels can be simulated to analyze how the containment strategy can mitigate the virus dissemination through traffic. This approach is successfully applied to a network of Chinese provinces and the epidemic strength is smoothly interpreted by flow maps. Through this node-to-node interpretation of transmission risks, both overall and detailed epidemic hazards are properly analyzed, which can provide valuable intervention advice during public health emergencies.

by Se Bum Jang, Suk Hee Lee, Dong Eun Lee, Sin-Youl Park, Jong Kun Kim, Jae Wan Cho, Jaekyung Cho, Ki Beom Kim, Byunggeon Park, Jongmin Park, Jae-Kwang Lim The recent medical applications of deep-learning (DL) algorithms have demonstrated their clinical efficacy in improving speed and accuracy of image interpretation. If the DL algorithm achieves a performance equivalent to that achieved by physicians in chest radiography (CR) diagnoses with Coronavirus disease 2019 (COVID-19) pneumonia, the automatic interpretation of the CR with DL algorithms can significantly reduce the burden on clinicians and radiologists in sudden surges of suspected COVID-19 patients. The aim of this study was to evaluate the efficacy of the DL algorithm for detecting COVID-19 pneumonia on CR compared with formal radiology reports. This is a retrospective study of adult patients that were diagnosed as positive COVID-19 cases based on the reverse transcription polymerase chain reaction among all the patients who were admitted to five emergency departments and one community treatment center in Korea from February 18, 2020 to May 1, 2020. The CR images were evaluated with a publicly available DL algorithm. For reference, CR images without chest computed tomography (CT) scans classified as positive for COVID-19 pneumonia were used given that the radiologist identified ground-glass opacity, consolidation, or other infiltration in retrospectively reviewed CR images. Patients with evidence of pneumonia on chest CT scans were also classified as COVID-19 pneumonia positive outcomes. The overall sensitivity and specificity of the DL algorithm for detecting COVID-19 pneumonia on CR were 95.6%, and 88.7%, respectively. The area under the curve value of the DL algorithm for the detection of COVID-19 with pneumonia was 0.921. The DL algorithm demonstrated a satisfactory diagnostic performance comparable with that of formal radiology reports in the CR-based diagnosis of pneumonia in COVID-19 patients. The DL algorithm may offer fast and reliable examinations that can facilitate patient screening and isolation decisions, which can reduce the medical staff workload during COVID-19 pandemic situations.

by Xi Chen, Xufeng Xie, Dianjun Wu, Shilei Zhang, Wenlong Zhang, Yongguo Cao Leptospirosis is an important global zoonosis caused by pathogenic Leptospira. It is estimated that more than 1 million people are infected by Leptospira each year, and the death toll is about 60,000. Some studies showed that delayed immune response was associated with severe leptospirosis, and TLR4 was very important in the control of leptospirosis. In this study, we aimed to explore the effect of the classical activator (LPS) of TLR4 on leptospirosis in susceptible and resistant hosts. The results showed that LPS pretreatment increased the survival rate of hamsters to 80%. And LPS pre-treatment also significantly reduced the leptospiral load and alleviated the pathological injury in organs of hamsters and mice. The result detected by ELISA in mice showed that the levels of TNF-α and IL-1β were increased in the LPS-treated group compared to the control group before infection. However, two days after infection, the level of cytokines in LPS group was down-regulated compared with that in control group. In addition, in vitro results showed that LPS pre-treatment enhanced the phagocytosis and bactericidal ability of macrophages on Leptospira. Collectively, our results indicated that the pre-activated immune response induced by LPS enhanced the ability of host against leptospirosis.

by Francisco Posada-Florez, Eugene V. Ryabov, Matthew C. Heerman, Yanping Chen, Jay D. Evans, Daniel E. Sonenshine, Steven C. Cook The ectoparasitic mite Varroa destructor is one of the most destructive pests of the honey bee (Apis mellifera) and the primary biotic cause of colony collapse in many regions of the world. These mites inflict physical injury on their honey bee hosts from feeding on host hemolymph and fat body cells/cellular components, and serve as the vector for deadly honey bee viruses, including Deformed wing virus (DWV) and the related Varroa destructor virus-1 (VDV-1) (i.e., DWV-like viruses). Studies focused on elucidating the dynamics of Varroa-mediated vectoring and transmission of DWV-like viruses may be confounded by viruses present in ingested host tissues or the mites themselves. Here we describe a system that includes an artificial diet free of insect tissue-derived components for maintaining Varroa mites for in vitro experimentation. Using this system, together with the novel engineered cDNA clone-derived genetically tagged VDV-1 and wild-type DWV, we demonstrated for the first time that Varroa mites provided an artificial diet supplemented with engineered viruses for 36 hours could acquire and transmit sufficient numbers of virus particles to establish an infection in virus-naïve hosts. While the in vitro system described herein provides for only up to five days of mite survival, precluding study of the long-term impacts of viruses on mite health, the system allows for extensive insights into the dynamics of Varroa-mediated vectoring and transmission of honey bee viruses.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.

Journal of Medical Virology, Accepted Article.