Coronavirus: ‘Add upset stomach in children to symptoms’

Researchers say it may be worth adding diarrhoea and vomiting to the list of symptoms.

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Coronavirus: Facebook, Twitter and YouTube ‘fail to tackle anti-vaccination posts’

Campaigners claim Facebook, Twitter and YouTube failed to act on flagged ‘clearly harmful posts’.

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Rise in gonorrhoea cases in England prompts safe sex warning

Annual STI cases are up by 5%, with 70,936 new gonorrhoea diagnoses driving the increase.

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Plasmin could be the link between COVID-19 comorbidities and serious illness

Sadis Matalon, Ph.D., of the University of Alabama at Birmingham and colleagues in Texas and San Francisco asked that question in a hypothesis paper published online in Physiological Reviews. This study was made available online in March 2020 ahead of final publication in issue on July 1, 2020. They reviewed, in detail, research literature for comorbidities like hypertension, diabetes, coronary heart disease, cerebrovascular illness, chronic obstructive pulmonary disease and kidney dysfunction, as well as many viral studies, studies of COVID-19 pathology and clinical presentation, and literature on the life-threatening acute respiratory distress syndrome.

Twelve days later, UAB Professor Emeritus Timothy Ness, M.D., Ph.D., posted plans on ClinicalTrials.gov for an exploratory COVID-19 outpatient study to test Matalon’s hypothesis and prevent worse clinical outcomes.

In the Physiological Reviews paper, the researchers noted that all those comorbidities feature elevated levels of the extracellular protease plasmin. Plasmin is able to nick proteins at amino acid sequences called furin sites. For many viruses, this nicking at furin sites increases their infectivity. Both SARS and MERS — the two virulent coronaviruses that are related to the COVID-19 virus — “have evolved an unusual two-step furin activation for fusion, suggestive of a role during the process of emergence into the human population,” the researchers wrote.

They noted that the COVID-19 virus, SARS-CoV-2, also has a furin site on its spike protein, the vital, viral protein for viral attachment to a lung cell. The researchers proposed that plasmin may cleave that furin site in the spike protein to increase its infectivity and virulence, and they hypothesized that, “the plasmin system may prove a promising therapeutic target for combating COVID-19.”

Ness already knew there is an inexpensive, commonly used drug — tranexamic acid, or TXA — that targets plasmin by inhibiting its conversion from the inactive precursor, plasminogen, to the active protease, plasmin.

TXA is approved by the U.S. Food and Drug Administration for treatment of heavy menstrual bleeding because having lower plasmin levels allows better clotting. TXA has a long track record of safety and is commonly given off-label. At UAB Hospital, TXA is used perioperatively as a standard-of-care for orthopedic and cardiac bypass surgeries; it is commonly used for hemorrhaging trauma patients and also has been used for spinal surgery, neurosurgery and corrective jaw surgeries. It is currently being studied for perioperative use in Cesarean section surgeries.

For the clinical trial, Ness and colleagues have started a double-blind study, giving either TXA or a placebo pill to COVID-19 outpatients who were recently diagnosed with COVID-19. Patients also receive an anticoagulant. The overall goal of the exploratory study is to assess both safety and efficacy of five days of TXA versus placebo in the COVID-19 population. Enrollment is ongoing.

Ness and colleagues hypothesize that the TXA treatment will reduce the infectivity and virulence of the virus, as measured by reduced need for hospitalization within a week if a patient’s condition deteriorates. Adults 19 years old and older are eligible, and all patients — whether in the control group or the TXA group — receive standard care as directed by their primary caretakers.

Other principal investigators for the trial are Sonya Heath, M.D., professor in the UAB Department of Medicine Division of Infectious Diseases; and Brant Wagener, M.D., Ph.D., associate professor, and Sadis Matalon, Ph.D., distinguished professor, both in the UAB Department of Anesthesiology and Perioperative Medicine. Ness is professor emeritus in that department.

Authors of the Physiological Reviews paper, “Elevated plasmin(ogen) as a common risk factor for COVID-19 susceptibility,” are Hong-Long Ji and Runzhen Zhao, University of Texas Health Science Centre at Tyler; Michael A. Matthay, University of California, San Francisco; and Matalon.

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An unprecedented discovery of cell fusion

Like humans, bacteria live together in communities, sometimes lending a hand — or in the case of bacteria, a metabolite or two — to help their neighbors thrive. Understanding how bacteria interact is critical to solving growing problems such as antibiotic resistance, in which infectious bacteria form defenses to thwart the medicines used to fight them.

Now, researchers at the University of Delaware have discovered that bacteria do more than just work together. Bacterial cells from different species can combine into unique hybrid cells by fusing their cell walls and membranes and sharing cellular contents, including proteins and ribonucleic acid (RNA), the molecules which regulate gene expression and control cell metabolism. In other words, the organisms exchange material and lose part of their own identity in the process.

This unprecedented observation, which was reported on Tuesday, Sept. 1 in mBio, a journal of the American Society for Microbiology, has the potential to shed light on unexplained phenomena affecting human health, energy research, biotechnology and more.

The research team, led by Eleftherios (Terry) Papoutsakis, Unidel Eugene Du Pont Chair of Chemical and Biomolecular Engineering, studied interactions between Clostridium ljungdahlii and C. acetobutylicum. These species of bacteria work together in a syntrophic system, producing metabolites that are mutually beneficial to each other’s survival.

The team found that C. ljungdahlii invades C. acetobutylicum. The two organisms combine cell walls and membranes and exchange proteins and RNA to form hybrid cells, some of which continue to divide and in fact differentiate into the characteristic sporulation program.

“They mix their machinery to survive or do metabolism, and that’s kind of extraordinary, because we always assumed that each and every organism has its own independent identity and machinery,” said Papoutsakis.

Previously, researchers have observed that bacteria could exchange some material through nanotubes. The combination into hybrid cells was unexpected.

“This is the first time we’ve shown this in this bacteria, and it’s also a new mechanism of how material is exchanged,” said Kamil Charubin, a doctoral student in chemical and biomolecular Engineering and first author of the paper.

Although this phenomenon of interspecies microbial fusion is now being reported for the first time, it is likely ubiquitous in nature among many bacterial pairs.

So why do bacteria bother to fuse together? The simple answer is likely because this process allows the microbes to share machinery that will increase their odds of survival.

For example, some pathogenic bacteria — those that can cause disease — may borrow proteins from other antibiotic-resistant bacteria in order to shore up their own resistance. Some bacteria might borrow machinery from others in order to evade detection by the immune system. This could also help to explain why some bacteria are difficult to culture, or grow for study or medical diagnostic purposes. These difficult-to-culture bacteria might combine with or work with and depend on other microorganisms for their existence instead of growing and multiplying on their own.

The team’s findings may influence understanding of the evolution of biology because once bacterial species share machinery, they can evolve together instead of only evolving on their own, said Papoutsakis.

“These findings will guide new thinking in not just the field of microbial evolution, but also toward biotechnological solutions that can benefit the soldier,” said Dr. Robert Kokoska, program manager, Army Research Office (ARO), an element of the U.S. Army Combat Capabilities Development Command’s Army Research Laboratory. “These include studies of how the human microbiome shapes soldier human health and cognition and how microbial communities can be better designed for a broad range of advances including strategies for reliable in-field biological sensing, waste remediation and novel means of biosynthesis.”

This work was supported by the Army Research Office (award no. W911NF-17-1-0343, and W911NF-19-1-0274) and the U.S. Department of Energy (DE-SC0019155).

Story Source:

Materials provided by University of Delaware. Original written by Julie Stewart. Note: Content may be edited for style and length.

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Study examines the benefits of virtual stroke rehabilitation programs

While virtual medical and rehabilitation appointments seemed novel when COVID-19 first appeared, they now seem to be part of the new norm and might be paving the way to the future.

A recent review paper, co-authored by Brodie Sakakibara with the Centre for Chronic Disease Prevention and Management (CCDPM) has determined that virtual appointments, in the form of telerehabilitation, also work for people recovering from a stroke.

After a stroke, a client is provided with a therapy program to help re-gain loss of skills or motion — this can range from speech and memory, strength, balance and endurance. While not initially introduced for disease outbreaks, Sakakibara a UBCO assistant professor says research shows remote therapy can be effective during stroke recovery.

“Telerehabilitation has been promoted as a more efficient means of delivering rehabilitation services to stroke patients while also providing care options to those unable to attend conventional therapy,” says paper co-author Sakakibara. “These services can be provided to remote locations through information and communication technologies and can be accessed by patients in their homes.”

To learn how effective telerehabilitation can be, six different clinical trials — examining stroke telerehabilitation programs — were launched across Canada as part of a Heart and Stroke Foundation initiative. People recovering from a stroke were provided with interventions ranging from lifestyle coaching to memory, speech skills and physical-exercise training.

“Researchers from each of the six trials came together to write a review paper describing their experiences conducting a telerehabilitation study, and to report on the facilitators and barriers to the implementation of telerehab services within a research context,” says Sakakibara.

Going forward with telerehabilitation as a new reality, Sakakibara says the study authors determined there are important lessons learned from each of the six trials. Most notably, the efficacy and cost of telerehabilitation is similar to that of traditional face-to-face management. He also notes patients mostly reported satisfaction with the telerehabilitation when therapists were trained appropriately, and when there was some social interaction. Overall, clinicians prefer face-to-face interactions but will use telerehabilitation when face-to-face is not feasible.

And finally, since seniors are a key target group for stroke rehabilitation — as stroke is associated with aging — the technology needs to be easy to use and suit the needs of the end users.

“The older adult of today, in terms of technology comfort and use, is different than the older adult of tomorrow,” he says. “While there might be some hesitation of current older adults using technology to receive health and rehab services, the older adult of tomorrow likely is very comfortable using technology. This represents a large opportunity to develop and establish the telehealth/rehabilitation model of care.”

Sakakibara notes COVID-19 has amplified the necessity for telehealth and telerehabilitation for many Canadians — especially those in remote areas or for the estimated 70 per cent of stroke victims who are no longer able to drive.

“Prior to the outbreak, telehealth/rehabilitation was highly recommended in Canadian stroke professional guidelines, but was underused,” he says. “Now in response to COVID-19, the use of telerehabilitation has been accelerated to the forefront. Once these programs are implemented in practice, it’ll be part of the norm, even when the outbreak is over. It is important that we develop and study telerehabilitation programs to ensure the programs are effective and benefit the patients.”

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Greater Manchester lockdown easing U-turn after cases rise

Plans to ease restrictions in Bolton and Trafford are scrapped following a spike in Covid-19 cases.

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Coronavirus: Cheap steroids save lives from severe Covid

Eight lives would be saved for every 100 critically ill patients given steroids.

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Deaths at home higher than normal – ONS figures

People may be being discharged from hospital earlier or are choosing to die at home.

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