A multinational cross-sectional study on the awareness and concerns of healthcare providers toward monkeypox and the promotion of the monkeypox vaccination.

Background: The aim of this study was to explore potential healthcare workers' (HCWs) concerns about the monkeypox virus in order to create practical solutions to manage this disease. Methods: Online cross-sectional research was conducted in 11 Arabic countries (Egypt, Saudi Arabia, Yemen, Syria, Libya, Algeria, Tunisia, Iraq, Palestine, Jordan, and Sudan) from 2 August 2022 to 28 December 2022. Results: Approximately 82% of respondents felt the need to acquire further information. The acceptability of the vaccine against monkeypox has been indicated by more than half of the participants (54.5%). Furthermore, we state that 45% of the participants are knowledgeable about the monkeypox virus, and 53.1% of the participants have never been affected with COVID-19 before are more worried about COVID-19 than about monkeypox. Participants diagnosed with COVID-19 were 0.63 times less likely to worry about monkeypox than those who were not diagnosed with COVID-19. A greater willingness to get the monkeypox vaccination was seen among the age group 21-30 years (42.4%) compared to the other age groups. Conclusion: Most healthcare professionals have a moderate knowledge of the monkeypox virus. Furthermore, they demonstrated a low willingness to get the vaccination against the monkeypox virus.

Purtscher-like retinopathy following coronary artery bypass grafting in an antiphospholipid syndrome patient: a case report.

BACKGROUND: Purtscher retinopathy is a rare occlusive microangiopathy comprising a constellation of retinal signs including cotton wool spots, retinal hemorrhages and Purtscher flecken. While classical Purtscher must be antedated by a traumatic incident, Purtscher-like retinopathy is used to refer to the same clinical syndrome in the absence of trauma. Various non-traumatic conditions have been associated with Purtscher-like retinopathy e.g. acute pancreatitis, preeclampsia, parturition, renal failure and multiple connective tissue disorders. In this case study, we report the occurrence of Purtscher-like retinopathy following coronary artery bypass grafting in a female patient with primary antiphospholipid syndrome (APS). CASE PRESENTATION: A 48-year-old Caucasian female patient presented with a complaint of acute painless diminution of vision in the left eye (OS) that occurred approximately two months earlier. Clinical history revealed that the patient underwent coronary artery bypass grafting (CABG) two months earlier and that visual symptoms started 4 days thereafter. Furthermore, the patient reported undergoing percutaneous coronary intervention (PCI) one year before for another myocardial ischemic event. Ophthalmological examination revealed multiple yellowish-white superficial retinal lesions i.e. cotton-wool spots, exclusively in the posterior pole and predominantly macular within the temporal vascular arcades only OS. Fundus examination of the right eye (OD) was normal and the anterior segment examination of both eyes (OU) was unremarkable. A diagnosis of Purtscher-like retinopathy was made based on clinical signs, suggestive history and consolidated by fundus fluorescein angiography (FFA), spectral domain optical coherence tomography (SD-OCT) and optical coherence tomography angiography (OCTA) of macula, optic nerve head (ONH) according to the diagnostic guidelines of Miguel. The patient was referred to a rheumatologist to identify the underlying systemic cause and was diagnosed with primary antiphospholipid syndrome (APS). CONCLUSIONS: We report a case of Purtscher-like retinopathy complicating primary antiphospholipid syndrome (APS) following coronary artery bypass grafting. This conveys a message to clinicians that patients presenting with Purtscher-like retinopathy should undergo meticulous systemic work-up in order to identify potentially life-threatening underlying systemic diseases.

Monkeypox Post-COVID-19: Knowledge, Worrying, and Vaccine Adoption in the Arabic General Population.

BACKGROUND: The outbreak of monkeypox was declared a global public health emergency by the World Health Organization on 23 July 2022. There have been 60,000 cases reported worldwide, most of which are in places where monkeypox has never been seen due to the travel of people who have the virus. This research aims to evaluate the general Arabic population in regard to the monkeypox disease, fears, and vaccine adoption after the WHO proclaimed a monkeypox epidemic and to compare these attitudes to those of the COVID-19 pandemic. METHODS: This cross-sectional study was performed in some Arabic countries (Syria, Egypt, Qatar, Yemen, Jordan, Sudan, Algeria, and Iraq) between 18 August and 7 September 2022. The inclusion criteria were the general public residing in Arabic nations and being older than 18. This questionnaire has 32 questions separated into three sections: sociodemographic variables, prior COVID-19 exposure, and COVID-19 vaccination history. The second portion assesses the knowledge and anxieties about monkeypox, while the third section includes the generalized anxiety disorder (GAD7) scale. Logistic regression analyses were performed to compute the adjusted odds ratios (aOR) and their confidence intervals (95%CI) using STATA (version 17.0). RESULTS: A total of 3665 respondents from 17 Arabic countries were involved in this study. Almost two-thirds (n = 2427, 66.2%) of the participants expressed more worry about COVID-19 than monkeypox diseases. Regarding the major cause for concern about monkeypox, 39.5% of participants attributed their anxiety to the fear that they or a member of their family may contract the illness, while 38.4% were concerned about monkeypox becoming another worldwide pandemic. According to the GAD 7 score, 71.7% of the respondents showed very low anxiety toward monkeypox and 43.8% of the participants scored poor levels of knowledge about monkeypox disease. Participants with previous COVID-19 infection showed a 1.206 times greater acceptance to receive the monkeypox vaccine than those with no previous infection. A 3.097 times higher concern for monkeypox than COVID-19 was shown by the participants who perceived monkeypox as dangerous and virulent than those who did not. Participants who have a chronic disease (aOR: 1.32; 95%CI: 1.09-1.60); participants worried about monkeypox (aOR: 1.21; 95%CI: 1.04-1.40), and perceived monkeypox as a dangerous and virulent disease (aOR: 2.25; 95%CI: 1.92-2.65); and excellent knowledge level (aOR: 2.28; 95%CI: 1.79-2.90) have emerged as significant predictors. CONCLUSIONS: Our study reported that three-fourths of the participants were more concerned about COVID-19 than monkeypox disease. In addition, most of the participants have inadequate levels of knowledge regarding monkeypox disease. Hence, immediate action should be taken to address this problem. Consequently, learning about monkeypox and spreading information about its prevention is crucial.

Dynamics of Anti-S IgG Antibodies Titers after the Second Dose of COVID-19 Vaccines in the Manual and Craft Worker Population of Qatar.

There is limited seroepidemiological evidence on the magnitude and long-term durability of antibody titers of mRNA and non-mRNA vaccines in the Qatari population. This study was conducted to generate evidence on long-term anti-S IgG antibody titers and their dynamics in individuals who have completed a primary COVID-19 vaccination schedule. A total of 300 male participants who received any of the following vaccines BNT162b2/Comirnaty, mRNA-1273, ChAdOx1-S/Covishield, COVID-19 Vaccine Janssen/Johnson, or BBIBP-CorV or Covaxin were enrolled in our study. All sera samples were tested by chemiluminescent microparticle immunoassay (CMIA) for the quantitative determination of IgG antibodies to SARS-CoV-2, receptor-binding domain (RBD) of the S1 subunit of the spike protein of SARS-CoV-2. Antibodies against SARS-CoV-2 nucleocapsid (SARS-CoV-2 N-protein IgG) were also determined. Kaplan-Meier survival curves were used to compare the time from the last dose of the primary vaccination schedule to the time by which anti-S IgG antibody titers fell into the lowest quartile (range of values collected) for the mRNA and non-mRNA vaccines. Participants vaccinated with mRNA vaccines had higher median anti-S IgG antibody titers. Participants vaccinated with the mRNA-1273 vaccine had the highest median anti-S-antibody level of 13,720.9 AU/mL (IQR 6426.5 to 30,185.6 AU/mL) followed by BNT162b2 (median, 7570.9 AU/mL; IQR, 3757.9 to 16,577.4 AU/mL); while the median anti-S antibody titer for non-mRNA vaccinated participants was 3759.7 AU/mL (IQR, 2059.7-5693.5 AU/mL). The median time to reach the lowest quartile was 3.53 months (IQR, 2.2-4.5 months) and 7.63 months (IQR, 6.3-8.4 months) for the non-mRNA vaccine recipients and Pfizer vaccine recipients, respectively. However, more than 50% of the Moderna vaccine recipients did not reach the lowest quartile by the end of the follow-up period. This evidence on anti-S IgG antibody titers should be considered for informing decisions on the durability of the neutralizing activity and thus protection against infection after the full course of primary vaccination in individuals receiving different type (mRNA verus non-mRNA) vaccines and those with natural infection.

Mutations in SARS-CoV-2: Insights on structure, variants, vaccines, and biomedical interventions.

COVID-19 is a worldwide pandemic caused by SARS-coronavirus-2 (SARS-CoV-2). Less than a year after the emergence of the Covid-19 pandemic, many vaccines have arrived on the market with innovative technologies in the field of vaccinology. Based on the use of messenger RNA (mRNA) encoding the Spike SARS-Cov-2 protein or on the use of recombinant adenovirus vectors enabling the gene encoding the Spike protein to be introduced into our cells, these strategies make it possible to envisage the vaccination in a new light with tools that are more scalable than the vaccine strategies used so far. Faced with the appearance of new variants, which will gradually take precedence over the strain at the origin of the pandemic, these new strategies will allow a much faster update of vaccines to fight against these new variants, some of which may escape neutralization by vaccine antibodies. However, only a vaccination policy based on rapid and massive vaccination of the population but requiring a supply of sufficient doses could make it possible to combat the emergence of these variants. Indeed, the greater the number of infected individuals, the faster the virus multiplies, with an increased risk of the emergence of variants in these RNA viruses. This review will discuss SARS-CoV-2 pathophysiology and evolution approaches in altered transmission platforms and emphasize the different mutations and how they influence the virus characteristics. Also, this article summarizes the common vaccines and the implication of the mutations and genetic variety of SARS-CoV-2 on the COVID-19 biomedical arbitrations.

Monkeypox Post COVID19: Knowledge, Worrying, and Vaccine Adoption of the Arabic General Population (preprint)

Abstract: Background: The outbreak of monkeypox was designated a global public health emergency by the World Health Organization on July 23, 2022. There have been more reported 60000 cases worldwide, most of which are in places where monkeypox has never been seen due to the travel of people who have the virus. This research aims to evaluate the Arabic general population on monkeypox disease, fears, and vaccine adoption after the WHO proclaimed a monkeypox epidemic and to compare these attitudes to those of the COVID-19 pandemic. Methods: This cross-sectional study was performed in some Arabic countries (Syria, Egypt, Qatar, Yemen, Jordan, Sudan, Algeria, and Iraq) between August 18 and September 7, 2022 to examine the Arabic people perspectives on monkeypox disease, fears, and vaccine adoption and to compare these attitudes to those of the COVID-19 pandemic. The inclusion criteria were the general public residing in Arabic nations and older than 18. This questionnaire has 32 questions separated into three sections: sociodemographic variables, prior COVID-19 exposure, and COVID-19 vaccination history. The second portion assesses knowledge and anxieties about monkeypox, while the third section includes the generalized anxiety disorder (GAD7) scale. Logistic regression analysis were performed to compute the adjusted odds ratios (aOR), and their confidence intervals (95%CI) using STATA (version 17.0) Results: A total of 3665 respondents from 17 Arabic countries were involved in this study. Almost two third (n= 2427, 66.2%) of participants expressed more worried about COVID -19 than monkeypox diseases. Regarding the major cause for concern about monkeypox, 39.5% of participants attributed their anxiety they or a member of their family may contract the illness, while 38.4% were concerned about another worldwide pandemic of monkeypox. According to the GAD 7 score, 71.7% of respondents showed very low anxiety toward monkeypox. 43.8% of the participants scored poor levels of knowledge about monkeypox disease. Participants with previous COVID-19 infection showed greater acceptance to receive the monkeypox vaccine 1.206 times than those with no previous infection. A higher concern for the monkeypox than COVID-19 was shown by the participants who perceived monkeypox as dangerous and virulent 3.097 times than those who didn’t. Participants who have a chronic disease (aOR: 1.32; 95%CI: 1.09-1.60); participants worried about monkeypox (aOR: 1.21; 95%CI: 1.04-1.40); and perceived monkeypox as a dangerous and virulent disease (aOR: 2.25; 95%CI: 1.92-2.65); and excellent knowledge level (aOR: 2.28; 95%CI: 1.79-2.90) have emerged as significant predictors. Conclusion: Our study reported that three fourth of the participants were more concerned about COVID-19 than monkeypox disease. As well, most of the participants have inadequate levels of knowledge regarding monkeypox disease. Hence immediate action should be taken to address this problem. Consequently, it is crucial to learn about monkeypox and spread information about its prevention.

Neutralizing antibodies against SARS-CoV-2 are higher but decline faster in mRNA vaccinees compared to individuals with natural infection.

BACKGROUND: Waning protection against emerging SARS-CoV-2 variants by pre-existing antibodies elicited due to current vaccination or natural infection is a global concern. Whether this is due to the waning of immunity to SARS-COV-2 remains unclear. AIM: We aimed to investigate the dynamics of antibody isotype responses among vaccinated naïve (VN) and naturally infected (NI) individuals. METHODS: We followed up antibody levels in COVID-19 mRNA-vaccinated subjects without prior infection (VN, n = 100) in two phases: phase-I (P-I) at ~ 1.4 and phase-II (P-II) at ~ 5.3 months. Antibody levels were compared to those of unvaccinated and naturally infected subjects (NI, n = 40) at ~ 1.7 (P-1) and 5.2 (P-II) months post-infection. Neutralizing antibodies (NTAb), anti-S-RBD-IgG, -IgM, and anti-S-IgA isotypes were measured. RESULTS: The VN group elicited significantly greater antibody responses (p < 0.001) than the NI group at P-I, except for IgM. In the VN group, a significant waning in antibody response was observed in all isotypes. There was about ~ a 4-fold decline in NTAb levels (p < 0.001), anti-S-RBD-IgG (~5-folds, p < 0.001), anti-S-RBD-IgM (~6-folds, p < 0.001), and anti-S1-IgA (2-folds, p < 0.001). In the NI group, a significant but less steady decline was notable in S-RBD-IgM (~2-folds, p < 0.001), and a much smaller but significant difference in NTAb (<2-folds, p < 0.001) anti-S-RBD IgG (<2-folds, p = 0.005). Unlike the VN group, the NI group mounted a lasting anti-S1-IgA response with no significant decline. Anti-S1-IgA, which were ~ 3 folds higher in VN subjects compared to NI in P-1 (p < 0.001), dropped to almost the same levels, with no significant difference observed between the two groups in P-II. CONCLUSION: While double-dose mRNA vaccination boosted antibody levels, vaccinated individuals' 'boost' was relatively short-lived.

Garcinia cambogia Phenolics as Potent Anti-COVID-19 Agents: Phytochemical Profiling, Biological Activities, and Molecular Docking.

COVID-19 is a disease caused by the coronavirus SARS-CoV-2 and became a pandemic in a critically short time. Phenolic secondary metabolites attracted much attention from the pharmaceutical industries for their easily accessible natural sources and proven antiviral activity. In our mission, a metabolomics study of the Garcinia cambogia Roxb. fruit rind was performed using LC-HRESIMS to investigate its chemical profile, especially the polar aspects, followed by a detailed phytochemical analysis, which led to the isolation of eight known compounds. Using spectrometric techniques, the isolated compounds were identified as quercetin, amentoflavone, vitexin, rutin, naringin, catechin, p-coumaric, and gallic acids. The antiviral activities of the isolated compounds were investigated using two assays; the 3CL-Mpro enzyme showed that naringin had a potent effect with IC50 16.62 µg/mL, followed by catechin and gallic acid (IC50 26.2, 30.35 µg/mL, respectively), while the direct antiviral inhibition effect of naringin confirmed the potency with an EC50 of 0.0169 µM. To show the molecular interaction, in situ molecular docking was carried out using a COVID-19 protease enzyme. Both biological effects and docking studies showed the hydrophobic interactions with Gln 189 or Glu 166, per the predicated binding pose of the isolated naringin.

Clinical and chest computed tomography features of patients suffering from mild and severe COVID-19 at Fayoum University Hospital in Egypt.

BACKGROUND: In pandemic COVID-19 (coronavirus disease 2019), the prognosis of patients has been determined using clinical data and CT (computed tomography) scans, but it is still unclear whether chest CT characteristics are correlated to COVID-19 severity. AIM: To explore the potential association between clinical data and 25-point CT score and investigate their predictive significance in COVID-19-positive patients at Fayoum University Hospital in Egypt. METHODS: This study was conducted on 252 Egyptian COVID-19 patients at Fayoum University Hospital in Egypt. The patients were classified into two groups: a mild group (174 patients) and a severe group (78 patients). The results of clinical laboratory data, and CT scans of severe and mild patients, were collected, analyzed, and compared. RESULTS: The severe group show high significance levels of CRP, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine, urea, ferritin, lactate dehydrogenase (LDH), neutrophil percent, and heart rate (HR) than the mild group. Lymphopenia, hypoalbuminemia, hypocalcemia, and decreased oxygen saturation (SpO2) were the most observed abnormalities in severe COVID-19 patients. Lymphopenia, low SpO2 and albumin levels, elevated serum LDH, ferritin, urea, and CRP levels were found to be significantly correlated with severity CT score (P<0.0001). CONCLUSION: The clinical severity of COVID-19 and the CT score are highly correlated. Our findings indicate that the CT scoring system can help to predict COVID-19 disease outcomes and has a strong correlation with clinical laboratory testing.

Validation of a Novel Fluorescent Lateral Flow Assay for Rapid Qualitative and Quantitative Assessment of Total Anti-SARS-CoV-2 S-RBD Binding Antibody Units (BAU) from Plasma or Fingerstick Whole-Blood of COVID-19 Vaccinees.

Background: Limited commercial LFA assays are available to provide a reliable quantitative measurement of the total binding antibody units (BAU/mL) against the receptor-binding domain of the SARS-CoV-2 spike protein (S-RBD). Aim: This study aimed to evaluate the performance of the fluorescence LFA FinecareTM 2019-nCoV S-RBD test along with its reader (Model No.: FS-113) against the following reference methods: (i) the FDA-approved GenScript surrogate virus-neutralizing assay (sVNT); and (ii) three highly performing automated immunoassays: BioMérieux VIDAS®3, Ortho VITROS®, and Mindray CL-900i®. Methods: Plasma from 488 vaccinees was tested by all aforementioned assays. Fingerstick whole-blood samples from 156 vaccinees were also tested by FinecareTM. Results and conclusions: FinecareTM showed 100% specificity, as none of the pre-pandemic samples tested positive. Equivalent FinecareTM results were observed among the samples taken from fingerstick or plasma (Pearson correlation r = 0.9, p < 0.0001), suggesting that fingerstick samples are sufficient to quantitate the S-RBD BAU/mL. A moderate correlation was observed between FinecareTM and sVNT (r = 0.5, p < 0.0001), indicating that FinecareTM can be used for rapid prediction of the neutralizing antibody (nAb) post-vaccination. FinecareTM BAU results showed strong correlation with VIDAS®3 (r = 0.6, p < 0.0001) and moderate correlation with VITROS® (r = 0.5, p < 0.0001) and CL-900i® (r = 0.4, p < 0.0001), suggesting that FinecareTM can be used as a surrogate for the advanced automated assays to measure S-RBD BAU/mL.

Comparison of antibody immune responses between BNT162b2 and mRNA-1273 SARS-CoV-2 vaccines in naïve and previously infected individuals.

BACKGROUND: Two mRNA vaccines, Pfizer-BNT162b2 and Moderna-mRNA-1273, obtained the Emergency Use Listing by WHO for preventing COVID-19. However, little is known about the difference in antibody responses induced by these two mRNA vaccines in naïve and previously infected (PI) individuals. METHOD: We investigated the levels of anti-S-RBD (total, IgG and IgA) levels in naïve and PI individuals, 1-13 (median = 6) weeks following the second dose of either vaccine. Results in the naïve-vaccinated group, the mRNA-1273 vaccine induced significantly higher levels of anti-S-RBD total antibodies (3.5-fold; P < 0.001), IgG (2-fold, P < 0.01) and IgA (2.1-fold, P < 0.001) as compared with the BNT162b2 vaccine. In addition, both vaccines produced significantly higher anti-S-RBD total antibody levels in the PI-group compared with naïve-vaccinated group. The PI group elicited a higher level of anti-S-RBD IgG than the naïve-BNT162b2 (P = 0.05), but not more than the naïve-mRNA-1273 (P = 0.9) group. Interestingly, the PI vaccinated group elicited a comparable level of IgA ratio to the naïve-mRNA-1273 group but significantly higher than the naïve-BNT162b2 group (1.6-fold, P < 0.001). CONCLUSION: Our results showed that the PI-vaccinated group produces a higher level of antibodies than the naïve vaccinated group, particularly for those vaccinated with BNT162b2.

Computerized tomography of the Thorax for surgical patients during the COVID-19 pandemic: Was it useful?

OBJECTIVES: Diagnostic challenges during the corona virus disease (COVID-19) pandemic forced the radiology regulating body to adopt the use of CT Chest as a triage and diagnostic tool, which was subsequently abandoned. The Royal Wolverhampton hospital followed both protocols. Here, we investigate the evidence behind this decision within the context of surgical admissions during the COVID-19 peak in our hospital. METHODS: Retrospective data collection and analysis of all surgical admissions between the 1st of March to the 31st of May. Data were collected from the radiology and electronic portal looking into patients undergoing CT chest to diagnose the presence of COVID-19 as well as swab results. RESULTS: Seventy-eight patients fulfilled our inclusion criteria. The scan either confirmed the presence or absence (4, 63 patients) of COVID-19 but was sometimes inconclusive (11 patients). Comparing these to the results of the swabs; CT showed sensitivity 42.86%, Specificity 97.92%, and accuracy 90.91%. In the inconclusive CT report group, chances of having a positive swab result were 45%: None of the scan results changed any of the surgical planning. Lymphocyte count in the context of surgical presentation did not have any statistical significance to predict the presence of COVID-19 (P = .7). Cost implications on our cohort of patients for adding the chest CT is estimated to be around £31 000. CONCLUSION: CT Thorax during the pandemic was a good negative predictor but had limited diagnostic value and did not change patient management. Newer, faster techniques of PCR swabs and antibody testing would be a better and cheaper alternative.

SARS-CoV-2 Infection Is at Herd Immunity in the Majority Segment of the Population of Qatar.

BACKGROUND: Qatar experienced a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic that disproportionately affected the craft and manual worker (CMW) population, who comprise 60% of the total population. This study aimed to assess ever and/or current infection prevalence in this population. METHODS: A cross-sectional population-based survey was conducted during July 26 to September 09, 2020, to assess both anti-SARS-CoV-2 positivity through serological testing and current infection positivity through polymerase chain reaction (PCR) testing. Associations with antibody and PCR positivity were identified through regression analyses. RESULTS: The study included 2641 participants, 69.3% of whom were <40 years of age. Anti-SARS-CoV-2 positivity was 55.3% (95% CI, 53.3%-57.3%) and was significantly associated with nationality, geographic location, educational attainment, occupation, and previous infection diagnosis. PCR positivity was 11.3% (95% CI, 9.9%-12.8%) and was significantly associated with nationality, geographic location, occupation, contact with an infected person, and reporting 2 or more symptoms. Infection positivity (antibody and/or PCR positive) was 60.6% (95% CI, 58.6%-62.5%). The proportion of antibody-positive CMWs who had a prior SARS-CoV-2 diagnosis was 9.3% (95% CI, 7.9%-11.0%). Only seven infections were ever severe, and only 1 was ever critical-an infection severity rate of 0.5% (95% CI, 0.2%-1.0%). CONCLUSIONS: Six in every 10 CMWs in Qatar have been infected, suggestive of reaching the herd immunity threshold. Infection severity was low, with only 1 in every 200 infections progressing to be severe or critical. Only 1 in every 10 infections had been previously diagnosed, which is suggestive of mostly asymptomatic or mild infections.

Can commercial automated immunoassays be utilized to predict neutralizing antibodies after SARS-CoV-2 infection? A comparative study between three different assays.

Background: High-throughput assays that can infer neutralizing activity against SARS-CoV-2 are of great importance for assessing the immunity induced by natural infection and COVID-19 vaccines. We aimed to evaluate the performance and degree of correlation of three fully automated anti-SARS-CoV-2 immunoassays with neutralization activity using a surrogate virus-neutralizing test (sVNT) from GenScript, targeting the receptor-binding domain. Methods: 110 sera collected from PCR-confirmed asymptomatic COVID-19 individuals were tested for neutralizing antibodies (nAbs) using the sVNT. Positive samples were tested on three automated immunoassays targeting different viral antigens: Mindray CL-900i®, Abbott Architect, and Ortho VITROS®. The diagnostic sensitivity, specificity, agreement, and correlation with the sVNT were assessed. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal thresholds for predicting the presence of neutralizing activity by each assay. Results: All three assays showed 100% specificities. The highest sensitivity was 99.0%, demonstrated by VITROS®, followed by 94.3%, for CL-900i®, and 81.0%, for Architect. Both VITROS® and CL-900i® had the strongest correlation with the sVNT (ρ = 0.718 and ρ = 0.712, respectively), while Architect showed a moderate correlation (ρ = 0.618). ROC curve analysis indicated that the manufacturer's recommended cutoff values are adequate for predicting the presence of nAbs and providing a strong correlation with the sVNT. Conclusion: VITROS® and CL-900i® serological assays, which detect antibodies against SARS-CoV-2 spike protein, could serve as reliable assays to predict neutralization activity after infection or vaccination.

Uv-Vis and Electrical Impedance Characterizations of the Hydroxychloroquine-Zinc Complex in the Phospholipid-Like Oleic Acid Phase (preprint)

UV-vis and impedance measurements were performed to determine the stable formation of the Hydroxychloroquine-Zinc (HCQ-Zn) complex within the oleic acid (oil) phase of the oil-water system. Decreased UV absorbance with increased Zn concentration was associated with the gradual formation of the complexes within the oil phase, agreeing with existing reports and our time-dependent-density-functional calculations. The reproducibility of our data over a long period indicates the stability of the complex within the oil phase. The impedance measurement showed that the dielectric loss of the oil phase due to the polarization of the complex is less than that due to the polarization of HCQ. A basic impedance measurement revealed that the aqueous-to-oil transfer of Zn is not possible without the HCQ, a result pertinent to the recent report that HCQ is Zn ionophore. Our work is thus important to the fundamental physical chemistry and the current COVID-19 issue where the Zn infusion across the living cell phospholipid membrane (mimicked as an oil-water interface) reduces viral replication.

A randomised controlled study of face-to-face versus internet-based teaching of CBT skills for healthcare professionals in Sudan.

BACKGROUND: A need has been identified for affordable and scalable methods for disseminating cognitive-behavioural therapy (CBT) to countries with barriers to traditional methods of teaching. OBJECTIVE: This study evaluated the effectiveness of internet-based teaching versus face-to-face teaching in improving the CBT theory, assessment, and formulation skills of a group of mental health practitioners in Khartoum, Sudan. METHOD: Participants (N = 36) were randomly assigned to (a) a 3 h live lecture, or (b) a computer-based multimedia recorded lecture of the same duration. Participants were rated before and after training for their ability to assess a simulated patient and construct a CBT formulation of the presenting difficulties. Participants also rated the feasibility and acceptability of the training they had received. RESULTS: Both teaching methods resulted in significant improvements in participants' abilities to carry out the assessment and formulation tasks. However, participants allocated to computer-based teaching performed better than those allocated to live teaching (between-groups effect size d = 0.26-0.74). Both teaching methods were rated as highly acceptable and feasible by participants. CONCLUSIONS: Computer-based teaching could offer a cheaper and effective method to help disseminate CBT to countries with limited resources and expertise, replacing and supplementing other costly traditional methods such as face-to-face teaching.

Mental Stress in Anesthesia and Intensive Care Physicians During COVID-19 Outbreak.

BACKGROUND: Since the announcement of the World Health Organization of COVID-19 as a global pandemic, the probability of experiencing psychological disturbances and mental health problems among the frontline doctors who deal early with the suspected or confirmed patients is expected to increase, especially among anesthesia and ICU physicians. OBJECTIVES: The objective of this study was to assess the magnitude of mental stress among anesthesia and ICU physicians in Cairo university hospitals, Egypt, treating patients exposed to COVID-19. METHODS: This cross-sectional, survey-based study collected the demographic and mental health data from anesthesia and ICU physicians working in Cairo university hospitals from March 15 to April 15, 2020, in Egypt. The level of stress was assessed by the perceived stress scale (PSS-10). RESULTS: A total of 193 out of 315 contacted physicians completed the survey. A significant proportion of participants (65%) experienced high levels of psychological distress during this acute situation, with the PSS-10 median score of 21 in the registrar group and 18 in the consultant group; the difference was statistically significant (P = 0.03). The most common causes of stress among the participants were the fears that they might transmit the disease to their loved people and the lack of a clear protocol on how to deal with COVID-19 cases, either suspected or confirmed. CONCLUSIONS: In this survey study, anesthesia and ICU physicians responding to the spread of COVID-19 reported high rates of symptoms of mental stress.