The development of countryside walking tourism in the time of the post-COVID crisis

With low investment, countryside walking tourism contributes to the rapid recovery of rural tourism in the post-covid time. The research purpose is to examine factors that impact the interest of tourists in the state-supported countryside walking tourism. The sample consisted of 467 respondents from the general public. The SPSS software was used for processing data. The results indicated that safety, content, and price are the most influential factors. For females, slightly more important factors were related to the possibility of consuming authentic food and beverages, buying traditional handmade products, the inclusion of the local population, and the well-being of urban residents. A village, with authentic local houses and cuisine, and local tour guides, are the epicenter of countryside walking tourism. Embedding countryside walking tourism in sustainable rural tourism development policies is recommended. The research contributes to the integration between sustainable rural development and sustainable tourism development.

Investigating neutrophil function during SARS-CoV2 infection in human airway epithelial cells from elderly and young individuals

The COVID-19 pandemic caused by the SARS-CoV2 virus poses a global health threat with over 5 million deaths recorded. There is little understanding regarding SARS-CoV2 pathogenesis in the human airways and disease severity increases with age. Neutrophils are white blood cells found in large numbers in the airways of the lungs in severe COVID-19 patients. It is not known whether this influx of neutrophils into the airway has a protective or detrimental effect. We aim to understand the role of neutrophils during COVID-19 pathology, using an experimental infection model of the airway epithelium from the eldelry and children. To do this, we collect nasal airway cells from healthy elderly and children and grow them at air-liquid interface. Once differentiation and ciliation of these cells is reached, we infect the cells with SARS-CoV2 virus and allow neutrophils to migrate from the basolateral (blood) to the apical (air) side of the epithelium, similar to a physiological airway. Using flow cytometric analyses, we measure the expression of activation markers and the number of neutrophils that migrate across the epithelium of different ages in response to SARS-CoV2 infection. Preliminary work shows less viable neutrophils recovered from the elderly epithelium, more activated neutrophils when migrating through the elderly epithelium, as well as increased numbers of neutrophils remaining on the basolateral (blood) side of the elderly epithelium. These findings point to an inflammatory neutrophil phenotype influenced by the damaged elderly epithelium and supports the hypothesis that neutrophils are responsible for the severity of disease.

Cerebral venous sinus thrombosis associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection

Introduction/Objective Coagulopathy induced by severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2) can be an underlying cause of cerebral venous sinus thrombosis (CVST), a less common type of stroke with a variable clinical presentation and high mortality rate. The objective of the paper is to present a series of CVST cases associated with SARS-CoV-2 infection. Methods This retrospective study evaluated clinical, laboratory and radiological presentations, risk factors, barriers to diagnosis, treatment and outcome of patients with SARS-CoV-2 infection-induced CVST. Results The study comprised six patients diagnosed with COVID-19-induced CVST during an 18-month period. The majority (66.7%) had no significant risk factors for developing CVST. The median time from the initial COVID-19 diagnosis to the onset of neurologic deficit was seven days (interquartile range 0.5–7 days). Clinical presentation comprised non specific neurological symptoms: headache (83.3%) and decreased consciousness (33.3%), together with elevated levels of D-dimer and inflammatory biomark-ers. The transverse (n = 4, or 66.7%), superior sagittal sinuses (n = 3, or 50%) and sigmoid sinus (n = 2, or 33.3%) were most commonly affected. Five patients (83.3%) had minimal to no symptoms at discharge (mRS ≤ 2). In-hospital mortality in our current series was relatively high (16.7%). Conclusion The high mortality rate of SARS-CoV-2-associated CVST urges clinicians to suspect CVST in patients with a history of COVID-19 infection presenting with non-specific neurological symptoms in order to provide proper treatment and prevent complications. © 2021, Serbia Medical Society. All rights reserved.

Virtual screening, drug-likeness analysis, and molecular docking study of potential severe acute respiratory syndrome coronavirus 2 main protease inhibitors

Due to the length of time required to develop specific antiviral agents, the World Health Organization adopted the strategy of repurposing existing medications to treat Coronavirus disease 2019 infection. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) main protease is possible biological target for potential antiviral drugs. We selected various compounds from PubChem database based on the structure of main protease inhibitors in Protein Data Bank database. Ten compounds showed nontumorigenic and nonmutagenic potential and met Egan's and Lipinski's rules. Molecular docking analysis was performed using AutoDock Vina software. Based on number and type of key binding interactions, as well as docking scores, we selected compounds 6, 8, and 17 that demonstrated the highest binding affinity for the target protein. Molecular dynamics simulations were then carried out on the protein-top docked ligand complexes which were subjected to Molecular mechanics/generalized Born and surface area calculations. The molecular dynamics simulation results indicated that protein-top docked ligand complexes showed good conformational stability. Among analyzed molecules, compound 17 emerged as the best in silico hit based on the docking score, MM/GBSA binding energy and MD results.

The local and systemic response to SARS-CoV-2 infection in children and adults

T1 Figure 1ConclusionsOverall, this largest paediatric single cell COVID-19 study to date showed significant differences in response to SARS-CoV-2 between children and adults, reflecting the changes of the immune landscape over developmental time, which in children are dominated by naïve and innate responses.

Is the decline in acute upper gastrointestinal bleeding associated with the lockdown during pandemic period of covid-19?

Aims The aim of this prospective cohort trial is to show the change trend of clinical, epidemiological and endoscopiccharacteristics of upper gastrointestinal bleeding (UGIB) during the “lockdown” pandemic (COVID-19) compared topandemic-free period. Methods In our study we compared 42 patients from period of the 'lockdown“ (from1st March to 30 th April 2020) with103 patients from the pandemic-free period (from 1st March to 30th April 2019). All of these patients were referred to University Hospital Center Sestre Milosrdnice with symptoms of bleeding from uppergastrointestinal tract. Urgent upper endoscopy performed within 24 hours of admission. Results During the “lockdown” for COVID-19 pandemic period, the number of patients with UGIB was 2.5 times lowercompared to pandemic-free period.(42 vs. 103 patients). The mostly of patients (about 90 %) have had non variceal uppergastrointestinal bleeding (NVB). During the “lockdown” significant reduction in relative number of patients with peptic ulcerbleeding (PUB) was not found (0.34 vs 0.44). The percentage of patients with low-risk peptic ulcers (Forrest 2c and Forrest 3) was significantly higher in “lockdown”COVID - 19 pandemic group compared to pandemic-free group, respectively. (61.5 vs. 36.6 %, p <0.001). When comparing“lockdown” COVID - 19 pandemic and pandemic - free period, there was no observed difference in the recurrence ofbleeding (7.7 vs 9.8 %), 15-day mortality (7.7 vs 7.3 %), in red blood cell transfusion (53.8 vs 56.1 %), fresh frozen plasmatransfusion (23.1 % vs 12.2 %), and the length of hospital stay (8 vs 7 days). There was no surgical intervention in patients with PUB during the “lockdown” pandemic COVID - 19 period. Conclusions During the “lockdown” pandemic of COVID-19 the number of patients with symptoms of UGIB was decreased without changing the proportion of individual types of NVB.