Testicular Adrenal Rest Tumors in a Patient With Congenital Adrenal Hyperplasia.

Ultrasound is the imaging examination of choice for evaluation of suspected testicular pathology. The differential diagnosis of bilateral testicular lesions includes malignancy such as lymphoma and metastases, infection, and, uncommonly, adrenal rest tumors. We present a patient who developed bilateral testicular adrenal rest tumors after years of poorly controlled congenital adrenal hyperplasia, possibly due to chronically elevated adrenocorticotropic hormone stimulating the growth of testicular stem cells. Our patient also has a testicular ultrasound appearance that is hyperechogenic, rather than hypoechogenic as commonly described in the literature. Treatment adherence is important in the management of congenital adrenal hyperplasia, as testicular adrenal rest tumors may eventually lead to infertility.

Progress in Antiviral Fullerene Research.

Unlike traditional small molecule drugs, fullerene is an all-carbon nanomolecule with a spherical cage structure. Fullerene exhibits high levels of antiviral activity, inhibiting virus replication in vitro and in vivo. In this review, we systematically summarize the latest research regarding the different types of fullerenes investigated in antiviral studies. We discuss the unique structural advantage of fullerenes, present diverse modification strategies based on the addition of various functional groups, assess the effect of structural differences on antiviral activity, and describe the possible antiviral mechanism. Finally, we discuss the prospective development of fullerenes as antiviral drugs.

Impacts of the COVID-19 lockdown on building energy consumption and indoor environment: A case study in Dalian, China.

Restricting social distancing is an effective means of controlling the COVID-19 pandemic, resulting in a sharp drop in the utilization of commercial buildings. However, the specific changes in the operating parameters are not clear. This study aims to quantify the impact of COVID-19 lockdowns on commercial building energy consumption and the indoor environment, including correlation analysis. A large green commercial building in Dalian, China's only country to experience five lockdowns, has been chosen. We compared the performance during the lockdown to the same period last year. The study found that the first lockdown caused a maximum 63.5% drop in monthly energy consumption, and the second lockdown was 55.2%. The energy consumption per unit area in 2020 dropped by 55.4% compared with 2019. In addition, during the lockdown, the compliance rate of indoor thermal environment increased by 34.7%, and indoor air quality was 9.5%. These findings could partly explain the short-term and far-reaching effects of the lockdown on the operating parameters of large commercial buildings. Humans are likely to coexist with COVID-19 for a long time, and commercial buildings have to adapt to new energy and health demands. Effective management strategies need to be developed.

SARS-CoV-2 Viral Budding and Entry can be Modeled Using BSL-2 Level Virus-Like Particles

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in December 2019 in Wuhan, China and expeditiously spread across the globe causing a global pandemic. Research on SARS-CoV-2, as well as the closely related SARS-CoV-1 and MERS coronaviruses is restricted to BSL-3 facilities. Such BSL-3 classification makes SARS-CoV-2 research inaccessible to the majority of functioning research laboratories in the US;this becomes problematic when the collective scientific effort needs to be focused on such in the face of a pandemic. However, a minimal system capable of recapitulating different steps of the viral life cycle without using the virus' genetic material could increase accessibility. In this work, we assessed the four structural proteins from SARS-CoV-2 for their ability to form virus-like particles (VLPs) from human cells to form a competent system for BSL-2 studies of SARS-CoV-2. After establishing the minimal system requirements for VLP production, we examined their morphological relevance with transmission electron microscopy (TEM). VLPs produced with all four viral structural proteins were approximately 100 nm in diameter and bared the characteristic coronavirus crown or ?corona?. We next sought to evaluate the entry competency of our VLPs. GFP-tagged VLPs were generated by fluorescently tagging one of the four structural proteins used to produce VLPs. Once incorporation of the GFP-tagged protein into VLPs was confirmed, we used these GFP-VLPs to infect HEK293 cells. GFP-VLPs indeed did enter HEK293 cells and properly colocalized with endocytic markers Rab5 and LAMP1 in accordance with live virus data. To further evaluate viral entry, we made the VLP entry assay accessible to TEM analysis by replacing the GFP tag with an ascorbate peroxidase (APEX2) tag, which when oxidized produces a dark brown precipitate visible on micrographs. APEX2-VLPs were found to be entry-competent as well. In addition to entry, APEX2-VLPs yield the ability to visualize VLP assembly at the ER-Golgi intermediary complex (ERGIC) and for the first time we show localization of the structural proteins during SARS-CoV-2 VLP assembly, budding, and egress. In total, this research provides ample resources for other BSL-2 laboratories interested in joining the growing field to try and understand SARS-CoV-2 assembly, budding, and entry dynamics, biochemical and biophysical questions on the four structural proteins, and drug screening of viral assembly, budding, and/or entry inhibitors.

Influence of the Coronavirus Disease 2019 Pandemic on Patients with ST-Segment Elevation Myocardial Infarction in Taiwan.

The outbreak of the new coronavirus disease 2019 (COVID-19) has notably affected the medical system worldwide and influenced the health-seeking behavior of people while depleting medical resources, causing a delay in ST-elevation myocardial infarction (STEMI) management. In this single-center, retrospective cohort study, we compared the clinical pictures of nontransfer patients who presented to the emergency department directly and received primary percutaneous cardiovascular intervention (PPCI) from February 1 to April 30, 2020 (group 2, N = 28), with patients who received PPCI from February 1 to April 30, 2016-2019 (group 1, N = 130). A total of 158 patients with STEMI who received PPCI were included in the study. A decrease in the percentage of patients with door-to-balloon time <90 minutes was found in group 2 (64.3% vs. 81.5%, p = 0.044). The adjusted odds ratio was calculated using logistic regression, according to potential confounding factors such as age, sex, off-hours, and Killip class. An adjusted odds ratio of 2.45 (95% confidence interval, 1.1-6.0, p = 0.048) was reported for group 2. A decrease in the percentage of patients meeting the criteria of door-to-balloon time <90 minutes was demonstrated, and differences were revealed in the clinical pictures of patients with STEMI after the pandemic. While systemic factors contributed the most, improvements and adjustments in the protocols for managing patients with STEMI for better outcomes in the COVID-19 era have yet to be studied.

SARS-CoV-2 viral budding and entry can be modeled using BSL-2 level virus-like particles.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in December 2019 in Wuhan, China, and expeditiously spread across the globe causing a global pandemic. Research on SARS-CoV-2, as well as the closely related SARS-CoV-1 and MERS coronaviruses, is restricted to BSL-3 facilities. Such BSL-3 classification makes SARS-CoV-2 research inaccessible to the majority of functioning research laboratories in the United States; this becomes problematic when the collective scientific effort needs to be focused on such in the face of a pandemic. However, a minimal system capable of recapitulating different steps of the viral life cycle without using the virus' genetic material could increase accessibility. In this work, we assessed the four structural proteins from SARS-CoV-2 for their ability to form virus-like particles (VLPs) from human cells to form a competent system for BSL-2 studies of SARS-CoV-2. Herein, we provide methods and resources of producing, purifying, fluorescently and APEX2-labeling of SARS-CoV-2 VLPs for the evaluation of mechanisms of viral budding and entry as well as assessment of drug inhibitors under BSL-2 conditions. These systems should be useful to those looking to circumvent BSL-3 work with SARS-CoV-2 yet study the mechanisms by which SARS-CoV-2 enters and exits human cells.

Dysosmia and dysgeusia in patients with COVID-19 in northern Taiwan.

BACKGROUND/PURPOSE: To investigate the characteristics of dysosmia and dysgeusia among patients diagnosed with coronavirus disease 2019 (COVID-19) in Taiwan. METHODS: Prospective data collection between January 22, 2020 to May 7, 2020 of nucleic acid confirmed COVID-19 hospitalized patients in northern Taiwan by the Taiwan Centers for Disease Control were analyzed. RESULTS: Of 217 patients enrolled, 78 (35.9%) reported dysosmia (n = 73, 33.6%) and/or dysgeusia (n = 62, 28.6%). The median duration of COVID-19 associated symptom-onset to development of dysosmia and/or dysgeusia was <1 days (interquartile range [IQR], <1-6 days) and 53 of 78 (67.9%) patients developed dysosmia and/or dysgeusia as one of the initial symptoms of COVID-19. Of 59 closely monitored patients, 41 (69.5%) patients recovered within 3 weeks after symptoms onset and the median time to recovery was 12 days (IQR, 7-20 days). Only 6 of the 59 (10.2%) patients reported persistent dysosmia and/or dysgeusia before discharge from hospitals. Multivariate analysis showed that younger individuals (adjusted hazard ratio [AHR], 0.93 per one-year increase; 95% confidence interval [95% CI], 0.89-0.97; P = 0.001), women (AHR, 2.76; 95% CI, 1.05-7.25; P = 0.04) and travel to North America (AHR, 2.35; 95% CI, 1.05-5.26; P = 0.04) were the significant factors associated with dysosmia and/or dysgeusia. CONCLUSION: Dysosmia and/or dysgeusia are common symptoms and clues for the diagnosis of COVID-19, particularly in the early stage of the disease. Physicians should be alerted to these symptoms to make timely diagnosis and management for COVID-19 to limit spread.

SARS-CoV-2 viral budding and entry can be modeled using virus-like particles.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first discovered in December 2019 in Wuhan, China and expeditiously spread across the globe causing a global pandemic. While a select agent designation has not been made for SARS-CoV-2, closely related SARS-CoV-1 and MERS coronaviruses are classified as Risk Group 3 select agents, which restricts use of the live viruses to BSL-3 facilities. Such BSL-3 classification make SARS-CoV-2 research inaccessible to the majority of functioning research laboratories in the US; this becomes problematic when the collective scientific effort needs to be focused on such in the face of a pandemic. In this work, we assessed the four structural proteins from SARS-CoV-2 for their ability to form viruslike particles (VLPs) from human cells to form a competent system for BSL-2 studies of SARS-CoV-2. Herein, we provide methods and resources of producing, purifying, fluorescently and APEX2-labeling of SARS-CoV-2 VLPs for the evaluation of mechanisms of viral budding and entry as well as assessment of drug inhibitors under BSL-2 conditions.

Ribavirin therapy for severe COVID-19: a retrospective cohort study.

The aim of this study was to compare ribavirin therapy versus supportive therapy only for patients with severe coronavirus disease 2019 (COVID-19). A total of 115 patients with laboratory-confirmed COVID-19 were retrospectively analysed. All patients received supportive care as well as regular laboratory and clinical monitoring. The 115 patients comprised 44 patients who received intravenous ribavirin (treatment group) and 71 who did not (control group). Baseline laboratory and clinical characteristics were similar between the two groups. The negative conversion time for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR in the ribavirin group was 12.8 ± 4.1 days compared with 14.1 ± 3.5 days in the control group (P = 0.314). Moreover, 7/41 patients (17.1%) in the ribavirin group died compared with 17/69 (24.6%) in the control group (P = 0.475). Adverse effects were similar between the two groups. In conclusion, in patients with severe COVID-19, ribavirin therapy is not associated with improved negative conversion time for SARS-CoV-2 test and is not associated with an improved mortality rate. Further assessment in designed randomised controlled trials is recommended.