A COVID-19 Decision Support System for Phone Call Triage, Designed by and for Medical Students.

During spring 2020, SARS-CoV-2 pandemic induced shortage of medical equipment, hospital capacity and staff. To tackle this issue, medical students have been strongly involved in early patient triage through medical phone call regulation. Here, we present an intelligent web-based decision support system for COVID-19 phone call regulation, developed by and for, medical students to help them during this difficult but crucial task. The system is divided into 5 tabs. The first tab displays administrative information, clinical data related to life-threatening emergency, and personalized recommendations for patient management. The second tab displays a PDF report summarizing the clinical situation; the third tab displays the guidelines used for establishing the recommendations, and the fourth tab displays the overall algorithm in the form of a decision tree. The fifth tab provided a short user guide. The system was assessed by 21 medical staff. More than 90% of them appreciated the navigation and the interface, and found the content relevant. 90,5% of them would like to use it during the medical regulation. In the future, we plan to use this system during simulation-based medical learning for the initial medical training of medical students.

A minimal self-organisation model of the Golgi apparatus.

The design principles dictating the spatio-temporal organisation of eukaryotic cells, and in particular the mechanisms controlling the self-organisation and dynamics of membrane-bound organelles such as the Golgi apparatus, remain elusive. Although this organelle was discovered 120 years ago, such basic questions as whether vesicular transport through the Golgi occurs in an anterograde (from entry to exit) or retrograde fashion are still strongly debated. Here, we address these issues by studying a quantitative model of organelle dynamics that includes: de-novo compartment generation, inter-compartment vesicular exchange, and biochemical conversion of membrane components. We show that anterograde or retrograde vesicular transports are asymptotic behaviors of a much richer dynamical system. Indeed, the structure and composition of cellular compartments and the directionality of vesicular exchange are intimately linked. They are emergent properties that can be tuned by varying the relative rates of vesicle budding, fusion and biochemical conversion.

Author Correction: Airway surface liquid acidification initiates host defense abnormalities in Cystic Fibrosis.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Airway surface liquid acidification initiates host defense abnormalities in Cystic Fibrosis.

Cystic fibrosis (CF) is caused by defective Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) protein. Morbidity is mainly due to early airway infection. We hypothesized that S. aureus clearance during the first hours of infection was impaired in CF human Airway Surface Liquid (ASL) because of a lowered pH. The ASL pH of human bronchial epithelial cell lines and primary respiratory cells from healthy controls (WT) and patients with CF was measured with a pH microelectrode. The antimicrobial capacity of airway cells was studied after S. aureus apical infection by counting surviving bacteria. ASL was significantly more acidic in CF than in WT respiratory cells. This was consistent with a defect in bicarbonate secretion involving CFTR and SLC26A4 (pendrin) and a persistent proton secretion by ATP12A. ASL demonstrated a defect in S. aureus clearance which was improved by pH normalization. Pendrin inhibition in WT airways recapitulated the CF airway defect and increased S. aureus proliferation. ATP12A inhibition by ouabain decreased bacterial proliferation. Antimicrobial peptides LL-37 and hBD1 demonstrated a pH-dependent activity. Normalizing ASL pH might improve innate airway defense in newborns with CF during onset of S. aureus infection. Pendrin activation and ATP12A inhibition could represent novel therapeutic strategies to normalize pH in CF airways.