International Liaison Committee on Resuscitation: COVID-19 consensus on science, treatment recommendations and task force insights.

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.

Public sentiment and discourse about Zika virus on Instagram.

OBJECTIVE: Social media have strongly influenced the awareness and perceptions of public health emergencies, and a considerable amount of social media content is now shared through images, rather than text alone. This content can impact preparedness and response due to the popularity and real-time nature of social media platforms. We sought to explore how the image-sharing platform Instagram is used for information dissemination and conversation during the current Zika outbreak. STUDY DESIGN: This was a retrospective review of publicly posted images about Zika on Instagram. METHODS: Using the keyword '#zika' we identified 500 images posted on Instagram from May to August 2016. Images were coded by three reviewers and contextual information was collected for each image about sentiment, image type, content, audience, geography, reliability, and engagement. RESULTS: Of 500 images tagged with #zika, 342 (68%) contained content actually related to Zika. Of the 342 Zika-specific images, 299 were coded as 'health' and 193 were coded 'public interest'. Some images had multiple 'health' and 'public interest' codes. Health images tagged with #zika were primarily related to transmission (43%, 129/299) and prevention (48%, 145/299). Transmission-related posts were more often mosquito-human transmission (73%, 94/129) than human-human transmission (27%, 35/129). Mosquito bite prevention posts outnumbered safe sex prevention; (84%, 122/145) and (16%, 23/145) respectively. Images with a target audience were primarily aimed at women (95%, 36/38). Many posts (60%, 61/101) included misleading, incomplete, or unclear information about the virus. Additionally, many images expressed fear and negative sentiment, (79/156, 51%). CONCLUSION: Instagram can be used to characterize public sentiment and highlight areas of focus for public health, such as correcting misleading or incomplete information or expanding messages to reach diverse audiences.

The content of social media's shared images about Ebola: a retrospective study.

OBJECTIVE: Social media have strongly influenced awareness and perceptions of public health emergencies, but a considerable amount of social media content is now carried through images, rather than just text. This study's objective is to explore how image-sharing platforms are used for information dissemination in public health emergencies. STUDY DESIGN: Retrospective review of images posted on two popular image-sharing platforms to characterize public discourse about Ebola. METHODS: Using the keyword '#ebola' we identified a 1% sample of images posted on Instagram and Flickr across two sequential weeks in November 2014. Images from both platforms were independently coded by two reviewers and characterized by themes. We reviewed 1217 images posted on Instagram and Flickr and identified themes. RESULTS: Nine distinct themes were identified. These included: images of health care workers and professionals [308 (25%)], West Africa [75 (6%)], the Ebola virus [59 (5%)], and artistic renderings of Ebola [64 (5%)]. Also identified were images with accompanying embedded text related to Ebola and associated: facts [68 (6%)], fears [40 (3%)], politics [46 (4%)], and jokes [284 (23%)]. Several [273 (22%)] images were unrelated to Ebola or its sequelae. Instagram images were primarily coded as jokes [255 (42%)] or unrelated [219 (36%)], while Flickr images primarily depicted health care workers and other professionals [281 (46%)] providing care or other services for prevention or treatment. CONCLUSION: Image sharing platforms are being used for information exchange about public health crises, like Ebola. Use differs by platform and discerning these differences can help inform future uses for health care professionals and researchers seeking to assess public fears and misinformation or provide targeted education/awareness interventions.

Presentation of the self antigen myelin basic protein by dendritic cells leads to experimental autoimmune encephalomyelitis.

Bone marrow (BM)-derived dendritic cells (DC) are potent stimulators of naive CD4+ T cell activation. Because DC are efficient at Ag processing and could potentially present self Ags, we investigated the role of DC in the presentation of an encephalitogenic peptide from myelin basic protein (Ac1-11) in the induction of experimental autoimmune encephalomyelitis (EAE). To determine if DC could prime for EAE, we transferred DC pulsed with Ac1-11 or with medium alone into irradiated mice in combination with CD4+ T cells isolated from a mouse transgenic for a TCR specific for Ac1-11 + I-Au. Mice transferred with Ac1-11-pulsed DC developed EAE 7-10 days later, whereas mice receiving medium-pulsed DC did not. By day 15, all mice given peptide-loaded DC had signs of tail and hind limb paralysis, and by day 20 infiltration of Ac1-11-specific CD4+ T cells was detected in the brain parenchyma. We also demonstrated interactions between Ac1-11-pulsed DC and Ac1-11-specific T cells in the lymph nodes 24 h following adoptive transfer of both cell populations. These data show that DC can efficiently present the self Ag myelin basic protein Ac1-11 to Ag-specific T cells in the periphery of mice to induce EAE.

Evidence for Fas-dependent and Fas-independent mechanisms in the pathogenesis of experimental autoimmune encephalomyelitis.

To determine whether Fas or Fas ligand (FasL) plays a role in susceptibility to experimental autoimmune encephalomyelitis (EAE), we bred a TCR transgenic mouse specific for the Ac1-11 peptide of myelin basic protein to mice with inactivating mutations in Fas (lpr) or FasL (gld). Disease induction by peptide immunization in such mice produced similar disease scores, demonstrating that Fas/FasL interactions were not necessary to generate EAE. However, adoptive transfer experiments showed evidence that these interactions can play a role in the pathogenesis of EAE, shown most dramatically by the absence of disease following transfer of cells from a normal myelin basic protein TCR transgenic mouse into a Fas-deficient lpr recipient. Furthermore, transfer of cells lacking FasL (gld) into normal or gld recipients gave a diminished disease score. Thus, Fas/FasL interactions can play a role in the pathogenesis of EAE, but they are not required for disease to occur.