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AbstractThe legal and illegal trade in wildlife for food, medicine and other products is a globally significant threat to biodiversity that is also responsible for the emergence of pathogens that threaten human and livestock health and our global economy. Trade in wildlife likely played a role in the origin of COVID-19, and viruses closely related to SARS-CoV-2 have been identified in bats and pangolins, both traded widely. To investigate the possible role of pangolins as a source of potential zoonoses, we collected throat and rectal swabs from 334 Sunda pangolins (Manis javanica) confiscated in Peninsular Malaysia and Sabah between August 2009 and March 2019. Total nucleic acid was extracted for viral molecular screening using conventional PCR protocols used to routinely identify known and novel viruses in extensive prior sampling (> 50,000 mammals). No sample yielded a positive PCR result for any of the targeted viral families—Coronaviridae, Filoviridae, Flaviviridae, Orthomyxoviridae and Paramyxoviridae. In the light of recent reports of coronaviruses including a SARS-CoV-2-related virus in Sunda pangolins in China, the lack of any coronavirus detection in our ‘upstream’ market chain samples suggests that these detections in ‘downstream’ animals more plausibly reflect exposure to infected humans, wildlife or other animals within the wildlife trade network. While confirmatory serologic studies are needed, it is likely that Sunda pangolins are incidental hosts of coronaviruses. Our findings further support the importance of ending the trade in wildlife globally.

Abstract The COVID-19 pandemic has affected human mobility via lockdowns, social distancing rules, home quarantines, and the full or partial suspension of transportation. Evidence-based policy recommendations are urgently needed to ensure that transport systems have resilience to future pandemic outbreaks, particularly within Global South megacities where demand for public transport is high and reduced access can exacerbate socio-economic inequalities. This study focuses on Metro Manila – a characteristic megacity that experienced one of the most stringent lockdowns worldwide. It analyzes aggregated cell phone and GPS data from Google and Apple that provide a comprehensive representation of mobility behavior before and during the lockdown. While significant decreases are observed for all transport modes, public transport experienced the largest drop (−74.5 %, on average). The study demonstrates that: (i) those most reliant on public transport were disproportionately affected by lockdowns; (ii) public transport was unable to fulfil its role as public service; and, (iii) this drove a paradigm shift towards active mobility. Moving forwards, in the short-term policymakers must promote active mobility and prioritize public transport to reduce unequal access to transport. Longer-term, policymakers must leverage the increased active transport to encourage modal shift via infrastructure investment, and better utilize big data to support decision-making.

The ongoing COVID-19 outbreak has expanded rapidly throughout China. Major behavioral, clinical, and state interventions are underway currently to mitigate the epidemic and prevent the persistence of the virus in human populations in China and worldwide. It remains unclear how these unprecedented interventions, including travel restrictions, have affected COVID-19 spread in China. We use real-time mobility data from Wuhan and detailed case data including travel history to elucidate the role of case importation on transmission in cities across China and ascertain the impact of control measures. Early on, the spatial distribution of COVID-19 cases in China was well explained by human mobility data. Following the implementation of control measures, this correlation dropped and growth rates became negative in most locations, although shifts in the demographics of reported cases are still indicative of local chains of transmission outside Wuhan. This study shows that the drastic control measures implemented in China have substantially mitigated the spread of COVID-19. One sentence summary: The spread of COVID-19 in China was driven by human mobility early on and mitigated substantially by drastic control measures implemented since the end of January.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. It is evident there is an urgent need for tourism companies to build highly responsive learning systems to adapt to COVID-19 threats and beyond. As such, only learning tourism companies that promote inquiry, challenging current actions, and departing away from adopted assumptions will be able to survive. However, there is paucity of studies exploring effective learning methods in tourism companies to adapt to unpredictable crisis consequences. This study argues that systems thinking approach for service delivery design can operationalize double loop learning in tourism companies of finding alternative service offerings. An exploratory case study was conducted in a leading cruise group company in Vietnam. Results show that systems thinking activated double-loop learning by promoting three different drivers: systematic judges and acts, problem-based task force teams, and service innovation. This paper theorizes systems thinking with double-loop learning as an organizational means to help tourism companies survive during COVID-19 global tragedy, and to transform their service offerings. It also extends current understanding of tourism companies’ organisational learning by incorporating double loop learning with structural design issues based on the lens of organic structures and introduces managers of tourism companies to the significance of organic structures for competitive advantage creation during crisis.

Abstract The study develops and examines the spatial distribution of the Corona Virus Disease (COVID) on mortality outcomes using a global panel dataset of 79 countries. The empirical evidence is based on Fixed Effect (FE) and System Generalized Method of Moment (SGMM) estimator. The predicted variable is proxy with daily mortality outcomes, while the predictor variable is proxy with spatial COVID spread while controlling for social tension and average temperature. The global and regional findings of the study established that spatial variation in COVID spread had positive and significant relationships with mortality outcomes. Further results also indicate that social tension is a contributing factor to the rising daily mortality outcome from the COVD outbreak, whereas temperature variation reduces mortality outcome. Thus, the study recommends the use of statistical modelling to predict and manage the epidemic. Also, there is an urgent demand to deploy essential social need to the vulnerable proportion of the population to reduce the level of social unrest, while strengthening collaborative research among scientists to develop, produce and distribute vaccines that will put an end to the pandemic.

Abstract Background Best practice for prevention, diagnosis, and management of venous thromboembolism (VTE) in patients with coronavirus disease 2019 (COVID‐19) is unknown due to limited published data in this population. Objectives We aimed to assess current global practice and experience in management of COVID‐19–associated coagulopathy to identify information to guide prospective and randomized studies. Methods Physicians were queried about their current approach to prophylaxis, diagnosis, and treatment of VTE in patients with COVID‐19 using an online survey tool distributed through multiple international organizations between April 10 and 14, 2020. Results Five hundred fifteen physicians from 41 countries responded. The majority of respondents (78%) recommended prophylactic anticoagulation for all hospitalized patients with COVID‐19, with most recommending use of low‐molecular‐weight heparin or unfractionated heparin. Significant practice variation was found regarding the need for dose escalation of anticoagulation outside the setting of confirmed or suspected VTE. Respondents reported the use of bedside testing when unable to perform standard diagnostic imaging for diagnosis of VTE. Two hundred ninety‐one respondents reported observing thrombotic complications in their patients, with 64% noting that the complication was pulmonary embolism. Of the 44% of respondents who estimated incidence of thrombosis in patients with COVID‐19 in their hospital, estimates ranged widely from 1% to 50%. One hundred seventy‐four respondents noted bleeding complications (34% minor bleeding, 14% clinically relevant nonmajor bleeding, and 12% major bleeding). Conclusion Well‐designed epidemiologic studies are urgently needed to understand the incidence and risk factors of VTE and bleeding complications in patients with COVID‐19. Randomized clinical trials addressing use of anticoagulation are also needed.

Abstract\ud The National Diabetes Audit (NDA) collates and analyses data on the quality and variation in clinical care and outcomes for people with diabetes. It also provides opportunities to assess trends, determinants, and outcomes of diabetes to help guide clinical and public health priorities.\ud \ud Cohort: \ud Between 1st January 2003 and 31st March 2020 a total of 5,280,885 people diagnosed with diabetes were included in at least one NDA data collection. To this date, median follow up was 12 and 8 years for people with type 1 diabetes and type 2 diabetes respectively. Comparisons with the 2019/20 Quality and Outcomes Framework show it included 98% of adults in England and Wales with diagnosed type 1 and type 2 diabetes. Data includes demographic characteristics (age, sex, ethnicity, age at diagnosis, deprivation), risk factors (HbA1c, blood pressure, cholesterol, body mass index, smoking status) diabetic and cardiovascular complications and deaths.\ud \ud Secondary analysis: \ud Secondary analyses have included: comparisons of HbA1c and blood pressure measurements in cohorts with similar characteristics to the Epidemiology of Diabetes Interventions and Complications study and the UK Prospective Diabetes Study; COVID-19 related mortality in people with Type 1 and Type 2 diabetes and incidence of Type 2 diabetes following admission to intensive care units.\ud \ud Future plans: \ud Commissioned NDA reports will continue to inform service development in England and Wales. The same data, with or without linkages to other external datasets, is also a rich resource for clinically orientated research.

The binding of F4+ enterotoxigenic Escherichia coli (ETEC) and the specific receptor on porcine intestinal epithelial cells is the initial step in F4+ ETEC infection. Porcine aminopeptidase N (APN) is a newly discovered receptor for F4 fimbriae that binds directly to FaeG adhesin, which is the major subunit of the F4 fimbriae variants F4ab, F4ac, and F4ad. We used overlapping peptide assays to map the APN-FaeG binding sites, which has facilitated in the identifying the APN-binding amino acids that are located in the same region of FaeG variants, thereby limiting the major binding regions of APN to 13 peptides. To determine the core sequence motif, a panel of FaeG peptides with point mutations and FaeG mutants were constructed. Pull-down and binding reactivity assays using piglet intestines determined that the amino acids G159 of F4ab, N209 and L212 of F4ac, and A200 of F4ad were the critical residues for APN binding of FaeG. We further show using ELISA and confocal microscopy assay that amino acids 553–568, and 652–670 of the APN comprise the linear epitope for FaeG binding in all three F4 fimbriae variants. Electronic supplementary material The online version of this article (10.1186/s13567-018-0519-9) contains supplementary material, which is available to authorized users.

Association of Surgeons in Training Surgical Summit, online, 17 Oct 2020 - 17 Oct 2020 2021 Virtual Annual Meeting / Surgical Research Society, online, 24 Mar 2021 - 25 Mar 2021, National Research Collaborative Meeting, online, 10 Dec 2020 - 10 Dec 2020, Royal Australasian College of Surgeons Annual Academic Surgery Conference, online, 5 Nov 2020 - 5 Nov 2020; The British journal of surgery : BJS 108(12), 1448-1464 (2021). doi:10.1093/bjs/znab336 Published by Wiley, New York, NY [u.a.]