Introduction on Coronavirus Disease (COVID-19) Pandemic: The Global Challenge.

By driving the ongoing pandemic of coronavirus disease 2019 (COVID-19), coronaviruses have become a significant change in twenty-first-century medicine, healthcare systems, education, and the global economy. This chapter rapidly reviews the origin, immunopathogenesis, epidemiology, diagnosis, clinical manifestations, and potential therapeutics of COVID-19. It would also explore the effects of the introduction of a single virus, the so-called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the public health preparedness planning.

Interdisciplinary Approaches to COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has been a significant concern worldwide. The pandemic has demonstrated that public health issues are not merely a health concern but also affect society as a whole. In this chapter, we address the importance of bringing together the world's scientists to find appropriate solutions for controlling and managing the COVID-19 pandemic. Interdisciplinary cooperation, through modern scientific methods, could help to handle the consequences of the pandemic and to avoid the recurrence of future pandemics.

The urgent need for integrated science to fight COVID-19 pandemic and beyond.

The COVID-19 pandemic has become the leading societal concern. The pandemic has shown that the public health concern is not only a medical problem, but also affects society as a whole; so, it has also become the leading scientific concern. We discuss in this treatise the importance of bringing the world's scientists together to find effective solutions for controlling the pandemic. By applying novel research frameworks, interdisciplinary collaboration promises to manage the pandemic's consequences and prevent recurrences of similar pandemics.

The Effect of Rituximab on the Cognitive Function of Patients with Relapsing-Remitting Multiple Sclerosis.

PURPOSE: Cognitive impairment can begin in the early stages of multiple sclerosis (MS). No medicine has been approved for treating cognitive impairment in MS patients. There is a lack of data on the role of rituximab in managing cognitive impairment in MS patients. Using minimal assessment of cognitive function in MS (MACFIMS), this study aims to investigate the effect of rituximab on the cognitive status of relapsing-remitting MS (RRMS) patients. METHODS: In this pre-post interventional trial, 28 eligible RRMS patients participated. They were administered rituximab for a year. Cognitive tests (MACFIMS), MS neuropsychological questionnaire (MSNQ), and Beck depression inventory-fast screen (BDI-FS) scores were evaluated at baseline, six, and 12 months following rituximab administration. FINDINGS: Eighteen participants with a mean age of 40.5 ± 12.91, 7 men, completed all three follow-ups. There was no statistically significant change in BDI-FS, MSNQ, Paced Auditory Serial Addition Test (P: 0.743), Symbol Digit Modalities Test (P: 0.711), Brief Visual Memory Test (BVMT) (P: 0.426), learning BVMT (P: 0.268), and delayed recall BVMT (P: 0.394) scores. However, the California Verbal Learning Test (CVLT), CVLT learning, and Controlled Oral Word Association Test scores significantly improved by 45.2% (P < 0.001), 12.3% (P: 0.013), and 26.7% (P: 0.011), respectively, 6-month follow-up rituximab treatment. There was a significant improvement in CVLT (+55.7%, P < 0.001), CVLT learning (+15.9%, P: 0.011), and delayed recall CVLT (+28%, P: 0.022) scores 12-month follow-up rituximab treatment. IMPLICATIONS: Rituximab prevents cognitive deterioration and improves some cognitive functions. Further investigations with a larger sample size, longer follow-ups, and inclusion of a placebo or another treatment arm are recommended.

Effects of backward-directed resistance on propulsive force generation during split-belt treadmill walking in non-impaired individuals.

Introduction: Backward-directed resistance is the resistance applied in the opposite direction of the individual's walking motion. Progressive application of backward-directed resistance during walking at a target speed engages adaptive motor control to maintain that speed. During split-belt walking, a motor control strategy must be applied that allows the person to keep up with the two belts to maintain their position on the treadmill. This situation becomes more challenging when progressive resistance is applied since each limb needs to adapt to the greater resistance to maintain the position. We propose that strategies aimed at changing relative propulsion forces with each limb may explain the motor control strategy used. This study aimed to identify the changes in propulsive force dynamics that allow individuals to maintain their position while walking on an instrumented split-belt treadmill with progressively increasing backward-directed resistance. Methods: We utilized an instrumented split-belt treadmill while users had to overcome a set of increasing backward-directed resistance through the center of mass. Eighteen non-impaired participants (mean age = 25.2 ± 2.51) walked against five levels of backward resistance (0, 5, 10, 15, and 20% of participant's body weight) in two different modalities: single-belt vs. split-belt treadmill. On the single-belt mode, the treadmill's pace was the participant's comfortable walking speed (CWS). In split-belt mode, the dominant limb's belt pace was half of the CWS, and the non-dominant limb's belt speed was at the CWS. Results: We assessed differences between single-belt vs. split-belt conditions in the slope of the linear relationship between change in propulsive impulse relative to change of backward resistance amount. In split-belt conditions, the slower limb showed a significantly steeper increase in propulsion generation compared to the fast limb across resistance levels. Discussion: As a possible explanation, the slow limb also exhibited a significantly increased slope of the change in trailing limb angle (TLA), which was strongly correlated to the propulsive impulse slope values. We conclude that the motor control strategy used to maintain position on a split-belt treadmill when challenged with backward-directed resistance is to increase the propulsive forces of the slow limb relative to the fast limb by progressively increasing the TLA. Clinical trial registration: ClinicalTrials.gov, identifier NCT04877249.

Severe congenital neutropenia due to G6PC3 deficiency: early and delayed phenotype of a patient.

BACKGROUND: Severe Congenital Neutropenia type 4 (SCN4), is a rare autosomal recessive condition, due to mutations in the G6PC3 gene. The phenotype comprises neutropenia of variable severity and accompanying anomalies. CASE PRESENTATION: We report a male patient with confirmed G6PC3 deficiency presented with recurrent bacterial infections and multi-systemic complications. Our case was the first with a novel homozygous frameshift mutation in G6PC3. The patient demonstrated large platelets on his peripheral blood smear which is a rare presentation of this disease. CONCLUSION: As SCN4 patients could be easily missed, it is recommended to consider G6PC3 mutation for any case of congenital, unexplained neutropenia.

Cytokine release syndrome: inhibition of pro-inflammatory cytokines as a solution for reducing COVID-19 mortality.

Coronavirus disease (COVID-19) reached pandemic proportions at the beginning of 2020 and continues to be a worldwide concern. End organ damage and acute respiratory distress syndrome are the leading causes of death in severely or critically ill patients. The elevated cytokine levels in severe patients in comparison with mildly affected patients suggest that cytokine release syndrome (CRS) occurs in the severe form of the disease. In this paper, the significant role of pro-inflammatory cytokines, including IL-1, IL-6, and TNF-alpha, and their mechanism of action in the CRS cascade is explained. Potential therapeutic approaches involving anti-IL-6 and anti-TNF-alpha antibodies to fight COVID-19 and reduce mortality rate in severe cases are also discussed.