Multifaceted Mechanisms of Action of Metformin Which Have Been Unraveled One after Another in the Long History

While there are various kinds of drugs for type 2 diabetes mellitus at present, in this review article, we focus on metformin which is an insulin sensitizer and is often used as a first-choice drug worldwide. Metformin mainly activates adenosine monophosphate-activated protein kinase (AMPK) in the liver which leads to suppression of fatty acid synthesis and gluconeogenesis. Metformin activates AMPK in skeletal muscle as well, which increases translocation of glucose transporter 4 to the cell membrane and thereby increases glucose uptake. Further, metformin suppresses glucagon signaling in the liver by suppressing adenylate cyclase which leads to suppression of gluconeogenesis. In addition, metformin reduces autophagy failure observed in pancreatic β-cells under diabetic conditions. Furthermore, it is known that metformin alters the gut microbiome and facilitates the transport of glucose from the circulation into excrement. It is also known that metformin reduces food intake and lowers body weight by increasing circulating levels of the peptide hormone growth/differentiation factor 15 (GDF15). Furthermore, much attention has been drawn to the fact that the frequency of various cancers is lower in subjects taking metformin. Metformin suppresses the mechanistic target of rapamycin (mTOR) by activating AMPK in pre-neoplastic cells, which leads to suppression of cell growth and an increase in apoptosis in pre-neoplastic cells. It has been shown recently that metformin consumption potentially influences the mortality in patients with type 2 diabetes mellitus and coronavirus infectious disease (COVID-19). Taken together, metformin is an old drug, but multifaceted mechanisms of action of metformin have been unraveled one after another in its long history.     

Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with COVID-19: A Retrospective Study

Diabetes and its related metabolic disorders have been reported as the leading comorbidities in patients with coronavirus disease 2019 (COVID-19). This clinical study aims to investigate the clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes in COVID-19 patients with or without diabetes. This retrospective study included 208 hospitalized patients (≥ 45 years old) with laboratory-confirmed COVID-19 during the period between 12 January and 25 March 2020. Information from the medical record, including clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes, were extracted for the analysis. 96 (46.2%) patients had comorbidity with type 2 diabetes. In COVID-19 patients with type 2 diabetes, the coexistence of hypertension (58.3% vs 31.2%), coronary heart disease (17.1% vs 8.0%), and chronic kidney diseases (6.2% vs 0%) was significantly higher than in COVID-19 patients without type 2 diabetes. The frequency and degree of abnormalities in computed tomography (CT) chest scans in COVID-19 patients with type 2 diabetes were markedly increased, including ground-glass opacity (85.6% vs 64.9%, P < 0.001) and bilateral patchy shadowing (76.7% vs 37.8%, P < 0.001). In addition, the levels of blood glucose (7.23 mmol·L⁻¹ (interquartile range (IQR): 5.80–9.29) vs 5.46 mmol·L⁻¹ (IQR: 5.00–6.46)), blood low-density lipoprotein cholesterol (LDL-C) (2.21 mmol·L⁻¹ (IQR: 1.67–2.76) vs 1.75 mmol·L⁻¹ (IQR: 1.27–2.01)), and systolic pressure (130 mmHg (IQR: 120–142) vs 122 mmHg (IQR: 110–137)) (1 mmHg = 133.3 Pa) in COVID-19 patients with diabetes were significantly higher than in patients without diabetes (P < 0.001). The coexistence of type 2 diabetes and other metabolic disorders is common in patients with COVID-19, which may potentiate the morbidity and aggravate COVID-19 progression. Optimal management of the metabolic hemostasis of glucose and lipids is the key to ensuring better clinical outcomes. Increased clinical vigilance is warranted for COVID-19 patients with diabetes and other metabolic diseases that are fundamental and chronic conditions.     

一次性使用医用手套标准解读

一次性医用手套是能够防止人们交叉感染的常用防护用品。随着新冠肺炎疫情在全球范围的迅速蔓延,疫情防控一线以及广大普通民众对一次性医用手套的需求与日俱增,其标准也受到广泛关注。本文对中国国家标准涉及一次性使用医用手套的4项产品标准进行了解读,并分析它们与国外同种产品标准间的对应关系以及重点指标的差异。     

FibVID: Comprehensive fake news diffusion dataset during the COVID-19 period

As the SARS-CoV-2 (COVID-19) pandemic has run rampant worldwide, the dissemination of misinformation has sown confusion on a global scale. Thus, understanding the propagation of fake news and implementing countermeasures has become exceedingly important to the well-being of society. To assist this cause, we produce a valuable dataset called FibVID (Fake news information-broadcasting dataset of COVID-19), which addresses COVID-19 and non-COVID news from three key angles. First, we provide truth and falsehood (T/F) indicators of news items, as labeled and validated by several fact-checking platforms (e.g., Snopes and Politifact). Second, we collect spurious-claim-related tweets and retweets from Twitter, one of the world’s largest social networks. Third, we provide basic user information, including the terms and characteristics of “heavy fake news” user to present a better understanding of T/F claims in consideration of COVID-19. FibVID provides several significant contributions. It helps to uncover propagation patterns of news items and themes related to identifying their authenticity. It further helps catalog and identify the traits of users who engage in fake news diffusion. We also provide suggestions for future applications of FibVID with a few exploratory analyses to examine the effectiveness of the approaches used.     

Viability of intertwined supply networks: extending the supply chain resilience angles towards survivability. A position paper motivated by COVID-19 outbreak

An intertwined supply network (ISN) is an entirety of interconnected supply chains (SC) which, in their integrity secure the provision of society and markets with goods and services. The ISNs are open systems with structural dynamics since the firms may exhibit multiple behaviours by changing the buyer-supplier roles in interconnected or even competing SCs. From the positions of resilience, the ISNs as a whole provide services to society (e.g. food service, mobility service or communication service) which are required to ensure a long-term survival. The analysis of survivability at the level of ISN requires a consideration at a large scale as resilience of individual SCs. The recent example of coronavirus COVID-19 outbreak clearly shows the necessity of this new perspective. Our study introduces a new angle in SC resilience research when a resistance to extraordinary disruptions needs to be considered at the scale of viability. We elaborate on the integrity of the ISN and viability. The contribution of our position study lies in a conceptualisation of a novel decision-making environment of ISN viability. We illustrate the viability formation through a dynamic game-theoretic modelling of a biological system that resembles the ISN. We discuss some future research areas.     

Experimental Treatment with Favipiravir for COVID-19: An Open-Label Control Study

There is currently an outbreak of respiratory disease caused by a novel coronavirus. The virus has been named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes has been named coronavirus disease 2019 (COVID-19). More than 16% of patients developed acute respiratory distress syndrome, and the fatality ratio was 1%–2%. No specific treatment has been reported. Herein, we examined the effects of favipiravir (FPV) versus lopinavir (LPV)/ritonavir (RTV) for the treatment of COVID-19. Patients with laboratory-confirmed COVID-19 who received oral FPV (Day 1: 1600 mg twice daily; Days 2–14: 600 mg twice daily) plus interferon (IFN)-α by aerosol inhalation (5 million international unit (IU) twice daily) were included in the FPV arm of this study, whereas patients who were treated with LPV/RTV (Days 1–14: 400 mg/100 mg twice daily) plus IFN-α by aerosol inhalation (5 million IU twice daily) were included in the control arm. Changes in chest computed tomography (CT), viral clearance, and drug safety were compared between the two groups. For the 35 patients enrolled in the FPV arm and the 45 patients in the control arm, all baseline characteristics were comparable between the two arms. A shorter viral clearance median time was found for the FPV arm versus the control arm (4 d (interquartile range (IQR): 2.5–9) versus 11 d (IQR: 8–13), P < 0.001). The FPV arm also showed significant improvement in chest CT compared with the control arm, with an improvement rate of 91.43% versus 62.22% (P = 0.004). After adjustment for potential confounders, the FPV arm also showed a significantly higher improvement rate in chest CT. Multivariable Cox regression showed that FPV was independently associated with faster viral clearance. In addition, fewer adverse events were found in the FPV arm than in the control arm. In this open-label before-after controlled study, FPV showed better therapeutic responses on COVID-19 in terms of disease progression and viral clearance. These preliminary clinical results provide useful information of treatments for SARS-CoV-2 infection.     

Epidemic contact tracing with smartphone sensors

ABSTRACT

Contact tracing is widely considered as an effective procedure in the fight against epidemic diseases. However, one of the challenges for technology based contact tracing is the high number of false positives, questioning its trust-worthiness and efficiency amongst the wider population for mass adoption. To this end, this paper proposes a novel, yet practical smartphone-based contact tracing approach, employing WiFi and acoustic sound for relative distance estimate, in addition to the air pressure and the magnetic field for ambient environment matching. We present a model combining six smartphone sensors, prioritising some of them when certain conditions are met. We empirically verified our approach in various realistic environments to demonstrate an achievement of up to 95% fewer false positives, and 62% more accurate than Bluetooth-only system. To the best of our knowledge, this paper was one of the first work to propose a combination of smartphone sensors for contact tracing.     

It doesn’t take a village to fall for misinformation: Social media use,discussion heterogeneity preference,worry of the virus,faith in scientists,and COVID-19-related misinformation beliefs

With the circulation of misinformation about the COVID-19 pandemic, the World Health Organization has raised concerns about an “infodemic,” which exacerbates people’s misperceptions and deters preventive measures. Against this backdrop, this study examined the conditional indirect effect of social media use and discussion heterogeneity preference on COVID-19-related misinformation beliefs in the United States, using a national survey. Findings suggested that social media use was positively associated with misinformation beliefs, while discussion heterogeneity preference was negatively associated with misinformation beliefs. Furthermore, worry of COVID-19 was found to be a significant mediator as both associations became more significant when mediated through worry. In addition, faith in scientists served as a moderator that mitigated the indirect effect of discussion heterogeneity preference on misinformation beliefs. That is, among those who had stronger faiths in scientists, the indirect effect of discussion heterogeneity preference on misinformation belief became more negative. The findings revealed communication and psychological factors associated with COVID-19-related misinformation beliefs and provided insights into coping strategies during the pandemic.     

Identification of Host Cellular Protein Substrates of SARS-COV-2 Main Protease

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease-19 (COVID-19) being associated with severe pneumonia. Like with other viruses, the interaction of SARS-CoV-2 with host cell proteins is necessary for successful replication, and cleavage of cellular targets by the viral protease also may contribute to the pathogenesis, but knowledge about the human proteins that are processed by the main protease (3CLpro) of SARS-CoV-2 is still limited. We tested the prediction potentials of two different in silico methods for the identification of SARS-CoV-2 3CLpro cleavage sites in human proteins. Short stretches of homologous host-pathogen protein sequences (SSHHPS) that are present in SARS-CoV-2 polyprotein and human proteins were identified using BLAST analysis, and the NetCorona 1.0 webserver was used to successfully predict cleavage sites, although this method was primarily developed for SARS-CoV. Human C-terminal-binding protein 1 (CTBP1) was found to be cleaved in vitro by SARS-CoV-2 3CLpro, the existence of the cleavage site was proved experimentally by using a His₆-MBP-mEYFP recombinant substrate containing the predicted target sequence. Our results highlight both potentials and limitations of the tested algorithms. The identification of candidate host substrates of 3CLpro may help better develop an understanding of the molecular mechanisms behind the replication and pathogenesis of SARS-CoV-2.     

Additively manufactured respirators: quantifying particle transmission and identifying system-level challenges for improving filtration efficiency

The COVID-19 pandemic has disrupted the supply chain for personal protective equipment (PPE) for medical professionals, including N95-type respiratory protective masks. To address this shortage, many have looked to the agility and accessibility of additive manufacturing (AM) systems to provide a democratized, decentralized solution to producing respirators with equivalent protection for last-resort measures. However, there are concerns about the viability and safety in deploying this localized download, print, and wear strategy due to a lack of commensurate quality assurance processes. Many open-source respirator designs for AM indicate that they do not provide N95-equivalent protection (filtering 95% of SARS-CoV-2 particles) because they have either not passed aerosol generation tests or not been tested. Few studies have quantified particle transmission through respirator designs outside of the filter medium. This is concerning because several polymer-based AM processes produce porous parts, and inherent process variation between printers and materials also threaten the integrity of tolerances and seals within the printed respirator assembly. No study has isolated these failure mechanisms specifically for respirators. The goal of this paper is to measure particle transmission through printed respirators of different designs, materials, and AM processes. The authors compare the performance of printed respirators to N95 respirators and cloth masks. Respirators in this study printed using desktop- and industrial-scale fused filament fabrication processes and industrial-scale powder bed fusion processes were not sufficiently reliable for widespread distribution and local production of N95-type respiratory protection. Even while assuming a perfect seal between the respirator and the user’s face, although a few respirators provided >90% efficiency at the 100−300 nm particle range, almost all printed respirators provided <60% filtration efficiency. Post-processing procedures including cleaning, sealing surfaces, and reinforcing the filter cap seal generally improved performance, but the printed respirators showed similar performance to various cloth masks. The authors further explore the process-driven aspects leading to low filtration efficiency. Although the design/printer/material combination dictates the AM respirator performance, the identified failure modes originate from system-level constraints and are therefore generalizable across multiple AM processes. Quantifying the limitations of AM in producing N95-type respiratory protective masks advances understanding of AM systems toward the development of better part and machine designs to meet the needs of reliable, functional, end-use parts.