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Background Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by SARS-CoV-2. Anti-viral immune response is crucial to achieve pathogen clearance, however in some patients an excessive and aberrant host immune response can lead to an acute respiratory distress syndrome. The comprehension of the mechanisms that regulate pathogen elimination, immunity, and pathology is essential to better characterize disease progression and widen the spectrum of therapeutic options. Methods We performed a flow cytometric characterization of immune cells subsets from 30 COVID-19 patients and correlated these data with clinical outcomes. Results COVID-19 patients showed decreased numbers of circulating T, B and NK cells, and exhibited a skewing of CD8+ T cells towards a terminally differentiated/senescent phenotype. In agreement, T CD4+, T CD8+ but also NK cells displayed reduced anti-viral cytokine production capability. Moreover, a reduced cytotoxic potential was identified in COVID-19 patients, particularly in those that required intensive care. The latter group of patients showed also increased serum IL-6 levels, that correlated to the frequency of granzyme-expressing NK cells. Off-label treatment with tocilizumab restored the cytotoxic potential of NK cells. Conclusion In conclusion, the association between IL-6 serum levels and the impairment of cytotoxic activity suggests the possibility that targeting this cytokine may restore anti-viral mechanisms. Funding This study was supported by funds of Dept. of Experimental and Clinical Medicine of University of Florence (ex-60%) derived from Ministero dell'Istruzione, dell'Università e della Ricerca (Italy).BackgroundFrom March 2-April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize COVID-19 impact on NYC resident physicians.MethodsIRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors (PDs) April 3-12, 2020, encompassing events from March 2-April 12, 2020.ResultsFrom an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2,306 residents. 45.1% of programs reported at least one resident with confirmed COVID-19 101 resident physicians were confirmed COVID-19-positive, with an additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. Two COVID-19-positive residents were hospitalized, with one in intensive care. Among specialties with &gt;100 residents represented, negative binomial regression indicated that infection risk differed by specialty (p=0.039). 80% of programs reported quarantining a resident. [https://www.selleckchem.com/peptide/box5.html selleck compound] 90/91 programs reported reuse or extended mask use, and 43 programs reported that personal protective equipment (PPE) was suboptimal. 65 programs (74.7%) have redeployed residents elsewhere to support COVID-19 efforts.ConclusionMany resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty.FundingAHA, MPB, RWSC, CGM, LRDG, JDH NEI Core Grant P30EY019007, RPB Unrestricted Grant. ACP and JS Parker Family Chair. SXX University of Pennsylvania.This article assesses the radiological environment at the nuclear site of the Mayak PA, Russian Federation, during and after the accident in 1957, the so-called 'Kyshtym Accident', and the radiation doses to those who participated in the eradication of its consequences. Based on numerous archival documents, this paper presents the radiation data for 1957-1960, including individual dosimetry monitoring data and estimated doses to the Mayak workers, as well as the to personnel in supporting organisations and the military involved in the remediation operations. From 1957-1959 some 38 500 individuals took part in the clean-up actions and remediation of contaminated areas of the Mayak PA industrial site after the accident, including individuals exposed at the time of the accident Mayak PA employees, militarypersonnel, and civil construction workers. External equivalent doses to 10 500 individuals were estimated in the range of 220 to 265 mSv, while there were cases of doses up to 950 mSv and higher. The collective dose received during the accident and its aftermath was in the region of 7300 person-Sv. By October-December 1957, the collective dose was about 4500 person-Sv. Collective doses recorded in 1958 and 1959 amounted to 2250 person-Sv and 480 person-Sv, respectively.Although radiation protection is challenged by many uncertainties, there is no systematic study investigating the definitions and types of these uncertainties. To address this gap, in this paper we offer a scoping review to comprehensively analyse, for the first time, peer-reviewed scientific articles (n = 33) related to uncertainties in the following radiation exposure situations nuclear emergencies, decommissioning of nuclear/radiological installations and long-term radiological exposure situations (e.g. naturally occurring radioactive materials). The results suggest that firstly, there is no agreement regarding definitions of uncertainty, which is mainly defined based on its sources, types or categories rather than by its meaning. Secondly, different actors are faced with different types of uncertainties. Uncertainties of the scientific community are mostly data and methodology-driven (e.g. dose-response relationships), those of the decision-makers are related to the likely consequences of decision options and public reactions, while laypeople's uncertainties are mainly related to the trustworthiness of experts or the emotional potential of specific risk exposures. Furthermore, the majority of articles focus on the uncertainties of the scientific community, while those of the information receivers (i.e. decision-makers and laypeople) receive much less consideration. Finally, there was no difference in types of uncertainties across the different risk-related study areas analysed (radiation versus other risks). Based on these findings, we provide some preliminary recommendations regarding research on uncertainty related to radiation protection, as well as communication practices.