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What The Study Did: Coronavirus disease 2019 (COVID-19) infection in North American pediatric intensive care units is described in this observational study, including how it presented, whether there were comorbidities, the severity of disease, therapeutic interventions, clinical trajectory and early outcomes.

Authors: Lara S. Shekerdemian, M.D., M.H.A., of Texas Children's Hospital and Baylor College of Medicine in Houston, is the corresponding author.

To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamapediatrics.2020.1948)

Editor's Note:  The article includes conflict of interest disclosures. Please see the article for additional information, including other authors, author contributions and affiliations, conflicts of interest and financial disclosures, and funding and support.

A University of Alaska Fairbanks-led research team has developed a way to use satellite images to determine the amount of methane being released from northern lakes, a technique that could help climate change modelers better account for this potent greenhouse gas.

By using synthetic aperture radar, or SAR, researchers were able to find a correlation between "brighter" satellite images of frozen lakes and the amount of methane they produce. Comparing those SAR images with ground-level methane measurements confirmed that the satellite readings were consistent with on-site data.

SAR data, which were provided by UAF's Alaska Satellite Facility, are well-suited to the Arctic. The technology can penetrate dry snow, and doesn't require daylight or cloud-free conditions. SAR is also good at imaging frozen lakes, particularly ones filled with bubbles that often form in ice when methane is present.

"We found that backscatter is brighter when there are more bubbles trapped in the lake ice," said Melanie Engram, the lead author of the study and a researcher at UAF's Water and Environmental Research Center. "Bubbles form an insulated blanket, so ice beneath them grows more slowly, causing a warped surface which reflects the radar signal back to the satellite."

The new technique could have significant implications for climate change predictions. Methane is about 30 times more powerful than carbon dioxide as a heat-trapping gas, so accurate estimates about its prevalence are particularly important in scientific models.

Previous research had confirmed that vast amounts of methane are being released from thermokarst lakes as the permafrost beneath them thaws. But collecting on-site data from those lakes is often expensive and logistically challenging. Because of that, information about methane production is available from only a tiny percentage of Arctic lakes.

"This new technique is a major breakthrough for understanding the Arctic methane budget," said UAF researcher Katey Walter Anthony, who also contributed to the study. "It helps to resolve a longstanding discrepancy between estimates of Arctic methane emissions from atmospheric measurements and data upscaled from a small number of individual lakes."

To confirm the SAR data, researchers compared satellite images with field measurements from 48 lakes in five geographic areas in Alaska. By extrapolating those results, researchers can now estimate the methane production of more than 5,000 Alaska lakes.

"It's important to know how much methane comes out of these lakes and whether the level is increasing," Engram said. "We can't get out to every single lake and do field work, but we can extrapolate field measurements using SAR remote sensing to get these regional estimates."

Most financiers of international infrastructure program, the Belt and Road Initiative (BRI), are falling short on biodiversity safeguards, according to University of Queensland research.

The BRI is China's ambitious regional connectivity initiative encompassing thousands of transport, energy and industrial infrastructure projects, built along eight trans-national corridors spanning 70 countries in Asia, Europe and Africa.

UQ PhD candidate Divya Narain, from UQ's Centre for Biodiversity and Conservation Science, said biodiversity must be protected in the face of this development for the sake of the world's species.

"The six terrestrial infrastructure corridors envisaged under BRI crisscross some of the most ecologically-fragile geographies in Southeast Asia, Central Asia and South Asia," Ms Narain said.

"The initiative's road and rail routes potentially affect 150,000 square kilometres of critical habitat."

The research team compiled a list of the BRI's financiers and scrutinised their policies for enforceable requirements to protect biodiversity.

"Our research shows that most financiers of the BRI are yet to put in place binding biodiversity impact mitigation requirements.

"The considerable biodiversity impact of infrastructure projects could remain unmitigated."

UQ's Professor Martine Maron said financier safeguards could act as an important line of defence against construction-induced effects on biodiversity.

"Safeguards of multi-lateral development banks offer international best practice that has evolved over decades," Professor Maron said.

"International best practice requires a 'net gain' of biodiversity in cases where there are impacts upon critical habitat.

"Strong safeguards like this are especially important for projects that potentially damage large areas of essential biodiversity habitat.

"Co-financing by multi-lateral development banks offers the opportunity for transfer of best practice to financiers who lack biodiversity safeguards, through capacity building and technical assistance.

"Biodiversity protection needs its own policy infrastructure if it is to be protected."

University of Adelaide researchers have found that South Australia's population of Grey-headed flying foxes, which took up residence in 2010, has been exposed to a number of viruses, including Hendra virus that can be transmitted to humans via horses. But they have not found evidence of exposure to Australian bat lyssavirus.

The research, published today in PLOS ONE, details three years of research into the local flying fox population and their exposure to paramyxoviruses (Hendra, Cedar and Tioman) and a rhabdovirus (Australian bat lyssavirus).

Hendra virus and Australian bat lyssavirus are classified as zoonotic viruses. Hendra virus for example can be transmitted to horses and then to humans by airborne droplets causing acute respiratory diseases and death. In the case of Australian bat lyssavirus, humans and other animals need to be bitten or scratched by a carrier. The risks posed by Hendra virus are extremely low with only seven cases in humans, all of whom had been in contact with infected horses, never directly from bats.

Dr Wayne Boardman from the University of Adelaide's School of Animal and Veterinary Sciences says given the Grey-headed flying foxes are known carriers of viruses, they wanted to understand if the local population of flying foxes had been exposed to them.

"Grey-headed flying foxes are essential ecosystem service providers contributing to large-scale pollination and seed dispersal and are a nationally threatened species," Dr Boardman said.

"They have this extraordinary ability to be infected with viruses but don't show any ill effects, except for one virus; the Australian bat lyssavirus. It's important to understand what risks they pose to humans.

"We have found the local population has developed antibodies for the Hendra, Cedar and Tioman viruses, meaning they have been exposed at some stage in their lives.

"What's good news for South Australia is that the local population has not shown exposure to Australian bat lyssavirus, which in humans causes serious illness including paralysis, delirium, convulsions and death.

"It's positive to discover that the risk of lyssavirus transmission in South Australia is lower than anticipated.

"However, this doesn't mean that flying foxes are safe to touch; only people with experience in handling these animals should ever come into contact with them."

The Grey-headed flying fox has made the Botanic Gardens in Adelaide home for the past 10 years, having come to South Australia from New South Wales and Victoria in search of a suitable climate and food.

The research on the local population has also revealed that Hendra virus levels were significantly higher in pregnant females; results that align with findings interstate. However, good body condition is a risk factor for a bigger proportion of the population being exposed to Hendra virus because the flying foxes are in better condition in winter than summer, which is the opposite of what has been found in the eastern states.

Dr Boardman said this means the flying foxes are finding plenty to eat here in winter time specifically, enjoying the introduced foods that are planted in gardens, along roads and in parklands, similar to the normal food source for those in the eastern states.

"The Grey-headed flying fox is certainly enjoying the local environment during the South Australian winter, but we have seen on numerous occasions that the heat in summer certainly knocks the population around so we are looking at ideas to help support them during heatwaves in summer using high level misters and sprinklers."

TORONTO, CANADA (May 11, 2020) - New research published today in the journal Nature Astronomy reveals a type of destructive event most often associated with disaster movies and dinosaur extinction may have also contributed to the formation of the Moon's surface.

A group of international scientists led by the Royal Ontario Museum has discovered that the formation of ancient rocks on the Moon may be directly linked to large-scale meteorite impacts.

The scientists conducted new research of a unique rock collected by NASA astronauts during the 1972 Apollo 17 mission to the Moon. They found it contains mineralogical evidence that it formed at incredibly high temperatures (in excess of 2300 °C/ 4300 °F) that can only be achieved by the melting of the outer layer of a planet in a large impact event.

In the rock, the researchers discovered the former presence of cubic zirconia, a mineral phase often used as a substitute for diamond in jewellery. The phase would only form in rocks heated to above 2300 °C, and though it has since reverted to a more stable phase (the mineral known as baddeleyite), the crystal retains distinctive evidence of a high-temperature structure. An interactive image of the complex crystal used in the study can be seen here using the Virtual Microscope.

While looking at the structure of the crystal, the researchers also measured the age of the grain, which reveals the baddeleyite formed over 4.3 billion years ago. It was concluded that the high-temperature cubic zirconia phase must have formed before this time, suggesting that large impacts were critically important to forming new rocks on the early Moon.

Fifty years ago, when the first samples were brought back from the surface of the Moon, lunar scientists raised questions about how lunar crustal rocks formed. Even today, a key question remains unanswered: how did the outer and inner layers of the Moon mix after the Moon formed? This new research suggests that large impacts over 4 billion years ago could have driven this mixing, producing the complex range of rocks seen on the surface of the Moon today.

"Rocks on Earth are constantly being recycled, but the Moon doesn't exhibit plate tectonics or volcanism, allowing older rocks to be preserved," explains Dr. Lee White, Hatch Postdoctoral Fellow at the ROM. "By studying the Moon, we can better understand the earliest history of our planet. If large, super-heated impacts were creating rocks on the Moon, the same process was probably happening here on Earth".

"By first looking at this rock, I was amazed by how differently the minerals look compared to other Apollo 17 samples," says Dr. Ana Cernok, Hatch Postdoctoral Fellow at the ROM and co-author of the study. "Although smaller than a millimetre, the baddeleyite grain that caught our attention was the largest one I have ever seen in Apollo samples. This small grain is still holding the evidence for formation of an impact basin that was hundreds of kilometres in diameter. This is significant, because we do not see any evidence of these old impacts on Earth."

Dr. James Darling, a reader at the University of Portsmouth and co-author of the study, says the findings completely change scientists' understanding of the samples collected during the Apollo missions, and, in effect, the geology of the Moon. "These unimaginably violent meteorite impacts helped to build the lunar crust, not only destroy it," he says.

In February and July of 2019, the Hayabusa2 spacecraft briefly touched down on the surface of near-Earth asteroid Ryugu. The readings it took with various instruments at those times have given researchers insight into the physical and chemical properties of the 1-kilometer-wide asteroid. These findings could help explain the history of Ryugu and other asteroids, as well as the solar system at large.

When our solar system formed around 5 billion years ago, most of the material it formed from became the sun, and a fraction of a percent became the planets and solid bodies, including asteroids. Planets have changed a lot since the early days of the solar system due to geological processes, chemical changes, bombardments and more. But asteroids have remained more or less the same as they are too small to experience those things, and are therefore useful for researchers who investigate the early solar system and our origins.

"I believe knowledge of the evolutionary processes of asteroids and planets are essential to understand the origins of the Earth and life itself," said Associate Professor Tomokatsu Morota from the Department of Earth and Planetary Science at the University of Tokyo. "Asteroid Ryugu presents an amazing opportunity to learn more about this as it is relatively close to home, so Hayabusa2 could make a return journey relatively easily. "

Hayabusa2 launched in December 2014 and reached Ryugu in June 2018. At the time of writing, Hayabusa2 is on its way back to Earth and is scheduled to deliver a payload in December 2020. This payload consists of small samples of surface material from Ryugu collected during two touchdowns in February and July of 2019. Researchers will learn much from the direct study of this material, but even before it reaches us, Hayabusa2 helped researchers to investigate the physical and chemical makeup of Ryugu.

"We used Hayabusa2's ONC-W1 and ONC-T imaging instruments to look at dusty matter kicked up by the spacecraft's engines during the touchdowns," said Morota. "We discovered large amounts of very fine grains of dark-red colored minerals. These were produced by solar heating, suggesting at some point Ryugu must have passed close by the sun."

Morota and his team investigated the spatial distribution of the dark-red matter around Ryugu as well as its spectra or light signature. The strong presence of the material around specific latitudes corresponded to the areas that would have received the most solar radiation in the asteroid's past; hence, the belief that Ryugu must have passed by the sun.

"From previous studies we know Ryugu is carbon-rich and contains hydrated minerals and organic molecules. We wanted to know how solar heating chemically changed these molecules," said Morota. "Our theories about solar heating could change what we know of orbital dynamics of asteroids in the solar system. This in turn alters our knowledge of broader solar system history, including factors that may have affected the early Earth."

When Hayabusa2 delivers material it collected during both touchdowns, researchers will unlock even more secrets of our solar history. Based on spectral readings and albedo, or reflectivity, from within the touchdown sites, researchers are confident that both dark-red solar-heated material and gray unheated material were collected by Hayabusa2. Morota and his team hope to study larger properties of Ryugu, such as its many craters and boulders.

"I wish to study the statistics of Ryugu's surface craters to better understand the strength characteristics of its rocks, and history of small impacts it may have received," said Morota. "The craters and boulders on Ryugu meant there were limited safe landing locations for Hayabusa2. Finding a suitable location was hard work and the eventual first successful touchdown was one of the most exciting events of my life."

Peptides are short chains of amino acids that occur in our body, in plants or bacteria to control diverse functions. Several peptides are used as drugs such as insulin, which controls the metabolism of sugar, and cyclosporine, which suppresses organ rejection after transplants. More than 40 peptides are already approved as drugs, generating revenues in the billions. There are several hundreds of peptide-based medications currently in clinical trials.

But almost none of these drug-peptides can be taken orally. Since peptides are an important part of food, the stomach and intestines harbor countless enzymes that can degrade them, meaning that most peptide-based medication do not survive the passage through the gastrointestinal tract.

Hope to generate more stable peptides came from "cyclic" peptides, whose ends are joined together by chemical bridges making them more stable than linear ones because their backbones are less flexible and thus harder to attack by enzymes. In 2018, the research group of Christian Heinis at EPFL developed a peptide format termed double-bridged peptides, where peptides are cyclized by two chemical bridges that provide even higher stability. Despite its success, most such peptides were not sufficiently stable to survive the enormous enzymatic pressure found in the gastrointestinal tract.

Now, Heinis's group has developed a new method that identifies among billions of double-bridged peptides those that bind a disease target of interest and survive enzymes of the gastrointestinal tract. The method is published in Nature Biomedical Engineering, and involves three steps.

First, billions of genetically encoded random peptide sequences are cyclized by two chemical bridges that impose conformational constraints onto the peptides' backbones so that they are more difficult to attack by enzymes. Second, this library of peptides is exposed to enzymes from cow intestine to eliminate all those peptides that are not stable. In the third and last step, the scientist dip target proteins into the pool of surviving peptides to fish out those that bind to the wanted disease target. "It's a bit like searching a needle in a haystack, and this method makes this easy," says Heinis.

With this method, the researchers have succeeded for the first time in evolving target-specific peptides that can resist breakdown in the gastrointestinal tract. For example, they gave mice a lead peptide that inhibits thrombin - an important anti-thrombosis target - in the form of a pill. The peptide remained intact in the stomach and intestines, and even though it reached the blood stream in rather small quantities, most of it remained fully intact across the entire gastrointestinal tract. This is a key step towards engineering oral peptide drugs.

Heinis's group is now applying the new method to develop oral peptides that act directly on gastrointestinal targets, meaning that they don't need to travel into the blood stream. "We are focusing on chronic inflammatory diseases of the gastrointestinal tract like Crohn's disease and ulcerative colitis as well as bacterial infections," says Heinis. "We have already succeeded in generating enzyme-resistant peptides against the interleukin-23 receptor, an important target of these diseases, which affect millions of patients worldwide without any oral drug available."

SEATTLE -- May 11, 2020 -- Unprecedented collaboration and resources will be required to research and develop safe and effective vaccines for COVID-19 that can be manufactured and delivered in the scale of billions of doses to people globally.

Vaccine development often takes years. To speed up the process, Dr. Larry Corey of Fred Hutchinson Cancer Research Center, and experts at the National Institutes of Health outline a vision to create a coordinated and efficient approach to creating COVID-19 vaccines.

In a perspective published online May 11 by the journal Science, Corey and coauthors Dr. Anthony Fauci, Dr. John Mascola, and Dr. Francis Collins, share their plan for bringing together industry, government and academia to meet this urgent need. Dr. Fauci is the director of the National Institute of Allergy and Infectious diseases, part of NIH. Dr. Mascola is the director of the NIAID Vaccine Research Center, and Dr. Collins is the NIH director.

"We're experiencing a series of unprecedented events with a disease that has spread globally and infected more people in a shorter time than any other infection in modern times," said Corey, past president and director of Fred Hutch and a professor in its Vaccine and Infectious Disease Division. "In order to overcome the challenges in front of us, we each need to bring nothing short of our absolute best. The research and development of COVID-19 vaccines will require creativity, cooperation and commitment to save as many lives as possible as soon as we can."

Throughout his career in developing vaccines, therapeutics and immunotherapies, Corey has led the successful integration of academic institutions, biotechnology and pharmaceutical companies in collaboration with public funding from NIH.

"Besides scientists and health experts, we need the help of industry and affected communities throughout the country to participate in large-scale trials of potential COVID vaccines," he said.

The authors call for harmonizing each step of the process, from creating a common oversight body and shared set of criteria to evaluate the vaccine studies underway, to transparency and data sharing, to marshalling the full resources of private, public and philanthropic sectors to scale up eventual manufacturing capacity and distribution chains for COVID-19 vaccines.

"We want to see multiple successful vaccines and vaccine platforms meet the global need of immunizing billions of adults, children and restoring economic and health to the world," urged Corey.

Sometimes the most complex problems actually have very simple solutions. A group of South Korean researchers reported an efficient and effective redox-based strategy for incorporating multiple functions into simple molecular reagents against neurodegenerative disorders. The team developed redox-active aromatic molecular reagents with a simple structural composition that can simultaneously target and modulate various pathogenic factors in complex neurodegenerative disorders such as Alzheimer's disease.

Alzheimer's disease is one of the most prevalent neurodegenerative disorders, affecting one in ten people over the age of 65. Early-onset dementia also increasingly affects younger people.

A number of pathogenic elements such as reactive oxygen species, amyloid-beta, and metal ions have been suggested as potential causes of Alzheimer's disease. Each element itself can lead to Alzheimer's disease, but interactions between them may also aggravate the patient's condition or interfere with the appropriate clinical care.

For example, when interacting with amyloid-beta, metal ions foster the aggregation and accumulation of amyloid-beta peptides that can induce oxidative stress and toxicity in the brain and lead to neurodegeneration.

Because these pathogenic factors of Alzheimer's disease are intertwined, developing therapeutic agents that are capable of simultaneously regulating metal ion dyshomeostasis, amyloid-beta agglutination, and oxidative stress responses remains a key to halting the progression of the disease.

A research team led by Professor Mi Hee Lim from the Department of Chemistry at KAIST demonstrated the feasibility of structure-mechanism-based molecular design for controlling a molecule's chemical reactivity toward the various pathological factors of Alzheimer's disease by tuning the redox properties of the molecule.

This study, featured as the 'ACS Editors' Choice' in the May 6th issue of the Journal of the American Chemical Society (JACS), was conducted in conjunction with KAIST Professor Mu-Hyun Baik's group and Professor Joo-Young Lee's group at the Asan Medical Center.

Professor Lim and her collaborators rationally designed and generated 10 compact aromatic molecules presenting a range of redox potentials by adjusting the electronic distribution of the phenyl, phenylene, or pyridyl moiety to impart redox-dependent reactivities against the multiple pathogenic factors in Alzheimer's disease.

During the team's biochemical and biophysical studies, these designed molecular reagents displayed redox-dependent reactivities against numerous desirable targets that are associated with Alzheimer's disease such as free radicals, metal-free amyloid-beta, and metal-bound amyloid-beta.

Further mechanistic results revealed that the redox properties of these designed molecular reagents were essential for their function. The team demonstrated that these reagents engaged in oxidative reactions with metal-free and metal-bound amyloid-beta and led to chemical modifications. The products of such oxidative transformations were observed to form covalent adducts with amyloid-beta and alter its aggregation.

Moreover, the administration of the most promising candidate molecule significantly attenuated the amyloid pathology in the brains of Alzheimer's disease transgenic mice and improved their cognitive defects.

Professor Lim said, "This strategy is straightforward, time-saving, and cost-effective, and its effect is significant. We are excited to help enable the advancement of new therapeutic agents for neurodegenerative disorders, which can improve the lives of so many patients."

Supply chains collapse, companies are facing bankruptcy, and mass unemployment ensues. Covid-19 has triggered a global financial crisis and is forcing states to develop rescue packages on a scale not seen before. In addition, the crisis has called into question the US dollar's hegemony and could redefine the global monetary system. A team of researchers from the Institute for Advanced Sustainability Studies (IASS) has developed four scenarios that show how political decisions will shape the post-Corona world.

Scientific scenarios have become an important tool for political decision-makers as they tackle the Covid-19 pandemic. Models of the Corona Crisis developed by researchers, and predicting shocking infection and death rates, have persuaded governments around the world to adopt strict lockdown measures and reduce economic activities to a minimum. The magnitude of this decision is now becoming increasingly apparent. The measures adopted have triggered a global economic and financial crisis that is affecting both industrialized and - even more so - developing nations, jeopardizing efforts to achieve the United Nations Sustainable Development Goals. Governments tackling this crisis face unprecedented challenges. Their task is made all the more difficult by the dearth of economic scenarios and models that could support decision-making in this situation.

In a collaboration between the IASS, Harvard University and Boston University, a team of researchers led by Steffen Murau, Joe Rini and Armin Haas has developed an innovative political-economic methodology to study the impact of global economic and financial crises precipitated by events such as the Covid-19 pandemic on the global monetary and financial systems. Their findings were recently published in the Journal of Institutional Economics.

The Covid-19 pandemic: A turning point in the global economic order?

At the outset of their study, the researchers examined the dynamics underpinning the development of the global monetary and financial system in recent decades. The team identified two trends that are of central importance in this context: First, while the US dollar is the centrepiece of the global financial system, a substantial share of this currency is now created by private financial institutions outside the USA, and thus outside the control of the United States' central bank, the Federal Reserve (Fed). This happens, for example, when banks outside the United States create deposits by issuing loans in US dollars to finance trade within global supply chains. The researchers refer to this as "offshore dollar creation". Second, shadow banks have become systemically relevant entities and are creating novel forms of credit instruments that researchers now refer to as "shadow money".

In the case of complex and privatized structures such as the offshore dollar-based monetary and financial system, crises are key drivers of change. It is in these moments that political decision-makers lay the groundwork for future developments. The global financial crisis of 2007 - 2009, which escalated following the collapse of US investment bank Lehman Brothers, was one such moment. That crisis began in the shadow banking system and was essentially a bank run on offshore dollars and shadow money. The massive loss of confidence driving that crisis could only be mitigated through the introduction of an institutional innovation: a new form of cooperation between the central banks of the G7 countries - so-called "swap lines" - through which central banks outside the USA could borrow US dollars from the Federal Reserve to support domestic banks.

"In today's global dollar system, the Federal Reserve's US dollar swap lines are the ultimate safety net," explains Steffen Murau, who has researched this issue first at the IASS and then at Harvard University and Boston University. "The European Central Bank is the Federal Reserve's most important partner in this area. In times of crisis, the ECB can borrow US dollars from the Fed and then pass them on as loans to euro zone banks. The crucial issue for the future of the global US dollar system is how robust this safety net will prove to be."

"The Covid-19 pandemic has triggered a new global crisis, the scale of which we still cannot foresee," says Armin Haas, who leads the research team at the IASS. "How political decision-makers respond to this crisis is crucial for the future development of the global economic order. Covid-19 is also a crisis of the global monetary and financial system based on offshore dollars".

This aspect has been the focus of research at the IASS since 2017: "In our research project, we studied scenarios both with and without systemic crises and developed four alternative scenarios," explains Haas. "The scenarios explore possible developments over the next two decades and, in light of the unfolding Covid-19 pandemic, are already proving to be highly relevant for policymakers."

Four scenarios for the global financial system in 2040

The researchers explore four possible development pathways in their analysis. The first two presuppose that the financial system continues to evolve - resolving crises with the instruments of the existing system, much as occurred in 2008. The other two explore possible developments resulting from a collapse of the system that the Fed failed to prevent.

The analyses explore the following four scenarios:

a continuation of the current US dollar hegemony;

the co-existence of competing monetary blocks;

the emergence of an international monetary federation; or

international monetary anarchy.

In the "business as usual" scenario (1), US dollar hegemony persists, with the USA maintaining its role as the central stabilizing factor in the financial system. In this scenario, Trumpism and its policy of "America First" prove to be passing fads. The Eurozone, meanwhile, remains mired in a backlog of much-needed reforms and China fails to establish itself as a rival financial centre.

"The current Covid-19 crisis is putting extreme pressure on the global privatized US dollar system. But the Federal Reserve's interventions in March and April have stabilized the system for the time being, allowing it to continue along its current development path. In doing so, the Federal Reserve is acting as the de facto global central bank," says Steffen Murau. "The eurozone, on the other hand, is in troubled waters. Once again, the issue of Eurobonds is putting the EU to the test and revealing the gulf between reality and European aspirations to strengthen the euro's international role."

In contrast, the second scenario sees the establishment of competing monetary blocs, with the EU and China emerging as two significant rivals to the USA. In this scenario the latter no longer stands as the guarantor of global stability, while the Eurozone successfully overcomes its deficits and China succeeds in internationalizing its currency, the renminbi. These developments result in the further regionalism of world trade and the financial system.

"The pandemic is exposing the failings of America's welfare state. The collapse of the US economy could weaken the geopolitical position of the United States in the medium term. China, on the other hand, has a head-start when it comes to overcoming the effects of the pandemic and could use this to its advantage in the trade war opened by Trump," Murau explains.

In the third (revolutionary) scenario the Federal Reserve proves unable to withstand the global crisis and the global US dollar system implodes in a series of defaults and bankruptcies of leading private financial institutions. However, the scenario assumes that the G20 succeeds in creating an alternative global monetary system at the height of the crisis; a system built not around a single national currency, but around an international organization. In this scenario, the international monetary hierarchy has shifted, with national currency areas now operating alongside each other. In the EU, the Member States reintroduce their former currencies, but retain the euro as a regional supranational unit of account. Offshore credit money creation is completely abolished. While shadow banks continue to operate in some states, elsewhere governments push for tougher regulation aimed at eliminating shadow money.

"The Federal Reserve's rescue efforts run counter to the policies of the Trump Administration, which has probably not yet grasped the scope of these interventions. The question is whether the Fed can maintain this level of commitment in the medium term, especially in the event of Trump's re-election. It is not impossible that a chain of circumstances could take the Fed's swap network to breaking point - an event that would be comparable to the Bank of England's cancellation of the gold standard in 1931," says Armin Haas. "Naturally, there's a touch of liberal utopia to our third scenario. However, proposals for this kind of system have been around in various forms for at least 150 years."

In the fourth scenario, following the collapse of the existing system based on private offshore dollar creation, efforts by the G20 to establish an alternative monetary and financial system founder and eventually fail. Instead, international monetary anarchy reigns. As a consequence, the international payments system grows increasingly unreliable, international value chains break down and barter arrangements become commonplace in international trade. The result: a hard-hitting global depression that compels states to experiment with different institutional arrangements in order to tackle the challenges. These experiments lay the foundations for the development of a new system at some point in the future.

"This is the only scenario in which crypto-currencies are of more than marginal importance," says Joe Rini, who has previously worked in the fintech sector. "In our view, the strong path dependency of the global dollar system makes it unlikely that crypto will emerge as a genuine alternative - unless, of course, the current system implodes. Crypto currencies have been largely ignored in the context of the Covid-19 Crisis and have failed to profit from it so far. But this could quickly change in the event of an uncontrolled systemic collapse."

Charting a course for the transformation towards sustainability

"Our scenarios are not intended to be exact predictions of the future, nor are they normative assessments or institutional blueprints," explains Armin Haas. "What they do is extrapolate existing trends and create a space of possibility in which we can explore the development of the international monetary system along different development pathways through to 2040."

"The ideas presented in these scenarios are already being discussed in expert circles. What we have done is to link these ideas to political and economic development pathways and to highlight the central role of shadow banks and offshore money creation," says Haas. "These scenarios emphasize the decisive role of the US Federal Reserve as the creditor of last resort for the global dollar system and its ability to tackle the crisis."

The development of scenarios to explore the future of the international monetary and financial system dovetails with the mission of the IASS to analyse and support global transformations towards sustainability. "Exploring the implications of different scenarios for the ecological transformation of our societies is integral to our research programme." After all, "financing for transitions towards sustainability will either be provided through the global financial system - or they will not take place," says Armin Haas. "Efforts to create a sustainable and climate-friendly global economy cannot succeed in the absence of a functioning global monetary and finance system."

In an article written in 1931, the American economist and mathematician Harold Hotelling published a model to describe the evolution of the prices of non-renewable resources. Following the 1973 oil crisis, the model aroused fresh interest: the growth theorist Robert Solow named the initial equation in this article 'the Hotelling rule', establishing it as a fundamental principle of the economics of non-renewable resources. However, the prices observed over the past century have never been in line with this equation*, something which has constantly puzzled economists.

Despite everything, the Hotelling rule still retains its central status in the economics of mineral and energy resources: it is on this basis that more sophisticated 'extensions' are constructed to account for market realities. Roberto Ferreira da Cunha, from the Berkeley Research Group (Brazil), and Antoine Missemer, a CNRS researcher attached to CIRED, the International Centre for Research on Environment and Development (CNRS/CIRAD/AgroParisTech/Ecole des Ponts ParisTech/EHESS), undertook a detailed and unprecedented examination of Harold Hotelling's archives**. By analysing the origins of the model, they conclude that its scope of validity is more limited t han commonly established, and decisively clarify the reasons for its empirical weaknesses.

Hotelling's drafts, as well as his correspondence, with oil engineers for example, point to a reinterpretation of the 1931 article. It turns out that the 'rule', which he had devised as early as 1924 for abstract assets, was in no way intended to be applied to the concrete case of mineral and energy resources. From 1925 to 1930, Hotelling himself identified unavoidable geological constraints that changed his initial result: increased production costs as extraction progresses, or the cost resulting from ramped up production. As he outlined, this transformed his model, which was then potentially able to describe bell-shaped production paths, such as those used in debates about peak oil.

The two researchers thus show that, if the Hotelling rule has such difficulty in passing the hurdle of empirical tests in the field of energy and mineral resources, it is because it was not designed for that! They propose to reconstruct the models used in this area, taking as a starting point an alternative Hotelling rule that is more in line with geological realities. More generally, their study questions the theoretical instruments used to address energy and environmental issues today. History, and in this case the history of economic thought, can help to take a fresh look at tools that, although considered well established, still deserve to be questioned.

Researchers at King's College London, Massachusetts General Hospital and health science company ZOE have developed an artificial intelligence diagnostic that can predict whether someone is likely to have COVID-19 based on their symptoms. Their findings are published today in Nature Medicine.

The AI model uses data from the COVID Symptom Study app to predict COVID-19 infection, by comparing people's symptoms and the results of traditional COVID tests. Researchers say this may provide help for populations where access to testing is limited. Two clinical trials in the UK and the US are due to start shortly.

More than 3.3 million people globally have downloaded the app and are using it to report daily on their health status, whether they feel well or have any new symptoms such as persistent cough, fever, fatigue and loss of taste or smell (anosmia).

In this study, the researchers analysed data gathered from just under 2.5 million people in the UK and US who had been regularly logging their health status in the app, around a third of whom had logged symptoms associated with COVID-19. Of these, 18,374 reported having had a test for coronavirus, with 7,178 people testing positive.

The research team investigated which symptoms known to be associated with COVID-19 were most likely to be associated with a positive test. They found a wide range of symptoms compared to cold and flu, and warn against focusing only on fever and cough. Indeed, they found loss of taste and smell (anosmia) was particularly striking, with two thirds of users testing positive for coronavirus infection reporting this symptom compared with just over a fifth of the participants who tested negative. The findings suggest that anosmia is a stronger predictor of COVID-19 than fever, supporting anecdotal reports of loss of smell and taste as a common symptom of the disease.

The researchers then created a mathematical model that predicted with nearly 80% accuracy whether an individual is likely to have COVID-19 based on their age, sex and a combination of four key symptoms: loss of smell or taste, severe or persistent cough, fatigue and skipping meals. Applying this model to the entire group of over 800,000 app users experiencing symptoms predicted that just under a fifth of those who were unwell (17.42%) were likely to have COVID-19 at that time.

Researchers suggest that combining this AI prediction with widespread adoption of the app could help to identify those who are likely to be infectious as soon as the earliest symptoms start to appear, focusing tracking and testing efforts where they are most needed.

Professor Tim Spector from King's College London said: "Our results suggest that loss of taste or smell is a key early warning sign of COVID-19 infection and should be included in routine screening for the disease. We strongly urge governments and health authorities everywhere to make this information more widely known, and advise anyone experiencing sudden loss of smell or taste to assume that they are infected and follow local self-isolation guidelines."

War, torture, human trafficking and extreme poverty are just some of the appalling experiences to which refugees are exposed, both before and during their flight. Experiences such as these put those affected at risk of mental illness, even years afterwards. If that were not enough, after arriving in Germany refugees are often forced to live in conditions which cause further mental stress. A team of researchers led by Hannelore Ehrenreich at the Max Planck Institute for Experimental Medicine has now demonstrated that each additional risk factor puts further strain on the mental health of young refugees. The consequences are functional deficits and behavioural problems, which may be expressed as aggressive and criminal behaviour later in life. It is therefore even more vital to provide care and support for refugees, and to offer them the opportunity to break out of the spiral of negative experiences.

Traumatic experiences, physical and sexual abuse, consumption of cannabis and alcohol, living in cities: these are all factors which increase the risk of a person developing mental disorders. If a person is subjected to several of these risk factors together before the age of 20, he or she is more likely to exhibit aggressive and criminal behaviour later in life.

This observation from previous studies led a group of Göttingen researchers to take a closer look at a specific risk group: young refugees, who often experience traumatic events not only in their home country and during their flight, but often also face mentally stressful conditions after their arrival in Germany. The effect of these risk factors is more pronounced amongst young people, because their brains are still developing, and react particularly sensitively to adverse influences.

Interviews with migrants

To better understand the impact of harmful environmental stress on young refugees, and the consequences for their mental health, the researchers carried out detailed interviews with 133 refugees. The average age of the participants was 22, and they were considered to be in good health. Many had travelled to Germany as unaccompanied minors. In addition to the history taking, the researchers also evaluated the physical health of the participants, and used structured interviews to assess any emerging indications of behavioural problems.

"Many refugees are exposed to a shocking number of risk factors," reports Martin Begemann, first author on the publication. In addition to the actual migration experience, more than 95 percent of the refugees are affected by other stressful life events, habits or living conditions that make them more susceptible to mental illness. The researchers identified two, three or even more than four additional risk factors in the vast majority of cases. Around half the participants had undergone traumatic experiences before and during their journey; a quarter of participants had suffered physical and sexual abuse. Around 40 percent of participants had scars or wounds from stabbing or shooting injuries, explosions or the resultant burns. Four young men displayed clear psychotic symptoms, two of these also had suicidal thoughts.

Number of risk factors is crucial

Overall, the scientists' findings showed: the more risk factors that are present in a person, the greater the reduction in their ability to function, and the more likely they were to exhibit initial indications of mental health problems. Precisely which risk factors were present was less significant. Interestingly, close and stable personal relationships offered the refugees no protection from these negative effects: having fled accompanied by family or friends, or having a good social network at the time of the study, had no influence on a person's current mental state. The authors suspect that social support has only a weak protective effect.

It will be a number of years before researchers will be able to determine the number of young people who actually go on to exhibit psychological problems or even criminal behaviour. However, they expect that they will only be able to contact about half of the participants again. They are likely to lose track of the others due to numerous transfers between refugee centres and deportations to the country of origin.

So what can be done right now to improve the poor prognosis for refugees under extreme stress? "Given that each additional risk factor increases the probability of subsequent aggressive behaviour, criminal activity and mental disorders, we have to prevent the accumulation of further stress factors," Ehrenreich insists. For example, we could consider providing refugees with close medical and psychological care, and giving them their first simple work activities and language courses even before a final decision on their residence status has been made. This could help them to escape from cramped housing conditions where they are confronted with boredom, violence and drugs.

How people vote in the Eurovision Song Contest may tell us more than just the musical tastes of a nation - according to new research.

Although this year's Eurovision Song Contest has been postponed due to the COVID-19 outbreak, academics from the University of Stirling and University of Glasgow have revealed interesting patterns from previous years' public votes.

Dr Isaac Tabner, from Stirling Management School, and Dr Antonios Siganos, from the Adam Smith Business School, have looked at how each country's votes for its favourite song can give an indication of the likelihood and nature of business exchanges across borders.

It has long been alleged that the Eurovision Song Contest is less a talent show and more a measure of countries' geopolitical standing with others. That theory has been supported by anecdotal evidence of favourable voting between countries such as Cyprus and Greece, or Ireland and the UK.

The new research - published in the Journal of International Business Studies - looks in detail at voting patterns between 1999, when public voting began, and 2013 to establish that patterns of voting bias do exist. Dr Tabner and Dr Siganos estimated bias by subtracting the average number of points received by each country from all participants in the contest, from the number of points received from a counterpart within a particular pair.

The authors say: "This research demonstrates that simple voting in the Eurovision Song Contest actually captures more complex elements of relationships which are driven by emotions, familiarity, psychological distance, and feelings of intimacy.

"We found that countries which share above average voting in Eurovision are likely to share more cross-border mergers between businesses. The flipside of this, where countries deliver below average votes for each other and share fewer business transactions, is also true.

"Voting patterns also correlate with levels of foreign direct investment and migration movements across borders. Of course, there are other factors which influence business exchanges between countries, including: sharing a border, the distance between capital cities, the degree to which languages are shared, and whether or not armed conflict has taken place between the countries in question.

"The insight into social affinity between nations which this analysis of Eurovision voting patterns provides may be a better predictor of international business exchanges than traditional measures of cultural similarity, and distance, if you believe that sometimes opposites attract, or that too much similarity, or closeness can lead to friction, clashes or even hostile rivalry.

"While much prior research focusses on similarity and distance measures, we argue that there are times when too much closeness and similarity can be counter-productive. For example, by creating destructive competitive rivalry, or just simply reminding counterparties of each-others' bad points.

"This research provides a measure of affinity by which social scientists can explore nuanced relations between the populations of participating countries, and has the additional benefit of using a sample size - in the millions - much bigger than is typically achieved by surveys."

Telemedicine tools developed at UVA Health to battle Ebola have huge potential in the fight against COVID-19, UVA experts report in a new scientific paper. The tools, they say, allow doctors to provide personal, high-quality care while conserving vital personal protective equipment and reducing infection risks.

The battle against highly contagious diseases represents an important new application for the technology, which has traditionally been used to expand access to healthcare and spare patients the need to travel to see doctors and specialists. Other hospitals and healthcare facilities, the UVA experts believe, can benefit from embracing the potential of telemedicine to enhance care for patients with COVID-19 and other highly infectious illnesses.

"One of the few bright spots of the COVID-19 crisis is that it's shown us how remarkably powerful and versatile telemedicine can be during outbreaks of novel contagious diseases," said UVA Health epidemiologist Costi Sifri, MD. "Its importance in helping us care for patients in their home while sheltering-in-place is clear. What we show here is that telemedicine solutions can also be used within the walls of hospitals, emergency rooms and clinics to help provide enhanced, more efficient and safer patient care for those potentially infected with high-risk pathogens."

The Power of Telehealth

UVA's Karen S. Rheuban Center for Telehealth has long been a leader in using telemedicine to extend care where it's needed most. In the last 20 years, the center has facilitated more than 50,000 patient encounters at more than 150 locations around the state. But UVA leaders turned their attention to a potential internal application of the technology after the state and the federal Centers for Disease Control and Prevention designated UVA a treatment center for Ebola during a worldwide outbreak in 2014.

UVA Health leaders found telemedicine a powerful resource for preparing for the highly infectious illness. They developed the Isolation Communication Management System (iSOCOMS) to provide remote treatment, guidance and supervision for UVA's Special Pathogens Unit and a biocontainment room in UVA's Emergency Department. They have since expanded it to rooms in UVA Health's new South Tower.

The secure system includes visual and audio connections to allow care providers to monitor and communicate with a patient in isolation, and to communicate with care providers inside the room. This limits the number of people who must enter the space, saving valuable PPE and reducing infection risk, and allows doctors who have not received special PPE training to consult on the patient's care. Medical students, too, can be trained in the environment safely.

Importantly, the setup also allows family members, spiritual advisers and others to communicate with the patient. And it helps the patient connect with their care providers by allowing communication without layers of PPE separating them.

Kendall Barger, RN, a nurse in UVA's medical intensive care unit, called iSOCOMS "a game-changer in our ability to safely provide quality care to COVID patients."

"It allows us to communicate with one another as a team, continually visualize the patient and their IV medications for optimal response to clinical change and connect families outside the hospital to their loved ones via video calls," she said.

'Clear Benefit'

In a new paper published in the Annals of the American Thoracic Society, UVA's epidemiology and telehealth leaders report that iSOCOMS provided "clear benefit" to patient care and healthcare provider safety when ruling out potential Ebola cases. (No cases were found at UVA.) "We were surprised by the number of case-use scenarios that were built around iSOCOMS during Ebola preparedness planning, ranging from PPE use, supervision and support of direct patient care, healthcare worker safety, patient-team member communication, extension of consult health services, patient-family communication, patient-support service communications and trainee education," they write.

They caution that hospitals must be mindful of patient privacy even when using secure telemedicine setups internally. But they urge their healthcare colleagues to consider the technology's potential as a relatively low-cost way to improve COVID-19 care.

"The digital transformation of healthcare has unquestionably been propelled by the COVID-19 pandemic," said Karen S. Rheuban, MD, a founder and medical director of UVA's telehealth program. "The use of iSOCOMs and a broad range of telehealth solutions has positively impacted patient access and reduced exposure for our patients and providers alike."