There are no egalitarians in a pandemic. The scale of the challenge for health systems and public policy means that there is an ineluctable need to prioritise the needs of the many. It is impossible to treat all citizens equally, and a failure to carefully consider the consequences of actions could lead to massive preventable loss of life. In a pandemic there is a strong ethical need to consider how to do most good overall. Utilitarianism is an influential moral theory which states that the right action is the action which is expected to produce the greatest good. It offers clear operationalizable principles. In this paper we provide a summary of how utilitarianism could inform two challenging questions that have been important in the early phase of the pandemic Triage which patients should receive access to a ventilator if there is overwhelming demand outstripping supply? Lockdown How should countries decide when to implement stringent social restrictions, balancing preventing deaths from COVID-19 with causing deaths and reducing in wellbeing from other causes? Our aim is not to argue that utilitarianism is the only relevant ethical theory, or in favour of a purely utilitarian approach. However, clearly considering which options will do the most good overall will help societies identify and consider the necessary cost of other values. Societies may choose either to embrace or not to embrace the utilitarian course, but with a clear understanding of the values involved and the price they are willing to pay.Background Proline specific peptidases (PSPs) are a unique group of enzymes that specifically cleave bonds formed by a proline residue. The study of PSPs is important due to their role in the maturation and degradation of peptide hormones and neuropeptides. In addition, changes in the activity of PSPs can result in pathological conditions, including various types of cancer. Scope of review PSPs annotated from the Homo sapiens genome were compared and classified by their physicochemical and biochemical features and roles in vital processes. In addition to catalytic activity, we discuss non-enzymatic functions that may regulate cellular activity. Major conclusions PSPs apparently have multiple functions in animals. Two functions rely on the catalytic activity of the enzyme one involved in a regulatory pathway associated with the ability of many PSPs to hydrolyze peptide hormones and neuropeptides, and the other involved in the trophic pathway associated with the proteolysis of total cellular protein or Pro-containing dietary proteins in the digestive tract. PSPs also participate in signal transduction without proteolytic activity by forming protein-protein interactions that trigger or facilitate the performance of certain functions. General significance PSPs are underestimated as a unique component of the normal human peptidase degradome, providing the body with free proline. A comparative analysis of PSPs can guide research to develop inhibitors that counteract the abnormalities associated with changes in PSP activity, and identify natural substrates of PSPs that will enable better understanding of the mechanisms of the action of PSPs in biological processes and disease.Background A communicating syringomyelia can develop in association with hydrocephalus, with communication between the syringomyelia and fourth ventricle a representative neuroimaging finding. Case description A 51-year-old female was presented with slowly progressive bladder dysfunction, along with scoliosis. She had a non-functioning cerebrospinal fluid shunt that had been placed after birth for neonatal hydrocephalus. Tetraventricular enlargement and holocord syrinx were noted in neuroimaging findings, while phase contrast magnetic resonance and ventriculogram imaging revealed communication between the syrinx and fourth ventricle via a dilated central canal. Placement of a de novo ventriculoperitoneal shunt led to collapse of the syringomyelia, though apparent improvement of clinical symptoms was not obtained. Conclusions A communicating syringomyelia can develop as a late complication in patients with shunted hydrocephalus. In the majority of reported cases, shunt revision has been shown effective, though some require posterior fossa decompression and exploration.Despite the ferment aroused in the scientific community by the COVID-19 outbreak and the over 11,000 papers listed in PubMed, published evidence on safe and effective drugs has not progressed yet at the same speed of the pandemic.  https://www.selleckchem.com/products/Thiazovivin.html  However, clinical research is rapidly progressing, as shown by the hundreds of registered clinical trials on candidate drugs for COVID-19. Unfortunately, information on protocols of individual studies differs from registry to registry. Furthermore, study designs, criteria for stratification of patients and choice of outcomes are quite heterogeneous. All this makes data sharing and secondary analysis difficult.At last, small single centre studies and the use of drugs on a compassionate basis should be replaced by highly powered, multi-centre, multi-arm clinical trials, in orderto provide the required evidence of safety and efficacy of novel or repurposed candidate drugs. Hopefully, the efforts of clinical researchers in the fight against the SARS Cov-2 will result into the identification of effective treatments. To make this possible, clinical research should be oriented by guidelines for more harmonized high-quality studies and by a united commitment of the scientific community to share personal knowledge and data. Allergists and clinical immunologists should have a leading role in this unprecedent challenge.Artificial intelligence (AI) is generating substantial interest in the field of medicine. One form of artificial intelligence, deep learning, has led to rapid advances in automated image analysis. In 2017, an algorithm demonstrated the ability to diagnose certain skin cancers from clinical photographs with the accuracy of an expert dermatologist. Subsequently, deep learning has been applied to a range of dermatology applications. Though experts will never be replaced by AI, it will certainly impact the specialty of dermatology. In this first article of a two-part series, the basic concepts of deep learning will be reviewed with the goal of laying the groundwork for effective communication between clinicians and technical colleagues. In part two of the series, the clinical applications of deep learning in dermatology will be reviewed considering limitations and opportunities.