Investigation of hospital discharge cases and SARS-CoV-2 introduction into Lothian care homes

Background The first epidemic wave of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in Scotland resulted in high case numbers and mortality in care homes. In Lothian, over one-third of care homes reported an outbreak, while there was limited testing of hospital patients discharged to care homes. Aim To investigate patients discharged from hospitals as a source of SARS-CoV-2 introduction into care homes during the first epidemic wave. Methods A clinical review was performed for all patients discharges from hospitals to care homes from 1st March 2020 to 31st May 2020. Episodes were ruled out based on coronavirus disease 2019 (COVID-19) test history, clinical assessment at discharge, whole-genome sequencing (WGS) data and an infectious period of 14 days. Clinical samples were processed for WGS, and consensus genomes generated were used for analysis using Cluster Investigation and Virus Epidemiological Tool software. Patient timelines were obtained using electronic hospital records. Findings In total, 787 patients discharged from hospitals to care homes were identified. Of these, 776 (99%) were ruled out for subsequent introduction of SARS-CoV-2 into care homes. However, for 10 episodes, the results were inconclusive as there was low genomic diversity in consensus genomes or no sequencing data were available. Only one discharge episode had a genomic, time and location link to positive cases during hospital admission, leading to 10 positive cases in their care home. Conclusion The majority of patients discharged from hospitals were ruled out for introduction of SARS-CoV-2 into care homes, highlighting the importance of screening all new admissions when faced with a novel emerging virus and no available vaccine

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Towards a critical edition of De XII Abusivis : Introductory essays with a provisional edition of the text and accompanied by an English translation

THESIS 153

Art and analogy through evolutionary computation

In this thesis the development of a computer system capable of generating art through the process of analogy is presented. A visual display is generated analogous to a given piece of music. This analogy is based upon the aesthetics of both music and visuals whereby an aesthetic piece of music should prompt an aesthetic visual display with similar characteristics. The aesthetics of both music and visuals which form the core of the proposed system remain difficult to capture. A novel approach is presented, designed to capture and evaluate aesthetic experience for use in computational systems using a graph based ranking approach. A number of experiments were conducted to analyse the performance of this approach, and a number of studies were conducted using this approach to gather aesthetic data. Representing an analogy within a computer system requires codifying the connections between two domains. Mapping expressions are introduced to represent these connections. Together with the aesthetic data gathered, these mapping expressions are evolved using a computational evolution approach. The output of this process is an abstract representation of an analogy. This representation is then used to create a visual display. Further studies have been carried out to evaluate the effect of these generated visuals on the aesthetic experience of a viewer

A New Irish Fragment of the Continuatio to Rufinus-Eusebius Historia Ecclesiastica

Breen Aidan. A New Irish Fragment of the Continuatio to Rufinus-Eusebius Historia Ecclesiastica. In: Scriptorium, Tome 41 n°2, 1987. pp. 185-204

Art and analogy through evolutionary computation

In this thesis the development of a computer system capable of generating art through the process of analogy is presented. A visual display is generated analogous to a given piece of music. This analogy is based upon the aesthetics of both music and visuals whereby an aesthetic piece of music should prompt an aesthetic visual display with similar characteristics. The aesthetics of both music and visuals which form the core of the proposed system remain difficult to capture. A novel approach is presented, designed to capture and evaluate aesthetic experience for use in computational systems using a graph based ranking approach. A number of experiments were conducted to analyse the performance of this approach, and a number of studies were conducted using this approach to gather aesthetic data. Representing an analogy within a computer system requires codifying the connections between two domains. Mapping expressions are introduced to represent these connections. Together with the aesthetic data gathered, these mapping expressions are evolved using a computational evolution approach. The output of this process is an abstract representation of an analogy. This representation is then used to create a visual display. Further studies have been carried out to evaluate the effect of these generated visuals on the aesthetic experience of a viewer

À propos du synode de Whitby. Étude des observations astronomiques dans les Annales irlandaises

The astronomical entries scattered through the Irish Annals have been examined in a serious astronomical context by R. R. Newton as part o fhis research into the accelerations of the earth andmoon, and by D. Schove and A. Fletcher as part of the Spectrum of Time project. They have never, however, been fully collated and examined as a whole as this paper undertakes to do. What emerges is a body of records from 442 to 1133 documenting eclipses, cornets, aurorae, volcanic dust clouds and possibly a supernova ; from 664 to 1 133 ail of these records are of observations made in or near Ireland, and most of them are accurate in their chronological and descriptive details. Analysis of the details of these records implies that, at least from the seventh to the eleventh centuries careful and sustained observation and recording of astro-nomical phenomena were conducted in some Irish monasteries and it is clear that the underlying motive was religious and specifically eschatological, i. e. to detect the first signs of the end of time as prognosticated in the Book of Revelation. Critical examination of this data allows us to throw new light on the circumstances of the Synod of Whitby in 664 and to identify a possible Western observation of the supernova of 1054. (© 1997 Elsevier Science Ltd. All rights reserved).Les entrées astronomiques qui se relèvent ici et là dans les Annales irlandaises ont été examinées dans une perspective astronomique par R. R. Newton, dans le cadre de ses recherches sur l'accélération de la rotation de la terre et de la lune, et par D. Schove et A. Fletcher, dans le cadre du projet Spectrum of tinte. Cependant, ces entrées n'ont jamais été collationnées et examinées dans leur ensemble, ce que nous entreprenons de faire dans cet article. Le résultat est un corpus d'enregistrements, entre 442 et 1133, d'éclipsés, de comètes, d'aurores boréales, de nuages de poussière volcanique, et probablement d'une supernova. De 664 à 1 133, tous ces enregistrements proviennent d'observations effectuées en Irlande ou à proximité, et la plupart d'entre eux est correcte, tant du point de vue de la chronologie que de la description. L'analyse des détails de ces enregistrements implique que, au moins entre le VIIe et le XIe siècle, des observations et des enregistrements minutieux et systématiques des phénomènes astronomiques ont été menés dans des monastères irlandais. Il est évident que la motivation sous-jacente était d'ordre religieux et plus particulièrement eschatologique : la détection des premiers signes de la fin du monde annoncée dans le livre des Révélations (Apocalypse). L'examen critique de ces données permet d'apporter un nouvel éclairage sur les circonstances du Synode de Whitby en 664 et d'identifier à titre d'hypothèse une observation occidentale de la supernova de 1054). (© 1999 Elsevier Science Ltd. Tous droits réservés).MacCarthy Daniel, Breen Aidan. À propos du synode de Whitby. Étude des observations astronomiques dans les Annales irlandaises. In: Annales de Bretagne et des pays de l'Ouest. Tome 107, numéro 3, 2000. pp. 25-56

Comparison between microwave and microwave plasma sintering of nickel powders

Materials Science Forum, January, 2011There is considerable interest in processing technologies which can lead to more energy efficient sintering of metal powders. The use of microwave sintering in particular leads to reduced energy usage during sintering as the volumetric heating process is considerably more efficient compared with resistance heating. In this study the use of a novel plasma microwave processing technology for the sintering of nickel powder discs is evaluated. The sintering study was carried out on 20 mm diameter by 2 mm thick pressed discs of nickel powder, with mean particle size of 1 μm. The discs were fired in a 5 cm diameter microwave (2.45 GHz) plasma ball under a hydrogen atmosphere at a pressure of 2 kPa. The same discs were also sintered using both non plasma microwave and tube furnace firing. The microwave plasma sintering is very rapid with full disc strength of approx. 1000 N based on 3--point bend tests being achieved within 10 minutes. In contrast the sintering time in the tube furnace involved treatments of up to 6 hours. The non plasma microwave system involved intermediate treatment periods of 1 to 2 hours. Another advantage of the microwave plasma treatment is that the degree of sintering between the individual nickel powder particles can be precisely controlled by the duration of the treatment time in the plasma. There was a broadly linear increase in fired pellet breaking strength with plasma treatment duration. In addition to breaking load, the mechanical properties of the sintered nickel discs were compared based on Rockwell hardness tests and density measurements. The morphology of the sintered discs was compared using microscopy and SEM. This study demonstrated that the plasma microwave sintered discs produced similar or superior performance (depending on processing conditions) to discs fired using the non-plasma microwave and furnace firing conditions. Accurate control of the sample conditions and structure can easily be controlled with the plasma system compared with the conventional systems. The apparent volumetric heating in the microwave systems give a more uniform heating at lower temperatures and allows for greater control and homogeneity.Author has checked copyrightAD 22/01/201

Comparison of thermal and microwave-assisted plasma sintering of nickel-diamond composites

There is considerable interest in processing technologies which can lead to more energy efficient sintering of metal powders. Microwave sintering has recently been shown to reduce energy usage as the volumetric heating process is considerably more efficient than resistance heating. RF plasma sintering meanwhile has been shown to deliver heat via uniform excitation of the processing gas resulting in ion bombardment of the workpiece. In this study the use of a rapid, novel microwave-assisted plasma sintering (MaPS) technology for processing of nickel-diamond metal matrix composites is evaluated. Nickel powder and polycrystalline diamond were mixed to prepare 20 mm discs under uniaxial compaction pressures of 100, 200 and 300 MPa. The discs were fired in a low pressure microwave plasma under a hydrogen atmosphere. For comparison, discs were also sintered using conventional tube furnace firing. The MaPS sintering is very rapid with full disc strength of >1000N, based on 3-point bend tests, being achieved within 10 minutes compared with 8 hours for furnace treatment. This study demonstrates that the microwave-assisted plasma sintered discs produced similar or superior performance to discs fired using furnace firing conditions but with sintering cycle time reduced by up to 95%.Author has checked copyrightAD 22/01/201