Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Good Governance in International Sport Organisations: an Analysis of the 35 Olympic Sport Governing Bodies

In this paper, structural issues with regard to the quality of the self-governance of the 35 Olympic Sport Governing Bodies (SGBs) are analysed. Firstly, this paper presents empirical evidence on the lack of accountability arrangements in SGBs. In particular, the watchdog function of their member organisations is severely undermined by the general absence of objective criteria and transparency in the distribution of funding to members. With regard to checks and balances, arguably the most topical issue is the complete lack of independent ethics committees. Secondly, our survey demonstrates that most SGBs have institutionalised athlete participation. However, in the overwhelming majority of the organisations, they have not been granted a share of formal decision making power. Thirdly, with regard to executive body members, there is the rather anachronistic dominance of the European continent and also the preponderance of male officials. In addition, the general lack of term limits poses serious threats with regard to the concentration of power, which is evidenced for instance by the overall number of years SGB presidents are in office. The empirical evidence clearly supports the recent calls for improved governance in sport, according to which SGBs need to agree upon, and act in accordance with, a set of well-defined criteria of good governance. Only then will the self-governance of sport be credible and the privileged autonomy of these organisations justifiable.status: publishe

Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

Background: Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods: A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre-specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results: A total of 4164 patients were included, with a median age of 68 (i.q.r. 57\u201375) years (54\ub79 per cent men). Some 1153 (27\ub77 per cent) received NSAIDs on postoperative days 1\u20133, of whom 1061 (92\ub70 per cent) received non-selective cyclo-oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4\ub76 versus 4\ub78 days; hazard ratio 1\ub704, 95 per cent c.i. 0\ub796 to 1\ub712; P = 0\ub7360). There were no significant differences in anastomotic leak rate (5\ub74 versus 4\ub76 per cent; P = 0\ub7349) or acute kidney injury (14\ub73 versus 13\ub78 per cent; P = 0\ub7666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35\ub73 versus 56\ub77 per cent; P < 0\ub7001). Conclusion: NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement