Spread of a SARS-CoV-2 variant through Europe in the summer of 2020.

Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3–5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes. © 2021, The Author(s), under exclusive licence to Springer Nature Limited

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Mouse Chromosome 11

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46996/1/335_2004_Article_BF00648429.pd

EFFECTS OF CYCLING WARM UP VERSUS STATIC STRETCHING INVOLVING CYCLING SPECIFIC MUSCLES ON WINGATE PERFORMANCE

C.L. Whitlock, J.T. Nadeau, M.C. Eastwood, V.K. Mehndiratta & D.B. Thorp Gonzaga University, Spokane, WA Previous studies evaluating muscle performance during a maximal physical test have failed to find an optimum intensity warm-up; high intensity warm-ups have induced fatigue while low intensity warm-ups failed to prepare the muscles for optimal performance. Further, the relatively few studies that have examined the effects of performing short-duration static stretching as a warm-up (group) on maximal performance offer equivocal results. One key variable in the effectiveness of a warm-up on performance is an increase in muscle temperature (TM). Research has shown that task a specific warm-up is more effective in raising muscle temperature in active muscles than a non-specific warm-up. PURPOSE: The purpose of this study is to test the hypothesis that moderate intensity cycling warm-up (CWU) would increase peak power during a Wingate cycling test (WT) in comparison to a static stretching warm-up (SS) involving active cycling muscle groups. It was also hypothesized that TM would have a greater increase in CWU. METHODS: Nineteen (9 male, 10 female) untrained college students participated in the study [mean ± SD; age = 19.9 ± 1.1 yr, height = 173.6 ± 10.8 cm, body mass = 69.7 ± 13.9 kg, fat free mass = 59.7 ± 12.4 kg]. Subjects performed a thirty-second maximal effort Wingate test on a mechanically braked cycle ergometer with 7.5% of their body weight as resistance on two occasions (randomized order, separated by 48 hours). Each WT was performed five minutes after completion of one of two warm-up protocols: 1) 8 min, 20 s of SS focusing on the following muscle groups: hamstring, groin, gluteus maximus, hip flexors, quadriceps, gastrocnemius, soleus, and hip rotator muscles, or 2) 12 min, 30 s of CWU at 60-65% of HRmax. Heart rate, blood lactate concentration, and skin temperature (TS) were measured pre and post warm-up. TS was then used to predict muscle temperature (TM) using the equation: TM (˚C) = 1.02TS (˚C) + 0.89. Peak power (PP), anaerobic capacity (AC), time to peak power (TPP), minimum power (MP), and fatigue index (FI) were determined during the WT. All power measures were corrected by fat free mass (FFM). Warm-up protocols were compared using paired t-tests (significance at p AC and MP were significantly greater following CWU compared to SS (9.2 W/kg vs 9.5 W/kg and 6.3 W/kg vs 6.7 W/kg). PP and FI were similar regardless of warm-up. However, PP was achieved sooner following SS. Post warm-up muscle temperature was similar in both conditions. CONCLUSION: CWU at moderate intensity increases WT performance as indicated by PP when compared to short duration SS despite similar TM. This increased performance is by some mechanism other than muscle temperature

LOWER EXTREMITY KINEMATICS AND MUSCLE ACTIVATION CHANGES DURING ANKLE AND HIP GAIT ADAPTATION STRATEGIES

J.T. Nadeau, J.T. Droessler, M.C. Eastwood, C.L. Whitlock, V.R. Gieser, & B.K. Higginson Gonzaga University, Spokane, WA Gait modification can be beneficial in reducing pain or compensating for muscle weakness at the ankle or hip. Two strategies proposed for clinical gait modification are the ankle strategy and hip strategy. The ankle strategy is characterized by increased plantar flexion, which provides a forward push to the leg that can either propel the whole body in late stance or initiate recovery during swing phase. This strategy is commonly utilized among elderly individuals with anterior hip impairments. For the hip strategy, hip flexor muscles pull the leg forward during swing phase to reduce peak plantar pressures or compensate for impaired ankle power generation in the elderly. PURPOSE: To verify gait adaptation efficacy by analysis of plantar flexor EMG coupled with lower limb kinematics. METHODS: Thirteen healthy female undergraduate students walked on a treadmill at a self-selected speed using three gait strategies: natural ankle push-off (NP), increased ankle push-off (IP), and decreased ankle push-off (DP). IP was intended to simulate the ankle strategy, while DP was to simulate the hip strategy. Average muscle activation for the right lateral gastrocnemius (LG), medial gastrocnemius (MG) and soleus (S) were quantified and normalized with respect to NP over five subsequent strides. Lower extremity joint and segment angles were measured at both heel strike and toe off. All measures were averaged over five strides and compared using within-subject repeated measures ANOVA (α = 0.05). RESULTS: Relative to the NP strategy, average muscle activation was significantly higher in IP for the LG (54.7%, p = 0.002), MG (26.1%, p = 0.034) and S (40.6%, p = 0.008), while no significant changes in activation were found for DP (LG: 11.0%, p = 0.256; MG: 1.2%, p = 1.000; S: 8.5%, p = 0.258). Leg and thigh segment angles for the IP strategy at heel strike were significantly smaller than in NP (1.9%, p = 0.010 and 1.4%, p = 0.009, respectively). No significant kinematic differences were found between DP and NP strategies. CONCLUSION: Based solely on muscle activation, young healthy females were able to adapt to the ankle strategy, but may have had difficulty adapting to the hip strategy. Lower leg kinematics did not appear to be effective indicators of gait strategy adaptation

Climate and pre-Columbian settlement at Anse à la Gourde, Guadeloupe, Northeastern Caribbean

The authors present a reconstruction of precipitation, seasonality, and vegetation cover over the period from 200 cal yr B.C. to 1600 cal yr A.D. for the archaeological site of Anse à la Gourde, Guadeloupe, based on the oxygen and carbon isotope composition of accelerator mass spectrometry (AMS) 14C-dated aragonitic shells of the landsnail Bulimulus guadaloupensis. The results show that the Late Cedrosan Saladoid population (400-800 cal yr A.D.) disappeared at the beginning of a dry and stormy period lasting from 800 to 1000 cal yr A.D. The Mamoran Troumassoid started to populate the site around 1000 cal yr A.D. when the climate became wetter, and remained until 1300 cal yr A.D. The snail-shell carbon isotope values changed significantly around the period that the Late Cedrosan Saladoid occupation started. This indicates a vegetational response either to the wetter conditions, or because of the replacement of existing C4 plant vegetation by introduced C3 crops

Climate and pre-Columbian settlement at Anse à la Gourde, Guadeloupe, Northeastern Caribbean

The authors present a reconstruction of precipitation, seasonality, and vegetation cover over the period from 200 cal yr B.C. to 1600 cal yr A.D. for the archaeological site of Anse à la Gourde, Guadeloupe, based on the oxygen and carbon isotope composition of accelerator mass spectrometry (AMS) 14C-dated aragonitic shells of the landsnail Bulimulus guadaloupensis. The results show that the Late Cedrosan Saladoid population (400-800 cal yr A.D.) disappeared at the beginning of a dry and stormy period lasting from 800 to 1000 cal yr A.D. The Mamoran Troumassoid started to populate the site around 1000 cal yr A.D. when the climate became wetter, and remained until 1300 cal yr A.D. The snail-shell carbon isotope values changed significantly around the period that the Late Cedrosan Saladoid occupation started. This indicates a vegetational response either to the wetter conditions, or because of the replacement of existing C4 plant vegetation by introduced C3 crops