Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Exploiting the value of post-consumer plastics: an analysis of the main technological options

The paper describes the main technological options for exploiting the value of urban wastes and suggests and tests a methodological approach for their selectio

Eficácia de herbicidas em diferentes quantidades de palha de cana-de-açúcar no controle de Euphorbia heterophylla Efficacy of herbicides in different amounts of sugar cane straw on Euphorbia heterophylla control

Este trabalho foi realizado com o objetivo de estudar o efeito de diferentes quantidades de palha de cana-de-açúcar, colhida sem queima prévia do canavial, sobre a eficácia de alguns herbicidas recomendados para esta cultura. O experimento foi conduzido em campo no Centro de Ciências Agrárias/UFSCar, em Araras, SP. Os tratamentos consistiram dos herbicidas trifloxysulfuron-sodium + ametryn (1.463 + 37 g i.a ha-1), imazapic (84 g i.a ha-1), imazapyr (200 g i.a ha-1), ¹diuron + hexazinone (1.170 + 330 g i.a ha-1) e ²diuron + hexazinone (1.330 + 160 g i.a ha-1) aplicados em pré-emergência de Euphorbia heterophylla e sobre cinco quantidades de palha de cana-de-açúcar (0, 5, 10, 15 e 20 t ha-1). A eficácia de controle das plantas daninhas foi avaliada aos 7, 14, 21 e 28 dias após a aplicação dos tratamentos (DAT). A palha (15 e 20 t ha-1) reduziu a população de E. heterophylla. À medida que se aumentou a quantidade de palha, houve redução na eficácia dos herbicidas; com 15 t ha-1 de palha, o controle foi considerado satisfatório (90%) apenas para os tratamentos ¹diuron + hexazinone e trifloxysulfuron-sodium + ametryn. Com 20 t ha-1, nenhum herbicida foi eficaz; entretanto, a palha foi eficiente na supressão dessa espécie, verificando-se que o número de plantas emergidas foi menor mesmo na testemunha.<br>This work aimed to study the effect of different amounts of sugar cane straw, collected unburned, on the efficacy of some herbicides recommended for this culture. The experiment was carried out in the field, at the Centro de Ciências Agrárias/UFSCar, Araras, SP. The treatments consisted of herbicides trifloxysulfuron-sodium + ametryn (1,463 + 37 g a.i ha-1), imazapic (84 g a.i ha-1), imazapyr (200 g a.i ha-1), diuron + hexazinone (1,170 + 330 g a.i ha ¹) and ²diuron + hexazinone (1,330 + 160 g a.i ha-1) applied in pre emergence of Euphorbia heterophylla and five increasing amounts of sugar cane straw ( 0, 5, 10, 15 and 20 t ha-1).Weed control efficacy was evaluated on 7, 14, 21 and 28 days after treatments (DAT). Straw (15 and 20 t ha-1) reduced the population of E. heterophylla. As the amount of straw increased, herbicide effectiveness decreased; with 15 t ha-1 straw, control was satisfactory (90%) only for the treatments ¹diuron + hexazinone and trifloxysulfuron-sodium + ametryn. With 20 t ha-1 straw, no herbicide was effective; however, in this case, straw was efficient in suppressing this species, since the number of emerged plants was smaller, even in the plots without herbicide