Impact of COVID-19 pandemic on cardiovascular testing in Asia: the IAEA INCAPS-COVID study

BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known. OBJECTIVES This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia. METHODS The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison. RESULTS Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020. CONCLUSIONS The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted

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

Optimización topológica bidireccional con esquema de penalización de material y restricciones de desplazamiento

Se presenta la optimización topológica de estructuras bidimensionales en estado de tensión plana, considerando un esquema de optimización bidireccional que incorpora un parámetro de penalización para maximizar la rigidez de la estructura considerando restricciones del tipo cinemático. Un código abierto de optimización topológica escrito en MATLAB® con capacidades de encontrar el óptimo para una fracción de volumen definida a priori, se modifica para obtener la estructura óptima cuando se impone un desplazamiento límite o admisible. Dos problemas clásicos de la literatura se analizan introduciendo los conceptos desarrollados. Los resultados obtenidos permiten concluir que para un estado particular de carga es posible definir distintas configuraciones de máxima rigidez dependiendo del desplazamiento considerado. Cada una de estas configuraciones se estructura a base de elementos en compresión y tracción que se asemejan a un enrejado, con distribuciones tensionales casi uniformes en cada elemento. La relevancia del presente trabajo radica en que permite visualizar la existencia de configuraciones de máxima rigidez dependiendo del desplazamiento límite o admisible elegido y como este converge hacia una estructura con tensiones uniformes

Barley adaptation. Lessons learned from landraces will help to cope with climate change

27 Pags., with Figs. y Tabls.Adaptation of crops to temperate climates depends to a large extent on plants having the appropriate combination of genes to respond to environmental cues. Global warming poses new challenges to plant breeding. In many places, current cultivars will no longer be suited for cultivation. We present several findings on barley adaptation to Mediterranean climates, which resulted from the study of adaptations presented by local landraces. Winter barley is widely grown in the Mediterranean region. We found that local winter landraces have some degree of vernalization requirement, tuned to respond to the winter temperatures typical for each region. Our results demonstrate that the allelic series of the main vernalization gene, VrnH1, is essential to determine the length of the cold period needed to promote flowering in barley. The presence of photoperiod gene HvFT3 in most Mediterranean landraces is presented as a safety mechanism to promote flowering, which comes into play at least when vernalization conditions are not optimum (rather often in some areas). This mechanism is coordinated with the vernalization pathway through repression by VrnH2. A latitudinal pattern of distribution of HvFT1 in Spanish barleys suggests a role in adaptation. This gene integrates the photoperiod and vernalization pathways in barley, and seems to present an allelic series of at least five functionally different alleles. We present evidences from several independent sets of materials that demonstrate the effect of three of these alelles, in accordance with the latitudinal distribution observed. A combination of these three mechanisms optimizes the growth cycle of Mediterranean landraces. These mechanisms have a wider interest in a climate change scenario, as temperatures in most of Europe will increase, and may become beneficial in higher latitudes. Cultivars with new combinations of vernalization, photoperiod and frost tolerance alleles will have to be bred for the upcoming conditions.Funded by Spanish Ministries of Economy and Competitiveness (former Science and Innovation) and Agriculture.Peer reviewe