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

Optimal placement and coordination of the protection devices simultaneous with optimal allocation of the DGs

Abstract Optimal coordination of the protection devices (PDs) is performed here simultaneous with optimal allocation of them and the DGs. The PDs are a set of directional overcurrent relays (DOCRs) and voltage relays, each with its own fast switch (FS). In previous optimal DG placement studies the coordination of the PDs has been considered as a constraint. So, it was not possible to optimal coordination of the PDs simultaneously. In the present study, the coordination between the PDs is considered in calculating the value of the energy not supplied (ENS) that is a part of an overall cost function. The cost function considered here includes cost of purchase, installation, and maintenance of the DGs and the PDs, cost of the energy losses, cost of the ENS, cost of the purchased energy from the main grid and the DGs, and the penalty cost for emitting environmental pollutants. Here, output of the renewable DGs and the network loads during the year, in a 96‐h model, has been considered as variable. To solve the desired optimization problem, an algorithm based on evolutionary algorithms such as genetic algorithm (GA) is proposed. Finally, various cases have been simulated by considering a standard 33‐bus radial network

Considering DGs Voltage Protection in Optimal Coordination of Directional Overcurrent Relays to Minimize the Energy Not Supplied

So far, the overall operation time of relays has been used as the objective function in all directional overcurrent relays (DOCRs) optimal coordination problems. However, it cannot guarantee that in an optimal coordination of DOCRs at presence of distributed generations (DGs), the reliability indices will reach the minimum value. The reason is the existence of DGs voltage protection at their connection point to the network. This protection plays a key role in determining participation of DGs in improving network reliability during fault conditions. However, in the previous studies in which the overall operation time of relays is considered as the objective function, the voltage protection of DGs is not taken into account. In this article, coordination between DOCRs and their interactions with the DGs voltage protection is considered in calculation of the energy not supplied (ENS). Also, instead of the overall operation time of the DOCRs, the ENS value is considered as the optimization objective function. A probabilistic hourly seasonal model has been used to model the renewable DGs and the network loads. Various scenarios have been simulated to demonstrate the efficiency of the proposed method over a standard 33-bus radial distribution network

Critical thinking ability and its associated factors among preclinical students in Yazd Shaheed Sadoughi University of Medical Sciences (Iran)

 Abstract Background: The aim of this study was to investigate the ability of Iranian medical and dental students in thinking critically and to assess their ability in using definite components of critical thinking (CT). Methods: Multistage cluster sampling was utilized to recruit 125 preclinical (1st, 2nd and 3rd year of study) students in Yazd Shaheed Sadoughi University of Medical Sciences in Yazd, Iran. The Watson-Glaser Critical Thinking Appraisal (WGCTA) was applied to collect data. The statistical analysis of the data included One-way analysis of variance (ANOVA), t-test and bivariate correlations. Results: The mean total score for this sample was 45.33±5.4. Significant differences were found in total critical thinking score by gender (p= 0.022), residency (p= 0.026) and the year of education (p= 0.01). A significant correlation was found between the total CT score and the student’s number of passed credits (r= 0.297, p= 0.003). Also, a significant difference was found in the students’ scores on the WGCTA evaluation subtest by passing any research method courses (p= 0.04). Conclusion: The CT ability in medical and dental students in the present study was weak overall. Medical educators and clinical instructors should try to develop the ability of CT by teaching methods and techniques like purposeful planning and problem-based teaching to promote the components of CT in their students. The improving of CT in medical students has implications for medical education and promotion of medical profession

Genetic Association of PPARGC1A Gene Single Nucleotide Polymorphism with Milk Production Traits in Italian Mediterranean Buffalo

PPARGC1A gene plays an important role in the activation of various important hormone receptors and transcriptional factors involved in the regulation of adaptive thermogenesis, gluconeogenesis, fiber-type switching in skeletal muscle, mitochondrial biogenesis, and adipogenesis, regulating the reproduction and proposed as a candidate gene for milk-related traits in cattle. This study identified polymorphisms in the PPARGC1A gene in Italian Mediterranean buffaloes and their associations to milk production and quality traits (lactation length, peak milk yield, fat and protein yield, and percentage). As a result, a total of seven SNPs (g.-78A>G, g.224651G>C, g.286986G>A, g.304050G>A, g.325647G>A, g.325817T>C, and g.325997G>A) were identified by DNA pooled sequencing. Analysis of productivity traits within the genotyped animals revealed that the g.286986G>A located at intron 4 was associated with milk production traits, but the g.325817T>C had no association with milk production. Polymorphisms in g.-78A>G was associated with peak milk yield and milk yield, while g.304050G>A and g.325997 G>A were associated with both milk yield and protein percentage. Our findings suggest that polymorphisms in the buffalo PPARGC1A gene are associated with milk production traits and can be used as a candidate gene for milk traits and marker-assisted selection in the buffalo breeding program

Assessment of Land Suitability Potentials for Winter Wheat Cultivation by Using a Multi Criteria Decision Support- Geographic Information System (MCDS-GIS) approach in Al-Yarmouk Basin (S Syria)

In the last few years, the agricultural sector in Syria has suffered from major problems related to land degradation. To cope with this problem, a land suitability assessment has become an essential tool for sustainable land use management. The present research qualitatively evaluated the suitability of land in the Al-Yarmouk Basin (S-Syria) for rainfed winter wheat (Triticum aestivum) cultivation. In this study, a regional spatial approach involving three steps was developed, based on the method proposed by Sys et al. In the first step, a soil survey was carried out and 107 soil profiles were described, sampled and analyzed. In the second step, climatic gridded datasets from 1984–2014 MRm at a high spatial resolution (30 meters) and the Digital Elevation Model (DEM) were clipped from NASA's Shuttle Radar Topography Mission (SRTM) and prepared for the study area. In the third step, a land suitability assessment was performed using the geographical information system (GIS) and multi criteria decision support (MCDS). Soil survey outcomes showed that the study area was dominated by five soil orders: Mollisols, Inceptisols, Vertisols, Entisols and Aridisols. Also, results from the Sys model illustrated that more than 23.8% of the study area is highly suitable (S1–0) for wheat production without any limitations, whereas 38.7% and 37.5% are highly suitable (S1–1) and moderately suitable (S2), respectively. Also, the study emphasizes the important role of topographical factors in the study area for wheat cultivation. All in all, this research suggests W-Syria as a potential region for wheat cultivation, instead of the eastern area which is subject to climate change and a shortage of water. Integrating the Sys-approach and the GIS framework offers a good tool for policy-makers to apply in Syria for land suitability assessments

Risk of stroke in hospitalized SARS-CoV-2 infected patients: A multinational study

Background: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients