Airborne dispersion of droplets during coughing: a physical model of viral transmission

The Covid-19 pandemic has focused attention on airborne transmission of viruses. Using realistic air flow simulation, we model droplet dispersion from coughing and study the transmission risk related to SARS-CoV-2. Although most airborne droplets are 8-16 $\mu$m in diameter, the droplets with the highest transmission potential are, in fact, 32-40 $\mu$m. Use of face masks is therefore recommended for both personal and social protection. We found social distancing effective at reducing transmission potential across all droplet sizes. However, the presence of a human body 1 m away modifies the aerodynamics so that downstream droplet dispersion is enhanced, which has implications on safe distancing in queues. Based on median viral load, we found that an average of 0.55 viral copies is inhaled at 1 m distance per cough. Droplet evaporation results in significant reduction in droplet counts, but airborne transmission remains possible even under low humidity conditions

Oxide Dispersion Strengthened (ODS) SS316L Prepared by Laser Powder Bed Fusion (L-PBF): Analysis of Microstructure and Hardness Properties

In this paper, dense oxide dispersion-strengthened (ODS) SS316L with 0.5 wt.% Y2O3 was fabricated using nano-Y2O3-embedded spherical SS316L powder via laser powder bed fusion (LPBF). The molten pool, oxide dispersion, cellular structure, and microhardness of the as-printed ODS SS316L were investigated through optical microscopy (OM), scanning electron microscopy (SEM), energy dispersive X-Ray Spectroscopy (EDX), and Vickers hardness testing, respectively. The results reveal a uniform dispersion of Y-rich nanoparticles in as-printed ODS SS316L, contributing to the development of a fine-grain structure in the as-printed ODS SS316L. A wide and shallow molten pool was observed in as-printed ODS SS316L, and enhanced microhardness was observed in ODS SS316L compared to pristine SS316L. The effects of Y2O3 on microstructure evolution and reinforcing mechanisms of microhardness are discussed.Mechanical Engineerin

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Balanced Topology NEMO Construction for the Internet-Based MANET

International audienceL'effet dévolutif de l'appel interdit au juge d'appel de statuer sur une demande de mainlevée de la mesure de protection formée pour la première fois devant elle quand elle n'est saisie que de l'appel d'une ordonnance portant changement de protecteur. Le juge des tutelles ne peut ordonner la mainlevée d'une mesure de protection juridique que s'il constate que les causes ayant justifié son ouverture ont disparu

Comparison of the efficacy of manual nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract

AIM: To compare the efficacy of broken nuclear small incision cataract surgery and phacoemulsification cataract surgery in the treatment of hard nuclear cataract.METHODS: Totally 42 patients with hard nuclear cataract were divided into observation group and control group, the observation group patients chosen broken nuclear small incision cataract surgery, the control group chosen phacoemulsification cataract surgery. Vision correction, corneal astigmatism effect after 1 day, 1 week, 1 month and 3 months and postoperative complications of two groups were observed and compared.RESULTS: After 1 day, 1 week, 1 month and 3 months, the difference of the proportion of patients corrected visual acuity 0.5-1.0 had no significant significance(P>0.05). Postoperative 1 day and 1 week, the observation group patients with corneal astigmatism higher than that in the control group, the difference was significant(PP>0.05). Sac membrane rupture in the control group was significantly higher than the observation group, the ratio of postoperative corneal edema in the control group were significantly higher than the observation group, the differences were statistically significant(PCONCLUSION: Broken nuclear small incision cataract surgery has good effect and few complications