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

Estudo da utilização do efluente de biodigestor no cultivo hidropônico do meloeiro Utilization of biodigestor effluent in the hydroponic cultivation of melon

Objetivando-se o aproveitamento do efluente de biodigestor no cultivo hidropônico do meloeiro, desenvolveu-se a presente pesquisa. O experimento foi conduzido no Departamento de Engenharia Rural da Faculdade de Ciências Agrárias e Veterinárias da UNESP, campus de Jaboticabal, cultivando-se o meloeiro (Cucumis melo L. cv. Bonus n&ordm; 2). O delineamento experimental utilizado foi em blocos casualisados, com 6 repetições, cujos tratamentos foram: 1) cultivo hidropônico em sistema fechado tipo NFT ("nutrient film technique") com uso de solução nutritiva organo-mineral (biofertilizante com complementação mineral); 2) cultivo hidropônico em sistema fechado tipo NFT, com uso de solução nutritiva 100% mineral; 3) cultivo hidropônico em sistema aberto, com substrato e solução nutritiva organo-mineral e 4) cultivo hidropônico em sistema aberto, com substrato e solução nutritiva 100% mineral. O biofertilizante e o substrato foram obtidos a partir do efluente de biodigestor, produzido com estrume bovino. As plantas cultivadas no tratamento 1 tiveram desenvolvimento prejudicado, devido ao acúmulo de partículas sólidas junto ao sistema radicular. O tratamento 2 proporcionou às plantas desenvolvimento vegetativo mais rápido e maior produtividade. Os frutos produzidos no tratamento 2 apresentaram maior peso, formato mais alongado e maior teor de sólidos solúveis totais. A substituição parcial de adubos minerais por biofertilizante mostrou-se possível em sistema hidropônico aberto com substrato.<br>With the objective to use effluent of biodigestor in the hydroponic cultivation, an experiment was conducted in the Department of Rural Engineering Faculty of Agricultural and Veterenary Sciences of UNESP, campus of Jaboticabal where a melon crop (Cucumis melo L. cv. Bonus n&ordm; 2) was cultivated. The experimental design used was a randomized blocks, with 6 repetitions and the treatments studied were: 1) hydroponic cultivation in closed system type NFT (nutrient film technique) with use of organic-mineral nutrient solution (biofertilizer with mineral complementation); 2) hydroponic cultivation in closed system type NFT with use of 100% mineral solution; 3) hydroponic cultivation in open system, with substrate and organic-mineral nutrient solution and 4) hydroponic cultivation in an open system, with substrate and 100% mineral solution. The biofertilizer and the substrate were obtained from biodigestor effluent produced with cowdung. Plant development in treatment 1 was affected due to accumulation of solid particles in the root system. Treatment 2 provided to the plants rapid vegetative development and higher productivity. The fruits produced in treatment 2 presented higher weight, more elongated shape and higher total soluble solid content. A partial substitution of mineral fertilizers by biofertilizers showed viability of hydroponic cultivation of the melon plant in an open system with substrate

Análise do resfriamento da solução nutritiva para cultivo hidropônico do morangueiro Nutrient solution cooling evaluation for hydroponic cultivation of strawberry plant

Este trabalho teve como objetivo a produção hidropônica de morangos com resfriamento da solução nutritiva, em Jaboticabal - SP. O experimento foi conduzido no Setor de Plasticultura do Departamento de Engenharia Rural da FCAV/UNESP, Câmpus de Jaboticabal, em casa de vegetação coberta com filme de polietileno, sendo o transplantio realizado em 9-1-2002. Foram avaliadas duas variedades de morango: Campinas e "Sweet Charlie", cultivadas em sistema hidropônico tipo NFT, com ou sem resfriamento da solução nutritiva. A solução nutritiva resfriada foi mantida à temperatura de aproximadamente 12 ºC, por meio de um trocador de calor. A variedade "Sweet Charlie" apresentou melhores resultados para peso médio dos pseudofrutos, diâmetro médio longitudinal, diâmetro médio transversal, número médio de pseudofrutos e produtividade. O resfriamento da solução nutritiva conferiu maior número de pseudofrutos colhidos, maior produtividade e maior teor de sólidos solúveis totais aos pseudofrutos da variedade "Sweet Charlie". No entanto, o resfriamento da solução nutritiva não causou efeitos sobre a variedade Campinas.<br>This work had as its major aim the hydroponic production of strawberries with the cooling of the nutrient solution, in Jaboticabal - SP - Brazil. The experiment was conducted in a covered greenhouse with a plastic film and seed transplantation achieved on January 9, 2002. Two varieties of strawberries were evaluated: Campinas and Sweet Charlie, both cultivated under the hydroponic system NFT type with or without cooling the nutrient solution. The cooling of the nutrient solution at about 12 &deg;C was in a heating exchange device. The Sweet Charlie variety presented the best results for both the average weight and number of pseudofruit, longitudinal average diameter, cross average diameter, average number of pseudofruit and productivity. The cooling of the nutrient solution confered greater number of pseudofruit collected and better productivity of Sweet Charlie variety. However, the cooling of the nutrient solution didn't cause any effects over the Campinas variety

Solubility and bacterial sealing ability of MTA and root-end filling materials

ABSTRACT Objective To evaluate solubility and sealing ability of Mineral Trioxide Aggregate (MTA) and root-end filling materials. Material and Methods The materials evaluated were: MTA, Calcium Silicate Cement with zirconium oxide (CSC/ZrO2), and zinc oxide/eugenol (ZOE). Solubility test was performed according to ANSI/ADA. The difference between initial and final mass of the materials was analyzed after immersion in distilled water for 7 and 30 days. Retrograde cavities in human teeth with single straight root canal were performed by using ultrasonic tip CVD 9.5107-8. The cavities were filled with the evaluated materials to evaluate sealing ability using the bacterial leakage test with Enterococcus faecalis. Bacterial leakage was evaluated every 24 hours for six weeks observing the turbidity of Brain Heart infusion (BHI) medium in contact with root apex. Data were submitted to ANOVA followed by Tukey tests (solubility), and Kruskal-Wallis and Dunn tests (sealing ability) at a 5% significance level. Results For the 7-day period, ZOE presented highest solubility when compared with the other groups (p<0.05). For the 30-day period, no difference was observed among the materials. Lower bacterial leakage was observed for MTA and CSC/ZrO2, and both presented better results than ZOE (p<0.05). Conclusion MTA and CSC/ZrO2 presented better bacterial sealing capacity, which may be related to lower initial solubility observed for these materials in relation to ZOE

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology