Increasing risk of breakthrough COVID-19 in outbreaks with high attack rates in European long-term care facilities, July to October 2021

We collected data from 10 EU/EEA countries on 240 COVID-19 outbreaks occurring from July-October 2021 in long-term care facilities with high vaccination coverage. Among 17,268 residents, 3,832 (22.2%) COVID-19 cases were reported. Median attack rate was 18.9% (country range: 2.8-52.4%), 17.4% of cases were hospitalised, 10.2% died. In fully vaccinated residents, adjusted relative risk for COVID-19 increased with outbreak attack rate. Findings highlight the importance of early outbreak detection and rapid containment through effective infection prevention and control measures.S

A survey of foot problems in community-dwelling older Greek Australians

<p>Abstract</p> <p>Background</p> <p>Foot problems are common in older people and are associated with impaired mobility and quality of life. However, the characteristics of foot problems in older Australians for whom English is a second language have not been evaluated.</p> <p>Methods</p> <p>One hundred and four community-dwelling people aged 64 to 90 years with disabling foot pain (according to the case definition of the Manchester Foot Pain and Disability Index, or MFPDI) were recruited from four Greek elderly citizens clubs in Melbourne, Australia. All participants completed a Greek language questionnaire consisting of general medical history, the Medical Outcomes Study Short-Form 36 (SF-36) questionnaire, the MFPDI, and specific questions relating to foot problems and podiatry service utilisation. In addition, all participants underwent a brief clinical foot assessment.</p> <p>Results</p> <p>The MFPDI score ranged from 1 to 30 (median 14), out of a total possible score of 34. Women had significantly higher total MFPDI scores and MFPDI subscale scores. The MFPDI total score and subscale scores were significantly associated with most of the SF-36 subscale scores. The most commonly reported foot problem was difficulty finding comfortable shoes (38%), and the most commonly observed foot problem was the presence of hyperkeratotic lesions (29%). Only 13% of participants were currently receiving podiatry treatment, and 40% stated that they required more help looking after their feet. Those who reported difficulty finding comfortable shoes were more likely to be female, and those who required more help looking after their feet were more likely to be living alone and have osteoarthritis in their knees or back.</p> <p>Conclusions</p> <p>Foot problems appear to be common in older Greek Australians, have a greater impact on women, and are associated with reduced health-related quality of life. These findings are broadly similar to previous studies in English-speaking older people in Australia. However, only a small proportion of this sample was currently receiving podiatry treatment, and a substantial number stated that they required more help looking after their feet. To address this issue, steps need to be taken to increase awareness of podiatry services among older Greek Australians.</p

TOI-1338 : TESS' first transiting circumbinary planet

Funding: Funding for the DPAC has been provided by national institutions, in particular, the institutions participating in the Gaia Multilateral Agreement. W.F.W. and J.A.O.thank John Hood Jr. for his generous support of exoplanet research at SDSU. Support was also provided and acknowledged through NASA Habitable Worlds grant 80NSSC17K0741 and NASA XRP grant 80NSSC18K0519. This work is partly supported by NASA Habitable Worlds grant 80NSSC17K0741. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship Program under grant No.(DGE-1746045). A.H.M.J.T. has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant agreement No. 803193/BEBOP) and from a Leverhulme Trust Research Project grant No. RPG-2018-418. A.C. acknowledges support by CFisUC strategic project (UID/FIS/04564/2019).We report the detection of the first circumbinary planet (CBP) found by Transiting Exoplanet Survey Satellite (TESS). The target, a known eclipsing binary, was observed in sectors 1 through 12 at 30 minute cadence and in sectors 4 through 12 at 2 minute cadence. It consists of two stars with masses of 1.1 M⊙ and 0.3 M⊙ on a slightly eccentric (0.16), 14.6 day orbit, producing prominent primary eclipses and shallow secondary eclipses. The planet has a radius of ∼6.9 R⊕ and was observed to make three transits across the primary star of roughly equal depths (∼0.2%) but different durations—a common signature of transiting CBPs. Its orbit is nearly circular (e ≍ 0.09) with an orbital period of 95.2 days. The orbital planes of the binary and the planet are aligned to within ∼1°. To obtain a complete solution for the system, we combined the TESS photometry with existing ground-based radial-velocity observations in a numerical photometric-dynamical model. The system demonstrates the discovery potential of TESS for CBPs and provides further understanding of the formation and evolution of planets orbiting close binary stars.Publisher PDFPeer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Αριθμητική επίλυση λυγισμού και μεταλυγισμικής συμπεριφοράς σε ανελαστικά κελύφη

The research in the present dissertation is aimed at developing advanced numerical tools for the simulation of shell buckling and post-buckling behavior, in the inelastic range. In particular, this work describes the development and the implementation of a J2 - non-associative plasticity model, which takes into account the "corner-like" effects at the loading point on the yield surface, and is suitable for shell buckling calculations.The main task of the present work consists of the development and the numerical implementation of a special-purpose constitutive model, suitable for large-scale structural stability computations within a finite element framework. The model employs von Mises yield surface (J2 - plasticity) and the rate form of J2 - deformation theory, it accounts for large strains, and leads to a non-associated flow rule. Special emphasis is paid on the continuity of plastic flow, to overcome numerical problems of convergence. The numerical implementation is conducted through both the backward-Euler and a forward-Euler substitution scheme, where stress and strain tensors are described in curvilinear coordinates, accounting for the extra constraint of zero normal stress through the shell thickness. The model is incorporated in a special-purpose nonlinear cylindrical shell finite element methodology, where the shell is described through a Lagrangian approach with convected coordinates and discretization is considered through a three-node “tube element”. The above technique is suitable for identifying bifurcation, investigating imperfection sensitivity and determining post-bifurcation behavior of the steel cylinder under compressive loads (uniform compression or bending). The numerical results are compared with available experimental data and analytical predictions and is demonstrated that the present methodology is capable of describing accurately and efficiently buckling and post-buckling behavior of rather thick-walled cylindrical shells in the inelastic range. Furthermore, wrinkling and post-wrinkling behavior of thick-walled high-strength seamless tubular (circular hollow section) members are presented in terms of both the ultimate load and the deformation capacity of typical cross-sections, in order to determine their ability to sustain load well above the first yield level. The results are aimed at evaluating the applicability of EN 1993-1-1 provisions for cross-sectional classification in the case of high-strength steel CHS seamless tubular members an issue of major importance for the design of tubular structures. The numerical results are compared with available experimental data, performed elsewhere.Αντικείμενο της διδακτορικής διατριβής είναι η προσομοίωση της συμπεριφοράς μεταλλικών κελυφών σε λυγισμό, με στόχο να χαράσσεται με ακρίβεια ο δρόμος ισορροπίας της μεταλυγισμικής συμπεριφοράς και να περιγράφεται η ευαισθησία σε αρχικές ατέλειες μέσω της ανάπτυξης ενός ειδικού μοντέλου μη-συνηρτημένης πλαστικότητας. Ο κύριος στόχος της εργασίας είναι η ανάπτυξη ενός μη-συνηρτημένου μοντέλου πλαστικότητας (J2 - non-associative plasticity model), το οποίο λαμβάνει υπόψη την δημιουργία μιας εικονικής γωνίας (“corner-like” effects) στην επιφάνεια διαρροής στο σημείο της φόρτισης και είναι κατάλληλο για την εξέταση του λυγισμού και τη μεταλυγισμική συμπεριφορά των κελυφών. Για την δημιουργία του νέου μη-συνηρτημένου μοντέλου πλαστικότητας χρησιμοποιήθηκε η αυξητική μορφή του μοντέλου πλαστικότητας συνολικών τάσεων παραμορφώσεων (J2 – deformation plasticity model). Το νέο μοντέλο πλαστικότητας διατηρεί τα βασικά χαρακτηριστικά της κλασσικής θεωρίας, αλλά επεκτείνει την βασική θεωρία ώστε να μπορεί να προσομοιώνει με ακρίβεια το λυγισμό των κελυφών, χωρίς επιπλέον παραμέτρους που απαιτούν τα μοντέλα corner/pseudo-corner theory of plasticity. Το μοντέλο θεωρεί μηδενική τάση κάθετη στην επιφάνεια του κελύφους, και ολοκληρώνεται με μία εύρωστη μέθοδο backward-Euler καθώς επίσης και με την μέθοδο forward-Euler. Το μοντέλο επεκτείνεται και για μεγάλες παραμορφώσεις, όπου ολοκληρώνεται μέσω μιας εύρωστης μεθοδολογίας που βασίζεται στην πολική ανάλυση του τανυστή κλίσης της παραμόρφωσης.Για την προσομοίωση της ελαστοπλαστικής συμπεριφοράς του κελύφους και των αρχικών ατελειών, έχει χρησιμοποιηθεί ένας πηγαίος κώδικας πεπερασμένων στοιχείων που αναπτύχθηκε από την ερευνητική ομάδα του Πανεπιστημίου Θεσσαλίας και έχει δώσει εξαιρετικά αποτελέσματα για κυλινδρικά κελύφη. Το καταστατικό μοντέλο ελαστοπλαστικής συμπεριφοράς έχει ενσωματωθεί στο πρόγραμμα πεπερασμένων στοιχείων, όπου χρησιμοποιείται μία μεθοδολογία μη γραμμικής ανάλυσης κατασκευών, η οποία βασίζεται σε μία Λαγκρανζιανή περιγραφή του παραμορφώσιμου στερεού με «ενσωματωμένες» συντεταγμένες. Ο κώδικας έχει την δυνατότητα ελαστοπλαστικής ανάλυσης με μεγάλες παραμορφώσεις/μετατοπίσεις και μεταλυγισμικής ανάλυσης του κελύφους και χρησιμοποιεί ένα εξειδικευμένο τρικομβικό “στοιχείο σωλήνα” (“tube element”)για την ανάλυση των κυλινδρικών κελυφών το οποίο συνδυάζει την διαμήκη παραμόρφωση τύπου δοκού με την παραμόρφωση της διατομής του σωλήνα. Ο πηγαίος κώδικας έχει την δυνατότητα να λαμβάνει υπόψη οιαδήποτε μορφή αρχικής ατέλειας και οιαδήποτε κατανομή παραμενουσών τάσεων, επιτρέποντας την συστηματική παραμετρική διερεύνηση της οριακής αντοχής των αγωγών.Στο τελευταίο μέρος της διατριβής παρουσιάζεται αριθμητικά αποτελέσματα, τα οποία συγκρίνονται με αναλυτικές λύσεις και πειραματικά αποτελέσματα. Ειδικότερα, παρουσιάζεται μια σημαντική πρακτική εφαρμογή της ανωτέρω μεθοδολογίας, που αφορά τον λυγισμό σωλήνων από χάλυβα υψηλής αντοχής. Η εφαρμογή αυτή είναι σημαντική για τον δομικό σχεδιασμό σωληνωτών κατασκευών, ιδιαίτερα για την αξιολόγηση των ισχυόντων σχεδιαστικών διατάξεων του αντίστοιχου Ευρωπαϊκού κανονισμού

ATTEL PROJECT PERFORMANCE‐BASED APPROACHES FOR HIGH STRENGTH TUBULAR COLUMNS AND CONNECTIONS UNDER EARTHQUAKE AND FIRE LOADINGS - D2

D2.1: Report on the design of specimens D2.2: Definition of practical solutions for the selected typologies of column bases, of HSSCHS columns and HSS‐CFT columns and of HSS‐concrete composite beam‐to‐column joint

ATTEL PERFORMANCE-BASED APPROACHES FOR HIGH STRENGTH TUBULAR COLUMNS AND CONNECTIONS UNDER EARTHQUAKE AND FIRE LOADINGS - D6

Design Guidelines and proposal for EC3, EC4 and EC