Case fatality rate (CFR) and doubling time are important characteristics of any epidemic. For coronavirus disease 2019 (COVID-19), wide variations in the CFR and doubling time have been noted among various countries. Early in the epidemic, CFR calculations involving all patients as denominator do not account for the hospitalised patients who are ill and will die in the future. Hence, we calculated cumulative CFR (cCFR) using only patients whose final clinical outcomes were known at a certain time point. We also estimated the daily average doubling time. Calculating CFR using this method leads to temporal stability in the fatality rates, the cCFR stabilises at different values for different countries. The possible reasons for this are an improved outcome rate by the end of the epidemic and a wider testing strategy. The United States, France, Turkey and China had high cCFR at the start due to low outcome rate. By 22 April, Germany, China and South Korea had a low cCFR. China and South Korea controlled the epidemic and achieved high doubling times. The doubling time in Russia did not cross 10 days during the study period.

Changed spatial configurations at sowing have been investigated as a strategy to minimize interspecific competition and improve the establishment and persistence of multi-species plantings in pastures, but the impact of this practice on the soil microbiome has received almost no previous research attention. Differences in populations of bacteria and fungi in the surface 10 cm of soil in the third year following pasture establishment were quantified using quantitative polymerase chain reaction and terminal restriction fragment length polymorphism methods. Populations were compared on, and between, drill rows sown to either the perennial grass phalaris (Phalaris aquatica L.), perennial legume lucerne (alfalfa; Medicago sativa L.) or the annual legume subterranean clover (Trifolium subterraneum L.). Results showed that soil microbial abundance and diversity were related to plant distribution across the field at the time of sampling and to soil chemical parameters including total carbon (C), mineral nitrogen (N), pH, and available phosphorus (P), potassium (K) and sulfur (S). Despite the 27-month lag since sowing, pasture species remained concentrated around the original drill row with very little colonization of the inter-row area. The abundance and diversity of bacterial and fungal populations were consistently greater under drill rows associated with higher total C concentrations in the surface soil compared with the inter-row areas. Our results showed that the pH and available nutrients were similar between the subterranean clover drill row and the inter-row, suggesting that soil microbial populations were not impacted directly by these soil fertility parameters, but rather were related to the presence or absence of plants. The abundance of bacteria and fungi were numerically lower under phalaris rows compared to rows sown to legumes. The richness and diversity of fungal populations were lowest between rows where lucerne was planted. Possible explanations for this observation include a lower C:N ratio of lucerne roots and/or a lack of fibrous roots at the soil surface compared to the other species, illustrating the influence of contrasting plant types on the soil microflora community. This study highlights the enduring legacy of the drill row on the spatial distribution of plants well into the pasture phase of a cropping rotation and discusses the opportunity to enhance the microbiome of cropping soils on a large scale during the pasture phase by increasing plant distribution across the landscape.

Background: Curbing unnecessary laboratory testing represents a significant opportunity for cost reduction in the Canadian health care system. A Choosing Wisely report cited a 31% decline in the number of tests ordered in a Canadian emergency department (ED) after implementation of recommendations. The international normalized ratio (INR) remains frequently ordered in emergency departments without an appropriate indication. Aim Statement: We aimed to reduce the number of INR tests completed in the St. Joseph's Healthcare Hamilton Emergency Department by 50% by April 30, 2019. Measures & Design: We conducted the study in an urban, academic ED employing the Epic electronic health record (EHR). We tailored interventions according to the Hierarchy of Effectiveness to address root causes revealed by analysis of our baseline ordering behaviour. Interventions included provider education around evidence-based ordering indications and removal of the INR from our “chest pain” bloodwork panel. Our outcome measure was the weekly number of INR tests completed per ED visit. Process measures included the proportion of INR tests ordered for inappropriate indications on monthly audits of 20 charts where an INR was completed. Balancing measures included average ED length of stay for patients receiving INR testing. Evaluation/Results: We collected outcome, process, and balancing measures through the EHR and analyzed this data using statistical process control charts. Over the nine-month study period, we decreased weekly INR tests from 248.4 to 115.0, a reduction of 56% which met criteria for special cause variation. This amounts to a cost savings of $43,008 per year. ED length of stay for patients receiving INR testing did not change significantly. Discussion/Impact: Our interventions were successful in realising our 50% target reduction in INR tests without an increase in ED length of stay from repeat venipuncture. This result is in keeping with similar efforts in other Canadian EDs. Our interventions could likely be spread to other settings where an INR is included as part of a “chest pain” panel. This may represent a substantial cost reduction opportunity on a national scale. Further work is needed in order to assess long term sustainability, which can be supported by employing high effectiveness mechanisms such as automation of optimal behaviour.

Mental Health care in the community has changed significantly over the last few decades following the closure of asylums and the development of community mental health care.

Legislation in most countries has failed to keep pace with the changes.

The repeated relapses and long hospital stays come at a both personal as well as a public cot.

Both ACT model and the CTOs have failed to have consistent benefits internationally. The AOTs have struggled to justify their existence in the UK, while CTOs are new and lacks support of its use from existing international research.

CTOs are aimed at the psychiatric patient population caught in a revolving door situation. This patients group tend to relapse due non-adherence and disengagement once discharged leading to further re-admissions.

We would like to present the findings from an AOT in an inner London borough that has modified the ACT model to suit the UK mental health care system, and has in recent years used CTOs successfully in reducing the impact on hospitalization and bed-usage. We will also present data on health care benefits of these patients, and the cost-benefits.

Our research is a retrospective analizes that aims to compare pre-CTO versus current CTO period on three main outcomes:

1. 1. Bed Occupancy

2. 2. Admission rates

3. 3. Health of the Nation (HoNOS) scores.

We feel that this can be a useful learning experience for many of Europe's large cities that have similar health care systems and face similar challenges.

The binary metal oxides are increasingly used as supercapacitor electrode materials in energy storing devices. Particularly NiCo2O4 has shown promising electrocapacitive performance with high specific capacitance and energy density. The electrocapacitive performance of these oxides largely depends on their morphology and electrical properties governed by their energy band-gaps and defects. The morphological structure of NiCo2O4 can be altered via the synthesis route, while the energy band-gap could be altered by doping. Also, doping can enhance crystal stability and bring in grain refinement, which can further improve the much-needed surface area for high specific capacitance. Given the above, this study evaluates the electrochemical performance of Ca-doped Ni1-xCaxCo2O4 (0 ≤ x ≤ 0.8) compounds. This stipulates promising applications for electrodes in future supercapacitors.

Methane (CH4) consumption in agricultural soil is imperative for the mitigation of climate change. However, the effect of tillage and cropping systems on CH4 consumption is less studied. Experiments were carried out in Madhya Pradesh, India with soybean-wheat (SW), maize-wheat (MW) and maize-gram (MG) cropping systems under conventional tillage (CT) and no-tillage (NT). Soybean/maize was cultivated during the kharif season (July–October) and wheat/chickpea in the rabi season (October–March) for 9 years consecutively. Soil samples were collected during vegetative growth stages of soybean and maize from different cropping systems. Methane consumption, the abundance of methanotrophs as particulate methane monooxygenase (pmoA) gene copies, soil and crop parameters were estimated. Methane consumption rate was higher in NT and upper soil layer (0–5 cm) than CT and 5–15 cm depth. Methane consumption rate k ranged from 0.35 to 0.56 μg CH4 consumed/g soil/d in the order of MW>SW>MG in 0–5 cm. The abundance of pmoA gene copies ranged from 43 × 104/g soil to 13 × 104/g soil and was highest in MW-NT and lowest in MG-CT. Available nitrogen, phosphorus and potassium were higher in 0–5 cm than in 5–15 cm depth. Soil and plant parameters and abundance of pmoA genes correlated significantly and positively with CH4 consumption rate. No-tillage stimulated CH4 consumption compared to CT irrespective of cropping system and CH4 consumption potential was highest in MW and lowest in MG. However, the magnitude of the positive effect of NT towards CH4 consumption was higher in SW and MG than MW.

Mycetoma is a chronic granulomatous, suppurative and progressive inflammatory disease that usually involves the subcutaneous tissue and bones after traumatic inoculation of the causative organism. In India, actinomycotic mycetoma is prevalent in south India, south-east Rajasthan and Chandigarh, while eumycetoma, which constitutes one third of the total cases, is mainly reported from north India and central Rajasthan. The objective was to determine the epidemiological profile and spectrum of eumycetoma from a tertiary care hospital in Delhi, North India. Thirty cases of eumycetoma were diagnosed by conventional methods of direct microscopy, culture and species-specific sequencing as per standard protocol. The spectrum of fungal pathogens included Exophiala jeanselmei, Madurella mycetomatis, Fusarium solani, Sarocladium kiliense, Acremonium blochii, Aspergillus nidulans, Fusarium incarnatum, Scedosporium apiospermum complex, Curvularia lunata and Medicopsis romeroi. Eumycetoma can be treated with antifungal therapy and needs to be combined with surgery. It has good prognosis if it is timely diagnosed and the correct species identified by culture for targeted therapy of these patients. Black moulds required prolonged therapy. Its low reporting and lack of familiarity may predispose patients to misdiagnosis and consequently delayed treatment. Hence health education and awareness campaign on the national and international level in the mycetoma belt is crucial.

Biochar has received attention due to its potential for mitigating climate change through carbon sequestration in soil and improving soil quality and crop productivity. This study evaluated the effects of rice straw biochar (RSB) and rice husk ash (RHA) each applied at 5 Mg ha−1 and four N levels (0, 40, 80, and 120 kg ha−1) on soil fertility, growth, and yield of rice and wheat for three consecutive rice–wheat rotations. RSB significantly increased electrical conductivity, dehydrogenase activity, and P and K contents when compared to control (no amendment) up to 7.5 cm soil depth. Both RSB and RHA did not influence shoot N concentration in wheat plant but significantly increased P and K concentrations at 60 days after sowing. Grain yields of both rice and wheat were significantly higher in RSB as compared to control (no amendment) and RHA treatments. While the highest grain yields of rice and wheat were observed at 120 kg N ha−1 in RHA and no biochar-treated plots, a significant increase in grain yields was observed at 80 kg N ha−1 in RSB treatment, thereby saving 40 kg N ha−1 in each crop. Both agronomic and recovery N efficiencies in rice and wheat were significantly higher in RSB-amended soil compared to control. Significant positive correlations were observed between soil N, P, and K concentrations and total N, P, and K concentrations in aboveground biomass of wheat at 60 days after sowing. This study showed the potential benefits of applying RSB for improving soil fertility and yields of rice and wheat in a rice–wheat system.

At GE Research, we are combining “physics” with artificial intelligence and machine learning to advance manufacturing design, processing, and inspection, turning innovative technologies into real products and solutions across our industrial portfolio. This article provides a snapshot of how this physical plus digital transformation is evolving at GE.

A mother's nutritional choices while pregnant may have a great influence on her baby's development in the womb and during infancy. There is evidence that what a mother eats during pregnancy interacts with her genes to affect her child's susceptibility to poor health outcomes including childhood obesity, pre-diabetes, allergy and asthma. Furthermore, after what an infant eats can change his or her intestinal bacteria, which can further influence the development of these poor outcomes. In the present paper, we review the importance of birth cohorts, the formation and early findings from a multi-ethnic birth cohort alliance in Canada and summarise our future research directions for this birth cohort alliance. We summarise a method for harmonising collection and analysis of self-reported dietary data across multiple cohorts and provide examples of how this birth cohort alliance has contributed to our understanding of gestational diabetes risk; ethnic and diet-influences differences in the healthy infant microbiome; and the interplay between diet, ethnicity and birth weight. Ongoing work in this birth cohort alliance will focus on the use of metabolomic profiling to measure dietary intake, discovery of unique diet–gene and diet–epigenome interactions, and qualitative interviews with families of children at risk of metabolic syndrome. Our findings to-date and future areas of research will advance the evidence base that informs dietary guidelines in pregnancy, infancy and childhood, and will be relevant to diverse and high-risk populations of Canada and other high-income countries.

Fifth generation (5G) is the current hot topic of the world's leading telecommunication companies. The compact designs of antennas made it possible for them to resonate at higher frequencies, thus to enable the devices to attain higher data rate as compared to 4G technology. Data rate of 5G technology for low mobility users is expected to be 50.0 Gbps and for high mobility users it is 5.0 Gbps. On the other hand, International telecommunication union's objective for 5G is 3 times more spectrally efficient thanlong-term evolution (LTE). The paper has carried out meticulous study over the impact of 5G antennas on the size of antenna, size/type of substrate, gain, efficiency, and isolation, etc. Also, different arrays andmultiple input multiple outputs (MIMOs) with patch antenna, magneto electric-dipole, microstrip grid array antenna, folded dipole, series-fed array, connected antenna array, MIMO are studied. The paper also includes the existing technology i.e 4G LTE and their isolation enhancement approaches. Many of the designs used the reflector plates to reduce the back lobe radiation problem in MIMO/array antennas to increase front-to-back ratio. The gain in 5G antennas can be increased by using balun, parasitic element as directors, multiple notch structures, three identical slot sub-arrays, etc. Mathematical equations of multi-element/port antennas are included to model the designed antennas. The beam steering is also included for the 5G technology in this paper.