Symptoms and laboratory manifestations of mild COVID-19 in a repatriated cruise ship cohort.

Much of our current understanding about novel coronavirus disease 2019 (COVID-19) comes from hospitalised patients. However, the spectrum of mild and subclinical disease has implications for population-level screening and control. Forty-nine participants were recruited from a group of 99 adults repatriated from a cruise ship with a high incidence of COVID-19. Respiratory and rectal swabs were tested by polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sera were tested for anti-SARS-CoV-2 antibodies by enzyme-linked immunosorbent assay (ELISA) and microneutralisation assay. Symptoms, viral shedding and antibody response were examined. Forty-five participants (92%) were considered cases based on either positive PCR or positive ELISA for immunoglobulin G. Forty-two percent of cases were asymptomatic. Only 15% of symptomatic cases reported fever. Serial respiratory and rectal swabs were positive for 10% and 5% of participants respectively about 3 weeks after median symptom onset. Cycle threshold values were high (range 31-45). Attempts to isolate live virus were unsuccessful. The presence of symptoms was not associated with demographics, comorbidities or antibody response. In closed settings, incidence of COVID-19 could be almost double that suggested by symptom-based screening. Serology may be useful in diagnosis of mild disease and in aiding public health investigations.

Carbapenemase-producing Enterobacteriaceae in Australian hospitals: outcome of point-prevalence screening in high-risk wards.

Carbapenemase-producing Enterobacteriaceae (CPE) infections are increasingly reported in Australian hospitals, but prevalence is unknown. In 2016, Victorian hospitals conducted CPE point-prevalence surveys in high-risk wards (intensive care, haematology, transplant). Forty-three hospitals performed 134 surveys, with 1839/2342 (79%) high-risk patients screened. Twenty-four surveys were also performed in other wards. Inability to obtain patient consent was the leading reason for non-participation. In high-risk wards, no CPE cases were detected; three cases were identified in other wards. Since there is low prevalence in high-risk wards, continuous screening is not recommended. Targeted screening may be enhanced by review of patient consent processes.

The effects of replacing a portion of endurance training by explosive strength training on performance in trained cyclists.

To investigate the effects of replacing a portion of endurance training by strength training on exercise performance, 14 competitive cyclists were divided into an experimental (E; n = 6) and a control (C; n = 8) group. Both groups received a training program of 9 weeks. The total training volume for both groups was the same [E: 8.8 (1.1) h/week; C: 8.9 (1.7) h/week], but 37% of training for E consisted of explosive-type strength training, whilst C received endurance training only. Simulated time trial performance (TT), short-term performance (STP), maximal workload (Wmax) and gross (GE) and delta efficiency (DE) were measured before, after 4 weeks and at the end of the training program (9 weeks). No significant group-by-training effects for the markers of endurance performance (TT and Wmax) were found after 9 weeks, although after 4 weeks, these markers had only increased (P < 0.05) in E. STP decreased (P < 0.05) in C, whereas no changes were observed in E. For DE, a significant group-by-training interaction (P < 0.05) was found, and for GE the group-by-training interaction was not significant. It is concluded that replacing a portion of endurance training by explosive strength training prevents a decrease in STP without compromising gains in endurance performance of trained cyclists.

Relative degree of stimulation-evoked glycogen degradation in muscle fibres of different type in rat gastrocnemius.

1. The relative degree of glycogen degradation, caused in different fibre types by supramaximal electrical activation of the muscle nerve, was investigated in m. gastrocnemius medialis of young adult rats under general pentobarbitone anaesthesia. Four different protocols of intermittent maximal tetanic activation were used, each lasting 6 s (33% duty cycle; fast and slow isovelocity concentric (shortening) contractions, brief- and long-burst isometric contractions; 6 rats per group). All contractions were evoked under ischaemic conditions. 2. Work output finally dropped to 29% of the initial value for the fast concentric and to 87% for the slow concentric contractions. In isometric protocols evoked by the same stimulation patterns, the force x time area rose to 110% for brief-burst contractions and dropped to 95% for the long-burst contractions. 3. Following the physiological procedures, the experimental muscle and its contralateral control were removed and prepared for histochemical analysis. Serial sections were stained for glycogen (periodic acid-Schiff (PAS) method) and myofibrillar ATPase (mATPase), the latter reactions being used for classifying the fibres as types I, IIA, IIBd and IIBm. 4. For deep 'red' regions of non-stimulated contralateral control muscles the optical density of PAS staining was ranked between fibre types such that I < IIA < IIBd < IIBm. In superficial 'white' regions of the same muscles, no significant difference in PAS staining density was found between IIBd and IIBm fibres (types I and IIA not present). 5. All contractile protocols produced a significant glycogen degradation in IIBm fibres, and the fast concentric activation procedure was associated with a significant decline of PAS staining in all fibre types. For all activation protocols, the relative degree of glycogen degradation within a given region was ranked such that IIBm > IIBd > IIA > I. For IIBm vs. IIBd fibres, the differences in relative degradation were greater and more consistently significant for superficial white regions than in the deeper red muscle portions. 6. The results are discussed in relation to glycogen degradation measurements in studies of motor unit recruitment. Furthermore, the results from red vs. white muscle regions underline that fibres of seemingly the same mATPase type may differ considerably in other properties.