Complex network analysis techniques for the early detection of the outbreak of pandemics transmitted through air traffic.

Air transport has been identified as one of the primary means whereby COVID-19 spread throughout Europe during the early stages of the pandemic. In this paper we analyse two categories of methods - dynamic network markers (DNMs) and network analysis-based methods - as potential early warning signals for detecting and anticipating COVID-19 outbreaks in Europe on the basis of accuracy regarding the daily confirmed cases. The analysis was carried out from 15 February 2020, around two weeks before the first COVID-19 cases appeared in Europe, and 1 May 2020, approximately two weeks after all the air traffic in Europe had been shut down. Daily European COVID-19 information sourced from the World Health Organization was used, whereas air traffic data from Flightradar24 has been incorporated into the analyses by means of four alternative adjacency matrices. Some DNMs have been discarded since they output multiple time series, which makes it very difficult to interpret their results. The only DNM outputting a single time series does not emulate the COVID-19 trend: it does not detect all the main peaks, which means that peak heights do not match up with the increase in the number of infected people. However, many combinations of network analysis based methods and adjacency matrices output good results (with high accuracy and 20-day advance forecasts), with only minor differences from one to another. The number of edges and the network density methods are slightly better when dynamic flight frequency information is used.

Multi-attribute analysis of trophic state and waterfowl management in Ringkøbing Fjord, Denmark.

A multi-attribute analysis by means of the general multi-attribute analysis (GMAA) decision support system was performed in order to rank different strategies for good water quality with respect to trophic state, and good conditions for waterfowl, in the lagoon Ringkøbing Fjord, Denmark. The remedial strategies included nutrient abatement and the construction of facilities to increase the water exchange between the lagoon and the sea. The analysis showed that it is essential to keep the mean annual salinity level constant, since a drastic change in salinity may cause massive destruction of the macrophyte belt with large effects on the water quality and waterfowl abundance. It may be cost-effective to build and maintain a saltwater pumping station or a second sluice to increase the seawater inflow. Further nutrient abatement may not be cost-effective, at least not on time-scales shorter than 20 years, but the utility from nutrient abatement increases if a second sluice is built additionally. However, all of the remedial strategies, except decreasing the salinity, were projected to cause rather small changes in the effect variables compared to the no action alternative.

Effect of body position on gas exchange after bronchoalveolar lavage.

OBJECTIVE: To assess the possible influence of body position on oxygen saturation after bronchoscopy (BC) with bronchoalveolar lavage (BAL). DESIGN: Prospective, open, randomized study. SETTING: The respiratory unit of a first level, community hospital. PATIENTS: Forty-one consecutive patients in which BC with BAL, using at least 150 mL of BAL fluid, was performed. METHOD: We randomly assigned 21 patients to lie in lateral decubitus (LD) with the lung where BAL was performed uppermost after BC, and 20 to lie in supine position (SP). Oxygen saturation (SO2) was measured for all patients from 10 min before to 30 min after the end of the BC. Saturation parameters were compared for both groups. RESULTS: Mean SO2 was significantly lower after than before the BC, both for LD and SP groups (LD: 91.4+/-3% vs. 94.9+/-2%, respectively; P=0.0001) (SP: 91.6+/-3 vs. 95.8+/-3%, respectively; P=0.0003). We did not find significant differences between LD and SP groups, after BC, regarding mean SO2 (91.4+/-3% vs. 91.6+/-3%), minimum SO2 (86.2+/-4.5% vs. 86.6+/-5.4%, respectively) or percentages of registry time at saturations below 90% (26.3+/-35.9% vs. 27.6+/-38.2%, respectively) (P:NS for all values). CONCLUSION: BC with BAL caused significant oxygen desaturation in our patients. We have not been able to demonstrate a significant influence of body position on SO2 after BAL.

Multiple pulmonary nodules in a patient with Crohn's disease.

Crohn's disease (CD) can be associated with respiratory involvement. Multiple pulmonary nodules are an infrequent finding in patients with CD. When they are found, histology usually shows sterile necrobiotic nodules, which are spherical aggregates of neutrophils, which frequently cavitate. We report a patient with inactive CD treated with mesalazine, who presented with multiple pulmonary nodules. Transthoracic biopsy of one of the nodules disclosed a benign, nongranulomatous inflammatory lymphoid infiltration. The radiographic abnormalities responded well to oral prednisone. Focal, nongranulomatous lymphoid infiltration thus must be considered in the differential diagnosis of multiple pulmonary nodules in patients with CD.