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Objective We investigated the incidence, predictor variables, clinical characteristics, and stroke outcomes in patients with COVID-19 seen in emergency departments (EDs) before hospitalization. Methods We retrospectively reviewed all COVID-19 patients diagnosed with stroke during the COVID-19 outbreak in 62 Spanish EDs. We formed two control groups: COVID-19 patients without stroke (control A) and non-COVID-19 patients with stroke (control B). We compared disease characteristics and four outcomes between cases and controls. Results We identified 147 strokes in 74,814 patients with COVID-19 seen in EDs (1.96 parts per thousand, 95% confidence interval [CI] = 1.66 parts per thousand to 2.31 parts per thousand), being lower than in non-COVID-19 patients (6,541/1,388,879, 4.71 parts per thousand, 95% CI = 4.60 parts per thousand to 4.83 parts per thousand; odds ratio [OR] = 0.42, 95% CI = 0.35 to 0.49). The estimated that standardized incidences of stroke per 100,000 individuals per year were 124 and 133 for COVID-19 and non-COVID-19 individuals, respectively (OR = 0.93 for COVID patients, 95% CI = 0.87 to 0.99). Baseline characteristics associated with a higher risk of stroke in COVID-19 patients were hypertension, diabetes mellitus, and previous cerebrovascular and coronary diseases. Clinically, these patients more frequently presented with confusion, decreased consciousness, and syncope and higher D-dimer concentrations and leukocyte count at ED arrival. After adjustment for age and sex, the case group had higher hospitalization and intensive care unit (ICU) admission rates (but not mortality) than COVID-19 controls without stroke (OR = 3.41, 95% CI = 1.27 to 9.16; and OR = 3.79, 95% CI = 1.69 to 8.50, respectively) and longer hospitalization and greater in-hospital mortality than stroke controls without COVID-19 (OR = 1.55, 95% CI = 1.24 to 1.94; and OR = 1.77, 95% CI = 1.37 to 2.30, respectively). Conclusions The incidence of stroke in COVID-19 patients presenting to EDs was lower than that in the non-COVID-19 reference sample. COVID-19 patients with stroke had greater need for hospitalization and ICU admission than those without stroke and longer hospitalization and greater in-hospital mortality than non-COVID-19 patients with stroke.

OBJECTIVE: To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). METHODS: We systematically characterized consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c, and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines. RESULTS: Patients (median 59 years, 62.9% female) mostly had type 2 diabetes (96%), half for >5 years (48.6%). Obesity (45.5%) and central obesity (females 84.8%; males 62.7%) were common. The median HbA1c was 8.7% (72 mmol/mol), ranging from 7.7% (61 mmol/mol; Peru) to 10.4% (90 mmol/mol; South Africa). Antidiabetes treatment included metformin (62.6%), insulin (37.8%), and other oral glucose-lowering drugs (34.8%). Disease complications included eyesight problems (50.4%), EGFR

To describe the characteristics and management of Diabetes mellitus (DM) patients from low- and middle-income countries (LMIC). We systematically characterized consecutive DM patients attending public health services in urban settings in Indonesia, Peru, Romania and South Africa, collecting data on DM treatment history, complications, drug treatment, obesity, HbA1c, and cardiovascular risk profile; and assessing treatment gaps against relevant national guidelines. Patients (median 59 years, 62.9% female) mostly had type 2 diabetes (96%), half for >5 years (48.6%). Obesity (45.5%) and central obesity (females 84.8%; males 62.7%) were common. The median HbA1c was 8.7% (72 mmol/mol), ranging from 7.7% (61 mmol/mol; Peru) to 10.4% (90 mmol/mol; South Africa). Antidiabetes treatment included metformin (62.6%), insulin (37.8%), and other oral glucose-lowering drugs (34.8%). Disease complications included eyesight problems (50.4%), EGFR

Summary The 2013 annual monitoring programme for the pinewood nematode, Bursaphelenchus xylophilus, analysed a total of 267 wood samplescollected from declining or symptomatic coniferous trees distributed among national forests, gardens, public parks, distribution centres,wood-processing industries, as well as 104 samples collected from wood packing material originated from several other countries. From atotal of eight species found, five have been previously reported from Romania, while three other species (Bursaphelenchus abietinus, Bursa-phelenchus fraudulentus and Bursaphelenchus fuchsi) represent new findings for Romania. In addition, B. mucronatus was found in packingwood originated from Russia. Herein, we provide a morphological, morphometric and molecular characterization for the new species foundfor Romania. Bursaphelenchus xylophilus was not detected. 1 Introduction The pinewood nematode (PWN), Bursaphelenchus xylophilus (Steiner and Buhrer, 1934) Nickle, 1970, is considered one ofthe most important pests and pathogens of conifer forests worldwide. The general fear of establishment of the PWN, causalagent of the pine wilt disease (PWD) into new areas, assumes huge relevance due to the devastating damage that this spe-cies can cause to pine forests (Vicente et al. 2012). As the first report of this species in Europe (Mota et al. 1999), all Euro-pean Union members have adopted recommended regulations and have performed national surveys for monitoring thepotential entry of this quarantine species.In the past years, Romania has been following EU regulations, such as the 2012/535/UE decision on emergency mea-sures to prevent the introduction and spread of the PWN, thereby annual national surveys have been conducted under theMinistry of Agriculture and Rural Development. The total forest area in Romania consists of over 6.3 million ha, corres-ponding to 27% of the total land area of the country. Romanian forests are diverse, with 31% represented by conifers,including several Pinus species (e.g. Pinus cembra, P. mugo, P. nigra and P. sylvestris) (Donita et al. 1990; Borlea et al.2006). Although the current phytosanitary measures and monitoring programme in Romania aim to minimizes the risk ofentry of the PWN into the country, the favourable climatic conditions, associated with the presence of highly susceptiblepine trees (P. nigra and P. sylvestris) and distribution of Monochamus species (Ruicanescu 2007), which can mediate thetransportation and transmission of the PWN, impose a continuous challenge to protect the national pine forests.This quarantine programme has not only allowed monitoring of the national pine forests and several critical areas wherethe PWN could entry/establish (entry ports and wood factories), but also has provided the opportunity to identify andcharacterize other species belonging to the genus Bursaphelenchus. The first report of the genus in Romania was given in2013 (Calin et al. 2013), followed by the identification and characterization of five species of this genus, namely B. hofman-ni Braasch, 1998; B. poligraphi Fuchs, 1937; B. vallesianus Braasch, Sh€onfeld, Polomski & Burgermeister, 2004; B. willibaldiShonfeld, Braasch & Burgermeister, 2006, including the€ first description of B. andrassyi Dayi, Calin, Akbulut, Gu, Schr€oder,Vieira & Braasch, 2014 (Dayi et al. 2014).During 2013, the sampled areas throughout the country and the number of wood samples collected were intensified, aswell as the number of samples collected from wood originating from other countries. As a result, three additional Bursaphe-lenchus species, new for Romania, have been identified. In this context, we provide a morphological and molecular charac-terization of the newly found Bursaphelenchus species.

This work describes a comparative study of staged and non-staged anaerobic flters for treating a synthetic dairy waste under similar operating conditions. The effect of increasing the substrate concentration from 3 to 12 g COD dmˉ³ at a constant hydraulic residence time (HRT) of 2 days was evaluated with respect to overall reactor performance, biogas production, volatile fatty acids profiles along the height, methanogenic and acidogenic activity distribution, and hydrodynamic behaviour. The potential maximum specific methanogenic activity against acetate, hydrogen, propionate and butyrate and the lactose specific activity were determined for sludge sampled from three different points in each reactor, under two operating conditions (influent COD of 3 and 9 g COD dmˉ³). Although all trophic groups involved in the anaerobic process were found throughout the reactors, it was possible to identify different specific sludges at different heights in both reactors. Performances of the two configurations were very similar under the operating conditions tested and the plug flow behaviour of the staged reactor was clearly reduced when the influent concentration increased from 3 to 9 g COD dmˉ³., The financial support of the EU Human Capital and Mobility network Improved Application of Anaerobic Digestion Technology (EXBCHRXCT 930262) and FCT National Programme project number PEAM/SEL/517/95 are gratefully acknowledged. Image analysis was accomplished using IMAGO, a MATLAB programme written by Luís Amaral and Eugénio Ferreira.