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Ideally, weather forecasts should be provided for points and not for the large regions represented by global model grid boxes. This requirement can be addressed by post-processing global forecast model output, as in “ecPoint”, an entirely new and innovative statistical technique developed by ECMWF that uses decision trees and non-local calibration. Products from ecPoint explicitly incorporate the expected sub-grid variability and gridscale bias correction (which both vary according to a diagnosed “grid-box weather type”).The HIGHLANDER (HIGH-performance computing to support smart LAND sERvices) project is funded under the Connecting Europe Facility (CEF) – Telecommunication Sector Programme of the European Union. One of its main goals is data processing for more intelligent and sustainable management of natural resources and the territory. And one component of this, managed by ECMWF, is exploiting the CINECA supercomputer facilities in Bologna to extract maximum benefit from the ecPoint technique. The specific aims here are to improve probabilistic 24-h rainfall and 2m temperature representation in sub-seasonal forecasts and in the ERA5 reanalysis. Pre-existing 6-h (currently running in CINECA) and 12-h ecPoint-Rainfall forecasts products are currently being provided by ECMWF in real-time, using shorter range (day 1-15) twice daily predictions at 18km resolution. These probabilistic forecasts have exhibited clear improvements, in both reliability and resolution, relative to the raw model output. ecPoint benefits tend to be more significant when working at a lower resolution, so downscaling from 36km in the sub-seasonal forecast and 31 km in ERA5 can in principle deliver even greater improvements for users (relative to raw model and reanalysis output) than we have seen hitherto.The final ecPoint sub-seasonal products will cover lead times of 16 to 30 days. They will provide more reliable climatological representations, for points on the land surface, than can raw model output (e.g. numbers of dry or wet days, days of freezing temperatures, which are both relevant for agricultural applications). Meanwhile, ERA5 ecPoint products will be the first probabilistic reanalysis products to have incorporated bias-corrected uncertainty information at point scale. ecPoint products for both systems will comprise 24-h accumulated rainfall and daily minimum, maximum and mean 2m temperature, for both percentiles (1, 2,..99) and (derived from these) probabilities of exceeding certain thresholds. Global outputs will be created, but a particular focus will be Italy, and surrounding Mediterranean areas, for agricultural planning purposes, to deliver benefits in both economic and resource availability terms.In this presentation, we will introduce the ECMWF activities in the project and the methodologies applied to create the final probabilistic forecast and reanalysis products.

BACKGROUND Telemedicine in obstetrics has mostly been described in the rural areas that have limited access to subspecialties. During the COVID-19 pandemic, health systems rapidly expanded telemedicine services for urgent and nonurgent healthcare delivery, even in urban settings. The New York University health system implemented a prompt systemwide expansion of video-enabled telemedicine visits, increasing telemedicine to >8000 visits daily within 6 weeks of the beginning of the pandemic. There are limited studies that explore patient and provider satisfaction of telemedicine visits in obstetrical patients during the COVID-19 epidemic, particularly in the United States. OBJECTIVE This study aimed to evaluate both the patients’ and the providers’ satisfaction with the administration of maternal-fetal medicine services through telemedicine and to identify the factors that drive the patients’ desire for future obstetrical telemedicine services. STUDY DESIGN A cross-sectional survey was administered to patients who completed a telemedicine video visit with the Division of Maternal-Fetal Medicine at the New York University Langone Hospital—Long Island from March 19, 2020, to May 26, 2020. A 10-question survey assessing the patients’ digital experience and desire for future use was either administered by telephone or self-administered by the patients via a link after obtaining verbal consent. The survey responses were scored from 1—strongly disagree to 5—strongly agree. We analyzed the demographics and survey responses of the patients who agreed to vs those who answered neutral or disagree to the question “I would like telehealth to be an option for future obstetric visits.” The providers also answered a similar 10-question survey. The median scores were compared using appropriate tests. A P value of

Background – There is a paucity of data describing the effects of COVID-19, especially in asymptomatic patients, on placental pathology. Although the pathophysiology of COVID-19 is not completely understood, there is emerging evidence that it causes a severe systemic inflammatory response and results in a hypercoagulable state with widespread microthrombi. We hypothesized that it is plausible that a similar disease process may occur in the fetal-maternal unit. Objective – The aim of this study was to determine whether COVID-19 in term patients admitted to Labor and Delivery, including women without COVID-19 symptomatology, is associated with increased placental injury compared to a cohort of COVID-19 negative controls. Study Design – This was a retrospective cohort study performed at NYU Winthrop Hospital between 3/31/2020 and 6/17/2020. During the study period all women admitted to Labor and Delivery were routinely tested for SARS-CoV-2 regardless of symptomatology. The placental histopathological findings of COVID-19 patients (n=77) who delivered a singleton gestation at term were compared to a control group of term patients without COVID-19 (n=56). Controls were excluded if they had obstetric or medical complications including fetal growth restriction, oligohydramnios, hypertension, diabetes, coagulopathy or thrombophilia. Multivariable logistic regression models were performed for variables that were significant in univariable analyses. A subgroup analysis was also performed comparing asymptomatic COVID-19 cases to negative controls. Results – In univariable analyses, COVID-19 cases were more likely to have evidence of fetal vascular malperfusion, i.e. presence of avascular villi and/or mural fibrin deposition (32.5% (25/77) vs. 3.6% (2/56), p

Importance Coronavirus disease 2019 (COVID-19) infection has resulted in a global crisis. Investigating the potential association of climate and seasonality with the spread of this infection could aid in preventive and surveillance strategies. Objective To examine the association of climate with the spread of COVID-19 infection. Design, Setting, and Participants This cohort study examined climate data from 50 cities worldwide with and without substantial community spread of COVID-19. Eight cities with substantial spread of COVID-19 (Wuhan, China; Tokyo, Japan; Daegu, South Korea; Qom, Iran; Milan, Italy; Paris, France; Seattle, US; and Madrid, Spain) were compared with 42 cities that have not been affected or did not have substantial community spread. Data were collected from January to March 10, 2020. Main Outcomes and Measures Substantial community transmission was defined as at least 10 reported deaths in a country as of March 10, 2020. Climate data (latitude, mean 2-m temperature, mean specific humidity, and mean relative humidity) were obtained from ERA-5 reanalysis. Results The 8 cities with substantial community spread as of March 10, 2020, were located on a narrow band, roughly on the 30° N to 50° N corridor. They had consistently similar weather patterns, consisting of mean temperatures of between 5 and 11 °C, combined with low specific humidity (3-6 g/kg) and low absolute humidity (4-7 g/m3). There was a lack of substantial community establishment in expected locations based on proximity. For example, while Wuhan, China (30.8° N) had 3136 deaths and 80 757 cases, Moscow, Russia (56.0° N), had 0 deaths and 10 cases and Hanoi, Vietnam (21.2° N), had 0 deaths and 31 cases. Conclusions and Relevance In this study, the distribution of substantial community outbreaks of COVID-19 along restricted latitude, temperature, and humidity measurements was consistent with the behavior of a seasonal respiratory virus. Using weather modeling, it may be possible to estimate the regions most likely to be at a higher risk of substantial community spread of COVID-19 in the upcoming weeks, allowing for concentration of public health efforts on surveillance and containment.

Objective To determine the incidence of fallopian tube endometriosis in patients undergoing laparoscopic surgery with a preoperative diagnosis of endometriosis, pelvic pain, infertility, or cystic adnexal mass. Design Retrospective cross-sectional study. Setting Gynecologic oncology and minimally invasive surgery practice. Patient(s) All patients who underwent surgery for endometriosis from July 2015 to June 2018 were included. Exclusion criteria were age ≥55 years, diagnosis of cancer, laparotomy, previous bilateral salpingectomy, and preoperative diagnosis other than endometriosis, pelvic pain, infertility, or cystic adnexal mass. Intervention(s) Subjects were divided by those who did and those who did not have a salpingectomy at the time of surgery. Main Outcome Measure(s) Diagnosis of tubal endometriosis was based on macroscopic evidence of endometrial implants on the fallopian tube(s) noted within the operative report and microscopic evidence of endometriosis noted within the pathology report. Result(s) A total of 444 surgeries were performed and 185 met the study criteria. Among those, 153 (82.7%) had histologically diagnosed endometriosis within the abdominopelvic cavity. The incidence of tubal endometriosis was 11%–12% macroscopically and 42.5% microscopically after salpingectomy. Patients with tubal endometriosis were more likely to have severe disease. Conclusion(s) Among patients with endometriosis, the incidence of microscopic tubal endometriosis was significantly greater than that of macroscopic disease.

Key Points Question Is severe acute respiratory syndrome coronavirus 2 associated with seasonality, and can its spread be estimated? Findings In this cohort study of 50 cities with and without coronavirus disease 2019 (COVID-19), areas with substantial community transmission of COVID-19 had distribution roughly along the 30° N to 50° N latitude corridor with consistently similar weather patterns, consisting of mean temperatures of 5 to 11 °C combined with low specific and absolute humidity. Meaning In this study, the distribution of substantial community outbreaks of COVID-19 along restricted latitude, temperature, and humidity measurements were consistent with the behavior of a seasonal respiratory virus; with modeling, it may be possible to estimate areas at high risk of substantial community transmission of COVID-19., This cohort study examines the association between climate and the spread of coronavirus disease 2019 (COVID-19) infection., Importance Coronavirus disease 2019 (COVID-19) infection has resulted in a global crisis. Investigating the potential association of climate and seasonality with the spread of this infection could aid in preventive and surveillance strategies. Objective To examine the association of climate with the spread of COVID-19 infection. Design, Setting, and Participants This cohort study examined climate data from 50 cities worldwide with and without substantial community spread of COVID-19. Eight cities with substantial spread of COVID-19 (Wuhan, China; Tokyo, Japan; Daegu, South Korea; Qom, Iran; Milan, Italy; Paris, France; Seattle, US; and Madrid, Spain) were compared with 42 cities that have not been affected or did not have substantial community spread. Data were collected from January to March 10, 2020. Main Outcomes and Measures Substantial community transmission was defined as at least 10 reported deaths in a country as of March 10, 2020. Climate data (latitude, mean 2-m temperature, mean specific humidity, and mean relative humidity) were obtained from ERA-5 reanalysis. Results The 8 cities with substantial community spread as of March 10, 2020, were located on a narrow band, roughly on the 30° N to 50° N corridor. They had consistently similar weather patterns, consisting of mean temperatures of between 5 and 11 °C, combined with low specific humidity (3-6 g/kg) and low absolute humidity (4-7 g/m3). There was a lack of substantial community establishment in expected locations based on proximity. For example, while Wuhan, China (30.8° N) had 3136 deaths and 80 757 cases, Moscow, Russia (56.0° N), had 0 deaths and 10 cases and Hanoi, Vietnam (21.2° N), had 0 deaths and 31 cases. Conclusions and Relevance In this study, the distribution of substantial community outbreaks of COVID-19 along restricted latitude, temperature, and humidity measurements was consistent with the behavior of a seasonal respiratory virus. Using weather modeling, it may be possible to estimate the regions most likely to be at a higher risk of substantial community spread of COVID-19 in the upcoming weeks, allowing for concentration of public health efforts on surveillance and containment.

We report a rare case of a 30-year-old female who had a long-standing history of middle aortic syndrome that was being managed nonsurgically. She presented with hypertension and buttock pain with plans to become pregnant. She underwent an aortoiliac bypass.