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First Irish National Corneal Transplant Registry report.To report about current corneal transplantation practices in Ireland including patient demographics, indications and types of transplant performed and to compare the findings with other developed countries.Nationwide retrospective review of the corneal transplants performed in Ireland between 2016 and 2019.Overall, 536 keratoplasties were carried out: 256 (47.8%) Penetrating Keratoplasties (PK), 212 (39.6%) Descemet Stripping Automated Endothelial Keratoplasties (DSAEK), 30 (5.6%) Descemet Membrane Endothelial Keratoplasties (DMEK), and 25 (4.7%) Deep Anterior Lamellar Keratoplasties (DALK). The most common indication was Keratoconus (KC, 19%), followed by Fuchs endothelial dystrophy (FED, 18.8%), and Pseudophakic bullous keratopathy (PBK, 17%). KC (34%) and re-grafting (17%) were the leading indications for PK, whereas FED and PBK were the major indications for DSAEK (38% and 33%) and DMEK (67% and 20%), respectively. During the period studied, the number of transplants increased from 11.3 to 14 grafts per month. The number of PKs remained stable, whereas Endothelial Keratoplasties, DSAEK and DMEK, increased (3.8 to 5.6 and 0.2 to 1.6 per month, respectively), becoming the most commonly performed grafts since 2018. Only a small number of DALK were performed.Corneal transplantation in Ireland is following international trends as endothelial procedures have become the most common approach since 2018. However, a low overall number of transplants is performed in Ireland compared with other countries suggesting that care pathways should be implemented to improve access to corneal transplantation.

Objectives: To describe the clinical sequelae and immunological features of COVID-19 survivors who have been discharged from the hospital for 5-8 months. Methods: This study is a cross-sectional study of confirmed COVID-19 patients aged ≥18 years who were discharged from hospitals in Wuhan from January to April 2020. The demographics, clinical features, and laboratory findings of the participants were collected from medical records in the hospital. The participants from the study completed an investigation of clinical sequelae, blood tests, a pulmonary function examination and an unarmed rehabilitation evaluation at Hubei Provincial Hospital of Traditional Chinese & Western Medicine. A group of volunteers who were free of COVID-19 and lived in Wuhan during the outbreak were recruited as the comparison group. Results: The average age of the 574 COVID-19 survivors was 57.7±11.4 years, and 348 (60.6%) survivors were female. The average number of days from the onset of symptoms was 241.79±16.16. The average number of days from discharge was 194.3±14.4. Clinical sequelae were common, including general symptoms (n=321, 55.9%), respiratory symptoms (n=265, 46.2%), digestive symptoms (n=84, 14.6%), nervous symptoms (n=75,13.1%) and psychosocial symptoms (n=201, 35%). A total of 190 (33.7%) survivors reported reduced exercise capacity. Through the results of pulmonary function examination, anomalies were noted in carbon monoxide diffusion capacity (DLCO)% in 110 cases (32.4%), maximal mid-expiratory flow (MMEF)% in 105 cases (30.7%), forced expired flow at 50% of forced vital capacity (FEF 50 )% in 128 cases (37.4%), and forced expired flow at 75% of forced vital capacity (FEF 75 )% in 240 cases (70.2%). The counts of T lymphocyte, CD4+ T lymphocyte counts, CD8+ T lymphocyte counts, B lymphocyte and NK cell in the survival group was significantly lower than that in the comparison group(all P 0.05). The T lymphocyte counts, CD4+ T lymphocyte counts and CD8+ T lymphocyte counts of the patients before discharge were significantly higher than those in the early stage of admission (P < 0.025). There were 319 (55.6%) survivors with positive or weakly positive IgG antibodies and 17 (2.9%) survivors with positive or weakly positive IgM antibodies. Conclusion: Even after 5 to 8 months of discharge, many survivors still have clinical sequelae, and some of them have impaired immune function. Therefore, the long-term rehabilitation of COVID-19 survivors remains a concern. Funding Statement: This study was funded by the National Key R&D Plan of China (2020YFC0841600), Guangdong Provincial Key Laboratory of Research on Emergency in TCM (2017B030314176), R&D plan in key areas of Guangdong Province (2020B1111300005), and National Administration of Traditional Chinese Medicine (2020ZYLCYJ05-11). Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: This study was approved by the ethical committees of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China (GPHCM; No. BF2020-205-01). All participants signed informed consent forms.

Earthquake rupture speed can affect ground shaking and therefore seismic hazard. Seismological observations show that large earthquakes span a continuum of rupture speeds, from slower than Rayleigh waves up to P-wave speed, and include speeds that are predicted to be unstable by two-dimensional theory. This discrepancy between observations and theory has not yet been reconciled by a quantitative model. Here we present numerical simulations that show that long ruptures with oblique slip (both strike-slip and dip-slip components) can propagate steadily at various speeds, including those previously suggested to be unstable. The obliqueness of slip and the ratio of fracture energy to static energy release rate primarily control the propagation speed of long ruptures. We find that the effects of these controls on rupture speed can be predicted by extending the three-dimensional theory of fracture mechanics to long ruptures with oblique slip. This model advances our ability to interpret supershear earthquakes, to constrain the energy ratio of faults based on observed rupture speed and rake angle, and to relate the potential rupture speed and size of future earthquakes to the observed slip deficit along faults. Long fault ruptures that have both strike-slip and dip-slip components can propagate at a wide range of speeds, including those theoretically predicted to be unstable, according to numerical simulations.

Bariatric surgery is an effective treatment for morbid obesity and its metabolic related comorbidities; type 2 diabetes, hypertension and hyperlipidaemia.1 However, the literature is scarce regarding the long-term outcome after bariatric surgery, especially among multi-ethnic Asian populations. Considering the growing number of bariatric metabolic surgeries in Asia, we have attempted to provide a regional perspective on 5-year long-term clinical outcomes post bariatric surgery in Singapore. Between 2010 and 2016, all bariatric operative cases were included, and these comprised: laparoscopic sleeve gastrectomy (LSG), 393; laparoscopic Roux-En-Y gastric bypass (RYGB), 125; laparoscopic mini-gastric bypass (MGB), 43. The primary outcome measure was the percentage of excess weight loss (% EWL) at 6 months, 1, 2, 3, 4 and 5 years, with % remission of type 2 diabetes mellitus (T2DM) at 1 year following LSG (49.7%, 61.2%, 56.1%, 47.8%, 40.8% and 47.3%; 82.2%), RYGB (60.2%, 62.1%, 57.6%, 50.1%, 48.7% and 47.7%; 86.9%) and MGB (58%, 68.1%, 62.7%, 66.2%, 64.0%, 65.2%; 71.9%). In conclusion, MGB and RYGB showed the greatest % EWL at 5 years and are recommended for moderate T2DM. LSG is an effective bariatric operation with a high % EWL up to 2 years, and a high remission rate of mild T2DM. The remission rate of T2DM was equally high in all 3 surgical groups, independent of ethnic differences.

Based on first-principles calculations and symmetry analysis, we propose that EuIn2As2 is a long-awaited axion insulator with antiferromagnetic (AFM) long-range order. Characterized by the parity-based invariant ℤ4=2, the topological magnetoelectric effect is quantized with θ=π in the bulk, with a band gap as large as 0.1 eV. When the staggered magnetic moments of the AFM phase are along the a or b axis, it is also a topological crystalline insulator phase with gapless surface states emerging on (100), (010), and (001) surfaces. When the magnetic moments are along the c axis, both the (100) and (001) surfaces are gapped, and the material can also be viewed as a high-order topological insulator with one-dimensional chiral states existing on the hinges between those gapped surfaces. We have calculated both the topological surface states and the hinge state in different phases of the system, respectively, which can be detected by angle-resolved photoemission spectroscopy or STM experiments.

The largest earthquakes propagate laterally after saturating the fault's seismogenic width and reach large length-to-width ratios L/W. Smaller earthquakes can also develop elongated ruptures due to confinement by heterogeneities of initial stresses or material properties. The energetics of such elongated ruptures is radically different from that of conventional circular crack models: they feature width-limited rather than length-dependent energy release rate. However, a synoptic understanding of their dynamics is still missing. Here we combine computational and analytical modeling of long ruptures in three dimension (3D) and 2.5D (width-averaged) to develop a theoretical relation between the evolution of rupture speed and the along-strike distribution of fault stress, fracture energy, and rupture width. We find that the evolution of elongated ruptures in our simulations is well described by the following rupture-tip-equation-of-motion: G(c) = G(0) (1 - (v)over dot(r)W/v(s)(2) gamma/A alpha(P)(s)) where G(c) is the fracture energy, G(0) is the steady state energy release rate, v(s) is the S wave speed, v(r) is the rupture speed, (v)overdot(r) = dv(r)/dt is the rupture acceleration, and gamma/A alpha(P)(s) is a known function of rupture speed. The steady energy release rate is limited by rupture width as G(0) = gamma Delta tau W-2/mu, where gamma is a geometric factor, Delta tau is the stress drop (spatially smoothed over a length scale smaller than W), and mu is the shear modulus. If G(c) is a constant and exactly balanced by G(0), the rupture can in principle propagate steadily at any speed. If G(c) increases with rupture speed, steady ruptures have a well-defined speed and are stable. When G(c) not equal G(0), the rupture acquires an inertial effect: the rupture-tip-equation-of-motion depends explicitly on rupture acceleration. This inertial effect does not exist in the classical theory of dynamic rupture in 2-D unbounded media and in unbounded faults in 3D, but emerges in 2-D bounded media or, as shown here, as a consequence of the finite rupture width in 3D. These findings highlight the essential role of the seismogenic width on rupture dynamics. Based on the rupture-tip-equation-of-motion we define the rupture potential, a function that determines the size of next earthquake, and we propose a conceptual model that helps rationalize one type of "supercycles" observed on segmented faults. More generally, the theory developed here can yield relations between earthquake source properties (final magnitude, moment rate function, radiated energy) and the heterogeneities of stress and strength along the fault, which can then be used to extract statistical information on fault heterogeneity from source time functions of past earthquakes or as physics-based constraints on finite-fault source inversion and on seismic hazard assessment.