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Get PDF. This article has been updated in response to reviewer comments, and to include 49 new transmission events which have been added to our online database. South Korea, Singapore, Italy, Japan. We recorded the country and further details about the type of setting, the numbers of primary and secondary cases in the Base Empfehlen, cluster sizes, and attack rates. Just click for source under content management cck content catalog blogging directory. I believe War Thunder Г¤ndern authors should provide a strong disclaimer, either in the abstract or early in the discussion that we really don't have much to go on w. Temporary Roads These please click for source cover site haul roads and access routes of unbound construction.

Although information on the index and early cases in a setting was often reported, further information on the subsequently reported 10— cases in a country was difficult to extract.

Moreover, the index cases were often quarantined and hence not linked to further transmission in most settings. In this review of SARS-CoV-2 transmission events, we found that clusters of cases were reported in many, predominantly indoor, settings.

Note that we restrict cluster size to only include individuals infected within a specific setting, and exclude secondary infections which occurred outside the settings.

Most clusters involved fewer than cases, with the exceptions being in healthcare hospitals and elderly care , large religious gatherings, food processing plants, schools, shopping, and large co-habiting settings worker dormitories, prisons and ships.

Other settings with examples of clusters between 50— cases in size were weddings, sport, bar, shopping and work. The majority of our reports are from China and Singapore.

The settings collated here are biased due to the nature of our general search for SARS-CoV-2 transmission described above. Although based on a systematic review of published peer-reviewed literature, many of the reports included came from media articles where relevant epidemiological quantities were not always reported, resulting in many missing data.

Many of the more detailed studies originated from the early outbreak in China, especially those providing household information.

The settings we identified here therefore might not be representative of settings from a global perspective. Bias is present when relying on media coverage - a cluster is more likely to be reported if controversial or if there is an interesting social narrative.

This is then compounded by the method search engines use to provide results where priority is given to high traffic stories.

Overall, this can lead to some settings being overly represented in our database, which is why the numbers of clusters per settings should be compared cautiously.

Similarly, there is a bias in our reports which means that attendance in settings with many individuals is more likely to be linked to a cluster: recall bias Spencer et al.

The accuracy of memories is influenced by subsequent events and experiences such that special, one-off events may be more likely to be remembered and potentially reported.

If multiple single transmission events had occurred whilst walking in a park, for example, these would be less likely to be remembered, and more difficult to detect and hence record.

Networks of close contacts also tend to be small, resulting in multiple opportunities for transmission, and hence potentially increase the importance of households or workplace for transmission instead of single outstanding settings of potential transmission.

Hence, we cannot determine with any reliability the relative importance of the reported different types of settings beyond the record that clusters have been linked to such places.

But, in the absence of rigorous surveillance systems and widespread testing that would allow countries to link and report the transmissions of such events, such connections remain speculation.

In many settings, only symptomatic cases of disease severe enough to require hospitalization are tested and ultimately reported.

This misses those infections that result in mildly symptomatic or asymptomatic symptoms, although there is mounting evidence for a significant proportion of infections to remain asymptomatic Gudbjartsson et al.

For some of the clusters, primarily households, all contacts were tested for infection; but for most of the data collated here, the number of COVID symptomatic cases was the only information provided.

These reported cases are a subset of all infections and in the absence of more comprehensive data, such as could be collated through widespread cluster investigation and community testing, we cannot conclude anything about clusters of infections, nor that we have included all relevant settings in which transmission can occur.

We were also unable to estimate attack rates from the available data, meaning that comparison between rates of transmission in settings is impossible to achieve.

One type of setting that was associated with large numbers of eventual cases was religious venues.

The common features of these meetings are the large number of attendees, confined spaces and physical contact.

In this particular religious venue, no preventative action was taken despite knowing members were infected with SARS-CoV In other venues, transmission events took place without prior knowledge of any infections and before the WHO declared pandemic status.

Attendees returned to their home countries where they continued to transmit. This generated many secondary cases internationally as well as locally.

The number of cases in each cluster is an approximation, and little is known about the number of index cases in these religious meetings to begin with, with the exception of the South Korea cluster.

Religious events are well known sources of heightened transmission; there is a focus on vaccination recommendations for attendees to the annual Hajj pilgrimage for example, which is currently being postponed for Aljazeera, Worker dormitories have been recognised as key places linked to transmission in Singapore, with out of new cases recorded on April 18th being residents in such dormitories Asia, We found 21 reported clusters, one of which had the second largest cluster size of all the events we report here; cases which from the data we believe is a first-generation cluster.

Worker dormitories are similar to households Dalling, in the sense that they are places where people live together and come in frequent close contact; however, the number of residents in dormitories is higher than in most other households.

This probably contributes to the higher cluster sizes seen in this setting. Additionally, hygiene facilities can be limited in worker dormitories Paul et al.

These points also apply to prisons, another type of large co-habiting setting for which we have identified 4 clusters with a maximum cluster size of cases.

It would be beneficial to compare attack rates across households, worker dormitories and prisons, to better understand which factors influence the risk of transmission between people who share a living space.

Unfortunately, we were unable to identify the total number of residents in these dormitories and prisons, which prevented us from deriving attack rates and making this comparison.

In addition to religious events and worker homes, we also identified clusters of more than cases in elderly care homes, hospitals and ships.

These are all known to be at risk of clusters of infectious disease Blanco et al. Moreover, people in these settings are often older than the general population and hence at greater risk of severe forms of COVID disease U.

S Centers for Disease Control and Prevention, The increased mortality and likely dependence on availability of personal protective equipment PPE mean that healthcare clusters are more politically sensitive and hence more likely to be reported.

A more unexpected setting type is perhaps food processing plants, in which we identified clusters of up to cases Cannon, These plants have been the source of clusters in multiple countries.

It is possible that the cold atmosphere in this setting has facilitated the spread of the virus Molteni, Other possible explanations include the close proximity of workers for prolonged periods shared welfare spaces, as well as the need to speak loudly to communicate over the noise of the machines, which could lead to an increased projection of viral particles.

Another explanation is that we may not be seeing clusters from other manufacturing settings with similar working environments, as fewer have been in operation due to lockdown guidelines during the pandemic, whereas food production has continued.

Notably, sport, bars, shopping areas and conferences are predominantly indoor settings, where people are in close proximity.

For conferences and work, like religious events, transmission within the cluster is facilitated by the duration of the events over several days, as well as the combination of interactions there workshops, dinners etc….

This can also apply to weddings, where transmission is further increased due to the close-proximity interactions between people kissing, hugging, dancing etc….

As for bars and shopping areas, these are places with important fluxes of people, which increases the diversity of contacts.

The pursuit of the first transmission events revealed little on settings of transmission. This reflects the wider issue we found of under reporting and is likely to reflect the fact that many public health surveillance systems were quickly overwhelmed and could not continue outbreak investigations.

An example of this is the UK where only limited information on case follow-up and cluster investigation appears to be available.

The impact of such under reporting is that we cannot say with certainty what contribution each setting had to overall transmission — we do not have the denominator information on time and contact in all settings.

Nor do we have universal screening for detection of all infections, many of which will be asymptomatic. The importance of such universal testing for infection in interpreting whether transmission has occurred in a setting is highlighted by the difference between the low number of clusters linked to schools and the high level of infection reported in one French high school study Fontanet et al.

Further work could pursue data from early investigation of cases where available, to explore the relative importance of different settings to transmission.

Importantly, this may counter a bias towards small cluster sizes: with a lack of follow-up only some of the cases actually linked to a setting may be reported and linked.

Detailed outbreak investigations should also be explored to get information on the places where transmission is unlikely to have occurred, e.

We found that many clusters of cases were linked to indoor settings, but this may be because early spread in China was during their winter, with people naturally spending more time inside close spaces.

Further work is needed to clarify this. We found only few clusters in school settings. However, there were many clusters associated with household transmission, and children could be the entry point for the virus into this setting.

More generally, the role of children in widespread transmission of the virus is unclear, and whether reopening schools could trigger increased introductions of the virus into households and further within-household spread will have to be carefully monitored.

Further investigation of settings that facilitate clusters of transmission could provide important information for containment strategies as countries lift some of the current restrictions.

Previous work has suggested that there might be considerable heterogeneity in individual transmission, which would imply a disproportionate impact from preventing large transmission events from occurring Endo et al.

Whilst widespread contact tracing is often considered part of future containment strategies, there is a need for this to be complemented with retrospective investigation of clusters in order to better understand the extent to which certain settings and behaviours are at particular risk of generating clusters of transmission.

This could, in turn, inform contact tracing efforts and might be particularly relevant in the context of contact tracing using mobile phone apps, which has recently been suggested in support of more traditional contact tracing Ferretti et al.

For example, past co-location in certain settings could be a trigger for notification of risk from an app instead of, or in addition to, individual contacts.

This database will be kept as a static source linked to this report, but with an additional tab for newly reported settings.

However, reporting should be improved in the majority of settings, with implementation of systematic reporting on the number of potentially exposed individuals and the number of confirmed and suspected cases from these settings, to allow the estimation of attack rates.

This database provides references and information on cluster sizes as well as notes about the studies. We would also like to thank all the anonymous individuals who suggested updates for transmission events in our online database.

They can now be found at the top of the panel on the right, linked from the box entitled Open Peer Review. Choose the reviewer report you wish to read and click the 'read' link.

You can also read all the peer review reports by downloading the PDF. Is the work clearly and accurately presented and does it cite the current literature?

Is the study design appropriate and is the work technically sound? Are sufficient details of methods and analysis provided to allow replication by others?

If applicable, is the statistical analysis and its interpretation appropriate? Are all the source data underlying the results available to ensure full reproducibility?

Competing Interests: No competing interests were disclosed. Alongside their report, reviewers assign a status to the article:. All Comments 3.

Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality.

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We have sent an email to , please follow the instructions to reset your password. ALL Metrics. Get PDF. Get XML. How to cite this article.

NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article.

Close Copy Citation Details. Naomi M. Lisa E. Gwenan M. However, there are increasing concerns about the severe economic and wider societal consequences of these measures.

The aim of this work was to inform such exit strategies by exploring the types of indoor and outdoor settings where transmission of SARS-CoV-2 has been reported to occur and result in clusters of cases.

Methods : We performed a systematic review of available literature and media reports to find settings reported in peer reviewed articles and media with these characteristics.

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There are many different pods. You can add friends from other pods and communicate with them. All the servers communicate with each others, so no matter where you sign up, you will always be able to communicate with anyone from any pod.

There is a list of pods at Pod Uptime. You can freely sign up on many of these pods. There are various pod listings.

Since Diaspora is decentralized they can differ from each other. Invite your friends using the email link in the side-bar.

Follow tags to discover others who share your interests, and add those who post things that interest you to an aspect. If you are on the same pod you can search for just their username.

An alternative is to search for them by their profile name the name you see on screen. If a search does not work the first time, try it again.

An aspect is one of the faces you show to the world. It might be who you are at work, or who you are to your family, or who you are to your friends in a club you belong to.

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Click on My Aspects in the side-bar and then click individual aspects in the list to select or deselect them.

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We do hope to add group functionality in the future, so watch this space! In your list of aspects on the left side of the main page, point your mouse at the aspect you want to rename.

Click rename in the box that appears. When you are making a post, use the aspect selector button to select or deselect aspects.

Your post will be visible to all the aspects you select. You could also select the aspects you want to post to in the side-bar.

When you post, the aspect s that you have selected in the list on the left will automatically be selected in the aspect selector when you start to make a new post.

Go to your contacts page and click my contacts. For each contact you can use the menu on the right to add them to or remove them from as many aspects as you want.

Or you can add them to a new aspect or remove them from an aspect by clicking the aspect selector button on their profile page.

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Base Empfehlen Video

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These integrated features in K2 not only save website administrators precious management time from managing a dozen extensions which would otherwise be required , but they also allow for better performance.

K2 was actually built on these 4 principles: feature-rich content in Joomla, ease of use for any type of user , flexible templating, performance And best of all?

K2 is totally free to use! Tagged under content management cck content catalog blogging directory. Available Releases April 29th, Download v2.

Download v2. There are many different pods. You can add friends from other pods and communicate with them. All the servers communicate with each others, so no matter where you sign up, you will always be able to communicate with anyone from any pod.

There is a list of pods at Pod Uptime. You can freely sign up on many of these pods. There are various pod listings.

Since Diaspora is decentralized they can differ from each other. Invite your friends using the email link in the side-bar.

Follow tags to discover others who share your interests, and add those who post things that interest you to an aspect. If you are on the same pod you can search for just their username.

An alternative is to search for them by their profile name the name you see on screen. If a search does not work the first time, try it again.

An aspect is one of the faces you show to the world. It might be who you are at work, or who you are to your family, or who you are to your friends in a club you belong to.

You can make People be visible to each other inside your aspect. If you make a limited post, it will only be visible to the people you have put in that aspect or those aspects, if it is made to multiple aspects.

Click on My Aspects in the side-bar and then click individual aspects in the list to select or deselect them.

Only the posts by people in the selected aspects will appear in your stream. If you check this option then contacts from that aspect will be able to see who else is in it, on your profile page under your picture.

This means that the people you have placed in an aspect may not have placed you or each other into an equivalent aspect in their accounts, and may not be sharing with each other at all.

For an aspect to work as a group, each member would have to be connected to every other member and to have placed every other member into one aspect.

We do hope to add group functionality in the future, so watch this space! In your list of aspects on the left side of the main page, point your mouse at the aspect you want to rename.

Click rename in the box that appears. When you are making a post, use the aspect selector button to select or deselect aspects.

Your post will be visible to all the aspects you select. You could also select the aspects you want to post to in the side-bar.

When you post, the aspect s that you have selected in the list on the left will automatically be selected in the aspect selector when you start to make a new post.

Go to your contacts page and click my contacts. For each contact you can use the menu on the right to add them to or remove them from as many aspects as you want.

Or you can add them to a new aspect or remove them from an aspect by clicking the aspect selector button on their profile page.

You can change the aspects they are in right there. In your list of aspects on the left side of the main page, point your mouse at the aspect you want to delete.

Click the delete button in the box that appears. Anyone using the internet can potentially see a post you mark public, so make sure you really do want your post to be public.

Your public posts will appear in the streams of anyone following you. If you included tags in your public post, anyone following those tags will find your post in their streams.

Public posts may also be indexed by search engines. Comments, likes, and reshares of public posts are also public.

Deselecting aspects does not affect a public post. What is an Alkali? Examples of Acids Names of acids Chemical formula Where can it be found?

Acidic or not? Chemical name Name of compound Is it Acidic? The gas forms a white precipitate with limewater.

Uses of Acids Acids Preserving food -acetic acid in vinegar Making industrial products -nitric acid in fertilisers -sulphuric acid in detergents Rust removal from iron and steel -Sulphuric acid -Hydrochloric acid Car battery -Sulphuric acid Complete the Puzzle Across 1.

Down 2. Answer Across 1. Acids react with bases to give salt and water only. Only aqueous solution of acids have acidic properties. In a strong acid, the acid molecules are completely ionised.

Ethanoic acid is an example of a weak acid. Acids have a sour taste. Answer Down 2. Sulphuric acid is an example of a strong acid which is found in car battery.

Carbonates react with acids to give off a gas that forms a white precipitate with limewater. When dissolved in water, acid molecules can ionise to give hydrogen ions.

Hydrogen gas is evolved when acids react with metals. You just clipped your first slide! Clipping is a handy way to collect important slides you want to go back to later.

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