Service time, waiting time, good practices and areas for improvement in the UP Health Service during the 2020 COVID-19 pandemic: A five-day cross-sectional study

Background@#The COVID-19 pandemic has emphasized the critical task of the UP Health Service in recognizing and addressing the primary care needs of health care workers and support staff of the Philippine General Hospital. This helps in effective staff management and engendering trust in the hospital that performs critical functions in the pandemic response.@*Objectives@#To determine the service and waiting time in the facilities of the UPHS and describe good practices and areas for improvement for better service delivery at the UPHS during the COVID-19 pandemic@*Methods@#A cross-sectional study using patient flow analysis of processes in the non-COVID, COVID, and swabbing areas of the UPHS was conducted from June 1 to 5, 2020. All clinic visits by PGH employees and health care workers, including consultations and procedure for swabbing, were included in the study. Average service and waiting time in three areas of the UPHS were measured and analyzed from recorded time points using Microsoft Excel. Daily observations recorded on field notes were transcribed and analyzed using MaxQDA Analytics Pro 2020.@*Results@#A total of 604 PGH employee visits in the three main service areas of the UPHS were recorded during the 5-day study period. The average total service time was 25 (SD±17) minutes in the non-COVID clinic and 12 (SD±5) minutes in the COVID clinic. The mean swabbing time was 2 (SD±3) minutes. The average waiting time was longest in the COVID clinic at 46 (SD±39) minutes, followed by the swabbing area at 33 (SD± 32) minutes, and was shortest in the non-COVID clinic at 10 (SD±17) minutes. Good practices were observed in the areas of communication and coordination among the UPHS team, staff complementation, and application of telehealth solutions. Meanwhile, improvements may be made in identifying a practical and robust queuing system, enforcing firmer infection prevention and control measures and providing clearer patient instructions and cues especially during patient surge.@*Conclusion@#The average service time in the non-COVID, COVID and swabbing areas of the UPHS, were 25, 12 and 2 minutes, respectively. The average waiting time was longest in the COVID clinic, followed by the swabbing and non-COVID areas. Good practices were observed in terms of leadership, communication, staff complementation and feedback process while infection control and prevention measures, queuing system for crowd control and patient instructions can be further improved.

Solid-phase extractions in flow analysis

ABSTRACT Coupling solid-phase extraction (SPE) to flow systems has promoted a synergistic development. Whereas SPE mechanization leads to improved precision and higher sample throughput, as well as diminishes systematic errors and contamination risks, analyte concentration and separation from the sample matrix provides a remarkable impact on detectability and selectivity in flow analysis. Historical aspects, main cornerstones, tips for system design, and recent applications are critically reviewed, in the context of analyte(s) separation/concentration, sample clean-up, and release of sorbed chemical species involving both packed (e.g. mini-columns, cartridges, and disks) or fluidized (e.g. beads and magnetic materials) particles. Novel (bio)sorbents, selective synthetic materials, and stationary phases for low-pressure chromatography are also discussed. Moreover, the feasibility of SPE for sample treatment before chromatographic separation, as well as the exploitation of direct measurements on the solid phase (optosensing) are emphasized.

Determination of Nitrate in Seawater with Valve-free Continuous Flow Analysis / 分析化学

A valve-free continuous flow method and instrument were established,with only a multi-channel pump for delivering the sample and reagent,and without any injection or solenoid valves and sample loop for selecting and adding the sample or reagent.Nitrate was reduced to nitrite with Cu-Cd reductant column,and then detected with spectrophotometric detector.The proposed method was suitable for determination of nitrate at normal level in most of estuary and coastal seawaters.With the optimum parameters,the linear range and detection limit were 5-180 μmol/L and 0.27 μmol/L,respectively.The samples of 10 and 80 μmol/L nitrate were continually measured for 11 times,and the relative standard deviations were 1.4％ and 1.3％,respectively.The recovery of real samples at different salinity ranged between 99.4％ and 106.1％.There was no significant difference in the analytical results between the proposed method and the flow injection analysis (FIA).In comparison with FIA,the method and instrument were less cost and easy to operate,and was suitable to be applied in general laboratories and field for continuous monitoring.The method was successfully used to measure the nitrate in seawater samples in Xiamen's Western Harbor and monitor nitrate in Jiulongjiang estuary.

Fenestrated Stent Graft Repair of Abdominal Aortic Aneurysm: Hemodynamic Analysis of the Effect of Fenestrated Stents on the Renal Arteries

OBJECTIVE: We wanted to investigate the hemodynamic effect of fenestrated stents on the renal arteries with using a fluid structure interaction method. MATERIALS AND METHODS: Two representative patients who each had abdominal aortic aneurysm that was treated with fenestrated stent grafts were selected for the study. 3D realistic aorta models for the main artery branches and aneurysm were generated based on the multislice CT scans from two patients with different aortic geometries. The simulated fenestrated stents were designed and modelled based on the 3D intraluminal appearance, and these were placed inside the renal artery with an intra-aortic protrusion of 5.0-7.0 mm to reflect the actual patients' treatment. The stent wire thickness was simulated with a diameter of 0.4 mm and hemodynamic analysis was performed at different cardiac cycles. RESULTS: Our results showed that the effect of the fenestrated stent wires on the renal blood flow was minimal because the flow velocity was not significantly affected when compared to that calculated at pre-stent graft implantation, and this was despite the presence of recirculation patterns at the proximal part of the renal arteries. The wall pressure was found to be significantly decreased after fenestration, yet no significant change of the wall shear stress was noticed at post-fenestration, although the wall shear stress was shown to decrease slightly at the proximal aneurysm necks. CONCLUSION: Our analysis demonstrates that the hemodynamic effect of fenestrated renal stents on the renal arteries is insignificant. Further studies are needed to investigate the effect of different lengths of stent protrusion with variable stent thicknesses on the renal blood flow, and this is valuable for understanding the long-term outcomes of fenestrated repair.

Preparation of Electrophoretic Microcolumn Packed with Quartz Microncrystal and Its Application to Electrophoretic Separation / 分析化学

The preparation of electrophoretic microcolumn and its application to the electrophoretic separation of amino acids with a 2-mm I.D. fused-silica microcolumn packed with uniform quartz microncrystal prepared by hydrothermal synthesis are reported. With 1.5 mmol/L disodium phosphate buffer solution (pH 11.5) containing 30% (V/V) methanol, the tryptophan, phenylalanine and tyrosine were separated by the microcolumn electrophoresis and detected by an UV spectrophotometer without derivatization. The limits of detection were 0.038, 0.21 and 0.20 mol/L, respectively. The separation efficiency of tryptophan was 4.4×104 plates/m. The sample capacity of the electrophoretic microcolumn achieved 35 μL. The precisions of the microcolumn electrophoresis were satisfactory. The thermal effects of the electrophoretic microcolumn that without packing, packed with 360 μm quartz sand and with 9 μm length quartz microncrystal were discussed, respectively. It was found that the electrophoretic microcolumn packed with quartz microncrystal was able to inhibit Joule heat, increase sample capacity and enhance detection sensitivity. The microcolumn electrophoresis is one of the high-performance separation techniques for an in-situ, real-time and portable electrokinetic flow analysis system.

Assessment of Patency of Coronary Artery Bypass Grafts Using Segmented K-space Breath-hold Cine Cardiovascular Magnetic Resonance Imaging: A Clinical Feasibility Study

PURPOSE: The efficacy of magnetic resonance imaging for evaluating coronary artery disease has been reported. In this study, we evaluated the usefulness of breath-hold segmented K-space cine MR imaging for evaluating the patency of coronary artery bypass grafts (CABG). MATERIALS AND METHODS: Thirty eight patients with a total of 92 CABGs (36 internal thoracic arteries and 56 saphenous vein grafts) were evaluated using segmented Kspace cardiac-gated fast gradient echo sequence (2D-FASTCARD) MR imaging. MR magnitude images were evaluated from the hard copies by two independent observers. A graft was defined as patent if it was seen as a bright small round area on at least two consecutive images throughout the cardiac cycle at a position consistent with the expected location for that graft. RESULTS: MR images were obtained successfully for 23 patients (61%). The sagittal planes were most helpful in visualizing the cross-section of sapheneous vein bypass graft to left circumflex artery branch, whereas the transverse planes were used for identification of internal mammary artery grafts to left anterior descending coronary artery or its branch and identification of saphenous vein grafts to right coronary artery. Forty five grafts were visible using this MR technique, while the grafts were not visible on seven saphenous vein grafts and two internal mammary artery grafts. In two patients showing symptoms of myocardial ischemia, one or two bypass grafts were not visible. Imaging, perpendicular plane to a CABG was important to visualize the flow inside the CABG with maximum sensitivity. CONCLUSION: Evaluation of patency of the bypass graft was clinically feasible by 2DFASTCARD MR imaging, whereas any invisible bypass grafts should be further studied by contrast-enhanced MR angiography or by conventional angiography for confirmation of abnormalities.

User program for PC to perform clinical spirometric test / 대한의료정보학회지

User package program run on PC was developed for clinical spirometric test, which enabled to perform popular FVC, SVC, and MVV test items in a very convenient manner. In addition, a program module for research was implemented to study breathing pattern of a patient. The program written in C language was designed to run on Windows OS, and consisted of patient information management, test procedure control, results print out, and accumulation of parameter values in a customized data base which made possible future clinical research and quality assurance. When engaged with the previously developed respiratory air flow measurement unit, the system resulted in an accurate enough performance in that FVC data showed a high correlation coefficient of higher than 0.98 with an imported system. The technician tried the present system under clinical environment and judged the convenient utility to be satisfactory. Therefore, industrialization effort is being currently made and expected to be successful.

Determination of Total Hardness in Water by Air-Segmented Continuous Flow Analysis / 环境与健康杂志

0.999 0, and RSDs were not more than 3.26%. The recovery rates were 94.12%-104.30% .The lowest detected concentration was 1.43 mg/L. There was no significant difference between the results of this method and Na2EDTA titration. Conclusion The method was rapid, accurate and highly sensitive.

Determination of Potassium in Environmental Water Samples by Continuous Flow Analysis / 环境与健康杂志

Objective To establish a continuous flow analytical method for determination of potassium in environmental water sample.Methods The concentration of patassium in environmental water sample was determined by ALLIANCE auto-matic analyzer,and its data were compared with the data obtained from atomic absorption spectrophotometry.Results The de-tection limit of this method was0.5?g /ml.The method revealed linear relationship at the potassium concentrations of5-1000?g /ml.The recovery rate of standard addition method ranged from to97%to102%.The relative standard deviations were0.82%-1.23%.Conclusion The contents of potassium in environmental water samples could be accurately and rapidly deter-mined by continuous flow analysis.