ABSTRACT
Aim: The global pandemic of COVID-192020 has led to the extensive practice of online synchronous learning. Our primary goal is to compare different learning activities to evaluate students' perceptions. Moreover, we also aim to identify factors influencing their perception and satisfaction in these activities. Method(s): We have divided the online activities into bedside teaching, practical skill sessions, tutorials or problem-based learning, and lectures. A questionnaire was distributed to our clinical year students to document their perceptions. Result(s): Three hundred sixty-eight valid responses were received among these four learning activities combined (96 from bedside teaching, 67 from practical skill sessions, 104 from PBL/tutorial, and 101 from lecture). With the relative positive perception regarding online PBL and tutorials and preference for online lectures, there is a high possibility that these classes will remain online. To further improve their experience, students should turn on their videos during lectures. During online PBL and tutorials, good audio and video quality should always be ensured while being encouraged to remain their mic switched on. Online practical skill classes scored high in the DREEM-extracted questionnaire but were not preferred over face-to-face classes. Implementing online classes in this category should remain cautious with the limitations of tools, practice, and feedback. Good audio and video quality may help improve the experience. Conclusion(s): The advantages of learning online may lead to a persistent practice of online teaching after this pandemic. This study provides insight and specific areas that need to improve.
ABSTRACT
Background: Metabolic syndrome (MetS) is a cluster of risk factors presaging the development of cardiovascular disease and diabetes. It is a risk factor for severe coronavirus disease 2019 (COVID-19). Purpose: To estimate the prevalence of MetS in the US National Health and Nutrition Examination Survey (NHANES) 2011-2018. Methods: This cohort study included 22370 eligible participants aged ≥20 years from the NHANES 2011-2018. MetS was defined as the presence of at least three of these components: central obesity, reduced high-density lipoprotein, elevated triglycerides, elevated blood pressure and elevated fasting blood glucose. The prevalence of MetS was estimated taking into account the complex sampling. The time trend was evaluated using logistic regression. Annual percentage changes (APC) were measured trend in MetS prevalence. Results: The prevalence of MetS was 36.2% (95% CI, 32.3-40.3), 34.8% (95% CI, 32.3-37.4), 39.9% (95% CI, 36.6-43.2) and 38.3% (95% CI, 35.3-41.3) in 2011-2, 2013-4, 2015-6, 2017-8, respectively (P for trend = 0.08). Among the MetS components, the prevalence of elevated glucose increased from 48.7% (95% CI, 45.9-51.5) in 2011-2 to 64.3% (95% CI, 61.0-67.4) in 2017-8 [P for trend <0.001;APC=11.7, (95% CI, 3.5-21.0)]. The prevalence of MetS in non-Hispanic Asian increased from 21.8% (95% CI, 16.7-28.0) in 2011-2 to 31.2% (95% CI, 27.4-35.3) in 2017-8 [P for trend <0.001;APC=14.6, (95% CI, 2.5-34.8)]. Conclusions: The prevalence of MetS remained stable during 2011 to 2018. Lifestyle modification is needed, especially among non-Hispanic Asians to prevent the metabolic syndrome and the associated risks of diabetes and cardiovascular disease.
ABSTRACT
The Pfizer-BioNTech coronavirus disease 2019 (COVID-19) vaccine is the first novel nucleoside-modified messenger ribonucleic acid (modRNA) vaccine to receive Emergency Use Authorization from the Food and Drug Administration in the United States. It is indicated to be used in patients ≥12 years-of-age as of May 25th, 2021, including populations with high atherosclerotic cardiovascular disease (ASCVD) burden. However, little is known about the potential impact this vaccine may have on serum lipoprotein levels in patients with familial hypercholesteremia (FH), who are predisposed to high ASCVD burden due to elevated low-density lipoprotein cholesterol (LDL-C). We present an interesting case where a patient with heterozygous FH (HeFH) and elevated triglycerides (TG)-controlled for years on medication and apheresis-experienced significantly elevated TG, one day after receiving his second Pfizer-BioNTech COVID-19 vaccine dose. It is not known whether this adverse event may be seen in other FH patients and may be worth assessing in such patients to determine the possibility of a rare adverse reaction from a COVID-19 vaccine.