ABSTRACT
We retrospectively report a case of rapid exchange of a percutaneous radiologic gastrostomy tube (balloon-occluded type catheter) via off-label use of a pigtail catheter for nutrition supply during a very early episode of coronavirus disease 2019 (COVID-19) in an outpatient clinic. This case demonstrates that minimally invasive percutaneous procedures might be provided safely and effectively under appropriate precautions for preventing COVID-19 transmission during the pandemic.Copyright © 2023, Society of Gastrointestinal Intervention.
ABSTRACT
Introduction: The COVID-19 pandemic highlighted poor engagement with home uploading to the Diasend platform among the paediatric diabetes population at Darent Valley Hospital, UK. The repercussions of this became apparent when in-person appointments were switched to telephone consultations, meaning that clinic staff were unable to review patients' blood glucose trends and provide management advice. Thus, it became more pertinent than ever to ensure patients and their parents were engaging with home uploads. Consequently, a quality improvement project was necessary to identify how home uploading could be improved, which was conducted as part of a medical student-led project at King's College London. Objectives: To increase the number of blood glucose readings uploaded to Diasend from a baseline of 2 uploads per week to a target of 15 uploads a week between October 2020 and February 2021. Methods: A questionnaire was used to identify the barriers to uploading data to Diasend. Thematic analysis highlighted the most relevant themes which formed the basis of the plan-do-study-act (PDSA) cycles that drove the quality improvement methods. In PDSA1, an educational email containing information about how to upload blood glucose readings to Diasend was sent to patients. In PDSA2, email reminders were sent out to patients on a weekly basis for 6 weeks. Results: The number of uploads in each week was greater than the median baseline of 2 uploads per week. Our aim of 15 uploads per week was achieved during week 10;this was sustained for the remaining 2 weeks of the project. Finally, PDSA2 had a greater number of total uploads compared to PDSA1, with 92 uploads versus 45 uploads respectively. Conclusions: The clear synergistic effect of the changes implemented in the PDSA cycles were likely pivotal in promoting positive behavioural changes. Empowering patients and carers to be more active in their diabetes management will improve patient-centred care and reduce future hospital admissions.
ABSTRACT
To review systematically the progress of all domestic and foreign clinical trials since the emergence of the COVID-19 epidemic and the overview of human challenge study (HCS) in the past year, grasp relevant information of ethical review, and explores the feasibility of human challenge study and provide references for stake holders. Based on the Chinese Clinical Trial Registration Center and clinical trial. gov, clinical trials that were consistent with COVID-19 was searched, and the deadline was June 11, 2020.Basic information was extracted and the number of trials was selected from the research type, clinical stage, recruitment status, and ethical passing status. Literature search was conducted based on Pubmed between January 1, 2019 and June 11, 2020.According to the included literature, basic information was extracted and opinions were reported on HCS. 638 and 1935 clinical trials were carried out at home and abroad respectively, of which the number of clinical trials carried out in Hubei reached 323. China and the United States conducted more interventional trials, and the United States had the most clinical trials entered in Phase II, there were a total of 142. Most of the clinical trials were in the stage of recruiting research subjects. In addition, a total of 539 clinical trials in China had passed ethical approval. A total of 5 documents were included in the Human Challenge Study, four maintained a positive attitude towards HCS and put forward corresponding thinking about ethical review. Under the COVID-19, clinical trials for new drugs and new coronavirus vaccines have rapidly increased, which puts forward higher requirements for the progress of ethical review. In the face of such public health emergencies and special research, it is urgent to establish a sound ethical review system and an ethical review system, as well as to construct an ethical model for special research. © 2021, Editorial Board of Pharmaceutical Biotechnology. All right reserved.
ABSTRACT
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, decreased presentations for various emergent conditions have been observed. Our objective was to compare the volume of patients with urologic emergencies presenting to emergency departments (EDs) within a single health system before and after the onset of the COVID-19 pandemic. MATERIALS AND METHODS: A retrospective chart review was performed for 3 EDs within a single health system in the United States to identify all ED consults to urology from January 1, 2019 to May 31, 2020. For emergent consults, covariates were extracted, including demographic information, insurance status, Charlson Comorbidity Index (CCI) score, travel distance from home to the ED, and whether the patient had seen a provider in the hospital system before. Data were compared between COVID-19 months (March-May 2020) and corresponding months in 2019. RESULTS: The study period encompassed 1,179 consults and 373 urologic emergencies. We observed not only a 22% decrease in urologic presentations to the ED compared to corresponding months in 2019, but also a 54% decrease in the proportion of urologic presentations that were truly emergent. For patients with emergent diagnoses, April 2020 saw an increase in Medicare/Medicaid coverage and a decrease in private insurance, May 2020 saw a decreased travel distance from home to the ED, and March and May 2020 saw an increase in patients who had previously seen a health system provider outside of the ED. No changes were seen in demographic characteristics or CCI. CONCLUSIONS: During the early COVID-19 pandemic, urologic emergencies within a single health system decreased by 54% compared to the corresponding months pre-pandemic. Those who do present for care may be influenced by both locality and provider familiarity.
ABSTRACT
The recent pandemic of COVID-19 makes personal protective facial masks in high demand. Melt-blown or electrospun nanofibers are considered to be ideal air filter materials for resisting virus-containing fine aerosol particle, eliminating particulate matter (PM) air pollution, and protecting public health. For the commercial micro/nanofiber membranes, the general strategy for improving filtration efficiency is to simply increase the base weight. However, the influence of the base weight on overall filtration performance of air filters is usually ignored, which always leads to large pressure drop and poor breathing comfort. Here, a fabrication process using the electrospinning method with phase separation of charged droplets is reported for the thermoplastic polyurethane (TPU) nanofiber/net membranes based air filters. The average pore areas of TPU nanofiber/nets can be tunable from 0.6504 μm2 to 0.0083 μm2 via the incorporation of different Li+ ion concentrations. The optimized TPU nanofiber/net membranes based air filter demonstrates the attributes of high PM0.1 removal efficiency up to 97.08%, μ58 Pa pressure drop, 0.061 Pa-1 quality factor, and good optical transparency with the only 6 g·m-2 base weight, which is ground-breaking compared with the existing micro/nanofiber membrane based air filters for ultrafine particle filtration. © 2020 American Chemical Society.