Improvement of the Laparoscopic Cholecystectomy Service at a District General Hospital during the COVID-19 Pandemic

Background: British Association of Day Surgery and Royal College of Anaesthetists guidelines specify that 75% of elective Surgery should be done as a day-case. Our Trust reported a laparoscopic cholecystectomy day-case rate of 25% pre-pandemic. Following The first wave of The pandemic our waiting list increased significantly. Therefore, to address this, we aimed to improve The day-case rate by developing The booking pathway, such as introducing The Cholecystectomy As A Day-case (CAAD) score. Method(s): Retrospective data for laparoscopic cholecystectomy were reviewed between 19th March and 9th July 2021. Specific documents reviewed were The operation booking forms, hospital-specific 'boarding cards' for booking and CAAD score completion, and a day-case rate was calculated. Result(s): A total of 86 procedures were performed. There was an overall day-case rate of 54.7%. of those booked to be day-cases (n=39), 61.5% remained day-case post-operatively and 28.2% were discharged The next day. of The patients that were not discharged The same day (n=39), 18 cases had no documented reason for The additional stay. Incomplete booking forms (n=42) demonstrated a day-case rate of 50% versus 60.5% with complete forms (n=38). Conclusion(s): Overall, The day-case rate has improved. We believe this is from adhering to The boarding card and introduction of The CAAD score to guide appropriate booking. However, for further improvement we are going to revise The booking form and create a Standard Operating Procedure (Sop) for The booking of these operations. Together with CAAD scoring, this should improve day-case rates further to reach The nationally accepted standard.

The Impact of the COVID-19 Pandemic on the Use of Library-Licensed Electronic Resources: Using Data to Challenge Core Assumptions and Leveraging Disruption to Initiate Meaningful Strategic Change

Academic libraries are engaged in the process of assessing the impacts the COVID-19 health pandemic has had on the use of the electronic resources their institutions provide. Trends related to e-resource use prior to and during the pandemic at a small academic library and within its consortium are discussed. The results of this assessment dispel the assumptions behind a hypothesis that licensed online resources would see greater use in supporting instruction and research as institutions pivoted to online-only course delivery in the early months of the pandemic. Some potential underlying factors that may be leveraged to inform strategic collection development, information literacy, and service changes are explored. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

Taking STEM Enrichment Camps Virtual: Strategies Reflections from Quick Pivot due to COVID-19

Since COVID-19 began spreading in the US and quickly established as a global pandemic in March of 2020, the NSF-funded STEM SEALS team at North Florida College faced the touch decision to either cancel their inaugural hands-on STEM enrichment camp planned for Summer 2020 or rushing at full speed to take it virtual. The biggest concern in making the decision to go virtual was a passionate belief in the importance of not losing the hands-on focus that had been planned. After all, the STEM SEALs effort at NFC was designed to expand access to high quality STEM experiences for historically underserved students in a high poverty, rural area. Changing from the in-person delivery to distance learning with minimal preparation presented a daunting challenge and also a unique opportunity;the opportunity to study the process and provide guidance to other STEM providers who are considering a move to a virtual platform. This exploratory study aimed to (1) identify the barriers to moving STEM enrichment programming in a rural environment from in-person to virtual activities during the COVID-19 pandemic, (2) describe key decisions that were made in transitioning to the virtual format along with the rationale behind those decisions, and (3) disseminate best practices that emerged from the inaugural effort. © 2021 IEEE.

COVID-19 should be considered as a differential diagnosis for an 'acute abdomen'

SARS-CoV2 is a novel RNA virus which originated in Wuhan, China early in January 2020 and spread as a global pandemic. The virus, thought to cause primarily respiratory pathology, is presenting with more extra-pulmonary presentations as time progresses. Abdominal symptoms, such as acute abdominal pain, can present without any respiratory complaints which can cause a diagnostic dilemma for the treating physician, leading to delayed or missed diagnoses and often resulting in a suboptimal outcome for the patient.

Estimating the duration of seropositivity of human seasonal coronaviruses using seroprevalence studies

Background: The duration of immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still uncertain, but it is of key clinical and epidemiological importance. Seasonal human coronaviruses (HCoV) have been circulating for longer and, therefore, may offer insights into the long-term dynamics of reinfection for such viruses.

Estimating the duration of seropositivity of human seasonal coronaviruses using seroprevalence studies

Background: The duration of immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still uncertain, but it is of key clinical and epidemiological importance. Seasonal human coronaviruses (HCoV) have been circulating for longer and, therefore, may offer insights into the long-term dynamics of reinfection for such viruses. Methods: Combining historical seroprevalence data from five studies covering the four circulating HCoVs with an age-structured reverse catalytic model, we estimated the likely duration of seropositivity following seroconversion. Results: We estimated that antibody persistence lasted between 0.9 (95% Credible interval: 0.6 - 1.6) and 3.8 (95% CrI: 2.0 - 7.4) years. Furthermore, we found the force of infection in older children and adults (those over 8.5 [95% CrI: 7.5 - 9.9] years) to be higher compared with young children in the majority of studies. Conclusions: These estimates of endemic HCoV dynamics could provide an indication of the future long-term infection and reinfection patterns of SARS-CoV-2. © 2021 Rees EM et al.

Clinical characteristics and outcome of critically ill COVID-19 patients with acute kidney injury: a single centre cohort study.

BACKGROUND: Acute kidney injury (AKI) is a common manifestation among patients critically ill with SARS-CoV-2 infection (Coronavirus 2019) and is associated with significant morbidity and mortality. The pathophysiology of renal failure in this context is not fully understood, but likely to be multifactorial. The intensive care unit outcomes of patients following COVID-19 acute critical illness with associated AKI have not been fully explored. We conducted a cohort study to investigate the risk factors for acute kidney injury in patients admitted to and intensive care unit with COVID-19, its incidence and associated outcomes. METHODS: We reviewed the medical records of all patients admitted to our adult intensive care unit suffering from SARS-CoV-2 infection from 14th March 2020 until 12th May 2020. Acute kidney injury was defined using the Kidney Disease Improving Global Outcome (KDIGO) criteria. The outcome analysis was assessed up to date as 3rd of September 2020. RESULTS: A total of 81 patients admitted during this period. All patients had acute hypoxic respiratory failure and needed either noninvasive or invasive mechanical ventilatory support. Thirty-six patients (44%) had evidence of AKI (Stage I-33%, Stage II-22%, Renal Replacement Therapy (RRT)-44%). All patients with AKI stage III had RRT. Age, diabetes mellitus, immunosuppression, lymphopenia, high D-Dimer levels, increased APACHE II and SOFA scores, invasive mechanical ventilation and use of inotropic or vasopressor support were significantly associated with AKI. The peak AKI was at day 4 and mean duration of RRT was 12.5 days. The mortality was 25% for the AKI group compared to 6.7% in those without AKI. Among those received RRT and survived their illness, the renal function recovery is complete and back to baseline in all patients. CONCLUSION: Acute kidney injury and renal replacement therapy is common in critically ill patients presenting with COVID-19. It is associated with increased severity of illness on admission to ICU, increased mortality and prolonged ICU and hospital length of stay. Recovery of renal function was complete in all survived patients.