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Asia Pacific Scholar ; 7(2):46-50, 2022.
Article in English | Academic Search Complete | ID: covidwho-1836452


Introduction: Medical students (MS) may lack the knowledge and experience in performing basic surgical skills (BSS) when they first commence their postgraduate surgical training. We conducted a pilot BSS workshop with specific learning outcomes for MS. Methods: Our BSS workshop program consisted of reading the pre-workshop online modules, watching the instructional videos of skills demonstration, and completing the pre-workshop multiple-choice questions (MCQ). MS attended the onsite workshop a week later, which consisted of a basic surgical theory lecture, live demonstration of the skills by the teaching faculty and, supervised skills training coupled with feedback. Surgical skills taught were knot tying, suturing techniques, laparoscopic peg transfer, precision cutting, application of endoloop ties. A standardised surgical skills rubric was used to assess the competency and safety of BSS. A post-workshop MCQ was administered to assess the knowledge learned. The criteria for successful completion of BSS were a satisfactory grade in the surgical skills assessment and a pass score in the MCQ. Results: All the participating MS achieved a satisfactory grade in the surgical skills assessment and passed the MCQ. Several pedagogical methods were used to enhance knowledge learning and practical skills competency including a flipped classroom in blended learning, technology-enhanced learning, kinesthetic learning, and providing effective feedback. Conclusion: MS taught in BSS workshop can achieve competency in knowledge, skills, safe attitude and prepare them for future postgraduate surgical training. In the current COVID-19 pandemic, our challenge is to develop similar BSS in a safe environment using technology-enhanced tools such as online instructional videos and online feedback. [ FROM AUTHOR] Copyright of Asia Pacific Scholar is the property of Centre for Medical Education (CenMed) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

PLoS One ; 17(3): e0265117, 2022.
Article in English | MEDLINE | ID: covidwho-1742021


BACKGROUND: To investigate the mortality and health care resource use among patients with severe or critical coronavirus disease of 2019 (COVID-19) in the first wave of pandemic in China. METHODS: We performed a systematic review and meta-analysis to investigate the mortality, discharge rate, length of hospital stay, and use of invasive ventilation in severe or critical COVID-19 cases in China. We searched electronic databases for studies from China with no restrictions on language or interventions patients received. We screened records, extracted data and assessed the quality of included studies in duplicate. We performed the meta-analysis using random-effect models through a Bayesian framework. Subgroup analyses were conducted to examine studies by disease severity, study location and patient enrolment start date. We also performed sensitivity analysis using various priors, and assessed between-study heterogeneity and publication bias for the primary outcomes. RESULTS: Out of 6,205 titles and abstracts screened, 500 were reviewed in full text. A total of 42 studies were included in the review, of which 95% were observational studies (n = 40). The pooled 28-day and 14-day mortalities among severe or critical patients were 20.48% (7,136 patients, 95% credible interval (CrI), 13.11 to 30.70) and 10.83% (95% CrI, 6.78 to 16.75), respectively. The mortality declined over time and was higher in patients with critical disease than severe cases (1,235 patients, 45.73%, 95% CrI, 22.79 to 73.52 vs. 3,969 patients, 14.90%, 95% CrI, 4.70 to 39.57) and patients in Hubei compared to those outside Hubei (6,719 patients, 26.62%, 95% CrI, 13.11 to 30.70 vs. 244 patients, 5.88%, 95% CrI 2.03 to 14.11). The length of hospital stay was estimated at 18.48 days (6,847 patients, 95% CrI, 17.59 to 21.21), the 28-day discharge rate was 50.48% (3,645 patients, 95% CrI, 26.47 to 79.53), and the use of invasive ventilation rate was 13.46% (4,108 patients, 95% CrI, 7.61 to 22.31). CONCLUSIONS: Our systematic review and meta-analysis found high mortality among severe and critical COVID-19 cases. Severe or critical COVID-19 cases consumed a large amount of hospital resources during the outbreak.

COVID-19 , Critical Care , Length of Stay , Pandemics , SARS-CoV-2 , COVID-19/mortality , COVID-19/therapy , China/epidemiology , Critical Illness , Humans , Severity of Illness Index
Math Biosci Eng ; 17(4): 2842-2852, 2020 03 25.
Article in English | MEDLINE | ID: covidwho-806316


Since the first case of coronavirus disease (COVID-19) in Wuhan Hubei, China, was reported in December 2019, COVID-19 has spread rapidly across the country and overseas. The first case in Anhui, a province of China, was reported on January 10, 2020. In the field of infectious diseases, modeling, evaluating and predicting the rate of disease transmission is very important for epidemic prevention and control. Different intervention measures have been implemented starting from different time nodes in the country and Anhui, the epidemic may be divided into three stages for January 10 to February 11, 2020, namely. We adopted interrupted time series method and develop an SEI/QR model to analyse the data. Our results displayed that the lockdown of Wuhan implemented on January 23, 2020 reduced the contact rate of epidemic transmission in Anhui province by 48.37%, and centralized quarantine management policy for close contacts in Anhui reduced the contact rate by an additional 36.97%. At the same time, the estimated basic reproduction number gradually decreased from the initial 2.9764 to 0.8667 and then to 0.5725. We conclude that the Wuhan lockdown and the centralized quarantine management policy in Anhui played a crucial role in the timely and effective mitigation of the epidemic in Anhui. One merit of this work is the adoption of morbidity data which may reflect the epidemic more accurately and promptly. Our estimated parameters are largely in line with the World Health Organization estimates and previous studies.

Betacoronavirus , Coronavirus Infections/epidemiology , Models, Biological , Pandemics , Pneumonia, Viral/epidemiology , Basic Reproduction Number/statistics & numerical data , COVID-19 , China/epidemiology , Computer Simulation , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Humans , Interrupted Time Series Analysis/statistics & numerical data , Markov Chains , Mathematical Concepts , Monte Carlo Method , Morbidity/trends , Pandemics/prevention & control , Pandemics/statistics & numerical data , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Quarantine/statistics & numerical data , SARS-CoV-2