Analysis of factors affecting the construction duration of public health emergency medical facilities.

Objectives: This study explores the factors influencing the construction duration of public health emergency medical facilities and the ways in which they can be enhanced. Methods: Combining 30 relevant emergency medical facility construction cases in different cities in China from 2020 to 2021, seven condition variables and an outcome variable were selected, and necessary and sufficient condition analyses of duration influence factors were conducted using the fsQCA method. Results: The consistency of seven condition variables was <0.9, which shows that the construction period of public health emergency medical facilities is not independently affected by a single condition variable but by multiple influencing factors. The solution consistency value of the path configurations was 0.905, indicating that four path configurations were sufficient for the outcome variables. The solution coverage of the four path configurations was 0.637, indicating that they covered ~63.7% of the public health emergency medical facility cases. Conclusion: To reduce the construction duration, the construction of emergency medical facilities should focus on planning and design, the selection of an appropriate form of construction, the reasonable deployment of resources, and the vigorous adoption of information technology.

Radiographic findings of SARS-CoV-2 infection.

STUDY OBJECTIVE: The 2019-20 coronavirus pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19). This study was undertaken to identify and compare findings of chest radiography and computed tomography among patients with SARS-CoV-2 infection. METHODS: This retrospective study was undertaken at a tertiary care center. Eligible subjects included consecutive patients age 18 and over with documented SARS-CoV-2 infection between March and July 2020. The primary outcome measures were results of chest radiography and computed tomography among patients with documented SARS-CoV-2 infection. RESULTS: Among 724 subjects, most were admitted to a medical floor (46.4%; N = 324) or admitted to an ICU (10.9%; N = 76). A substantial number of subjects were intubated during the emergency department visit or inpatient hospitalization (15.3%; N = 109). The majority of patients received a chest radiograph (80%; N = 579). The most common findings were normal, bilateral infiltrates, ground-glass opacities, or unilateral infiltrate. Among 128 patients who had both chest radiography and computed tomography, there was considerable disagreement between the 2 studies (52.3%; N = 67; 95% confidence interval: 43.7% to 61.0%).). The presence of bilateral infiltrates (infiltrates or ground-glass opacities) was associated with clinical factors including older age, ambulance arrivals, more urgent triage levels, higher heart rate, and lower oxygen saturation. Bilateral infiltrates were associated with poorer outcomes, including higher rate of intubation, greater number of inpatient days, and higher rate of death. CONCLUSIONS: Common radiographic findings of SARS-CoV-2 infection include infiltrates or ground-glass opacities. There was considerable disagreement between chest radiography and computed tomography. Computed tomography was more accurate in defining the extent of involved lung parenchyma. The presence of bilateral infiltrates was associated with morbidity and mortality.

First wave of COVID-19 impact on emergency general surgery in a Spanish tertiary hospital. A cohort study.

INTRODUCTION: The need to care for patients with emergency symptoms still continues during the COVID-19 pandemic. The number of emergency surgery procedures performed in Spanish hospitals decreased significantly during the first wave of COVID-19. PATIENTS AND METHODS: We performed a retrospective cohort study comparing the emergency surgery activity in a Spanish tertiary Hospital during the COVID-19 pandemic and emergency surgery activity registered in 2019 during the equivalent time period. RESULTS: A total of 1802 patients were included in control group (CG) versus 756 in pandemic group (PG). Mean number of patients who underwent emergency surgery during the control and pandemic periods was 3.42 patients per day, in contrast to 1.62 during the pandemic period, which represents a 52.6% decrease in emergency surgery activity. During the pandemic period, most of the patients consulted after more than 72 h of symptoms, representing a delay in presenting in the ER of 23.7% when compared to CG. Surgeries due to complications from previous elective procedures decreased (12% vs. 6.1%) in PG, probably because elective procedures are being postponed. We had a 13.1% COVID-19 positivity rate. Morbidity was higher during pandemic (52.5% vs. 35.2%). Mortality rates in patients undergoing emergency surgery was higher in PG (12.1% vs. 4.8%). CONCLUSIONS: The impact of the first wave of COVID-19 in emergency surgery activity has been profound. A significant reduction in emergency surgery was observed, along with longer time periods between patients' onset of symptoms and their arrival at the Emergency Department. Higher morbidity was also observed during the pandemic period.

Role of lung ultrasonography in the diagnosis of COVID-19 patients admitted to the emergency department.

INTRODUCTION: In this study, the use of lung ultrasonography (LUS) to diagnosis lung findings was evaluated in patients with suspected COVID-19 who were admitted to the emergency department (ED). METHODS: This observational clinical study was conducted in the ED of the Ankara City Hospital during the period April 1-30, 2020. Patients who were admitted to the ED were triaged as COVID-19 infected and who agreed to undergo LUS/LCT (lung computed tomography) were included in the study. RESULTS: Included in the study were 40 patients who had been prediagnosed with COVID-19. Pneumonia was detected with LCT in 32 (80%) patients, while the LUS examination identified pneumonia in 23 patients. The most common finding in LCT was ground-glass opacity (n = 29, 90.6%). Of the 23 patients with pneumonia findings in LUS, 15 (65.2%) had direct consolidation. Among the 32 patients who were found to have pneumonia as a result of LCT, 20 (62.5%) had signs of pneumonia on LUS examination, and 12 had no signs of pneumonia. In addition, 3 patients showed no signs of pneumonia with LCT, but they were misdiagnosed with pneumonia by LUS. The sensitivity of LUS in the diagnosis of pneumonia in the COVID-19 patients was 62.5%, while its specificity was 62.5%. In addition, its positive predictive value was 87.0%, and its negative predictive value was 29.4%. CONCLUSION: LUS may also be used in the diagnosis of pneumonia in COVID-19 patients because it is a valuable and accessible bedside diagnostic tool.

Assessment of Knowledge, Attitude, and Practices Toward Coronavirus Disease 2019 and the Risks of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Iranian Emergency Medical Services Workers: An Online Cross-Sectional Survey

Objective: Coronavirus disease 2019 (COVID-19), a severe acute respiratory infection, has spread rapidly around the world. To expand and enhance knowledge regarding virus prevention/transmission, this study aimed to evaluate the knowledge, attitudes, and practices of emergency medical services (EMS) workers as a part of the health care system because of their essential role in the front lines of the COVID-19 outbreak. Method(s): An online cross-sectional survey was conducted on EMS workers to assess their knowledge, attitudes, and practices toward COVID-19. The questionnaire included 5 topics: demographic information, knowledge and attitude questions, professional behavior of employees during the epidemic, and anxiety score. Result(s): A total of 86 EMS workers answered the questionnaire, and 55.63% of the respondents answered the knowledge questions correctly;knowledge appeared to have no correlation to their education, age, or experience. In addition, there was no apparent correlation between the infection rate and exposure to an infected or suspected patient. Conclusion(s): The findings of the present study indicate that more than half of the EMS workers have good knowledge about the epidemic, and the level of knowledge was not related to their demographic characteristics. The results of professional behaviors showed a high level of compliance with the principles and guidelines by workers, and the absence of a relationship between employees' contamination and exposure to infected patients supports the awareness and legality of EMS workers.Copyright © 2023 Air Medical Journal Associates

Government emergency aid and perceived financial security in COVID-19: evidence from a sample of vulnerable women in Brazil

PurposeThe purpose of this study is to examine if public policy satisfaction is related with perceived financial security. The public policy examined is an emergency income policy in Brazil.Design/methodology/approachThe authors used a questionnaire to interview a random sample of 235 single-parent women who received Emergency Aid (EA) resources in Brazil during the pandemic. The questionnaire included measures of financial security, financial anxiety, financial resilience and profile aspects. The authors applied a multiple regression approach to identify the determinants of financial security during the pandemic.FindingsOur findings show that factors such as satisfaction with the emerging income policy and financial resilience are positively related to perceived financial security. Financial anxiety, financial fragility and job loss in the pandemic are negatively related with perceived financial security.Research limitations/implicationsWhile our results correspond to a random probabilistic sample of women residing in southern Brazil, they may not be generalizable to Brazil as a whole.Practical implicationsThis study provides evidence of the financial situation in the pandemic for the lives of economically vulnerable women. The research encourages government and financial institutions to understand the unique challenges faced by vulnerable populations during the pandemic and analyzes the direct results of EA. The study contributes to the establishment of policies to support vulnerable populations, encouraging security and financial resilience.Originality/valueThis research is innovative in its analysis of women's financial situations during the pandemic, taking into consideration both behavioral aspects and profiles. Our focus on a specific case of emergency income policy adds to the understanding of the relation of such policies on vulnerable populations.

Smart Ambulance Monitoring System Using Iot

A vehicle which is used to transport patients to hospitals is called as ambulance, this ambulance vehicle is equipped with some vital lifesaving equipment's and first aid medicines. With these medicines and equipment's, the patients are given first aid till it reaches the desired hospital. Whenever a patient is in life-threatening emergency, then the ambulance paramedics should act promptly and must update the status of the patient to their doctors. This type of treatment or service is called Emergency Medical Service (EMS). It deals with immediate treatment and timely movement of the patients. For implementing EMS in ambulance several solutions have been developed for faster means of communication between the equipment's used in ambulance and the doctors. But the solutions are not viable in emergency situations. In additions during Covid wave in 2020 there was a scarcity for hospitals beds, it was filled with many covid patients. In many hospitals there was a queue of ambulances with patients waiting outside the hospitals. In some cases, the patients even died before getting any treatment, to overcome such crucial situations we have come out with a new system combining IoT, Sensor system and Embedded Controllers. The system developed here has sensors to monitor patients' vital parameters and transmits to the hospital server, such that a doctor can know the live condition of the patient and he can give instructions to the paramedics to do emergency aids. The system is a compactable and connects to the server with a mobile hotspot. The information is updated every 10 seconds. By implementing this system in ambulances, it saves many valuable lives of the people.

Cases of Covid-19 in Patients Withi Mmune-Mediated Rheumatic Diseases after Vaccination against Sars-Cov-2 in Manaus-Amazon

Objectives: Immunization against SARS-CoV-2 is an effective strategy to reduce morbidity and mortality in the face of the COVID-19 pandemic. People with Immune-mediated Rheumatic Diseases (IMRD) also benefited from this campaign. However, there is a limited amount of data on the outcome of vaccination in these patients, in terms of those who were infected by the virus. This study had the objective to evaluate the rate of COVID-19 cases in patients with IMRD after vaccination against SARS-CoV-2. Method(s): Observational, longitudinal and ambidirectional study with follow-up of subgroups of patients with IMRD immunized with vaccines made available by the National Immunization Plan (inactivated adsorbed vaccine registered by the Instituto Butantan (IB), recombinant vaccines registered by Bio Manguinhos/ Fiocruz and by Janssen, and Pfizer/BioNTech). Sociodemographic data and questionnaires on flu syndrome, laboratory confirmation of infection and need for hospitalization and outcomes were collected and stored via an online platform. This study is associated to the SAFER Project from the Brazilian Society of Rheumatology and it was approved by the local Research Ethics Committee. Result(s): A total of 223 patients aged over 18 years, mean age 42.79 +/- 15.18 years, were included. All were within the inclusion/exclusion criteria, with 83% being female. The main IMRD included were systemic lupus erythematosus (39%) and rheumatoid arthritis (33.6%). After the 1st dose, 1.45% of patients had COVID-19, 50% sought health services (emergency care), without the need for hospitalization and after the 2nd dose, 1.5% had the disease, of which none sought health services, required hospitalization or had a negative outcome. After the 3rd dose,: 2.9%were infected with SARS-CoV-2 one month later, 15.6% two to three months later and 5.5% four to six months later, all with laboratory confirmation;only 4% presenting any serious complication;there were no deaths. After the 4th dose, 9.1%of patients had COVID-19, of which 40%were hospitalized, without the need for assisted ventilation;half of these patients had a serious complication, but there no deaths. Conclusion(s): In this study, we observed the effectiveness of the vaccine in preventing severe cases of COVID-19 and complications of SARS-CoV-2 infection.

The Use of Acute-Phase Proteins Apache Ii and Sofa to Predict the Mortality of Covid-19 Patients

Objective: Acute-phase proteins are a family of proteins synthesized by the liver. With this study, we aimed to investigate the effects of COVID-19 infection on acute phase reactants (AFR) and determine the usability of AFRs as prognostic factors in COVID-19 disease. Material(s) and Method(s): Serum samples taken for routine analysis of the patients admitted to the Emergency Department and diagnosed with COVID-19, were used. AFR levels of 30 patients who resulted in mortality and 30 recovered patients were evaluated. C-reactive protein (CRP), ferritin (FER), ceruloplasmin (Cp), albumin (Alb), prealbumin (Prealb), transferrin (Trf), lactate, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) assessment was performed. Result(s): The hazard ratio and 95% confidence interval for FER, CRP, lactate, Alb, Cp, Prealb, Trf, Age, SOFA, and APACHE were 1.001 (1.000-1.001), 1.005 (1.001- 1.008), 1.141 (1.016-1.243), 1.016 (0.740-1.399), 1.016 (0.740-1.399), 1.056 (1.017-1.100), 0.978 (0.917-1.035), 1.000 (0.995-1.006), 1.032 (1.004- 1.064), 1.104 (0.971-1.247), and 1.012 (0.974-1.051), respectively, in univariable model. Only CRP, lactate, and FER found significant in multivariable model. In addition, patients in the nonsurvivors group had significantly higher FER, CRP, lactate, APACHE, age, and SOFA. Nonsurvivors also had lower Alb, Prealb, and serum Trf level compared to survivors. Conclusion(s): CRP, lactate, and FER, which we have shown to be significantly higher in severe COVID-19 patients, will be valuable parameters that will contribute to clinical improvement if they are used in the follow-up of patients due to their easy measurement and predictive values.Copyright © 2023, Nobelmedicus. All rights reserved.

Patient Safety Culture in the Emergency Center at the University Clinical Center of Kosovo and the COVID-19 Pandemic

BACKGROUND: Despite the developments in Kosovo's healthcare, there are still many challenges that hamper the delivery of proper health-care service. This was especially highlighted during the coronavirus disease 2019 (COVID-19) pandemic. AIM: This study aims to elucidate the factors that impede proper health service as well as reduce preventable medical errors by focusing on safety as a fundamental principle in patient care and a key component health services quality management. The main goal is to improve the overall approach to the patient by improving the workers performance and redesigning systems, with the goal of reducing patient risk not only in normal working environment but also in new and unusual situations such as COVID-19 pandemic. METHOD(S): In this cross-sectional study, data were collected and analyzed. Two questionnaires were compiled for this research: one was compiled to address patients who sought health services at the Emergency Center;the second questionnaire was designed for the Emergency Center personnel to identify the relationships between the workers, managerial staff, the problems of reporting errors, and similar. Moreover, relevant publications on the impact of the pandemic on the provision of health services were compared. Statistical analysis was done by IBM SPSS version 25. CONCLUSION(S): There is a need for improving Patient Safety Culture in The Emergency Center at the University Clinical Center of Kosovo. By reorganizing working hours for the workers of the Emergency Center, preventable medical errors would be reduced. Raising the capacities of the primary care level would reduce the load of the Emergency Center from interventions, which can be handled without a problem at the lower levels. Continuous professional trainings, as well as trainings focused on stress management, working under time pressure, and relationships between health service providers would significantly improve the level of patient safety in the Emergency Center.Copyright © 2023, Scientific Foundation SPIROSKI. All rights reserved.

Using implementation science to support the adoption of routine HIV testing in a suburban emergency department

Background: Implementation science (IS) involves using techniques to promote implementation of evidence-based guidance to improve healthcare quality and outcomes. Sutton has an HIV prevalence rate of 2.5/1000 and a high late diagnosis rate. Testing in emergency departments (ED) has been shown to be effective and has been adopted in many UK metropolitan centres. Routine testing in EDs of high prevalence areas is recommended by NICE. Method(s): Our project started in November 2019 and was designed to promote uptake of opt-out HIV testing into routine practice through education, training, and incentives. Strategies employed outlined in table 1. We assessed acceptability and adoption of the guidance. Result(s): HIV testing increased from average 7.5 tests/ month to 592 tests/month (17,165 tests in 28 months). Three previously undiagnosed people and 1 individual with a known diagnosis who had disengaged were identified. Testing numbers ranged from 191-1229/month. Numbers dropped during the following challenging periods: 1. Tendering of the sexual health service 2. IT and sample processing issues on implementation 3. Emergence of SARS CoV-2 4. Blood bottle shortage in 2021 Conclusion(s): This project demonstrated that while implementation of routine opt out HIV testing in ED is feasible and acceptable, it took a long time for the practice to be embedded and it was easily de-railed by external circumstances. Acknowledgements- This project was conducted with support from an Implementation Science grant by ViiV. (Table Presented).

Teacher-efficacy as a complex web: Lessons from a qualitative case study on the transition of military faculty to emergency remote teaching during COVID-19

Although scholars have well-established the benefits of higher teacher-efficacy, the lack of literature regarding the sources and influences of these self-beliefs has led to an overly-reductionistic view of the construct. A teacher's sense of efficacy is a multifaceted entity which involves the interplay of various factors individuals leverage to formulate their judgement of their abilities. These influencers include a combination of internal elements such as an individual's previous experiences or social interactions, and external elements such as the environmental context or surroundings. The aim of this study was to explore the intricacies of the teacher-efficacy development process as situated during a crisis event. Crises, such as the COVID-19 pandemic, are ominous in that they tend to be volatile, uncertain, complex, and ambiguous (VUCA). With the crisis in mind, this study involved an ecological examination of the teacher efficacy construct concerning a group of professional military education personnel during the transition to emergency remote teaching during the COVID-19 pandemic. The goal of this study was to illuminate patterns and themes from within the data by comparing (1) the design context, principles, and design team choices to promote efficacy development during the pandemic with (2) how the course graduates perceived their efficacy.The exploratory nature of this single case qualitative study involved a constant comparative analysis of semi-structured interview protocols with seven participants, archived documents of curriculum artifacts and course materials, and analytic memos. The participants consisted of three course design team members, who planned and implemented the professional development (PD) course, and four military faculty course graduates, who completed the PD and taught their first virtual teaching session. The result of using an inductive analytical approach revealed three interconnected themes that facilitated the efficacy-building process. The consistency in the data exposed that the degree to which the participants perceived authenticity in the curriculum, their ability to harness collaborative engagement among colleagues and faculty, and their opportunity to source prior exposures to handling disruptions and change intertwined to influence the developmental effort. The implications of this study counter the dominant narrative in the literature that teacher-efficacy is a linear, simplistic process. Instead, scholars and practitioners might approach efficacy-building using a collection of biological, psychological, and social influencers. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Response to the impact of COVID-19 by health professions education institutions in Africa: a case study on preparedness for remote learning and teaching

BackgroundAfrica, like other parts of the world, continuously strives to deliver quality health professions education. These efforts are influenced to a larger extent by the socio-economic and cultural context of the region, but also by what happens globally. The global disruption caused by the COVID-19 pandemic in 2020 necessitated the implementation of emergency remote teaching to continue delivering on the mandate of educating future health professionals. The purpose of this research was to describe the response of selected health professions education institutions in Southern Africa to the impact of COVID-19 and their preparedness for remote learning and teaching.MethodsA case study design was applied using an adapted ADKAR model as a conceptual framework for data interpretation. The purposively selected study population consisted of educators, students, and administrators in undergraduate medical and nursing programmes from six institutions in five countries.ResultsA total of 1307 respondents provided data for the study. Many of the institutions were caught off-guard when most educators and almost all students were required to leave their universities and go home. Stakeholders immediately became aware of the need to adopt online approaches as an emergency measure. In all programmes, educators, students, and administrators agreed that change was desired, and students realised that they had to take charge of their own learning independently. Overall educators reported confidence in the ability to use of standard Microsoft software, while knowledge of learning management systems proved more challenging for both educators and students. Many stakeholders, especially students and administrators, reported uncertainty about their ability to function in the new reality. Conducive family dynamics, a quiet space to study, good connectivity, a reliable electricity supply and appropriate devices were reported to reinforce learning and teaching.ConclusionsThe findings highlight the need for higher education institutions to prepare for alternative modes to face-to-face learning and teaching approaches with the ultimate aim of transitioning to full online learning more expeditiously. This requires scaling up educational infrastructure, prioritising strategic directives driving continuous professional development of educators and fostering co-constructivist approaches towards student centered education.

Evaluation of Quality-of-Care Indicators Among Patients With Crohn's Disease and Ulcerative Colitis in the United States: 2019-2020

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) can be difficult to manage and, due to a lack of meaningful quality measures, patient (pt) care may vary by provider. To understand where gaps in care may exist for these pts, this study assessed specific healthcare resource utilization (HRU) and medication metrics that may be potential quality of care (QOC) indicators. Method(s): Using a large commercial US claims database (2019-2020), pts with CD or UC were identified. Potential QOC indicators were selected based on clinical guidelines and recommendations from measures of quality organizations and included CD or UC prevalence;gastroenterologist (GE) and IBD-related non-GE outpatient visits;IBD-related emergency department visits or hospitalizations;excessive steroid use (prednisone equivalent >=10 mg/day for >=60 consecutive days or a single prescription of >=600 mg prednisone);excessive steroid users on corticosteroid (CS)-sparing therapy;excessive steroid users with central dual-energy X-ray absorptiometry (DEXA) or osteoporosis pharmacologic treatment;use of targeted immunomodulators (TIMs) and oral mesalamine (CD only);imaging assessments;and assessment of inflammatory biomarkers. National percentages of pts achieving each metric are reported. Result(s): In total, 41,555 CD and 52,507 UC pts were identified in 2019, resulting in a 0.3% and 0.4% prevalence, respectively (Table). Over a third of CD pts (39.8%) and almost half of UC pts (45.5%) did not visit a GE in 2019. Around 10% CD pts, and up to 6.4% of UC pts, had IBD-related ED visits or hospitalizations. 17.1% CD and 14.5% UC pts were excessive steroid users, yet < 9% CD and UC pts, received DEXA scans and/or bone treatments. A third of excessive steroid users with CD (34.5%), and over half (53.0%) of those with UC, did not receive CS-sparing therapy. The rate of TIM use was over two times higher in CD vs UC pts (CD: 44.3%;UC: 18.9%). Despite evidence that mesalamine is ineffective in CD, 18.7% of pts with CD were prescribed it. Inflammatory biomarker level testing rates were < 50% in both CD and UC. Similar outcomes were reported in 2020, with lower HRU, possibly due to COVID-19. Conclusion(s): This analysis of QOC indicators highlights various areas for improvement that may provide better treatment outcomes and reduce HRU for pts with CD and UC. Future research is needed to assess outcomes in pts that are not being routinely monitored. (Table Presented).

Best practices for pediatricians in diagnosing and treating asthma

Additionally, they can treat atopic comorbidities such as atopic dermatitis, chronic urticaria, nasal polyps, eosinophilic esophagitis, and hypereosinophilic syndrome, resulting in improved quality of life for our patients. Parents should be made aware of its updated black box warning for possible effects on mental health and behavior changes,3 including but not limited to suicidal ideation. FDA requires boxed warning about serious mental health side effects for asthma and allergy drug montelukast (Singulair);advises restricting use for allergic rhinitis.

Global Pandemic and Human Security: Using Health-EDRM Risk Assessment Framework to Enhance Technology Support for DRR

‘Biological hazard' is regarded as a major human security threat to people's well-being and development. In the era of globalisation and rapid technological development, COVID-19 pandemic once again revealed how an emerging communicable disease might impact not only health but also the socioeconomic ecology of people globally, while the related health risk can be mitigated by the employment of appropriate technology. The chapter examines how the latest World Health Organization Health-EDRM framework (2019) may inform the conceptualisation and assessment of health risks and proposes a Health-EDRM assessments framework for biological hazard. A case study of how health risks and vulnerability associated with home care may be reduced by employing technology in non-standard living context during pandemic and a case study of community resilience and community engagement are also included. The discussion also puts Health-EDRM framework into a human security perspective. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer 2022.

Prognostic Value of Elevated Lipase in Pancreatitis versus Non Pancreatitis Hyperlipasemia (NPHL) due to Non-Malignant Causes

Introduction: While elevated lipase is typically used to diagnose acute pancreatitis, it has also been associated with other critical disease states including sepsis, COVID-19, bowel obstruction, and trauma. In this study we compared outcomes of patients with elevated lipase who had pancreatitis and NPHL. Method(s): Retrospective analysis was performed on all patients who presented to the Emergency Department between February 2016 and August 2020 with lipase >= 3x the upper limit of normal. Patient demographics and past medical history, including active cancer, were noted. Patient outcomes were followed through November 2021. If applicable, dates of death were also documented. Result(s): 414 total patients were included in this study. Upon initial evaluation, 305/414 (74%) were diagnosed with acute pancreatitis (AP) and 109/414 had NPHL. The age (54 617 vs. 58 618, p=0.0220), Sex (male 164/305 vs. 49/109, p=0.1194), and BMI (28.9 67.4 vs. 25.8 64.6, p=0.0066) were compared between the AP and NPHL groups. The serum lipase in the AP and NPHL group were respectively 1471 61070 vs. 605 6555 (p< 0.0001). The most common causes of NPHL were sepsis (10/109;9%) renal failure (7/109;6%), GI bleed (5/109;4%), and bowel obstruction (5/109;4%). The NPHL group had higher rate of malignancy (29/105;28%) compared to those with AP (35/305;11%, p< 0.0001). NPHL patients without malignancy had a higher mortality rate (63/80;80%) compared to those without malignancy in the AP group (17/270;6.3%, p< 0.0001). The most common malignancy in patients with AP was breast (6/35;17%, vs. 3/29;10%, p=0.4943). In NPHL, the most common malignancies were pancreatic (4/29;14%, vs. 3/35;9%, p=0.6920) and bowel malignancies (4/29;14%, vs. 4/35, 11% p51.0000). Conclusion(s): Patients with NPHL without malignancy have higher mortality than those with pancreatitis despite lower serum lipase levels. A limitation of our study is the difference between age and BMI of AP versus NPHL patients. Whether this impacts the prognostic relevance of NPHL on survival need to be explored in future studies.

Understanding Chinese students' online learning experiences with emergency remote teaching: a case study

Despite the growing body of research on college students' online learning experiences during the COVID-19 pandemic, little is known about how individual students perceive and experience emergency remote teaching in China. To fill this gap, this study seeks to explore college students' perceptions of emergency remote teaching as well as the factors deemed favourable and unfavourable to online learning. This study, adopting a photo elicitation method, investigated four college students' online learning experiences in an emergency remote instruction context. Our study revealed that students went through three stages of online learning and their perceptions of emergency remote teaching changed from one stage to another. Additionally, student-content interaction, strong teacher support and a high-level of digital inclusion were three factors that facilitated effective online learning, whereas lack of interaction with teachers and peers and dormitory confinement were two factors perceived as hindrance. The study explored possible explanations of the findings and made pedagogical recommendations to foster online learning success. The study bears significance for teachers and administrators practicing technology-supported teaching activities amid and beyond the pandemic.

Cognitive bias in the context of epidemic

In connection with the scope and duration of the COVID-19 pandemic, the clinical judgement of clinicians and medical practitioners could be influenced such that diagnostic errors (delays and inaccuracies) may ensue. We hereby recall through two clinical scenarios the constant need for practitioners to take a step back in reflecting of the diagnostic process to avoid the <<tunnel effect>> which may result in delaying common and frequent infectious diseases. The flu-like symptoms presented by these patients (fever, myalgia and asthenia...) quickly prompted our emergency room colleagues to suspect SARS-CoV-2 infection. However, further investigations including imagery and blood cultures revealed completely different but common infectious disease conditions, which are potentially fatal.Copyright © 2020 Editions Medecine et Hygiene. All rights reserved.

Multisystem inflammatory syndrome associated with COVID-19 in adult: the case report

The multisystem inflammatory syndrome associated with COVID-19 coronavirus infection was first described in April-May 2020, mainly among children who had an acute infectious disease. Soon there were reports of the development of MIS in adults (MIS-A). More than 200 cases of MVS in adults have been described and systematized in the world, while in Russia there is no separate registration of MVS, a single description of MVS is given in the literature. Material and methods. We presented Case report of MIS-A in a 21-year-old woman, accompanied by persistent fever, multiple organ failure syndrome, is presented. The stages of diagnosis and treatment of MIS-A. Result and discussion. A positive effect was achieved during therapy with corticosteroids and intravenous immunoglobulin. MIS-A is a rare life-threatening complication of a COVID-19 that requires emergency therapy with the inclusion of corticosteroids and intravenous immunoglobulin in an adequate dose. The given example will be interesting for general practitioners, infectious disease specialists and therapists.Copyright © 2023 The authors.