Impact of public transport disruption on access to healthcare facility and well-being during the COVID-19 pandemic: A qualitative case study in Metro Manila, Philippines.

The COVID-19 pandemic has forced many governments to halt public transport operations. A consequence of such disruption is the reduction in access to critical facilities by individuals who rely on public transport for their daily mobility. We investigate the impact disparities caused by the restriction of public transportation on the access of healthcare workers and patients to healthcare facilities during the COVID-19 pandemic. Metro Manila is an appropriate case study site because the duration of suspension of public transport in the mega-city is one of the longest in the world. The prolonged duration of the lockdown could have devastating impacts on the well-being of individuals who are reliant on public transport to access essential services. Guided by the Yin-Eisenhardt approach to qualitative research, we examined the data from 55 individuals using within-case and cross-case analyses iteratively for the purpose of building a model on the impact of change in access due to public transport disruption on well-being. We mobilized constructs and concepts known in the literature, such as well-being, access, disruption, resistance, resilience, and vulnerability, in developing our two-step conceptual model. Given the profound impact of the prolonged and system-wide suspension of public transport on the well-being of individuals, it is necessary to provide sufficient public transport and active transport infrastructure and services that can cover their mobility needs. The two-step conceptual model from this study can provide guidance on specific policy interventions.

Measurement of epicardial adipose tissue using non-contrast routine chest-CT: a consideration of threshold adjustment for fatty attenuation.

BACKGROUND: Epicardial adipose tissue (EAT) is known as an important imaging indicator for cardiovascular risk stratification. The present study aimed to determine whether the EAT volume (EV) and mean EAT attenuation (mEA) measured by non-contrast routine chest CT (RCCT) could be more consistent with those measured by coronary CT angiography (CCTA) by adjusting the threshold of fatty attenuation. METHODS: In total, 83 subjects who simultaneously underwent CCTA and RCCT were enrolled. EV and mEA were quantified by CCTA using a threshold of (N30) (- 190 HU, - 30 HU) as a reference and measured by RCCT using thresholds of N30, N40 (- 190 HU, - 40 HU), and N45 (- 190 HU, - 45 HU). The correlation and agreement of EAT metrics between the two imaging modalities and differences between patients with coronary plaques (plaque ( +)) and without plaques (plaque ( -)) were analyzed. RESULTS: EV obtained from RCCT showed very strong correlation with the reference (r = 0.974, 0.976, 0.972 (N30, N40, N45), P < 0.001), whereas mEA showed a moderate correlation (r = 0.516, 0.500, 0.477 (N30, N40, N45), P < 0.001). Threshold adjustment was able to reduce the bias of EV, while increase the bias of mEA. Data obtained by CCTA and RCCT both demonstrated a significantly larger EV in the plaque ( +) group than in the plaque ( -) group (P < 0.05). A significant difference in mEA was shown only by RCCT using a threshold of N30 (plaque ( +) vs ( -): - 80.0 ± 4.4 HU vs - 78.0 ± 4.0 HU, P = 0.030). The mEA measured on RCCT using threshold of N40 and N45 showed no significant statistical difference between the two groups (P = 0.092 and 0.075), which was consistent with the result obtained on CCTA (P = 0.204). CONCLUSION: Applying more negative threshold, the consistency of EV measurements between the two techniques improves and a consistent result can be obtained when comparing EF measurements between groups, although the bias of mEA increases. Threshold adjustment is necessary when measuring EF with non-contrast RCCT.

Comparison of the Initial Overseas Evacuation Operations Due to COVID-19: A Focus on Asian Countries

During the early stages of the COVID-19 pandemic in 2020, state governments all over the world were forced to respond to the crisis, prioritizing not only inbound activities but also their citizens abroad. Our study focused on the reasons for the differences in the evacuation operations, procedures, and outcomes in each country. This study focused on Asian countries/territories that experienced the pandemic earlier than other regions, to compare their prompt evacuation processes between January and May, 2020. Data on the evacuation missions and COVID-19 situation in each studied country/territory were collected. The evacuation operations were reviewed and analyzed using the Business Process Model and Notation to identify the differences that made some of the operations more effective. The insight can contribute to future adaptation and development to implement more effective operations during the emergency response to a pandemic.

The Role of Fever Clinics in the Strategic Triage of Suspected Cases of Imported COVID-19.

INTRODUCTION: Novel coronavirus pneumonia (COVID-19) is an acute respiratory infectious disease, which has the characteristic of human-to-human transmission and is extremely contagious. Correctly standardizing the process of early screening of infection or suspected cases in the fever clinic has become a key part of the fight against the pandemic. METHODS: A retrospective analysis of patients in the fever clinic of Shenyang Medical College Affiliated Central Hospital from January 23 to March 1, 2020, was conducted in the present study. RESULTS: It was found that 16 suspected cases of COVID-19 in the fever clinic were diagnosed with respiratory infections, accounting for 0.59%. CONCLUSION: In case of a negative result in the second nucleic acid test, strategic triage and typing might be more conducive for the following nucleic acid tests for suspected cases in order to prevent the spread of the epidemic caused by missed diagnosis.