RESUMEN
An additional helicopter base has been built for the Government Flying Service at the former Kai Tak airport runway site in Hong Kong, China. The base allows high-rise development to take place at Tung Chung new town near the service's existing base at Hong Kong International airport, which would have restricted emergency helicopter operations during poor weather. The project involved construction of a take-off and landing pad, parking bays and hangar for two helicopters, plus an office building for the flight planning centre and air command and control centre. This paper describes how use of an NEC contract helped ensure close collaboration between the employer and contractor, leading to timely completion with zero accidents despite restrictions caused by the Covid-19 pandemic.
RESUMEN
An additional helicopter base has been built for Government Flying Service at the former Kai Tak airport runway site in Hong Kong. The base allows high-rise development to take place at Tung Chung new town near the service's existing base at Hong Kong International airport, which would have restricted emergency helicopter operations during poor weather. The project involved construction of a take-off and landing pad, parking bays and hangar for two helicopters, plus an office building for the flight planning centre and air command and control centre. This paper describes how use of an NEC contract helped ensure close collaboration between the employer and contractor, leading to timely completion with zero accidents despite restrictions caused by the Covid-19 pandemic.
RESUMEN
BACKGROUNDPediatric SARS-CoV-2 infection can be complicated by a dangerous hyperinflammatory condition termed multisystem inflammatory syndrome in children (MIS-C). The clinical and immunologic spectrum of MIS-C and its relationship to other inflammatory conditions of childhood have not been studied in detail.METHODSWe retrospectively studied confirmed cases of MIS-C at our institution from March to June 2020. The clinical characteristics, laboratory studies, and treatment response were collected. Data were compared with historic cohorts of Kawasaki disease (KD) and macrophage activation syndrome (MAS).RESULTSTwenty-eight patients fulfilled the case definition of MIS-C. Median age at presentation was 9 years (range: 1 month to 17 years); 50% of patients had preexisting conditions. All patients had laboratory confirmation of SARS-CoV-2 infection. Seventeen patients (61%) required intensive care, including 7 patients (25%) who required inotrope support. Seven patients (25%) met criteria for complete or incomplete KD, and coronary abnormalities were found in 6 cases. Lymphopenia, thrombocytopenia, and elevation in inflammatory markers, D-dimer, B-type natriuretic peptide, IL-6, and IL-10 levels were common but not ubiquitous. Cytopenias distinguished MIS-C from KD and the degree of hyperferritinemia and pattern of cytokine production differed between MIS-C and MAS. Immunomodulatory therapy given to patients with MIS-C included intravenous immune globulin (IVIG) (71%), corticosteroids (61%), and anakinra (18%). Clinical and laboratory improvement were observed in all cases, including 6 cases that did not require immunomodulatory therapy. No mortality was recorded in this cohort.CONCLUSIONMIS-C encompasses a broad phenotypic spectrum with clinical and laboratory features distinct from KD and MAS.FUNDINGThis work was supported by the National Institutes of Health, National Institute of Arthritis and Musculoskeletal and Skin Diseases; the National Institute of Allergy and Infectious Diseases; Rheumatology Research Foundation Investigator Awards and Medical Education Award; Boston Children's Hospital Faculty Career Development Awards; the McCance Family Foundation; and the Samara Jan Turkel Center.