scholarly journals Q-DEPICT: Qatar Determining Emergency Physician Incidence of COVID-Positive Testing

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Shada A. Kodumayil ◽  
Ashid Kodumayil ◽  
Sarah A. Thomas ◽  
Sameer A. Pathan ◽  
Zain A. Bhutta ◽  
...  
Keyword(s):  
Emergency Physician ◽  
A Priori ◽  
Management Program ◽  
Emergency Physicians ◽  
Positive Real ◽  
Protective Measures ◽  
Operations Planning ◽  
The Mean ◽  
Polymerase Chain ◽  
Source Of Information

Despite protective measures such as personal protective equipment (PPE) and a COVID airway management program (CAMP), some emergency physicians will inevitably test positive for COVID. We aim to develop a model predicting weekly numbers of emergency physician COVID converters to aid operations planning. The data were obtained from the electronic medical record (EMR) used throughout the national healthcare system. Hamad Medical Corporation's internal emergency medicine workforce data were used as a source of information on emergency physician COVID conversion and numbers of emergency physicians completing CAMP training. The study period included the spring and summer months of 2020 and started on March 7 and ran for 21 whole weeks through July 31. Data were extracted from the system's EMR database into a spreadsheet (Excel, Microsoft, Redmond, USA). The statistical software used for all analyses and plots was Stata (version 16.1 MP, StataCorp, College Station, USA). All data definitions were made a priori. A total of 35 of 250 emergency physicians (14.0%, 95% CI 9.9%–19.9%) converted to a positive real-time reverse transcriptase-polymerase chain reaction (PCR) during the study's 21-week period. Of these. only two were hospitalized for having respiratory-only disease, and none required respiratory support. Both were discharged within a week of admission. The weekly number of newly COVID-positive emergency physicians was zero and was seen in eight of 21 (38.1%) weeks. The peak weekly counts of six emergency physicians with new COVID-positive were seen in week 14. The mean weekly number of newly COVID-positive emergency physicians was 1.7 ± 1.9, and the median was 1 (IQR, 0 to 3). This study demonstrates that in the State of Qatar's Emergency Department (ED) system, knowing only four parameters allows the reliable prediction of the number of emergency physicians likely to convert COVID PCR tests within the next week. The results also suggest that attention to the details of minimizing endotracheal intubation (ETI) risk can eliminate the expected finding of the association between ETI numbers and emergency physician COVID numbers.

scholarly journals An assessment of the extent to which the contents of PROSPERO records meet the systematic review protocol reporting items in PRISMA-P

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 773
Author(s):  
Alison Booth ◽  
Alex S. Mitchell ◽  
Andrew Mott ◽  
Sophie James ◽  
Sarah Cockayne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
A Priori ◽  
Health Interventions ◽  
Systematic Review Protocol ◽  
Eligibility Criteria ◽  
Single Entry ◽  
Review Protocol ◽  
The Mean ◽  
Source Of Information

Background: PROSPERO is an international prospective register for systematic review protocols. Many of the registrations are the only available source of information about planned methods. This study investigated the extent to which records in PROSPERO contained the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Methods: A random sample of 439 single entry PROSPERO records of reviews of health interventions registered in 2018 was identified. Using a piloted list of 19 PRISMA-P items, divided into 63 elements, two researchers independently assessed the registration records. Where the information was present or not applicable to the review, a score of 1 was assigned. Overall scores were calculated and comparisons made by stage of review at registration, whether or not a meta-analysis was planned and whether or not funding/sponsorship was reported. Results: Some key methodological details, such as eligibility criteria, were relatively frequently reported, but much of the information recommended in PRISMA-P was not stated in PROSPERO registrations. Considering the 19 items, the mean score was 4.8 (SD 1.8; median 4; range 2-11) and across all the assessed records only 25% (2081/8227) of the items were scored as reported. Considering the 63 elements, the mean score was 33.4 (SD 5.8; median 33; range 18-47) and overall, 53% (14,469/27,279) of the elements were assessed as reported. Reporting was more frequent for items required in PROSPERO than optional items. The planned comparisons showed no meaningful differences between groups. Conclusions: PROSPERO provides reviewers with the opportunity to be transparent in their planned methods and demonstrate efforts to reduce bias. However, where the PROSPERO record is the only available source of a priori reporting, there is a significant shortfall in the items reported, compared to those recommended. This presents challenges in interpretation for those wishing to assess the validity of the final review.

scholarly journals [Urethral discharge in Morocco: prevalence of microorganisms and susceptibility of gonococcos]

2002 ◽  
Vol 08 (06) ◽  
pp. 794-804
Author(s):  
K. Alami
Keyword(s):  
Sociodemographic Characteristics ◽  
Sex Partners ◽  
Chain Reaction ◽  
Protective Measures ◽  
Urethral Discharge ◽  
Multiple Sex Partners ◽  
History Of ◽  
Acute Form ◽  
The Mean ◽  
Polymerase Chain

We studied 422 patients with urethral discharge recruited from 4 sentinel sites in Morocco to determine sociodemographic characteristics, history of STI infection, infecting organism and antibiotic susceptibility of Neisseria gonorrhoeae. The mean age of the sample was 28 years [range 16-67 years], and most were single, had multiple sex partners without taking protective measures and came from all social backgrounds; 59.9% had a history of a previous STI. The majority [87%] of the infections were the acute form. By polymerase chain reaction of urine samples of 399 patients, 41.6% had N. gonorrhoeae infection, 6.3% Chlamidia trachomatis and 10.8% both organisms; in 41.4% no organism was identified. N. gonorrhoeae was strongly susceptible to ciprofloxacin.

scholarly journals An assessment of the extent to which the contents of PROSPERO records meet the systematic review protocol reporting items in PRISMA-P

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 773
Author(s):  
Alison Booth ◽  
Alex S. Mitchell ◽  
Andrew Mott ◽  
Sophie James ◽  
Sarah Cockayne ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
A Priori ◽  
Health Interventions ◽  
Systematic Review Protocol ◽  
Eligibility Criteria ◽  
Single Entry ◽  
Review Protocol ◽  
The Mean ◽  
Source Of Information

Background: PROSPERO is an international prospective register for systematic review protocols. Many of the registrations are the only available source of information about planned methods. This study investigated the extent to which records in PROSPERO contained the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Methods: A random sample of 439 single entry PROSPERO records of reviews of health interventions registered in 2018 was identified. Using a piloted list of 19 PRISMA-P items, divided into 63 elements, two researchers independently assessed the registration records. Where the information was present or not applicable to the review, a score of 1 was assigned. Overall scores were calculated and comparisons made by stage of review at registration, whether or not a meta-analysis was planned and whether or not funding/sponsorship was reported. Results: Some key methodological details, such as eligibility criteria, were relatively frequently reported, but much of the information recommended in PRISMA-P was not stated in PROSPERO registrations. Considering the 19 items, the mean score was 4.8 (SD 1.8; median 4; range 2-11) and across all the assessed records only 25% (2081/8227) of the items were scored as reported. Considering the 63 elements, the mean score was 33.4 (SD 5.8; median 33; range 18-47) and overall, 53% (14,469/27,279) of the elements were assessed as reported. Reporting was more frequent for items required in PROSPERO than optional items. The planned comparisons showed no meaningful differences between groups. Conclusions: PROSPERO provides reviewers with the opportunity to be transparent in their planned methods and demonstrate efforts to reduce bias. However, where the PROSPERO record is the only available source of a priori reporting, there is a significant shortfall in the items reported, compared to those recommended. This presents challenges in interpretation for those wishing to assess the validity of the final review.

scholarly journals Patient Suggestions to Improve Emergency Physician Empathy and Communication

2021 ◽  
Vol 8 ◽  
pp. 237437352199698
Author(s):  
Sophia Aguirre ◽  
Kristen M Jogerst ◽  
Zachary Ginsberg ◽  
Sandeep Voleti ◽  
Puneet Bhullar ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Satisfaction ◽  
Emergency Physician ◽  
Active Listening ◽  
Patient Relationship ◽  
Emergency Physicians ◽  
Future Improvement ◽  
Survey Responses ◽  
Physician Empathy

Emergency physician empathy and communication is increasingly important and influences patient satisfaction. This study investigated if there is a need for improvement in provider empathy and communication in our emergency department and what areas could be targeted for future improvement. Patients cared for by emergency physicians with the lowest satisfaction scores were surveyed within 1 week of discharge. Patients rated their emergency provider’s empathy and communication and provided feedback on the patient–provider interaction. Compared to survey responses nationally, our providers fell between the 10th and 25th percentiles for all questions, except question 5 (making a plan of action with [the patient]) which was between the 5th and 10th percentile. Areas most frequently cited for improvement were “wanting to know why” (N = 30), “time is short” (N = 15), and “listen to the patient” (N = 13). Survey percentiles and open-ended suggestions demonstrate a need for providers to give thorough explanations, spend more time with the patient, and demonstrate active listening. These themes can be used to strengthen the provider–patient relationship.

Comprehensiveness of Breast Radiology Fellowship Online Content

2020 ◽  
Author(s):  
Spencer Beck ◽  
Aditya Khurana ◽  
Ana P Lourenco ◽  
Adam E M Eltorai
Keyword(s):  
Breast Imaging ◽  
Online Content ◽  
Program Coordinator ◽  
Contact Information ◽  
Significant Difference ◽  
Fellowship Programs ◽  
The Mean ◽  
Program Characteristics ◽  
Application Requirements ◽  
Source Of Information

Abstract Objective The content of websites for fellowship programs is an important source of information for residents applying to breast imaging fellowship programs (BIFPs). The purpose of this study is to evaluate the comprehensiveness of online content of BIFPs. Methods A list of BIFPs was obtained from the Society of Breast Imaging website. Each program’s website was evaluated for the presence of 19 training-relevant content variables. Impact of program characteristics on comprehensiveness scores was determined. For statistical analysis, Kruskal–Wallis tests were used to assess differences in comprehensiveness scores based upon region, and two-tailed t-tests were used to compare based upon program size. Results A total of 79 BIFP websites were analyzed. The mean comprehensiveness score of BIFP websites based on meeting the 19 criteria was 44.1% (8.4 ± 2.7/19). Program coordinator contact information (72/79, 91.1%), application requirements (71/79, 89.9%), and faculty information (56/79, 70.9%) appeared on >70% of websites. The majority of fellowships had a dedicated webpage for their program (71/79, 89.9%). Information regarding 12 of the 19 criteria appeared on fewer than 50% of websites. Program region (P = 0.32) and size (P = 0.16) were not associated with any differences in mean comprehensiveness score. Additionally, there was no significant difference in scores associated with filling all available positions for the 2020 match cycle (P = 0.77). Conclusion There is a paucity of information commonly sought out by applicants on the websites of most BIFPs. Both programs and applicants may mutually benefit from increasing comprehensive online content.

Maternal attendance patterns of Steller sea lions (Eumetopias jubatus) from stable and declining populations in Alaska

2003 ◽  
Vol 81 (2) ◽  
pp. 340-348 ◽  
Author(s):  
Linda L Milette ◽  
Andrew W Trites
Keyword(s):  
Prey Availability ◽  
A Priori ◽  
Population Decline ◽  
Perinatal Period ◽  
Eumetopias Jubatus ◽  
Steller Sea Lions ◽  
Sea Lions ◽  
First Feeding ◽  
Attendance Patterns ◽  
The Mean

Maternal attendance patterns of Alaskan Steller sea lions (Eumetopias jubatus) were compared during the summer breeding seasons in 1994 and 1995 at Sugarloaf Island (a declining population) and Lowrie Island (a stable population). Our goal was to determine whether there were differences in maternal attendance between the two populations that were consistent with the hypothesis that lactating Steller sea lions in the area of decline were food-limited during summer. Our a priori expectations were based on well-documented behavioural responses of otariids to reduced prey availability. We found that foraging trips were significantly shorter in the area of population decline, counter to initial predictions. The mean length of foraging trips in the declining area was 19.5 h compared with 24.9 h in the stable area. In contrast, the mean perinatal period (time between parturition and first feeding trip) was significantly longer in the area of decline (9.9 versus 7.9 days), again countering initial predictions. The mean length of shore visits for the declining population was also significantly longer (27.0 h compared with 22.6 h where the population was stable). For both populations, the mean time that mothers foraged increased as pups grew older, whereas the time that they spent on shore with their pups became shorter. Behavioural observations of maternal attendance patterns are inconsistent with the hypothesis that lactating Steller sea lions from the declining population had difficulty obtaining prey during summer.

Serological Differences after Acute Zika Virus Infections between Children and Adults: Implication for Use of a Serological Test

2021 ◽  
Author(s):  
Jurai Wongsawat ◽  
Patama Suttha ◽  
Sumalee Chanama ◽  
Somkid Srisopa ◽  
Nichapa Yonchoho ◽  
...  
Keyword(s):  
Zika Virus ◽  
Nonstructural Protein ◽  
Serological Test ◽  
Cross Reactivity ◽  
Virus Infections ◽  
Positive Real ◽  
Nonstructural Protein 1 ◽  
Age Related ◽  
Polymerase Chain ◽  
Post Onset

Information is limited regarding differential serological responses after acute Zika virus (ZIKV) infections and prevalence of cross-reactivity with anti-dengue virus (DENV) assays comparing children and adults. Early convalescent sera from a cohort of suspected mild DENV cases between December 2016 and September 2018 at Bamrasnaradura Infectious Diseases Institute in Thailand were tested for nonstructural protein 1 (NS1)–based anti-ZIKV IgM and IgG ELISAs (Euroimmun), and in-house anti-DENV IgM- and IgG-capture ELISAs. ZIKV cases were identified by positive real-time reverse transcriptase-polymerase chain reaction on urine. Sera from 26 (10 children and 16 adults) ZIKV and 237 (153 children and 74 adults) non-ZIKA cases collected at the median duration of 18 days (interquartile range [IQR] 18,19) post-onset of symptoms were tested. Comparing pediatric ZIKV to adult ZIKV cases, the mean anti-ZIKV IgM ratio was higher (2.12 versus 1.27 units, respectively; P = 0.07), whereas mean anti-ZIKV IgG ratio was lower (3.13 versus 4.24 units, respectively; P = 0.03). Sensitivity of anti-ZIKV IgM and specificity of anti-ZIKV IgG in pediatric ZIKV were higher than in adult ZIKV cases (80.0% versus 43.7% and 79.1% versus 43.2%, respectively). No cross-reactivity with anti-DENV IgM- and IgG-capture ELISA were reported in pediatric ZIKV cases in our study, whereas 25% and 12.5% were found in adult ZIKV cases, respectively. Age-related ZIKV serological differences have been observed. Positive NS1-based anti-ZIKV IgM and IgG ELISA at the early convalescent phase could be useful for ZIKV diagnosis in children, even in a dengue endemic setting.

Abstract 167: MicroRNA Profiles of Non--ST-Elevation Myocardial Infarction

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Jeanine Ward ◽  
Rafael de la Puente ◽  
David McManus
Keyword(s):  
Medical Center ◽  
A Priori ◽  
Extraction Procedure ◽  
Mirna Profile ◽  
Cardiovascular Development ◽  
Potential Biomarker ◽  
Acute Mi ◽  
St Elevation ◽  
Polymerase Chain ◽  
Translational Regulators

Significance: MicroRNAs (miRNAs) are short, stable, noncoding translational regulators used as early biomarkers for numerous disease processes. Although specific miRNA patterns are associated with STEMI, the profile and timecourse of miRNA release in NSTEMI is currently unknown but of potential clinical significance.Materials and Methods: With IRB approval, patients identified with chest pain were identified at the UMass Medical Center. Upon ED arrival (T0), a K2EDTA tube of whole blood was obtained with simultaneous troponin cTnI levels. After a 6 hour (T6) observation period, another additional K2EDTA tube was drawn, again contemporaneous with cTnI levels. Patients were selected based on an elevated cTnI level (greater then or equal to ≥ 0.04 ng/ml) at T6 as compared to a negative cTnI levels (< 0.04 ng/ml) at T0. MiRNA was isolated from patient plasma using a Trizol extraction procedure. Real-time reverse transciptase polymerase chain reaction (QRT-PCR) was performed for 94 a priori miRNAs common to cardiovascular development or disease. Results: Of the 94 miRNAs examined, 11 demonstrated greater than 2-fold change as compared to baseline (Figure 1). A subset of this cohort, namely miRNAs 208a, 483-5p, and 601 revealed statistically significant fold difference (p< 0.05). MiRNA 208a is associated with acute MI. MiRNA 601 has not been previously shown correlated with heart disease. Conclusion: This investigation reveals a novel 11 member miRNA profile, including miRNA 208a, 483-5p, and 601, which is associated with NSTEMI. Our findings suggest this miRNA profile by be used as a potential biomarker of myocardial injury.

scholarly journals Role of emergency physician–performed ultrasound in the differential diagnosis of abdominal pain

2018 ◽  
Vol 27 (2) ◽  
pp. 79-86
Author(s):  
Nalan Kozaci ◽  
Mustafa Avci ◽  
Gul Tulubas ◽  
Ertan Ararat ◽  
Omer Faruk Karakoyun ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Emergency Physician ◽  
Gold Standard ◽  
Acute Abdominal Pain ◽  
Point Of Care ◽  
Final Diagnosis ◽  
Free Fluid ◽  
Emergency Physicians ◽  
Abdominal Ultrasonography

Objectives: This prospective study was performed to evaluate the diagnostic accuracy of bedside point-of-care abdominal ultrasonography performed by emergency physician in patients with non-traumatic acute abdominal pain. Methods: The patients, who were admitted to emergency department due to abdominal pain, were included in this study. The emergency physician obtained a routine history, physical examination, blood draws, and ordered diagnostic imaging. After the initial clinical examinations, all the patients underwent ultrasonography for abdominal pathologies by emergency physician and radiologist, respectively. Point-of-care abdominal ultrasonography compared with abdominal ultrasonography performed by radiologist as the gold standard. Results: The study included 122 patients. Gallbladder and appendix pathologies were the most commonly detected in the abdominal ultrasonography. Compared with abdominal ultrasonography, point-of-care abdominal ultrasonography was found to have 89% sensitivity and 94% specificity in gallbladder pathologies; 91% sensitivity and 91% specificity in acute appendicitis; 79% sensitivity and 97% specificity in abdominal free fluid; 83% sensitivity and 96% specificity in ovarian pathologies. Compared to final diagnosis, preliminary diagnoses of emergency physicians were correct in 92 (75.4%) patients. Conclusion: This study showed that emergency physicians were successful in identifying abdominal organ pathologies with point-of-care abdominal ultrasonography after training.

A Geometric Model of the Beating Heart

2007 ◽  
Vol 46 (03) ◽  
pp. 282-286 ◽  
Author(s):  
C. Lorenz ◽  
J. von Berg
Keyword(s):  
Computed Tomography ◽  
A Priori ◽  
Anatomical Landmarks ◽  
Motion Model ◽  
A Priori Information ◽  
Average Accuracy ◽  
Tomography Image ◽  
The Mean ◽  
Priori Information ◽  
Computed Tomography Image

Summary Objectives : A comprehensive model of the human heart that covers multiple surfaces, like those of the four chambers and the attached vessels, is presented. It also contains the coronary arteries and a set of 25 anatomical landmarks. The statistical model is intended to provide a priori information for automated diagnostic and interventional procedures. Methods : The end-diastolic phase of the model was adapted to fit 27 clinical multi-slice computed tomography images, thus reflecting the anatomical variability to be observed in that sample. A mean cardiac motion model was also calculated from a set of eleven multi-phase computed tomography image sets. A number of experiments were performed to determine the accuracy of model-based predictions done on unseen cardiac images. Results : Using an additional deformable surface technique, the model allows for determination of all chambers and the attached vessels on the basis of given anatomical landmarks with an average accuracy of 1.1 mm. After such an individualization of the model by surface adaptation the centerlines of the three main coronary arteries may be estimated with an average accuracy of 5.2 mm. The mean motion model was used to estimate the cardiac phase of an unknown multislice computed tomography image. Conclusion : The mean shape model of the human heart as presented here complements automated image analysis methods with the required a priori information about anatomical constraints to make them work fast and robustly.

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