Clinical Analysis of Four Maternity Deaths in Iraq by COVID-19

This study aims to identify maternal death cases caused by Coronavirus infection 2019 pneumonia, including disease progression, fetal consequences, and the fatality cause. Patients and methodology: A retrospective case collection of Iraqi pregnant women in their second and third trimesters diagnosed with COVID-19 pneumonia and died due to it. The four cases were all of a young age, had a brief complaint period, and had no comorbidities. Fever, dyspnea, and fatigue were the most common symptoms. Hypoxia was present in all cases and was the cause of mortality in three cases, with thromboembolism being a potential cause in the fourth. Prelabour membrane breakup, fetal growth restriction, and fetal death are all examples of adverse fetal effects. Conclusion: COVID-19 pneumonia induces substantial fetal and maternal mortality rates through pregnancy, which should be considered when treating these cases.

Development of Tool for Case Submission and Review as Foundation for Department Patient Safety / Quality Improvement Program

Objective: Describe creation and implementation of secure case collection tool for the foundation of otolaryngology department Patient Safety/Quality Improvement (PSQI) program. Describe how tool decreased burden while fulfilling stakeholders’ reporting requirements. Methods: Incorporation of elements of required reports into online tool, facilitating improved case submission for Morbidity and Mortality conference (M&M) review. Reviewer commentary and conference discussion notes are recorded within the project. Regular reports tailored to each stakeholder were designed. Results: During first 8 months of implementation, 83 cases were submitted–5250 surgical procedures were performed by our department in that period—compared to 75 cases submitted via prior system in a same time period the year before (6930 surgical procedures performed). Elements of routine reports for interdepartmental use and external stakeholder requirements determined and reported. Discussion: Preliminary description of secure online tool with a single platform serving multiple stakeholders with unique reporting elements. This presents an opportunity to reduce the burden of essential administrative tasks while providing a reliable PSQI repository. Future metrics for ongoing evaluation will be identified and incorporated. Case submissions were maintained through a period of altered clinical activity (SARS-CoV-2 pandemic). Implications for Practice: This tool will allow our department to review cases for our required M&M with improved efficiency and efficacy, while supporting our PSQI program and generate necessary reports to stakeholders. Reduction of electronic task burden may reduce risk of physician burnout. Facilitating implementation of essential and required PSQI efforts will strengthen our curriculum and clinical work.

Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results

It is almost 20 years since the largest observational, multicentre study evaluating the risks of mortality associated with general anaesthesia in horses. We proposed an internet-based method to collect data (cleaned and analysed with R) in a multicentre, cohort, observational, analytical, longitudinal and prospective study to evaluate peri-operative equine mortality. The objective was to report the usefulness of the method, illustrated with the preliminary data, including outcomes for horses seven days after undergoing general anaesthesia and certain procedures using standing sedation. Within six months, data from 6701 procedures under general anaesthesia and 1955 standing sedations from 69 centres were collected. The results showed (i) the utility of the method; also, that (ii) the overall mortality rate for general anaesthesia within the seven-day outcome period was 1.0%. In horses undergoing procedures other than exploratory laparotomy for colic (“noncolics”), the rate was lower, 0.6%, and in “colics” it was higher, at 3.4%. For standing sedations, the overall mortality rate was 0.2%. Finally, (iii) we present some descriptive data that demonstrate new developments since the previous CEPEF2. In conclusion, horses clearly still die unexpectedly when undergoing procedures under general anaesthesia or standing sedation. Our method is suitable for case collection for future studies.

HITS: Harnessing a Collaborative Training Network to Create Case Studies that Integrate High-Throughput, Complex Datasets into Curricula

As educators and researchers, we often enjoy enlivening classroom discussions by including examples of cutting-edge high-throughput (HT) technologies that propelled scientific discovery and created repositories of new information. We also call for the use of evidence-based teaching practices to engage students in ways that promote equity and learning. The complex datasets produced by HT approaches can open the doors to discovery of novel genes, drugs, and regulatory networks, so students need experience with the effective design, implementation, and analysis of HT research. Nevertheless, we miss opportunities to contextualize, define, and explain the potential and limitations of HT methods. One evidence-based approach is to engage students in realistic HT case studies. HT cases immerse students with messy data, asking them to critically consider data analysis, experimental design, ethical implications, and HT technologies.The NSF HITS (High-throughput Discovery Science and Inquiry-based Case Studies for Today’s Students) Research Coordination Network in Undergraduate Biology Education seeks to improve student quantitative skills and participation in HT discovery. Researchers and instructors in the network learn about case pedagogy, HT technologies, publicly available datasets, and computational tools. Leveraging this training and interdisciplinary teamwork, HITS participants then create and implement HT cases. Our initial case collection has been used in >15 different courses at a variety of institutions engaging >600 students in HT discovery. We share here our rationale for engaging students in HT science, our HT cases, and network model to encourage other life science educators to join us and further develop and integrate HT complex datasets into curricula.

Awake Surgery for Arteriovenous Malformations (AVM) in Eloquent Area: Risk and Outcome Analysis in the Most Complete Case-Collection

Background: Artero-venous malformations (AVMs) located in eloquent area are associated with significant risk of neurological deterioration, especially in patients presenting with unruptured AVMs and minimal or no neurological deficits. Awake-surgery allows a better identification of eloquent gyrus, but its feasibility and application in resection of eloquent AVMs is controversial and mostly limited to small case series.Methods: A total of 31 patients suffering from intracranial AVMs have been operated on in our Department. Patients were stratified into two groups: patients submitted to Asleep Surgery and patients submitted to Awake surgery. We implemented the Awake Group with results from the most complete case series reported in the literature to obtain a complete uni and multivariate analysis of surgical risks and outcome.Results: Awake craniotomy was performed in 19,35% of the AVMs treated in our centre. Considering the reported cases from all other series published in the literature, we obtained a comparison between the asleep group of 25 patients derived from our series and the awake group of 34 patients. No statistically significant differences were identified regarding the risk of postoperative complications, surgical radicality, presence of residual, and need for adjuvant treatment. Interestingly, however, improvement in performance status was more rapid and effective during follow-up in patients treated with awake surgery compared with asleep surgery.Conclusions: In contrast to what is commonly believed, applying awake surgery in this type of lesions does not involve increased intra-operative risks, but rather it seems to determine a greater improvement in the outcome of patients from the thirtieth postoperative day. Awake patients allow for more precise brain mapping and superior clinical neurologic monitoring, which facilitates resection by defining the safe margins without an increased risk.

Public Space Sharing Strategies for Youth Education Building

Education building can be activated by space sharing strategies to satisfy the large demand of outside school education needs. The public space of youth education building has a more flexible social adaptability than the full-time school. Through case collection, data research, statistical analysis methods, design elements of public space of youth education buildings are studied. Based on the consideration of design elements, the spatial layout modes and design strategies are summarized. These results are helpful for the similar space design in outside school education buildings.

Pursuing Data Modernization in Cancer Surveillance by Developing a Cloud-Based Computing Platform: Real-Time Cancer Case Collection

Cancer surveillance is a field focused on collection of data to evaluate the burden of cancer and apply public health strategies to prevent and control cancer in the community. A key challenge facing the cancer surveillance community is the number of manual tasks required to collect cancer surveillance data, thereby resulting in possible delays in analysis and use of the information. To modernize and automate cancer data collection and reporting, the Centers for Disease Control and Prevention is planning, developing, and piloting a cancer surveillance cloud-based computing platform (CS-CBCP) with standardized electronic reporting from laboratories and health-care providers. With this system, automation of the cancer case collection process and access to real-time cancer case data can be achieved, which could not be done before. Furthermore, the COVID-19 pandemic has illustrated the importance of continuity of operations plans, and the CS-CBCP has the potential to provide such a platform suitable for remote operations of central cancer registries.